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Biomedical subjects

Pascal Demoly

Publications and source records attributed to Pascal Demoly.

29 records · Page 2Linked to original sources
PubMed2003

[Identifying and understanding drug allergies].

Drug hypersensitivity reactions frequently occur in hospitalized and out-patients. Clinical presentations are numerous and heterogeneous, from a mild urticaria to a dramatic anaphylactic shock and an extensive bullous skin disease. Allergic reactions are unpredictable reactions, related to immunologic mechanisms. Some reactions mimic allergic reactions but no drug specific antibody or T cell proliferation can be demonstrated. A true diagnosis is rarely set up and the tools for it are lacking. In this review, we will focus on the available epidemiological data concerning these reactions, including data on incidence and mortality and on the most recent advances in the pathophysiology and allergy diagnosis of drug hypersensitivity reactions.

Anaphylaxis↗
PubMed2003

Asthma therapy during pregnancy.

Numerous pregnant women suffer from asthma and the use of asthma medications during pregnancy may be a necessity. Although some information is known about the effects of asthma medications during pregnancy, there is still a significant amount of information to learn and particular attention is required when prescribing drugs to these patients. In addition, physiological changes associated with pregnancy may affect airway responsiveness in some individuals. Guidelines on the management of asthma are published regularly, the most popular being the Global Initiative for Asthma (GINA), and medication can be prescribed during pregnancy when the apparent benefit of the drug is greater than the apparent risk. Usually, there is at least one 'safe' drug from each major class used to control symptoms. We will review the current literature on this subject.

Adrenergic beta-Agonists↗
PubMed2003

Treatment of allergic rhinitis during pregnancy.

Allergic rhinitis is a frequent problem during pregnancy. In addition, physiological changes associated with pregnancy can affect the upper airways. Evidence-based guidelines on the management of allergic rhinitis have recently been published, the most recent being the Allergic Rhinitis and its Impact on Asthma (ARIA)--World Health Organization consensus. Many pregnant women experience allergic rhinitis and particular attention is required when prescribing drugs to these patients. Medication can be prescribed during pregnancy when the apparent benefit of the drug is greater than the apparent risk. Usually, there is at least one drug from each major class that can be safely utilised to control symptoms. All glucocorticosteroids are teratogenic in animals but, when the indication is clear (for diseases possibly associated, such as severe asthma exacerbation), the benefit of the drug is far greater than the risk. Inhaled glucocorticosteroids (e.g. beclomethasone or budesonide) have not been incriminated as teratogens in humans and are used by pregnant women who have asthma. A few histamine H(1)-receptor antagonists (H(1)-antihistamines) can safely be used as well. Most oral decongestants (except pseudoephedrine) are teratogenic in animals. There are no such data available for intra-nasal decongestants. Finally, pregnancy is not considered as a contraindication for the continuation of allergen specific immunotherapy.

Administration, Inhalation↗
PubMed2002

ERASM, a pharmacoepidemiologic survey on management of intermittent allergic rhinitis in every day general medical practice in France.

BACKGROUND: The actual management of intermittent allergic rhinitis is still little known about, despite the disease being very prevalent. We used a cross-sectional survey to address this issue in everyday general medical practice in France. METHODS: A total of 1321 general practitioners enrolled 3026 patients consulting for a spring exacerbation of allergic rhinitis. Both doctors and patients filled out a specific questionnaire on allergic rhinitis. RESULTS: These patients consulted their doctor two-and-a-half weeks, on average, after the onset of their symptoms. They were bothered for an average of six days per week (5.9 +/- 1.7 days) and for two months per year (8.7 +/- 7.7 weeks) by symptoms which largely exceed the ENT (ear, nose and throat) field, with ocular symptoms (51.7%), pharyngeal irritation (39.0%), cough (30.8%), or respiratory discomfort (17.9%). Of these patients 79.2% had some impairment of their professional life and 91.8% of their daily life. Fifty percent of patients knew to what allergens they were allergic; only 11.1% had additional laboratory tests and 10.3% had subsequent specialist consultation (for most this was with an allergologist). Prescribed drugs were oral antihistamines (92.4%) and nasal glucocorticosteroids (45.2%). Prescriptions were written for a duration of six weeks on average. Seventy-nine percent of patients considered that the information they had received was adequate and easy to understand, but 58.2% of patients would have liked more advice. Furthermore, only 54.7% followed their doctor's prescription scrupulously, and 44% used frequent self-medication. CONCLUSIONS: Intermittent allergic rhinitis is a real health problem because of its increasing prevalence, the induction of impaired quality of life and loss of performance, especially at work. General practitioners play a major role in this disorder; they make the diagnosis, start the treatment, give the relevant information, and monitor most of the patients.

Adult↗
PubMed2002

Drug allergy diagnosis work up.

Drug hypersensitivity reactions are a daily worry for clinicians. The tools allowing a definitive diagnosis are few and poorly validated. They include a thorough clinical history, standardized skin tests, reliable biological test, and sometimes drug provocation tests. These tools are currently being evaluated by the European Network of Drug Allergy, under the aegis of the EAACI drug hypersensitivity group of interest.

Drug Hypersensitivity↗
PubMed2001

Overexpression of the human glucocorticoid receptor alpha and beta isoforms inhibits AP-1 and NF-kappaB activities hormone independently.

The human glucocorticoid receptor isoforms GRalpha and GRbeta are generated by alternative splicing. Upon hormone binding, GRalpha regulates positively or negatively transcription. In particular, it represses numerous genes encoding pro-inflammatory mediators by inhibiting the transcription factors activator protein (AP)-1 and nuclear factor (NF)-kappaB. The observation that GRbeta, which does not bind the hormone, may act as a dominant negative receptor is subject to controversy. Because GRbeta must be more abundant than GRalpha to act as such, we evaluated the relative amounts of GRalpha and GRbeta in COS-1, A549 and HeLa cells using a monoclonal antibody that recognises the two isoforms equally well on western blots. Messenger RNA levels of GRalpha and GRbeta were compared by reverse transcriptase polymerase chain reaction analysis. To gain insight into the possible function of GRbeta, we examined the ability of overexpressed GRbeta to alter transcription of glucocorticoid, AP-1 and NF-kappaB inducible reporter genes using transient transfection in COS-1 and A549 cells. Subcellular localisation of GRbeta was determined in A549 cells by immunofluoresence microscopy. Data indicate that GRalpha is the predominant endogenous isoform in A549 and HeLa cells. GRbeta became the major form after transfection with the corresponding expression vector and translocated into cell nuclei even in the absence of hormone. Overexpression of GRbeta inhibited glucocorticoid-induced transcription markedly in COS-1 cells but weakly in A549 cells. We found that GRbeta did not act as a dominant negative modulator of GRalpha for repression of AP-1 and NF-kappaB activities. In fact, both GRbeta and GRalpha inhibited hormone-independently these activities by 25-60%. This property was not shared by the closely related mineralocorticoid receptor. Our results suggest that overexpression of either GRalpha or GRbeta may have an anti-inflammatory effect.

Animals↗