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2022 ◽  
Vol 10 (1) ◽  
pp. 01-11
Author(s):  
Ravi Shrivastava ◽  
Rémi Shrivastava ◽  
Nathalie Maneby ◽  
Gilles Giroir ◽  
Marjorie Georges ◽  
...  

Background: Pollution induced allergic rhinitis and respiratory symptoms is becoming a major health problem in the world for which still there is no safe and preventive treatment. Objectives: Conceive and evaluate the allergen preventive properties and clinical efficacy of an osmotic, polymeric, stable filmogen spray, called PCNS. Materials and Methods: Amb A 1 (ragweed), Der P 1 and 2 (dust mite), Bet v 1 (birch), Alt a 1 (Alternaria, fungus), and Fel d 1 (cat dander) allergens were exposed at a concentration of 5µg/ml (20 µl per tube) on the polymeric test product film (120 and 240µl layer) and the allergens crossing the barrier were quantified in the agar gel beneath the film. 0.40% HPMC and PBS solutions, tested identically, served as controls. Clinical efficacy of PCNS nasal spray was evaluated in patients suffering from allergic rhinitis and/or respiratory symptoms (29 in test product v/s 15 in saline controls) for 22 days. Nasal, ocular, respiratory symptoms and Rhino conjunctivitis Quality of Life Questionnaire (RQLQ) were measured. Statistical analyses: The normality of the populations was determined by the Shapiro-Wilk test, then statistical analysis was performed by two-tailed Student’s test for comparisons between two groups and the two-way ANOVA followed by the post hoc Bonferroni’s test for comparisons of multiple groups. p<0.05 was considered statistically significant. The analyses were performed with the software GraphPad Prism (version 8.4.2, La Jolla, USA). NS indicates not significant. Results: PCNS polymeric spray blocked the diffusion of all the allergens while 0.40% HPMC was able to prevent diffusion of only Alt a 1 and Fel d 1 allergens. Mean reflective total nasal symptom scores (rTNSS), reflective total ocular symptom score (rTOSS), and respiratory symptoms including effect on wheezing, cough, dyspnea, and chest tightness were moderately improved in the control saline group, but the improvements were nearly twice better in the PCNS group. RQLQ was improved by 23% in saline spray v/s 46% PCNS group. 4/15 patients in saline group v/s 1/29 in PCNS group required rescue medication during the study. PCNS was highly effective in reducing allergen and pollution induced respiratory symptoms. Conclusion: a polymeric, osmotic, and stable nasal barrier against pollutants and allergens represents an innovative approach against pollution induced respiratory symptoms.


2021 ◽  
Author(s):  
Maira Bonini ◽  
GIANNA MONTI ◽  
MATTEO PELAGATTI ◽  
VALENTINA CERIOTTI ◽  
ELISABETTA RE ◽  
...  

Abstract Objectives: 1. To investigate the correlation between ragweed pollen concentration and conjunctival, nasal and asthma symptoms severity in patients allergic to ragweed using ambient pollen exposure in the Milan area during the 2014 ragweed season; 2. to calculate the pollen / symptom thresholds and 3. to assess the effectiveness of ragweed Allergen Immuno Therapy (AIT).Patients: 66 subjects allergic to Amb a 1 enrolled in the study and were divided into two cohorts: AIT treated (24) and non-AIT treated (42).Measurements: Pollen counts and daily symptom/medication patient diaries. Autoregressive Distributed Lag Models were used to develop predictive models of daily symptoms and to evaluate the short-term effects of temporal variations in pollen concentration on the onset of symptoms. Results: We found significant correlations between ragweed pollen load and the intensity of symptoms, for all three symptom categories respectively, both in non-AIT treated (𝛕= 0.341, 0.352, 0.721 and ρ = 0.48, 0.432, 0.881, p-value < 0.001) and in AIT treated patients (O= 0.46, 0.610, 0.66 and ρ = 0.692, 0.805, 0.824; p-value < 0.001). In both cohorts, we observed a positive correlation between the number of symptoms reported and drug use. Mean symptom levels were significantly greater in non-AIT treated than in AIT treated patients (p < 0.001) for all symptom categories. Pollen concentration thresholds for three symptom severity levels were calculated.Conclusions: Ragweed pollen concentration is predictive of symptom severity in ragweed (Amb a 1) allergy patients. AIT treated patients had significantly reduced mean symptom levels compared to non-AIT patients.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Anne K. Ellis ◽  
Remi Gagnon ◽  
David I. Bernstein ◽  
Hendrik Nolte

Abstract Background Post hoc analyses of randomized placebo-controlled trials have demonstrated efficacy and tolerability of the ragweed sublingual immunotherapy (SLIT)-tablet in Canadian adults with ragweed pollen-induced allergic rhinitis/conjunctivitis (AR/C). This post hoc analysis evaluated the efficacy and tolerability of the ragweed SLIT-tablet in the subpopulation of Canadian children and adolescents with AR/C in a previously described randomized, double-blind, placebo-controlled trial. Methods The trial (NCT02478398) was conducted in North American and European children/adolescents ages 5–17 years with ragweed pollen-induced AR/C with or without asthma (FEV1 ≥ 80% predicted). Participants were randomized to daily ragweed SLIT-tablet (12 Amb a 1-U) or placebo for up to 28 weeks. The primary endpoint was the average total combined score (TCS; sum of rhinoconjunctivitis daily symptom score [DSS] and daily medication score [DMS]) during peak ragweed pollen season (RPS). Key secondary endpoints were TCS during the entire RPS, and DSS and DMS during peak RPS. Post hoc analyses of the primary and key secondary endpoints were conducted in the subpopulation of Canadian participants. Results Of the 1025 randomized participants, 246 (SLIT-tablet, n = 116; placebo, n = 130) were in the Canadian subpopulation. In the total study population, relative TCS (95% CI) improvement with ragweed SLIT-tablet versus placebo was − 38.3% (− 46.0%, − 29.7%; least square [LS] mean difference, − 2.73; P < 0.001) during peak RPS. In the Canadian subpopulation, relative TCS improvements with ragweed SLIT-tablet versus placebo were − 40.8% (− 54.5%, − 20.2%; LS mean difference, − 1.59; P = 0.001) during peak RPS and − 36.6% (− 50.2%, − 16.5%; LS mean difference, − 1.36; P = 0.002) during the entire RPS. DSS and DMS during peak RPS in the Canadian subpopulation improved with SLIT-tablet versus placebo by − 30.6% (− 45.2%, − 7.7%; LS mean difference, − 0.94; P = 0.010) and − 77.2% (− 97.5%, − 44.2%; LS mean difference, − 0.66; P = 0.003), respectively. No events of anaphylaxis, airway compromise, intramuscular epinephrine administration, eosinophilic esophagitis, or severe treatment-related systemic allergic reactions were reported in the overall population or Canadian subpopulation. Conclusion Efficacy and safety of the ragweed SLIT-tablet in Canadian children/adolescents with ragweed pollen-induced AR/C was consistent with the total study population. The ragweed SLIT-tablet resulted in clinically meaningful improvement in symptoms, decreased symptom-relieving medication use, and was well tolerated in Canadian children/adolescents. Trial registration: clinicaltrials.gov, NCT02478398. Registered June 23, 2015, https://clinicaltrials.gov/ct2/show/NCT02478398?term=NCT02478398&draw=2&rank=1


2021 ◽  
Vol 23 (4) ◽  
pp. 921-926
Author(s):  
N. N. Zhukova ◽  
M. V. Manzhos ◽  
L. R. Khabibulina ◽  
E. Yu. Syrtsova

Allergic rhinitis and bronchial asthma are widespread respiratory allergic diseases. In some territories of the Russian Federation, the dominant cause of pollinosis is ragweed. The aim of the study was to evaluate the clinical and immunological efficacy of ASIT with the allergen Ambrosia artemisiifolia in patients sensitized to Ambrosia trifida in the Samara region. Patients with proven sensitization to Ambrosia trifida was held immunotherapy with Ambrosia artemisiifolia allergoid preseason. After treatment, patients had a decrease in the severity of symptoms of allergic rhinitis according to VAS (p = 0.00001), a decrease in the need for medications (p = 0.0003), as well as the need for corticosteroids against the background of therapy from 34.6% to 0% (p = 0.00001). In 8% of cases, the result of treatment was good, in 69% satisfactory, in 23% unsatisfactory. In the control group, there were no changes in the severity of symptoms (p = 0.858). Also, in the control group, the need for medications remained unchanged and 14.3% of patients continued to use corticosteroids.After ASIT, there was a decrease in the level of IL-4 (p = 0.002), and a decrease in the ratio of IL-4/ IL-10 (p = 0.0063); at the same time, changes in the level of other cytokines (IL-10; IFNγ) were statistically insignificant (p > 0.05). Before treatment, the levels of IL-4/ IL-10 in both groups were comparable, and after treatment, the differences became statistically significant (p = 0.031). We did not get a statistically significant change in the level of IgG4 Amb a 1 or IgG4 Amb trifida. There was no correlation between the level of individual cytokines and the results of treatment. As a result of the conducted ASIT, positive clinical and immunological results were obtained. In most patients, the disease has acquired a controlled course. At the same time, the lack of excellent and low number of good results of ASIT is probably due to the intraspecific allergenic properties of ragweed. 


2021 ◽  
Vol 12 ◽  
Author(s):  
Chao Gu ◽  
Katherine Upchurch ◽  
Joshua Horton ◽  
Mathew Wiest ◽  
Sandra Zurawski ◽  
...  

The epithelium-associated cytokine thymic stromal lymphopoietin (TSLP) can induce OX40L and CCL17 expression by myeloid dendritic cells (mDCs), which contributes to aberrant Th2-type immune responses. Herein, we report that such TSLP-induced Th2-type immune response can be effectively controlled by Dectin-1, a C-type lectin receptor expressed by mDCs. Dectin-1 stimulation induced STAT3 activation and decreased the transcriptional activity of p50-RelB, both of which resulted in reduced OX40L expression on TSLP-activated mDCs. Dectin-1 stimulation also suppressed TSLP-induced STAT6 activation, resulting in decreased expression of the Th2 chemoattractant CCL17. We further demonstrated that Dectin-1 activation was capable of suppressing ragweed allergen (Amb a 1)-specific Th2-type T cell response in allergy patients ex vivo and house dust mite allergen (Der p 1)-specific IgE response in non-human primates in vivo. Collectively, this study provides a molecular explanation of Dectin-1-mediated suppression of Th2-type inflammatory responses and suggests Dectin-1 as a target for controlling Th2-type inflammation.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Nandini Ghosh ◽  
Gaurab Sircar ◽  
Claudia Asam ◽  
Martin Wolf ◽  
Michael Hauser ◽  
...  

AbstractSunflower pollen was reported to contain respiratory allergens responsible for occupational allergy and pollinosis. The present study describes the comprehensive characterization of a major sunflower allergen Hel a 6. Natural Hel a 6 was purified from sunflower pollen by anion exchange and gel filtration chromatography. Hel a 6 reacted with IgE-antibodies from 57% of 39 sunflower-sensitized patient sera suggesting it to be a major allergen. The patients were of Indian origin and suffering from pollinosis and allergic rhinitis. Hel a 6 exhibited allergenic activity by stimulating mediator release from basophils. Monomeric Hel a 6 displayed pectate lyase activity. The effect of various physicochemical parameters such as temperature, pH, and calcium ion on the functional activity of Hel a 6 revealed a stable nature of the protein. Hel a 6 was folded, and its melting curve showed reversible denaturation in which it refolded back to its native conformation from a denatured state. Hel a 6 displayed a high degree of sequence conservation with the pectate lyase allergens from related taxonomic families such as Amb a 1 (67%) and Art v 6 (57%). The IgE-cross reactivity was observed between Hel a 6 and its ragweed and mugwort homologs. The cross-reactivity was further substantiated by the mediator release when Hel a 6-sensitized effector cells were cross-stimulated with Art v 6 and Amb a 1. Several putative B cell epitopes were predicted and mapped on these 3 allergens. Two antigenic regions were found to be commonly shared by these 3 allergens, which could be crucial for cross-reactivity. In conclusion, Hel a 6 serves as a candidate molecule for diagnosis and immunotherapy for weed allergy.


2020 ◽  
Vol 46 (6) ◽  
pp. 1221-1228
Author(s):  
O. O. Mikheeva ◽  
M. A. Kostromina ◽  
D. D. Lykoshin ◽  
M. N. Tereshin ◽  
S. K. Zavriev ◽  
...  

2020 ◽  
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2020 ◽  
Vol 95 (1) ◽  
pp. 13-17
Author(s):  
Jae-Hyun Lee

It is very important to identify the causal allergen of each patient in the diagnosis and treatment of allergic diseases. An experimental method of specific IgE testing for single clinically meaningful antigens is called component resolved diagnosis (CRD). Since the introduction of CRD, many single antigens with clinical significance from animal and plant allergenic source have become known. Bet v 1, the major allergen of white birch pollen, can be an indication marker for allergen-specific immunotherapy if the patient is sensitized. Phl p 1, the group I allergen of timothy grass pollen, is an important marker that suggests that patients are truly sensitized to grass pollen. The major allergen of ragweed pollen, Amb a 1 and Art v 1, which is the major allergen of mugwort pollen, are clinically important to distinguish true sensitization. House dust mites have several clinically useful component allergens. Der p 1 and Der p 2 are the initiation molecules in the molecular spreading of allergic diseases caused by house dust mites. Among food allergens, Ara h 2 from peanut, which is closely related to anaphylaxis among several clinical manifestation of peanut allergy. Tri a 19, well known to omega-5 gliadin is important in patients with wheat-dependent exercise-induced anaphylaxis. It is conceivable that the molecular biological concept of CRD methods should lead to ‘patient-customized treatment’ beyond ‘diagnosis’ in the future. Primary prevention of the allergic diseases will apply, which will conceptually be called ‘allergen immunprophylaxis’. This is the right direction of future precision allergology.


2020 ◽  
Vol 46 (6) ◽  
pp. 761-769
Author(s):  
О. О. Михеева ◽  
М. А. Костромина ◽  
Д. Д. Лыкошин ◽  
М. Н. Терешин ◽  
С. К. Завриев ◽  
...  
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