Background
The precise immunological mechanisms for the early clinical protection of venom immunotherapy (VIT) have not yet been explained. Our aim was to evaluate whether high‐affinity IgE receptor ...(FcεRI) and the related basophil function have a role in the induction of short‐term VIT protection.
Methods
We included 60 adults and 48 children. Basophil threshold sensitivity (CD‐sens) to anti‐FcεRI stimulation, and FcεRI gene and cell‐surface expression were assessed at the beginning and just before the first maintenance dose (MD) of 100 μg of ultra‐rush VIT (day 5) and at the beginning, during buildup, and just before the first MD of 70 μg and of 100 μg of semi‐rush VIT (weeks 1–2 and 5).
Results
We demonstrated a significant reduction in CD‐sens to anti‐FcεRI stimulation before the first MD in both ultra‐rush and semi‐rush VIT in all included subjects. FcεRI gene and/or cell‐surface expression was decreased in 34–100% of subjects, with different dynamics between VIT protocols.
Conclusion
We found a marked desensitization of FcεRI‐activated basophils after short‐term VIT. This suppression, which could be highly relevant for the development of early protective mechanisms, might be also related to the changes at the level of FcεRI expression.
VIT provides long-term protection to most patients who were previously allergic to insect stings, a small minority of patients having worse reactions after repeated insect stings.
Background
The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing the EAACI Guidelines on Allergen Immunotherapy (AIT) for the management of insect venom ...allergy. To inform this process, we sought to assess the effectiveness, cost‐effectiveness and safety of AIT in the management of insect venom allergy.
Methods
We undertook a systematic review, which involved searching 15 international biomedical databases for published and unpublished evidence. Studies were independently screened and critically appraised using established instruments. Data were descriptively summarized and, where possible, meta‐analysed.
Results
Our searches identified a total of 16 950 potentially eligible studies; of which, 17 satisfied our inclusion criteria. The available evidence was limited both in volume and in quality, but suggested that venom immunotherapy (VIT) could substantially reduce the risk of subsequent severe systemic sting reactions (OR = 0.08, 95% CI 0.03–0.26); meta‐analysis showed that it also improved disease‐specific quality of life (risk difference = 1.41, 95% CI 1.04–1.79). Adverse effects were experienced in both the build‐up and maintenance phases, but most were mild with no fatalities being reported. The very limited evidence found on modelling cost‐effectiveness suggested that VIT was likely to be cost‐effective in those at high risk of repeated systemic sting reactions and/or impaired quality of life.
Conclusions
The limited available evidence suggested that VIT is effective in reducing severe subsequent systemic sting reactions and in improving disease‐specific quality of life. VIT proved to be safe and no fatalities were recorded in the studies included in this review. The cost‐effectiveness of VIT needs to be established.
The formation of the spectrum of short wind waves from the gravity-capillary and capillary ranges under the effect of three-wave interactions is considered. In order to determine the spectrum, the ...kinetic equation for wave packets is integrated to the point where the solution is established. Three-wave interactions are described by a collision integral without introducing any additional assumptions simplifying the problem. This calculation procedure reproduces the Zakharov-Filonenko theoretical spectra, which correspond to the cases of energy equipartition and the inertial range. It is shown that the main role of three-wave interactions lies in the energy transfer from the range of short gravity waves to waves with shorter wavelengths. This transfer is accomplished both locally in the Fourier space and as a result of interactions between short and long waves. Its characteristic features are the formation of a dip on the curvature spectrum in the region of a minimum phase velocity of waves and the formation of a secondary peak in the capillary range. The dip is filled and disappears as the wind speed increases. Taking into account the interaction between short and long waves increases the spectrum in the capillary range several times, and the balance between energy input from long waves and viscous dissipation is established in the capillary range. The energy sink caused by three-wave interactions, viscous dissipation, and wind forcing cannot give the stability of the spectrum of short gravity waves.
Cytotoxic CD8⁺ T cells have been suggested to be key players in the pathogenesis of chronic obstructive pulmonary disease (COPD). We wanted to investigate the phenotype of lung tissue T lymphocytes ...(LTL) and tumour-infiltrating T lymphocytes (TIL) in smokers with peripheral non-small cell lung carcinoma (NSCLC) with moderate/severe versus mild COPD. Lung tissue and tumour samples were obtained from patients with moderate/severe stage of COPD (n = 10) and from patients with mild stage of COPD (n = 7) at lung resection for a solitary peripheral NSCLC, processed and analysed by flow cytometry. The flow-cytometric results showed that lung tissue T cells, regardless of the severity of COPD, were mostly of the activated phenotype, expressed the CXCR3 chemokine receptor characteristic of type 1 T cells, and did neither significantly differ in the expression of activation markers (CD69, CD25 and HLA-DR), differentiation markers (CD27 and CD28) and chemokine receptors (CXCR3 and CCR4) between the selected groups, nor showed any significant correlation with lung function measured as forced expiratory volume in 1 s (FEV₁) or TLCO. Compared with LTL, a significantly greater proportion of TIL expressed the activation markers CD69 and CD25, but a lower proportion showed a fully differentiated CD27⁻28⁻ phenotype. We conclude that lung LTL patterns are similar in NSCLC patients with moderate/severe or mild stages of COPD, and are not significantly related to lung function. LTL and TIL possess different phenotype characteristics. The majority of tumour tissue T cells are activated, but it seems that their process of differentiation is incomplete.
In the Air Pollution and Health: A European Approach (APHEA2) project, the effects of ambient ozone concentrations on mortality were investigated. Data were collected on daily ozone concentrations, ...the daily number of deaths, confounders, and potential effect modifiers from 23 cities/areas for at least 3 years since 1990. Effect estimates were obtained for each city with city-specific models and were combined using second-stage regression models. No significant effects were observed during the cold half of the year. For the warm season, an increase in the 1-hour ozone concentration by 10 mug/m3 was associated with a 0.33% (95% confidence interval CI, 0.17-0.52) increase in the total daily number of deaths, 0.45% (95% CI, 0.22-0.69) in the number of cardiovascular deaths, and 1.13% (95% CI, 0.62-1.48) in the number of respiratory deaths. The corresponding figures for the 8-hour ozone were similar. The associations with total mortality were independent of SO2 and particulate matter with aerodynamic diameter less than 10 mum (PM10) but were somewhat confounded by NO2 and CO. Individual city estimates were heterogeneous for total (a higher standardized mortality rate was associated with larger effects) and cardiovascular mortality (larger effects were observed in southern cities). The dose-response curve of ozone effects on total mortality during the summer did not deviate significantly from linearity.
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