Our aim is to determine the number of leukocytes, T lymphocytes and B lymphocytes and the expression of activation markers CD200 and CD23 on B lymphocytes in atopic dermatitis (AD) patients (treated and not treated with dupilumab) during the pollen season. We examined 29 patients not treated with dupilumab, 24 patients treated with dupilumab and 40 healthy subjects as a control group. The count of T and B lymphocytes and their subsets were assessed by flow cytometry. The non-parametric Kruskal-Wallis one-factor analysis of variance with post hoc by Dunn's test with Bonferroni's modification was used for statistical processing. Although there was a significant improvement in skin findings in patients treated with dupilumab, the changes in immunological profile show a persistent altered immune response characterized by dysregulation and overactivation of B lymphocytes. Dupilumab therapy leads to normalization of relative T regulatory lymphocytes and total memory B lymphocytes and to decreased count of absolute CD8+ T lymphocytes. Why carry out this study?Studies investigating the immunological profile of atopic dermatitis (AD) patients during the pollen season are rare. There are no studies investigating the count of B lymphocytes (CD5+, CD22+ and CD73+ B lymphocytes) and the expression of activation markers CD23 and CD200 on B lymphocytes and on their subsets during pollen season in AD patients treated and non-treated with dupilumab therapy.What was learned from the study?In atopic dermatitis (AD) patients with and without dupilumab therapy, we confirmed the significantly higher count of absolute neutrophils, absolute monocytes, absolute eosinophils, absolute basophils, non-switched B lymphocytes, transitional B lymphocytes, CD23 memory, naive, non-switched, switched and total CD23 B lymphocytes, the relative count of CD200 memory and CD200 switched B lymphocytes.In dupilumab treated patients, we confirmed the significantly higher count of relative eosinophils, relative CD16+ eosinophils, relative CD200 non-switched B lymphocytes and lower count of absolute CD8+ T lymphocytes. Further studies should focus on investigating the effect of dupilumab on CD8+ T lymphocytes and their subpopulations.In patients without dupilumab therapy, we confirmed the significantly higher count of relative neutrophils, relative T regulatory lymphocytes and total memory B lymphocytes.The changes in the count of CD5+, CD22+ and CD73+ B lymphocytes were not observed during pollen season in both groups of AD patients.
- MeSH
- atopická dermatitida * farmakoterapie imunologie MeSH
- B-lymfocyty imunologie MeSH
- CD antigeny MeSH
- dospělí MeSH
- humanizované monoklonální protilátky * terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- pyl imunologie MeSH
- receptory IgE MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Adherence to rhinitis treatment has been insufficiently assessed. We aimed to use data from the MASK-air mHealth app to assess adherence to oral antihistamines (OAH), intra-nasal corticosteroids (INCS) or azelastine-fluticasone in patients with allergic rhinitis. METHODS: We included regular European MASK-air users with self-reported allergic rhinitis and reporting at least 1 day of OAH, INCS or azelastine-fluticasone. We assessed weeks during which patients answered the MASK-air questionnaire on all days. We restricted our analyses to data provided between January and June, to encompass the pollen seasons across the different assessed countries. We analysed symptoms using visual analogue scales (VASs) and the combined symptom-medication score (CSMS), performing stratified analyses by weekly adherence levels. Medication adherence was computed as the proportion of days in which patients reported rhinitis medication use. Sensitivity analyses were performed considering all weeks with at most 1 day of missing data and all months with at most 4 days of missing data. RESULTS: We assessed 8212 complete weeks (1361 users). Adherence (use of medication > 80% days) to specific drug classes ranged from 31.7% weeks for azelastine-fluticasone to 38.5% weeks for OAH. Similar adherence to rhinitis medication was found in users with or without self-reported asthma, except for INCS (better adherence in asthma patients). VAS and CSMS levels increased from no adherence to full adherence, except for INCS. A higher proportion of days with uncontrolled symptoms was observed in weeks with higher adherence. In full adherence weeks, 41.2% days reported rhinitis co-medication. The sensitivity analyses displayed similar results. CONCLUSIONS: A high adherence was found in patients reporting regular use of MASK-air. Different adherence patterns were found for INCS compared to OAH or azelastine-fluticasone that are likely to impact guidelines.
- MeSH
- adherence k farmakoterapii * MeSH
- antialergika terapeutické užití MeSH
- antihistaminika terapeutické užití MeSH
- dospělí MeSH
- flutikason terapeutické užití aplikace a dávkování MeSH
- ftalaziny terapeutické užití MeSH
- hormony kůry nadledvin terapeutické užití aplikace a dávkování MeSH
- lidé středního věku MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- pyl imunologie MeSH
- roční období * MeSH
- sezónní alergická rýma * farmakoterapie epidemiologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
- MeSH
- alergická konjunktivitida etiologie farmakoterapie imunologie MeSH
- alergie diagnóza farmakoterapie MeSH
- antigeny rostlinné škodlivé účinky terapeutické užití MeSH
- břízovité imunologie škodlivé účinky MeSH
- desenzibilizace imunologická metody MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- pyl imunologie škodlivé účinky MeSH
- randomizované kontrolované studie jako téma MeSH
- sezónní alergická rýma etiologie farmakoterapie imunologie MeSH
- stromy * imunologie škodlivé účinky MeSH
- sublinguální imunoterapie metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- novinové články MeSH
- Klíčová slova
- SLIT tablety RAGWIZAX,
- MeSH
- alergická konjunktivitida * farmakoterapie MeSH
- alergická rýma farmakoterapie MeSH
- Ambrosia škodlivé účinky MeSH
- antigeny rostlinné MeSH
- bronchiální astma farmakoterapie MeSH
- desenzibilizace imunologická MeSH
- dítě MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- pyl imunologie škodlivé účinky MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
Tato kazuistika dokládá efekt sublinguální tabletové alergenové imunoterapie u dospělého alergika profesně exponovaného pylovým alergenům.
his case report demonstrates the efficacy of sublingual immunotherapy allergy tablets in an adult patient with allergy who is occupationally exposed to pollen allergens.
- Klíčová slova
- Oralair,
- MeSH
- alergie * farmakoterapie imunologie MeSH
- antigeny rostlinné aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- aplikace sublinguální MeSH
- desenzibilizace imunologická MeSH
- lidé středního věku MeSH
- lidé MeSH
- pyl imunologie škodlivé účinky MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
BACKGROUND AND AIM: Progress in laboratory diagnostics of IgE-mediated allergy is the use of component-resolved diagnosis. Our study analyses the results of specific IgE to 295 allergen reagents (117 allergenic extracts and 178 molecular components) in patients suffering from atopic dermatitis (AD) with the use of ALEX2 Allergy Explorer. METHOD: The complete dermatological and allergological examination, including the examination of the sensitization to molecular components with ALEX2 Allergy Explorer testing, was performed. The statistical analysis of results was performed with these methods: TURF (total unduplicated reach and frequency), best reach and frequency by group size, two-sided tests, Fisher's exact test, and chi-square test (at an expected minimum frequency of at least 5). RESULTS: Altogether, 100 atopic dermatitis patients were examined: 48 men, 52 women, the average age 40.9 years, min. age 14 years, max. age 67 years. The high and very high level of specific IgE was reached in 75.0% of patients to 18 molecular components: from PR-10 proteins (Aln g 1, Bet v 1, Cor a1.0103, Cor a1.0401, Fag s 1), lipocalin (Can f 1), NPC2 family (Der f 2, Der p 2), uteroglobin (Fel d 1), from Alternaria alternata (Alt a 1), Beta expansin (Lol p 1, Phl p 1), molecular components from Timothy, cultivated rye (Secc pollen) and peritrophin-like protein domain Der p 23. The high and very high level of specific IgE to other lipocalins (Fel d 7, Can f 4), to arginine kinase (Bla g 9, German cockroach), and to allergen extracts Art v (mugwort), and Cyn d (Bermuda grass) reached 52.0% of patients. The severity of AD is in significant relation to the sensitization to molecular components of storage mites (Gly d 2, Lep d 2-NPC2 family), lipocalins (Can f 1, Can f 2, Can f 4, and Can f 6), arginine kinase (Asp f 6, Bla g 9, Der p 20, Pen m 2), uteroglobin (Fel d 1, Ory c 3), Mn superoxide dismutase (Mala s 11), PR-10 proteins (Fag s 1, Mal d 1, Cor a 1.0401, Cor a 1.0103), molecular components of the peritrophin-like domain (Der p 21, Der p 23), and to Secc pollen. In the subgroup of patients suffering from bronchial asthma, the significant role play molecular components from house dust mites and storage mites (Lep d 2, Der p 2, Der f 2-NPC2 family), cysteine protease (Der p 1), peritrophin-like protein domain (Der p 21, Der p 23), enolase from Alternaria alternata (Alt a 6), and Beta expansin Phl p 1. CONCLUSION: The results of our study demonstrate the detailed profile of sensitization to allergens reagents (allergen extract and molecular components) in patients with atopic dermatitis. We show the significance of disturbed epidermal barrier, resulting in increased penetration of allergens. We confirmed the significant relationship between the severity of AD, the occurrence of bronchial asthma and allergic rhinitis, and high levels of specific IgE to allergen reagents. Our results may be important for regime measures and immunotherapy; Der p 23 shall be considered as an essential component for the diagnosis and specific immunotherapy of house dust mite allergy.
- MeSH
- alergeny MeSH
- alergická rýma diagnóza imunologie MeSH
- atopická dermatitida diagnóza imunologie MeSH
- bronchiální astma diagnóza imunologie MeSH
- dospělí MeSH
- imunoglobulin E analýza metabolismus MeSH
- kožní testy metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- pyl imunologie MeSH
- Pyroglyphidae imunologie MeSH
- senioři MeSH
- zvířata MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Farmaceutická společnost ALK uvedla v roce 2020 na český trh první sublinguální tabletu obsahující alergenový extrakt z přírodního pylu břízy (12-SQ Bet sublinguální lyofilizát) k imunomodulační léčbě pacientů s alergickou rinitidou a konjunktivitidou a senzibilizací na pyl jarních stromů. Efekt navození tolerance vůči spouštěcímu alergenu a bezpečnost tablet byly doloženy v klinických studiích. Článek shrnuje výsledky studie EPITREE zaměřené na časnou iniciaci alergenové imunoterapie u pacientů s projevy alergie na pyl břízy anebo na pyl stromů homologní skupiny (olše, líska, buk, habr, jedlý kaštan a dub).
n 2020, the pharmaceutical company ALK launched the first sublingual tablet containing birch pollen allergen extract (12 Q SQ Bet sublingual lyophilisate) on the Czech market for immunomodulation of patients with allergic rhinitis and conjunctivitis and sensitization to spring tree pollen. The effect of inducing tolerance to the trigger allergen and the safety of this tablet was supported by clinical studies. The article presents the results of the EPITREE study focused on the early initiation of allergen immunotherapy in patients with allergies to birch pollen and pollen with high homology to birch pollen (alder, hazel, beech, hornbeam, chestnut, and oak).
- MeSH
- aplikace sublinguální MeSH
- bříza imunologie MeSH
- časná lékařská intervence MeSH
- desenzibilizace imunologická * metody MeSH
- klinické zkoušky jako téma MeSH
- lidé MeSH
- pyl imunologie MeSH
- sezónní alergická rýma farmakoterapie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- Klíčová slova
- ITULAZAX-SLIT,
- MeSH
- alergie terapie MeSH
- antigeny rostlinné aplikace a dávkování terapeutické užití MeSH
- aplikace sublinguální MeSH
- desenzibilizace imunologická metody MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- pyl imunologie MeSH
- sezónní alergická rýma farmakoterapie MeSH
- Check Tag
- lidé MeSH
- Klíčová slova
- ITUZALAX,
- MeSH
- alergeny imunologie škodlivé účinky terapeutické užití MeSH
- alergie farmakoterapie MeSH
- bříza imunologie škodlivé účinky MeSH
- desenzibilizace imunologická * metody MeSH
- dospělí MeSH
- imunologická tolerance účinky léků MeSH
- lidé MeSH
- mladiství MeSH
- pyl imunologie škodlivé účinky MeSH
- randomizované kontrolované studie jako téma MeSH
- sérum imunologie účinky léků MeSH
- sublinguální imunoterapie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
