Variation in bucco‐palatal maxillary sinus width does not permit a meaningful sinus classification

Abstract

Objectives

The bucco‐palatal sinus width (SW) appears as relevant factor for graft consolidation after maxillary sinus (MS) floor augmentation. The present study aimed to assess a) SW at different height levels of posterior teeth, b) possible factors influencing SW, and c) whether a simple/meaningful sinus classification based on SW is possible.

Methods

The following parameters were recorded on computed tomographies of 76 edentulous and 86 partially edentulous maxillary quadrants displaying 383 tooth sites in total: i) alveolar ridge height, ii) ‐area, iii) ‐width 2mm apical to the alveolar crest, iv) ‐width at the sinus floor, and v) SW and sinus area at a level 2, 4, 6, 8, and 10mm above the sinus floor. The possible influence of gender, tooth position [i.e., premolar (PM); molar (M)], tooth‐gap extent, and residual alveolar ridge dimensions on SW was assessed. Further, based on percentiles of average values or on the frequency distribution of SW <10, 10‐15, or >15mm, it was attempted to classify the sinus at each given site into narrow, average, or wide.

Results

Gender and tooth‐gap extent presented no relevant impact on MS dimensions; however, significant differences were observed among the various tooth positions regarding all evaluated parameters. The lower the residual alveolar ridge, the wider the MS at 4‐10mm height, while the wider the residual alveolar ridge, the wider the MS. Large variation in SW classes among the different height levels within the same tooth position and among tooth positions within the same person was observed, irrespective of the threshold applied. Further, at a MS height of 10mm at PM1, PM2, M1, and M2, SW was <10mm in 68%, 33%, 0%, and 7% of the cases, respectively, while in 3%, 21%, 65%, and 57%, respectively, SW was >15mm.

Conclusions

There is a large variation in SW depending on the height level within the sinus and on tooth position, which does not permit a simple/meaningful classification of each sinus as "narrow", "average", or "wide". Nevertheless, narrow sinuses (<10mm) are rather prevalent in the premolar region, while wide sinuses (>15mm) in the molar region; further, a wider and shorter residual alveolar ridge is associated with a wider SW.

This article is protected by copyright. All rights reserved.

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Basophil Activation Test: Old and New Applications in Allergy

Abstract

Purpose of Review

The basophil activation test (BAT) using flow cytometry has supplanted traditional methods of measuring basophil degranulation using histamine and other mediator release, and can be used for clinical applications as well as to explore the immune mechanisms of effector cell response to allergen. This review discusses the advancements made in clinical, diagnostic and laboratory research of allergy utilizing an ever-evolving BAT.

Recent Findings

Being an in vitro surrogate of the allergic reaction that happens in vivo in the sick patient, the BAT can be used to support the diagnosis of various allergic conditions, such as food, drug, respiratory and insect venom allergies, and the assessment of clinical response to allergen-specific immunotherapy and other immunomodulatory treatments. The BAT can also be used for research purposes to explore the mechanisms of allergy and tolerance at the level of the basophil, for instance by manipulating IgE and IgG and their receptors and by studying intracellular signalling cascade in response to allergen.

Summary

This review covers the applications of the BAT to the clinical management of allergic patients and the increased understanding of the mechanisms of immune response to allergens as well as technological advancements made in recent years.

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Cochlear Implant Users’ Vocal Control CorrelatesAcross Tasks

Cochlear implants (CIs) provide access to auditory information that can affect vocal control. For example, previous research shows that, when producing a sustained vowel, CI users will alter the pitch of their voice when the feedback of their own voice is perceived to shift. Although these results can be informative as to how perception and production are linked for CI users, the artificial nature of the task raises questions as to the applicability of the results to real-world vocal productions.

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Characterization of the Continuous Elastic Parameters of Porcine Vocal Folds

This paper presents an evaluation of the elastic properties of porcine vocal folds through uniaxial tensile tests. Inferior vocal fold tissue samples were subjected to tension in the longitudinal direction while digital image correlation techniques were employed to determine strain values throughout the tests. The stress-strain results showed a low-strain linear region, followed by both a nonlinear exponential and then a higher strain linear region. Data from 16 porcine vocal fold samples were analyzed following a similar optimization method as proposed in prior studies [1] to yield continuous model parameters which describe the elastic properties of the tissue.

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The Role of the Pelvic Floor in Respiration: A Multidisciplinary Literature Review

To conduct an interdisciplinary literature review on the function of the pelvic floor musculature during respiration and its role in phonation, particularly singing.

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Mast cell chymase impairs bronchial epithelium integrity by degrading cell‐junction molecules of epithelial cells

Abstract

Background

An increased degree of mast cell (MC) degranulation and damage to the epithelial lining are prominent features of bronchial asthma. In asthmatic airways, it seems likely that epithelial cells will be exposed to increased concentrations of proteases from MC, though their actions on the epithelium are still not very clear.

Methods

Bronchial rings from human lung tissue or 16HBE cell monolayer were incubated with MC‐chymase in different doses or various inhibitors. The sections of paraffin‐embedded tissue were haematoxylin‐eosin stained and computerized by image analysis for epithelial damage‐scale‐evaluation; the cell viability, proliferation, adhesion, LDH release were assayed; the expressions of gelatinases, cell‐junction molecules and structure proteins of 16HBE were examined.

Results

MC‐Chymase was found to provoke profound changes in the morphology of bronchi epithelial layer. Following incubation with chymase there was 40% reduction of the length of epithelium that was intact, with detachment of columnar epithelial cells and basal cells. Chymase reduced epithelial cell proliferation and induced cell detachment, which were associated with the changes in secretion and activation of matrix metalloproteinase‐2/9. In intact epithelial cell layers, immunocytochemistry study revealed that chymase reduced the expressions of occludin, claudin‐4, ZO‐1, E‐cadherin, focal adhesion kinase and cytokeratin. Overall data of this study indicated that MC‐chymase can influence tissue remodelling, disrupt epithelial cell‐junctions, inhibit wound healing and impair the barrier function of epithelium, resulting in dysfunction of airway wall and ECM remodelling in pathogenesis of asthma.

Conclusions

MC‐chymase plays a key role in inducing the damage to bronchial epithelium in asthma.

This article is protected by copyright. All rights reserved.

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Less exacerbations and sustained asthma control 12 months after high altitude climate treatment (HACT) for severe asthma

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Cord‐serum per‐ and poly‐fluoroalkyl substances (PFAS) and atopy and eczema at 12‐months

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New insights into the origin of mast cells

Abstract

Single‐cell RNA‐sequencing and colony‐forming assays suggest that bone marrow hematopoietic stem and progenitor cells traverse through a differentiation landscape before commitment to the mast cell and other cell lineages.¹ However, the bone marrow contribution for the formation of tissue‐resident mast cells has been questioned, and the prenatal origin of mast cells was recently uncovered.² Through fate mapping experiments Gentek et al² elegantly demonstrated that mast cells arise during two distinct waves of the embryonic development, one from the yolk sac and the other via the aorta‐gonad‐mesonephros.

This article is protected by copyright. All rights reserved.

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Salvage surgery for a locally persistent or recurrent tumour in maxillary cancer patients who have undergone radiotherapy and concomitant intra-arterial cisplatin: implications for surgical margin assessment

Limited information about salvage surgery is available for locally persistent and recurrent maxillary sinus cancers after the completion of chemoradiation therapy. Seventy-six maxillary sinus cancer patients who had undergone chemoradioselection using initial radiotherapy and concomitant intra-arterial cisplatin were screened retrospectively. Twenty-four of these patients who had a locally persistent or recurrent tumour were investigated. The 2-year overall survival rate of patients with maxillary sinus cancer of all types was 39.0% for those who underwent salvage surgery and 10.0% for those who did not.

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Impact of incubation method on the release of growth factors in Non-Ca2+-activated PRP, Ca2+-activated PRP, PRF and A-PRF

The aim of this study was to investigate the influence of different incubation methods on the growth factor content of lysates of platelet-rich fibrin (PRF), advanced-platelet-rich fibrin (A-PRF) and platelet-rich plasma (PRP) products. A comparison of related studies suggests that the method of sample preparation has a significant influence on growth factor content. There are few reports on the comparison of non-Ca2+-activated PRP, Ca2+-activated PRP, A-PRF, and PRF, along with a lack of information on the release of PDGF-BB, TGF-β1, and VEGF among the different incubation methods.

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The Effect of Disc Repositioning and Post-operative Functional Splint for the Treatment of Anterior Disc Displacement in Juvenile Patients with Class II Malocclusion

To evaluate the effect of temporomandibular joint (TMJ) disc repositioning and post-operative functional splint for the treatment of anterior disc displacement (ADD) in juvenile patients with Class II malocclusion.

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Blended learning modules for lectures on oral and maxillofacial surgery

Over the last couple of years, new teaching methods have been developed and implemented in German universities, but only rarely in dental schools. The aim of this project therefore was to implement students' requests for such methods to be used in dental education. In 2012, based on an analysis of both quantitative and qualitative requirements, we designed a questionnaire for quantitative analysis, and evaluated a series of lectures on oral and maxillofacial surgery. Based on our findings, we then designed a blended learning module that was gradually integrated into the series.

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Citation for the 2017 BAOMS Surgery prize – Rajiv Anand

Citation for Rajiv Anand (Reg) DOB 17/1/67.

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Exercise-induced anaphylaxis associated with the use of bee pollen

The use of alternative and complementary medicine, including herbal supplements, is widespread in the United States. Some supplements have been associated with allergic reactions, even anaphylaxis. One such over-the-counter (OTC) supplement is bee pollen. This product is derived from pollen loads collected by honeybees and held together via enzymes secreted in the saliva of the bees. It contains various pollens that can vary based on the path of the individual insect as well the geographical location and associated plant species.

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Nasal Cytology: A Comparative Study of Two Different Techniques of Processing—Smeared versus Cytocentrifuged Slides

Nasal cytology is a precious tool to study nasal disorders, but in current literature, there is no consensus on the standardization of the processing procedure of the obtained samples. Therefore, we decided to test on specimens obtained by nasal scraping, a common way of nasal specimen sampling, two different processing techniques, smear and cytocentrifugation, and compare them in terms of inflammatory cell content, quality of slides, and validity on clinical assessment. We analyzed 105 patients with suspected sinonasal diseases, and in each patient, we performed nasal cytology with both techniques. Our analysis showed a good correlation between the two techniques for neutrophil and eosinophil percentages, both returned well-preserved cells, and showed higher neutrophil percentage in males and in smokers and higher eosinophil percentage in patients with polyposis, with a good concordance with clinical symptoms, as measured by a specific disease-related questionnaire (Sino-Nasal Outcome Test-22). Technically speaking, smeared slides were easier to prepare, with no need of dedicated equipment, but cell distribution was better in cytocentrifuged slides allowing shorter reading time. In conclusion, both techniques can be considered superimposable and worthy to be used.

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Cryptococcal meningitis in a multiple sclerosis patient treated with Fingolimod: a case report and review of imaging findings

Publication date: Available online 14 November 2018

Source: Clinical Imaging

Author(s): Insun Chong, Kevin Yuqi Wang, Christie M. Lincoln

Abstract

Fingolimod is an oral medication approved by the Food and Drug Administration in 2009 for the treatment of relapsing remitting multiple sclerosis (RRMS). Initial clinical trials did not show a significantly increased rate of serious infections with fingolimod therapy. However, a mildly increased risk of less serious infections, such as varicella zoster virus and herpes simplex virus, was reported. Recently, however, several instances of serious opportunistic infections have been reported. In the years following approval of fingolimod for use in multiple sclerosis (MS), seven cases of cryptococcal meningitis in patients undergoing treatment have been described in the literature. We present a 40-year old woman with RRMS on fingolimod therapy presenting with a rare case of cryptococcal meningitis exhibiting alterations of consciousness, which was initially diagnosed as an MS relapse.

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The role of tongue position in laryngeal contrasts: An ultrasound study of English and Brazilian Portuguese

Publication date: November 2018

Source: Journal of Phonetics, Volume 71

Author(s): Suzy Ahn

Abstract

Many languages make a two-way laryngeal contrast in obstruents, but the phonological and phonetic characterization of these contrasts continues to be controversial. In English, utterance-initial /b d ɡ/ stops are often phonetically voiceless. Languages like Brazilian Portuguese, however, exhibit phonetic voicing for /b d ɡ/ stops utterance-initially. This study focuses on tongue position as an articulatory correlate of laryngeal contrasts. Results of an ultrasound study show that tongue position differences are similar for English and Portuguese despite VOT differences, although English speakers show more variation. Tongue root advancement/tongue body lowering is found in both English and Portuguese /b d ɡ/ stops, compared to /p t k/ counterparts. In addition to VOT, which reflects the timing of the oral and laryngeal gestures, the tongue position during closure may be an integral part of the articulatory properties of laryngeal contrasts. Results imply that these languages have different laryngeal gestures but share a similar supralaryngeal articulatory gesture, which may be necessary to distinguish between /b d ɡ/ and /p t k/ stops with respect to supralaryngeal cavity volume.

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Reliability of different three-dimensional cephalometric landmarks in cone-beam computed tomography : A systematic review.

Reliability of different three-dimensional cephalometric landmarks in cone-beam computed tomography : A systematic review.

Angle Orthod. 2018 Nov 13;:

Authors: Sam A, Currie K, Oh H, Flores-Mir C, Lagravere-Vich M

Abstract
OBJECTIVES:: Conventional two-dimensional (2D) cephalometric radiography is an integral part of orthodontic patient diagnosis and treatment planning. One must be mindful of its limitations as it indeed is a 2D representation of a vaster three-dimensional (3D) object. Issues with projection errors, landmark identification, and measurement inaccuracies impose significant limitations, which may now be overcome with the advent of cone-beam computed tomography (CBCT). A systematic review of the reliability of different 3D cephalometric landmarks in CBCT imaging was conducted.
MATERIALS AND METHODS:: Electronic database searches were administered until October 2017 using PubMed, MEDLINE via OvidSP, EBMR and EMBASE via OvidSP, Scopus, and Web of Science. Google Scholar was used as an adjunctive search tool.
RESULTS:: Thirteen articles considering CBCT scans of human subjects from preexisting data sets were selected and reviewed. Most of the studies had methodological limitations and were of moderate quality. Because of their heterogeneity, key data from each could not be combined and were reported qualitatively. Overall, in 3D, midsagittal plane landmarks demonstrated greater reliability compared with bilateral landmarks. A minimum number of dental landmarks were reported, although most were recommended for use.
CONCLUSIONS:: Further research is required to evaluate the reliability of 3D cephalometric landmarks when evaluating 3D craniofacial complexes.

PMID: 30423256 [PubMed - as supplied by publisher]

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Non-invasive evaluation of periodontal ligament stiffness during orthodontic tooth movement.

Non-invasive evaluation of periodontal ligament stiffness during orthodontic tooth movement.

Angle Orthod. 2018 Nov 13;:

Authors: Westover L, Faulkner G, Flores-Mir C, Hodgetts W, Raboud D

Abstract
OBJECTIVES:: To evaluate the longitudinal changes in periodontal ligament (PDL) stiffness during orthodontic tooth movement using the Advanced System for Implant Stability Testing (ASIST).
MATERIALS AND METHODS:: ASIST measurements of maxillary canines that were actively retracted into an extraction space were collected approximately once per month for 12 adolescent female patients. The ASIST Stability Coefficient (ASC) values, which are directly related to PDL stiffness, were determined for each visit to examine longitudinal changes for individual canines as they were exposed to different forces (approximately 80 and 150 g) during retraction.
RESULTS:: The pattern of longitudinal changes in ASC was similar for both canines (regardless of the two force levels applied) in individual patients and across patients. All patients showed some decrease in ASC, with an average maximum reduction in stiffness of 73.4 ± 7.7%. Some recovery was observed for most patients; however, none of the patients had the PDL stiffness return to the pre-treatment value at the final measurement appointment which was some time close after space closure was completed. On average, the ASC value at the final measured visit was 48.1 ± 12.2% of the initial value. No measurements are available after removal of orthodontic appliances and during retention.
CONCLUSIONS:: The ASIST was able to detect changes in PDL stiffness during orthodontic treatment, providing some insight into the mechanical changes that occur at the tooth root interface.

PMID: 30423255 [PubMed - as supplied by publisher]

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Caries, antemortem tooth loss and tooth wear observed in indigenous peoples and Russian settlers of 16th to 19th century West Siberia

Publication date: Available online 14 November 2018

Source: Archives of Oral Biology

Author(s): Hyejin Lee, Jong Ha Hong, Yeonwoo Hong, Dong Hoon Shin, Sergey Slepchenko

Abstract

Objective

Increased prevalence of dental caries evidently is correlated with increasing intake of sugar and carbohydrate-rich foods. Preceding and accompanying this dietary alteration might have been a shift from a hunting-and-gathering subsistence strategy to one based on agriculture. We corroborated this conjecture by means of a study on the prevalence of caries, antemortem tooth loss (AMTL) and tooth wear among 16^th to 19^th century hunter-gatherers and agriculturalists who co-existed in West Siberia.

Design

Indigenous skeletons (n = 75) exhumed from Tatar, Selkup, Khant, and Nenet graves along with Russian settler skeletons (n = 79) from Izyuk were examined. The prevalence of caries, AMTL and tooth wear among the indigenous peoples were compared with those among the Russian settlers. The resulting statistical inferences were tested using package R.

Results

The agriculturalist Russian settlers showed a significantly higher prevalence of dental caries (11.88%) than did the non-agriculturalist indigenous Siberian people (3.85%). Among the latter, the prevalence was the lowest in the Khanty and the highest in the Tatars, suggesting that caries differently affected each sub-group of indigenous Siberian people. Correspondingly to the case of dental caries, the Russian settlers' AMTL prevalence also was higher than that of the indigenous Siberians, regardless of age. On the other hand, the native Siberians and the Russian settlers did not show statistical differences in tooth wear.

Conclusion

In the study on 16^th to 19^th century West Siberian populations, we were able to corroborate our presumption that agriculturalists ingesting a carbohydrate-rich diet would have higher rates of dental caries and AMTL than would hunter-gatherers.

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Corrigendum to ‘Extensions to Hybrid Code Networks for FAIR Dialog Data’ Computer Speech & Language volume 53 (2019) Pages 80-91

Publication date: Available online 13 November 2018

Source: Computer Speech & Language

Author(s): Jiyeon Ham, Soohyun Lim, Kyeng-Hun Lee, Kee-Eung Kim

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The role of genetics in the current diagnostic workup of idiopathic non‐histaminergic angioedema

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Novel cytokine and chemokine markers of hidradenitis suppurativa reflect chronic inflammation and itch

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Modes of operation: A topographic neural gradient supporting stimulus dependent and independent cognition

Publication date: Available online 14 November 2018

Source: NeuroImage

Author(s): Charlotte Murphy, Hao-Ting Wang, Delali Konu, Rebecca Lowndes, Daniel S. Margulies, Elizabeth Jefferies, Jonathan Smallwood

Abstract

Human cognition is flexible - drawing on both sensory input, and representations from memory, to successfully navigate complex environments. Contemporary accounts suggest this flexibility is possible because neural function is organized into a hierarchy. Neural regions are organized along a macroscale gradient, anchored at one end by unimodal systems involved with perception and action, and at the other by transmodal systems, including the default mode network, supporting cognition less directly tied to immediate stimulus input. The current study tested whether this cortical hierarchy captures modes of behaviour that depend on immediate input, as well as those that depend on representations from memory. Participants made decisions regarding the location or identity of shapes using information in the environment (0-back) or from a prior trial (1-back). Using task based imaging we established that, regardless of the nature of the decision, medial and lateral visual cortex were recruited when decisions rely on immediate input, while transmodal regions were recruited when judgments depend on information from the prior trial. Using principal components analysis, we demonstrated that shifting decision-making from perception to memory altered the focus of neural activity from unimodal to transmodal regions (and vice versa). Notably, the more pronounced these shifts in neural activity from unimodal to transmodal regions when decisions relied on memory, the more efficiently individuals performed this task. These data illustrate how the macroscale organization of neural function into a hierarchy allows cognition to rely on input, or information from memory, in a flexible and efficient manner.

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Assessment of mesoscopic properties of deep gray matter iron through a model-based simultaneous analysis of magnetic susceptibility and R2* - A pilot study in patients with multiple sclerosis and normal controls

Publication date: Available online 14 November 2018

Source: NeuroImage

Author(s): Yanis Taege, Jesper Hagemeier, Niels Bergsland, Michael G. Dwyer, Bianca Weinstock-Guttman, Robert Zivadinov, Ferdinand Schweser

Abstract

Most studies of brain iron relied on the effect of the iron on magnetic resonance (MR) relaxation properties, such as R2∗, and bulk tissue magnetic susceptibility, as measured by quantitative susceptibility mapping (QSM). The present study exploited the dependence of R2∗ and magnetic susceptibility on physical interactions at different length-scales to retrieve information about the tissue microenvironment, rather than the iron concentration. We introduce a method for the simultaneous analysis of brain tissue magnetic susceptibility and R2∗ that aims to isolate those biophysical mechanisms of R2∗ -contrast that are associated with the micro- and mesoscopic distribution of iron, referred to as the Iron Microstructure Coefficient (IMC). The present study hypothesized that changes in the deep gray matter (DGM) magnetic microenvironment associated with aging and pathological mechanisms of multiple sclerosis (MS), such as changes of the distribution and chemical form of the iron, manifest in quantifiable contributions to the IMC. To validate this hypothesis, we analyzed the voxel-based association between R2∗ and magnetic susceptibility in different DGM regions of 26 patients with multiple sclerosis and 33 age- and sex-matched normal controls. Values of the IMC varied significantly between anatomical regions, were reduced in the dentate and increased in the caudate of patients compared to controls, and decreased with normal aging, most strongly in caudate, globus pallidus and putamen.

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Characterization of the Continuous Elastic Parameters of Porcine Vocal Folds

Publication date: Available online 14 November 2018

Source: Journal of Voice

Author(s): Garret Burks, Raffaella De Vita, Alexander Leonessa

Abstract

This paper presents an evaluation of the elastic properties of porcine vocal folds through uniaxial tensile tests. Inferior vocal fold tissue samples were subjected to tension in the longitudinal direction while digital image correlation techniques were employed to determine strain values throughout the tests. The stress-strain results showed a low-strain linear region, followed by both a nonlinear exponential and then a higher strain linear region. Data from 16 porcine vocal fold samples were analyzed following a similar optimization method as proposed in prior studies [1] to yield continuous model parameters which describe the elastic properties of the tissue. The average low and high strain linear modulus values were found to be 17.86 kPa and 609.27 kPa, respectively. The model also identified the location of two transition points: p₁, describing the transition from the low-strain linear region to an exponential region at 0.122 ± 0.058 mm/mm and p₂, describing the transition from the exponential to the high strain linear region at 0.308 ± 0.069 mm/mm. The exponential region of the averaged data set was found to be described by the relationship σm(ϵxx)=0.083e19.32ϵxx+2.0951 kPa. In addition to locating transition points, the optimization method maintained modulus continuity across all strain values. Averaged elastic modulus values across strain from 0 to 0.40 mm/mm were compared to representative low and high strain linear modulus which were measured at 0.05 and 0.35 mm/mm, respectively. Statistically significant differences were found among all strain intervals between the two transition points and the linear modulus values. These results indicate the need to consider the location of transition points and further highlight the nonlinearity and changes in elastic modulus which are especially important when using excised porcine vocal folds as a model for phonation. The results quantify continuous linear and nonlinear parameters describing the elastic properties which can be used as a framework for future excised larynx tests and while evaluating the dynamics of sound production, which rely heavily on the elastic properties of the tissue.

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A Preliminary Study of Vocal Health Among Collegiate A Cappella Singers

Publication date: Available online 12 November 2018

Source: Journal of Voice

Author(s): Brandon J. Baird, Tara E. Mokhtari, C. Kwang Sung, Elizabeth Erickson-DiRenzo

Abstract

Objective

Collegiate a cappella groups have grown significantly in popularity and prominence; however, there have been few studies that evaluate the vocal health of this subgroup of young singers. The objective of this preliminary study was to conduct a multiparametric evaluation of the vocal health characteristics of a sample of collegiate a cappella singers. We further tested whether differences in vocal health assessments exist between a cappella singers with and without vocal training and trained collegiate singers who do not participate in a cappella groups.

Study design

Point prevalence study.

Methods

Forty-one collegiate singers participated in this study. Participants were divided into the following three groups: trained singers (TS), trained a cappella singers (ATS), and untrained a cappella singers (AUS). Participants were administered a set of surveys to assess self-perception of singing voice health and perceived access and attitudes toward voice-related health care. Acoustic and laryngoscopic assessments of participant's speaking and singing voice was performed and validated vocal health questionnaires administered as a means to objectively evaluate for the presence of voice problems.

Results

Overall, 87.5% of the ATS and 60% of the AUS groups reported experiencing problems with their singing voice. However, no vocal abnormalities were detected during laryngoscopic and acoustic assessments. Furthermore, minimal differences between any of the measured vocal health parameters were observed between the TS, ATS, and AUS groups.

Conclusion

Collectively, a high percentage of collegiate a cappella singers with and without vocal training report singing voice problems. However, our sample of a cappella singers did not have increased singing voice problems as compared to vocally trained collegiate singers not in a cappella groups. We did find that a cappella singers may be more inclined to seek information about maintaining a healthy singing voice from their fellow musicians as opposed to singing teachers or other voice health professionals. Singing teachers, otolaryngologists, and speech-language pathologists may need to play a more active role in educating a cappella singers regarding maintaining good vocal health.

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Cost-effectiveness of diagnostic algorithms for peanut allergy in children

Publication date: Available online 14 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Natalia R. Kunst, Helene Lindvik, Kai-Håkon Carlsen, Geir Håland, Eivind Jørgensen, Karin C. Lødrup Carlsen

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Transcriptional and Functional Diversity of Human Macrophage Repolarization

Publication date: Available online 14 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Sina A. Gharib, Ryan S. McMahan, William E. Eddy, Matthew E. Long, William C. Parks, Moira L. Aitken, Anne M. Manicone

Abstract

Background

Macrophage plasticity allows cells to adopt different phenotypes, a property with important implications in disorders such as cystic fibrosis (CF) and asthma.

Objective

To examine the transcriptional and functional significance of macrophage repolarization from an "M1" towards an "M2" phenotype, and assess the role of a common human genetic disorder (CF) and a prototypical allergic disease (asthma) in this transformation.

Methods

Monocyte-derived macrophages were collected from healthy and CF subjects and polarized to an M2 state using IL-4, IL-10, glucocorticoids, apoptotic PMNs, or azithromycin. We performed transcriptional profiling and pathway analysis for each stimulus. We assessed the ability of M2-repolarized macrophages to respond to LPS re-challenge and clear apoptotic neutrophils, and used murine models to determine conserved functional responses to IL-4 and IL-10. We investigated whether M2 signatures were associated with alveolar macrophage phenotypes in asthma.

Results

We found that macrophages exhibit highly diverse responses to distinct M2-polarizing stimuli. Specifically, IL-10 activated pro-inflammatory pathways and abrogated LPS-tolerance allowing for rapid restoration of LPS responsiveness. In contrast, IL-4 enhanced LPS-tolerance, dampening pro-inflammatory responses after repeat LPS challenge. A common theme observed across all M2 stimuli was suppression of interferon-associated pathways. We found that CF macrophages had intact reparative and transcriptional responses, suggesting that macrophage contributions to CF lung disease are primarily shaped by their environment. Finally, we leveraged in vitro-derived signatures to show that allergen provocation induces distinct M2-state transcriptional patterns in alveolar macrophages.

Conclusion

Our findings highlight the diversity of macrophage polarization, attribute functional consequences to different "M2" stimuli, and provide a framework to phenotype macrophages in disease states.

Graphical abstract

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Ordinary vibratory angioedema is not generally associated with ADGRE2-mutation

Publication date: Available online 14 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Zuotao Zhao, Sascha Reimann, Shan Wang, Yuhan Wang, Torsten Zuberbier

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Histologic similarities in children with eosinophilic esophagitis and PPI-responsive esophageal eosinophilia

Publication date: Available online 14 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Nathalie Nguyen, Anna Baumgarten, Benjamin L. Wright, Kelley E. Capocelli, Zhaoxing Pan, James J. Lee, Glenn T. Furuta, Joanne C. Masterson

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Nasal Allergen Neutralising IgG4 Antibodies Block IgE-mediated Responses: Novel biomarker of Subcutaneous Grass Pollen Immunotherapy

Publication date: Available online 14 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Mohamed H. Shamji, Jasper Kappen, Hisham Abubakar-Waziri, Jinjin Zhang, Esther Steveling, Shelley Watchman, Lubna Kouser, Aarif Eifan, Amy Switzer, Gilda Varrichi, Gianni Marone, Natália C. Couto-Francisco, Moises Calderon, Stephen R. Durham

Abstract

Background

Grass pollen subcutaneous immunotherapy (SCIT) is associated with induction of serum IgG₄-associated inhibitory antibodies that prevent IgE-facilitated allergen binding to B cells.

Objective

To determine whether SCIT induces nasal allergen-specific IgG₄ antibodies with inhibitory activity that correlate closely with clinical response.

Methods

In a cross-sectional, controlled study, nasal fluid and sera were collected during the grass pollen season from 10 SCIT-treated patients, 13 untreated allergics (SAR) and 12 non-atopic controls (NA). Nasal and serum IgE and IgG₄ to Phleum pratense (Phl p) components were measured by ISAC microarray. Inhibitory activity was measured by IgE-FAB assay. IL-10⁺Breg cells were quantified in peripheral blood by flow cytometry.

Results

Nasal and serum Phl p1 and Phl p5-specific IgE levels were elevated in SAR compared to NA (all, P < .001) and SCIT group. Nasal IgG₄ levels were increased in SCIT compared to SAR group (P < .001) during the pollen season compared to out of season. IgG-associated inhibitory activity in nasal fluid and serum was significantly increased in SCIT compared to SAR group (both, P < .001). The magnitude of the inhibitory activity was 96% in the nasal fluid compared to 66% in serum and was reversed following depletion of IgG in nasal fluid (P = .03) and serum (P = .002). Both nasal fluid (r = -0.67, P = .0011) and serum (r = -0.59, P = .0097) blocking activity correlated global symptom improvement. IL-10⁺Breg cells were increased in season compared to out of season in SCIT group (P < .01).

Conclusion

For the first time, we show that nasal IgG₄-associated inhibitory activity correlate closely with the clinical response to allergen immunotherapy in allergic rhinitis with/without asthma.

Graphical abstract

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The Expression and Function of the Ectopic Olfactory Receptor OR10G7 in Atopic Dermatitis

Publication date: Available online 14 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Elizabeth Huiwen Tham, Nathan Dyjack, Byung Eui Kim, Cydney Rios, Max A. Seibold, Donald YM. Leung, Elena Goleva

Abstract

Background

Ectopic olfactory receptors (OR) are found in the skin but their expression and biological functions in normal skin and atopic dermatitis (AD) are unknown.

Objectives

To characterize the expression of ORs in the skin and assess OR-mediated biological responses of primary human keratinocytes in the presence of odorant ligands.

Methods

OR expression was examined by whole transcriptome sequencing of skin tape strips collected from AD and healthy controls (NC). OR10G7 and FLG-1 expression were analyzed by RT-PCR and immunostaining in AD and NC skin biopsies and primary human keratinocytes. ATP and cyclic AMP production by control and OR10G7 siRNA transfected keratinocytes in response to odorant stimulation with acetophenone and eugenol were assessed.

Results

A total of 381 OR gene transcripts were detected in the skin samples, with the greatest OR expression detected in the skin tape strips, corresponding to the upper granular layer of the skin. OR10G7 expression was significantly increased in AD compared to NC skin biopsies (p=0.01) and inversely correlated with FLG-1 expression (p=0.009). OR10G7 expression was highest in undifferentiated AD keratinocytes and was down-regulated with progressive differentiation. Primary human keratinocytes produced ATP, an essential neurotransmitter in sensory pathways, in response to acetophenone and eugenol, odorants previously identified as potential ligands for this receptor. This response was abolished in OR10G7 siRNA-transfected keratinocytes.

Conclusions

OR10G7 is expressed at significantly higher levels in undifferentiated AD keratinocytes compared to normal controls. OR10G7 is likely involved in the transmission of skin-induced chemosensory responses to odorant stimulation, which may modulate differential nociceptive responses in AD skin.

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Selection of house dust mite allergic patients by molecular diagnosis may enhance success of specific immunotherapy

Publication date: Available online 14 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Kuan-Wei Chen, Petra Zieglmayer, René Zieglmayer, Patrick Lemell, Friedrich Horak, Carmen Panaitescu Bunu, Rudolf Valenta, Susanne Vrtala

Summary

AIT performed with HDM extracts inducing IgG antibodies only to Der p 1 and 2 was beneficial for patients sensitized exclusively to these allergens but not for patients with sensitization to other HDM allergens.

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Shedding light on corticosteroid-resistant Type-2 high severe asthma

Publication date: Available online 14 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Kian Fan Chung

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Lab-on-a-Chip Technologies for Diagnosis and Monitoring of Airway Inflammation

Publication date: Available online 14 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Mehdi Javanmard

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Immunologic reconstitution following hematopoietic stem cell transplantation despite lymph node paucity in NIK deficiency

Publication date: Available online 14 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Khaoula Ben Farhat, Mohammed F. Alosaimi, Hiba Shendi, Suleiman Al-Hammadi, Jennifer Jones, Klaus Schwarz, Ansgar Schulz, Laila S. Alawdah, Sandra Burchett, Sultan Albuhairi, Jennifer Whangbo, Neha Kwatra, Hanan E. Shamseldin, Fowzan S. Alkuraya, Janet Chou, Raif S. Geha

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Remission of persistent childhood asthma: early predictors of adult outcomes

Publication date: Available online 14 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Alberta L. Wang, Soma Datta, Scott T. Weiss, Kelan G. Tantisira

Abstract

Background

Few data exist on the predictors of asthma remission by early adulthood in North America.

Objective

The predictors of adult asthma remission were determined in a multiethnic population of mild-to-moderate persistent childhood asthmatics.

Methods

Asthma remission in early adulthood was measured using two definitions, a clinical and a strict definition. Both included normal lung function and the absence of symptoms, exacerbations, and medication use. The strict definition also included normal airways responsiveness. Predictors were identified from 23 baseline measures using multivariate logistic regression. The probability of remission was modeled using decision tree analysis.

Results

In 879 subjects, mean baseline age was 8.8 years (SD ± 2.1), 59.4% were males, and 68.7% were Caucasian. By adulthood, 229 (26.0%) of 879 participants were in clinical remission and 111 (15.0%) of 741 participants were in strict remission. The degree of forced expiratory volume in one second to forced vital capacity (FEV₁/FVC) impairment was the largest predictor of asthma remission. Over half of boys and two-thirds of girls with baseline FEV₁/FVC ≥ 90% were in remission at adulthood. Decreased airways responsiveness was also a predictor for both remission definitions (clinical remission OR 1.23, 95% CI 1.09-1.39; strict remission OR 1.52, 95% CI 1.26-1.84). The combination of normal FEV₁/FVC, airways responsiveness, and serum eosinophil count at baseline yielded > 80% probability of remission by adulthood.

Conclusion

A considerable minority of persistent childhood asthmatics will develop disease remission by adulthood. Clinical prognostic indicators of asthma remission, including baseline lung function, can be seen from an early age.

Graphical abstract

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Social Media and Allergy

Abstract

Purpose of Review

Social media services dominate online consumption of information and play an ever expanding role in our lives. They are not only used to connect with friends and family but also to educate and recruit colleagues and patients, and to stay up-to-date with the new developments in the field of allergy and immunology.

Recent Findings

There are known risks to social media user by health care professionals mostly related to breaches of patient confidentiality, professionalism, and privacy. Malpractice and liability risks have been linked to irresponsible use of social media.

Summary

This review provides a comprehensive overview of the current social media tools in allergy. We recommend a pragmatic approach to maximize social media tools for the allergy practice.

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