Suchergebnisse

ZusammenfassungBei 10 % aller Birkenpollenallergiker wurden allergische Reaktionen auf die Sojabohne nachgewiesen. Typischerweise manifestieren diese sich in Form eines milden oralen Allergiesyndroms. Wir stellen 4 Patienten (1 Mann, 3 Frauen, 50 – 72 Jahre) mit primärer Birkenpollenallergie aus unserer Allergieabteilung vor, bei denen sich jedoch nach Verzehr von Sojamilch/-drink schwere allergische Reaktionen bis hin zur Anaphylaxie entwickelten. Diese Patienten litten unter einer Rhinoconjunctivitis allergica im Frühjahr und zusätzlichen pollenassoziierten Nahrungsmittelallergien. Haut-Pricktestungen auf Sojaprodukte waren positiv. Bei 3 von 4 Patienten war die Sojaallergie lediglich durch spezifische IgE-Antikörper auf das birkenpollenhomologe PR-10-Protein Gly m 4 nachweisbar, jedoch nicht auf den Sojagesamtextrakt (< 0,35 KU/l). Bei einer Patientin, die Sojaprodukte bisher immer vertragen hatte, wurde die Sojaallergie erst durch orale Provokationstestung nachgewiesen. Es handelt sich bei allen Patienten um eine sekundäre birkenpollenassoziierte Sojaanaphylaxie nach Einnahme großer Mengen an geringgradig verarbeiteten Sojaprodukten (Sojadrink). Diese stellt für Birkenpollenallergiker mit IgE-vermittelten Allergien sowohl auf das Birkenpollenallergen Bet v 1 als auch auf das homologe Gly m 4 in der Sojabohne aufgrund einer Kreuzreaktion ein Risiko dar.

BACKGROUND: The European Union requires allergenic food ingredients to appear on labels in order to protect allergic consumers. OBJECTIVE: To determine whether traces of egg-, milk-, and fish-derived processing aids used in winemaking might elicit clinical reactions in food-allergic patients. METHODS: Five German wines were fined with a high dose of egg albumin, lysozyme, milk casein, fish gelatin, or isinglass, and filtered. Fourteen adults with allergy to egg (n = 5), milk (n = 5), or fish (n = 4) were included. Skin prick tests were performed with fining agents, and fined and unfined wines. All patients underwent double-blind placebo-controlled food challenges with fined and unfined wines. RESULTS: Skin prick tests were positive to hen's egg (n = 5), ovalbumin (n = 5), lysozyme (n = 4), cow's milk (n = 5), casein (n = 4), and cod (n = 3), but not to isinglass or fish gelatin (n = 0). Positive skin prick test results were observed for wines fined with albumin (n = 3), lysozyme (n = 2), casein (n = 1), gelatin (n = 0), and isinglass (n = 3), and for unfined wines (n = 1-2 in each patient group), with no significant differences between groups. Seventy-five percent of skin test-positive patients had specific immunoglobulin E to other allergens present in wine (eg, carbohydrates). The provocation test revealed no reactions to fined or unfined wines. CONCLUSIONS: Although concentrated fining agents containing ovalbumin, lysozyme, and casein were allergenic in the skin prick test, no patient reacted adversely in the provocation test to fined wine. Wines treated with fining agents at commercial concentrations appear not to present a risk to allergic individuals when filtered

Milk-based fining materials that are used during winemaking may trigger allergic reactions. If they are present in the final product and depending on a countrys legislation, these substances may have to be declared on the wine label. This labeling helps consumers with allergies avoid wines that may trigger their allergic symptoms. This study investigated the utility of several procedures for removing allergenic residues remaining in wine after the use of milk protein-containing fining agents. Winemaking practices are different depending on country and areas, and because of these different standards, a fining trial was conducted to study the efficiency of various filtration methods and of other treatments for reducing the levels of milk-derived allergens, even in a worst-case scenario involving the use of high amounts of fining agents. ELISA was used to detect milk proteins in wine, and in vivo allergy tests were also conducted. All filtration methods used in this study removed casein from both red and white wines to levels undetectable by the ELISA. Other removal methods evaluated in this study were equally efficient, apart from flash pasteurization or silica sol, when a large amount of casein was applied. However, an additional sterile filtration after flash pasteurization or silica sol fining decreased casein proteins to undetectable levels as well.

ZusammenfassungDie Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein der Technischen Universität München (TUM) wurde 1969 in Betrieb genommen und feiert daher im Jahr 2019 ihr 50-jähriges Bestehen. Die Ursprünge dieser Klink gehen aber wie an vielen Orten auf ältere Versorgungsstrukturen zurück. Anlässlich des 50-jährigen Bestehens soll dieser Artikel die Entwicklung und aktuelle Ausrichtung der Klinik illustrieren und dabei auch die Wertschätzung für unsere Vorgänger ausdrücken, die sich auf den verschiedenen Positionen für unsere Patienten eingesetzt und so die Basis für eine erfolgreiche Klinik in Krankenversorgung, Forschung und Lehre geschaffen haben. Die Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein gehört zum Universitätsklinikum, dem Klinikum rechts der Isar, der Technischen Universität München (TUM), sie selbst liegt jedoch links der Isar, im schönen Schwabing unweit des Englischen Gartens. Sie ist eine von 3 Hautkliniken in München, die im Rahmen der Münchner Dermatologischen Gesellschaft (MDG e. V.) regelmäßig Fortbildungen ausrichten. Die MDG am Biederstein wird sich im Jahr 2019 neben der Fortbildung auch dem Jubiläum dieser Klinik widmen.Die Klinik als universitäre Einrichtung umfasst den Bereich medizinische Versorgung mit 74 Betten auf 4 Stationen, einen ambulanten Bereich mit einer großen Poliklinik für Allgemein- und Privatpatienten (jährlich mehr als 60 000 Patientenbesuche), den Bereich Forschung mit verschiedenen Forschungsgruppen und großen Laboratorien sowie den Bereich Lehre, Weiter- und Fortbildung. Ein Schwerpunkt in der klinischen Versorgung und in der Forschung war bereits zur Zeit der Gründung der Klinik 1969 die Allergologie. Weiterhin bestehen Schwerpunkte im Bereich der entzündlichen Hauterkrankungen, der Dermatoonkologie, der Dermatoinfektiologie, der Dermatochirurgie und der Wundversorgung. Die Klinik hat das Comprehensive Allergy Center der Technischen Universität München (ACTUM) und EU-Exzellenz-Zentrum für Allergie auf den Weg gebracht und ist Teil der Krebszentren Comprehensive Cancer Center München der Technischen Universität München (CCC MünchenTUM) und des Comprehensive Cancer Center München (CCCM). Pro Semester werden etwa 450 Studenten im Rahmen von Vorlesungen, Seminaren und Praktika betreut. Neben Kongressen wie der Jahrestagung der Arbeitsgemeinschaft Dermatologische Forschung (ADF) im Jahr 2019 oder der European Society for Dermatological Research (ESDR) im Jahre 2016 richten die Klinik und der Lehrstuhl regelmäßige Fortbildungsveranstaltungen im Rahmen des Biedersteiner Symposiums, des Biedersteiner Kolloquiums und der MDG aus.

BACKGROUND: Food allergy is targeted as a public health priority by the European Union Commission. Parental perception of food allergy in their offspring is a proxy measure of the potential demand for allergy medicine services in the paediatric population. METHODS: A representative sample of the general population was contacted by a randomised telephone survey in Austria, Belgium, Denmark, Finland, Germany, Greece, Italy, Poland, Slovenia and Switzerland. A standardised questionnaire was administered regarding parentally perceived food allergy reports, symptoms, foods and medical service use by their live-in children. RESULTS: 40,246 adults were polled, yielding data on 8,825 children. Parentally perceived food allergy prevalence was 4.7% (90% CI 4.2-5.2%). The most affected age group was 2- to 3-year olds (7.2%). Single-country incidence ranged between 1.7% (Austria) to 11.7% (Finland). Milk (38.5%), fruits (29.5%), eggs (19.0%) and vegetables (13.5%) were most often implicated, although with significant age-linked variations. Medical treatment was needed by 75.7% of affected children because of a food reaction. This translates into a proxy measure for food allergy prevalence of 3.75%. Skin symptoms were widespread (71.5%), followed by gastrointestinal (27.6%) and respiratory (18.5%) symptoms. DISCUSSION: We provide the first point prevalence of parentally perceived food allergy in the general paediatric population across the European Union. Parental reports confirm the public health significance of adverse reactions to some foods in specified age groups. Our data may inform intervention planning, cost of illness assessments and quality-of-life-enhancing public health measures.

BACKGROUND: In recent years, skin reactions secondary to the use of medical devices (MD), such as allergic contact dermatitis have increasingly been observed (e.g. to continuous blood sugar monitoring systems, insulin pumps, wound dressings, medical gloves, etc.): this is regarded as a developing epidemic. Lack of labelling of the composition of MD, as well as frequent lack of cooperation of manufacturers to disclose this relevant information, even when contacted by the clinician for the individual case of an established adverse reaction, significantly impede patient care. OBJECTIVES: To advocate for full ingredient labelling in the implementation of EU regulation for MD. METHODS: This position paper reviews the scientific literature, the current regulatory framework adopted for MD to date, and the likely impact, including some costs data in case of the absence of such labelling. RESULTS: Efforts made by several scientific teams, who are trying to identify the culprit of such adverse effects, either via asking for cooperation from companies, or using costly chemical analyses of MD, can only partly, and with considerable delay, compensate for the absence of meaningful information on the composition of MD; hence, patient management is compromised. Indeed, without knowing the chemical substances present, physicians are unable to inform patients about which substances they should avoid, and which alternative MD may be suitable/tolerated. CONCLUSION: There is an urgent need for full and accurate labelling of the chemical composition of MD in contact with the human body.

Background: In recent years, skin reactions secondary to the use of medical devices (MD), such as allergic contact dermatitis have increasingly been observed (e.g. to continuous blood sugar monitoring systems, insulin pumps, wound dressings, medical gloves, etc.): this is regarded as a developing epidemic. Lack of labelling of the composition of MD, as well as frequent lack of cooperation of manufacturers to disclose this relevant information, even when contacted by the clinician for the individual case of an established adverse reaction, significantly impede patient care. Objectives: To advocate for full ingredient labelling in the implementation of EU regulation for MD. Methods: This position paper reviews the scientific literature, the current regulatory framework adopted for MD to date, and the likely impact, including some costs data in case of the absence of such labelling. Results: Efforts made by several scientific teams, who are trying to identify the culprit of such adverse effects, either via asking for cooperation from companies, or using costly chemical analyses of MD, can only partly, and with considerable delay, compensate for the absence of meaningful information on the composition of MD; hence, patient management is compromised. Indeed, without knowing the chemical substances present, physicians are unable to inform patients about which substances they should avoid, and which alternative MD may be suitable/tolerated. Conclusion: There is an urgent need for full and accurate labelling of the chemical composition of MD in contact with the human body.

Background: In recent years, skin reactions secondary to the use of medical devices (MD), such as allergic contact dermatitis have increasingly been observed (e.g. to continuous blood sugar monitoring systems, insulin pumps, wound dressings, medical gloves, etc.): this is regarded as a developing epidemic. Lack of labelling of the composition of MD, as well as frequent lack of cooperation of manufacturers to disclose this relevant information, even when contacted by the clinician for the individual case of an established adverse reaction, significantly impede patient care. Objectives: To advocate for full ingredient labelling in the implementation of EU regulation for MD. Methods: This position paper reviews the scientific literature, the current regulatory framework adopted for MD to date, and the likely impact, including some costs data in case of the absence of such labelling. Results: Efforts made by several scientific teams, who are trying to identify the culprit of such adverse effects, either via asking for cooperation from companies, or using costly chemical analyses of MD, can only partly, and with considerable delay, compensate for the absence of meaningful information on the composition of MD; hence, patient management is compromised. Indeed, without knowing the chemical substances present, physicians are unable to inform patients about which substances they should avoid, and which alternative MD may be suitable/tolerated. Conclusion: There is an urgent need for full and accurate labelling of the chemical composition of MD in contact with the human body.

Urticaria is a frequent disease. The lifetime prevalence for urticaria is approximately 20%. Urticaria not only causes a decrease in quality of life, but also affects performance at work and school and, as such, is a member of the group of severe allergic diseases. This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors, and pathomechanisms. In addition, it outlines evidence-based approaches to economical diagnosis for different subtypes of urticaria. The correct management of urticaria, which is of paramount importance for patients, is very complex and is consequently covered in a separate guideline. This German language guideline was prepared on the basis of the international English language guideline, which was acknowledged by UEMS (European Union of Medical Specialists), taking into account medical conditions in the German language area. This guideline, together with its sister guideline on the management of urticaria, is the result of a consensus reached during a panel discussion at the 3rd International Consensus Meeting on Urticaria, "Urticaria 2008", a joint initiative of the Dermatology Section of the EAACI (European Academy of Allergy and Clinical Immunology), the EU-funded network of excellence GA(2)LEN (Global Allergy and Asthma European Network), the EDF (European Dermatology Forum) and the WAO (World Allergy Organization). For the first time, given that evidence was sufficient, the Grading-of-Recommendations-Assessment- De vel opment-and- Evaluation-(GRADE)-Method was used here as far as possible.

Urticaria is a frequent disease. The lifetime prevalence for urticaria is approximately 20%. Urticaria not only causes a decrease in quality of life, but also affects performance at work and school and, as such, is a member of the group of severe allergic diseases. This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors, and pathomechanisms. In addition, it outlines evidence-based approaches to economical diagnosis for different subtypes of urticaria. The correct management of urticaria, which is of paramount importance for patients, is very complex and is consequently covered in a separate guideline. This German language guideline was prepared on the basis of the international English language guideline, which was acknowledged by UEMS (European Union of Medical Specialists), taking into account medical conditions in the German language area. This guideline, together with its sister guideline on the management of urticaria, is the result of a consensus reached during a panel discussion at the 3rd International Consensus Meeting on Urticaria, Urticaria 2008, a joint initiative of the Dermatology Section of the EAACI (European Academy of Allergy and Clinical Immunology), the EU-funded network of excellence GA(2)LEN (Global Allergy and Asthma European Network), the EDF (European Dermatology Forum) and the WAO (World Allergy Organization). For the first time, given that evidence was sufficient, the Grading-of-Recommendations-Assessment- De vel opment-and- Evaluation-(GRADE)-Method was used here as far as possible.

Background: For patients with food allergy there has been no alternative treatment to food allergen avoidance. In a study supported by the European union, a new approach aimed to reduce the allergenicity of foods of animal origin to achieve better tolerance. Patients and methods: the prevalence of food allergy was assessed by telephone interviews with more than 40000 persons in 10 European countries. By thermal and enzymatic the allergenicity of the animal food allergens hen's egg, cow's milk, beef and poultry was reduced. Patients with proven food allergy to those foods of animal origin were recruited and assessed allergologically. In-vitro cellular test systems were established. The allergenicity of food products were investigated before and after allergen reduction. Results: The prevalence of food allergy in Europe is 3% with considerable regional differences. In 41.1% of food allergic patients, food allergens of animal origin were thought to be responsible for eliciting symptoms. In total, 249 patients with food allergy were recruited. The threshold for eliciting symptoms was below the lowest test dose (e.g. 10 mu g egg powder) in the double-blind placebo-controlled food challenge in 53 of 249 (21%) of patients, whereas 50 of 249 patients (20%) only reacted to the highest given dose (e.g. one full egg). Symptoms in the provocation test developed predominantly on the skin and in the gastrointestinal tract, however, also involved respiratory tract and cardiovascular system. Allergen-reduced cow's milk and hen's egg were produced and in part tolerated by patients in the skin prick test and provocation test. The extent of allergen reduction was characterized, also by cellular test systems involving mast cell lines. Conclusions: the concept of allergen reduction in food allergy is a new approach, which could reduce dietary interventions and support tolerance in food allergic patients.