Abatacept to induce remission of peanut allergy during oral immunotherapy (ATARI): protocol for a phase 2a randomized controlled trial

ContextWhile oral immunotherapy (OIT) has been shown to promote the remission of mild peanut allergy in young children, there is still an unmet need for a disease-modifying intervention for older patients and those with severe diseases. In mice models, abatacept, a cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) immunoglobulin fusion protein, has been shown to promote immune tolerance to food when used as an adjuvant to allergen immunotherapy. The goal of this study is to explore the potential efficacy of abatacept in promoting immune tolerance to food allergens during OIT in humans.MethodsIn this phase 2a proof-of-concept study (NCT04872218), 14 peanut-allergic participants aged from 14 to 55 years will be randomized at a 1:1 ratio to abatacept vs. placebo for the first 24 weeks of a peanut OIT treatment (target maintenance dose of 300 mg peanut protein). The primary outcome will be the suppression of the OIT-induced surge in peanut-specific IgE/total IgE at 24 weeks, relative to the baseline. Sustained unresponsiveness will be assessed as a secondary outcome starting at 36 weeks by observing incremental periods of peanut avoidance followed by oral food challenges.DiscussionThis is the first study assessing the use of abatacept as an adjuvant to allergen immunotherapy in humans. As observed in preclinical studies, the ability of abatacept to modulate the peanut-specific immune response during OIT will serve as a proxy outcome for the development of clinical tolerance, given the small sample size. The study will also test a new patient-oriented approach to sustained tolerance testing in randomized controlled trials

InVeST proceedings, 10-12 April 2017

Learning of specific technical procedures can be particularly challenging for veterinary students. Self-evaluation can be a very effective method to monitor progress and to improve learning and self-confidence in the context of the clinical skills laboratory (CSL). Monitoring of student attendance in the CSL is generally performed using a paper register. However, this does not give detailed information on each visited workstation and is time-consuming when data processing is needed. Since September 2016, a new method of self-evaluation by means of QR code technology has been used. This gave students autonomy for their own learning and allowed staff to better monitor skills laboratory visitations and students’ progress. The VetSims’App is based on QR codes scanned by students with their smartphones or with tablets available in the CSL. Each workstation instruction booklet provided a QR code. Scanning the QR code also redirected the student to a specific web page with links to instructions and videos. Attendance rate and the duration of time spend at the station or in the clinical skills laboratory could therefore be recorded. At the end of the learning process, students had to provide a self-evaluation, stating if they did not acquire the skills/acquired the skills/acquired and mastered the skills. All the data were recorded and linked with the EnvA Learning Management System (http://eve.vet-alfort.fr/). The use of this new app based on QR codes seems highly beneficial. Veterinary student expressed enthusiasm for the technology with subsequent increase in attendance rate throughout the three months of the study.Poster presented at the 5th International Veterinary Simulation in Teaching Conference, 10-12 April 2017, held at the Intundla Conference Venue, Pretoria, South Africa.Sponsored by Virtalis, South Africa. Dept. of Higher Education & Training, Anatomoulds, Veterinary Simulator Industries, National Research Foundation, University of Pretoria. Faculty of Veterinary Science, Zoetis and Breed 'n Betsyab201

Evolution des pratiques et des représentations suite à la formation : « J’écorne efficacement, facilement et sans douleur »

28 éleveurs laitiers bretons ont participé en trois groupes à une journée de formation intitulée : « J’écorne facilement, efficacement et sans douleur ». Des entretiens et observations de pratiques menés dans leur exploitation ont permis d’en évaluer l’impact. Au-delà d’une appréciation globale très positive, la formation a permis des acquisitions de connaissances et des changements de pratiques qui contribuent à améliorer le bien- être des veaux et à faciliter le travail des éleveurs : écornage plus précoce, meilleures procédures pour limiter la brulure. Elle a aussi contribué à sensibiliser à la douleur, même si la prise en charge de celle-ci a peu progressé. Le déploiement de ces formations est en cours

Relationships between welfare and reproductive performance in French dairy herds

This study aimed to investigate the relationship between cow reproductive performance and welfare evaluated at the herd level using the Welfare Quality protocol. The 11 criteria, four principles (good feeding, good housing, good health and appropriate behavior, scale 0-100) and overall welfare category (excellent/enhanced/acceptable/not classified = poor welfare) were included as risk factors for calving to first service interval (CFSI) and calving rate (CR). The confounding factors cow breed, parity, season of calving and AI, calving to AI interval, rank of AI (1-3) and milk production were taken into account. The sample included 3951 AIs (2172 AI1, 1182 AI2, 597 AI3) in 124 French commercial dairy herds. Median CFSI was shorter for the cows bred in herds with a higher overall welfare category (median 75 and 76 days in enhanced and acceptable herds vs. 86 in poor welfare ones, P =  0.02). The scores for absence of injuries and expression of social behavior tended to be associated with CFSI (P <  0.10). Calving rate (34.5%) was not related to the overall welfare category. However, CR was positively related to the good housing score and a positive trend was observed with the scores for absence of prolonged hunger and absence of injuries. In conclusion, this study confirms a positive relationship between CFSI and welfare in dairy cows with no explicit links with specific aspects of animal welfa

Simulation-based education to improve management of refractory anaphylaxis in an allergy clinic

Abstract Background High-fidelity simulations based on real-life clinical scenarios have frequently been used to improve patient care, knowledge and teamwork in the acute care setting. Still, they are seldom included in the allergy-immunology curriculum or continuous medical education. Our main goal was to assess if critical care simulations in allergy improved performance in the clinical setting. Methods Advanced anaphylaxis scenarios were designed by a panel of emergency, intensive care unit, anesthesiology and allergy-immunology specialists and then adapted for the adult allergy clinic setting. This simulation activity included a first part in the high-fidelity simulation-training laboratory and a second at the adult allergy clinic involving actors and a high-fidelity mannequin. Participants filled out a questionnaire, and qualitative interviews were performed with staff after they had managed cases of refractory anaphylaxis. Results Four nurses, seven allergy-immunology fellows and six allergy/immunologists underwent the simulation. Questionnaires showed a perceived improvement in aspects of crisis and anaphylaxis management. The in-situ simulation revealed gaps in the process, which were subsequently resolved. Qualitative interviews with participants revealed a more rapid and orderly response and improved confidence in their abilities and that of their colleagues to manage anaphylaxis. Conclusion High-fidelity simulations can improve the management of anaphylaxis in the allergy clinic and team confidence. This activity was instrumental in reducing staff reluctance to perform high-risk challenges in the ambulatory setting, thus lifting a critical barrier for implementing oral immunotherapy at our adult center

Projet éthique et bien-être animal: contrôle de la douleur liée à l'hyperthermie au cours du processus infectieux

Projet éthique et bien-être animal: contrôle de la douleur liée à l'hyperthermie au cours du processus infectieux. Journées d'animation scientifique de la fédération de recherche en infectiologie (FéRI