Asia Pacific AllergyPub Date : 2023-12-01Epub Date: 2023-11-02DOI: 10.5415/apallergy.0000000000000123
Ying Li, Ping He, Bing Yan, Yimin Ren, Bangyu Cui, Ming Wang, Siyuan Ma, Jun Yang, Luo Zhang, Chengshuo Wang
{"title":"Induction of a type 2 inflammatory chronic rhinosinusitis in C57BL/6 mice.","authors":"Ying Li, Ping He, Bing Yan, Yimin Ren, Bangyu Cui, Ming Wang, Siyuan Ma, Jun Yang, Luo Zhang, Chengshuo Wang","doi":"10.5415/apallergy.0000000000000123","DOIUrl":"https://doi.org/10.5415/apallergy.0000000000000123","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic chronic rhinosinusitis (CRS) has been widely studied for its intractability and high recurrence rate. It can be divided into pure and mixed type 2 CRS subtypes. Mouse models that reflect pure type 2 inflammation of CRS are lacking.</p><p><strong>Objective: </strong>This study aims to establish a relatively pure type 2 CRS mouse model and compare it with 2 mixed type 2 CRS models.</p><p><strong>Methods: </strong>Three mouse CRS models were constructed: (1) aerosol ovalbumin (OVA) + aspergillus oryzae-derived protease (AP); (2) intranasal OVA + AP; (3) Intraperitoneal then intranasal OVA + AP (n = 10 per group). Nasal, lung symptoms, IgE, inflammatory cells, cytokines, and remodeling factors were evaluated.</p><p><strong>Results: </strong>Histological and micro-computed tomography showed inflammation, polyps, and opacification in all 3 experimental groups. The aerosol group had significantly increased local eosinophils and type 2 cytokines, while other types of cytokines showed no noticeable change. The nasal instillation groups also showed elevated other inflammatory factors and tissue polypoid changes were more pronounced. More severe pulmonary inflammation was observed with aerosol delivery.</p><p><strong>Conclusion: </strong>Aerosol inhalation mouse model is superior for studying nasal relatively pure type 2 inflammation and lower airway comorbidities.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"13 4","pages":"164-174"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138795658","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}
Asia Pacific AllergyPub Date : 2023-12-01DOI: 10.5415/apallergy.0000000000000128
Xun Meng, J. Layhadi, Sean T. Keane, Natanya J.K. Cartwright, S. R. Durham, M. Shamji
{"title":"Immunological mechanisms of tolerance: Central, peripheral and the role of T and B cells","authors":"Xun Meng, J. Layhadi, Sean T. Keane, Natanya J.K. Cartwright, S. R. Durham, M. Shamji","doi":"10.5415/apallergy.0000000000000128","DOIUrl":"https://doi.org/10.5415/apallergy.0000000000000128","url":null,"abstract":"T and B cells are key components of the adaptive immune system. Through their immune properties and their interactions with other immune cells and cytokines around them, they build a complex network to achieve immune tolerance and maintain homeostasis of the body. This is achieved through mechanisms of central and peripheral tolerance, both of which are associated with advantages and disadvantages. For this reason, the immune system is tightly regulated and their dysregulation can result in the subsequent initiation of various diseases. In this review, we will summarize the roles played by T cells and B cells within immune tolerance with specific examples in the context of different diseases that include allergic disease. In addition, we will also provide an overview on their suitability as biomarkers of allergen-specific immunotherapy.","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"44 1","pages":"175 - 186"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138626984","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}
Asia Pacific AllergyPub Date : 2023-12-01Epub Date: 2023-10-09DOI: 10.5415/apallergy.0000000000000119
Kenneth V Gaceja, Zaynah Faith R Ancheta, Abigail Charisse A Buna, Sandra Mae S Clarencio, Maria Angelica R Garrido, John Donnie A Ramos
{"title":"Association of interleukin-13 gene single nucleotide polymorphism rs1800925 with allergic asthma in Asian population: A meta-analysis.","authors":"Kenneth V Gaceja, Zaynah Faith R Ancheta, Abigail Charisse A Buna, Sandra Mae S Clarencio, Maria Angelica R Garrido, John Donnie A Ramos","doi":"10.5415/apallergy.0000000000000119","DOIUrl":"https://doi.org/10.5415/apallergy.0000000000000119","url":null,"abstract":"<p><strong>Background: </strong>The interleukin-13 (IL-13) gene has been associated with allergic asthma pathogenesis due to its role in IgE synthesis. The IL-13 single nucleotide polymorphism (SNP) rs1800925 has been implicated in exacerbated allergic asthma symptoms in different ethnicities.</p><p><strong>Objectives: </strong>To determine the association of IL-13 SNP rs1800925 with allergic asthma symptoms in the Asian population.</p><p><strong>Methods: </strong>Major databases were searched for studies on the association of IL-13 rs1800925 with allergic asthma in various Asian populations published between 2010 and February 2022. The odds ratio with 95% CI was obtained from included studies, and the association was evaluated using different genetic models. Heterogeneity was explored by subgroup analyses and <i>I</i><sup>2</sup> statistic evaluation.</p><p><strong>Results: </strong>Eleven studies with a total of 2895 cases and 2914 controls were included in this meta-analysis. The majority of the cases exhibited CC genotype (n = 1897), followed by CT genotype (n = 852), and TT genotype (n = 146). IL-13 rs1800925 was significantly associated with increased allergic asthma risk in the Asian population under the recessive model (TT vs CT/CC: OR, 1.48; 95% CI, 1.14-1.93; <i>P</i> = 0.37; <i>I</i><sup>2</sup> = 08%). Subgroup analyses by ethnicity showed an elevated risk of allergic asthma in West Asians (Iranian and Saudi Arabian) followed by East Asians (Chinese and Japanese) using the recessive model. Both age groups (adults and children) exhibited an increased risk of allergic asthma.</p><p><strong>Conclusion: </strong>This meta-analysis provides evidence that IL-13 SNP rs1800925 is a risk factor for allergic asthma in the Asian Population. It also suggests that rs1800925 is a risk factor present in both adult and children population.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"13 4","pages":"148-157"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138795654","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}
Asia Pacific AllergyPub Date : 2023-09-01Epub Date: 2023-09-07DOI: 10.5415/apallergy.0000000000000109
Rita Limão, Borja Bartolomé, Fátima Cabral Duarte
{"title":"The relevance of oral food challenge in a patient allergic to peanut and tree nuts.","authors":"Rita Limão, Borja Bartolomé, Fátima Cabral Duarte","doi":"10.5415/apallergy.0000000000000109","DOIUrl":"10.5415/apallergy.0000000000000109","url":null,"abstract":"<p><p>Peanut allergy is one of the most common food allergies in childhood. In vitro cross-sensitization between peanut and tree nuts (TN) is high, but only a subgroup of patients allergic to peanut will have a concomitant allergy to one or several TN. In this article, the authors report a case of a 12-year-old boy who experienced 1 episode of lips and mouth itching, generalized urticarial, and eyelid angioedema 20 minutes after ingestion of peanut at 4 years of age. The immunoallergological study revealed the presence of a concomitant allergy to peanut, pistachio, and cashew confirmed with medically supervised oral food challenges (OFC) in a child who had never eaten these TN. The mechanism of IgE-mediated hypersensitivity was demonstrated by positive skin prick tests (SPT) with commercial extracts, although the specific IgE (sIgE) for these foods was negative. As described in the literature, we concluded that serum peanut and TN sIgE measurements have lower sensitivity than SPT to assess IgE sensitization, and OFC is the gold standard for accurate diagnosis of food allergy. We highlight the relevance of excluding or confirming TN allergy in a peanut-allergic patient who had never ingested certain TN, and of knowing the clinical relevant cross-reactivity patterns between TN, pistachio/cashew, and walnut/pecan, that could reduce the need for OFC in clinical practice, reducing allergy rates and financial and health burdens of food allergy.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"13 3","pages":"132-134"},"PeriodicalIF":1.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41101327","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}
Asia Pacific AllergyPub Date : 2023-09-01Epub Date: 2023-09-07DOI: 10.5415/apallergy.0000000000000112
Maria Cristina V Balotro-Torres, Frances M Tan, Cecilia Gretchen Navarro-Locsin, Marysia T Recto, Joel A Romualdez, Josephine B Ramos, Emily G Resurreccion, Rommel Crisenio M Lobo, Eloisa S de Guia, Ma Fredelita Carreon-Asuncion, Jean Bousquet
{"title":"Real-world physician practices on the diagnosis and management of allergic rhinitis in the Philippine setting.","authors":"Maria Cristina V Balotro-Torres, Frances M Tan, Cecilia Gretchen Navarro-Locsin, Marysia T Recto, Joel A Romualdez, Josephine B Ramos, Emily G Resurreccion, Rommel Crisenio M Lobo, Eloisa S de Guia, Ma Fredelita Carreon-Asuncion, Jean Bousquet","doi":"10.5415/apallergy.0000000000000112","DOIUrl":"https://doi.org/10.5415/apallergy.0000000000000112","url":null,"abstract":"<p><strong>Background: </strong>Physician awareness and adherence to guidelines varies among countries and between types of physician practice. Identifying the needs of the physician and patient is essential to improve patient outcome. Data on physician diagnosis and management of allergic rhinitis (AR) in the Philippines is currently limited.</p><p><strong>Objective: </strong>Study objectives are to assess awareness and use of guidelines, practices on diagnosis and management of intermittent and persistent AR, reasons for choice of therapy, and familiarity with immunotherapy.</p><p><strong>Methods: </strong>A cross-section of 590 specialist and 223 subspecialist physicians from 17 regions of the Philippines were surveyed from October 2021 to July 2022. Survey consisted of a 12-point validated online questionnaire on knowledge and use of guidelines for diagnosis and treatment, use of diagnostic tests, preferred pharmacologic treatment, preferred adjuvant therapy, reasons for treatment choice, and familiarity with immunotherapy.</p><p><strong>Results: </strong>Seventy-seven percent of respondents used Allergic Rhinitis and its Impact on Asthma guidelines for diagnosis and management of AR. Three-fifths of respondents \"always\" routinely evaluated AR patients' history and performed a physical examination for asthma; 57% of respondents \"always\" routinely evaluated asthma patients' history and performed a physical examination for AR. Allergy testing was \"sometimes\" recommended by 62.2%. Oral second-generation antihistamines were the preferred choice for the treatment of intermittent AR. Intranasal steroids were the preferred treatment for persistent AR. Top reasons for choice of treatment were guideline recommendations, efficacy, onset of action, cost, and availability of treatment.</p><p><strong>Conclusion: </strong>Filipino specialists and subspecialists are aware and use guidelines in diagnosis and management of AR. Clinical history and physical examination are the cornerstone of diagnosis. Management practices for intermittent and persistent AR are similar for both groups. Recognizing the role of patient treatment preferences and allergen-specific immunotherapy remains to be a gap in the management of AR by Filipino physicians.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"13 3","pages":"105-113"},"PeriodicalIF":1.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b3/09/pa9-13-105.PMC10516311.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41098305","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":"A 14-year-old boy with severe erythema multiforme due to amoxicillin.","authors":"Mami Kurihara, Shingo Yamanishi, Saeko Ozaki, Ruby Pawankar","doi":"10.5415/apallergy.0000000000000108","DOIUrl":"https://doi.org/10.5415/apallergy.0000000000000108","url":null,"abstract":"<p><p>The most common cause of erythema multiforme (EM) in children is infectious diseases which account for approximately 90% of cases. Drug eruptions are another common cause. Here we are reporting about a male patient aged 14 years with lymphadenitis who developed severe diffuse erythema during the course of treatment with medications including several antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs). Based on the pathological findings of the skin biopsy, the skin rash was due to EM. Upon investigating the underlying cause of EM, viral antibody was positive for Coxsackie A6, lymphocyte transformation testing (LTT) was positive for one of the NSAIDs, and the patch test (PT) was positive for amoxicillin. Based on the pattern of distribution of the skin rash, the cause of EM was considered to be drug-induced eruption due to amoxicillin. In this case, we did not derive a diagnosis of drug eruption without investigating the possibility of drug induction, because most cases of EM in children are induced by infection and the antibody against Coxsackie A6 was elevated. To diagnose the possibility of amoxicillin-induced EM, it was important to distinguish between the distribution patterns of infectious versus drug-induced EM and to evaluate the possibility of drug induction by both LTT and PT. If the diagnosis of amoxicillin-induced EM, had not been made, the potential recurrence of EM with amoxicillin could have occurred.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"13 3","pages":"135-138"},"PeriodicalIF":1.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/cf/pa9-13-135.PMC10516312.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41099780","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}
Asia Pacific AllergyPub Date : 2023-09-01Epub Date: 2023-09-07DOI: 10.5415/apallergy.0000000000000114
Bernard Yu-Hor Thong, Ruby Pawankar, Hae-Sim Park, Amir Hamzah Abdul Latiff
{"title":"Evaluating immune responses to pneumococcal vaccines.","authors":"Bernard Yu-Hor Thong, Ruby Pawankar, Hae-Sim Park, Amir Hamzah Abdul Latiff","doi":"10.5415/apallergy.0000000000000114","DOIUrl":"https://doi.org/10.5415/apallergy.0000000000000114","url":null,"abstract":"<p><p><i>Streptococcus pneumoniae</i> (pneumococcus) is a significant cause of bacterial infections ranging from mild infections affecting the respiratory tract such as otitis media and sinusitis to severe diseases including bacteremia, pneumonia, and invasive pneumococcal disease (IPD) (eg, meningitis, septic arthritis, and endocarditis). Pneumococcal vaccines were first developed in the 1970s as capsular pneumococcal polysaccharide vaccines, which were T-cell independent and hence lacked immunologic memory. Subsequently in the year 2000, pneumococcal conjugate vaccines (PCV) conjugated to a protein to increase immunogenicity were developed and made commercially available. The increasing number of pneumococcal serotypes identified and the expanding pipeline of PCV vaccines with improved immunogenicity have significantly reduced the morbidity and mortality associated with IPD in high-risk patients. Pneumococcal vaccines also play an important role in the diagnosis and immunophenotyping of children and adults with inborn errors of immunity (IEI) given the increasing diversity/heterogeneity of IEI presenting with primary and/or specific antibody deficiency. Other than the quantitation of serotype levels in routine clinical care, other measurements of immune response including the functional activity of antibodies, antibody avidity, cell-mediated immunity, and immunological memory remain limited to clinical trials during vaccine development.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"13 3","pages":"127-131"},"PeriodicalIF":1.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41103858","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}
Asia Pacific AllergyPub Date : 2023-09-01Epub Date: 2023-09-11DOI: 10.5415/apallergy.0000000000000117
Amir Hamzah Abdul Latiff
{"title":"Pandemic effects on the care of patients with inborn errors of immunity.","authors":"Amir Hamzah Abdul Latiff","doi":"10.5415/apallergy.0000000000000117","DOIUrl":"https://doi.org/10.5415/apallergy.0000000000000117","url":null,"abstract":"It is evident that the COVID-19 pandemic has challenged the healthcare systems worldwide and exposed many deficiencies in these systems and required restructuring to mitigate these deficiencies in a modern-day pandemic [1]. A myriad of effects resulting from this pandemic not only have an impact physiologically, but also psychologically and thus, has had a huge impact on the mental health of the global community [2]. Enormous resources were required to provide continuous high-level care for those infected and this led to the neglect of uninfected patients with chronic diseases. These chronic diseases include inborn errors of immunity (IEI) for which nearly 500 gene defects have been described [3]. IEI present typically with recurring infections, but also as autoimmune, autoinflammatory, and allergic conditions. Even in the nonpandemic circumstances, patients with IEI and their caregivers would report significant care inadequacies, both in diagnostic and therapeutic care. In general, IEI are usually underdiagnosed and this could have worsened during the pandemic leading to further morbidity and mortality. On the other hand, several groups have also assessed the possibility of novel IEI presenting as severe COVID-19 infection and has led to the discovery of new IEI gene defects [4, 5]. This highlights and strengthens the observation that IEI as an experiment of nature, aids in progressive understanding of the human immune system, and thereby provides opportunities in developing targeted therapies for immune-mediated diseases. It also illustrates the importance of the field of clinical immunology during any pandemic and that immunologists, both clinical and scientists alike, play a central role in managing any pandemic. The need for a lockdown to mitigate the spread of the recent COVID-19 pandemic had detrimental effects on an effective delivery of treatment to IEI patients. Depending on the type of IEI, therapeutic options include antibiotics prophylaxis, immunoglobulin replacement therapy (IRT), hemopoietic stem cell transplant, and gene therapy. The mainstay of treatments for most patients with IEI, that is, predominantly antibody deficiencies is IRT, which is commonly delivered intravenously, and possibly subcutaneously. Immunoglobulin therapy contains antibodies to compensate for the defective immune system’s inability to produce them. Individuals with IEI need IRT regularly throughout their lives to help combat infections and prevent organ damage. Without IRT, they are in danger of suffering from morbidity, poor quality of life, and reduced life expectancy. As immunoglobulin is derived from human plasma, there are concerns about the availability of supply, particularly to treat life-threatening conditions that cannot be improved with other medications. It is estimated that 75% to 80% of IEI patients do not have access to adequate immunoglobulin therapy throughout the world [6]. Certainly, delivery of IRT was affected during the pandemic due to","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"13 3","pages":"95-96"},"PeriodicalIF":1.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/10/pa9-13-095.PMC10516314.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41095433","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":"Optimal period for achieving sustained unresponsiveness in peanut oral immunotherapy.","authors":"Kosei Yamashita, Toshinori Nakamura, Takanori Imai, Aiko Honda, Yuki Okada, Mayu Maeda, Taro Kamiya","doi":"10.5415/apallergy.0000000000000110","DOIUrl":"https://doi.org/10.5415/apallergy.0000000000000110","url":null,"abstract":"<p><strong>Background: </strong>Oral immunotherapy (OIT) can help children with persistent food allergies achieve sustained unresponsiveness (SU). However, the optimal therapeutic period for obtaining SU remains unclear.</p><p><strong>Objective: </strong>We aimed to retrospectively investigate the association between the OIT treatment period and achievement of SU.</p><p><strong>Methods: </strong>We enrolled patients who received OIT for peanut allergy between January 1, 2018 and December 31, 2022. OIT comprised the build-up phase, maintenance phase, complete avoidance, and an oral food challenge (OFC) for confirming SU. The peanut dose in the OFC was gradually increased to 3,000 mg (peanut protein: 795 mg), which was subsequently maintained for ≥5 months. SU was defined as a negative response to 795 mg of peanut protein after ≥2 weeks of complete avoidance. We evaluated the therapeutic OIT period for achieving SU using Kaplan-Meier analysis.</p><p><strong>Results: </strong>Forty-eight patients underwent peanut OIT. The starting age at OIT initiation was 8 (interquartile range [IQR], 7-10) years. Forty-one (85%) patients had a history of anaphylaxis. The median specific immunoglobulin E concentration to peanut and Ara h 2 at OIT initiation was 85.3 (IQR, 33.7-100) and 57.6 (IQR, 21.9-100) UA/mL, respectively. The median observational period was 2.1 (IQR, 1.6-3.0) person-years (PY). Thirty-four (71%) patients achieved SU, with the rate of SU achievement gradually increasing with the therapeutic period. The median period until SU achievement was 2.1 (95% confidence interval, 1.6-2.5) PY. The rate of SU achievement slowed down after 2.7 PY.</p><p><strong>Conclusion: </strong>OIT for at least 2.7 PY can increase the rate of SU achievement. The protocol No. 3107.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"13 3","pages":"97-104"},"PeriodicalIF":1.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41104701","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}
Asia Pacific AllergyPub Date : 2023-09-01Epub Date: 2023-09-14DOI: 10.5415/apallergy.0000000000000115
Melinda See Kee Kwan, Sze Ling Tan, Thamron Keowmani, Sor Leng Goh, James Yau Hon Voo, Hoo Seng Tan, Mohd Ridzuan Bin Zakaria, Sivaraj Raman, Jackie Chit Khong Ho, Diyanah Khan Binti Zainullah Faidin, Nur'Ain Binti Madi, Khamisah Binti Itim
{"title":"Drug allergy knowledge, attitude, and practice: A survey among doctors and pharmacists in public health facilities of Sabah, Malaysia.","authors":"Melinda See Kee Kwan, Sze Ling Tan, Thamron Keowmani, Sor Leng Goh, James Yau Hon Voo, Hoo Seng Tan, Mohd Ridzuan Bin Zakaria, Sivaraj Raman, Jackie Chit Khong Ho, Diyanah Khan Binti Zainullah Faidin, Nur'Ain Binti Madi, Khamisah Binti Itim","doi":"10.5415/apallergy.0000000000000115","DOIUrl":"https://doi.org/10.5415/apallergy.0000000000000115","url":null,"abstract":"<p><strong>Background: </strong>Given the deficits in allergists and testing capacity, the diagnosis of drug allergy is largely dependent on the clinician's and pharmacist's judgment. The ability to recognize drug allergies and respond appropriately is crucial to patient safety. Currently, there is a void in the evidence that limits the ability to recommend comprehensive and swift improvements on this front.</p><p><strong>Objective: </strong>This study thus aimed to evaluate the knowledge, attitude, and practice toward drug allergy among doctors and pharmacists working in public healthcare facilities in Sabah, Malaysia.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in 24 hospitals and 11 clinics in Sabah. A validated Drug Allergy Knowledge, Attitude, and Practice Questionnaire was adapted from a published study and developed on an online survey platform. The questionnaire was distributed to all listed eligible respondents via email and personal messenger service.</p><p><strong>Results: </strong>A total of 549 doctors and pharmacists responded, with an overall response rate of 18.2%. The total mean knowledge, attitude, and practice scores were 8.3 (SD, 1.98), 18.9 (SD, 2.55), and 17.3 (SD, 4.4), respectively. It was found that pharmacists performed significantly poorer than both medical officers (mean score difference = -0.5; <i>P</i> = 0.006) and specialists (mean score difference = -0.9; <i>P</i> = 0.020) in the knowledge domain. As the time in service doubles, the knowledge score increases significantly by 0.3 (<i>P</i> = 0.015).</p><p><strong>Conclusion: </strong>Knowledge, attitude, and practice on drug allergy among doctors and pharmacists in Sabah were poor. It is thus timely for advanced educational programs on drug allergy to be formalized and implemented.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"13 3","pages":"121-126"},"PeriodicalIF":1.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/a2/pa9-13-121.PMC10516309.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41106196","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}