#Allergy & Immunology Case reports

[firstmedicaldiagnosticspvtltd]

WHY IMUPRO?

Your building blocks for better health

GOLD STANDARD OF IgG TESTING FOR DELAYED FOOD ALLERGIES

The German manufacturer R-Biopharm AG is leader in Clinical diagnostics and Food & feed analysis

More than 15 years of experience in IgG testing

R-Biopharm AG is ISO certified (ISO 9001 and ISO 13485)

Kits are CE marked

Standard curve calibrated against the international reference preparation “1st WHO IRP 67/86 for human IgG”

Yearly interlaboratory tests

Excellent reproducibility of the test results

Standardized production of allergens

Close cooperation with international scientific experts from nine countries

SOPHISTICATED DOCUMENTS FOR THE PATIENT

TO FACILITATE THE THERAPIST’S DAILY WORK!

Detailed report

Personal nutritional guidelines

Individualized recipes (ImuPro Complete)

CONVINCING CONCEPT FOR SATISFIED PATIENTS

AND MEDICAL SUCCESS

Improved concept developed on the basis of hundreds of thousands of patients’ cases and doctors’ experiences

(3 phases: elimination, provocation, rotation)

Helps the patient to find his personal trigger foods

Patient documents are highly personalized

The ImuPro concept comprises the key to avoid malnutrition: rotation of all tolerated foods

guaranteed varied diet supplying all necessary micro-nutriments and avoiding monotony

helps to avoid unintended nutritional mistakes

(the guidelines point out in detail which products might be hidden in which processed foods)

helps to avoid the appearance of IgG to newly introduced

WHY CHOOSE IMUPRO?

IT WORKS • IT´S ACCURATE • IT´S INDIVIDUAL

WHY IgG INSTEAD OF

IgA OR IgG4?

Your building blocks for better health

Some laboratories and manufacturers use IgA to detect a delayed food allergy. Does this make sense?

Which antibody is best to detect a delayed food allergy?

OVERVIEW OF THE FUNCTIONS OF IgA, IgG4 AND IgG

IgA

Principal isotype in secretions (esp. mucus epithelium of the intestinal and respiratory tracts)

Neutralizing antibody against bacteria and toxins “first line of defense” with short half-life time (~6 days)

Weak activator of complement and opsonisation – bound antigens are removed by macrophages with little to no inflammation

Operates mainly on epithelial surfaces where complement and phagocytes are normally not present

Is believed to act as a „discrete housekeeper“, in which foreign antigens are bound by IgA into complexes and removed by the

macrophages, but with little or no resultant inflammation

Less specific antigen binding site than IgG, e.g. higher cross reactivity and more false positives

IgG4

Antibody involved in the desensotisation of type I allergies (IgE)

The guideline of the EAACI (European Academy of Allergy and Immunology) states that testing for IgG4 is not

recommended for the detection of delayed food allergies (https://www.ncbi.nlm.nih.gov/pubmed/18489614).

Biochemically difficult to measure due to very low IgG4 concentrations and specificity of detection antibodies against IgG4

Indicates tolerance not hypersensitivity

Is not able to induce inflammation

Is an anti-inflammatory antibody triggered by IL-10 (an anti-inflammatory cytokine)

IgG

Principal isotype in the blood and extracellular fluid, where accessory cells and molecules are available

Efficiently opsonises pathogens for engulfment by phagocytes and activates the complement system

Persistent antibody with a half-life time of 20 days

Induces inflammation

Vojdani* found a parallel in development of IgG and IgA antibodies to food, although less elevated levels

for IgA and in some cases no IgA response could be seen. In none of the cases presented, IgA was

positive alone; thus there seems to be no necessity to test for IgA alone.

* Detection of IgE, IgG, IgA and IgM antibodies against raw and processed food antigens.

Aristo Vojdani Nutrition & Metabolism 2009, 6:22

WHY CHOOSE IMUPRO?

• THERE IS NO ADDITIONAL BENEFIT IN MEASURING IgA TOO!

• MEASURING IgG4 IS NOT A RELEVANT MARKER FOR DELAYED FOOD ALLERGIES!

• IgG IS THE RELEVANT PARAMETER FOR IDENTIFYING POTENTIAL DELAYED FOOD

ALLERGIES IN THE HUMAN BLOOD!

IMUPRO AND COMPETITORS

Your building blocks for better health

Why ImuPro is the gold standard of IgG testing for delayed food allergies

TECHNICAL INFORMATION

ImuPro

ELISA (Enzyme-linked immunosorbent assay) as a commonly accepted, accurate lab detection method

Reliable and reproducible test results due to standardized procedures and simple pre analytical procedures.

Robust sample matrix. No cell based assays, which might be subject to difficult pre-analytical procedures

Extensive technical validation (related to CLSI guidelines) of the single parameters (foods)

Detection of the relevant biological marker (IgG)

Standardized calibration curve according to 1st WHO IRP 67/86 for human IgG

Calibration curve on each plate to avoid plate-to-plate variations

Highly standardized and certified allergen production

Pool test of food antigens avoided, to ensure most reliable information for each food stuff

Quality control through annual Inter laboratory comparisons

Competitors:

Various detection methods. Some are not generally accepted such as e.g. Bioresonance Therapy or Hair Testing

Some competitors use complex and potentially less reliable test principles, such as cell based assays.

To our knowledge, no or very basic technical validation data

Some competitors claim to measure IgG4 or IgA

Calibration curve according to 1st WHO IRP 67/86 for human IgG : Unclear / not standardized

Calibration curve: several competitors either use only one curve or only use a one point calibration.

Standardization of allergen production: No / not known

Competitors often use pool tests to maximize the number of tested foods

Interlaboratory tests: To our knowledge, the competitors do not conduct such tests

CONCEPT AND PATIENT CARE

ImuPro

Comprehensive post-test guidance for patients

Provocation challenge test as integrational part of the ImuPro concept

Provocation enables the accurate identification of actual trigger foods

Stabilization phase helps the patients to permanently improve their condition

Several clinical trials conducted with ImuPro

Comprehensive scientific support and advice

Competitors:

No defined provocation concept

No provocation challenge test

No definite identification of trigger foods

Stabilisation phase is not part of their concepts

Very few publications

If support at all, then very brief

[themomsandthecity]

Is It Safe to Take Allergy Medication While Pregnant? Experts Weigh In

Being pregnant is tough, in more ways than one. It's so draining that it almost feels unfair that you can get sick while being pregnant. Especially considering that when you're under the weather, many of the medicines that you'd normally reach for are totally off limits. Case in point: allergy medications. More than 50 million people in the US experience allergies yearly, according to the American College of Allergy, Asthma & Immunology, and those allergies don't go away during the nine-plus months you're pregnant. In fact, while as many as 33 percent of people say their symptoms lessen during pregnancy, the other two-thirds say they stay the same or get worse, according to the Allergy & Asthma Network. That group are left wondering: can you take allergy medicine while pregnant? The reality is that not all medications are safe or recommended for pregnant people to take. That's why it's so important to talk to your doctor about the best options for your symptoms. We asked experts to give us an overview of taking allergy medicine while pregnant, but every person is different and nothing beats getting individualized advice. Editor's note: This information in this article is not medical advice. You should always consult your doctor regarding matters pertaining to your health and before starting any course of medical treatment, especially when you're pregnant. Can You Take Allergy Medicine While Pregnant? The good news is that there are allergy medications available that are safe for pregnant people to take, according to experts. "Many over-the-counter allergy medications can be used to safely treat allergy symptoms during any trimester of pregnancy," Sarah McBane, PharmD, a clinical professor at UC Irvine's School of Pharmacy & Pharmaceutical Sciences, tells PS. A 2021 article in the journal Allergy reports similarly, citing several studies that show antihistamines are "widely prescribed during pregnancy for various indications" and "that the literature regarding antihistamine safety . . . is reassuring" for second-generation antihistamines, a medication classification used to treat symptoms of allergies. Likewise, there are some cases where first-generation antihistamines might be favored despite having more sedating properties. But Dr. McBane also emphasizes that other options exist. "The best medication for a pregnant or breastfeeding individual with allergy symptoms is not always an oral medication," she says. Instead, she suggests talking to your care team about eye drops or nasal sprays to treat your most irritating symptoms, which might be a better and lower-risk option. "Since these medications are not taken by mouth, much less of them gets into a pregnant or breastfeeding individual's system and therefore lessens any potential exposure to a developing fetus or breastfeeding infant," she says. Dr. McBane emphasizes it's "always best to speak with a pharmacist or physician before taking any medications during pregnancy or while breastfeeding." Worth mentioning: when it comes to the safety of allergy-medication use during pregnancy, vague language like "may be safe" is often used. The Association of American Medical Colleges explains that because pregnant people are generally excluded from clinical trials, safety data is often collected through retrospective analysis. However, that doesn't mean there aren't safe options available - but it does indicate that it's always a good idea to check in with your doctor or pharmacist, who can weigh in on your specific circumstances on which medications, if any, would be best. Find more info on specific oral medications below. Can You Take Benadryl While Pregnant? "Benadryl, also called diphenhydramine, is a first-generation antihistamine," Dr. McBane says. "It tends to make people drowsy and may cause side effects such as dry mouth or constipation." She explains that taking Benadryl is considered to be safe during pregnancy; however, she… https://www.popsugar.com/family/allergy-medicine-while-pregnant-49048432?utm_source=dlvr.it&utm_medium=tumblr

[reasoningdaily]

A Decongestant in Cold Medicines Is Ineffective. Here’s What to Use Instead.

Cold season just got trickier.

On Tuesday, an advisory committee to the Food and Drug Administration unanimously said that a popular ingredient found in oral cold and allergy decongestants is ineffective.

The F.D.A. will make its own decision on whether to remove medications containing the ingredient, phenylephrine, which is found in products like Sudafed P.E., NyQuil Severe Cold & Flu and Tylenol Cold & Flu Severe. But in the meantime, and as cold and flu season approaches, consumers will need to weigh their options.

If I take a medicine with phenylephrine, am I at risk?

The advisory committee focused on oral medications that contain phenylephrine; nasal sprays with phenylephrine are still considered effective. If you have oral medications with the ingredient, they are not necessarily harmful at their recommended doses, and some may contain other ingredients that can be helpful.

“It’s not a safety issue. It’s an effectiveness issue,” said Dr. Mark Dykewicz, an allergist and immunologist at Saint Louis University School of Medicine.

But you still may want to look for alternatives. “Me, personally, I wouldn’t want myself or my kid to take anything that’s unnecessary and that’s demonstrated ineffective,” said Jennifer Le, a member of the advisory committee and a professor of clinical pharmacy with the Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of California, San Diego.

If I want to relieve congestion, what ingredients should I look for instead?

Pseudoephedrine, which is found in behind-the-counter products like Sudafed, is effective at clearing congestion, Dr. Dykewicz said; just keep in mind that it can come with side effects. Some people taking the medication report trouble sleeping, feeling jittery or elevated blood pressure, he said.

Nasal decongestant sprays like Afrin or those that contain phenylephrine can also offer relief, Dr. Dykewicz said — but you shouldn’t use them for longer than three to five days. After that, you run the risk of rebound congestion: when the mucosal surfaces in your nose swell, making you feel even more clogged up than before. There are some sprays that you can use for longer stretches, without the rebound risk, namely steroid sprays that contain ingredients like fluticasone (Flonase) or triamcinolone (Nasacort), which are available over-the-counter.

If allergies are the source of your congestion, oral antihistamines like Zyrtec, Claritin or Allegra might help. You can pinpoint whether your stuffy nose comes from allergies or a viral infection, like the cold and flu, by paying attention to other symptoms, said Dr. Mark Aronica, an allergy and immunology specialist at the Cleveland Clinic. If you also have a sore throat, fever or body aches, it’s likely something other than allergies.

Can I treat congestion without medication?

In many cases, you can treat a stuffed-up nose by standing in a steamy shower or using a humidifier to help clear your nasal passages, Dr. Le said. A nasal saline spray can also help clear out irritants and mucus trapped in the nose, said Dr. Andrew Lane, director of the Johns Hopkins Sinus Center.

“You can’t do too much saline,” Dr. Lane said.

Neti pots are another useful tool to irrigate your sinuses, Dr. Aronica said, although you should be careful to use sterile or distilled water.

But if congestion is interfering with your ability to get through the day, or if you find yourself suffering for multiple days on end, you may want to seek out other options, Dr. Le suggested.

Will cold medicines containing phenylephrine be off the shelves soon?

The F.D.A. has not issued a final decision, and it could be some time before the agency announces whether it will pull medications that have phenylephrine. “The process will take a lot,” Dr. Le said.

[myfeeds]

New genetic disorder that causes susceptibility to opportunistic infections

The discovery, reported Jan. 20 in the journal Science Immunology, will help identify people who carry this in-born error of immunity (IEI). “Our findings will provide the basis for genetic diagnosis and preventive treatment for these groups of patients,” Martínez-Barricarte said. IEIs, also known as primary immunodeficiencies, are genetic defects characterized by increased susceptibility to infectious diseases, autoimmunity, anti-inflammatory disorders, allergy, and in some cases, cancer. To date, 485 different IEIs have been identified. It is now thought that they occur in one of every 1,000 to 5,000 births, making them as prevalent as other genetic disorders, including cystic fibrosis and Duchene’s muscular dystrophy. Despite recent medical advances, about half of patients with IEIs still lack a genetic diagnosis that could help them avoid debilitating illness and death. That’s why this research is so important. The error in this case is a mutation in the gene for the protein IRF4, a transcription factor that is pivotal for the development and function of B and T white blood cells, as well as other immune cells. As a postdoctoral fellow at The Rockefeller University, Martínez-Barricarte was part of an international research team that, in 2018, identified an IRF4 mutation associated with Whipple’s disease, a rare bacterial infection of the intestine that causes diarrhea, weight loss, and abdominal and joint pain. Martínez-Barricarte is now an assistant professor of Medicine in the Division of Genetic Medicine, and of Pathology, Microbiology & Immunology in the Division of Molecular Pathogenesis. In 2020, after moving his lab to VUMC, he began collaborating with Aide Tamara Staines-Boone, MD, and her colleagues in Monterrey, Mexico. They were caring for a young boy who was suffering from severe and recurrent fungal, viral, mycobacterial, and other infections. Martínez-Barricarte and his team sequenced the protein-encoding regions of the boy’s genome and discovered a de novo IRF4 mutation, which originated in the patient and was not inherited from his parents. Upon consulting with IRF4 experts at the Imagine Institute for the study and treatment of genetic diseases in Paris, they were told that seven other groups were independently characterizing the same mutation. They now collaborate as the IRF4 International Consortium. In the current study, the consortium identified seven patients from six unrelated families across four continents with profound combination immunodeficiency who experienced recurrent and serious infections, including pneumonia caused by the fungus Pneumocystis jirovecii. Each patient had the same mutation in the DNA-binding domain of IRF4. Extensive phenotyping of patients’ blood cells revealed immune cell abnormalities associated with the disease, including impaired maturation of antibody-producing B cells, and reduced T-cell production of infection-fighting cytokines. Two knock-in mouse models, in which the mutation was inserted into the mouse genome, exhibited a severe defect in antibody production consistent with the combined immune deficiency observed in the patients. The researchers also discovered the mutation had a “multimorphic” effect detrimental to the activation and differentiation of immune cells. While the mutant IRF4 binds to DNA with a higher affinity than the native form of the protein (in a hypermorphic way), its transcriptional activity in common, canonical genes is reduced (hypomorphic), and it binds to other DNA sites (in a neomorphic way), altering the protein’s normal gene expression profile. This multimorphic activity is a new mechanism for human disease. “We anticipate that variants with multimorphic activity may be more widespread in health and disease,” the researchers concluded. Co-authors from Martínez-Barricarte’s lab included graduate students Jareb Pérez Caraballo and Xin Zhen, and research assistant Linh Tran. His research was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (grant #AI171466).

[hilaris1]

Clinical and Medical Case Reports

The Journal provides wide scope and communicates latest case studies on multitude of human diseases and disorders. The Journal offers an excellent online open access platform for clinical practitioners to share their latest clinical finding and critical observations. The journal aims to cover new and unexplored areas of clinical approaches to expand the current knowledge base by encouraging reporting diverse case studies on diagnosis, symptomatology, treatment and management across all major medical disciplines. The Journal was established in the year 2017 and had successfully compiled four volumes at bimonthly frequency.  In 2020, the Journal has published articles on oncology, immunology, neurology, diabetic nephropathy, obstetrics, and timeline monitoring of adverse  effects of enzyme inhibitors and receptor blockers. Interested authors can submit their manuscripts at https://www.scholarscentral.org/submissions/clinical-medical-case-reports.html  or can send as an e-mail attachment to the Editorial Office at editorialoffice@hilarispublisher.com. The journal offers several advantages to the contributing authors such fast allocation (within 72 hr) of manuscript ID, seamless manuscript processing based on secure and transparent editorial tracking and review system, relatively faster turnaround time (average 3 weeks), language assistance, as well as post-production promotion including Pubmed posting for NIH funded articles.  

[sciencenewsforstudents]

Chiggers are a common summertime irritation. These tiny parasites — a type of mite — can leave itchy, red spots on the skin. And that itch can be so severe that it drives people to distraction. But a new report suggests these mite bites might trigger even bigger problems: an allergy to red meat.

Chiggers are the larvae of harvest mites. These tiny spider relatives hang out in forests, shrubs and grassy areas. Adult mites feed on plants. But their larvae eat skin. When people or other animals spend time in — or even just walk through — areas with chiggers, the larvae may drop or climb onto them.

Once the larval mites find a patch of skin, they inject saliva into it. Enzymes in that saliva help break down skin cells into a gloopy liquid. Think of it as a smoothie that chiggers slurp up. It’s the body’s reaction to those enzymes that make the skin itch.

But the saliva may contain more than just enzymes, finds Russell Traister. He works at Wake Forest Baptist Medical Center in Winston-Salem, N.C. As an immunologist, he studies how our bodies respond to germs and other invaders. Traister teamed up with colleagues at Wake Forest and the University of Virginia in Charlottesville. They also worked with an entomologist, or insect biologist, at the University of Arkansas in Fayetteville. The group reported on three cases of people who developed allergies to red meat after a skin infestation of chiggers. Such allergies had previously been seen only after tick bites.

The body detects an invader

How could a chigger’s dining on skin make the body later react to eating meat? Red meat comes from mammals. And the muscle cells of mammals contain a carbohydrate made from small sugar molecules known as galactose (Guh-LAK-tose). Scientists call this muscle carb “alpha-gal” for short.

Meat is rich in muscle. Normally, when people eat red meat, its alpha-gal stays in their gut, where it causes no problem. But some critters, such as the Lone Star tick, have alpha-gal in their saliva. When these ticks bite someone, that alpha-gal gets into their blood. The victim’s immune system can react as though alpha-gal is some germ or other invader. Their body then creates lots of antibodies against alpha-gal. (Antibodies are proteins that help the immune system respond quickly to what the body views as a threat.)

The next time these people eat red meat, their bodies are primed to react — even though that alpha-gal poses no real harm. Such immune responses to non-threatening things (like pollen or alpha-gal) are known as allergies. Symptoms may include hives (big, red welts), vomiting, a runny nose or sneezing. Affected people may even go into anaphylaxis (AN-uh-fuh-LAK-sis). This is an extreme allergic reaction. It makes the body go into shock. In some instances, it can cause death.

Allergic reactions to alpha-gal are tricky to identify. They only show up several hours after eating meat. So it can be hard for people to realize the meat was responsible.

Hunting down the cause

Traister and his team knew tick bites could trigger alpha-gal allergies. It’s not very common, but does happen. So when they met three patients who had recently developed the allergy, it wasn’t too surprising. Except that none had recent tick bites. What each patient did have in common: chiggers.

One man became allergic after his skin had become infested by hundreds of chiggers while hiking. He had been bitten by ticks years earlier. But his meat allergy only showed up after the chigger encounter — soon after.

Another man had worked near some shrubs. He found dozens of tiny red mites on himself. His skin also developed the telltale red blotches from some 50 chigger bites. A few weeks later, he ate meat and for the first time ever reacted by breaking out in hives.

And a woman similarly became allergic to meat after chigger bites. Although she too had suffered tick bites years earlier, her meat reaction emerged only after the chiggers.

Traister’s group described these cases July 24 in The Journal of Allergy and Clinical Immunology: In Practice.

Could this be mistaken identity?

It might seem these chigger encounters were clearly behind the new cases of alpha-gal allergy. But Traister cautions that it can be hard to know for sure. Chiggers look a lot like “seed ticks” — the tiny larvae of ticks. The skin reaction to each also looks similar and becomes equally itchy.

For these reasons, Traister says, “It is easy for a layperson to misidentify [what] has bitten them.” And that, he adds, makes it difficult to prove chiggers caused the meat allergy. Still, the circumstances certainly suggest the three new cases got their meat allergy from chiggers. Two of them even described their attackers as red — the color of adult mites. The researchers also questioned several hundred other people with alpha-gal allergy. Some of them, too, said they never had been bitten by a tick.

“The notion of chiggers causing red-meat allergy makes sense,” says Scott Commins. He is an immunologist at the University of North Carolina in Chapel Hill. He was not involved with the study but notes that chiggers and ticks share some habits. “Both can take blood meals through the skin,” he says, “which is the ideal route to create an allergic response.”

The researchers are working to figure out whether chiggers are the source of some alpha-gal allergies. Fortunately, it’s not something to get too worried about. “Overall, this allergy is very rare,” Traister says. Few people infested by ticks or chiggers ever become allergic to meat.

[orcinus-ocean]

1. Vaccination And Immunization Are The Same

 What the vet says:

“Prevention is better than cure. Vaccination is the way we cause animals to become resistant (immune) to infections. A vaccine consists of a modified or killed virus or bacterium. It is prepared in such a way that the body’s defenses recognise it as a threat and react to it as if it were a real infection. The body will produce antibodies which are proteins which recognise and attach to chemicals on the surface of the organism, killing it. These antibodies are then available to kill any of the real infection organisms the animal might pick up during its life. They are lost gradually and the body needs occasional reminders (booster vaccinations) to keep the antibody level high enough to prevent real infections. Vaccination reactions are very rare. A booster is recommended each year.“

Our issue with this advice:

The body doesn’t react to a vaccine the same way it would to the real disease.

When exposed to a real virus, the body forms immunity by filing that information away in memory cells. The memory cells, called cellular immunity, are responsible for mounting a quick attack the next time they are faced with the same disease and the body, armed with the knowledge the memory cells have stored away, quickly neutralizes the disease by triggering circulating antibodies. This is why humans only get chicken pox once and dogs can only get parvovirus once. After the first episode, they’re protected for life.

Vaccines try to emulate this, but they don’t do a complete job.

Vaccines stimulate circulating antibodies, called humoral immunity, and they bypass the memory cells. This creates an artificial immunity called humoral bias and this essentially turns the immune system inside out.

To learn more about this effect, read our article on Vaccines And The Immune System.

But the real problem with this statement is their desire for antibody levels to be high. High antibody levels mean high levels of circulating antibodies – or humoral bias.

The higher the titer, the more chronically inflamed the body is.

This humoral bias and resulting chronic inflammation result in many of the autoimmune diseases we commonly see in dogs today: allergies, cancer, arthritis, diabetes, bowel disease and many, many more. Vaccine reactions may be rare, but the risk and severity of chronic disease that vaccines cause increase with each and every vaccine given.

2. Vaccinating Puppies At 6 Weeks Of Age

 What the vet says:

“Your puppy vaccination course should be started at 6 weeks of age. A primary vaccination is first given and a booster 2-4 weeks later. This course must be completed before your puppy is fully protected. Unfortunately, the protection provided by vaccinating is not life-long and hence an annual booster is recommended. At XXXX veterinary clinic we will send you out an annual reminder to ensure your pet is kept up to date and protected.”

Our issue with this advice:

Vaccinating a puppy at 6 weeks? According to veterinary vaccine researcher Dr Jean Dodds, only 30% of puppies will be protected from a vaccine given at 6 weeks of age.

100% of them will be exposed to disease when taken to the vet clinic for that shot.

Moreover, vaccines create immune suppression for 10 to 14 days.

So, choosing to vaccinate a puppy at 6 weeks means exposing him to the most disease-ridden location he could possibly be in – the vet clinic – while creating immune suppression at the same time. Your puppy is much more likely to get the disease he is being vaccinated for, and all in exchange for a 30% chance the vaccine will work.

That’s a pretty high gamble with a puppy’s life.

The reason the vaccine is unlikely to work at that young age is because the puppy is protected against disease with maternal antibodies – immunity passed down from his mother. This protection wanes over time, but is still pretty strong at 6 weeks. That’s why in most cases the vaccine doesn’t work at this age: the maternal antibodies are strong enough to block the vaccine.

Here is problem number two with vaccinating at that age: the maternal antibodies will be less effective after the vaccine is given because vaccines cause immune suppression.

We also object to this statement: “This course must be completed before your puppy is fully protected.” There are two problems with this statement actually.

You can’t be partially protected: immunity is like being a virgin, you either are or you aren’t. Either the immune system has filed that information away or it hasn’t: there is no grey area, you are either immune or you are not.

As for the other problem, a course of vaccines is not necessary: it only takes ONE vaccine to protect a puppy – ONE AND DONE.

For more information on this, you might want to read Taking The Risk Out Of Puppy Shots.

3. Lifelong Immunity

 What the vet says:

“Primary pet vaccinations do not cover your animal for the rest of their life, so annual booster vaccinations are required for continued protection.”

Our issue with this advice:

Wow, bad grammar aside, there’s one very big problem with this statement – a monumental problem of biblical proportions!

Not only do core vaccines last for years, some for the life of the animal, vets have known about this for about forty years!

We won’t even go into why annual vaccination is a very, very bad choice – because vaccinating every three years or every five years is also a bad choice based on unsound science.

Why would you vaccinate every year if the minimum immunity starts at 7 years? Why put your dog at risk?

Nuff said.

4. Revaccination Is Backed By Research

 What the vet says:

“At XXXX Veterinary Hospital, we are aware of some of the controversy currently surrounding immunization protocols. However, until industry leaders and experts, such as the vaccine manufacturers and the American Veterinary Medical Association (AVMA), arrive at some definitive conclusions, we believe it to be in the best interest of your pet and the general public to continue to adhere to our established immunization protocols. We recommend that your pet should receive annual boosters.”

Our issue with this advice:

Controversy? Industry leaders and experts?

Here is the crux of the problem: these vets are waiting for the vaccine manufacturers, AAHA and the AVMA to decide how often to vaccinate. Don’t you think that all of these entities have a financial interest in how often you vaccinate your dog?  Are they capable of making an unbiased recommendation?

Apparently, they aren’t.

The report of the American Animal Hospital Association Canine Vaccine Taskforce in JAAHA (39 March/April 2003) includes the following information for vets:

Misunderstanding, misinformation and the conservative nature of our profession have largely slowed adoption of protocols advocating decreased frequency of vaccination; Immunological memory provides durations of immunity for core infectious diseases that far exceed the traditional recommendations for annual vaccination.

This is supported by a growing body of veterinary information  as well-developed epidemiological vigilance in human medicine that indicates immunity induced by vaccination is extremely long lasting and, in most cases, lifelong.

And the American Animal Hospital Association’s own Preventive Healthcare Guidelines state:

Tailor vaccination protocols to your pet. While some vaccines, like rabies, are required by law because of the risk to humans, others may be necessary for your pet’s lifestyle. In some scenarios, a titer to previous vaccines can be measured to help decide if a booster vaccination is necessary. Your veterinarian will know what’s best for your pet.

If you would like to read more about how vets arbitrarily chose the period of three years for revaccination, even though they knew back in 2003 that vaccines lasted likely for the life of the dog, read Lifelong Immunity And The AAHA Revaccination Guidelines.

5. Your Vet Is A Vaccine Expert

What the vet says:

“Annual boosters are painless for your pet, and help to fight off contagious illnesses throughout the year. The staff at XXXX Veterinary Clinic are expertly trained in the welfare of your pet.”

Our issue with this advice:

Any vet who advocates annual vaccinations – or even uses the term booster – is clearly not expertly trained in immunization or the welfare of your pet.

In fact, most vets are woefully inept when it comes to understanding immunity. (We already talked about this above)

They are very good at giving vaccines – yet most vets are not taught very much about immunity at all.

Perhaps that’s because immunity is taught by the vaccine manufacturers. It’s no wonder that vets are well armed with needles yet lack the knowledge or motivation to question just what damage those needles are doing.

And even if they acknowledge the research that proves annual vaccines are unnecessary, most are not willing to lose the profits those yearly visits bring in.

If you would like to learn more about how little vets feel they were taught about vaccination, and the diseases they’ve seen vaccines cause in their patients, read our ground-breaking featured article, Vets On Vaccines.

In the end, it doesn’t matter whether vets continue to dispense this bad advice out of ignorance or for financial gain (most veterinary practices earn 14% of their income from vaccines). Either way, the bad advice is out there and dog owners – and dogs – will fall victim to that bad advice every day.

If you find your vet dispensing bad vaccine advice, don’t ignore it.  Perhaps reading and sharing What Every Vet (And Pet Owner) Should Know About Vaccines will help you both to begin understanding that immunity involves more than just shots and boosters.

[alwaysfirst]

Children with primary immunodeficiency may be at higher risk of serious Covid-19 complications

Sep 19, 2022 05:44 IST Washington , September 19 (Always First): According to a new study, children with specific immunodeficiency illnesses have abnormalities in genes that regulate the body's immune system against viral infections and have a higher death risk owing to COVID-19. The study was published in the Journal of Allergy and Clinical Immunology. Most children infected with the SARS-CoV-2 coronavirus develop a mild illness or show no symptoms at all. But for a small percentage, serious complications may develop. "Mortality is much higher among children with primary immunodeficiency diseases infected with SARS-CoV-2. Our results indicate that basic immunological examination and genetic analysis should be conducted in children with severe COVID-19 or multi-inflammatory syndrome (MIS-C). The clinicians will then be able to help these children with more precise therapies based on their genetic changes,"says Qiang Pan-Hammarstrom, professor at the Department of Biosciences and Nutrition, Karolinska Institutet, who led the study. How the infection affects patients with primary immunodeficiency diseases, i.e. hereditary and congenital diseases of the immune system, is controversial. Even among these patients, some suffer from severe COVID-19 while others experience mild or no symptoms. To investigate this more closely, and try to find genetic explanations for severe forms of COVID-19, researchers from Karolinska Institutet have studied young patients with primary immunodeficiency diseases (also called inborn errors of immunity, IEI) who developed severe or critical SARS-CoV-2 infection. Genetic and immunological analyses were performed. "Our results clarify the molecular mechanism of these immune diseases, which opens up the possibility of developing a more targeted therapy. The knowledge acquired from the study also allows us to develop better strategies for the treatment and prevention of severe COVID-19 disease in these patients," says Qiang Pan-Hammarstrom. The study included 31 children aged five months to 19 years. All children had some type of primary immunodeficiency disease without a molecular diagnosis and suffered from severe or critical COVID-19. Participants were recruited from August to September 2020 in Iran. None of the children were vaccinated against COVID-19. Eleven of the children, more than one-third, died of complications from the infection. Five children, 16 per cent, met the criteria for multi-inflammatory syndrome, MIS-C. Some of the children lacked antibodies to the coronavirus. "This suggests that many children with this type of immune disease cannot produce antiviral antibodies and therefore would not have the full benefit of vaccination," says Hassan Abolhassani, assistant professor at the Department of Biosciences and Nutrition, Karolinska Institutet, and the study's first author. Genetic analyses showed that more than 90 per cent of the participants, 28 children, had mutations in genes that are important for our immune defense, and that could explain their immunodeficiency. An important mechanism was mutations that affect proteins that regulate the immune system during virus infection, known as interferons. The analyses of the patients' immune responses showed that children with MIS-C had immunological profiles that differ from the profiles of children with primary immunodeficiency but without MIS-C. The study also includes a literature review, where the researchers globally found reports of approximately 1,210 patients with primary immunodeficiency disease and COVID-19. About 30 per cent of them were children. The mortality rate among children with primary immunodeficiency disease and COVID-19 was more than eight per cent, compared with about 0.01 per cent among children in the general population. The study is limited to severe cases of COVID-19, infected with the original strain of the virus, and non-vaccinated children. Further studies are needed to evaluate the importance of different virus variants and vaccines in this patient group. The study was conducted within the research consortium ATAC, funded by the European Commission in response to the COVID-19 pandemic and coordinated by Karolinska Institutet. Collaboration with Uppsala University, Tehran University of Medical Sciences (Iran), Iran University of Medical Sciences, Ahvaz Jundishapur University of Medical Sciences (Iran), North Khorasan University of Medical Sciences (Iran), Howard Hughes Medical Institute (USA), Rockefeller University (USA) and Necker Hospital for Sick Children (France) were also crucial for the implementation of the study. The study was also funded by the Swedish Research Council and the Knut and Alice Wallenberg Foundation. (Always First) Read the full article

[pranalipawarshinde]

Cat Allergy in Humans Market to grow at a CAGR of 6.3% from 2022 to 2031

Cat Allergy in Humans Market Outlook 2031

The global cat allergy in humans market was  valued at US$ 4.2 Bn in 2021

The global market is projected to grow at a CAGR of 6.3% from 2022 to 2031

The global cat allergy in humans market is  anticipated to exceed US$ 7.8 Bn by 2031

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Overview of Cat Allergy in Humans Market

When people are exposed to various pets, such as dogs and cats, they develop a variety of allergies. The most common types of allergies are runny nose, sneezing, nasal congestion, itchy eyes, as well as skin rash. Allergies to cat is a human allergic reaction to allergens produced by cats. Cat allergens of the most common types are Fel d1 (secreted by the cat's sebaceous glands) and Fel d4 (found in the cat's saliva). pet allergy affects nearly 25% of allergic patients due to Fel d1 and Fel d4 proteins. Cat allergens, particularly Fel d1, are abundant in the form of dander and are thought to be a major cause of allergic asthma around the world. The primary treatment for allergic patients is to avoid cats. Certain allergy Treatment and allergy shots, on the other hand, can help control the symptoms of cat allergies.

Rise in Adoption of Cats as Pets to Drive Global Market

Pet humanization is becoming a globally accepted term in the pet industry, as an increasing number of pet owners want to provide their pets with human-like products or experiences. For instance, according to Pet data, in 2018, the adoption rate for dogs in China was 11.8% and 19.9% for cats. Increase in R&D for drugs and vaccines for treatment or prevention of pet allergy is expected to drive the demand across the globe.

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According to data from Allergy, Asthma & Immunology Research, in 2018, allergies to dogs and cats affected 10% to 20% of the global population with allergic rhino conjunctivitis and allergic asthma. Rising prevalence of various types of pet allergies, increasing investment by manufacturers in the development of novel Cat allergy therapeutics, and growing importance of self-medication are primary factors driving the market.

Allergy-causing Genetic Traits to Contribute to Prevalence Rate of Allergy

An article published by Allergy U.K. stated that children born into families with a history of allergies are more likely to develop allergies as compared to other children. Increase in tendency of families and children to develop allergies due to their genetic links is known as ‘being atopic’. Researchers have estimated that half of the children from atopic families are likely to have allergies themselves. However, this rate in children from non-atopic families is 1 in 5 children who may go on to have an allergy.

Along with lifestyle changes, changing climate with increased pollution, CO2 levels, and particulate matter (PM) across the world are pushing the prevalence and intensity of allergies. In 2020, according to the World Allergy Organization (WAO), allergic rhinitis was one of the most prevalent allergies, affecting 400 million people globally.

Preference for Antihistamine Medication Due to Immediate Relief and Easy Availability

In terms of treatment, the antihistamines segment is projected to dominate the market and account for 50% share by 2031. Antihistamines are the first line of treatment in case of pet allergies. They are cost-effective, easily available, and provide immediate relief. Antihistamines treat allergy symptoms such as nasal congestion, runny nose, sneezing, or itching, nasal passage enlargement, hives, and other skin rashes, and itchy, runny eyes. Treating these symptoms can help the patient feel better during the day and sleep better at night. The antihistamine dosage is determined by the allergy symptoms.

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Increase in Prevalence of Allergic Rhinitis to Lead Global Cat Allergy in Humans Market

Based on application, the allergy treatment segment accounted for a major share of 95% of the global market in 2021. Easy availability and low cost of anti-allergy drugs are expected to drive the segment during the forecast period. The growth of the segment is due to rise in prevalence of allergic rhinitis and the expansion of government-funded healthcare programmes to raise awareness about cat litter allergy in humans. Increasing pollution levels around the world as well as distinct genetic changes are driving the allergy treatment segment. Moreover, increase in adoption of immunotherapy to treat pet allergy conditions, owing to good efficacy of therapy is expected to propel the segment over the next few years.

Regional Outlook of Global Cat Allergy in Humans Market

North America dominated the global cat allergy in humans market in 2021. The market in the region is anticipated to grow at a CAGR of 6.1% from 2022 to 2031. The growth of the market in North America can be attributed to high prevalence of cat allergy in humans and increase in pet cat population.

According to the American Academy of Allergy, Asthma, and Immunology, Pet allergies (cat) affect about 15% of the U.S. population each year. In 2014, it was also reported that approximately 14% of children aged 6 to 19 were allergic to cats.

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The market in Asia Pacific is estimated to grow at a notable CAGR rate during the forecast period, due to development of appropriate healthcare infrastructure and rise in awareness about progressive immunotherapy, such as allergen immunotherapy, in allergy treatment. Increase in awareness about pet Allergy is also fueling the market in Asia Pacific.

Analysis of Key Players in Global Cat Allergy in Humans Market

The cat allergy in humans market report concludes with the company profiles section, which includes information about key players in the global cat allergy in humans market. Leading players analyzed in the report include Bayer AG, Covis Pharma B.V, HollisterStier Allergy (Jubilant Pharma, Cipla Limited, GlaxoSmithKline plc, Merck & Co., Inc, Regeneron Pharmaceuticals, Inc, Saiba Animal Health AG, Sanofi, and Stallergenes Greer.

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[unifiedcitationjournals]

Global Journal of Medical & Clinical Case Reports & Studies [GJMCCRS]

Introduction:

A rare symptom of Echinococcus infection is cardiac hydatidosis. It makes up between 0.5 and 2% of all hydatic illnesses. Although it can also affect the right ventricle, atrium, pericardium, interventricular septum, and pulmonary artery, the left ventricle's myocardium is where it most frequently localizes. From clinical delay or modest symptoms to cardiogenic shock and rapid death, clinical presentation varies. The left ventricle's intramyocardial hydatid cyst is described in this case. Hydatid serology and cardiac imaging can help with diagnosis. Surgery and medical treatment with albendazole or mebendazole should be combined in therapy management.

Regarding the Journal:

Reports on clinical and medical cases:

is a peer-reviewed journal that publishes original research projects done as case reports in the medical area on a variety of cases, including each case's specific clinical and diagnosing concerns.

Reports on clinical and medical cases:

is an Open Access Scientific Journal with a fascinating publishing platform that strives to keep scientists, physicians, researchers, and students up to date on the relevant field's ongoing research.To uphold the highest standards of the journal and attain a high impact factor, exceptional publications are encouraged.

Reports on clinical and medical cases:

is utilizing editorial tracking to keep the standard of the peer review process high. An online system for submitting, reviewing, and monitoring manuscripts is called Editorial Manager. The Journal of Clinical Case Reports editorial board members or outside specialists handles reviews. Any citeable paper must receive the approval of at least two independent reviewers before being accepted by the editor. Manuscripts may be submitted, and authors may follow their progression through the system, perhaps leading to publication. Manuscripts can be downloaded by reviewers, who can then provide the editor with their feedback. Editors can oversee the entire submission, review, revision, and publication process.

Abstract:

Although it happens seldom, echinococcosis may cause cardiac involvement, with cysts developing inside or next to the heart's myocardial tissues. Every time there is clinical or radiological suspicion, a thorough differential diagnosis with various mass formations and uncommon cardiac tumors is required. Serology and imaging tests will establish the diagnosis. In all situations, a multidisciplinary approach is required, and surgical intervention is usually necessary. Patients frequently appear with dyspnea and chest discomfort. The postoperative course of each case must be closely monitored while being adequately treated with albendazole (or mebendazole) to prevent recurrences

Impact on the Journal:

The journal disperses original works in the following disciplines, without limitation: Cardiovascular case reports, cancer case reports, clinical pathology case reports, diabetes case reports, nanotechnology case reports, psychology case reports, clinical reviews, immunology case reports, joint fluid analysis case reports, medical case reports, neurology case reports, ophthalmology case reports, stem cell case reports, urology case reports, global health case reports, health care case reports Clinical Reviews, Global Health Reports, Cardiovascular Case Reports, Case Reports in Cancer Science, Case Reports in Clinical Pathology, Case Reports in Nanotechnology, Case Reports in Psychology, medical case reports, immunology case reports, joint fluid analysis, neurology case reports, ophthalmology case reports, stem cell case reports, health care case reports, case reports in clinical studies, Case Reports in Allergy and Clinical Immunology, Clinical and Medical Case Reports, Clinical Case Studies, Medical Case Studies, Case Reports in Clinical Neurology and Neurosurgery, Case Reports in Cancer Research and Clinical Oncology, and Case Reports in Nutrition in Clinical Practice Case Reports in Forensic Medicine, Case Reports in Clinical Genetics, Case Reports in Clinical Immunology, Case Reportsin Clinical and Experimental Dermatology, Case Reports in Clinical and Experimental Medicine, Case Reports in Clinical and Experimental Ophthalmology, Case Reports in Clinical and Experimental Pathology, Case Reports in Clinical and Experimental Biomechanics, and Case Reports in Clinical International Medicine

Conclusion:

An extremely uncommon condition is a cardiac Hydatid cyst. The most prevalent symptom is chest discomfort. The major form of treatment is surgery.

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Reference and blogs

[ftsmanufact]

The Landlord or Contractor About Potential Mold Problems

Copyright ) 2008 Law Offices of Jonathan CooperAlthough I've seen numerous ads screaming "MOLD DESTROYS YOUR HOME AND YOUR HEALTH!", and that 'EXPOSURE TO TOXIC MOLD CAUSES PSYCHOLOGICAL DEPRESSION, FATIGUE, PSORIASIS AND 'MOLD LUNG DISEASE!", the current scientific literature does not support these wholesale claims. As a result, the courts have, with increasing frequency, dismissed those mold claims that do not meet strict evidentiary criteria.  In order to clarify those areas where mold claims are particularly vulnerable, I have compiled the following "Three Deadly Sins" list that should be consulted in evaluating the strength - or weakness - of a mold exposure claim.

Deadly Sin #1 - Failing to Get Appropriate and Timely Clinical Testing that Confirms a Mold AllergyA 2006 peer-reviewed article published by the Journal of Allergy and Clinical Immunology recommends that patients with a suspected mold allergy should undergo an accepted skin or blood test for IgE antibodies to  Christmas fawn countdown mold antigens as part of a clinical evaluation for mold allergies. The findings in this article have been cited by other experts in the relevant medical fields as being necessary to demonstrate a mold allergy. Consequently, when a plaintiff was purportedly unable to support her claims that she sustained various allergic and neurological injuries secondary to mold exposure with these test results confirming her mold allergy, a New York County judge dismissed these claims without allowing them to go before a jury for consideration.Deadly Sin #2 - Failing to Get Appropriate and Timely Environmental Testing that Confirms the Presence of Injury-Inducing MoldThe scientific literature over the last several years has consistently noted that while exposure to certain fungi, or molds, can cause human illness through allergy or hypersensitivity, direct infection by the organism, or toxic-irritant effects from mold byproducts, not all species of mold have been correlated with these reactions.

 Therefore, simply showing pictures depicting apparent mold growth are insufficient to prove mold injury; in order for a mold exposure claim to survive, the plaintiff will likely need to show that specific species of molds, which have been scientifically linked to the particular injuries alleged, were present in sufficient amounts to cause these injuries.Deadly Sin #3 - Failing to Notify The Landlord or Contractor About Potential Mold Problems in The HomeOne of the bedrock principles of the United States tort system is that a landowner may not be held liable for a dangerous condition on his property unless the claimant can prove that the owner either knew, or should have known of this defect, and that it existed for a sufficient length of time prior to the incident complained of to permit the owner's employees to discover and remedy it. This is commonly referred to as the "notice" doctrine. In that regard, there are reported cases from New York's appellate courts stating that even where a landlord is tacitly aware of discoloration of walls, and has knowledge of previous water damage from a flood, neither constitutes "notice" of a likelihood of mold growth. Consequently, unless the owner is specifically notified of a mold condition, the claim may be subject to dismissal.

[mrfrblogresearch02]

Pediatric Healthcare Market In – Depth Analysis of Industry Share, Size, Growth Outlook up to 2027

Pediatric Healthcare Market Overview:

Assaying the market structure, this report accounts for the future growth potential of the market. It characterizes the strategies of the topmost market players in the market and supports the competitive developments like research & developments (R&D), mergers & acquisitions, new product developments,  and joint ventures, in the market.

Pediatric Healthcare Market Size is expected to grow expected to reach US$ 63.6 billion by during the forecast period at CAGR of 4.1%.

The most relevant market driver for the pediatric healthcare market growth is the rising infant mortality rate in the African countries. Other factors leading to the pediatric healthcare pediatric healthcare market growth include decent technological advancement in the Middle East region, government initiatives to improve healthcare sector, heavy malnutrition, demand as well as initiatives to curb malnutrition, massive demand for pediatric medical devices, increasing birth defects among newborn, lack of awareness, increasing demand for pediatric medical devices, efforts by healthcare firms to create awareness among mothers in Africa, high incidence of chronic illnesses among children, high premature birth rate, and rising awareness regarding disease conditions among children.

Pediatric Healthcare Market Top Companies:

Big players in the pediatric healthcare market are Arabian Millennium Medical Trading (AMMT) (Dubai), AstraZeneca (UK), Bristol-Myers Squibb Company (USA), Eli Lilly & Company (USA), Janssen Global Services LLC (Belgium), King Faisal Specialist Hospital & Research Centre (Saudi Arabia), Novartis AG (Switzerland), and VPS Healthcare (UAE).

Pediatric Healthcare Market Segmental Analysis:

Middle East and Africa Pediatric healthcare Market has been segmented on the basis of type of diseases which comprise Short term diseases, chronic diseases, and others. Diarrhea and an increase in injury-related cases are more common in children, so chronic illness is projected to account for the largest share of the pediatric healthcare market. Children's lower immunity leads to an increased demand for chronic disease services.

On the basis of Therapeutics which comprise cardiology, allergy and immunology, gastroenterology, infectious disease, and others. Due to numerous changes in childcare patterns, increased emissions and reduced immunity, an increase in the number of hospitals and clinics dedicated to childcare, and an increase in demand for the sector, the allergy and immunology segment generated the most revenue. On the other hand, metabolic disorders such as obesity and diabetes, which are caused by a sedentary lifestyle caused by a lack of proper food and physical activity, as well as an increase in childhood hunger, are fueling the segment's development.

Pediatric Healthcare Market Regional Overview:

A geographical outlining of the Middle East and Africa pediatric medical devices covers the Middle East region and Africa region.

In the Middle East region, the major markets are Egypt, Saudi Arabia, UAE, Egypt, and others. Although geographically Egypt is located in Africa, this report categorizes it as a part of the Middle East Market.

The major factors that help the market to grow in the Middle East include the development of the healthcare system, increasing support by the government authorities for the development of novel therapies, an increase in education, and the rising importance of diagnosis as well as treatment of diseases. Observing the other countries of Middle East estimates sizable revenue contributions from these countries too.

In Africa, the market is small, but it has a huge potential to attain growth. Due to increasing health problems among infants and children, this region has a huge demand for pediatric medical devices. Not only many government organizations are engaged in the evaluation of healthcare conditions in Africa, but many healthcare firms are undertaking projects such as healthcare camps for women and children in this region. In this region, there is a possibility of South Africa becoming an important market, given the fact that Christian Barnard of this country was the first doctor in the world to perform a heart transplant.

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[didanawisgi]

Abstract

Go to:

Background

Helicobacter pylori (H. pylori) eradication is usually assessed using the 13C-urea breath test (UBT), anti-H. pylori antibody and the H. pylori stool antigen test. However, a few reports have used pepsinogen (PG), in particular, the percentage change in the PG I/II ratio. Here, we evaluated the usefulness of the percentage changes in serum PG I/II ratios for determining the success of eradication therapy for H. pylori.

Go to:

Materials and methods

In total, 650 patients received eradication therapy from October 2008 to March 2013 in our Cancer Institute Hospital. We evaluated the relationship between H. pylori eradication and percentage changes in serum PG I/II ratios before and 3 months after treatment with CLEIA® (FUJIREBIO Inc, Tokyo, Japan). The gold standard of H. pylori eradication was defined as negative by the UBT performed 3 months after completion of eradication treatment. Cut-off values for percentage changes in serum PG I/II ratios were set as +40, +25 and +10% when the serum PG I/II ratio before treatment was below 3.0, above 3.0 but below 5.0 and 5.0 or above, respectively.

Go to:

Results

Serum PG I and PG II levels were measured in 562 patients with H. pylori infection before and after eradication therapy. Eradication of H. pylori was achieved in 433 patients studied (77.0%). The ratios of first, second, third-line and penicillin allergy eradication treatment were 73.8% (317/429), 88.3% (99/112), 75% (12/16) and 100% (5/5), respectively. An increasing percentage in the serum levels of the PG I/II ratios after treatment compared with the values before treatment clearly distinguished success from failure of eradication (108.2±57.2 vs. 6.8±30.7, p<0.05). Using the above cut-off values, the sensitivity, specificity and validity for determination of H. pylori were 93.1, 93.8 and 93.2%, respectively.

Go to:

Conclusion

In conclusion, the percentage changes in serum PG I/II ratios are useful as evaluation criteria for assessing the success of eradication therapy for H. pylori.

Introduction

Pepsinogen (PG) is the inactive precursor of pepsin, specifically produced in the stomach, of which 99% is secreted into the gastric lumen and 1% into the bloodstream [1] [2]. PG mainly comprises two biochemically and immunologically different isozymes (PG I and PG II). PG I is secreted only from the oxyntic mucosa, whereas PG II is secreted from the fundic pyloric and proximal duodenal glands [1] [2]. Recent prospective cohort studies confirmed measurement of serum PG levels before eradication of Helicobacter pylori is useful for assessing the risk of gastric cancer [3]. The production of PG I is considerably reduced or abolished in the case of atrophy of the corpus mucosa and the loss of chief cells as well as parietal cells. By contrast, the serum levels of PG II increase when the gastric mucosa is infiltrated by neutrophils and mononuclear cells in the antrum as a result of H. pylori infection and its extension into the upper stomach [1] [2]. Thus, the ratio of PG I to II decreases further in association with low PG I levels by advanced atrophic gastritis in the corpus.

In Japan, diagnosis methods of H. pylori infection are based on an invasive examination method using an endoscope (rapid urease test (RUT), microscopic examination, culturing method) and a noninvasive examination method without endoscope (13C-urea breath test (UBT), anti-H. pylori antibody measurement, H. pylori stool antigen test) according to the recommendation of the Japanese Society for Helicobacter Research [4–9]. If we could diagnose eradication of H. pylori infection by measuring the PG I/II ratio, it would be both cost effective and convenient.

[nuadox]

Immunotherapy with house dust mite extract reduces symptoms of atopic dermatitis

- By Luciana Constantino , Agência FAPESP -

Treatment with house dust mite extract was found to be effective against signs and symptoms of atopic dermatitis (eczema), a chronic inflammatory disease that results in itchy, swollen and cracked skin. 

Researchers at the University of São Paulo’s Ribeirão Preto Medical School (FMRP-USP) in Brazil studied the effects of sublingual immunotherapy with extract of Dermatophagoides pteronyssinus, a ubiquitous dust mite, administered to patients in drops for 18 months.

Dust mites are microscopic arachnids that live in house dust and feed on dead human skin cells.  

After 18 months of treatment, pruritus (itchy skin) and lesions diminished, almost disappearing in some cases. Side-effects were rare, mainly consisting of mild local reactions that did not last long. 

The study was supported by FAPESP and the National Council for Scientific and Technological Development (CNPq). An article reporting the findings is published in the Journal of Allergy and Clinical Immunology: in Practice.

Allergen immunotherapy consists of repeated administration of gradually increasing doses of the substance (allergen) to which the patient is allergic in an attempt to reduce sensitivity and induce tolerance of dust mites, pollen or insect venom, among others.

The study involved a randomized, double-blind, placebo-controlled clinical trial, considered the gold standard for assessment of drug efficacy. The trial was conducted between May 2018 and June 2020 at the Clinical Research Unit of FMRP-USP’s hospital. A group of 66 patients received placebo or dust mite extract three days per week for 18 months. They were attended by medical doctor Sarah Sella Langer, a graduate scholar at FMRP-USP and first author of the article. 

“Previous research had already shown that dust mite immunotherapy worked well in cases of rhinitis, conjunctivitis and allergic asthma, but for atopic dermatitis the results were uneven, especially when it involved subcutaneous injections. When sublingual immunotherapy came along, with less probability of adverse side-effects such as systemic reactions, we decided to investigate and obtained positive results,” said Luisa Karla de Paula Arruda, Professor of Clinical Medicine at FMRP-USP and last author of the article. 

The fact that the extract is given in the form of drops is an advantage, she explained, because it facilitates the administration of increasing doses and avoids the use of fixed dose throughout the treatment, as in the case of sublingual pills, for example. 

In the study, the first three months entailed an initial dilution of 1:1 million volume:volume (v:v), progressing to 1:100,000 v:v, 1:10,000 v:v until it reached 1:10 v:v, administered for a period of 15 days. The placebo solution was identical to the diluent of the extract, comprising water and glycerol, and administered according to the same schedule.

The sublingual immunotherapy substance was supplied by a Brazilian laboratory licensed to prepare and commercialize it from a lyophilized extract of D. pteronyssinus produced in Spain as the result of processing a culture of these mites, which are macerated, diluted and centrifuged to obtain the extract. 

“Dust mites should be environmentally controlled by using waterproof mattress covers and pillow cases and removing cushions, carpets and rugs. Topical treatment is also recommended for the eczema-like skin allergy, with hydration and use of specific medications, but it’s often insufficient for adequate control of symptoms,” Arruda said. “Immunotherapy is a step further and can lead to a clinical improvement that was absent before, even if other measures are also taken. Our study points to a practical application, which allergists can offer their patients.”

Atopic dermatitis causes inflammation of the skin, itching, rashes, and bumps that may leak fluid and crust over. It mainly affects knee and elbow bends, and may be associated with asthma and rhinitis. 

Environmental factors may contribute to development of the disease in genetically predisposed people, such as allergy to dust mites, pollen, mold, pets, and exposure to cleaning products or other chemicals. Dry air, intense cold, heat, sweat and stress can intensify the symptoms, as can infection of cracked skin by bacteria such as Staphylococcus aureus, and by viruses and fungi.

Little is known for sure about the prevalence of atopic dermatitis, and estimates range from 0.2% to 20%. However, some 30% of the population have allergies of some kind, among which rhinitis and asthma are particularly common, according to the World Health Organization (WHO).

Results

The researchers deployed several tools to analyze responses to the treatment. One was SCORAD (SCORing Atopic Dermatitis), an internationally accepted clinical tool used to assess the extent and severity of the disease. It results in a score based on the percentage of the body affected and symptoms such as itchiness, swelling, dryness, etc., as well as insomnia. Less than 25 is considered mild, 25-49 moderate and 50 or more severe.

After 18 months, the score had fallen by 15 or more in 74.2% of the patients given immunotherapy, and by 55% from the initial baseline scores, compared with 34.5% for the control group given placebo. This difference was considered statistically significant, confirming the efficacy of the treatment. The results were similar using O-SCORAD (Objective SCORAD, leaving out patients’ assessments of symptoms).

The researchers also used a tool known as the Investigator Global Assessment (IGA), a five-point scale ranging from 0 to 4, where 0 indicates clear skin, 1 almost clear, 2 mild eczema, 3 moderate, and 4 severe. The number of patients graded 0-1 was far higher in the immunotherapy group (14 out of 35, compared with 5 out of 31 in the control group). 

The two groups were not significantly different according to the Dermatology Life Quality Index (DLQI). 

“The design of the study was innovative,” Arruda said. “Another novelty was the use of data for Brazilian patients. Most research on this topic uses data from other countries, but in the case of allergies, the results may vary widely. I think it’s important to do research with our own patients so that we can develop additional, more targeted treatments.”

The article “Efficacy of house dust mite sublingual immunotherapy in patients with atopic dermatitis: a randomized, double-blind, placebo-controlled trial” is at: www.sciencedirect.com/science/article/abs/pii/S2213219821012502?via%3Dihub.

This text was originally published by FAPESP Agency according to Creative Commons license CC-BY-NC-ND. Read the original here.

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[sciencenewsforstudents]

A no-fuss immune therapy involving liquid drops placed under the tongue could protect people with peanut allergies from reacting if exposed.

Results from a small study of the treatment — called sublingual immunotherapy, or SLIT — rival those of a similar treatment that also builds allergy tolerance by exposing sufferers to small, daily doses of an allergen, researchers report September 4 in the Journal of Allergy and Clinical Immunology. But in that approach, called oral immunotherapy or OIT for short, doses are swallowed rather than administered under the tongue (SN: 11/18/18).

The question with SLIT “was always about efficacy,” says Brian Schroer, director of allergy and immunology at Akron Children’s Hospital in Ohio, who was not involved with the research. The new study “shows it’s pretty much equivalent to OIT in terms of protection from accidental food exposures,” he says.

SLIT’s delivery method through the mouth’s mucous membrane means that much smaller doses can be used than with the oral treatment, says Edwin Kim, a pediatric allergist and immunologist at the University of North Carolina’s School of Medicine in Chapel Hill.

SLIT also produced milder side effects, such as a mouth itch that lasted for up to 15 minutes, compared with OIT, which occasionally has caused allergic reactions that required epinephrine, Kim and colleagues report. And while patients need a two-hour rest period after taking the oral treatment, those receiving a sublingual dose need only hold it under their tongues for two minutes. And “then you’re in the clear to go about your day,” Kim says.

A potential new peanut allergy treatment involves receiving, in a controlled setting, a few drops of liquid peanut protein under the tongue. CREDIT: ALLERGENUITY HEALTH

Still, the SLIT approach isn’t quite ready for prime time until it can be tested further in larger studies, says pediatric allergist Christina Ciaccio at the University of Chicago School of Medicine. She was not involved in the new research, but has helped to run studies for companies developing other peanut allergy treatments. But “would I fault someone in private practice for trying it in the right patient? Probably not,” she says.

Food allergies affect nearly 8 percent of U.S. kids and 11 percent of adults, estimates suggest. A study in 2010 suggests that the number of known peanut allergy cases tripled, for unclear reasons, from 1997 to 2008. Today, an estimated 2 percent of kids are allergic to peanuts.

In the new study, dozens of children ages 1 to 11 received daily doses of liquefied peanut protein that increased gradually over a year until leveling off at two milligrams daily for up to four more years. Of the 37 kids who completed the trial, 32 — or 86 percent — were then able safely to eat 750 milligrams of peanut protein, the amount found in two to three peanuts. Twelve children (32 percent) could tolerate 5,000 milligrams, the amount found in 17 to 20 peanuts, and many of the children maintained that tolerance threshold after two to four weeks of stopping the treatment.

By comparison, a trial of OIT tested the effects of daily capsules containing up to 300 milligrams of peanut protein on 372 children. After a year, two-thirds of participants could tolerate at least 1,043 milligrams of peanut protein, the amount in three to four peanuts.

The U.S. Food and Drug Administration is expected in September to review a licensing application for peanut capsules by Aimmune Therapeutics, based in Brisbane, Calif. With growing interest in the sublingual approach, Sanofi Pharmaceuticals in Rockville, Md., said last year that it would launch a safety study. And Intrommune Therapeutics’ chief executive officer, Michael Nelson, said his New York-based biotechnology company would complete its first in-human study of a SLIT-based toothpaste in 2020.

SLIT is approved by the FDA for use in tablet form to treat a small number of environmental allergens such as pollen, ragweed and dust mites. Both dissolving tablets and liquid SLIT are used routinely in Europe as an alternative to allergy shots for environmental allergies. Though the sublingual approach is not approved for food allergies in the United States, a small number of allergists are offering SLIT for both food and environmental allergens. And some parents are already seeking out the therapy for their allergy-suffering kids.

“We choose SLIT because of how easy it is to administer and the low risk of reactions,” says Bailie Kopco, whose 4-year-old son is receiving the liquid version at Allergenuity Health in Charlotte, N.C. “We were never looking for him to eat PB&J sandwiches at this point,” she says. “Our goal at this time is to protect him from cross-contamination and accidental ingestion.”