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  • 1
    In: JDDG: Journal der Deutschen Dermatologischen Gesellschaft, November 2018, Vol.16(11), pp.1315-1322
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/ddg.13679_g/abstract Byline: Margitta Worm, Novin Molaie, Sabine Dolle Zusammenfassung Hintergrund Adrenalin intramuskular mit Hilfe eines Autoinjektors ist das Mittel der Wahl zur Selbstbehandlung schwerer allergischer Reaktionen. Zahlen aus dem Anaphylaxie-Register zeigen, dass Adrenalinautoinjektoren selten von Patienten eingesetzt werden. Apotheker sind eine wichtige Schnittstelle zwischen verordnendem Arzt und Patienten. Patienten und Methodik Ziel der vorliegenden Arbeit war es, den Wissensstand bei Apothekern zur Anaphylaxie und deren Behandlung mittels definierter Wissensfragen strukturiert zu erheben. Hierzu wurden Daten von einer standardisierten Fragebogenerhebung von 213 Apotheken analysiert. Ergebnisse Die Daten zeigen, dass Apotheker die Anaphylaxie als eine Erkrankung mit reduzierter Lebensqualitat einschatzen. Die Benennung der haufigsten Ausloser einer Anaphylaxie durch die Apotheker entspricht den Daten aus dem Anaphylaxie-Register (Insektengift, Nahrungsmittel und Medikamente). Die Auswertung zum Wissensstand der Apotheker zeigt, dass Fallbeschreibungen einer Anaphylaxie richtig zugeordnet werden konnen. Es bestehen jedoch Wissensdefizite bei Fragen zur Behandlung einer Anaphylaxie mit Adrenalin und zu den Leitlinien. Schlussfolgerungen Die vorliegende Untersuchung zeigt, dass der Wissensstand von Apothekern zur Anaphylaxie verbessert werden kann. Da Apotheker eine wesentliche Schnittstelle bei der Versorgung von Patienten mit allergischen Erkrankungen darstellen, sollte Ziel weiterfuhrender Ma[sz]nahmen sein, diese Schnittstelle durch Aufklarungs- und Schulungsmodule zu verstarken, um somit die Patientenversorgung zu verbessern.
    ISSN: 1610-0379
    E-ISSN: 1610-0387
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  • 2
    Language: English
    In: The Journal of Allergy and Clinical Immunology, February 2015, Vol.135(2), pp.491-499
    Description: Cofactors contribute to the elicitation of anaphylaxis. β-Blockers and angiotensin-converting enzyme (ACE) inhibitors are widely used cardiovascular drugs. We specially designed a mouse model to further analyze the cofactor potential of these drugs. We sought to test the hypothesis that β-blockers and ACE inhibitors alter the risk for severe anaphylaxis and to pinpoint the associated mechanism. The risk factor potency of cardiovascular drugs on the severity of anaphylaxis in patients from German-speaking countries was analyzed. interaction of the cardiovascular drugs metoprolol (β-blocker) and ramipril (ACE inhibitor) with the anaphylactic response was determined. Mast cell (MC) mediators (histamine, serotonin, leukotriene C , prostaglandin D , and mouse mast cell protease 1) were quantified in serum. Bone marrow–derived cultured MCs served to identify whether the therapeutics targeted MCs directly. Our anaphylaxis database indicated a higher risk of severe anaphylaxis after monotherapy with β-blockers or ACE inhibitors, which was more pronounced when both drugs were combined. This was confirmed in our mouse model. While single therapeutics had either no significant (ramipril) or a modestly aggravating (metoprolol) effect, their combined administration exacerbated anaphylactic symptoms potently and simultaneously enhanced MC mediators, hinting at MCs as direct targets. In fact, FcεRI-mediated MC histamine release was synergistically increased by metoprolol/ramipril or metoprolol/bradykinin (the latter increased after ACE inhibitor intake), whereas the substances had no significant effect on their own. MC priming was particularly pronounced when FcεRI aggregation was in the suboptimal range, reflecting common clinical settings. β-Blockers and ACE inhibitors synergistically aggravate anaphylaxis at least partly by decreasing the threshold of MC activation.
    Keywords: Anaphylaxis ; Β-Blocker ; Angiotensin-Converting Enzyme Inhibitor ; Cofactor ; Mast Cells ; Cardiovascular Medication ; Medicine
    ISSN: 0091-6749
    E-ISSN: 1097-6825
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  • 3
    Language: English
    In: PLoS ONE, 01 January 2017, Vol.12(1), p.e0169620
    Description: Vitamin D deficiency is frequent during the winter and occurs throughout the year in the elderly or patients suffering from autoimmune diseases. The objective of this study was to evaluate the pharmacokinetic properties of oral supplementation versus a single intramuscular injection of cholecalciferol in healthy individuals.Up to 8,000 I.U. oral cholecalciferol was administered daily for 84 days in a 4 week dose-escalation setting to vitamin D deficient individuals. In another cohort, a single intramuscular injection of 100,000 I.U. cholecalciferol was given. In both cohorts, individuals without vitamin D intake served as the comparison group. 25-hydroxyvitamin D (25(OH)D) concentrations were measured in all individuals at defined time points throughout the studies.The mean 25(OH)D serum concentration increased significantly after oral cholecalciferol intake compared to the control group (day 28: 83.4 nmol/l and 42.5 nmol/l; day 56: 127.4 nmol/l and 37.3 nmol/l; day 84: 159.7 nmol/l and 30.0 nmol/l). In individuals receiving 100,000 I.U. cholecalciferol intramuscular, the mean 25(OH)D serum concentration peaked after 4 weeks measuring 70.9 nmol/l compared to 32.7 nmol/l in the placebo group (p = 0.002). The increase of 25(OH)D serum concentrations after 28 days was comparable between both routes of administration (p = 0.264).Oral and intramuscular cholecalciferol supplementation effectively increased serum 25(OH)D concentrations.
    Keywords: Sciences (General)
    E-ISSN: 1932-6203
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  • 4
    In: PLoS ONE, 2013, Vol.8(6)
    Description: The plant pathogen Pepino mosaic virus (PepMV) is a major disease of greenhouse tomato crops worldwide. Plant pathogens can induce expression of defence- or pathogenesis-related proteins, including identified allergens. Therefore we hypothesised that PepMV infection results in the expression of allergens leading to a higher allergenic potential of tomato fruits. Transcript level analyses showed differential expression of 17 known and putative tomato fruit allergen encoding genes at early and late time points after PepMV inoculation, but no general induction was detected. Immunoblot analyses were conducted and IgEs from a serum pool of tomato allergic subjects reacted with 20 proteins, of which ten have not yet been described. In parallel, skin prick tests with a group of tomato allergic subjects did not show a general difference between PepMV infected and non-infected tomato fruits and basophil activation tests confirmed these results. In summary, PepMV infection of tomato plants can lead to long-lasting up-regulation of particular allergens in fruits, but the hypothesis that this results in a higher allergenic potential of the fruits proved invalid.
    Keywords: Research Article ; Biology ; Medicine
    E-ISSN: 1932-6203
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  • 5
    Language: English
    In: Journal of the Science of Food and Agriculture, September 2011, Vol.91(12), pp.2234-2240
    Description: Food allergies are increasing in the European population. At present the onset of symptoms can be avoided only by elimination of a particular fruit or vegetable from the diet. A new approach is to develop hypoallergenic food products. This study characterises the allergenic potential of tomatoes, considering cultivation conditions, developmental stages and genotypes, in order to identify hypoallergenic fruits. Patients with a history of tomato allergy were recruited for skin allergy tests. Tomatoes carrying distinct genotypes were grown under various cultivation conditions and harvested at different maturation stages. Cultivation conditions (nitrogen fertilisation, light exposure and plant nutrition) did not affect the skin reactivity in tomato‐allergic patients. However, skin reactivity was significantly lower when using green‐unripe compared with red‐ripe tomatoes and when using landrace cultivars compared with cultivars bred for use in organic horticulture. Depending on their genetic background and maturity level, some tomato cultivars elicit positive reactions in tomato‐allergic patients in the skin allergy test. This novel finding should pave the way for the development of tomatoes with reduced allergenicity to relieve sufferers of tomato allergy. Copyright © 2011 Society of Chemical Industry
    Keywords: Food Allergy ; Tomato ; Cultivars ; Environmental Cultivation Conditions
    ISSN: 0022-5142
    E-ISSN: 1097-0010
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  • 6
    Language: English
    In: Acta dermato-venereologica, 06 July 2013, Vol.93(4), pp.485-6
    Keywords: Anaphylaxis -- Etiology ; Antigens, Plant -- Adverse Effects ; Brassica -- Adverse Effects ; Carrier Proteins -- Adverse Effects ; Food Hypersensitivity -- Etiology ; Plant Proteins -- Adverse Effects
    ISSN: 00015555
    E-ISSN: 1651-2057
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  • 7
    Language: German
    In: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, July 2016, Vol.59(7), pp.836-40
    Description: Anaphylactic reactions due to food occur in the context of food allergy and, together with venom and drugs, are the most frequent elicitors of severe allergic reactions. In small children the most frequent elicitors of severe allergic reactions according to data from the anaphylaxis registry are hen's egg and milk, whereas in school children peanut and hazelnut are frequent elicitors of allergic reactions. Other frequent elicitors of anaphylactic reactions in childhood are wheat and soy. In adults the most frequent elicitors of severe allergic reactions due to food, based on data from the anaphylaxis registry, are wheat, soy, celery, shellfish and hazelnut. Rare elicitors of food-induced anaphylaxis in German-speaking countries are mustard and cabbage. However, the panel of rare elicitors of food-induced anaphylaxis show regional differences. As of March 2015, 17 cases of fatal anaphylaxis were registered and among these seven were food-induced. Co-factors can either trigger the elicitation of a severe allergic reaction or affect its severity. Among such co-factors are physical activity, the intake of certain drugs, and psychological stress. The data on the role of cofactors is sparse. The management of food-induced anaphylaxis includes acute management according to current guidelines, but also long-term management, which should include educational measures regarding treatment but also information about the food allergen in daily life.
    Keywords: Anaphylaxis Registry ; Co-Factors ; Elicitors ; Food-Induced Anaphylaxis ; Management ; Registries ; Anaphylaxis -- Mortality ; Food Hypersensitivity -- Mortality
    ISSN: 14369990
    E-ISSN: 1437-1588
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  • 8
    Language: German
    In: Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, 2016, Vol.59(7), pp.836-840
    Description: Anaphylaktische Reaktionen auf Lebensmittel sind im Rahmen einer Nahrungsmittelallergie möglich und gehören mit Insektengiften und Arzneimitteln zu den häufigsten Auslösern schwerer allergischer Reaktionen. Die Daten aus dem Anaphylaxie-Register zeigen, dass im Kleinkindesalter die häufigsten Auslöser schwerer allergischer Reaktionen Hühnereiweiß und Milcheiweiß sind. Ab dem Schulalter sind dagegen Erdnüsse und Haselnüsse häufige Auslöser schwerer allergischer Reaktionen. Weitere häufige Auslöser anaphylaktischer Reaktionen im Kindesalter sind Weizen und Soja. Im Erwachsenenalter sind europaweit, so zeigen die Daten aus dem Anaphylaxie-Register, die häufigsten Auslöser schwerer allergischer Reaktionen die Nahrungsmittel Weizen, Soja, Sellerie, Krusten- und Schalentiere sowie Haselnüsse. Seltene Auslöser einer nahrungsmittelabhängigen Anaphylaxie sind gemäß Daten aus dem Anaphylaxie-Register im deutschsprachigen Raum Senf und Kohl, wobei zu berücksichtigen ist, dass regionale Unterschiede auftreten können. Bis März 2015 wurden an das Anaphylaxie-Register 17 Todesfälle gemeldet, wobei 7 durch Nahrungsmittel ausgelöst wurden. Kofaktoren können die Auslösung und/oder den Schweregrad einer lebensmittelabhängigen Anaphylaxie beeinflussen. Hierzu gehören körperliche Anstrengung aber auch z. B. die Einnahme bestimmter Medikamente oder auch psychische Belastung, wobei die Datenlage hier heterogen ist. Das Management der lebensmittelabhängigen Anaphylaxie beinhaltet die Akutversorgung gemäß der aktuellen Leitlinie sowie das Langzeitmanagement, wobei hier Schulungsmaßnahmen und Aufklärung zur Verbreitung des entsprechenden Nahrungsmittels von besonderer Bedeutung sind. Anaphylactic reactions due to food occur in the context of food allergy and, together with venom and drugs, are the most frequent elicitors of severe allergic reactions. In small children the most frequent elicitors of severe allergic reactions according to data from the anaphylaxis registry are hen’s egg and milk, whereas in school children peanut and hazelnut are frequent elicitors of allergic reactions. Other frequent elicitors of anaphylactic reactions in childhood are wheat and soy. In adults the most frequent elicitors of severe allergic reactions due to food, based on data from the anaphylaxis registry, are wheat, soy, celery, shellfish and hazelnut. Rare elicitors of food-induced anaphylaxis in German-speaking countries are mustard and cabbage. However, the panel of rare elicitors of food-induced anaphylaxis show regional differences. As of March 2015, 17 cases of fatal anaphylaxis were registered and among these seven were food-induced. Co-factors can either trigger the elicitation of a severe allergic reaction or affect its severity. Among such co-factors are physical activity, the intake of certain drugs, and psychological stress. The data on the role of cofactors is sparse. The management of food-induced anaphylaxis includes acute management according to current guidelines, but also long-term management, which should include educational measures regarding treatment but also information about the food allergen in daily life.
    Keywords: Food-induced anaphylaxis ; Anaphylaxis registry ; Elicitors ; Co-factors ; Management
    ISSN: 1436-9990
    E-ISSN: 1437-1588
    Source: Springer Science & Business Media B.V.
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  • 9
    In: JDDG: Journal der Deutschen Dermatologischen Gesellschaft, November 2018, Vol.16(11), pp.1315-1321
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/ddg.13679/abstract Byline: Margitta Worm, Novin Molaie, Sabine Dolle Summary Background Epinephrine autoinjectors for intramuscular administration are the treatment of choice for self-medicating severe allergic reactions. Data from the anaphylaxis registry shows that patients rarely use their epinephrine pens. Pharmacists play a key role as liaison between prescribers and patients. Patients and methods Using a standardized questionnaire, the objective of the present study was to assess the level of knowledge among pharmacists regarding anaphylaxis and its treatment. Data derived from 213 pharmacists was included in the study. Results Our data reveals that pharmacists consider anaphylaxis to be a disorder that is associated with an impairment in quality of life. The most common triggers of anaphylaxis according to pharmacists (insect venom, foods, and drugs) correspond to those listed in the anaphylaxis registry. Based on the survey, pharmacists readily recognize anaphylactic reactions from case descriptions. However, there are still knowledge deficits with respect to the management of anaphylaxis and current guidelines. Conclusions Our findings suggest that the level of knowledge among pharmacists with regard to anaphylaxis warrants improvement. As this professional group plays a crucial part in the care of patients with allergic disorders, future measures should be aimed at strengthening this role by raising awareness and introducing training modules.
    Keywords: Pharmacists – Usage ; Epinephrine – Usage ; Anaphylaxis – Usage;
    ISSN: 1610-0379
    E-ISSN: 1610-0387
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  • 10
    Language: English
    In: Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology, 2016, Vol.12, pp.67
    Description: Polyethylene glycols (PEGs) or macrogols are polyether compounds and are widely used as additives in pharmaceuticals, cosmetics, and food. We report on a Caucasian patient experiencing recurrent severe allergic reactions to several drugs. An extensive diagnostic workup including skin prick tests, intradermal tests (IDT) and a double-blind oral challenge was performed to identify the trigger of anaphylaxis. In the present case hypersensitivity to the additive polyethylene glycol was confirmed by an IDT suggesting an Immunoglobulin E-dependent mechanism as a cause of the reaction. Potential life-threatening hypersensitivity reactions to hidden molecules like macrogol may be underdiagnosed. Cases of immediate-type PEG hypersensitivity were reported with increasing frequency. The awareness regarding the allergenic potential of PEG should be raised and a proper product labelling is crucial to prevent PEG mediated hypersensitivity.
    Keywords: Anaphylaxis ; Drug Additives ; Hypersensitivity ; Macrogol ; Polyethylene Glycol
    ISSN: 1710-1484
    E-ISSN: 17101492
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