Head and Neck Medicine by Alexandros G.Sfakianakis

Publication date: Available online 21 February 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Anne K. Ellis, Charles W. Frankish, Robyn E. O'Hehir, Kristen Armstrong, Lisa Steacy, Mark Larché, Roderick P. Hafner
BackgroundSynthetic peptide immunoregulatory epitopes are a new class of immunotherapy to treat allergic rhinoconjunctivitis (ARC). Grass allergen peptides, comprising 7 synthetic T-cell epitopes derived from Cyn d 1, Lol p 5, Dac g 5, Hol l 5, and Phl p 5, is investigated for treatment of grass pollen–induced ARC.ObjectiveWe sought to evaluate the efficacy, safety, and tolerability of intradermally administered grass allergen peptides.MethodsA multicenter, randomized, double-blind, placebo-controlled study evaluated 3 regimens of grass allergen peptides versus placebo in patients with grass pollen–induced allergy (18-65 years). After a 4-day baseline challenge to rye grass in the environmental exposure unit (EEU), subjects were randomized to receive grass allergen peptides at 6 nmol at 2-week intervals for a total of 8 doses (8x6Q2W), grass allergen peptides at 12 nmol at 4-week intervals for a total of 4 doses (4x12Q4W), or grass allergen peptides at 12 nmol at 2-week intervals for a total of 8 doses (8x12Q2W) or placebo and treated before the grass pollen season. The primary efficacy end point was change from baseline in total rhinoconjunctivitis symptom score across days 2 to 4 of a 4-day posttreatment challenge (PTC) in the EEU after the grass pollen season. Secondary efficacy end points and safety were also assessed.ResultsTwo hundred eighty-two subjects were randomized. Significantly greater improvement (reduction of total rhinoconjunctivitis symptom score from baseline to PTC) occurred across days 2 to 4 with grass allergen peptide 8x6Q2W versus placebo (−5.4 vs −3.8, respectively; P = .0346). Greater improvement at PTC also occurred for grass allergen peptide 8x6Q2W versus placebo (P = .0403) in patients with more symptomatic ARC. No safety signals were detected.ConclusionGrass allergen peptide 8x6Q2W significantly improved ARC symptoms after rye grass allergen challenge in an EEU with an acceptable safety profile.

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The impact on quality of life on families of children on an elimination diet for Non-immunoglobulin E mediated gastrointestinal food allergies

The impact on health related quality of life (HRQL) has been well studied in children with Immunoglobulin E (IgE)-mediated food allergy. However limited data exists on related quality of life (QOL) of families...

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A New Application of the Bioarchaeology of Care Approach: A Case Study from the Metal Period, Philippines

Abstract

A case of disability in the Metal Period of the Philippines, likely requiring healthcare from others, is presented to explore aspects of group dynamics in this period of antiquity. B243, a middle-aged male excavated from the Napa site in the central Philippines, suffered severe trauma to the right leg resulting in considerable restrictions to mobility and self-maintenance of survival related behaviours such as food provision and hygiene. It is likely that B243 required assistance from others to survive for some period of time prior to eventual death. The bioarchaeology of care method was applied to assess the types of healthcare that B243 likely required, and to consider potential social and biological impacts to both B243 and his community. Provision of healthcare practice in this case suggests that B243's community had access to health-related resources, knowledge on the treatment of his injuries and underlying values in the group for sustaining human life in the case of injury and disability.

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