Gell and Coombs's classification: is it still valid?

Descotes, Jacques; Choquet-Kastylevsky, Geneviève

doi:10.1016/s0300-483x(00)00400-5

Cited by 103 publications

(61 citation statements)

References 20 publications

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“…Academic freedom allows anyone to create his/her own list of warning signs of PID, or to modify an existing one if it is understood to be outdated. In the field of immunological diseases, which includes PID, a time-honored classification by Gell and Coombs has recently been revised in-depth, on the basis of extensive scientific evidence [11] . The latter revision was certainly not an anonymous document, nor lacked references to back it.…”

Section: Academic Freedom Scientific Accountability and Public Trustmentioning

confidence: 99%

How reliable is online diffusion of medical information targeting patients and families?

Xavier−Elsas

Bastos

Gaspar−Elsas

2015

WJEM

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AIM:To determine whether online diffusion of the "Ten Warning Signs of Primary Immunodeficiency Diseases (PID)'' adheres to accepted scientific standards. METHODS:We analyzed how reproducible is online diffusion of a unique instrument, the "Ten Warning Signs of PID", created by the Jeffrey Modell Foundation (JMF), by Google-assisted searches among highly visited sites from professional, academic and scientific organizations; governmental agencies; and patient support/advocacy organizations. We examined the diffusion, consistency of use and adequate referencing of this instrument. Where applicable, variant versions of the instrument were examined for changes in factual content that would have practical impact on physicians or on patients and their families. RESULTS:Among the first 100 sites identified by Google search, 85 faithfully reproduced the JMF model, and correctly referenced to its source. By contrast, the other 15 also referenced the JMF source but presented one or more changes in content relative to their purported model and therefore represent uncontrolled variants, of unknown origin. Discrepancies identified in the latter included changes in factual content of the original JMF list (C), as well as removal (R) and introduction (I) of novel signs ( the number of infectious episodes considered necessary to raise suspicion of PID, as well as the inclusion of various medical conditions not mentioned in the original. Together, these changes will affect the way physicians use the instrument to consult or to inform patients, and the way patients and families think about the need for specialist consultation in view of a possible PID diagnosis. CONCLUSION:The retrieved adaptations and variants, which significantly depart from the original instrument, raise concerns about standards for scientific information provided online to physicians, patients and families. Core tip: We analyzed how reproducible is online diffusion of a unique instrument, the "Ten Warning Signs of Primary Immunodeficiency Diseases", to define whether information made available to physicians, families and support/advocacy groups through the internet adheres to accepted scientific standards. The results show that this instrument is diffused through many sites, but the actual scientific contents often depart substantially from their purported model. This raises concerns about the quality of scientific information provided online on medical matters, and on the need for corrective mechanisms in an age when the public is increasingly dependent on the internet as primary source of knowledge.Xavier-Elsas P, Bastos SE, Gaspar-Elsas MIC. How reliable is online diffusion of medical information targeting patients and families? World J Exp Med 2015; 5(4): 244-250 Available from:

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Section: Academic Freedom Scientific Accountability and Public Trustmentioning

confidence: 99%

How reliable is online diffusion of medical information targeting patients and families?

Xavier−Elsas

Bastos

Gaspar−Elsas

2015

WJEM

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“…With further studies of adverse drug reactions, a new type of hypersensitivity reaction has increasingly been recognized (2), which is an acute, potentially fatal, systemic hypersensitivity reaction arising via a non-IgEdependent mechanism. The reaction occurs at the first contact with the drug without prior sensitization, and does not increase upon repeated exposure.…”

Section: Introductionmentioning

confidence: 99%

Agents that induce pseudo-allergic reaction

Wang

Hs²,

Zp³

2011

Drug Discov Ther

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Pseudo-allergic reactions may result from the activation of inflammatory or anaphylactic mechanisms independent of antigen-specific immune responses. Recent statistics show that pseudo-allergic reactions may represent as high as two thirds of all immediate hypersensitivity reactions, implying a great amount of morbidity and numerous health care costs. In this review, we concentrate on agents mediating pseudo-allergic reactions and evaluate accurately the available information on their modes of action. The agents discussed here are divided into three types: (i) Direct mast cell activators, which may activate mast cells in an IgE-independent manner, such as opioid drugs, basic secretagogues and calcium ionophore A23187; (ii) Complement activators, including liposomes, radiocontrast media and Cremophor EL, which may activate the complement system by different pathways: the classical pathway, the mannose-binding lectin pathway or the alternative pathway; (iii) Nonsteroidal anti-inflammatory drugs, which may inhibit the function of cyclooxygenase-1, resulting in the occurrence of adverse reactions. In addition, nonclinical detection methods of pseudoallergic reactions are also reviewed in order to supply valuable information for clinical diagnosis.

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“…Although our current knowledge of the immune system has widely increased, this classification is still in use, at least in teaching terms. In the clinical practice, however, its use has been challenged since it does not include all possible allergic reactions caused by medical drugs, and sometimes both humoral and cellular responses can occur at the same time [11,12]. Other scientists have proposed the existence of additional types of hypersensitivity [13,14].…”

Section: Classification Of the Allergic Reactionsmentioning

confidence: 99%

“…The affected cells are removed in minutes. Among the diseases associated with complement activation and type II hypersensitivity responses are drug-induced cytopenias [12]. The new improvements in the original classification from Gell and Coomb, now consider that Type IIa corresponds to the former Type II, where the inflammatory response results in cell death mediated by activation of the complement, phagocytosis, or cytolysis following the binding of antibodies to cell surface antigens on the target cell.…”

Section: Classification Of the Allergic Reactionsmentioning

confidence: 99%

Immune System and Atopic Disorders

Pascual

Roa

2013

SpringerBriefs in Genetics

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The terms "complex" or "multifactorial" are used interchangeably to refer to diseases that are obviously not the result of a single mutation or an environmental aggression. The genetic load of these diseases is unquestionable, and numerous studies have demonstrated both its heritability and the influence of certain anti-inflammatory factors, but both have proved to be insufficient to the complete understanding of their prevalence and patterns of heritability.Allergic rhinitis, atopic dermatitis, allergic asthma, food allergy, anaphylaxis, or contact dermatitis are examples of complex or multifactorial diseases for which much is yet to be understood. The term "allergy" was first used by Clemens von Pirquet in 1906 to define the unusual tendency of some people to develop reactivity symptoms or "hypersensitivity reactions" when exposed to seemingly innocuous substances. Atopic diseases, from the Greek atopos meaning "out of place", are associated with the production of specific IgE antibodies and with the expansion of specific T cell populations, which are reactive against what normally would be harmless substances.The prevalence of allergic diseases has increased around 75 % during the last three decades [1]. This rise in the epidemiological trend has not found a satisfactory explanation yet, although there is a general consensus that is not due solely to a genetic explanation. This observation has been subject of intense speculation, and the role of certain environmental factors has been studied. To this intriguing scenario we have to add that the pathogenesis of the disease as well as the contribution of genetic factors is still poorly understood [2].Today it is thought that about 300 million people worldwide suffer from asthma [3,4]. According to the American Academy of Allergy, Asthma and Immunology (www.aaaai.org), it is thought that more than half (54.6 %) of Americans are positive for one or more allergens [5,6], and that about 50 millions suffer from some kind of allergy, including allergies to food, drug, latex, insects, pollen, mites, or skin and eye allergic diseases. Allergic diseases in the US occupy the fifth position among the most common chronic diseases, and the third position among the most common chronic diseases in children under 18 years [7]. In a pioneer study that was conducted in Britain in 1992, the comparison of children from 1964 to

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Gell and Coombs's classification: is it still valid?

Cited by 103 publications

References 20 publications

How reliable is online diffusion of medical information targeting patients and families?

How reliable is online diffusion of medical information targeting patients and families?

Agents that induce pseudo-allergic reaction

Immune System and Atopic Disorders

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