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  • 1. Brandström, Josef
    et al.
    Vetander, Mirja
    Sundqvist, Ann-Charlotte
    Lilja, Gunnar
    Johansson, S. G. O.
    Melén, Erik
    Sverremark-Ekström, Eva
    Stockholms universitet, Naturvetenskapliga fakulteten, Institutionen för molekylär biovetenskap, Wenner-Grens institut.
    Nopp, Anna
    Nilsson, Caroline
    Individually dosed omalizumab facilitates peanut oral immunotherapy in peanut allergic adolescents2019Ingår i: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 49, nr 10, s. 1328-1341Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Peanut oral immunotherapy (pOIT) has showed good short-term outcomes, but allergic reactions may prevent effective up-dosing and is a major cause of stopping OIT. In placebo-controlled trials, omalizumab has been shown to facilitate allergen immunotherapy and increase tolerance to peanut.

    Objective: We hypothesized that by combining omalizumab with pOIT, and monitor treatment effects with basophil allergen threshold sensitivity tests (CD-sens), peanut allergic patients could safely initiate pOIT and thereafter slowly withdraw omalizumab.

    Methods: This is the 2nd part of a one-armed open phase-2 study where peanut allergic adolescents (n = 23) started pOIT after an individualized omalizumab treatment. The pOIT dose was increased from 280 to 2800 mg peanut protein in 8 weeks followed by an individualized step-wise withdrawal of omalizumab, based on clinical symptoms and CD-sens levels. pOIT continued for 12 weeks followed by an open peanut challenge. Peanut CD-sens and allergen-binding activity (ABA) and IgE-ab, IgG-ab and IgG4-ab to peanut and its components were measured during the study.

    Results: All 23 patients successfully reached the 2800 mg maintenance dose. Moderate/systemic allergic reactions were rare while receiving full-dose omalizumab. Eleven of 23 (48%) successfully continued with pOIT after omalizumab was stopped. Compared to treatment failures, median baseline IgE-ab to peanut components Ara h 1-3 and CD-sens to peanut were significantly lower among successfully treated patients and IgG4-ab to peanut, Ara h 2 and 6 increased significantly more during treatment.

    Conclusions and clinical relevance: This study indicates that omalizumab is an effective adjunctive therapy for initiation and rapid up-dosing of pOIT; however, adverse events from pOIT become more frequent as omalizumab doses are decreased.

  • 2. Bråbäck, L.
    et al.
    Vogt, H.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Migration and asthma medication in international adoptees and immigrant families in Sweden2011Ingår i: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 41, nr 8, s. 1108-1115Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Studies of asthma in migrant populations illustrate the effects of environmental changes.

    Objective In this register study we investigated the importance of exposure to a western lifestyle in different phases of development in Swedish residents with an origin in regions in the world where asthma usually is less prevalent.

    Methods The study population comprised 24 252 international adoptees, 47 986 foreign-born and 40 971 Swedish-born with foreign-born parents and 1 770 092 Swedish-born residents with Swedish-born parents (age 6–25 years). Purchased prescribed inhaled corticosteroids (ICS) during 2006 were used as an indicator of asthma.

    Results International adoptees and children born in Sweden by foreign-born parents had three- to fourfold higher rates of asthma medication compared with foreign-born children. The odds ratios (ORs) of asthma medication declined persistently with age at immigration. For adoptees the ORs compared with infant adoptees were 0.78 [95% confidence interval (CI) 0.71–0.85] for those adopted at 1–2 years, 0.51 (0.42–0.61) at 3–4 years and 0.35 (0.27–0.44) after 5 or more years of age. Corresponding ORs for foreign-born children with foreign-born parents immigrating at 0–4 years, at 5–9 years, at 10–14 years and at 15 years or more were 0.73 (0.63–0.86), 0.56 (CI 0.46–0.68) and 0.35 (CI 0.28–0.43), respectively. The ORs were only marginally affected by adjustment for region of birth and socio-economic indicators.

    Conclusions and Clinical Relevance Age at immigration is a more important determinant of purchased ICS than population of origin. This indicates the importance of environmental factors for asthma in schoolchildren and young adults.

  • 3. Hales, B. J.
    et al.
    Hizawa, N.
    Jenmalm, M.
    Sverremark-Ekström, Eva
    Stockholms universitet, Naturvetenskapliga fakulteten, Institutionen för molekylär biovetenskap, Wenner-Grens institut.
    Wardlaw, A. J.
    Developments in the field of allergy in 2014 through the eyes of Clinical and Experimental Allergy2015Ingår i: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 45, nr 12, s. 1723-1745Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    The pathogenesis of asthma continues to be a major topic of interest to our authors with reviews and original papers on the role of viruses, mechanisms of inflammation, biomarkers, and phenotypes of asthma being major topics. A number of papers described new treatments for asthma focusing on blocking the Th2 response reflecting the fact that two decades of work in this area is finally bearing fruit. The pathogenesis of chronic rhinosinusitis is a growing area of interest, but there has been less on the genetics of airways disease than in previous years possibly reflecting the degree of rigour (and therefore a smaller body of work), with which these sorts of studies are now being undertaken. There continues to be a wide range of papers dealing with mechanisms of allergic disease ranging from clinical-based studies to basic research and the use of in vivo animal models especially mice. As before, mechanisms and new approaches to immunotherapy are common themes. Several were published in the allergens section investigating modification of allergens to increase their effectiveness and reduce the risk of adverse events. Risk factors for allergic disease was a common theme in the epidemiology section and food allergy a common theme in clinical allergy with papers on the development of protocols to induce tolerance and attempts to find biomarkers to distinguish sensitization from allergic disease. This was another exciting year for the editors, and we hope the readers of the journal.

  • 4. Jernelov, S.
    et al.
    Lekander, Mats
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Almqvist, C.
    Axelsson, John
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Larsson, H.
    Development of atopic disease and disturbed sleep in childhood and adolescence a longitudinal population-based study2013Ingår i: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 43, nr 5, s. 552-559Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Both atopic diseases and sleep disturbances have increased during recent decades, especially in children. Sleep is important for many aspects of immune regulation relevant in allergic diseases, and sleep disturbances are common in patients with such diseases. A connection between sleep disturbances and fatigue, and atopic disease is well established. However, the time course and putative causal relationships between these factors are obscure.

    Objective We aimed at investigating the developmental relationships between subjectively reported sleep disturbances and symptoms of atopic disease, from childhood to adolescence.

    Methods This longitudinal study used parent-report questionnaire data on symptoms of atopic disease, and sleep disturbances, from the Twin Study of Child and Adolescent Development (TCHAD). Overall, 1480 twin pairs born in Sweden were approached first when children were 89years old, and again later at 1314years old. Response rates were 75% and 72%. Data from the TCHAD questionnaires were linked to the Swedish Medical Birth Register based on personal identification numbers.

    Results Being overtired at age 8 increased the risk [OR; 95% CI (2.59; 1.315.11)] to develop rhinitis symptoms at age 13, even when controlling for gender, previous rhinitis, Socio-economic status, birth weight and other sleep disturbances at age 8. Likewise, symptoms of asthma at age 8 was an independent risk factor for being overtired at age 13 [OR; 95% CI (2.64; 1.444.84)], controlling for similar confounders.

    Conclusion & Clinical Relevance The findings from this study are consonant with the proposition that atopic disease and disturbed sleep are more than passively interrelated. Future research needs to delineate whether causal relationships between these problems are at hand and, if so, at what periods in development this applies. These results point to a need for clinicians to investigate sleep difficulties and treat impaired sleep in paediatric patients with atopic disease.

  • 5.
    Saghafian-Hedengren, S.
    et al.
    Stockholms universitet, Naturvetenskapliga fakulteten, Wenner-Grens institut.
    Holmlund, U.
    Stockholms universitet, Naturvetenskapliga fakulteten, Wenner-Grens institut.
    Amoudruz, P.
    Nilsson, C.
    Sverremark-Ekström, E.
    Stockholms universitet, Naturvetenskapliga fakulteten, Wenner-Grens institut.
    Maternal allergy influences p38-mitogen-activated protein kinase activity upon microbial challenge in CD14+ monocytes from 2-year-old children2008Ingår i: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, ISSN 1365-2222, Vol. 38, nr 3, s. 449-57Artikel i tidskrift (Refereegranskat)
  • 6.
    Sjögren, Ylva Margareta
    et al.
    Stockholms universitet, Naturvetenskapliga fakulteten, Wenner-Grens institut för experimentell biologi.
    Jenmalm, Maria C.
    Linköpings universitet.
    Böttcher, Malin F.
    Linköpings universitet.
    Björkstén , Bengt
    Karolinska institutet.
    Sverremark-Ekström, Eva
    Stockholms universitet, Naturvetenskapliga fakulteten, Wenner-Grens institut för experimentell biologi.
    Altered early infant gut microbiota in children developing allergy up to 5 years of age2009Ingår i: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 39, s. 518-526Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Early colonization with bifidobacteria and lactobacilli is postulated to protect children from allergy, while Clostridium difficile colonization might be associated with allergic disease. Previous studies of the infant gut microbiota in relation to subsequent allergy development have mostly employed culture dependent techniques, studied genera of bacteria and the follow up period was limited to two years.

    Objective: To relate gut microbiota in early infancy, notably bifidobacteria and lactobacilli at species level, to allergy development during the first five years of life and study if environmental factors influence the early infant gut microbiota.

    Methods: Faecal samples were collected at one week, one month and two months after birth from 47 Swedish infants, followed prospectively to five years of age. Bacterial DNA was analysed with Real-time PCR and related to allergy development, family size as well as endotoxin and Fel d 1 levels in house dust samples. Primers binding to Clostridium difficile, four species of bifidobacteria, two lactobacilli groups and Bacteroides fragilis were used. Children regarded as allergic manifested allergic symptoms and were skin prick test positive during their first five years while non-allergic children were neither.

    Results: Children who developed allergy were significantly less often colonized with lactobacilli group I (Lactobacillus (L.) rhamnosus, L. casei, L. paracasei), Bifidobacterium adolescentis and Clostridium difficile during their first two months. Infants colonized with several Bifidobacterium species had been exposed to higher amounts of endotoxin and grew up in larger families than infants harbouring few species.

    Conclusion: A more diverse gut microbiota early in life might prevent allergy development and may be related to the previously suggested inverse relationship between allergy, family size and endotoxin exposure.

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