Year-round treatment initiation for a 6-grasses pollen allergoid in specific immunotherapy of allergic rhinoconjunctivitis and asthma

Immunotherapy ◽  
2019 ◽  
Vol 11 (18) ◽  
pp. 1569-1582
Author(s):  
Vera Mahler ◽  
Stefan Zielen ◽  
Martin Rosewich
Keyword(s):  
Grass Pollen ◽  
Pollen Season ◽  
Allergen Immunotherapy ◽  
Specific Immunotherapy ◽  
Treatment Initiation ◽  
Allergic Diseases ◽  
Phleum Pratense ◽  
Specific Igg4 ◽  
Group A ◽  
Group B

Aim: Allergen immunotherapy (AIT) is an effective treatment for allergic diseases. We investigate whether treatment-initiation during the pollen season is safe. Methods: RCT-IIIb-trial of 6-grass-pollen-allergoid (Allergovit®) in grass pollen-allergic patients (18–65 years) with moderate–severe rhinitis/rhinoconjunctivitis (± controlled asthma), randomized 2:1 to treatment-initiation during (Group-A) versus outside the pollen season (Group-B). Results: Of 240 patients (32.8 ± 9.9 years, 19.5% asthma) treated, 84.9% (Group-A) and 86.6% (Group-B) reached maintenance dose without delay. Treatment-emergent adverse events occurred in 108 (68.4%/Group-A) and 41 patients (56.2%/Group-B) leading to premature trial-termination in 11 patients (7%/A) versus 3 (4.1%/B). Across groups, physicians (for 190 patients; 85.2%) and patients (192; 86.1%) rated the tolerability as ‘very good’–‘good’. Phleum pratense-specific IgG4 increased in both groups (p < 0.0001). Conclusion: Year-round allergen immunotherapy-initiation with this preparation is safe.

Vitiligo is correlated with clinical benefits in patients with advanced cutaneous melanoma treated with immune checkpoint inhibitors (ICI).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e22023-e22023
Author(s):  
Gaston Martin Reinas ◽  
Marcelo Muino ◽  
Mariana Abal ◽  
Carlos Garcia Gerardi ◽  
Flavio Tognelli ◽  
...  
Keyword(s):  
Cutaneous Melanoma ◽  
Treatment Initiation ◽  
Checkpoint Inhibitors ◽  
Rank Test ◽  
Kaplan Meier ◽  
Clinical Benefits ◽  
Group A ◽  
Melanoma Patients ◽  
Group B ◽  
Group Characteristics

e22023 Background: Use of ICI changed the treatment of Advanced Cutaneous Melanoma Patients (ACMP). This paper analyzes the evolution of ACMP who develop vitiligo during ICI treatment at Instituto Oncológico Henry Moore (IOHM). Methods: We selected all ACMP that received ICI between August 2015 and December 2019. We collected clinical data and compared Group A (ACMP with vitiligo) with Group B (ACMP without vitiligo) on: response rate (RR), time from ICI treatment initiation to progression (TTP) and overall survival (OS), defined as time from ICI treatment initiation to death. Outcomes were assessed using table tests and Kaplan-Meier curves with log-rank test. Results: Out of 32 ACMP treated with ICI, 12 Pt (37%) were in Group A and 20 Pt (63%) were in Group B. Table shows group characteristics and outcomes. Conclusions: 1) During treatment with ICI, 12 out of 32 (37%) advanced cutaneous melanoma patients were afflicted with vitiligo. 2) Two out of three patients who responded to ICI treatment developed vitiligo and obtained better TTP and OS than those without vitiligo. 3) According to these results, vitiligo is the consequence of the immune system reactivation responsible for considerable clinical benefits. Further studies should analyze if it is feasible to reduce ICI doses in patients who develop this adverse effect. 4) In this small and retrospective series, Nivolumab was more frequently correlated with vitiligo and clinical benefits, but we need prospective studies to decide which ICI treatment is the most effective. [Table: see text]

scholarly journals Standardized Quantitative Evaluation of Clinical Effectiveness and Side Effect Profile of Subcutaneous and Sublingual Allergen-Specific Immunotherapy in Children: A 5-Year Single Center Experience

2021 ◽  
Vol 19 (3) ◽  
pp. 156-165
Author(s):  
Nazan TÖKMECI ◽  
Ali DEMIRHAN ◽  
Merve TURKEGUN SENGUL ◽  
Burcu CAGLAR YUKSEK ◽  
Aylin KONT ÖZHAN ◽  
...  
Keyword(s):  
Side Effects ◽  
Allergen Immunotherapy ◽  
Specific Immunotherapy ◽  
Allergic Diseases ◽  
Visual Analog Score ◽  
Allergen Specific Immunotherapy ◽  
Medication Score ◽  
Asthma Patients ◽  
Systemic Side Effects ◽  
High Responders

Objective: Allergen-specific immunotherapy (allergen-SIT) is a treatment method with variable efficacy in allergic diseases. This study aimed to investigate the effectiveness of allergen immunotherapy, frequency of LRs and SRs and variables affecting these parameters in patients who underwent allergen-SIT. Materials and Methods: In this study, the recorded data of 81 patients, who received subcutaneous (SCIT) or sublingual (SLIT) allergen immunotherapy for respiratory allergic diseases between 2014 and 2019, were analyzed. In asthma and/or allergic rhinoconjunctivitis (ARC) patients, the effectiveness of treatment was evaluated by analysing the change rates in disease symptom, medication and combined scores (symptom + medication) and visual analog score (VAS). Treatment success was defined by the degree of decrease in scores as; high response above 50%; low response between 20-50%; and failure <20%.Results: The mean age of allergen-SIT initiation was 11.4± 3.1 years. Diagnostic distributions of the patients were asthma (± ARC) in 64.2%, and ARC (without asthma) in 35.8%. The mode of allergen-SIT was SCIT in 77.8% (65% asthma and 35% ARC) and SLIT in 22.2% (61.1% asthma and 38.9% ARC). The main allergens used in allergen-SIT were mite (79%), grass-grain pollen (33.3%), alternaria (9.9%) and olea (8.6%). There was a significant decrease in symptoms, medication, combined and VAS scores in the asthma and ARC groups (p <0.0001), when end-SCIT values were compared to baseline. SLIT also resulted in significant decreases in these scores except asthma medication score. Among the asthma patients the rate of high-responders was 88.8% by SCIT and 50% by SLIT, according to combined asthma score. Among the ARC (without asthma) patients the rate of high-responders was 100% for both SCIT and SLIT. SCIT resulted in local (LR) and systemic side effects (SR) in 18% and 0.6% (all Grade I and Grade II) of the total injections performed. A high number of total injections was significantly associated with higher LR and SR rates. While LR was observed in 16.6% of the patients who underwent SLIT, no systemic reaction was found in any of the patients. Conclusion: SCIT was highly successful in the treatment of asthma and ARC in terms of the degree of therapeutic response. SLIT resulted in a high rate of good response in ARC patients, but a lower response degree in asthmatic patients. Systemic side effects were very low as a result of close risk monitoring and the dose adjustments performed. Keywords: Allergen-specific immunotherapy, SCIT, SLIT, efficacy, symptom score, medication score, visual analog score, side effects

scholarly journals A comparison of different methods of the allergen-specific immunotherapy in patients with pollinosis: the results of open randomized study

2019 ◽  
Vol 16 (3) ◽  
pp. 35-45
Author(s):  
A Y Nasunova ◽  
N M Nenasheva
Keyword(s):  
Pollen Season ◽  
Specific Immunotherapy ◽  
Allergic Rhinoconjunctivitis ◽  
Nasal Lavage ◽  
Subcutaneous Immunotherapy ◽  
Immune Reactivity ◽  
Allergen Specific Immunotherapy ◽  
New Findings ◽  
Study Results ◽  
Specific Igg4

Background. Allergen-specific immunotherapy (ASIT) is viewed as the only treatment that influences all patho-genetically significant parts of the allergic process in the initial and late phases of the IgE-mediated allergic reaction and modifies the abnormal immune reactivity to a specific allergen. Currently, sublingual (SLIT) and subcutaneous (SCIT) immunotherapy are most commonly used in clinical practice. Despite long experience of sublingual and subcutaneous immunotherapy application, questions remain about the preferred ASIT method and comparative effectiveness of different ASIT methods. This article evaluates the efficacy, benefits of SCIT and SLIT and highlights new findings related mechanisms and potential biomarkers. The aim of the study. To evaluate the comparative efficacy of different methods of ASIT (subcutaneous and sublingual) based on clinical data and biomarkers in the blood serum and other biological fluids in adult patients with allergic rhinoconjunctivitis (with/without asthma). Materials and methods. 60 patients with allergic rhinoconjunctivitis (with/without asthma) aged 18 to 50 were randomly assigned to 3 groups treated by sublingual immunotherapy with extracts of allergens, subcutaneous immunotherapy with extracts of allergens and subcutaneous with modified allergens (allergoids) respectively. Results. The efficiency of the first course of preseason ASIT (SCIT and SLIT) with extracts of allergens and aller-goids in the control of symptoms of allergic rhinoconjunctivitis (with/without asthma) was demonstrated. After the end of the first year pre-season ASIT data analysis scales (Total Symptom Score -TSS, Medircation Score -MS) revealed the best performance in the group of patients receiving SCIT with allergoids compared with patients receiving the SLIT with extracts of allergens: the scales of the TSS (p=0.023), MS (p=0.002). In addition, at the end of the maintenance phase of ASIT in patients treated with SCIT with allergoids the level of eosinophilic cationic protein (ECP) in the nasal lavage decreased by 22% (p=0.012), secretory immunoglobulin A (sIgA) in the nasal lavage increased by 70% (p=0.001), interleukin-10 (IL-10) in serum increased by 126% (p=0.006), allergen-specific IgG4 increased by 42% (p=0.01) from the initial values, that correlates with a decrease in the severity of clinical manifestations. In pollen season ECP level in nasal lavage was significantly (p=0.007) lower in a group of patients who received SCIT with allergoids compared with patients who received the SLIT with extracts of allergens. The most significant changes of serum level of IL-10 in the pollen season occurred in a group of patients receiving SCIT with allergoids compared with patients who received SLIT (p=0.013) and SCIT (p=0.001) with extracts of allergens. Conclusion. The study results deepen the existing understanding of the mechanisms of SCIT and SLIT. They allow to develop a comprehensive assessment of the therapy efficacy scheme based on clinical parameters and on monitoring of local (ECP, sIgA) and systemic biomarkers (IL-10, allergen-specific IgG4) as well.

scholarly journals Blood type mystery

2021 ◽  
Vol 30 (2) ◽  
pp. 91-93
Author(s):  
Inga Tymofiychuk ◽  
Svetlana Semenenko
Keyword(s):  
Blood Group ◽  
Allergic Diseases ◽  
Blood Groups ◽  
Blood Type ◽  
Systematic Change ◽  
Gene Frequencies ◽  
History Of ◽  
Group A ◽  
Group B ◽  
Immunological Protection

In ancient times there was blood a symbol of life flow and energy. It was believed that it gives strength. Red paint and wine were used in traditional rites.Blood type is able to tell a lot of interesting things about its "owner" facts. Having information about your own blood type can be better to understand yourself and your body. The purpose of the article. In Article studies on the history of medicine, which form new ones, are considered ideas about the formation of blood groups. The novelty of the study due to the fact that the idea of ​​blood groups from year to year replenished with new data, which encourages the historical sketch. Main part. With increasing population and changing the environment reduces the possibility to get meat food. As a result, this led to the emergence "Vegetarian" second blood group A. Resettlement of peoples in Europe is the reason for the predominance of people with the second blood group there at this time. It is believed that the homeland of the gene of the third group B is located in the foothills of the Himalayas, in present-day India and Pakistan. The fourth blood group AB arose as a result of mixing holders of gene A and carriers of gene B. Today only 6% Europeans have a fourth blood type, which is the youngest in ABO system. The uniqueness of this group in the inheritance of high immunological protection, which is manifested in resistance to autoimmune and allergic diseases. Conclusions. Evolution human is impossible without a systematic change in gene frequencies population. Is evolution continuing now? Thoughts sometimes contradictory. Some believe that man has reached the top evolutionary tree, others disagree with such conclusions.

scholarly journals Specific immunotherapy for allergic diseases

2016 ◽  
Vol 45 (4) ◽  
pp. 137
Author(s):  
Ariyanto Harsono
Keyword(s):  
19Th Century ◽  
Allergen Immunotherapy ◽  
Specific Immunotherapy ◽  
Allergic Diseases ◽  
Basic Principles ◽  
The 19Th Century ◽  
Careful Assessment ◽  
Specific Allergen

Specific allergen immunotherapy (SIT)involves the administration of allergenextracts to modify or abolish symptomsassociated with atopic allergy. The process isspecific, in that the treatment is targeted at thoseallergens recognized by the patient and physician asresponsible for symptoms. A decision to use SITtherefore demands a careful assessment of the patient’scondition and the role of allergic triggers.Immunotherapy was first developed at St Mary’sHospital, London at the end of the 19th century, andmany of the basic principles remain valid today.

Molecular profiles of IgE to Phleum pratense in children with grass pollen allergy: Implications for specific immunotherapy

2012 ◽  
Vol 129 (3) ◽  
pp. 834-839.e8 ◽  
Author(s):  
Salvatore Tripodi ◽  
Tullio Frediani ◽  
Sandra Lucarelli ◽  
Francesco Macrì ◽  
Giuseppe Pingitore ◽  
...  
Keyword(s):  
Grass Pollen ◽  
Specific Immunotherapy ◽  
Pollen Allergy ◽  
Phleum Pratense ◽  
Grass Pollen Allergy ◽  
Molecular Profiles

scholarly journals Adjunctive Corticosteroids for COVID-19: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Say Tat Ooi ◽  
Purnima Parthasarathy ◽  
Yi Lin ◽  
Valliammai Nallakaruppan ◽  
Shereen Ng ◽  
...  
Keyword(s):  
Lower Risk ◽  
Retrospective Cohort ◽  
Treatment Initiation ◽  
Cox Regression ◽  
Clinical Progression ◽  
Cox Regression Analysis ◽  
Treatment Groups ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Coronavirus disease 2019 (COVID-19) is associated with severe pneumonia, respiratory failure and death. We aim to evaluate the efficacy of adjunctive corticosteroids in the management of COVID-19. Methods: This is a retrospective cohort study of hospitalized adults (≥18 years) who were diagnosed with COVID-19 and were given treatment. Treatment included hydroxycholoroquine and lopinavir-ritonavir. Corticosteroids were included as adjunctive therapy in mid-April, 2020. We compared composite outcomes of clinical progression and invasive mechanical ventilation (MV) or death between group that received treatment only (Group A) versus group that received adjunctive corticosteroids (Group B). Entropy balancing was used to generate stabilized weight for covariates between treatment groups. Unweighted Kaplan-Meir curves, weighted and adjusted Cox regression analysis were used to estimate effect of adjunctive corticosteroids on composite outcomes. Subgroup analysis was performed on those with pneumonia. Results: Of 1046 patients with COVID-19, 57 received treatment alone (Group A) and 35 received adjunctive corticosteroids in addition to treatment (Group B). Median day of illness at treatment initiation was 5 day. There were 44 patients with pneumonia; 68.9% of them were not requiring supplemental oxygen at treatment initiation. Overall, 17 (18.5%) of 92 patients had clinical progression including 13 (22.8%) of 57 patients in Group A versus 4 (11.4%) of 35 patients in Group B (p=0.172). Unweighted Kaplan-Meier estimates showed no significant difference in the proportion of patients who had clinical progression or invasive MV or death between the 2 treatment groups. However in those with pneumonia, there were lower proportions of patients in Group B with clinical progression (11.1% , 95% CI 0.0 - 22.2 versus 58.8%, 95% CI 27.3 - 76.7, log rank p<0.001 ); and invasive MV or death (11.3%, 95% CI 0.0 - 22.5 versus 41.2%, 95% CI 12.4. - 60.5, log rank p=0.016). In weighted and adjusted cox regression analysis, patients in Group B were less likely to have clinical progression, (adjusted HR [aHR] 0.08, 95% CI 0.01-0.99, p=0.049) but there was no statistical significant difference in risk of requiring invasive MV or death (aHR 0.22, 95%CI 0.02 - 2.54, p=0.22). In subgroup with pneumonia, patients in Group B were significantly at lower risk of clinical progression (aHR 0.15, 95% CI 0.06 - 0.39, p<0.001) and requiring invasive MV compared to Group A (aHR 0.30, 0.10-0.87, p=0.029). Conclusions: Use of adjunctive corticosteroids is associated with lower risk of clinical progression and invasive MV or death, especially in those with pneumonia. Concurrent use of antivirals and corticosteroids should be considered in the management of COVID-19 related pneumonia.

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