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M Audicana

Publications and source records attributed to M Audicana.

12 recordsLinked to original sources

Systemic reactions to immunotherapy: influence of composition and manufacturer.

BACKGROUND: Although immunotherapy clearly demonstrated the benefit of reducing allergic symptoms, it has the drawback of adverse events, mainly systemic reactions that could be very inconvenient for patients and even life-threatening. OBJECTIVE: The aim of the present study was to assess the incidence of systemic reactions to immunotherapy in a large number of patients, and its potential relationship with the characteristics of therapy, such as allergen composition or manufacturing laboratory. METHODS: This study analysed the administration of specific immunotherapy during a period of 5 years, involving 1212 patients affected by respiratory hypersensitivity or hymenoptera venom anaphylaxis. Commercial extracts were supplied by five different laboratories. All the patients were attended at an out-clinic immunotherapy unit by the same experienced staff. Immunotherapy was given following a conventional schedule, modified according the usual recommendations. RESULTS: A total of 250 adverse reactions have been recorded, resulting in a frequency of 0.84% over the total number of injections. Seventy-nine of them (32%) were systemic reactions (0.27% SR/injection). The 79 systemic reactions were observed in 60 patients (5% of the patients). The frequency of systemic reactions was significantly lower (P < 0.01) on the group of mites than on the other groups. The frequency of systemic reactions varies according to the manufacturing laboratory. In the case of mite extracts, although one of the laboratories had a lower frequency of adverse systemic reactions, it did not reach the level of statistical significance. However, in relation to pollen extracts, preparations of one of the manufacturers had a significantly lower frequency of systemic reactions. Concerning the time of occurrence, 27% of systemic reactions were delayed, thus they appeared at least 30 min after the vaccine injection, most of them due to pollen extracts. CONCLUSION: This is a preliminary study to evaluate the factors that could facilitate the appearance of systemic reactions demonstrating that not only the composition but also the manufacturer is connected to systemic reactions. Although further studies are needed to clearly establish the influence of manufacturer on frequency and time of appearance of systemic reactions, it seems necessary to reach a wide consensus on allergen extract standardization methods.

Allergens↗

Prevalence of pollinosis in the Basque Country.

BACKGROUND: The prevalence of allergic diseases, mainly pollinosis, has increased within the last decades. Our study aimed to determine the prevalence of sensitization to Poaceae pollen in the Basque Country. This is a region of northern Spain, with an area of 7261 km2 and a population of 2109009 inhabitants. Two different climatic regions may be distinguished in the Basque Country (the Atlantic and the Oceanic). METHODS: A transversal study was carried out on 2216 subjects, aged 10-40 years. A personal interviewwas carried out in order to compile study data, by means of a questionnaire that had been previously validated with a clinical history and an allergy study. RESULTS AND CONCLUSIONS: Our results show the prevalence of pollinosis in the Basque Country to be 10.6% (C.I. 95% 9.35-11.96%) without significant differences between men and women. The prevalence in the Atlantic climate area (9.71%) was lower than in the Oceanic climate area (13.61%). There were no differences between persons living in a rural environment (10.87%) and those living in an urban setting (10.51%). Pollinosis was more frequent in individuals aged 10-20 (11.41%) and 20-30 (12.54%) than those aged 30-40 years (7.43%). Three features significantly distinguished pollinic from nonpollinic patients: 1) a more common complaint of symptoms after ingestion of Rosaceae fruits or nuts (10.2%) 2) a family history of atopy (8.8%) 3) a greater occurrence of bronchial asthmatic symptoms (23%).

Adolescent↗

Allergic reactions to betalactams: studies in a group of patients allergic to penicillin and evaluation of cross-reactivity with cephalosporin.

A group of 34 penicillin-allergic patients was studied to determine skin test reactivity to the different penicillins involved in inducing the allergic reaction and the cross-reactivity with side-chain-related and side-chain-unrelated cephalosporins. All the subjects selected for the study had to be skin test positive to at least one of the following determinants: benzyl-penicilloyl-polylysine (BPO-PLL), minor-determinant mixture (MDM), amoxicillin (AX), or ampicillin (AMP), or to possess in vitro IgE to the following conjugates: benzyl-penicilloyl-human-serum albumin (BPO-HSA), ampicilloyl-human-serum albumin (AMP-HSA), and amoxicilloyl-human-serum albumin (AX-HSA). Cephalexin (CE) and ceftazidime (CEF) were used to assess cross-reactivity. If skin tests to any of these compounds were positive, the patient was considered to be allergic; if negative, a challenge test was performed. Sixteen patients (47%) were skin test positive to BPO and/or MDM, and nine (26%) exclusively to AX and/or AMP. In three cases (8%), the RAST was positive although the skin test was negative; one to BPO-HSA and two to AX-HSA and AMP-HSA. Six patients (17%) needed to be challenged with the penicillin involved to establish the diagnosis. In five patients (14%), the skin tests were positive to CE and in none to CEF. In all the others, the skin tests were negative to both cephalosporins, and the patients tolerated the drugs when challenged. These results indicate the relevance of side-chain-specific minor determinants in betalactams allergy and provide support for the role of this chemical structure in the evaluation of cross-reactivity between penicillins and cephalosporins.

Adolescent↗

Sensitization from chestnuts and bananas in patients with urticaria and anaphylaxis from contact with latex.

We present eight patients allergic to latex and fruit (chestnut and banana), seven of whom are women, and aged 17 to 42 years (mean 25 years). Four had family and five personal atopic histories. The total IgE varied from 41 to 520 Ku/L (mean 263). The symptoms followed ingestion of fruit (anaphylaxis) in four patients and contact with rubber (contact urticaria and anaphylaxis) in the other four. Skin prick test (SPT) with latex and radioallergosorbent test to latex were positive in all the patients. Histamine release (HR) to latex was carried out on six patients and was positive in three. In the six patients with symptoms after having eaten chestnuts the SPT was positive and specific IgE was detected in five of them. Histamine release to chestnuts was positive in three of the six patients tested and one of them (-SPT and + IgE) tolerated the fruit. Two out of five patients with symptomatic banana allergy had negative SPT with banana while the test was positive in one patient who tolerated this fruit, this being the only case with specific IgE to banana. Histamine release with banana was only positive in one case. The important correlation between SPT, RAST, and HR results to latex and chestnut together with the total inhibition of the chestnut RAST with a serum pool by preincubation with latex suggests cross-reactivity among these allergens.

Adolescent↗