Allergo Journal International最新文献

{"title":"Diagnostic gap due to missing patch test allergens—status quo and possible scenarios for mitigation","authors":"Vera Mahler","doi":"10.1007/s40629-023-00281-6","DOIUrl":"10.1007/s40629-023-00281-6","url":null,"abstract":"<p>According to European Directive 2001/83/EC, test and therapeutic allergens are medicinal products in all Member States of the European Union. This applies equally to prick test and to patch test (PT) allergens (haptens). All test allergens commercially marketed in Germany are finished medicinal products requiring marketing authorization (MA). Currently, 211 PT substances are authorized in Germany, and an additional 59 are in an ongoing MA process and are marketable under a transitional provision until a decision on MA is made. The regulatory guidance (CMDh/399/2019) of the Co-ordination Group for Mutual Recognition and Decentralized Procedures—Human (CMDh), published in July 2020, specifies the regulatory requirements for different allergen products. Due to differences in origin and exposure, use, mode of action, and safety risks, the guideline clearly differentiates between products with active ingredients of biological origin (allergen extracts from natural source materials) and products with active ingredients of non-biological origin (hapten-based PT substances). Currently, guideline-compliant patch testing is hampered by the lack of numerous commercial PT allergens from the standard and special test series. Background and possible scenarios for mitigation are presented here.</p>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-023-00281-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139624069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tattoo allergy—diagnosis on a circuitous route?","authors":"Steffen Schubert,&nbsp;Carina Wolf,&nbsp; Ines Schreiver,&nbsp; Katherina Siewert,&nbsp; Uwe Karst","doi":"10.1007/s40629-023-00280-7","DOIUrl":"10.1007/s40629-023-00280-7","url":null,"abstract":"<div><h3>Background</h3><p>Decorative tattoos and permanent make-up have been gaining popularity for years. Increasingly, intolerance reactions occur.</p><h3>Methods</h3><p>Literature search of PubMed and reference books on diagnostic and treatment options for tattoo complications.</p><h3>Results</h3><p>At least one third of persistent intolerance reactions to tattoos are allergic reactions. The diagnostic work-up should include the tattoo ink used and, particularly in cases of scattered eczema, other products applied. Pigments penetrate very poorly into the epidermis and are not available as commercial test preparations. Consequently, patch tests very often show (false) negative results in affected individuals. Allergological individual diagnosis and assessment of clinical relevance are rarely possible as the chemical composition of the culprit tattoo ink is usually unknown.</p><h3>Discussion</h3><p>Diagnosis of tattoo allergy is challenging. The IVDK Tattoo Study 2.0 enables the identification of metals and pigments in skin samples, the preparation of individual patch test preparations with pigments, and the investigation of specific T lymphocytes in blood samples. In addition, assessment of the clinical relevance can be improved by exposure data and results of laboratory diagnostics.</p></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138949968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of systemic inflammation markers in patients with rhinitis","authors":"Sümeyra Alan Yalim,&nbsp;Ayse Füsun Kalpaklıoglu,&nbsp;Ayşe Baccıoglu,&nbsp;Merve Poyraz,&nbsp;Gulistan Alpagat,&nbsp;Betul Dumanoglu","doi":"10.1007/s40629-023-00277-2","DOIUrl":"10.1007/s40629-023-00277-2","url":null,"abstract":"<p>Rhinitis affects the majority of the population. It may generate localized nasal mucosal inflammation via allergic (AR) or nonallergic (NAR) processes, but it is unknown if this might also result in systemic inflammation, which can raise morbidity and death. Using current serum inflammatory markers, we sought to investigate systemic inflammation in patients with chronic rhinitis.</p><p>In this retrospective case–control study, we included 439 patients with newly diagnosed AR (<i>n</i> = 179), NAR (<i>n</i> = 157), and 103 healthy individuals. Inflammation-related blood parameters were collected as lymphocyte/monocyte ratio (LMR), neutrophil/lymphocyte ratio (NLR), eosinophil/neutrophil ratio (ELR), and systemic immune inflammation index (SII).</p><p>All groups were similar in terms of age, gender, and body mass index. Neutrophil counts were significantly higher both in AR and NAR groups compared to controls (4.51 ± 0.09, 4.54 ± 0.1 vs. 3.73 ± 0.1, <i>p</i> &lt; 0.001). NLR (1.91 ± 0.56, 1.89 ± 0.61, 1.61 ± 0.59, <i>p</i> &lt; 0.001), LMR (5.76 ± 0.17, 5.93 ± 0.17, 5.1 ± 0.15, <i>p</i> = 0.005), ELR (0.1335 ± 0.007, 0.0999 ± 0.006, 0.12 ± 0.009, <i>p</i> = 0.003), SII (533.3 ± 16.6, 558.1 ± 20.9, 479.9 ± 22.2, <i>p</i> = 0.035), and CRP (1.44 ± 0.09, 1.67 ± 0.09, 0.87 ± 0.04, <i>p</i> &lt; 0.001) were significantly higher in AR and NAR groups than the controls, respectively. SII (r = 0.146, <i>p</i> = 0.007) and ELR (r = 0.254, <i>p</i> &lt; 0.001) were correlated with the presence of asthma.</p><p>We found that systemic circulation of inflammatory cells was significantly increased in rhinitis with/without allergy compared to the control group. This study showed that not only AR, but also NAR triggers a systemic increase of inflammation which supports the link between rhinitis and comorbid conditions such as asthma. Therefore, effective treatment may be suggested for local inflammation and its systemic manifestations.</p>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139173394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of the systemic immune inflammation index and systemic inflammatory response index on omalizumab drug survival in chronic spontaneous urticaria","authors":"Adriano Fabi BMed,&nbsp;Stefan Milosavljevic MSc PhD,&nbsp;Claudia C. V. Lang MD,&nbsp;Carole Guillet MD,&nbsp; Peter Schmid-Grendelmeier MD","doi":"10.1007/s40629-023-00278-1","DOIUrl":"10.1007/s40629-023-00278-1","url":null,"abstract":"<div><h3>Background</h3><p>Omalizumab is recommended as adjunctive therapy for antihistamine-refractory chronic spontaneous urticaria (CSU). However, its long-term effectiveness is understudied. The systemic immune-inflammation index (SII) and the systemic inflammatory response index (SIRI) have shown prognostic value in cancer, strokes, and other diseases.</p><h3>Objectives</h3><p>This study aimed to evaluate the long-term effectiveness of omalizumab in CSU patients while investigating potential associations of SII and SIRI with the drug survival of omalizumab.</p><h3>Methods</h3><p>A retrospective study was conducted using patient data from the electronic hospital database, including patients with CSU treated with omalizumab between January 2018 and May 2021. Drug survival curves were visualized using Kaplan-Meier survival analysis. and Cox regression was utilized to assess potential associations.</p><h3>Results</h3><p>A total of 109 CSU treated with omalizumab at the University Hospital of Zurich were included. The mean drug survival was 13.6 ± 10.9 months. The mean SII and SIRI were 796.1 ± 961.3 and 2.1 ± 3.1, respectively. The multivariate model revealed that SIRI (<i>p</i> = 0.098) was a more robust predictor of omalizumab’s drug survival than SII (<i>p</i> = 0.367), while concurrent autoimmune disease or baseline immunoglobulin E (IgE) levels showed no significant impact.</p><h3>Conclusion</h3><p>This study suggests the potential utility of SIRI as a superior predictive indicator for omalizumab’s drug survival in CSU patients compared to SII. Concomitant autoimmune disease or baseline IgE levels did not significantly affect the drug’s effectiveness.</p></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-023-00278-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139008099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful desensitization to asfotase alfa in hypophosphatasia: a case report and IgE-mediated mechanism confirmation","authors":"Emilio Narváez-Fernández,&nbsp;Magdalena Lluch-Bernal,&nbsp;Ana Fiandor,&nbsp;Pilar Aguado,&nbsp;Carolina Tornero,&nbsp;Miguel González-Muñoz,&nbsp;Rosario Cabañas","doi":"10.1007/s40629-023-00279-0","DOIUrl":"10.1007/s40629-023-00279-0","url":null,"abstract":"","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138589377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contact allergy to medical devices","authors":"Nicola Wagner","doi":"10.1007/s40629-023-00276-3","DOIUrl":"10.1007/s40629-023-00276-3","url":null,"abstract":"<div><h3>Background</h3><p>Medical devices are not subject to any legal obligation to declare ingredients. With an increasing number of available medical devices, increasing reports of contact allergies to these devices result in a more difficult, delayed or lack of diagnosis of the trigger.</p><h3>Methods</h3><p>Elaborate chemical methods, such as gas chromatography–mass spectroscopy, were able to detect novel contact allergens in medical devices.</p><h3>Results</h3><p>Diabetic patients requiring insulin benefit from sophisticated glucose sensor measurement systems and insulin pump systems, but are limited in their choices by the development of contact allergy. Potential contact allergens in medical adhesives, plasters, and wound dressings require extensive diagnostic testing. Contact allergic reactions to cardiac electronic implants are rare. The potential relevance of a contact allergic reaction to endoluminal stents to restenosis of the treated vascular territory is discussed. Contact dermatitis to medical gloves is usually due to the vulcanization accelerators. Mouth–nose protective or FFP2 mask-associated eczema is often irritant, very rarely allergic in origin.</p><h3>Conclusion</h3><p>With continued development of medical devices, new contact allergens are introduced. The declaration of their ingredients is necessary for rapid diagnosis and future prevention.</p></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-023-00276-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135291163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orchestration of inflammation in contact allergy by innate immune and cellular stress responses","authors":"Stefan F. Martin,&nbsp;Anne-Catherine Rühl-Muth,&nbsp;Philipp R. Esser","doi":"10.1007/s40629-023-00275-4","DOIUrl":"10.1007/s40629-023-00275-4","url":null,"abstract":"<div><h3>Background</h3><p>Inflammation is central to the initiation of immune responses and to the pathogenesis of many diseases such as allergic contact dermatitis (ACD). ACD is an inflammatory skin disease caused by low molecular weight organic chemicals and metal ions. The immune system plays a decisive role. After protein binding, the triggering chemicals act as contact allergens that are recognized by specific T cells. Before this can happen, however, the chemicals must trigger inflammation in the skin, without which the adaptive immune system in particular is not activated.</p><h3>Methods</h3><p>In recent years, the inflammatory mechanisms of contact allergy have been studied at the cellular and molecular level in vivo and in vitro.</p><h3>Results</h3><p>Contact allergens activate the innate immune system and additionally cellular stress responses, which in interaction are responsible for skin inflammation. In this context, inflammation is required for both initial sensitization and elicitation of ACD.</p><h3>Conclusion</h3><p>Skin inflammation in ACD is orchestrated by the interplay of the innate immune system and cellular stress responses.</p></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-023-00275-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135290913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hives but no urticaria—what could it be?","authors":"Mathias Sulk,&nbsp;Carolin C. Albers,&nbsp;Maria Wulf,&nbsp;Stephan A. Braun,&nbsp;Christoph M. Hammers,&nbsp;Guido Heine","doi":"10.1007/s40629-023-00274-5","DOIUrl":"10.1007/s40629-023-00274-5","url":null,"abstract":"<div><p>Urticaria is a common inflammatory dermatosis characterized by transient, usually intensely itching wheals mediated by mast cells. Urticarial lesions can also be mimicked by other skin diseases. Differential diagnoses of urticaria should be considered if the single urticarial skin lesion persists for more than 24 h, if hyperpigmentation, scaling, or blistering occurs, if the lesions are not itching, or if fever or arthralgias are reported. In these cases, histologic examination and thorough serologic diagnostic may help to differentiate other dermatoses, such as vasculitis, autoimmune bullous skin diseases, drug reactions, or autoinflammatory syndromes. This article summarizes common differential diagnoses of urticaria.</p></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-023-00274-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134795495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-occupational epoxy resin allergy","authors":"Johannes Geier","doi":"10.1007/s40629-023-00273-6","DOIUrl":"10.1007/s40629-023-00273-6","url":null,"abstract":"<div><h3>Background</h3><p>Sensitization to epoxy resin is mostly acquired occupationally, with those employed in the construction industry being particularly affected. Cases of non-occupational epoxy resin allergy are observed less frequently. In the literature, an association between epoxy resin allergy and fragrance allergy is postulated.</p><h3>Methods</h3><p>Analysis of corresponding data from the Information Network of Departments of Dermatology (IVDK); literature review.</p><h3>Results</h3><p>In the IVDK 2013–2022, the rate of positive reactions to epoxy resin in patients with occupational dermatitis (OD) was 2.4–4.0%, in patients without OD 0.8–1.5%. Accompanying reactions to reactive diluents and hardeners prove an exposure to epoxy resins also in patients without OD. Patients sensitized to epoxy resin have an increased risk of reactions to other baseline series allergens. Case reports of non-occupational epoxy resin allergy concern work with casting resins. However, epoxy resin exposure is also possible, for example, from three-dimensional (3D) printing finishes or products for hoof repair in horses.</p><h3>Discussion</h3><p>Non-occupational epoxy resin allergy may be acquired not only from do-it-yourself activities in the narrow sense, which should be considered when taking the medical history. The association between epoxy resin and fragrance allergy does not go beyond the general level of associations between contact allergies with each other.</p></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136104145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic spontaneous urticaria—status quo and future","authors":"Susanne Melchers,&nbsp; Jan P. Nicolay","doi":"10.1007/s40629-023-00272-7","DOIUrl":"10.1007/s40629-023-00272-7","url":null,"abstract":"<div><p>Chronic spontaneous urticaria (CsU) is a chronic inflammatory dermatosis whose etiology is not yet fully understood. In affected patients, it is often associated with a high limitation of health-related quality of life, which necessitates effective therapeutic management. Different immune cell populations such as mast cells, eosinophilic and basophilic granulocytes, and T cells are involved in the pathogenesis of CsU, whereby mast cells playing a key role. In addition, type I autoallergic reactions with auto IgE antibodies or type IIb autoimmune reactions with auto IgG antibodies have been identified in a proportion of patients. The current international guideline initially recommends the use of second-generation H1 antihistamines, first in standard, then in off-label quadruple dosing. Subsequently, the anti-IgE antibody omalizumab should be added. However, this therapy algorithm does not lead to freedom from manifestations in all patients. Therefore, various targeted therapies are currently being evaluated for their efficacy in CsU, such as off-label use of the anti-interleukin receptor alpha (IL4Rα) antibody dupilumab, the anti-IL-17A antibody secukinumab, or interleukin‑5 blockade using mepolizumab, reslizumab, or benralizumab. In addition, new promising compounds such as the Bruton tyrosine kinase (BTK) inhibitors remibrutinib and fenebrutinib, the anti-cKIT antibody barzolvolimab, the anti-SIGLEC8 antibody lirentelimab, the anti-TSLP antibody tezepelumab, the anti-C5aR1 antibody advoralimab, or the topical application of Syk kinase inhibitors are being tested, which were developed according to new insights into the pathogenesis of CsU. The BTK inhibitor fenebrutinib is currently not being pursued due to a less favorable side effect profile compared to remibrutinib, as well as the anti-IgE antibody ligelizumab, which was inferior to omalizumab therapy in a phase 3 study. Overall, there is a high need for new therapeutic strategies to better treat CsU both symptomatically and curatively. This requires a more comprehensive understanding of pathogenesis of the disease in order to develop new targeted therapies.</p></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-023-00272-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134795948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}