Peroperatieve anafylactische reacties op basis van latexallergie

A 10-year-old girl with spina bifida underwent surgery to increase the capacity of her neurogenic bladder using an isolated loop of intestine. During the operation serious circulatory and respiratory problems occurred after the peritoneum was opened, when the ileum was manipulated using gloves containing latex. Latex allergy can lead to potentially fatal anaphylactic reactions. A survey is presented of the risk groups, together with measures recently advocated in the literature to detect latex allergy and to avoid major reaction

Clinical evaluation of a double-blind dust mite avoidance trial with mite-allergic rhinitic patients

Inheritance and allergen exposure are key factors in the development and the course of atopic allergy, expressed as conjunctivitis, rhinitis, asthma or dermatitis. This study concerns the clinical significance of mite and mite-allergen avoidance measures based on intensive cleaning with acaricide (solidified benzylbenzoate) added (10 dwellings), and without biocidal activity (10 other homes) as a control in a double-blind trial with matched pairs. Twenty subjects with persisting rhinitic complaints were selected. They lived in 20 different dwellings and were ail sensitized to pyroglyphid mites; 12 of them were also sensitized to stored product miles (Acari). Daily symptoms and medication score, guanine and dust exposure, total and mite-specific IgE in serum, eosinophilia in the blood and in the nasal smear, intracutaneous tests with house dust mite and storage mite extracts were compared in both pairs and groups. Acarological data, physiochemical aspects and exposure assessment are discussed in detail elsewhere. Symptom scores dropped significantly, as did the total IgE and exposure to dust and mite products in the acaricidal cleaner treatment group. After 1 year, the daily symptoms median was 47% (P= 0.025), total IgE was 38% (P=0.0049), and exposure to dust and mite products (guanine exposure) was 53% (P= 0.0449) better or lower than in the controls. Intensive cleaning, without acaricidal treatment performed twice a year, resulted in clinical improvement in four out of 10 subjects, of whom none became free of complaints. In the Acarosan treatment group (cleaning+ benzylbenzoate) eight out of 10 subjcets improved, in three cases subjective symptoms disappeared. The conclusion is that mite avoidance in homes can be carried out successfully with a special acaricidal cleaning formulation Acarosan

Expression of the immunoreactive buckwheat major allergenic storage protein in Lactococcus lactis

Proteins from buckwheat (Fagopyrum esculentum) are strong allergens that can cause serious symptoms, including anaphylaxis, in patients with hypersensitivity. In this study, we successfully developed a modified lactic acid bacterial vector (pNSH) and a recombinant strain of Lactococcus lactis NZ9000 (NZ9000) that produced a major allergenic storage protein of buckwheat, Fagag1 (61.2 kDa, GenBank accession number AF152003), with or without a green fluorescent protein (GFP) tag. GFP fluorescence allows for rapid, simple, and accurate measurement of target protein expression by microscopy or fluorimetry. We describe a convenient method for production of rGFP-Fagag1 fusion and rFagag1 proteins with a good yield in an advantageous probiotic host. We found that in vitro treatment of splenocytes isolated from buckwheat crude protein-immunized mice with rFagag1 increased the expression of allergic inflammation cytokines such as IL-4, IL-13, and IL-17 F. Because it was less antigenic, rGFP-Fagag1 protein from NZ9000 might be of limited use; however, rFagag1 from NZ9000 evoked a robust response as measured by induction of IL-4 and IL-17 F expression levels. The observed allergic activity is indicative of a Th2 cell-mediated immune response and is similar to the effects induced by exposure to buckwheat crude protein. Our results suggest that expression of rFagag1 in NZ9000 may facilitate in vivo applications of this system aimed at improving the specificity of immunological responses to buckwheat allergens

Complement Activation in the Disease Course of Coronavirus Disease 2019 and Its Effects on Clinical Outcomes

Background: Excessive activation of immune responses in coronavirus disease 2019 (COVID-19) is considered to be related to disease severity, complications, and mortality rate. The complement system is an important component of innate immunity and can stimulate inflammation, but its role in COVID-19 is unknown. Methods: A prospective, longitudinal, single center study was performed in hospitalized patients with COVID-19. Plasma concentrations of complement factors C3a, C3c, and terminal complement complex (TCC) were assessed at baseline and during hospital admission. In parallel, routine laboratory and clinical parameters were collected from medical files and analyzed. Results: Complement factors C3a, C3c, and TCC were significantly increased in plasma of patients with COVID-19 compared with healthy controls (P<.05). These complement factors were especially elevated in intensive care unit patients during the entire disease course (P<.005 for C3a and TCC). More intense complement activation was observed in patients who died and in those with thromboembolic events. Conclusions: Patients with COVID-19 demonstrate activation of the complement system, which is related to disease severity. This pathway may be involved in the dysregulated proinflammatory response associated with increased mortality rate and thromboembolic complications. Components of the complement system might have potential as prognostic markers for disease severity and as therapeutic targets in COVID-19. © 2020 The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America

Complement Activation in the Disease Course of Coronavirus Disease 2019 and Its Effects on Clinical Outcomes

Background: Excessive activation of immune responses in coronavirus disease 2019 (COVID-19) is considered to be related to disease severity, complications, and mortality rate. The complement system is an important component of innate immunity and can stimulate inflammation, but its role in COVID-19 is unknown. Methods: A prospective, longitudinal, single center study was performed in hospitalized patients with COVID-19. Plasma concentrations of complement factors C3a, C3c, and terminal complement complex (TCC) were assessed at baseline and during hospital admission. In parallel, routine laboratory and clinical parameters were collected from medical files and analyzed. Results: Complement factors C3a, C3c, and TCC were significantly increased in plasma of patients with COVID-19 compared with healthy controls (P<.05). These complement factors were especially elevated in intensive care unit patients during the entire disease course (P<.005 for C3a and TCC). More intense complement activation was observed in patients who died and in those with thromboembolic events. Conclusions: Patients with COVID-19 demonstrate activation of the complement system, which is related to disease severity. This pathway may be involved in the dysregulated proinflammatory response associated with increased mortality rate and thromboembolic complications. Components of the complement system might have potential as prognostic markers for disease severity and as therapeutic targets in COVID-19