ALERGOLOGÍA PARA MÉDICOS Y PACIENTES 2021

Managing Food Allergy When the Patient Is Not Highly Allergic Authors: Scott H. Sicherer, MD, Elissa M. Abrams, MD, Anna Nowak-Wegrzyn, MD, PhD, and Jonathan O’B. Hourihane, FRCPI Abstract: Few patients with food allergy are “highly allergic,” meaning they always have severe reactions and always react to very small amounts of allergen. Standard medical approaches for allergy management have focused on the safety and lifestyle modifications this group truly needs, but consequently families with food allergy are typically advised to strictly avoid any exposure to their implicated allergens. Most food-allergic subjects are actually not reactive to very low doses, and many never experience severe reactions. There are also notable conditions where a different care plan is already commonly offered: patients with pollen-related food allergy syndrome, with food-associated exercise-induced anaphylaxis, and with resolving or mild milk or egg allergy might be advised to ingest the allergens in sp...

The International EAACI/GA²LEN/EuroGuiDerm/APAAACI Guideline for the Definition, Classification, Diagnosis and Management of Urticaria Authors: T. Zuberbier, A.H. Abdul Latiff, M. Abuzakouk, S. Aquilina, R. Asero, D. Baker, B. Ballmer-Weber, C. Bangert, M. Ben-Shoshan, J.A. Bernstein, C. Bindslev-Jensen, K. Brockow, Z. Brzoza, H.J. Chong Neto, M. Church, P.R. Criado, I.V. Danilycheva, C. Dressler, L.F. Ensina, L. Fonacier, M. Gaskins, K. Gáspár, A. Gelincik, A. Giménez-Arnau, K. Godse, M. Gonçalo, C. Grattan, M. Grosber, E. Hamelmann, J. Hébert, M. Hide, A. Kaplan, A. Kapp, A. Kessel, E. Kocatürk, K. Kulthanan, D. Larenas-Linnemann, A. Lauerma, T. Leslie, M. Magerl, M. Makris, R.Y. Meshkova, M. Metz, D. Micallef, C.G. Mortz, A. Nast, H. Oude-Elberink, R. Pawankar, P. Pigatto, H. Ratti Sisa, M.I. Rojo Gutiérrez, S.S. Saini, P. Schmid-Grendelmeier, B. Sekerel, F. Siebenhaar, H. Siiskonen, A. Soria, P. Staubach-Renz, L. Stingeni, G. Sussman, A. Szegedi, S.F. Thomsen, Z. Vadas, C. Vesterga...

Safety and Efficacy of Single-Dose Ad26.COV2.S Vaccine against Covid-19 Authors: J. Sadoff, G. Gray, A. Vandebosch, V. Cárdenas, G. Shukarev, B. Grinsztejn, P.A. Goepfert, C. Truyers, H. Fennema, B. Spiessens, K. Offergeld, G. Scheper, K.L. Taylor, M.L. Robb, J. Treanor, D.H. Barouch, J. Stoddard, M.F. Ryser, M.A. Marovich, K.M. Neuzil, L. Corey, N. Cauwenberghs, T. Tanner, K. Hardt, J. Ruiz‑Guiñazú, M. Le Gars, H. Schuitemaker, J. Van Hoof, F. Struyf, and M. Douoguih Abstract: BACKGROUND The Ad26.COV2.S vaccine is a recombinant, replication-incompetent human adenovirus type 26 vector encoding full-length severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein in a prefusion-stabilized conformation. METHODS In an international, randomized, double-blind, placebo-controlled, phase 3 trial, we randomly assigned adult participants in a 1:1 ratio to receive a single dose of Ad26.COV2.S (5×1010 viral particles) or placebo. The primary end points were vaccine efficacy again...

 Autoimmune Diseases Are Linked to Type IIb Autoimmune Chronic Spontaneous Urticaria Authors: Pavel Kolkhir, Sabine Altrichter, Riccardo Asero , Alvaro Daschner, Marta Ferrer , Ana Giménez-Arnau, Tomasz Hawro, Thilo Jakob, Tamar Kinaciyan, Arno Kromminga, George N Konstantinou, Michael Makris, Martin Metz , Per Stahl Skov, Petra Staubach, Gordon Sussman , Ke Zhang, Marcus Maurer Abstract: Purpose: Patients with chronic spontaneous urticaria (CSU) have an increased risk for comorbid autoimmune diseases. In this retrospective multicenter study of CSU patients, we evaluated clinical and laboratory features of CSU associated with a higher risk of comorbid autoimmune diseases. Methods: We analyzed records of CSU patients (n = 1,199) for a history or presence of autoimmune diseases. Patients were diagnosed with type IIb autoimmune CSU (aiCSU) if all 3 tests were positive: autologous serum skin test (ASST), basophil histamine release assay (BHRA) and/or basophil activation test (BAT), an...

Adaptive immunity to SARS-CoV-2 and COVID-19 Authors:  Alessandro Sette and Shane Crotty Abstract: The adaptive immune system is important for control of most viral infections. The three fundamental compo- nents of the adaptive immune system are B cells (the source of antibodies), CD4+ T cells, and CD8+ T cells. The armamentarium of B cells, CD4+ T cells, and CD8+ T cells has differing roles in different viral infections and in vaccines, and thus it is critical to directly study adaptive immunity to SARS-CoV-2 to understand COVID-19. Knowledge is now available on relationships between antigen-specific immune responses and SARS-CoV-2 infection. Although more studies are needed, a picture has begun to emerge that reveals that CD4+ T cells, CD8+ T cells, and neutralizing antibodies all contribute to control of SARS-CoV-2 in both non-hospitalized and hospitalized cases of COVID-19. The specific functions and kinetics of these adaptive immune responses are discussed, as well as their in...

Hypersensitivity to β-lactam antibiotics: algorithms of management and desensitization as a vital therapeutic alternative Authors:  Ricardo Cardona, Luis Santamaría, Liliana Guevara-Saldaña, Ana Calle Abstract:  Hypersensitivity reactions can be complex and life-threatening to patients, especially when drugs such as β-lactam antibiotics are involved. To this day, there are diagnostic algorithms and mobile applications that improve the clinical approach, as well as laboratory tests and more specialized procedures, such as skin tests and controlled exposure tests; which are useful for identifying the drug involved and for selecting safe and effective therapeutic alternatives. For several years, the desensitization procedure has been positioned as a vital tool for clinical allergists and for their patients, and it is key to improving clinical outcomes such as survival and quality of life. DOI:   10.29262/ram.v68i1.892

 Latest Developments in the Management of Nut Allergies Authors:  H A Brough, R Gourgey, S Radulovic, J C Caubet, G Lack, A Anagnostou Abstract: Purpose of review: In this review, we sought to describe the most recent advances in the dietary and medical management of peanut and tree nut allergy, including selective introduction and immunotherapy. Recent findings: Dietary updates include changes to labeling laws, improved information sources, and new apps for buying foods in shops and overseas to better protect individuals with nut allergies. There are still issues in the management of nut allergies in schools, such as parents having to resort to packed lunches instead of school meals and patients experiencing bullying. Air travel also poses concern, but additional resources are now available to travelers, and recent evidence suggest limited airborne exposure to nuts. The medical management of anaphylaxis is use of epinephrine; however, this remains underutilized. Needle length...

 Effects of pregnancy on chronic urticaria: Results of the PREG-CU UCARE study Authors: Emek Kocatürk, Mona Al-Ahmad, Karoline Krause, Ana M Gimenez-Arnau, Simon Francis Thomsen, Niall Conlon, Alexander Marsland, Ekin Savk, Roberta F Criado, Inna Danilycheva, Daria Fomina, Kiran Godse, Maryam Khoshkhui, Aslı Gelincik, Ece Nur Degirmentepe, Semra Demir, Luis Felipe Ensina, Alicja Kasperska-Zajac, Michael Rudenko, Solange Valle, Iris Medina, Andrea Bauer, Zuotao Zhao, Petra Staubach, Laurence Bouillet, Özlem Su Küçük, Can Ateş, Marcus Maurer Abstract: Background: Chronic urticaria (CU) predominantly affects women, and sex hormones can modulate disease activity in female CU patients. As of now, the impact of pregnancy on CU is largely unknown. Aim: To analyze the course and features of CU during and after pregnancy. Patients and methods: PREG-CU is an international, multicenter study of the Urticaria Centers of Reference and Excellence (UCARE) network. Data were collected via a 47-ite...