Background
Anaphylaxis, which is rare, has been reported after COVID‐19 vaccination, but its management is not standardized.
Method
Members of the European Network for Drug Allergy and the European Academy of Allergy and Clinical Immunology interested in drug allergy participated in an online questionnaire on pre‐vaccination screening and management of allergic reactions to COVID‐19 vaccines, and literature was analysed.
Results
No death due to anaphylaxis to COVID‐19 vaccines has been confirmed in scientific literature. Potential allergens, polyethylene glycol (PEG), polysorbate and tromethamine are excipients. The authors propose allergy evaluation of persons with the following histories: 1—anaphylaxis to injectable drug or vaccine containing PEG or derivatives; 2—anaphylaxis to oral/topical PEG containing products; 3—recurrent anaphylaxis of unknown cause; 4—suspected or confirmed allergy to any mRNA vaccine; and 5—confirmed allergy to PEG or derivatives. We recommend a prick‐to‐prick skin test with the left‐over solution in the suspected vaccine vial to avoid waste. Prick test panel should include PEG 4000 or 3500, PEG 2000 and polysorbate 80. The value of in vitro test is arguable.
Conclusions
These recommendations will lead to a better knowledge of the management and mechanisms involved in anaphylaxis to COVID‐19 vaccines and enable more people with history of allergy to be vaccinated.
Portable devices, such as smartphones and mobile Internet access have become ubiquitous in the last decades. The term ‘eHealth’ stands for electronic health. The tools included in the eHealth concept utilize phones, computers and the Internet and related applications to improve the health care industry. Implementation of eHealth technologies has been documented for the management of different chronic diseases, including asthma and allergic conditions. Clinicians and patients have gained opportunity to communicate in new ways, which could be used cost‐effectively to improve disease control and quality of life of those affected. Additionally, these innovations bring new opportunities to academic researchers. For example, eHealth has allowed researchers to compile data points that were previously unavailable or difficult to access, and analyse them using novel tools, collectively described as ‘big data’. The role of eHealth become more important since early 2020, due to the physical distancing rules and the restrictions on mobility that have been applied worldwide as a response to the coronavirus disease 2019 pandemic. In this review, we summarize the most recent developments in various eHealth platforms and their relevance to the speciality of allergy and immunology, from the point of view of three major stakeholders: clinicians, patients and researchers.
Anaphylaxis is an unpredictable systemic hypersensitivity reaction and constitutes a high risk of maternal and fetal morbidity and mortality when occurring during pregnancy. Currently, the acute management of anaphylaxis is based on clinical parameters. A total serum tryptase is only used to support an accurate diagnosis. There is a need to detect other biomarkers to further assess high-risk patients in obstetrics. Our objective is to present biomarkers in this complex interdisciplinary approach beyond obstetrician and anaesthetic management. Candidate biomarkers derive either from mediators involved in immunopathogenesis or upcoming molecules from systems biology and proteomics. Serum tryptase is determined by singleplex immunoassay method and is important in the evaluation of anaphylactic mast cell degranulation but also in the assessment of other risk factors for anaphylaxis such as systemic mastocytosis. Another category of biomarkers investigates the IgE-mediated sensitization to triggers potentially involved in the etiology of anaphylaxis in pregnant women, using singleplex or multiplex immunoassays. These in vitro tests with natural extracts from foods, venoms, latex or drugs, as well as with molecular allergen components, are useful because in vivo allergy tests cannot be performed on pregnant women in such a major medical emergency due to their additional potential risk of anaphylaxis.
Dental wear is an irreversible loss of dental hard tissues under the action of physical and chemical factors that may come from the external or internal environment of the body. Dental wear is the consequence of three mechanisms: biocorrosion, friction and stress. The purpose of the study was to determine the impact of risk factors on the severity of erosive dental wear in children using factorial analysis. In this context, we used data from a statistical survey conducted between 2017-2018 on 456 rural and urban children aged 6 to 11 years, where dental wear was analyzed according to a series of diet-related factors, oral hygiene and behavioral patterns (bruxism). The major impact was caused by energy drinks, yoghurt and carbonated beverages. Through the associations resulting from the factorial analysis, the mechanisms involved in the erosive dental wear were also highlighted, and the main was biocorrosion, followed by friction and stress.
According to the Global Allergy and Asthma European Network (GA²LEN), a pan-European skin prick test panel for the diagnosis of allergic rhinitis and asthma includes 18 aeroallergen extracts, supplemented if necessary for regional or for particular patient needs, while the Allergen Subcommittee and Immunotherapy Committee of the American Academy of Allergy, Asthma and Immunology (AAAAI) selected 36 major clinically relevant aeroallergens for North America.
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