Day 2 :
Keynote Forum
Mona I Kidon
Keynote: Treatment of food allergies in preschool children: Minimizing the risks, enhancing the benefits
Time : 10:00-10:45
Biography:
Mona I Kidon is currently the Head of Pediatric Allergy at the Safra Children's Hospital in the Chaim Sheba Medical Center, Tel Hashomer and a Senior Lecturer with the Faculty of Pediatric Medicine, Sackler Medical School, Tel Aviv University in Israel. She is a long standing Member of the European Network of Drug Allergy (ENDA) and a Past Secretary of the EAACI's task force on NSAIDs hypersensitivity in children. She has published extensively on both drug allergy and food allergy in children. She has been a part of the allergy community in Singapore since the beginning of the century, when she established the Paediatric Allegy Clinic at KK Children's Hospital and collaborates extensively with researchers at the National University of Singapore.
Abstract:
Background: A majority of preschool children with Egg Allergy (EA), Cow's Milk Allergy (CMA) and sesame allergy, can tolerate Extensively Heated and Baked Forms of these foods (EHBF). Consumption of EHBF may promote faster resolution; however, no consensus exists as to the required amounts and treatment protocols. In the past few years we have conducted a series of studies evaluating the safety and efficacy and safety of a Structured Gradual Exposure Protocol (SGEP) with EHBF in promoting tolerance to allergenic foods in food allergic children.
Methods: In a series of case control studies, preschool children with Food Allergy (FA) to eggs, milk and sesame, treated with SGEP including EHBF were compared to children treated with strict avoidance. Data was collected from records and telephone questionnaires. Analysis was performed using non-parametric Kaplan-Meier and proportional hazard Cox regression model.
Results: The median age at resolution of FA in SGEP treated children was significantly lower in all treated groups compared to their matched controls. All treatment protocols were safe overall with few in treatment reactions, mostly during observed challenges.
Conclusion: A structured protocol with EHBF as practiced by a dedicated team of pediatric allergists in an appropriate setting appears to safely promote faster resolution of FA in preschool children.
Keynote Forum
Vincenzo Patella
Santa Maria della Speranza Hospital, Italy
Keynote: How air pollution and climate change impact on allergic and respiratory diseases
Biography:
Vincenzo Patella is the Professor of Post-doctoral Program in Allergy and Clinical Immunology, Department of Translational Medical Sciences, Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Italy. He is the Director of Allergy and Clinical Immunology Division, ASL SALERNO Battipaglia, Italy and also the Chairman of National Task Force for Climate and Environment Change, Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC).
Abstract:
The World Health Organization (WHO) reports that air pollution is associated with climate change and in particular with global warming. Moreover, the air pollution effects on airway and lung diseases were well documented in the past by a statement of the World Allergy Organization. Literatures were searched for the effects of interaction between air pollution and climate change on allergic and respiratory diseases. Since 1990 articles and reviews have been published on this topic and a large number of studies confirm that the warming of our planet is caused by the greenhouse effect, due to increased greenhouse gas emissions. However, air pollution is closely linked to global warming, the emissions of hydrocarbons combustion residues induce a growth also in the concentration of biological allergens such as pollen, generating a mixture of these micrometer particles, called PM. Understanding the mechanisms that make PM fraction a major cause of health problems is still a controversial issue. Several studies are trying to figure out the reasons of global warming. There is evidence that the raising of the concentration of pollen and air pollutants is able to activate the inflammatory mediators in the airways. Several studies underscore the major risks of global warming on human health due to increasing concentrations of air pollution. The impact of climate change on respiratory diseases appears well documented. Over the last decades, a rise in the concentration of pollen as well as air pollution has been registered. These phenomena are in parallel with an increasing number of people showing allergic symptoms (e.g. allergic rhinitis, conjunctivitis and asthma) which often lead to emergency medical care. Scientists of different disciplines should work together with institutions, pharmaceutical companies and lay organizations to limit the adverse health effects of air pollution and global warming.
- Asthma Pharmacology | Asthma Triggers | Asthma Medications | Allergy Medication | Allergens and Allergies | Occupational Asthma | COPD
Location: Seletar Room 1, Level 3
Session Introduction
Qian Zhang
Nanjing Medical University, China
Title: Epigenetic regulation on the gene expression signature in bronchial asthma with rhinitis syndrome by RNA sequence
Biography:
Qian Zhang has pursued his PhD degree in Pulmonary Medicine from Nanjing Medical University, Nanjing, China. In 2010, he has worked as a Visiting Scholar in the Department of Internal Medicine at Far Eastern Memorial Hospital, Taiwan. From 2011 to 2016, he has worked as a Post-Doctor in Nanjing General Hospital of Nanjing Military Command, Nanjing, China. Currently, he is working as a Chief Physician, Associate Professor and Director in the Department of Respiratory Medicine at Changzhou No.2 People’s Hospital affiliated to Nanjing Medical University. He is interested in pulmonary medicine, critical care medicine, molecular biology, allergy and immunology.
Abstract:
Background: Bronchial asthma with rhinitis syndrome is the global health problem that affects numbers of patients. This study was intended to identify the signature genes, which was helpful in understanding the potential molecule mechanism of bronchial asthma with rhinitis syndrome.
Methods: The blood samples of three patients with bronchial asthma (accompanied with rhinitis syndrome), three patients with rhinitis and three normal controls were obtained for the RNA sequence. Differentially expressed genes (DEGs) and miRNAs were identified by different software. MiRNA-gene target analysis was performed through prediction tools and the regulatory network was also constructed. Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes (KEGG) were used to analyze the biological function of differentially expressed genes.
Results: A total of 353 differentially expressed genes and 59 differentially expressed miRNAs were obtained in bronchial asthma compared with that in rhinitis. And 4650 differentially expressed genes and 88 differentially expressed miRNAs were screened in rhinitis compared with that in the control. After targeting correlation analysis, 159 differentially expressed genes were not only the target genes but also negatively correlated with 39 differentially expressed miRNAs in bronchial asthma compared with that in rhinitis. And 2685 differentially expressed genes were not only the target genes but also negatively correlated with 88 differentially expressed miRNAs in rhinitis compared with that in control. Finally, 52 differentially expressed genes and 16 differentially expressed miRNAs were identified after merging the data in above three groups. Among which, five genes including SLC14A1, SNCA, TNS1, KAT2B, PARP1 were target genes of differentially expressed miRNAs (hsa-miR-93-5p, hsa-miR-92a-3p, hsa-miR-21-5p) and were significantly associated with bronchial asthma with rhinitis syndrome. Additionally, functional analysis showed that phagosome was the significantly enriched signal pathway involving three important genes (HLA-DOA, TUBB2A and MRC2).
Conclusion: Taken together, eight genes including TLR2, ICAM1, C1QB, HLA-DOA, ABL1, CASP3, CAV1, CD55, RPS26 and TUBB2A under the regulation of miRNAs played significant roles in the process of bronchial asthma with rhinitis syndrome.
Tae Young Jang
Inha University, South Korea
Title: Nasal provocation test: Allergen provocation and cold air provocation test
Biography:
Tae Young Jang is a Professor at the Department of ORL-HNS, Inha University Hospital, Former President of Korean Rhinoloy Society, President of Korean Society of Aerospace Medicine, Board Member of PAFPRS and Board Member of ARSR.
Abstract:
Nasal Provocation Test (NPT) is an ideal test for diagnosing Allergic Rhinitis (AR), since the target organ, the nasal cavity itself, is directly provoked by the causative allergen. In spite of its usefulness, NPT has not been widely accepted in clinical practice, because of its lack of standardized method and diagnostic criteria. The nonspecific Nasal Hyper-Reactivity (NHR) could be defined as hyper-responsiveness of the nasal cavity induced by nonspecific, non-allergenic stimuli. Cold Dry Air (CDA) provocation test is one of the provocative protocols designed to detect and evaluate this NHR. It has been accepted that CDA provocation is superior to other protocols in detecting NHR. However, there had been still very few studies about its clinical application. This lecture will introduce our method of NPT using intranasal spray of house dust mite allergen extract. This lecture will also discuss the association between NPT and skin prick test, and the proposed diagnostic criteria of AR using acoustic rhinometry in our large-population based study. This lecture will introduce CDA machinery we developed, and discuss its usefulness in detecting and evaluating NHR. This lecture will also cover the diagnostic criteria of NHR using CDA provocation and acoustic rhinometry. Finally, our Subjective Cold Hyper-responsiveness (SCH) grade would be introduced, which was proved to correlate well with the actual result of CDA provocation test.
Jue Wang
Xi’an Jiaotong University, China
Title: Several drugs induce mast cell degranulation and pseudo-allergic reactions via MRGPRX2
Biography:
Jue Wang has her expertise in pseudo-allergic reactions and the possible mechanisms underlying anaphylactoid reactions. She currently focused on allergic asthma and mast cell related diseases.
Abstract:
Mast cells are unique immunocytes that function as sentinel cells in host defense reactions such as immediate hypersensitivity responses and anaphylactic responses. The mast cell specific receptor MRGPRX2 (Mas-related G protein-coupled receptor X2) triggers mast cell degranulation; a key process in anaphylactic reactions. In 2014, McNeil, et al. reported that MRGPRX2 was crucial for drug-induced pseudoallergic reactions. It is widely observed that antimicrobials, opioid receptor and muscle relaxant agonists can induce pseudo-allergic reactions (i.e. IgE-independent mechanism) with symptoms ranging from skin inflammation to life-threatening systemic anaphylaxis. But the allergy effects of these drugs and the possible mechanisms underlying anaphylactoid reactions have not been demonstrated.
Several drugs were screened by Ca2+ imaging using MRGPRX2 overexpressing HEK293 cells. MRGPRX2 related anaphylactoid reactions induced by these components were investigated using skin swelling and extravasation assays in vivo and mast cell degranulation assay in vitro. We showed that MRGPRX2 is involved in allergic-like reactions to three types of antimicrobials(antifungal agents, aminoglycosides and sulfonamides) and muscle relaxant agonists (Mivacurium and Cisatracurium). These drugs caused pseudo-allergic reactions in wild-type mice by inducing mast cells to release histamine. However, it did not induce a similar phenomenon in KitW-sh/W-sh mice. Furthermore, MrgprB2-knockout(MrgprB2 is the murine homologue of MRGPRX2) mice displayed no inflammatory response to them. They induced LAD2 cell degranulation in a dose-dependent manner. They stimulated intracellular calcium ion (Ca2+) influx in MRGPRX2-HEK293 cells but not in NC-HEK293 cells. The results of this study suggest that many clinicians should pay more attention to the possible pseudo-allergic reactions caused by these drugs and reduce the risk of allergic reactions.