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Dermatologic Therapy Dec 2022Bullous pemphigoid (BP) is the most common autoimmune blistering skin disease, characterized by the development of autoantibodies against hemidesmosomal components BP180...
Bullous pemphigoid (BP) is the most common autoimmune blistering skin disease, characterized by the development of autoantibodies against hemidesmosomal components BP180 and BP230. The mainstay of therapy is topical and systemic corticosteroids (CS) and immunosuppressors. As this pathology mainly involves the elderly, subjects often have numerous comorbidities that influence the clinical management. Omalizumab is a recombinant humanized monoclonal anti-IgE antibody which has recently emerged as a promising treatment for BP in patients for whom CS are contraindicated or conventional treatments have failed to control the disease. For this study, we selected five patients who presented with corticosteroid-dependent BP with a contraindication to the use of other immunosuppressive treatments. The objectives of our study were to evaluate the effectiveness of omalizumab in controlling BP and allowing to decrease the dosage of systemic CS, assessing the effects of omalizumab on the clinical manifestations and the titers of circulating anti-BP180 and BP230 antibodies, IgE and eosinophils. A reduction in the dose of systemic CS was possible in 100% of the patients and complete resolution of the clinical picture was seen in 100% for skin lesions and in 40% for pruritus. A reduction of circulating IgE was found in 40%, anti-BP180 and BP230 IgGs were decreased in 60% and eosinophils in 80%.
Topics: Humans; Adrenal Cortex Hormones; Autoantibodies; Autoantigens; Non-Fibrillar Collagens; Omalizumab; Pemphigoid, Bullous
PubMed: 36259470
DOI: 10.1111/dth.15946 -
Laboratory Medicine Jul 2020Anti-M is most often assumed to be naturally occurring and can be comprised of a mixture of predominantly immunoglobulin(Ig)M with a lesser IgG component....
BACKGROUND
Anti-M is most often assumed to be naturally occurring and can be comprised of a mixture of predominantly immunoglobulin(Ig)M with a lesser IgG component. Anti-M-antibodies usually do not react at 37°C and therefore are considered to be of little clinical significance.
METHODS
A 28-year-old man presented with hemorrhagic shock from numerous injuries sustained in a motor vehicle collision. The patient received several units of red blood cells (RBCs). The antibody screen, the direct antiglobulin test (DAT), and the RBC genotype were sent for laboratory evaluation.
RESULTS
A total of 12 days after the first antibody screening result was negative (7 days after transfusion), the lowest hemoglobin value was 5.5 g per dL, and we observed a positive antibody screening result and DAT with immunoglobulin (Ig)G anti-M identified. After transfusion of 4 units of M antigen-negative RBC, the post-transfusion hemoglobin level increased to 8.9 g per dL.
CONCLUSION
Obtaining M antigen-negative compatible RBCs is necessary in patients demonstrating IgG anti-M in plasma.
Topics: Adult; Antibodies, Anti-Idiotypic; Erythrocyte Transfusion; Humans; Immunoglobulin M; Male; Transfusion Reaction
PubMed: 31756244
DOI: 10.1093/labmed/lmz078 -
Expert Opinion on Biological Therapy Jul 2020Severe pediatric asthma is associated with significant morbidity as well as with a high economic burden. It represents a heterogeneous disease with multiple clinical... (Review)
Review
INTRODUCTION
Severe pediatric asthma is associated with significant morbidity as well as with a high economic burden. It represents a heterogeneous disease with multiple clinical phenotypes. Currently, physicians are facing the challenge to provide a 'personalized medicine approach', which is tailored to the diverse pathomechanisms underlying clinical presentations. Three main endotypes of airway inflammation have been described in children with severe asthma. While neutrophilic and paucigranulocytic inflammatory patterns are quite uncommon in childhood, type Th2 inflammation asthma with elevated IgE is the most prevalent in pediatric asthma. Considering the pivotal role of IgE in type Th2 inflammation asthma, the blockade of IgE using anti-IgE therapy represents a potent therapeutic option for severe pediatric asthma in children.
AREAS COVERED
This review aims to focus on the role of omalizumab as a treatment option in pediatric patients (aged six years and above) with severe allergic asthma.
EXPERT OPINION
The clinical efficacy and safety of omalizumab for the treatment of pediatric asthma is well documented in clinical trials and observational studies. Further studies are still required to characterize the potential benefit of anti-IgE therapy in airway remodeling, identify additional biomarkers of clinical response and address current unmet needs, including the limit on omalizumab use in children younger than six years.
Topics: Anti-Asthmatic Agents; Asthma; Child; Half-Life; Humans; Immunoglobulin E; Omalizumab; Pain; Severity of Illness Index; Treatment Outcome
PubMed: 32241196
DOI: 10.1080/14712598.2020.1751115 -
Scientific Reports Mar 2021The prognosis of the liver transplant patients was frequently deteriorated by ischemia and reperfusion injury (IRI) in the liver. Infiltration of inflammatory cells is...
The prognosis of the liver transplant patients was frequently deteriorated by ischemia and reperfusion injury (IRI) in the liver. Infiltration of inflammatory cells is reported to play critical roles in the pathogenesis of hepatic IRI. Although T lymphocytes, neutrophils and monocytes infiltrated into the liver underwent IRI, we found that neutrophil depletion significantly attenuated the injury and serum liver enzyme levels in a murine model. Interestingly, the expression of CD321/JAM-A/F11R, one of essential molecules for transmigration of circulating leukocytes into inflammatory tissues, was significantly augmented on hepatic sinusoid endothelium at 1 h after ischemia and maintained until 45 min after reperfusion. The intraportal administration of anti-CD321 monoclonal antibody (90G4) significantly inhibited the leukocytes infiltration after reperfusion and diminished the damage responses by hepatic IRI (serum liver enzymes, inflammatory cytokines and hepatocyte cell death). Taken together, presented results demonstrated that blockade of CD321 by 90G4 antibody significantly attenuated hepatic IRI accompanied with substantial inhibition of leukocytes infiltration, particularly inhibition of neutrophil infiltration in the early phase of reperfusion. Thus, our work offers a potent therapeutic target, CD321, for preventing liver IRI.
Topics: Animals; Antibodies, Anti-Idiotypic; Antibodies, Monoclonal; Cell Adhesion Molecules; Disease Models, Animal; Gene Expression; Hepatocytes; Humans; Liver; Liver Function Tests; Liver Transplantation; Mice; Neutrophil Infiltration; Protective Agents; Receptors, Cell Surface; Reperfusion Injury; Signal Transduction
PubMed: 33737554
DOI: 10.1038/s41598-021-85001-2 -
Current Opinion in Allergy and Clinical... Jun 2021To review the most relevant studies in the rapidly advancing field of omalizumab as an adjunct to food allergen oral immunotherapy (OIT). (Review)
Review
PURPOSE OF REVIEW
To review the most relevant studies in the rapidly advancing field of omalizumab as an adjunct to food allergen oral immunotherapy (OIT).
RECENT FINDINGS
Clinical trials have primarily focused on milk, peanut, and multiallergen OIT combined with omalizumab. These studies suggest that omalizumab in addition to OIT can decrease the time required to reach maintenance OIT dosing and adverse events; however, serious adverse events did still occur. There is limited long-term data but available information suggests that individuals are at risk for increased reactivity after stopping omalizumab, and many discontinued treatment. There has been diversity in study designs, dosing, and populations.
SUMMARY
The use of anti-IgE antibody as an adjunct to food allergen OIT has been an expanding area of research with several additional trials underway. Significant progress has been made in the past decades but further studies are needed to optimize protocols, improve safety and efficacy, and identify patients who will have the greatest benefit.
Topics: Adjuvants, Immunologic; Administration, Oral; Allergens; Desensitization, Immunologic; Food Hypersensitivity; Humans; Omalizumab
PubMed: 33605614
DOI: 10.1097/ACI.0000000000000736 -
Food Chemistry May 2021Recurring mycotoxins contamination has posedaseriousthreatto food safety worldwide. Competitive immunoassays are widely used techniques for high-throughput mycotoxins... (Review)
Review
Recurring mycotoxins contamination has posedaseriousthreatto food safety worldwide. Competitive immunoassays are widely used techniques for high-throughput mycotoxins detection in agricultural products and foods. However, the inevitable introduction of mycotoxin conjugates produced by chemical conjugation usually results in complicated by-products, large batch errors and threats to operators and environment. Biologically derived surrogates of mycotoxin conjugates or mycotoxin standards are renewable immunoreagents. They can serve the same function as the responding counterparts in the immunoassays. The substitute-based immunoassays exhibit satisfactory sensitivity, pose less health threats to operators and environment, and contribute to the standardization of immunoassays for mycotoxins. This review focuses on the current applications of substitute-based immunoassays, clarifies their underlying mechanisms and provides a careful comparison. Challenges and future prospects are discussed.
Topics: Antibodies, Anti-Idiotypic; Antigens; Bacteriophages; Humans; Immunoassay; Mycotoxins; Single-Domain Antibodies
PubMed: 33246689
DOI: 10.1016/j.foodchem.2020.128589 -
Allergologia Et Immunopathologia 2023Detection rate, serological characteristics, and clinical data of patients with Lewis blood group antibodies in Hunan Province were analyzed through retrospective...
BACKGROUND
Detection rate, serological characteristics, and clinical data of patients with Lewis blood group antibodies in Hunan Province were analyzed through retrospective analysis. This was undertaken in order to optimize the detection methods and blood transfusion strategies of these patients.
METHODS
Blood typing, antibody screening, and cross-matching were performed by microcolumn gel, and Lewis antigen was detected by immediate spin test, antibody identification of positive and negative ABO samples, positive antibody screening, and cross-blood mismatch samples. Antibodies were identified by immediate spin test and microcolumn gel antiglobulin method, and the clinical data of the patients with Lewis antibody characteristics were analyzed.
RESULTS
A total of 74 samples (15.91%) with Lewis antibodies were detected from 465 positive samples; cases were distributed in different cities of Hunan Province, with Changsha city being the most frequent (28%) one, with mostly non-O (66), anti-Le (31; 41.89%), anti-Le+anti-Le (23; 31.08%), anti-Le (5; 6.76%), anti-Le and anti-Le+anti-Le (1+4; 6.76%), and antibody types immunoglobulin M (IgM) (51; 68.92%), immunoglobulin G (8; 10.81%), and IgG+IgM (4; 5.41%) cases. Patients included more females (67.57%) than males. The detection rate of gynecological diseases and patients with solid tumors was highest (44.59%). In all cases, the Lewis blood group was Le (a-b-); none of the 15 transfusion patients had hemolytic transfusion reaction.
CONCLUSION
A variety of experimental methods must be adopted simultaneously to determine specificity and prevent the leakage of Lewis antibodies. The infusion of red blood cells matching with antiglobulin media at 37°C was recommended to ensure safe transfusion for recipients with Lewis antibodies.
Topics: Male; Female; Humans; Retrospective Studies; Blood Transfusion; Immunoglobulin G; Blood Group Antigens; Immunoglobulin M; Antibodies, Anti-Idiotypic
PubMed: 37169560
DOI: 10.15586/aei.v51i3.811 -
JAMA Pediatrics Jan 2020
Topics: Asthma; Child; Dermatitis, Atopic; Eczema; Humans; Medical Overuse; Omalizumab
PubMed: 31764954
DOI: 10.1001/jamapediatrics.2019.4509 -
Journal of Immunology (Baltimore, Md. :... Jun 2022Rare immune-mediated thrombotic thrombocytopenic purpura (iTTP) is a life-threatening disease resulting from a severe autoantibody-mediated ADAMTS13 (a disintegrin and...
Rare immune-mediated thrombotic thrombocytopenic purpura (iTTP) is a life-threatening disease resulting from a severe autoantibody-mediated ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 motifs, member 13) deficiency. Acute iTTP episodes are medical emergencies, but when treated appropriately >95% of patients survive. However, at least half of survivors will eventually experience a relapse. How remission of an initial episode is achieved and factors contributing to reemergence of anti-ADAMTS13 Abs and a relapsing course are poorly understood. In acquired hemophilia and systemic lupus erythematosus, anti-idiotypic Abs counteracting and neutralizing pathogenic autoantibodies contribute to remission. We selected and amplified the splenic anti-idiotypic IgG<sub>1</sub> Fab κ/λ repertoire of two relapsing iTTP patients on previously generated monoclonal inhibitory anti-ADAMTS13 Fabs by phage display to explore whether anti-idiotypic Abs have a role in iTTP. We obtained 27 single anti-idiotypic Fab clones, half of which had unique sequences, although both patients shared four H chain V region genes (V<sub>H</sub>1-69*01, V<sub>H</sub>3-15*01, V<sub>H</sub>3-23*01, and V<sub>H</sub>3-49*03). Anti-idiotypic Fab pools of both patients fully neutralized the inhibitor capacity of the monoclonal anti-ADAMTS13 Abs used for their selection. Preincubation of plasma samples of 22 unrelated iTTP patients stratified according to functional ADAMTS13 inhibitor titers (>2 Bethesda units/ml, or 1-2 Bethesda units/ml), with anti-idiotypic Fab pools neutralized functional ADAMTS13 inhibitors and restored ADAMTS13 activity in 18-45% of those cases. Taken together, we present evidence for the presence of an anti-idiotypic immune response in iTTP patients. The interindividual generalizability of this response is limited despite relatively uniform pathogenic anti-ADAMTS13 Abs recognizing a dominant epitope in the ADAMTS13 spacer domain.
Topics: Humans; Purpura, Thrombotic Thrombocytopenic; ADAMTS13 Protein; Autoantibodies; Epitopes; Recurrence; Antibodies, Anti-Idiotypic
PubMed: 35589126
DOI: 10.4049/jimmunol.2100868 -
Journal of Biomechanics Aug 2022Current evidence on the association between allergic diseases and bone metabolism indicates asthma may be a potential risk factor for bone health. Using anti-IgE has...
Current evidence on the association between allergic diseases and bone metabolism indicates asthma may be a potential risk factor for bone health. Using anti-IgE has been proven effective in allergic asthma treatment with a good safety profile; however, its effects on bone health are unknown. Thus, we aimed to investigate whether: (i) chronic allergic asthma (CAA) causes any meaningful changes in bone, and if any, (ii) anti-IgE therapy prevents any CAA-induced adverse alteration. A murine model was used to study CAA. Thirty-two BALB/c male-mice were assigned into four groups (eight-mice/group): Control, CAA (treated with saline), CAA + 100 µg of anti-IgE (CAA + 100AIgE), and CAA + 200 µg of anti-IgE (CAA + 200AIgE) groups. After immunization, saline or anti-IgE was performed intraperitoneally for 8-weeks (in five-sessions at 15-days interval). Three-point bending test was used for the mechanical analysis. Bone calcium (Ca) and phosphorus (P) as well as Ca/P ratio were evaluated using inductively-coupled plasma-mass-spectrometer (ICP-MS). Compared to control, reductions observed in yield and ultimate moments, rigidity, energy-to-failure, yield and ultimate stresses, elastic modulus, toughness, and post-yield toughness parameters of the CAA group were found significant (P < 0.05). Similar declines were also detected regarding bone Ca, P and Ca/P ratio (P < 0.05). Compared to control, we observed that 200 µg administration of anti-IgE in CAA + 200AIgE group hindered CAA-related impairments in mineral and mechanical characteristics of bone, while 100 µg in CAA + 100AIgE failed to do so. Our results showed CAA may cause bone loss, leading to a decrease in bone strength, and anti-IgE administration may dose-dependently inhibit these impairments in bone.
Topics: Animals; Antibodies, Anti-Idiotypic; Antibodies, Monoclonal; Asthma; Immunoglobulin E; Male; Mice
PubMed: 35724549
DOI: 10.1016/j.jbiomech.2022.111180