Two decades with omalizumab: what we still have to learn

From its availability for clinical use nearly two decades ago for severe asthma, omalizumab has gained strong evidence of efficacy and safety in the treatment of severe asthma not controlled by standard-of-care therapy. It has been acknowledged by Global Initiative on Asthma guidelines as add-on therapy against severe uncontrolled asthma. Thanks to controlled trials supporting its efficacy, omalizumab has also been licensed for the treatment of chronic spontaneous urticaria. The optimal duration of treatment in either disease has not been established. Despite its high price, omalizumab appears to be cost-effective in severe uncontrolled asthma as well as in chronic urticaria. The literature suggests a wide range of applications for omalizumab in various disorders regardless of allergic or non-allergic pathophysiology

Venom immunotherapy in patients with allergic reactions to insect stings

Allergy to Hymenoptera (Apis mellifera, Vespula species, Polistes species, Vespa crabro) venom can be safely and effectively treated by venom immunotherapy (VIT), which in the 40 years since its introduction has been able to prevent reactions to stings, and to treatment as well, though systemic reactions, occasionally severe, are possible. Areas covered: We reviewed the recent literature on VIT by searching in PubMed for the terms 'venom immunotherapy' and 'Hymenoptera venom immunotherapy' to highlight the current status of VIT and the likely development in the coming years. Expert commentary: VIT, provided the correct choice of the venom and adequate venom preparations and maintenance doses are used, is a treatment of great value in preventing systemic reactions to Hymenoptera stings. A 5-year duration ensures a prolonged tolerance to stings following VIT discontinuation, unless patients suffer from mastocytosis. In fact, due to reports of fatal reactions after stopping VIT, patients with mastocytosis, or with very severe reactions to stings, need an indefinite duration of treatment

Functional traits shape tree species distribution in the Himalayas

Plant functional traits determine plant performance and have therefore the potential to shape and predict species distributions along environmental gradients. This study analyses how traits affect tree species distribution along an elevational gradient in the Himalayas, Nepal. We addressed three questions: (a) what plant strategies can be distinguished among tree species? (b) how are plant traits and strategies associated with elevation? and (c) what plant traits are the best predictors of species positions along elevational gradient? We quantified for 31 tree species a set of 39 plant traits related to resource uptake, use and conservation. We analysed how traits cluster into separate functions using a cluster analysis, and how traits and clusters associate into distinct plant strategies using a principal component analysis. The cluster analysis showed five clusters of traits, reflecting (a) efficiency in vertical expansion, (b) efficiency in horizontal expansion, (c) efficiency in metabolism, (d) physical defence and (e) tree functional groups (conifers vs. broadleaf species). The first PCA axis reflects trade-offs in traits and clusters linked to elevation: highland species had trait values that increase safety against freezing induced cavitation, high solar radiation and strong wind, and that increase resource conservation. In contrast, lowland species had trait values that increase efficiency of resource acquisition, metabolism and expansion. Additionally, a bivariate analysis showed that the first PCA axis is more strongly related to elevation than the individual traits, indicating that the combination of traits is more important than the individual traits. An all subsets regression analysis showed that a small set of traits best explain species distribution: highland species had smaller size (low basal area), safer hydraulics (low conduit diameter) and lower leaf and branch display efficiency (low leaf area per xylem area, specific branch length) that increase persistence under harsh conditions. Remarkably, leaf traits were poor predictors of species' elevational positions. Synthesis. Multiple trade-offs in plant size, hydraulics and light competitiveness shape species distribution along the elevational gradient. Along this extreme environmental gradient, stem and branch traits that integrate multiple plant organs and functions are better predictors of species' elevational distributions than leaf traits

Data for: Functional traits shape tree species distribution in the Himalayas

This data is the result of research entitled "Functional traits shape tree species distribution in the Himalayas". The research was carried out along a species-rich steep elevational gradient along the southern slopes of the Himalayas in central Nepal. To understand how traits shape the distribution of plant species along the elevational gradient, we selected 31 common tree species that partitioned the elevational gradient. To adequately describe species’ trait values and account for elevational trait variation, we sampled for each species 6 trees; three trees from the lower limits of their elevational distribution ranges and three trees from the upper limits. To assure that the traits are fully expressed, we sampled healthy-looking trees with sun-exposed crowns (crown illumination index ≥2.5, Clark and Clark, 1992). To reduce ontogenetic variation, we sampled adult trees with a stem diameter at breast height (DBH) between 10 and 30 cm. We selected 39 traits that are important for resource acquisition, use and conservation and play a key role in defence, metabolism, or adaptation to harsh environmental conditions (e.g. freezing, drought, and low nutrients availability). Traits were measured following standardized protocols (Pérez-Harguindeguy et al., 2013; Scholz et al., 2013; Zhang et al., 2016). We analysed how traits cluster into separate functions using a cluster analysis, and how traits and clusters associate into distinct plant strategies using a Principal Component Analysis. We found that multiple trade-offs in plant size, hydraulics, and light competitiveness shape species distribution along the elevational gradient. Along this extreme environmental gradient, stem and branch traits that integrate multiple plant organs and functions are better predictors of species’ elevational distributions than leaf traits

Ethical, legal, and social implications in research biobanking: A checklist for navigating complexity

Biobanks’ activity is based not only on securing the technology of collecting and storing human biospecimen, but also on preparing formal documentation that will enable its safe use for scientific research. In that context, the issue of informed consent, the reporting of incidental findings and the use of Transfer Agreements remain a vast challenge. This paper aims to offer first–hand tangible solutions on those issues in the context of collaborative and transnational biobanking research. It presents a four‐step checklist aiming to facilitate researchers on their compliance with applicable legal and ethical guidelines, when designing their studies, when recruiting participants, when handling samples and data, and when communicating research results and incidental findings. Although the paper reflects the outcomes of the H2020 B3Africa project and examines the transfers from and to the EU as a case study, it presents a global checklist that can be used beyond the EU