Stability of Wheat Floret Metabolites during Untargeted Metabolomics Studies

A typical metabolomic analysis consists of a multi-step procedure. Variation can be introduced in any analysis segment if proper care in quality assurance is not taken, thus compromising the final results. Sample stability is one of those factors. Although sophisticated studies addressing sample decay over time have been performed in the medical field, they are emerging in plant metabolomics. Here, we focus on the stability of wheat floret extracts on queue inside an auto-injector held at 25 °C. The objective was to locate an analytical time window from extraction to injection with no significant difference occurring in the sample. Total ion current chromatograms, principal component analysis, and volcano plots were used to measure changes in the samples. Results indicate a maximum work window time of 7:45 h for Steele-ND wheat methanolic extractions in an auto-sampler at 25 °C. Comparisons showed a significant gradual increase in the number and intensity of compounds observed that may be caused by the degradation of other molecules in the sample extract. The approach can be applied as preliminary work in a metabolite profiling study, helping to set the appropriate workload to produce confident results.

Living with Food Allergies: The Recalibratory Body

As a growing global public health concern, an increasing proportion of the UK’s population must live with and manage the chronic disease of food allergies. Through a multi-method approach of autoethnography, cognitive mapping, and interviewing, this research investigates what matters to the bodily experience of people living with food allergies. I work with the concepts of embodiment and affect to delineate a theorisation of the allergic body as recalibratory and argue that the adrenaline auto-injector (AAI)—the lifesaving medication prescribed to individuals with severe food allergies—is integral to the allergic recalibratory body. I demonstrate the multiple, dynamic ways in which those living with food allergies “affectively relate” to the AAI and what contributes to this. An account of the body as recalibratory is advanced to account for the dynamicism of the body’s affective relations. The recalibratory body becomes a valuable tool for understanding the ways that macro-issues of AAI production shortages and the tragic occurrence of allergy fatalities as well as micro-level everyday experiences matter to those living with food allergies. The essay concludes by exploring how the concept of recalibration can expand beyond allergic bodies to understand what the body—any body—can be, do, and mean.

White paper on peanut allergy – part 1: Epidemiology, burden of disease, health economic aspects

Peanuts are Leguminosae, commonly known as the legume or pea family, and peanut allergy is among the most common food allergies and the most common cause of fatal food reactions and anaphylaxis.The prevalence of peanut allergy increased 3.5-fold over the past two decades reaching 1.4–2% in Europe and the United States. The reasons for this increase in prevalence are likely multifaceted. Sensitization via the skin appears to be associated with the development of peanut allergy and atopic eczema in infancy is associated with a high risk of developing peanut allergy.Until recently, the only possible management strategy for peanut allergy was strict allergen avoidance and emergency treatment including adrenaline auto-injector in cases of accidental exposure and reaction.This paper discusses the various factors that impact the risks of peanut allergy and the burden of self-management on peanut-allergic children and their caregivers.

Alliance with the School Personnel Is Crucial for the Management of Food Allergy and Anaphylaxis in School Children

Background: School nurses play an important role in coping with food allergy (FA) in schoolchildren, but in schools with no school nurse, the school personnel should be prepared to manage health emergencies. This study aimed to evaluate allergy management competences in primary schools in Cyprus. Methods: The study was conducted September 2016 to May 2017 in 11/13 primary schools, selected by stratified random sampling. Information was collected from a principal/designated teacher using a questionnaire from the EuroPrevall Project, adapted for Cypriot teachers. Results: An average of six children with FA per school was reported in the preceding three years. Protocols for the management of chronic diseases, including allergies, were in place in 8/11 schools. Regarding recognition of FA, 8/11 respondents knew some of the signs and symptoms. In an allergic emergency, 9/11 would call the child’s parent/caregiver first and 2/11 emergency medical support. Epinephrine auto-injector (EIA) was reported by 2/11 respondents to be available in the school, but only one reported training in its use. Conclusions: The preparedness of primary schools in Cyprus did not meet safety standards regarding the preparedness of school personnel to cope with an allergic reaction in children with FA, including the use of EIA.

Efficacy and Safety of up to 2 Years of Treatment With TransCon hGH (Lonapegsomatropin) in Treatment-Naïve and Treatment-Experienced Children With Growth Hormone Deficiency

Background: Once-weekly TransCon hGH (lonapegsomatropin) is an investigational long-acting prodrug of somatropin in development for GHD. In the pivotal 52-week phase 3 heiGHt trial, lonapegsomatropin demonstrated superior annualized height velocity (AHV) compared to the same weekly dose of daily somatropin in treatment-naïve children with GHD. In the 26-week fliGHt trial, switch from daily somatropin to lonapegsomatropin provided continued growth and maintained a good safety profile. Methods: Results are reported from heiGHt and fliGHt subjects who continued into the open-label long-term extension enliGHten trial (data cut: June 1st 2020). Subjects received either lonapegsomatropin (Group A; vial/syringe) or daily somatropin (Group B; pen device) in heiGHt, or lonapegsomatropin in fliGHt (Group C; vial/syringe). Upon entry into enliGHten, all subjects received lonapegsomatropin via vial/syringe, with subsequent switch to TransCon hGH Auto-Injector when available. Average IGF-1 was obtained on post-dose Day 5 (±1) in enliGHten. A by-visit ANCOVA model was used for numeric efficacy endpoints. Results: A total of 298 (98%) subjects continued into enliGHten. (A: n=103; B: n=55; C: n=140). The treatment difference in LS mean ∆ height SDS (A vs B) at the end of heiGHt (Week 52, 1.10 vs 0.96, P=0.015) was sustained through Week 104 (1.61 vs 1.49, P=0.158). For Group C, height SDS improved from −1.42 at fliGHt baseline to −0.69 at Week 78. AHV was within the expected range for 2nd year therapy. Among children who switched (B), an attenuation in the expected 2nd year decline of AHV suggested that lonapegsomatropin had an improved treatment effect relative to the previous daily somatropin. Mean (SD) average IGF-1 SDS remained stable and generally within the expected range for all groups (Week 104, A: 0.95 [1.22], B: 1.04 [1.25]; Week 78, C:1.81 [1.08]). An improvement in injection site tolerability was observed after switching to the TransCon hGH Auto-Injector; subjects and parents also indicated overall ease-of-use of the device (assessed by the Device Usability Questionnaire). With continued lonapegsomatropin treatment, the AE profile remained consistent with what was observed in the parent trials, with no new safety signals. Throughout enliGHten and the parent trials, non-neutralizing low-titer anti-hGH binding antibodies were detected post-dose in a total of 15 subjects (5.0%). Lab parameters were stable and generally remained within the normal range throughout the trials. As of the data cut, 2 subjects have achieved near adult height (AHV <2 cm/year over the last 9 months or bone age >14 [females] or >16 [males]) and thus have completed the trial. Conclusions: Children treated with lonapegsomatropin showed continued improvement of height SDS through their 2nd year of therapy. Lonapegsomatropin continued to demonstrate a safety profile comparable to that of daily somatropin therapy.

Efficacy of an adrenaline auto-injector diary for patients allergic to foods or insect stings

Background: Adrenaline auto-injectors (AAIs) are not used correctly by patients and their caregivers because of a lack of training. The aim of this study was to determine how to help patients maintain proper use of AAIs. Methods: Patients prescribed AAIs or their caregivers were recruited. At enrollment, they were asked to demonstrate use of a ‘trainer’ device, and they were given a calendar as a diary. They were asked to mark the days they practice for a year. After one year, their performance was re-evaluated. Their skills were evaluated in five steps that consisted of a) how to hold the AAI, b) removing the cap, c) selecting the mid-anterolateral thigh as the correct site of injection, d) holding firmly in place for 5 seconds, and e) massaging after injection. The primary endpoint was the percentage of participants that correctly used the AAI one year after enrollment. Results: A total of 102 participants were enrolled. At enrollment, of the 82 participants who had previous AAI prescriptions, 38 (46.3%) used it correctly. Except for evaluation items d) and e), 55 of 82 (67.1%) used it correctly. Ninety-seven participants could be confirmed after one year, and 81 of them (83.5%) used the AAI correctly. Conclusion: Distributing the diary was effective in maintaining AAI skill. It is thought that the diary helped participants maintain their motivation to practice using the AAI.