Davide Caimmi

Succinate as opposed to glucocorticoid itself allergy

allergens from the common house dust mite Dermatophagoides pteronyssinus. Part II. Identification of the major IgE-binding antigens by crossed radioimmunoelectrophoresis. J Allergy Clin Immunol 1984;74:142–146. 3. Lind P, Løwenstein H. Identification of allergens in Dermatophagoides pteronyssinus mite body extract by crossed radioimmunoelectrophoresis with two different antibody pools. Scan J Immunol 1983;17:263–273. 4. Ipsen H, Klysner SS, Larsen JN, Løwenstein H, Mattiesen F, Schou C et al. Allergenic extracts. Allergy: principles and practice, 4th edn. St Louis, CA: Mosby Year Book, 1993. 5. Bousquet J, Lockey RF, Malling HJ. WHO Position Paper. Allergen immunotherapy: therapeutical vaccines for allergic diseases. Allergy 1998;53(Suppl. 44):1–42. Succinate as opposed to glucocorticoid itself allergy

Comprehensive allergy work-up is mandatory in cystic fibrosis patients who report a history suggestive of drug allergy to beta-lactam antibiotics

BackgroundIn the general population, reports on suspected ß-lactam hypersensitivity are common. After a drug allergy work-up at best 20% of the selected patients are positive. However, these considerations have not been explored in cystic fibrosis patients for whom antibiotics are even more crucial.MethodsThe study, part of the Drug Allergy and Hypersensitivity (DAHD) cohort, was performed in the regional cystic fibrosis center of Montpellier, France. After identifying patients with a clinical history suggestive of drug allergy to ß-lactams, a complete drug allergy work-up, was carried out according to the EAACI recommendations.ResultsAmong the 171 patients involved, 23 reported clinical manifestations potentially compatible with a drug allergy to ß-lactams. After performing the complete drug-allergy work-up, 7 were considered as drug hypersensitive (3 had positive skin tests, 1 a positive provocation test, 3 declined the tests). Excluding the latter 3 patients with incomplete drug allergy work-up, the rate of proven drug allergy was 2.3%.ConclusionsDrug allergy to ß-lactams in cystic fibrosis patients is of importance. A full drug allergy work-up is mandatory in case of suspicion, because ß-lactam responsibility is often ruled out.

Understanding the molecular sensitization for Cypress pollen and peach in the Languedoc‐Roussillon area

Cypress allergy is a typical winter pollinosis and the most frequent one in the South of France. Main symptoms are rhinitis, conjunctivitis, and asthma. Peach allergy is common too in Southern Europe. Allergic cross‐reactions between cypress and peach have been reported, including an oral allergy syndrome. We wanted to investigate whether a cross‐reactive allergen between cypress and peach might be responsible for the observed clinical association.

Rhinovirus‐associated pulmonary exacerbations show a lack of FEV1 improvement in children with cystic fibrosis

Respiratory viral infections lead to bronchial inflammation in patients with cystic fibrosis, especially during pulmonary exacerbations. The aim of this study was to determine the impact of viral‐associated pulmonary exacerbations in children with cystic fibrosis and failure to improve forced expiratory volume in 1 s (FEV1) after an appropriate treatment.

DNA methylation at modifier genes of lung disease severity is altered in cystic fibrosis

BackgroundLung disease progression is variable among cystic fibrosis (CF) patients and depends on DNA mutations in the CFTR gene, polymorphic variations in disease modifier genes, and environmental exposure. The contribution of genetic factors has been extensively investigated, whereas the mechanism whereby environmental factors modulate the lung disease is unknown. In this project, we hypothesized that (i) reiterative stress alters the epigenome in CF-affected tissues and (ii) DNA methylation variations at disease modifier genes modulate the lung function in CF patients.ResultsWe profiled DNA methylation at CFTR, the disease-causing gene, and at 13 lung modifier genes in nasal epithelial cells and whole blood samples from 48 CF patients and 24 healthy controls. CF patients homozygous for the p.Phe508del mutation and ≥18-year-old were stratified according to the lung disease severity. DNA methylation was measured by bisulfite and next-generation sequencing. The DNA methylation profile allowed us to correctly classify 75% of the subjects, thus providing a CF-specific molecular signature. Moreover, in CF patients, DNA methylation at specific genes was highly correlated in the same tissue sample. We suggest that gene methylation in CF cells may be co-regulated by disease-specific trans-factors. Three genes were differentially methylated in CF patients compared with controls and/or in groups of pulmonary severity: HMOX1 and GSTM3 in nasal epithelial samples; HMOX1 and EDNRA in blood samples. The association between pulmonary severity and DNA methylation at EDNRA was confirmed in blood samples from an independent set of CF patients. Also, lower DNA methylation levels at GSTM3 were associated with the GSTM3*B allele, a polymorphic 3-bp deletion that has a protective effect in cystic fibrosis.ConclusionsDNA methylation levels are altered in nasal epithelial and blood cell samples from CF patients. Analysis of CFTR and 13 lung disease modifier genes shows DNA methylation changes of small magnitude: some of them are a consequence of the disease; other changes may result in small expression variations that collectively modulate the lung disease severity.

Performances of an improved device for skin prick tests

Every day allergists deal with skin prick testing. Following a recent paper showing that the intrevenous needle and the metal lancets are superior to the Stallerpoint® plastic lancet, the manufacturer has improved the device to reach better standards in terms of sensitivity, intra-patient reproducibility and inter-patient reproducibility, as demonstrated on 10 adult patients, comparing the results with skin tests performed with the intravenous needle. We evaluated the sensitivity of the device by calculating the ratio between the number of true-positive tests and the sum of true-positive and false-negative tests. To assess the reproducibility of the test, we calculated the interpatient and the intrapatient coefficient of variation between the mean diameters of the papules induced by the different techniques. The improved device shows performances similar to those obtained with the intravenous needle.

An IgE Immediate Reaction to Thiocolchicoside

Hypersensitivity reactions due to muscle relaxant drugs may be related either to a nonspecific release of allergic mediators or to allergic reactions induced by the molecules themselves. Rare cases of hypersensitivity reactions have been associated to thiocolchicoside, and no case of IgE-mediated immediate reaction has actually been reported to date. We report the first documented case of immediate anaphylaxis to thiocolchicoside.

Severe peach allergy in patients non-sensitized to Pru p 3

Background Allergy to Rosaceae is the fourth leading cause of food allergy in children in France. Typically, in Northern Europe, there is a prior sensitization to birch, through a PR-10 protein, while in Southern Europe the allergy is often preceded by a sensitization to a Lipid Transfer Protein (LTP). In Spain it is often recorded as a subsequent sensitization to apple (cross-reaction between Pru p 3 and Mal d 3). Beside, it has to be pointed out the frequent association between allergy to cypress and peach.