11^th International Conference on Allergy, Asthma & Clinical Immunology September 07-08, 2017 Edinburgh, Scotland

Biography:

Benjamin Wong completed his MD at University of Toronto, Canada. He subsequently completed Post-graduate training in Internal Medicine and Subspecialist training in Allergy and Clinical Immunology. He is a Consultant at North York General Hospital. For more than 10 years, he has been the Chair of the Section of Allergy and Clinical Immunology of the Ontario Medical Association. He has been the Chair and Co-chair of the Allergy Update, an annual symposium in Ontario where international researchers gather and participate in furthering the field of allergy and clinical immunology. At a national level, he serves as a member of the Board of Examiners of the Royal College of Physicians and Surgeons of Canada.

Abstract:

Allergy and clinical immunology is an exciting and ever changing field, providing allergists and clinical immunologists increasing and unique opportunities to work with multiple medical subspecialties and interdisciplinary personnel. Beta-lactam allergy has been a major focus in the field of drug allergy in part due to its ubiquitous use, implications for health care resource utilization, and increased awareness of antimicrobial stewardship. This presentation highlights work done at a community academic teaching hospital affiliated with the University of Toronto, Canada, over the past few years. Practical cases and management of penicillin allergy, opportunities for interdisciplinary collaborations with medical subspecialists and pharmacists, development of a practical clinical pathway with decision algorithms, patient history refinement on electronic medical records, as well as point-of-care management guide for non-allergists will be discussed. Research opportunities including utilization of point of care beta-lactam allergy skin testing (BLAST) and the standardized use of state of the art electronic order sets for oral challenges and desensitization will also be highlighted. 

Biography:

Luiz Werber-Bandeira is the Head of Clinical and Experimental Immunology Unit - Santa Casa de Misericórdia do Rio de Janeiro, Brazil. He has a degree in Medicine; completed his Post-doctorate in Immuno-Genetics and; PhD in Medicine-Immunology-Dermatology at Federal University of Rio de Janeiro. He is also specialized in Clinical Immunology-Allergy at Federal University of Rio de Janeiro. He is reorganizer of the clinical and experimental immunology unit - Santa Casa da Misericórdia, Rio de Janeiro. 

Abstract:

Primary cutaneous T cell lymphomas (CTCLs) are characterized by hyper proliferation of malignant CD4+ T cells with primary localization on the skin. The common characteristics are the migration of the malignant mature T-lymphocytes into the epidermis, with hyper proliferation of malignant CD4+ T cells and epidermotropism. Sézary syndrome (SS) is the leukemic variant. It was established that CTCLs arise from a clonal expansion of CD4+ T cells with an identical rearrangement of the T cell receptor. The purpose of this study was to evaluate the immunomodulation effect of photo chemotherapy-A [psoralen plus ultraviolet A (PUVA)]. Pre- and post-PUVA punch skin biopsies of nine patients were stained immunohistochemically for CD34+, CD8+, CD7+, CD16+, CD56+, CD1a+, Bcl2+, p53+, CD45RA+, and CD45RO+ cells. The results showed a pre-PUVA cells/mm² without significant difference among expansive or reactive cells. Post-PUVA analysis showed a significant decrease in the mean of expansive-reactive cells. PUVA was immunomodulated decreasing cellular infiltrate. These findings could contribute to the comprehension of how PUVA acts. We achieved ectoscopic clearance of the lesions, although post-PUVA, there still was a mononuclear pathological infiltrate. This result demonstrates that the PUVA treatment should only be withheld when the histological analysis is normal.

Biography:

Gennaro Maietta graduated from Faculty of Medicine of the University of Florence in 1981 and he received Post-graduate degree in Clinical Immunology and Allergology at School of Immunology of Prof. Ricci in 1984. During his Postgraduate course, he focused his interests in “Thyroid autoimmunity and in thyroid stimulating antibodies detection on FTRL5 cells”. He became the Head of Allergy Unit of Public Health department in City of Lecce (Italy) and the Head of the Laboratory of Immunology of Pignatelli Institute in the same city. He is interested in Basophils and their role in allergic disease. He is member of EAACI and of AAIITO (Italian Allergy and Immunology Society) and, he is the coordinator of the regional section of AAIITO in Apulia. 

Abstract:

Statement of the Problem: Specific immunotherapy (SIT) is able to modify the natural history of allergic diseases. In particular, SIT induces an immunological tolerance against the allergen and clinical control of disease. Clinical efficacy of subcutaneously SIT (SCIT) has been clearly demonstrated as well as sublingual SIT (SLIT), but we need to identify biological markers for SIT in the attempt to reveal patients with high risk of adverse reactions, to monitor the therapy outcome and to predict relapses after SIT discontinuation. We know that both SCIT and SLIT induce a sudden increase of the basophil sensitivity in the first weeks of immunotherapy followed by a gradual decrease over some months. The purpose of this study is to evaluate if Basophil Activation Test (BAT) can monitor the progressive desensitization of the patient during SIT.

Methodology: Patients between 18 and 60 years old allergic to wall pellitory or grass were enrolled in the study. Some of them were treated with SCIT, while others preferred to be treated with SLIT. BAT was performed at the beginning of the treatment and during pollen season for two years. BAT was performed with specific allergen at different concentrations in attempt to evaluate basophil activation as CD-sens (allergen concentration able to induce 50% of maximum activation). SIT outcome was evaluated clinically by using a VAS score.

Findings: BAT showed a higher and earlier reduction of CD-sens in patients treated with SCIT compared with SLIT treated ones. In some patients, it was not possible to observe a reduction in CD-sens. These patients had experienced persistence or worsening of clinical symptoms.

Conclusion & Significance: BAT should represent a useful tool in evaluating progressive desensitization during SIT by monitoring basophil sensitivity. CD-sens could be an interesting biomarker in deciding how long the SIT continues and when to suspend it. Probably, it could represent a biomarker in predicting clinical relapses after immunotherapy discontinuation.

Biography:

Sarah Van Nederveen-Bendien is working as a Pulmonologist in a teaching hospital in Hague, Netherlands. Her main interests include Asthma and Allergy. In 2014, she started a specialized asthma and pregnancy outpatient clinic. This resulted in a large cohort of pregnant patients with asthma. In the Netherlands, the treatment of asthma during pregnancy is still sub-optimally organized, mainly because of fear for teratogenic effects of asthma medication during pregnancy patients and doctors regularly stop or decrease medication.

Abstract:

Background: The diagnosis of asthma can be difficult to confirm. Recently, a study of Aaron et al in the JAMA showed that about 33% of adults with a physician diagnosis of asthma did not have asthma when assessed by a stepwise diagnostic algorithm. Dyspnoe during pregnancy can be a result of variable causes. In patients presenting with dyspnea during pregnancy, it is not always possible to confirm the diagnosis of asthma. Mainly because, in case of normal spirometry, performing bronchial provocation testing (BPT) during pregnancy is contra indicated.

Methods: This retrospective cohort consists of all pregnant women referred to the Asthma & Pregnancy outpatient clinic (Haga Teaching Hospital, Netherlands) from 2014 until 2017. At first consultation spirometric testing with reversibility, fractional exhaled nitric oxide (FeNO) measurement, asthma control questionnaire (ACQ), blood eosinophils and allergy testing were performed.

Results: 95 pregnant women were referred at a mean gestational age of 18 weeks. At first consultation mean ACQ was 2.1. In 63% of patients, the diagnosis of asthma was confirmed by spirometry and reversibility testing or bronchial provocation testing in combination with typical asthma symptoms, before or during the first consultation. In 37% of patients, the diagnosis of asthma could not be confirmed by spirometry or BPT; although their FeNO and blood eosinophils were lower as compared to the group with the diagnosis of asthma confirmed (table 1). In four patients, an alternative diagnosis was made OSAS (n=1), mycoplasma infection (n=2), sickle cell disease (n=1).

Conclusion: Since diagnosing asthma has the consequence of treating patients for a long time with medication with potential side effects, it is of importance to make maximum efforts to confirm or exclude asthma during or ideally before pregnancy. In case of normal spirometry, blood eosinophils and FeNO in combination with typical asthma symptoms could add important information when considering the diagnosis of asthma.

Biography:

Carlos Sanchez Salguero is the coordinator of the Allergy Pediatrics Section in Puerto Real University Hospital and Associate Professor of Pediatrics at the Medicine School in Cádiz (Spain). Specialist in Pediatrics since 1998. During the years 1999-2000 served as Director of Pediatrics Department in the Regional Hospital of Montilla (Córdoba). Then returns to the province of Cadiz where he was Director of the Pediatrics Department in the Regional Hospital of Villamartin. Since 2008 he moved to Puerto Real University Hospital where he was appointed Coordinator of the Allergy Pediatrics Section. Actually, his principal field of working is the Specific Oral Tolerance Induction with milk, egg and hake. He has published papers in relevant journals in the field of Pediatric Allergy. He has worked as an author in 4 books and chapters. He has authored several publications indexed in PubMed in national and international journals of prestige and more than 100 communications to national and international congresses of prestige.

Abstract:

In recent decades we have been assisting the identification, isolation and purification of a large number of allergens of different origins and, on the other hand, the application of recombinant DNA technology to the field of Pediatric Allergology for the biotechnological production of allergens with high purity and consistent quality from batch to batch, so that the use of purified allergens, natural or recombinant, is a real advance in clinical allergy.

The combination of these advances in molecular biology with those produced in nanotechnology has allowed the development of new technologies, among them the so-called microarrays. The protein microarray allows the detection of specific IgE against multiple molecules simultaneously, enabling the so-called molecular diagnosis or component diagnosis (CRD), which has a special interest in the diagnosis of food allergy as well as in the precision diagnosis of polysensitized patients.

The CRD will allow us to identify the individual patterns of sensitization to different proteins from the same allergenic source, with the possibility of identifying:

1.      Sensitization to proteins associated with an increased risk of serious reactions, such as lipid transfer proteins (LTP).

2.      Sensitization to homologous proteins in different allergenic sources with possible involvement in cross reactivity phenomena.

3.      Indicate a precise immunotherapy.

CONCLUSIONS

The microarray technology constitutes an important advance in the diagnosis of allergy, it allows us to establish an accurate molecular diagnosis, to know the patterns of sensitization that a patient presents with the own differences according to the geographical area to which it belongs and to detect sensitization to molecules responsible for cross reactivity syndromes. A clear indication of this tool is in the study of the patient polysensitized and in the precise indication of an immunotherapy.

Biography:

Giovanni Maria Traina completed his Graduation in Medicine and Surgery at University of Messina. He is Specialist in Pediatrics and Allergology Pediatrics at University of Messina, Perugia and Pavia. He is an author of over 25 scientific publications, speaker at over 50 national and international conferences.

Abstract:

Background: Pediatric sublingual immunotherapy (SLIT) has made it possible to attract many children allergic to desensitization path to inhalants. SLIT determines many compliance problems and sometimes it is difficult to fulfill. The alternative of SLIT is subcutaneous immunotherapy (SCIT), which is commonly performed subcutaneously with needle. This technique has not undergone special changes over the years and it is not without risk or inconvenience. This led to the search for alternative means of administering the vaccine, in order to reduce the discomfort for the child, expanding compliance and increase safety for medical vaccinators and especially reducing the potential risk of adverse reaction.

Aim: Aim of this study is to evaluate new route of administration subcutaneous immunotherapy hyposensitizing with device without needle, pain perceived by the patient registration with respect to that traditionally administered by needle, of any adverse events in the course of that procedure and also evaluate difficulties perceived by vaccinating with such methodical.

Materials & Methods: Our team together with that of Allergology Hospital Bambino Gesù in Rome has completed a first study, aimed precisely to assess the pain perceived by the patient and safety for the patient and for the operator, with interesting results. For this purpose, 36 patients were recruited and evaluated with oculorhinitis and/or bronchial asthma grass, aged between 5 and 18 years, which were administered under the skin of the arms, polymerized with glutaraldehyde extracted by grasses, with device without needle and with traditional SCIT with needle. They were recorded with dedicated VAS scale, the perceived pain, any adverse reactions and difficulty of the procedure by the vaccinator.

Results: All patients completed the study which provided 432 doses of AIT SCIT grasses, of which 216 with device without the needle. The perceived pain was significantly lower than that of immunotherapy administered by needle. In none of them, are adverse events of any grade occurred. It has highlighted the need for adequate training of the performer to better use the device without the needle. Changes made to the device have however solved these problems completely.

Conclusions: Vaccination with needleless device has several advantages and guarantees, compared to conventional administration SCIT, best welcome especially by children. This is important, to be able to start early immunotherapy, as recommended by the most recent studies, in order to prematurely change the natural evolution of allergic inflammation. The new technique provides a much higher safety for both the vaccinator that for the vaccinated, with a better acceptance by the patient of the procedure and thus a better and wider adherence to immunization programs. Just for the inoculation technique, such practice may allow a better distribution of the subcutaneous vaccine, with a broader recruitment of Langerhans cells by the antigen and thus a better immunological response. 

Biography:

Gilbert Glady has completed his MD at the age of 27 years from Strasbourg University of Medicine and postdoctoral studies from Besançon and Paris-Nord Universities of Medicine. He got during all these years an expertise in immunology and immunogenetics and developed also interest for alternative medicines. So he becames at 2010 the creator of the BI(G)MED method and director of EBMA, the european association for training the medical profession at the BI(G)MED. He has participated in numerous international congresses in the field of immuno-allergology, infectiology and oncology with posters and oral presentations. 

Abstract:

Oral immunotherapy has become a recognized method and validated by numerous publications, and its use has developed in the current practice of an allergy clinic. It has also been identified as likely to result in fewer adverse reactions than other conventional treatments administered by the systemic route. We propose an innovative and even revolutionary methodology by some aspects still little known in common allergology, which allows a soft and progressive regulation of the main molecular disorders involved at an immunogenetic level in the pathophysiological mechanisms of the various allergic diseases currently listed. For this purpose, we first resort to a regulation taking place at the epigenetic level thanks to the introduction in our therapeutic methodology of microRNAs used for their remarkable posttranscriptional regulatory action. All components of our cures are prepared in high dilutions to avoid any noxious side effects and administered per sublingual way. But the Bio Immuno(G)en Medicine - BI(G)MED in shortcut - is also holistic in that it does not just act in a regulating way on the immunogenetic mechanisms involved directly in the genesis of allergic diseases, but also search for neutralizing infectious, viral and bacterial and even fungal agents, which have a pernicious influence on the course of clinical allergic phenomena. To achieve this result the BI(G)MED uses a wide range of biological tests to measure the patient's reaction potential at the immunogenetic level and the impact of infectious agents in direct interaction with the immune system. The description of clinical cases of my private practice with their therapeutic modalities will make it possible to highlight the regulatory properties of this new method referring to the self-regulation potential inherent in cellular homeostasis.

Biography:

Dimitrios Balomenos received his PhD of Rutgers University, NJ. And continued his postdoctoral training at the Scripps Research Institute (La Jolla, Ca) and in the Department of Immunology and Oncology of CNB/CSIC in Madrid,Spain. In 2002 he was awarded an independent group research contract and from 2010 he is a tenured group leader at CNB/CSIC. Major discoveries include the absolute requirement of IFN-gamma for Systemic Lupus Erythematosus pathogenesis, (D. Balomenos et al, J. Clin. Invest. 1997), the discovery of p21-dependent pathways for regulation of T cell tolerance and autoimmunity (D. Balomenos et al, Nat. Med. 2000), and the requirement for p21 in reprogramming of M1-to-M2 macrophages, though the regulation of p50/p50 NF-kB and IFN-beta expression (Rackov et al, J. Clin Invest 2016). The group focuses in understanding how p21 and other molecules restrain extreme immune responses and discover p21 molecular patners that control ecssessive infalmmation and might harbor potential treatment capacity.

Abstract:

Decontrolled inflammatory responses induce live-threatening disease or aggravate autoimmunity or allergy. p21 was first identified as an inhibitor of and cyclin-dependent kinase 2 inhibitor (CDK2).   However, other functions are now attributed to p21, as it orchestrates unique anti-inflammatory functions.

p21 controls NF-κB activation, macrophage activation and LPS-induced septic shock. In the absence of p21, LPS treatment leads to increased NF-κB activation, macrophage overstimulation and excessive inflammatory production. Upon extreme TLR4 activation, macrophage hyperactivation is also controlled by reprograming of hyperinflammatory microphages (M1) to a hyporesponsive status (M2-like) after a secondary LPS challenge, which is known as endotoxin tolerance. We recently reported that p21 promotes M1-to-M2 polarization, as p21^-/- macrophages showed impaired ability to reprogram. p21 shifts the balance between active p65/p50 and inhibitory p50/p50 NF‑B and promotes macrophage reprogramming by favoring DNA-binding affinity of p50/p50 homodimers, which limit IFN- production. The first association of p21 with the immune response was its identification as an autoimmunity suppressor, and it was assumed to control T cell proliferation. However, our latest findings show that lack of p21 drives lupus-like disease by augmenting the activation status of T cells The major characteristic of this hype activation is the elevated production of IFN-gamma by T cells, a major inducer of lupus autoimmunity.  Our findings point to p21 as an early regulator of T cell activation that controls mitochondrial ROS production. Finally, in agreement with effect of p21 on the excessive immune responses, p21-deficient mice developed extreme allergic asthma when subjected to the allergy-inducing OVA model, exhibiting severe pneumonitis and striking perivascular and interstitial inflammation compare to controls.  Overall p21 emerges as a global guardian of hyperresponsivess in inflammatory, autoimmune and allergic pathologies at both the macrophage and T cell levels. 

Biography:

Michele Grasso, Senior resident in Otorhinolaryngology at Department of ENT surgery, University Sapienza of Rome. Fellowship at Department of ENT and Robotic surgery, Catholique University of Louvain, Mont-Godinne, Belgium, with Prof Marc Remacle and George Lawson (2012), working on the field of laryngeal papillomatosis and CO2 Lasers. Fellowship at the ENT Department of Bergamo, with Prof Gianni Danesi (2016-2017) working on the field of lateral skull base surgery. Author of many scientific manuscripts on journals with impact factor. Attended of international congresses as speaker, and cadaver dissection surgery courses.

Abstract:

Statement of the Problem: Chronic Allergic Rhinitis (CAR) represents a worldwide emergency pathology affecting between 10% and 40% of the world population (1). Despite the number of available treatments, the prevalence of such condition is still increasing (2).

There is a need for safe treatments to help prevent/reduce the acute allergic rhinitis episodes in CRA, especially in children. The role of daily nasal detersion with isotonic saline solutions has been recognized by the health Authorities as an efficient basic treatment for CAR (3)

The aim of this review was to analyze the clinical effectiveness of an isotonic sea water solution enriched with Mn nasal spray (STERIMAR Nose prone to allergies, SNPA) in CAR.

Methodology & Theoretical Orientation: SNPA has been marketed for a long time (1999) for nasal detersion .Post-Marketing Surveillance data and previous experiences showed that use of this medical device is safe and helps relieve nasal  symptoms of CAR (4,5) while recent experience pointed out its role in reducing the recurrence rates of allergic rhinitis in CAR  patients  (6).

 Findings: A 14-day treatment of SNPA significantly improved nasal ventilation-secretion, headache and sinus pain in 54 children affected by CAR (4). One to two month treatment in 20 children with CAR showed an improvement in nasal ventilation-obstruction and rhinorrhea (5). A 5-month course of STERIMAR nasal detersion demonstrated significant reduction of the recurrence rates of Acute Allergic Rhinitis episodes (fig 1) and improvement in the Quality Of Life (QOL) (6)

Conclusion & Significance: SNPA could help improve QOL, recurrences and signs and symptoms of CAR. These results, if confirmed in double-blind, randomized, controlled clinical trials, could represent a new, safe and less expensive approach for managing CAR in adults and children.

Biography:

Olga Britanova completed her PhD at Shemyakin and Ovchinnikov Institute of Bioorganic Chemistry of the Russian Academy of Science in 2003. She has been working in Laboratory of Genomics of Adaptive Immunity headed by Prof. D Chudakov, since 2008. Previously, her research was focused on the study of the molecular pathways during embryonic development of the mammalian cerebral cortex. She investigated the role of the transcription factor Satb2 in determination of the cell fate identity of cortical neurons. Her scientific interests are focused on Molecular Immunology. Particularly, she has developed PCR-based techniques for TCR and BCR profiling analysis.

Abstract:

The immunosenescence alterations in the T cell immunity contribute to deficiencies in response to vaccination, in protecting from various infections and increases risk of cancer development and autoimmune diseases.  One of the hallmarks of age-related processes is shrinking diversity of TCR repertoire which, on the cellular level, is associated with loss of naïve T cells and expansion of the memory and effector T cell populations. Implementing quantitative TCR repertoire profiling, we investigated changes in diversity and architecture of human TCR repertoires starting from umbilical cord blood to centenarian blood samples. Besides the overall reduction in the TCR repertoire diversity with age, we found that TCR diversity and percentage of naive CD4+ cells in males decreases significantly faster by the age of 40 compared to females. This gender difference disappears in more elderly individuals.  Remarkably, percentage of naive T cells within CD4 pool stably decreases with age but remains unexpectedly high in the oldest cohort (>75 y.o.) comparing to the ratio in CD8+ compartment.  It might indicate a possible association between high percentage of naive CD4+ cells and longevity. Despite the fact that naive CD4+ cells have low survival capacity than naive CD8+, the homeostatic machinery maintains   naive CD4+ pool diverse with age. Additionally, our analysis showed that functional TCR repertoires are more similar in the youth, and this similarity gradually decreased with age. These phenomena might be explained by enrichment of public clonotypes among naive T cells, including clones that originate from fetal period. Further analysis of sorted naive CD8 TCR repertoires across different age groups revealed that naive CD8 repertoires were more similar among young compared to aged donors. Identification of mechanisms driving ageing of TCR repertoire might shed light on vulnerability of elderly to infections, autoimmune disease and cancer development.

Biography:

Fabrício Prado Monteiro has his expertise in evaluation and passion in improving the health and immunology. He is a Medical director at Institute of allergy and immunology of West Bahia, Brazil & Specialist in Allergology & Immunology (since 2006, by ASBAI). Specialist in Pediatrics (since 2004, by SBP) Master and Doctorate (U.C.E.S / ARG) in Admistration and Economics (management) in health (public and private) Investigate the impact of legislation, regulations and policies on population health; He has built work model after years of experience in research, evaluation, teaching and attention in pediatrics and clinical allergy and immunology, both in hospital and education institutions.

Abstract:

Introduction: The beta glucuronidase is an agent stimulant of the immune system and has a desensitizing action under normal pH. This substance has an important role as immune response modifier that stimulates the expression of adhesion molecules by antigen-presenting cells in contact with lymphocytes and vice versa in the intra cellular space and acts on the balance shift TH2/TH1 responses. Method with proven security, without cases of deaths to this date and large scale in Brazil since the early of the 90’s was considered. However, there are few available randomized double-blind studies. Therefore, scientific elucidation is essential. New evidences brought by new and validated clinical studies will allow us to confirm that this therapeutic method can be more effective and safer for the immune compromised patients and with hypersensibility not only type I of Gell and Coombs.

Case Description: A 53 year old female patient Lausivan Martins De Miranda, Caucasian, farm labourer is reported to doctor's office complaining of itching dermatological diffuse for one year and eight months, associated with urticariformes boards, angioedema on hands and lips, diffuse rash and aphonia. She is on recurrent use of doxepin 10 mg​and bilastine 20 mg without any success. She denies social addictions and makes regular use of propranolol and chronic of metformin, aldactone, furosemide and NPH insulin, due to metabolic syndrome and hypertension. No history of hospitalizations, surgeries, adverse reactions to drugs, vaccines and atopics was found. Physical examination with exanthematous and hives urticaria diffusely distributed and aphonia. Still, BMI is greater than 35. Blood tests without notable changes and Patch test with positive results are for: Nickel sulfate (+ +), cobalt chloride (+ +) and parfum mix (+ +) and diagnosis of allergic contact dermatitis as well.

Immunological Aspects & Conclusions: Patient began the immunostimulation therapy in low doses with β-glucuronidase, β glucan and nickel sulphate, bimonthly (every two months) and obtained tolerance and energy after the first three doses. After six months, there was a great reduction of emergency medications and finally a substantial increase in the quality of life without the total exclusion of the triggering chemicals contactants. Immunostimulating subcutaneous therapy as proposed in the case, according to protocol and subcutaneous administration ITA bimonthly of β glucan and β glucuronidase associated with specific antigens in low dose showed great results providing an increase of antigenic recognition because of an efficient activation of antigen presenting cells through up-regulation of their receivers. Thus, the activation and degranulation of inflammatory products that cause various clinical manifestations are minimized and regulated, with the consequent clinical improvement despite associated medications and chemical environmental exclusion. Therefore, a great alternative for immune compromised patients and with several kinds of hypersensibility should be taken.

Biography:

Bibi Alladin-Karan established the first allergy clinic in Guyana in 2014 as a Pediatric Resident who received training from a pediatric allergist from Humber River Hospital in Canada. Completed Master’s in Pediatrics in May 2016 also has an Associate Degree in Pharmacy and currently lectures four courses at University of Guyana, School of Medicine and Pharmacy.

Abstract:

Background: There is an increasing trend in allergic diseases worldwide, particularly among children. Currently, however, there are no published statistics on the burden of allergies among children in Guyana.

Aim: Aim of this study is to determine the prevalence of allergens among pediatric patients (<13 year old) in Guyana and to assess the types and possible risk factors.

Methods: A retrospective chart review was conducted among pediatric patients who were seen at GPHC Allergy Clinic during 2014 July-2016 July. A standard allergy questionnaire was completed, skin prick test (SPT) was carried out in an attempt to identify the allergen. Descriptive statistics was applied to estimate the prevalence and trends for allergens.

Results: 50 patients met inclusion criteria, 46 (92%) had SPT. Majority of cases (44.4%) were of mixed decent, nearly all of the patients were from Georgetown-Mahaica. 25 (54%) patients had a positive SPT, 60% of positive SPT were females although the gender distribution was equal in the study population, rash was the most common presenting feature (60%, p<0.05), 40% had a history of dermatitis while 36% had history of asthma. 60% of individuals who had a positive SPT were allergic to just one allergen, and two (8%) were allergic to four of more allergens. Dust mites were the most common allergen (88%) followed by peanuts (20%) and mixed fish (16%).

Conclusion: Allergies are common among children in Guyana with a prevalence of 54% in children with risk factors. Dust mites were the most common allergen. Predictors for positive SPT included history of asthma and dermatitis, and positive family history. Patients who were treated for their allergies had more control of their asthma and eczema. The results of the study will also be used to sensitize the population on the functions of the clinic.

Biography:

Michael Roth is currently working as Head of Pulmonary Cell Research at University Hospital Basel, Switzerland. He has completed his PhD at University of Basel and worked as a Visiting Professor and Associate Professor at University of Sydney for two years. He has published 148 articles in reputed journals.

Abstract:

Chronic inflammatory lung diseases (CILD) are increasing worldwide and represent a major issue for daily life performance and public health expenditure. The two major CILD are asthma and chronic obstructive pulmonary diseases (COPD). The World Health Organization estimates that 280 million people suffer from asthma and 40% of all children suffer from asthma symptoms during childhood. According to the World Health Organization, 65 million people developed severe COPD with a death toll of 3 million/year in 2005. The likelihood to develop asthma or COPD was linked to inherited susceptibility factors; however, despite of large genetic cohorts, no specific candidate genes had been identified. Increasing evidence supports the hypothesis that the susceptibility to develop CILD is the consequence of exposure to risk factors during embryogenesis or early childhood. One of these factors is preterm birth which accounts for life-long reduced lung function due to incomplete maturation of the lung structure. Secondly, the exposure to fine dust, ozone, smoke particles, or viral infections early in life increases the risk to develop CILD, but the mechanisms that cause these largely irreversible modifications of lung structure and function are not well understood. Importantly, new studies in humans and animal models suggest that these pre-conditions for CILD susceptibility can be passed on over at least three generations. It is implied that the increased susceptibility for CILD is due to largely irreversible epigenetic modifications which may mimic a genetic trait. The available data points towards an epigenetic mechanism that involves mitochondrial genes rather than the human genome, which may explain why the inheritance of CILD susceptibility was linked to the maternal line. This review summarizes the knowledge supporting the hypothesis of an epigenetic rather than genetic event which underlies the inheritance of asthma and COPD susceptibility.

Biography:

Gilberto Filaci is an Associate Professor of Internal Medicine and Vice-Director of the Centre of Excellence for Biomedical Research at University of Genoa. He has published more than 90 papers in reputed journals and has been serving as Official Reviewer for international journals and research funding organizations. His scientific activity is mainly focused on Immuno-regulation and on the search for new diagnostic and immunotherapeutic agents. He is in the advisory board of pharmaceutics industries.

Abstract:

Telomerase, the enzyme synthesizing the telomeric regions of chromosomes, is considered as a universal tumor associated antigen because it is expressed by the majority of cancers. The several clinical trials performed adopting telomerase as immunogen confirmed the safety of telomerase vaccination, but raised doubts concerning: the immunogenicity of telomerase; the capacity of telomerase vaccines of inducing clinical responses. The immunogenicity concerns have been now dispelled by demonstrations that: Telomerase is presented by tumor and antigen presenting cells; ex vivo generated telomerase-specific CTL kills efficiently telomerase-expressing tumors; circulating telomerase-specific T cells are present in 90% of cancer patients and, surprisingly, in 100% of healthy individuals, as observed in studies. These findings boost the search for a new generation of telomerase vaccines able to overcome the limits of their first generation. In this effort, our group recently completed a phase I/II trial in prostate and renal cancer patients with GX301, a new generation cancer vaccine. This multi-peptidic vaccine includes four telomerase peptides, which bind promiscuously several HLA class I and II alleles allowing the coverage of the majority of HLA haplotypes and the induction of both helper and cytotoxic T cell responses. It also contains two adjuvants with complementary activities, making it able to efficiently activate both innate and adoptive immune responses. The results of a phase I/II trial, showing a 100% rate of telomerase-specific immune responses associated with evidences of clinical responses, suggest that innovative approaches may lead telomerase (and cancer) vaccination to an age of maturity.

Biography:

Chiaki Masuda is a licensed Pharmacist and pursuing her Doctoral degree at Tohoku Medical and Pharmaceutical University, Japan. She has been working on “Analyzing differences in the pathophysiology of allergic asthma between sexes, focusing on the molecular mechanisms underlying the sex-specific effects of dendritic cells”. Her focus is primarily on translational research such as conducting basic immunological studies using mouse models and applying the results obtained in studies of the etiology of asthma in humans.

Abstract:

Statement of the Problem: Prevalence and severity of asthma symptoms after puberty are higher in women than in men. The numbers of IL-13-producing peripheral blood T cells are significantly higher in female than in male patients of atopic asthma. These T cells accelerate the female-predominated Th2-oriented immune response in asthma. The uptake and processing of inhaled allergens by dendritic cells (DCs) are fundamental for sensitization and subsequent elicitation of allergic airway responses. Observational data have suggested that DCs rapidly accumulate in the lamina propria in patients with allergic asthma after allergen challenge. However, the mechanism of DC involvement in the female-predominant Th2 immune responses in asthma is unclear.

Methodology & Theoretical Orientation: Male and female wild-type (WT) mice were sensitized using two intraperitoneal injections of ovalbumin (OVA) and aluminum hydroxide, followed by exposure to OVA aerosol challenges for 1 h on two occasions 4 h apart or administration of OVA intra-tracheal challenge. Here, we investigated the role of two major subsets of DCs in mice, CD11b^hi and CD103⁺, in the orientation of T cells toward a Th2 phenotype observed predominantly in female patients of asthma.

Results: CD11b^hi and CD103⁺ DC numbers in bronchial lymph nodes in female mice present a significant increase, measured 16 h after OVA challenge, compared to those in male mice. Additionally, CD103⁺ DCs in females expressed higher CD86 levels and had a higher potential of driving antigen uptake and Th2-cell differentiation compared to those in males. In contrast, such differences between the sexes were not observed for CD11b⁺ DCs.

Conclusion & Significance: These results suggest that the increased number of DCs and specific properties of CD103⁺ DCs may be involved in the Th2 immune response observed predominantly in female patients of allergic asthma.

Biography:

Dana M Tofiq is assistant professor of allergy and immunology and the academic registrar of the college of medicine-university of Sulaimani, Sulaymaniyah, Iraq; member of AAAAI, ACAAI and EAACI and working as part-time consultant allergist at Sulaymaniyah allergy and asthma center. He is teaching allergy and immunology to both undergraduate and postgraduate students at the college of medicine-university of Sulaimani. His research areas of interest include asthma, allergic and autoimmune diseases.

Abstract:

Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease affecting spine, sacroiliac joint and less frequently peripheral joints. Although, there is a strong hereditary component marked by the strong association with HLA-27 in more than 85% of patients with AS; the pathogenesis of AS is still not fully understood. Some inflammatory cytokines also play major role in AS pathogenesis. IL-23 regulates Th17 function, proliferation and IL-17 production which promote inflammation and bone and cartilage destruction when expressed chronically and in inappropriate locations.

Objectives: To assess serum IL-23 level in AS patients and controls and its association with disease activity.

Patients & Methods: 45 AS patients and 45 apparently healthy controls included in this cross sectional study. Other than comparing serum IL-23 level in AS patients with controls; we compared serum IL-23 level in AS patients on biologic with those non-biologic treatment. Assessment of disease activity was done by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and spinal mobility by Bath Ankylosing Spondylitis Metrology Index (BASMI) for any association with serum IL-23 levels.

Results: Serum IL-23 levels were significantly higher in AS patients in comparison with healthy controls and patients on biologic therapy had lower levels of IL-23 level than those patients on non-biologic therapy. In the AS patients, the BASDAI and BASMI scores had no correlation with serum IL-23 level.

Conclusions: Higher serum IL-23 levels in AS patients reflect the role of IL-23 in the pathogenesis of AS; and the future potential role of IL-23 in practice as both a biomarker and therapeutic target.

Biography:

Mona Radwan has completed her PhD from Zagazig University and Post-doctoral studies from Lund University School of Medicine and School of Social Sciences, respectively. She is one of the steering committee members of Women IN Great Sciences (WINGS) at Lund University. She has published various articles in reputed journals and has been serving as an Editorial Board Member of repute.

Abstract:

Introduction: Asthma is marked by reversible airway obstruction and airway inflammation. People with asthma demonstrate symptoms such as wheezing, coughing, and exertional dyspnea—that are accompanied by greater airflow obstruction. Chronic bronchitis is described by chronic cough and sputum production. Pulmonary emphysema (commonly mentioned to as emphysema) is a pathologic course including air-space expansion distal to the terminal bronchioles, accompanied by destruction of the bronchiolar walls. COPD includes chronic bronchitis and emphysema.

Objective: Objectives of the study were to find out: The prevalence rate of asthma and other lung disease in general and by different sub-categories of populations that exist at different distances from war zone; predictive risk factors for asthma and other lung diseases and; the impact of chemical (Ch) and non-chemical (NCh) agents on different kinds of lung diseases in relationship to diverse war sectors.

Methods: A cross-sectional study constructed on a sample of 1155 Iraqis who survived in the Basra and Messan (South of Iraq) Provence in 2002. Only males were recruited in the study with the ages of 18–45 years and were within 300 Km of the epicenter of the 1991 GW. The study population were assigned to one of three GW exposure zones, based on where they were located during the 1991 GW, as follow: zone one (war zone within 100 Km of Kuwait), zone two (within 100-190 Km) and zone three (within 200-300 Km).

Results: The study results showed that 50.8% of study populations were in zone three and 14.5% in zone one. There was a significant difference in the prevalence rate of asthma in general across the three war zones: highest in zone one (9.8%) compared to zone two (1.8%), and 5.8% in zone three. The significant difference also applied to other lung diseases; pneumonia, bronchitis and other lung conditions studied. As to bronchitis, the highest rate was among zone one (27.2%) and the lowest among zone three (9.4%). The results identified the predictor risk factors for asthma as those of lived in zone two, with high BMI and higher income. All asthmatic, bronchitis, pneumonia and other lung diseases inhaled smoke from fired oil wells while there was no significant effect on exposure to non-chemical factors like hearing chemical alarms or any dead bodies.

Conclusion: The study concludes some risk factors for asthma and other lung diseases.

Biography:

Mabel Fabiola Ramallo Jadue is a Physician Surgeon specialist in Dermatology-Immunopathology and Allergy. She is a Professor and Chair of Dermatology-Immunoalergologia, Faculty of Medicine at University of Saint Francis Xavier. She has been the member of the Bolivian Society of Dermatology & Internal Medicine, Sucre Branch since 2002. She is also the member of International Society of Dermatology and member of European Academy of Allergy and Clinical Immunology.

Abstract:

Vitamin D is well known for its major role in the intestinal, skeletal, kidney and parathyroid mechanisms for homeostasis of calcium and phosphorus. Recently, vitamin D has acquired an important role as immunoregulator of biological functions. There is also revised effect of vitamin D in both chronic urticarial and atopic dermatitis. Aim of this study is to evaluate the effects of prenatal and postnatal preventive use of vitamin D in the development of skin diseases in the new-born such as atopic dermatitis. Rueter et al., (published in 2014) given an expert opinion reviewing the impact of in utero and postnatal vitamin D exposure on allergy risk in childhood. Authors concluded that low cord blood 25-hydroxyvitamin D levels may be associated with increased risk of eczema and wheeze but not asthma and allergic rhinitis. For respiratory allergic disease outcomes, several studies have reported reduced wheeze or asthma later on during childhood or allergic rhinitis in offspring when maternal intake of food-derived vitamin D in pregnancy was reportedly higher. For eczema, consumption during pregnancy of food containing vitamin D was protective against symptoms in the first two years of life. Currently, the evidence with regard to the influence of vitamin D status (affected by both diet and lifestyle) on the development of allergic disease is limited and conflicting. The majority of studies have failed to show any consistent associations between 25(OH)D levels and subsequent allergic disease. Others propose supplementing infants with vitamin D for reducing the risk of asthma and allergic diseases. It is difficult to determine the low serum vitamin D levels contributed to the development of AD, whether damage of skin from AD led to low vitamin D absorption from the sun, or if the two are unrelated.

Biography:

Rebecca Heath is a UK trained medic who has worked in the Manchester, Melbourne, the Nepali Himalayas and Ghana before her interest in rural and remote medicine and Aboriginal health found her at home in the Red Desert of Alice Springs for a couple of years before heading to Papua New Guinea in the Pacific to teach Emergency Medicine and work on capacity building programs in Madang. Keen to help find ways to develop practical and useful strategies to update practice in low income settings, as well as understand some of the complex challenges these contexts provide, she has focused on asthma, which is notoriously poorly managed in the Pacific. 

Abstract:

Objective

To implement evidence based practice guidelines using a culturally sensitive change management approach and improve asthma management in a developing world setting.

Methods

Setting: Emergency Department, Modilon hospital, Madang, Papua New Guinea. Nearly 700,000 people live in Madang Province and Modilon Hospital (with 258 beds) is the only government hospital in the region. Study Design: 1) Asthma management analysis: A questionnaire was completed by Emergency Department staff during consultations with known asthma patients consisting of patient demographics, departmental and discharge management. Results were compared to international evidence based guidelines.  2) Action research with program change model: An action research approach using a 4 step model of program change (exposure, adoption, implementation and practice) was adopted with staff education and consultation to design and implement a new departmental asthma guideline. Culturally sensitivity and flexibility were maintained throughout. 3) Asthma management analysis: 3 months after the guideline implementation asthma management was re-analysed in the form of a questionnaire and results compared to original management. A ‘post mortem’ questionnaire was also conducted with staff to review progress and inform practice learnings. Outcomes measured: Treatment in line with evidenced-based asthma management guidelines, patient perception of treatment and frequency of Emergency department visits. Staff perceptions of treatment change outcomes and approach in managing the clinical changes.

Results: Prior to intervention, asthma management involved frequent use of IV and oral antibiotics, IV steroids, paracetamol, simultaneous use of multiple short acting oral bronchodilators, limited use of oral steroids (of variable dose and duration) and no spacers, preventative steroid inhaled therapy, or asthma action plans. At 3 months staff felt the program improved asthma management. Data is still being collected.

Conclusion: A 4 step model of program change was used to develop and implement asthma treatment guidelines. 

Biography:

Abstract:

Statement of the Problem: Nasal irrigation with saline solutions is frequently used for relief of rhinitis symptoms. Literature suggests that manganese (Mn) contributes to a decrease in allergic nasal response. In vitro research studies were conducted on 3D model of airway epithelium to evaluate efficacy and safety of a Mn-enriched seawater solution called Stérimar Allergic Nose (SAN).

Methodology: The 3D Reconstituted Human Nasal Epithelium model (RHNE) was treated with 10 μL of SAN twice a day for four days to simulate repeated use (full strength) or untreated (control). For epithelium integrity (safety), the control and SAN-treated cultures were analyzed for: Trans-Epithelial-Electrical-Resistance (TEER) on days 1 (D1) and 4 (D4) post-treatment, and release of Lactate Dehydrogenase (LDH) and Interleukin 8 (IL-8) daily from D1 to D4. For efficacy, Mucociliary Clearance (MCC) and stimulation of epithelium-regeneration were assessed. MCC was measured by video-microscopy on D1 and D4 after the same treatment regimen. For epithelium-regeneration, RHNE was treated with 30 μL of SAN or saline. After a glass capillary injury, made 1 hour after treatment, regeneration stimulation was assessed as a percentage of wound closure by comparative photography immediately after the injury and 2, 6, 22 and 30 hours later.

Findings: SAN showed an average TEER of 302 and 323 ohm.cm² (p<0,001) on D1 and D4, respectively, safely above tissue integrity limit (100 ohm.cm²). LDH and IL-8 releases were similar for SAN and control at all-time points, also confirming epithelium integrity and safety. SAN showed a significant MCC increase as compared to control (P<0.01). Furthermore, SAN showed faster and greater wound closure than control (86.59% for SAN versus 50.65% at 22 hours).

Conclusion: SAN demonstrated efficacy and safety in the in vitro assays. The results support the use of Mn-enriched SAN in relief of rhinitis symptoms.

Biography:

Gilbert Glady has completed his MD at the age of 27 years from Strasbourg university of medicine and postdoctoral studies from Besançon and Paris-Nord universities of medicine. He got during all these years an expertise in immunology and immunogenetics and developed also interest for alternative medicines. So he becames at 2010 the creator of the BI(G)MED method and director of EBMA, the European association for training the medical profession at the BI(G)MED. He has participated in numerous international congresses in the field of immuno-allergology, infectiology and oncology with posters and oral presentations.

Abstract:

Inflammatory upper airway diseases, particularly chronic rhinosinusitis (CRS) and allergic rhinitis (AR), have a high worldwide prevalence. CRS and AR involve sustained and exaggerated inflammation that is associated with marked changes in gene and protein expression under tight regulation. MicroRNAs represent one of the fundamental epigenetic regulatory mechanisms used by cells that can mediate posttranscriptional gene silencing of target genes. As fine tuning regulators of gene expression, miRNAs are involved in diverse biologic processes, including cell proliferation, apoptosis, and differentiation, organ development, metabolism, stress responses, and signal transduction. Emerging evidence implicates an involvement of miRNAs in shaping the inflammation pattern in upper airways. Studies regarding the roles of miRNAs in allergic diseases have multiplied during the last 4 years, and the functions of miRNAs in the regulation and pathogenesis of these diseases are more and more better characterized. Recently, miRNAs have been shown to be detectable in cell-free body fluids such as serum and plasma samples. The circulating miRNAs are protected from blood RNAses either by existing in cell membrane-derived vesicles such as exosomes or by forming a complex with lipid-protein carriers such as high-density lipoprotein. So it becomes possible to use such kind of molecules for a therapeutic purpose, and that is what achieve the Bio Immun(G)en Medicine – BI(G)MED – by introducing high diluted microRNAs in nano compounds looking for a fine regulation in different upper airways diseases with an allergic etiology.

Biography:

Tasuku Kawano completed his PhD at Tohoku Medical and Pharmaceutical University in 2009. He is presently working as an assistant professor in the Department of Pathophysiology at Tohoku Medical and Pharmaceutical University. He aims to reduce asthma patients. He studies elucidation of asthmatic onset mechanism based on nerve-endocrine-immunity axis. He has been trying for the creation of new fields for the development of novel medicines and preventive drugs in asthma. He has published “The involvement of central nervous system histamine receptors in psychological stress-induced exacerbation of allergic airway inflammation in mice” Allergol Int. 2016 Sep; 65 Suppl:S38-44.

Abstract:

Statement of the Problem: Allergic asthma is characterized by Th2 type inflammation, essentially due to a breakdown of immune tolerance to an environmental allergen. Etiologically, experiences of early-life stress have been demonstrated to be associated with heightened prevalence of adult asthma. However, mechanisms underlying the stress leading to the development of asthma are poorly understood. Therefore, we examine if early-life stress increases the susceptibility to adult-onset asthma through the inhibition of the development of the respiratory tolerance.

Methodology & Theoretical Orientation: Female BALB/c pups were sensitized by intraperitoneal injections of ovalbumin (OVA)/Al(OH)₃ on postnatal days (PND) 24 and 29. Respiratory tolerance was induced by the inhalation of OVA on PNDs 18 and 21 before the sensitization. Maternal separation (MS) was used as a model of early-life stress and repeated from PND 17 to 22. On PND 76, the mice were challenged with OVA aerosol. Airway inflammation was evaluated with numbers of inflammatory cells in bronchoalveolar lavage fluid (BALF). The contents of IFN-g, IL-4, IL-5 and IL-13 in BALF were measured by ELISA. The airway hyper-responsiveness (AHR) was assessed by methacholine-induced airflow obstruction.

Conclusion & Significance: In tolerized mice, the numbers of inflammatory cells, the cytokine contents and AHR were remarkably decreased compared with those in non-tolerized mice. However, these effects of the tolerance were significantly reduced by MS exposure. These results suggested that early-life stress exposure has a potential to increase the risk of adult-onset asthma through the inhibition of the development of immune tolerance.

Biography:

Heewon Lee is presently persuing her MS-Ph.D integrated course in Pharmaceutical Sciences college of pharmacy, Ewha Woman’s University, Seoul, Korea. Completed B.S. in pharmacy college of pharmacy, Ewha Woman’s University, Seoul, Korea. Awarded with university scholarship & also has a Korean pharmacist license. Research includes studying the function of TCTP/HRF, a multifunctional protein. TCTP/HRF was found in body fluids of allergic patients and its importance was recognized, but the receptor and its mechanism of action were not yet known. Her ultimate goal was to find the HRF receptor, but attempts to isolate and identify it were unsuccessful. In the process, however, she discovered a functional domain that is thought to be the receptor binding domain of HRF. Antibodies targeting this region are being produced and the antibodies with good efficacy will be selected as HRF inhibitors.

Abstract:

We first reported that translationally controlled tumor protein (TCTP) acts as a histamine-releasing factor (HRF) associated with chronic allergic disease when it forms dimers. Despite the lack of signal peptide, HRF was found in nasal lavages, skin blisters and bronchoalveolar lavage fluids in late phases of allergic reaction. In a preliminary study, we found a significant increase in serum HRF levels in patients with asthma and allergic rhinitis. These results have led us to investigate whether HRF can be a therapeutic target for allergic diseases. By screening a phage-displayed 7-mer peptide library, we identified one peptide that showed strong affinity for the dimer TCTP (dTCTP). The peptide named dTCTP-binding peptide 2 (dTBP2) blocked the action of HRF by inhibiting binding to the cell surface. Specifically, dTBP2 inhibited the release of IL-8, an inflammatory cytokine, by inhibiting dTCTP-induced NF-κB and MAPK from human bronchial epithelial cell line BEAS-2B. In addition, dTBP2 dose-dependently reduced the symptom score and eosinophil recruitment to the nasal mucosa in OVA-induced allergic rhinitis mouse model, suggesting that in vivo inflammation-mediated airway pathology was alleviated. In this study, we showed that inhibition of dTCTP could alleviate allergic pathology and showed that dTCTP could be a new drug target for chronic allergic diseases such as allergic rhinitis.

Biography:

Boris Ferko is presetly working at EURRUS Biotech GmbH, Austria

Abstract:

We tested the efficacy of a novel biogenic peptidoamine compound, glutarimide histamine (XC8) in mouse, rat and guinea pig asthma models. Sensitized animals underwent oral treatments for at least 10 consecutive days with titrated doses of XC8 or corticosteroid reference drugs. In mice, XC8 efficiently inhibited eosinophilic lung inflammation of acute asthma disease onset, suppressed mucus hypersecretion, antigen-specific serum IgE or IgG1 titres, and methacholine-induced airway hyperresponsiveness (AHR). In Sephadex-induced migration of eosinophils in a rat model XC8 decreased the content of eosinophils in bronchalveolar lavages (BAL) 2.6-6.4 times. In guinea pig models of asthma and antigen-induced bronchospasm, XC8 reduced the number of degranulated mast cells and basophils in the lung tissue and the degree of degranulation. Moreover, XC8 also reduces hyperactivity of the lungs and reduces mortality of the animals from anaphylactic reactions. Chronic toxicity studies in rats and dogs revealed an excellent safety profile of XC8.

In vitro experiments indicated that the mode of XC8 action might be associated with the suppression of glutaminyl cyclase - an enzyme that converts the immature form of chemokines (CCL2, CCL7, CCL8, CCL13) into the mature form by the reaction of pyroglutamination, thus suppressing the chemokine-driven migration of eosinophils and other cells into the inflammation area and the degranulation of mast cells and basophils.

Our data demonstrate that XC8 efficiently suppresses experimental allergic asthma and provide support for its use as a treatment for human allergic asthma. 

Biography:

Luiz Werber-Bandeira is the Head of Clinical and Experimental Immunology Unit - Santa Casa de Misericórdia do Rio de Janeiro, Brazil. He has a degree in Medicine; completed his Post-doctorate in Immuno-Genetics and; PhD in Medicine-Immunology-Dermatology at Federal University of Rio de Janeiro. He is also specialized in Clinical Immunology-Allergy at Federal University of Rio de Janeiro. He is reorganizer of the clinical and experimental immunology unit - Santa Casa da Misericórdia, Rio de Janeiro. 

Abstract:

Background: The gene encoding the adrenergic β2 receptor (ADRβ2) located on chromosome 5q31-32 presents a high allelic diversity characterized by the presence of several single nucleotide polymorphisms (SNPs) associated with different receptor activities at the cellular levels. 45 SNPs have been identified along this gene, some with significant effect on clinical response to β2-agonists. The allelic distribution varies with ethnicity and due to alterations in sensitization and down regulation of these receptors. The existing studies refer to ethnically homogeneous populations, with no data on the distribution of these SNPs in ethnically mixed populations, although certain haplotypes appear to directly affect receptor function.

Objective: The objective of this study was to determine the prevalence of previously described SNPs in the coding region of the ADRβ2 gene, as well as to identify new SNPs in a group of individuals living in Rio de Janeiro through sequencing technique.

Patients & Methods: DNA samples from 162 individuals were subjected to PCR amplification and genotyping by sequencing.

Results: Analysis of the sequences generated identified the presence of nine different SNPs 46 (G>A), 66 (C>T), 79 (C>G), 252 (G>A), 455 (T>G), 470 (T>G), 491 C>T, 523 (C>A) e 579 (C>T) within the sequenced region (899 bp), from which, three: 455 (T>G), 470 (T>G), and 579 (C>T) were not yet described, and the characterization of 14 different haplotypes. The SNPs in codons 27 and 164, two of the most studied, showed different frequencies from those observed in other populations. The SNP in codon 27 was: 8.1% versus 24% in Caucasian-Americans and versus 18.7% in African-Americans. The SNP in codon 164 was: 4.6% versus 1% in Caucasian-Americans and versus 2% African-Americans. The SNP at codon 16, Arg16Gly, showed similar frequency to the one found in the literature in Caucasians and Chinese ethnicity: 54.9% vs. 39%, and 42% and 51% respectively.

Conclusion: The results of this study, although represent a partial mapping of the coding region of the ADRβ2 gene, demonstrated the diversity of this gene, of great clinical importance. The results represent the first data on the partial mapping of the gene ADRβ2 in an ethnically mixed population.

Biography:

Chiaki Masuda is a licensed Pharmacist and pursuing her Doctoral degree at Tohoku Medical and Pharmaceutical University, Japan. She has been working on “Analyzing differences in the pathophysiology of allergic asthma between sexes, focusing on the molecular mechanisms underlying the sex-specific effects of dendritic cells”. Her focus is primarily on translational research such as conducting basic immunological studies using mouse models and applying the results obtained in studies of the etiology of asthma in humans.

Abstract:

Statement of the Problem: Prevalence and severity of asthma symptoms after puberty are higher in women than in men. The numbers of IL-13-producing peripheral blood T cells are significantly higher in female than in male patients of atopic asthma. These T cells accelerate the female-predominated Th2-oriented immune response in asthma. The uptake and processing of inhaled allergens by dendritic cells (DCs) are fundamental for sensitization and subsequent elicitation of allergic airway responses. Observational data have suggested that DCs rapidly accumulate in the lamina propria in patients with allergic asthma after allergen challenge. However, the mechanism of DC involvement in the female-predominant Th2 immune responses in asthma is unclear.

Methodology & Theoretical Orientation: Male and female wild-type (WT) mice were sensitized using two intraperitoneal injections of ovalbumin (OVA) and aluminum hydroxide, followed by exposure to OVA aerosol challenges for 1 h on two occasions 4 h apart or administration of OVA intra-tracheal challenge. Here, we investigated the role of two major subsets of DCs in mice, CD11b^hi and CD103⁺, in the orientation of T cells toward a Th2 phenotype observed predominantly in female patients of asthma.

Results: CD11b^hi and CD103⁺ DC numbers in bronchial lymph nodes in female mice present a significant increase, measured 16 h after OVA challenge, compared to those in male mice. Additionally, CD103⁺ DCs in females expressed higher CD86 levels and had a higher potential of driving antigen uptake and Th2-cell differentiation compared to those in males. In contrast, such differences between the sexes were not observed for CD11b⁺ DCs.

Conclusion & Significance: These results suggest that the increased number of DCs and specific properties of CD103⁺ DCs may be involved in the Th2 immune response observed predominantly in female patients of allergic asthma.

Biography:

Tatiana Chioro is a Brazilian Physician with large experience in Cosmetic Dermatology. She is Member of Brazilian Society of Dermatology, American Academy of Dermatology and European Academy of Dermatology and Venereology. She is also an MSc candidate at Hospital do Servidor Público Estadual – IAMSPE – São Paulo – SP – Brazil 

Abstract:

Hyaluronic acid (HA) is biocompatible, easy-to-use, and reversible filler which is broadly-based filler in cosmetic medicine. More and more, non-expert physicians and non-physicians practitioners have been performing fillers in a large number of patients, which notices a high risk of unwanted outcomes, either in efficacy and safety fields. Unwanted results can mean overcorrection and asymmetries, as well as adverse events against these injectable fillers. Although HA-based fillers are defined as temporary materials, they can last up to 12 months or longer. Hyaluronidase is an endogenous enzyme that has a potent activity, which lets it to hydrolyze tissue HA, which is the key element of connective tissue. Given that, commercial hyaluronidase, when injected in areas wherein HA-based filler was placed, destroys HA and gives the possibility to adjust overcorrection and asymmetries. Although hyaluronidase has been used worldwide, only a few allergic reactions have been reported. Most of the described patients showed allergic reactions after peribulbar anesthesia for eye surgery despite the large use of HA fillers in aesthetic medicine. A 29-year-old Brazilian female patient was subjected to a 0.01 mL hyaluronidase injection (Pineda Laboratories, Sao Paulo, Brazil) in order to treat a malar hypercorrection as result of filling with HA. After about 10 minutes, she evolved with discrete erythema and edema at the injection site. A vial of 1 mL intramuscular injection of 5 mg/mL betamethasone dipropionate+2 mg/mL betamethasone disodium phosphate 2 mg/mL (BetaTrinta, Eurofarma, Sao Paulo/SP, Brazil) was immediately administered. After 1 hour, however, the patient presented an intense edema in her left hemiface, which suggested angioedema onset; this adverse event was immediately treated by injecting 4 mL of 500 mg hydrocortisone sodium succinate which helped her to clinically overcome such condition. Though, the patient was discharged to home with 40 mg/day/3 days of micronized prednisolone. A complete clinical improvement was observed in five days. In summary, side effects against hyaluronidase injections are rare in accordance with already published scientific literature; however, it is extremely important for professionals of cosmetic medicine to be an emergency conduct at their office.

Biography:

Tomomitsu Miyasaka completed his PhD at Tohoku University, Japan. He is an Assistant Professor at Tohoku Medical and Pharmaceutical University, Japan. His research area is Allergy, and he is interested in determining the mechanism(s) that are responsible for the altered asthma severity by sex or related to psychological stress. 

Abstract:

Statement of the Problem: Bronchial asthma is more severe in females than in males after puberty because of stronger Th2-oriented immune response in females. However, the mechanism of the sex difference in asthmatic immune response remains unclear. CD8⁺ T cells play an important role in regulating the asthma immune response through their suppressive effect on Th2 polarization within the localized lymph nodes.

Theoretical Orientation: In the present study, we investigated the sex-specific effect of CD8⁺ T cells on the female-predominant asthmatic immune responses using a mouse model.

Results: The number of eosinophil in bronchoalveolar lavage (BAL) fluid, lung Th2 cytokine levels, and IL-4 production by bronchial lymph node cells were significantly higher in wild-type female compared with male mice, whereas no such sex differences were observed between cd8α-disrupted (CD8KO) male and female mice. The adaptive transfer of wild-type male, but not female, CD8⁺ T cells reduced the number of inflammatory cells in the recovered BAL fluid of CD8KO male, but not female, recipient mice. Male CD8⁺ T cells produced higher levels of IFN-γ than female CD8⁺ T cells. Treatment with anti-IFN-γ antibody completely abrogated the sex difference in the suppressive activity of CD8⁺ T cells on IL-4 production from CD4⁺ T cells. However, IFN-γ receptor expression on CD4⁺ T cells was higher in male mice than in female mice. rIFN-γ treatment increased the proportion of IFN-γ receptor α⁺ CD4⁺ T cells in male naïve CD4⁺ T cells more than in female naïve CD4⁺ T cells.

Conclusion & Significance: These results suggest that female-dominant asthmatic immune responses are induced by the reduced production of IFN-γ by CD8⁺ T cells and the lower expression of IFN-γ receptor on CD4⁺ T cells caused by exposure to IFN-γ in females compared with males.

Biography:

Areum Kim is a PhD student at Jeju National University, Republic of Korea. He has research interest in Immunology and Radiobiology. He completed his BA in Nuclear and Energy Engineering at Jeju national University, South Korea from 2009-2013 and; MS in Interdisciplinary Graduate Program in Advanced Convergence Technology & Science at Jeju National University, Korea from 2013-2016.

Abstract:

Sargassum horneri, a species of brown macro algae, has been reported to have several health promoting effects such as anti-viral, anti-coagulant effect, and anabolic activity on bone metabolism or higher plumbum absorption. In the present study, we investigated the immunomodulatory activity of S. horneri using murine splenocytes and bone marrow cultured mast cells. S. horneri was enzymatically hydrolyzed using the celluclast (SHC). Polyphenol-rich fractions from S. horneri (SHP) were also used for assessing the anti-allergic activity in BMCMC. SHC induced the proliferation of splenocytes without cytotoxicity. Treatment with SHC led to a significant increase in the population of CD8⁺ T cells, CD8⁺CD25⁺ regulatory T cells, and granulocytes. SHC also increased the secretion of IFN-γ. Meanwhile, SHP didn’t show any cytotoxicity in BMCMC but significantly decreased the release of β-hexosaminidase in stimulated BMCMC. SHP also decreased the mRNA expression of IL-4, IL-6, IL-13, and TSLP in BMCMC. These findings indicate that S. horneri might modulate the Th2-type immune responses in immune-mediated disease. Therefore, S. horneri could be an excellent candidate for an anti-allergic agent.

Biography:

Jinhee Cho is a PhD student at Jeju National University, Republic of Korea. He has research interest in Immunology, especially Th1/Th2 type immune responses. He completed his BA in Veterinary Medicine at Jeju National University, South Korea from 2008-2014 and; MS in Veterinary Medicine at Jeju National University, South Korea from 2014-2016.

Abstract:

CD244 is a member of the signaling lymphocyte activation molecule (SLAM) family and can exhibit either activating or inhibitory effect on the cytotoxic activity of cells, depending on the density of its ligand CD48 and the availability of its adaptor protein SLAM-associated protein SAP. Although the role of CD244 has mainly been studied in virus infection, its role in autoimmune disease has not been well defined. In the present study, we examined the regulation of CD244 expression in experimental autoimmune encephalomyelitis (EAE), an induced model of autoimmune disease, and determined that the role of CD48 expression on T cells was markedly changed during EAE progression. To determine the type of CD244-expressing cells affected during the EAE progression, flow cytometry analysis was performed. In the spleen of naïve mice, most of the CD244-expressing cells were NK1.1+ NK cells although NK cells were not the major population in the spleen compared to T cells. In addition, the number of CD244+ NK cells was significantly decreased in early and peak stages of EAE compared to the naïve control. At the recovery phase, the numbers of CD244+ CD4+ T cells and CD244+ CD8+ T cells were increased relative to naïve levels, respectively, while the number of CD244+ NK cells returned to the naïve level, consistent with other reports which considered CD244 as one of exhaustion markers in various diseases. In addition, high CD48 expression was associated with IL-17a production. The reduction of CD244 expression in NK cells that infiltrated into the CNS appeared more dramatic than that in the periphery. Our results suggest that CD244 expression correlates with NK cell function during EAE progression.

Biography:

Jinhee Cho is a PhD student at Jeju National University, Republic of Korea. He has research interest in Immunology, especially Th1/Th2 type immune responses. He completed his BA in Veterinary Medicine at Jeju National University, South Korea from 2008-2014 and; MS in Veterinary Medicine at Jeju National University, South Korea from 2014-2016.

Abstract:

CD244 is a member of the signaling lymphocyte activation molecule (SLAM) family and can exhibit either activating or inhibitory effect on the cytotoxic activity of cells, depending on the density of its ligand CD48 and the availability of its adaptor protein SLAM-associated protein SAP. Although the role of CD244 has mainly been studied in virus infection, its role in autoimmune disease has not been well defined. In the present study, we examined the regulation of CD244 expression in experimental autoimmune encephalomyelitis (EAE), an induced model of autoimmune disease, and determined that the role of CD48 expression on T cells was markedly changed during EAE progression. To determine the type of CD244-expressing cells affected during the EAE progression, flow cytometry analysis was performed. In the spleen of naïve mice, most of the CD244-expressing cells were NK1.1+ NK cells although NK cells were not the major population in the spleen compared to T cells. In addition, the number of CD244+ NK cells was significantly decreased in early and peak stages of EAE compared to the naïve control. At the recovery phase, the numbers of CD244+ CD4+ T cells and CD244+ CD8+ T cells were increased relative to naïve levels, respectively, while the number of CD244+ NK cells returned to the naïve level, consistent with other reports which considered CD244 as one of exhaustion markers in various diseases. In addition, high CD48 expression was associated with IL-17a production. The reduction of CD244 expression in NK cells that infiltrated into the CNS appeared more dramatic than that in the periphery. Our results suggest that CD244 expression correlates with NK cell function during EAE progression.

Biography:

Inhwa Choi is working for Kyung-Hee University Hospital at Gangdong. Her specialties are in the areas of atopic dermatitis (AD) and allergic diseases, such as allergic rhinitis, asthma and allergic contact dermatitis. Her special interests include disorders of the immune system and she has devoted her time and knowledge to helping her patients reinforce and strengthen their resistance to these ailments through Korean medicine.  

Abstract:

Patients with atopic dermatitis (AD) exhibit various symptoms, especially itching. Recently, herbal medicines (HMs) are being used in combination with antihistamines for the treatment of AD in Korea. While oral  ntihistamines can alleviate itching, HMs appear to exert anti inflammatory effects with minimal side effects. However, there is little evidence regarding the effectiveness and safety of using HMs in combination with antihistamines for AD. To observe the effectiveness and safety of combination treatment with HMs and antihistamines, we performed a retrospective chart review of inpatients with AD who received this combination treatment for at least 7 days in a hospital. Of 163 inpatients, 40 met the inclusion criteria. All patients received HMs three times, and one or two antihistamines, a day after HM intake. A large proportion of patients received first-generation antihistamines. HMs comprised a mixture of an average of 20.69 different herbs in decoction. The mean total, objective, and subjective SCORing Atopic Dermatitis scores showed a significant decrease after combination treatment. Changes in the mean levels of aspartate transaminase, alanine transaminase, blood urea nitrogen, and creatinine were not statistically significant among treatments. There were no adverse events of pseudoaldosteronism or interstitial pneumonia. We observed that the short-term use of HMs in combination with oral antihistamines was safe and effective, with a low risk of adverse reactions. This study was limited by its retrospective design, and prospective studies with long-term follow-up periods are warranted to further elucidate the safety of this combination treatment for AD.