Allergy to Uncommon Pets: New Allergies but the Same Allergens.

The prevalence of exotic pet allergies has been increasing over the last decade. Years ago, the main allergy-causing domestic animals were dogs and cats, although nowadays there is an increasing number of allergic diseases related to insects, rodents, amphibians, fish, and birds, among others. The current socio-economic situation, in which more and more people have to live in small apartments, might be related to this tendency. The main allergic symptoms related to exotic pets are the same as those described for dog and cat allergy: respiratory symptoms. Animal allergens are therefore, important sensitizing agents and an important risk factor for asthma. There are three main protein families implicated in these allergies, which are the lipocalin superfamily, serum albumin family, and secretoglobin superfamily. Detailed knowledge of the characteristics of allergens is crucial to improvement treatment of uncommon-pet allergies

Systemic Corticosteroids in Patients with Bronchial Asthma: A Real-Life Study

25 p.Objectives: The objective of the present study was to determine the use of systemic corti-costeroids (SCs) in patients with bronchial asthma using big data analysis. Methods: We performed an observational, retrospective, noninterventional study based on secondary data captured from free text in the electronic health records. This study was per-formed based on data from the regional health service of Castille-La Mancha (SESCAM), Spain. We performed the analysis using big data and artificial intelligence via Savana® Manager version 3.0. Results: During the study period, 103 667 patients were diagnosed with and treated for asthma at different care levels. The search was restricted to patients aged 10 to 90 years (mean age, 43.5 [95%CI, 43.4-43.7] years). Of these, 59.8% were women. SCs were taken for treatment of asthma by 58 745 patients at some point during the study period. These patients were older, with a higher prevalence of hypertension, dyslipidemia, diabetes, ob-esity, depression, and hiatus hernia. SCs are used frequently in the general population with asthma (31.4% in 2015 and 39.6% in 2019). SCs were prescribed mainly in primary care (59%), allergy (13%) and pulmonology (20%). The frequency of prescription of SCs had a direct impact on the main associated adverse effects. Conclusion: In clinical practice, SCs are frequently prescribed to patients with asthma, especially in primary care. Use of SCs is associated with a greater number of adverse events. It is necessary to implement measures to reduce prescription of SCs to patients with asthma, especially in primary care

Increased TPSAB1 Copy Number in a Family With Elevated Basal Serum Levels of Tryptase

[EN]Background: Some recent familial studies have described a pattern of autosomal dominant inheritance for increased basal serum tryptase (BST), but no correlation with mRNA expression and gene dose have been reported. Objective: We analyzed TPSAB1 mRNA expression and gene dose in a four-member family with high BST and in two control subjects. Methods: Blood samples were collected from the family and control subjects. Complete morphologic, immunophenotypical, and molecular bone marrow mast cell (MC) studies were performed. mRNA gene expression and gene dose were performed in a LightCycler 480 instrument. Genotype and CNV were performed by quantitative real-time digital PCR (qdPCR). Results: CNV analysis revealed a hereditary copy number gain genotype (3β2α) present in all the family members studied. The elevated total BST in the family members correlated with a significant increase in tryptase gene expression and dose. Conclusions and Clinical Relevance: We present a family with hereditary α-tryptasemia and elevated BST which correlated with a high expression of tryptase genes and an increased gene dose. The family members presented with atypical MC-mediator release symptoms or were even asymptomatic. Clinicians should be aware that elevated BST does not always mean an MC disorder.Spanish Foundation of the Spanish Association of Allergy and Clinical Immunology (Sociedad Española de Alergologia e Inmunologia Clínica); the Council of Castilla y León; European Social Fund, the Immunoallergic Association of Salamanca; Asthma, Allergic, and Adverse Reactions networks for Cooperative Research in Health (ARADyAL); Instituto de Salud Carlos III; European Regional Development Fund (ERDF)

Clinical impact of the TPSAB1 genotype in mast cell diseases: A REMA study in a cohort of 959 individuals

[Background]: A close association between hereditary alpha-tryptasemia (HAT) and mast cell (MC) disorders has been previously reported. However, the relationship between HAT and the diagnostic subtypes and clinical features of MC disorders still remains to be established.[Objective]: To determine the prevalence of HAT in healthy donors (HD) vs patients with different diagnostic subtypes of MC activation syndromes (MCAS) and mastocytosis, and its relationship with the clinical behavior of the disease.[Methods]: A total of 959 subjects were studied including 346 healthy donors (HD), 464 mastocytosis, and 149 non-clonal MCAS patients. Molecular studies to assess the TPSAB1 genotype were performed, and data on serum baseline tryptase (sBT) and basal MC-mediator release episodes and triggers of anaphylaxis were collected.[Results]: HAT was detected in 15/346 (4%) HD versus 43/149 (29%) non-clonal MCAS and 84/464 (18%) mastocytosis cases. Among mastocytosis, HAT was more frequently found in patients with MC-restricted KITD816V (21% vs. 10% among multilineage KITD816V patients; p = .008). Overall, median sBT was higher in cases presenting with HAT (28.9 vs. 24.5 ng/mL; p = .008), while no significant differences in sBT were observed among HAT+ mastocytosis patients depending on the presence of 1 vs. ≥2 extra copies of the α-tryptase gene (44.1 vs. 35.2 ng/mL, p > .05). In turn, anaphylaxis was more frequently observed in HAT+ versus HAT− mastocytosis patients (76% vs. 65%; p = .018), while HAT+ and HAT− patients who did not refer anaphylaxis as the presenting symptom (n = 308) showed a similar prevalence of subsequent anaphylaxis (35% vs. 36%, respectively).[Conclusion]: The frequency of HAT in MC disorders varies according to the diagnostic subtype of the disease. HAT does not imply a higher risk (and severity) of anaphylaxis in mastocytosis patients in whom anaphylaxis is not part of the presenting symptoms of the disease.This work was supported by grants from the Fundación para la Investigación Biomédica del Hospital Ramón y Cajal IRYCIS (reference 2018/0250), Fundación Sociedad Española de Alergología e Inmunología Clínica 2018, Instituto de Salud Carlos III (reference PI22/01657) and Fundación Española de Mastocitosis (reference FEM-2021-SAM). PNN was supported by a grant of the Government of Castilla y León (Orden EDU 875 2021), Spain.Peer reviewe

Development and validation of a faecal immunochemical test-based model in the work-up of patients with iron deficiency anaemia

ObjectiveIn patients with iron deficiency anaemia (IDA), the diagnostic yield of gastroscopy and colonoscopy (bidirectional endoscopy) in detecting neoplastic lesions is low. This study aimed to develop and validate a faecal immunochemical test (FIT)-based model to optimise the work-up of patients with IDA.MethodsOutpatients with IDA were enrolled in a prospective, multicentre study from April 2016 to October 2019. One FIT was performed before bidirectional endoscopy. Significant gastrointestinal lesions were recorded and a combined model developed with variables that were independently associated with significant colorectal lesions in the multivariate analysis. The model cut-off was selected to provide a sensitivity of at least 95% for colorectal cancer (CRC) detection, and its performance was compared to different FIT cut-offs. The data set was randomly split into two groups (developed and validation cohorts). An online calculator was developed for clinical application.ResultsThe development and validation cohorts included 373 and 160 patients, respectively. The developed model included FIT value, age, and sex. In the development and validation cohorts, a model cut-off of 0.1375 provided a negative predictive value of 98.1 and 96.7% for CRC and 90.7 and 88.3% for significant colorectal lesions, respectively. This combined model reduced the rate of missed significant colorectal lesions compared to FIT alone and could have avoided more than one-fourth of colonoscopies.ConclusionThe FIT-based combined model developed in this study may serve as a useful diagnostic tool to triage IDA patients for early endoscopic referral, resulting in considerable reduction of unnecessary colonoscopies

The Third Workshop on Population of the RDBES Data Model (WKRDB-POP3)

The aims of this workshop were to explain the data model developed for the commercial fisheries Regional Database and Estimation System (RDBES), assist in populating it with real data for the second test data call for the RDBES, and encourage participants to take part in ongoing testing of the RDBES data submission system. This report documents the progress that participants have done to prepare their institutes for future use of the RDBES system. Some issues with data conversion have been identified and are documented in this report. None of the identified issues are thought to be serious impediments to moving forward with the RDBES development according to the roadmap decided by the Steering Committee of the Regional Fisheries Database in 2020. The RDBES Core Group (the group of people developing the RDBES data model) and ICES Data Centre will look at the results of this workshop and either respond to individual questions or adapt the data model and documentation as required. The workshop concluded and reported before the deadline of the test data call. For a complete test of the data model, all participants were encouraged to complete the data call. A report on the degree of completion of the data call may be expected from WGRDBESGOV which convenes after the data call deadline

Tacrolimus como tratamiento de la dermatitis atópica: estudio piloto

Los corticosteroides tópicos y emolientes representan el tratamiento habitual de las lesiones agudas de la DA. El uso reiterado de los corticosteroides tópicos conlleva un riesgo de efectos secundarios. Se decide realizar un estudio piloto abierto en condiciones de práctica clínica para evaluar la eficacia clínica de tacrolimus como tratamiento de la DA resistente al tratamiento tradicional. Material y métodos: Se seleccionaron 15 pacientes diagnosticados de DA de intensidad moderada-grave y resistentes al tratamiento tradicional. Se valoró el índice SCORAD (extensión, gravedad e intensidad de las lesiones cutáneas) previo a iniciar el tratamiento, a las 3 y a las 7 semanas. Resultados: Se compararon los valores del índice SCORAD antes y después del tratamiento con tacrolimus: 41,5 y 18,4 respectivamente, con una p = 0,001 tras su análisis estadístico. Al analizar cada variable de forma independiente se observó también una mejoría significativa; extensión de las lesiones antes y después del tratamiento (% superficie corporal afectada) 53% y 26,6%, respectivamente, con una p = 0,003. La gravedad e intensidad de las lesiones sí mejoraron aunque sus puntuaciones no alcanzaron diferencias estadísticamente significativas. Efectos secundarios: 11 pacientes (73%) refirieron la presencia de alguno, que en 10 casos (91%) fue prurito local. Conclusiones: Se demuestra la eficacia de tacrolimus tópico como tratamiento frente a la DA moderada-grave resistente al tratamiento tradicional y su seguridad, con pocos efectos secundarios entre los que destacó el prurito local

Advances in the understanding and clinical management of mastocytosis and clonal mast cell activation syndromes [version 1; referees: 2 approved]

Clonal mast cell activation syndromes and indolent systemic mastocytosis without skin involvement are two emerging entities that sometimes might be clinically difficult to distinguish, and they involve a great challenge for the physician from both a diagnostic and a therapeutic point of view. Furthermore, final diagnosis of both entities requires a bone marrow study; it is recommended that this be done in reference centers. In this article, we address the current consensus and guidelines for the suspicion, diagnosis, classification, treatment, and management of these two entities

Allergy to Prairie Dog Lipocalins

Depto. de Bioquímica y Biología MolecularFac. de Ciencias QuímicasTRUEpu

Identification of allergens in chicken meat allergy.

Depto. de Bioquímica y Biología MolecularFac. de Ciencias QuímicasTRUEpubPagado por el auto