Abstract
Allergologie select, Vol. 5/2021 (103-107)
Use of biologics in food allergy management
Margitta Worm, Wojciech Francuzik, Sabine Dölle-Bierke and Aikaterina Alexiou
Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité – Universitätsmedizin Berlin, Germany
Food allergies are a common medical problem, with children being the most affected patient group. The standard of care of food allergy consists of the acute treatment in case of a reaction and food avoidance in the long term, which influences the quality of life of patients. In this article, current developments for the causal treatment of food allergy including specific immunotherapy and biologics will be discussed. Epicutaneous and oral immunotherapy are currently in clinical development for the treatment of food allergy, and the results demonstrate good tolerability and efficacy with an increase in the oral threshold level. Biologics and, in particular, anti-IgE are currently investigated for their therapeutic use in food allergies. The results are promising, suggesting efficacy and tolerability.Correspondence to:
Univ.-Prof. Dr. med. Margitta Worm, Charité – Universitätsmedizin Berlin, Allergologie und Immunologie, Klinik für Dermatologie und Allergologie, Charitéplatz 1, 10117 Berlin, Germany
Email: [email protected]
Abstract
Allergologie select, Vol. 5/2021 (133-139)
Anaphylaxis in middle-aged patients
Wojciech Francuzik1, Magdalena Kraft1,2, Kathrin Scherer Hofmeier3, Franziska Ruëff4, Claudia Pföhler5, Regina Treudler6, Roland Lang7, Thomas Hawranek7, Nicola Wagner8, und Margitta Worm1
1Allergy and Immunology, Department of Dermatology, Venereology and Allergology, Charité – Universitätsmedizin Berlin, Berlin, 2Central Emergency Department, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany 3Allergology, Clinic for Dermatology, University Hospital Basel, Basel, Switzerland, 4Clinic and Polyclinic for Dermatology and Allergology, University Hospital Munich, Munich, 5Clinic for Dermatology, Venerology and Allergology, Saarland University Hospital and Medical Faculty of Saarland University, Homburg, 6Clinic and Polyclinic for Dermatology, Venerology and Allergology, Leipzig University Hospital, Leipzig, Germany, 7University Clinic for Dermatology and Allergology, Paracelsus Medical Private University Salzburg, Salzburg, Austria and 8Dermatology Clinic, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
Age is one of the most important factors influencing the course of anaphylaxis: moreover, the frequency of elicitors of anaphylaxis is age-associated. We analyzed 8,465 anaphylactic episodes in adult patients in three age groups with a focus on patients in the middle-age group (35 – 65 years old). Insect venom was the most frequent trigger in this age group (51.2%) followed by drugs (22.8%) and food (17.3%). Severe reactions were observed in 40.1% of middle-aged patients and occurred more frequently in this age group than in patients below 35 years (27.6%) and less frequently than in patients over 65 years (55.6%). The symptoms and comorbidity profile also changed with age, most significantly regarding the increase in rates of concomitant cardiologic diseases and (severe) cardiovascular symptoms.Correspondence to:
Prof. Dr. med. Margitta Worm, Allergologie und Immunologie, Klinik für Dermatologie, Venerologie, und Allergologie, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin
Email: [email protected]
Abstract
Allergologie select, Vol. 8/2024 (407-424)
Occupational anaphylaxis: A Position Paper of the German Society of Allergology and Clinical Immunology (DGAKI)
Regina Treudler1, Margitta Worm2, Andrea Bauer3, Heinrich Dickel4, Guido Heine5, Uta Jappe6, Ludger Klimek7, Monika Raulf8, Bettina Wedi9, Dorothea Wieczorek9, Wojciech Francuzik2, Thilo Jakob10, Oliver Pfaar11, Johannes Ring12, Franziska Rueff13, Sabine Schnadt14, Thomas Werfel9, Gerda Wurpts15, Julia Zarnowski16, Torsten Zuberbier1,17, and Knut Brockow12
1Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 2Department of Dermatology, Venereology and Allergology, Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 3Department of Dermatology, University AllergyCenter, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, 4Department of Dermatology, Venereology and Allergology, St. Josef Hospital, University Medical Center, Ruhr University Bochum, Bochum, 5Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, 6Division of Clinical and Molecular Allergology, Research Center Borstel, Airway Research, Center North (ARCN), Member of the German Center for Lung Research, Borstel, Interdisciplinary Allergy Outpatient Clinic, Department of Pneumology, University of Luebeck, 7Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz and Center for Rhinology and Allergology, Wiesbaden, 8Department of Allergology/Immunology; Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bochum, Germany, 9Department of Dermatology and Allergy, Comprehensive Allergy Center, Hannover Medical School, Hannover, 10Department of Dermatology and Allergology, University Medical Center Giessen (UKGM), Justus-Liebig-University Giessen, Giessen, 11Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, 12Department of Dermatology and Allergy Biederstein, School of Medicine and Health, Technical University of Munich TUM), 13Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, 14German Allergy and Asthma Association (DAAB), Mönchengladbach, 15Clinic for Dermatology and Allergology, Aachen Comprehensive Allergy Center (ACAC), University Hospital of RWTH Aachen University, Aachen, 16Department of Dermatology, Venerology and Allergology, University of Leipzig Medical Center, Leipzig, and 17Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
Background: Anaphylaxis is a systemic allergic reaction that is potentially life-threatening. Occupational anaphylaxis is an anaphylaxis that occurs in an occupational context. In this position paper, we propose diagnostic criteria for occupational anaphylaxis and provide an overview of the current state of knowledge in terms of prevalence, triggers, prevention, and management. Results: The most common triggers of occupational anaphylaxis include Hymenoptera venoms, followed by food and drugs. Chemicals, bites or contact with animals (mammals/snakes/insects) and natural rubber latex are far less common. Occupations at risk for occupational anaphylaxis are therefore beekeepers, outdoor workers, or those who handle food as well as healthcare workers. The route of contact, intensity, and frequency of exposure, type of allergen, and the simultaneous occurrence of co-factors determine the clinical manifestation. A detailed medical history is required to confirm the diagnosis of anaphylaxis and to identify the trigger. Both skin tests and the determination of specific IgE are recommended, but only very few commercially available and quality-tested allergens are available that can be examined using both test methods. Preventive measures are based on avoiding further exposure or, if necessary, replacing a working substance. A written emergency plan and the prescription of an adrenaline autoinjector as well as instructions for its use are mandatory. Allergen immunotherapy is recommended for systemic Hymenoptera venom allergy. Depending on the national healthcare systems, patients with occupational anaphylaxis must be reported to the accident insurance. Conclusion: Occupational anaphylaxis is very rare. We recommend educational measures and generally standardized recording of occupational anaphylaxis for occupations with an increased risk of anaphylaxis.Correspondence to:
Prof. Dr. Regina Treudler, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Institute of Allergology, Hindenburgdamm 30, 12203 Berlin, Germany
Email: [email protected]
