Nuestros investigadores

Marta Ferrer Puga

Publicaciones científicas más recientes (desde 2010)

Autores: Zubeldia, J. M.; Ferrer, Marta; Dávila, I.; et al.
Revista: JOURNAL OF INVESTIGATIONAL ALLERGOLOGY AND CLINICAL IMMUNOLOGY
ISSN 1018-9068  Vol. 29  Nº 2  2019  págs. 103 - 111
Allergen-specific immunotherapy (AIT) is the only treatment that can affect the natural course of allergic diseases such as allergic asthma, allergic rhinitis, and IgE-mediated food allergy. Adjuvants are used to induce a quicker, more potent, and longer-lasting immune response. Only 4 compounds are used as adjuvants in currently marketed AIT products: aluminum hydroxide, calcium phosphate, microcrystalline tyrosine (MCT), and monophosphoryl lipid A (MPL). The first 3 adjuvants are delivery systems with a depot effect, although they may also have immunomodulatory properties. These first-generation adjuvants are still widely used, especially aluminum hydroxide. However, aluminum is subject to limitations. MCT is the depot formulation of L-tyrosine; it enhances IgG production without inducing a significant increase in IgE, is biodegradable, and has good local and systemic tolerability. In turn, MPL is an immunostimulatory agent that is the only second-generation adjuvant currently used for AIT. In addition, multiple adjuvants are currently being studied, including immunostimulatory sequences (ISSs), nanoparticles (liposomes, virus-like particles, and biodegradable polymers), and phosphatidylserine derivatives. In a murine model of allergic bronchial inflammation by sensitization to olive pollen, the specific IgE level was significantly higher in sensitized mice treated with olive pollen and aluminum hydroxide. However, specific IgE levels were significantly reduced and bronchial hyperreactivity significantly improved in sensitized mice treated with olive pollen and bacterial derivatives (MPL or ISSs).
Autores: Jauregui, I.; Gimenez-Arnau, A.; Bartra, J.; et al.
Revista: HEALTH AND QUALITY OF LIFE OUTCOMES
ISSN 1477-7525  Vol. 17  Nº 1  2019  págs. 23 - 32
BACKGROUND: The daily diary Urticaria Activity Score (UAS) and its weekly score (UAS7) are widely used to assess signs and symptoms in patients with chronic spontaneous urticaria (CSU). The objective of this study was to assess the psychometric properties of a Spanish version of the once-daily UAS. METHODS: Observational study in patients ¿18¿years old receiving usual care for CSU (daily or almost daily occurrence of generalized hives or angioedema for ¿6¿weeks). Patients were included consecutively and completed the UAS, EQ-5D, and the Chronic Urticaria Quality of Life scale (CU-Q2oL) at two study visits 6¿weeks apart. On each occasion, the UAS was completed once-daily for 7 consecutive days to be able to calculate the UAS7 score. Psychometric properties of reliability, construct validity, and responsiveness were assessed. The Minimal Important Difference (MID) was estimated for the UAS7 using anchor- and distribution-based approaches. RESULTS: Data from 166 patients was available for analysis (mean age 49¿years, 65.7% female). Floor (5.4% of patients with the lowest possible score) and ceiling (1.2%) effects were low; 15% of patients had missing values. Internal consistency and test-retest reliability were good (Cronbach's alpha of 0.83 and an ICC of 0.84, respectively). Convergent validity was demonstrated through the pattern of correlations with the EQ-5D and CU-Q2oL and known groups' validity was demonstrated by the instrument's ability to discriminate between patients with different overall levels of urticaria severity, with between-group effect-sizes (ES) ranging from 0.36 to 1.19. The UAS7 proved responsive to change with effect sizes ranging from 0.3 to 1.52 in patients reporting improvement or deterioration in overall urticaria status. The MID for the UAS7 score was estimated at 7-8 points, on a scale of 0-42. CONCLUSIONS: The Spanish version of the UAS score has demonstrated a robust psychometric performance in patients with CSU managed in conditions of usual care. It can therefore be considered a suitable instrument to assess disease activity in clinical practice in Spanish-speaking patients. The Spanish version's reliability and validity are similar to those reported for other language versions of the once- and twice-daily variants of the UAS.
Autores: Ferrer, Marta, (Autor de correspondencia); Gimenez-Arnau, A.; Saldana, D. ; et al.
Revista: JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 
ISSN 2213-2198  Vol. 6  Nº 4  2018  págs. 1191 - 97
BACKGROUND: Omalizumab is highly effective in controlling chronic spontaneous urticaria (CSU) symptoms; however, patients can experience symptom return on treatment discontinuation. Pivotal clinical trials have identified 2 categories of patients who experience symptom return: rapid and slow. OBJECTIVE: The objective of this study was to identify potential predictors of the speed of symptom return after stopping omalizumab treatment. METHODS: Phase III randomized controlled trial (RCT) data from ASTERIA I (n = 319; 6 3 4 weekly injections of omalizumab 75, 150, 300 mg or placebo; NCT01287117) and ASTERIA II (n = 323; 3 3 4 weekly injections of omalizumab 75, 150, 300 mg, or placebo; NCT01292473) were pooled to identify predictors of symptom return after stopping omalizumab treatment (16-week follow-up). The least absolute shrinkage and selection operator regularization regression model was used to select predictive variables, and relapse probability was represented using heatmap visualizations. Model accuracy was tested using data from the GLACIAL phase III RCT (n = 336; 6 3 4 weekly injections of omalizumab 300 mg or placebo; NCT0126493). RESULTS: Of 746 variables assessed, 2 were selected by the model as predictors of symptom return: baseline urticaria activity score over 7 days (UAS7) and early area above the curve (AAC; determined by plotting the UAS7 scores across time points). Results suggest that high baseline UAS7 and low UAS7 AAC (slow decrease of symptoms) indicate a higher probability of rapid symptom return than low baseline UAS7 and high UAS7 AAC. CONCLUSIONS: These results suggest that the probability of rapid symptom return in patients with CSU who discontinue treatment with omalizumab can be estimated based on baseline UAS7 and early treatment response. (C) 2018 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY-NC-ND license.
Autores: Gastaminza, Gabriel, (Autor de correspondencia); Lafuente, Alberto; Goikoetxea, María José; et al.
Revista: ANESTHESIA AND ANALGESIA
ISSN 0003-2999  Vol. 127  Nº 2  2018  págs. 414 - 419
BACKGROUND: Differentiating between immunoglobulin E (IgE)-dependent and IgE-independent hypersensitivity reactions may improve the etiologic orientation and clinical management of patients with allergic reactions in the anesthesia setting. Serum tryptase levels may be useful to discriminate the immune mechanism of allergic reactions, but the diagnostic accuracy and optimal cutpoint remain unclear. We aimed to compare the diagnostic accuracy of tryptase during reaction (TDR) alone and the TDR/basal tryptase (TDR/BT) ratio for discriminating IgE- from non-IgE-mediated allergic reactions, and to estimate the best cut point for these indicators. METHODS: We included 111 patients (45% men; aged 3-99 years) who had experienced an allergic reaction, even though the allergic reaction could be nonanaphylactic. Allergy tests were performed to classify the reaction as an IgE- or non-IgE-mediated one. The area under the curve (AUC) of the receiver operating characteristic analysis was performed to estimate the discriminative ability of TDR and TDR/BT ratio. RESULTS: An IgE-mediated reaction was diagnosed in 49.5% of patients, of whom 56% met anaphylaxis criteria. The median (quartiles) TDR for the IgE-mediated reactions was 8.0 (4.9-19.6) and 5.1 (3.5-8.1) for the non-IgE-mediated (P = .022). The median (quartiles) TDR/BT ratio was 2.7 (1.7-4.5) in IgE-mediated and 1.1 (1.0-1.6) in non-IgE-mediated reactions (P < .001). The TDR/BT ratio showed the greatest ability to discriminate IgE- from non-IgE-mediated reactions compared to TDR (AUC TDR/BT = 0.79 [95% confidence interval (CI), 1.1-2.2] and AUC TDR = 0.66 [95% CI, 1.1-2.2]; P = .003). The optimal cut point for TDR/BT (maximization of the sum of the sensitivity and specificity) was 1.66 (95% CI, 1.1-2.2). CONCLUSIONS: The TDR/BT ratio showed a significantly better discriminative ability than TDR to discriminate IgE- from non-IgE-mediated allergic reactions. An optimal TDR/BT ratio threshold of approximately 1.66 may be useful in clinical practice to classify allergic reactions as IgE- or non-IgE-mediated.
Autores: D'Amelio, Carmen Mariana ; Ferrer, Marta; Martinez-Aranguren, R. M.; et al.
Revista: JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
ISSN 0091-6749  Vol. 141  Nº 2  2018  págs. AB152 - AB152
Autores: Ferrer, Marta;
Revista: ALLERGOLOGIA ET IMMUNOPATHOLOGIA
ISSN 0301-0546  Vol. 45  Nº Supp 1  2017  págs. 41-44
Autores: Vestergaard, C.; Toubi, E.; Maurer, M.; et al.
Revista: EUROPEAN JOURNAL OF DERMATOLOGY
ISSN 1167-1122  Vol. 27  Nº 1  2017  págs. 10 - 19
Chronic spontaneous urticaria (CSU) is characterized by the sudden, continuous or intermittent appearance of pruritic wheals (hives), angioedema, or both for six weeks or more, with no known specific trigger. The international EAACI/GA2LEN/EDF/WAO urticaria guideline advises standard-dose, second-generation H1-antihistamines as first-line therapy. However, H1-antihistamine treatment leads to absence of symptoms in fewer than 50% of patients. Updosing of second-generation H1-antihistamines (up to fourfold) as recommended by the EAACI/GA2LEN/EDF/WAO urticaria guideline as second-line therapy, can improve response, but many patients remain symptomatic. Definitions of response are often subjective and a consensus is needed regarding appropriate treatment targets. There is also an unmet need for biomarkers to assess CSU severity and activity and to predict treatment response. The EAACI/GA2LEN/EDF/WAO urticaria guideline recommends add-on omalizumab, ciclosporin A (CsA), or montelukast third-line treatment in patients with an inadequate response to high-dose H1-antihistamines. Omalizumab is currently the only licensed systemic biologic for use in CSU. Both omalizumab and CsA are effective third-line CSU treatments; montelukast appears to have lower efficacy in this setting. Omalizumab carries a label warning for anaphylaxis, although no cases of anaphylaxis were reported in the phase III trials of omalizumab in CSU and it is generally well tolerated in patients with CSU. Omalizumab
Autores: Gamazo, C, (Autor de correspondencia); D'Amelio, Carmen Mariana ; Gastaminza, Gabriel; et al.
Revista: HUMAN VACCINES & IMMUNOTHERAPEUTICS
ISSN 2164-5515  Vol. 13  Nº 10  2017  págs. 2416-27
Allergic diseases are reaching epidemic proportions in developed countries. In particular, food allergy is increasing in prevalence and severity, thus becoming an important socioeconomic burden. Numerous cell types and cell populations, which form an intricate and balanced network, are involved in an immune response. This balance is occasionally disturbed, leading to the onset of different diseases, such as allergic diseases. Antihistamines and corticosteroids provide some degree of relief from the symptoms of allergic conditions. However, the only treatment that can revert the disease is immunotherapy. Nevertheless, specific immunotherapy has at least 2 major drawbacks: it is time-consuming, and it can produce local and even systemic allergic side effects. Immunotherapy's potential goes beyond our current knowledge of the immune response; nevertheless, we can still design strategies to reach a safer immune modulation for treating allergies. This review deals with the use of adjuvants to reduce the undesirable side effects associated with specific allergen immunotherapy. For example, nanoparticles used as immunoadjuvants are offering promising results in preclinical assays.
Autores: Ferrer, Marta; Boccon-Gibod, I.; Gonçalo, M.; et al.
Revista: EUROPEAN JOURNAL OF DERMATOLOGY
ISSN 1167-1122  Vol. 27  Nº 5  2017  págs. 455-63
Omalizumab (a recombinant, humanized anti-immunoglobulin-E antibody) has been shown in three pivotal Phase III trials (ASTERIA I, II and GLACIAL) and real-world studies to be effective and well-tolerated for the treatment of chronic spontaneous urticaria (CSU), and is the only licensed third-line treatment for CSU. However, the definition of response to omalizumab treatment often differs between clinical trials, real-world studies, and daily practice of individual physicians globally. As such, a consensus definition of "complete", "partial" and "non-response" to omalizumab is required in order to harmonize treatment management and compare data. Here, it is proposed that a disease measurement tool, for example, the 7-Day Urticaria Activity Score (UAS7) or Urticaria Control Test (UCT) is required for defining response. The addition of quality of life measurements is helpful to gain insight into a patient's disease burden and its changes during treatment. A potential omalizumab treatment approach based on speed and pattern of response at 1-3 and 3-6 months is suggested. In cases where there is no response during the first 1-3 months, physicians should consider reassessing the original CSU diagnosis. Moreover, in patients showing partial response at 12 weeks, treatment with omalizumab should be continued in order to maximize the possibility of achieving symptom control. If patients have a UAS7>6 and/or UCT<12, then continued treatment is advised, dependent on physician judgement
Autores: Gamazo, C; Garcia-Azpiroz, M.; et al.
Revista: IMMUNOTHERAPY
ISSN 1750-743X  Vol. 9  Nº 15  2017  págs. 1205 - 1218
Background: Peanut allergy is the most common cause of anaphylaxis and food-related death. However, there is currently no approved immunotherapy treatment. Hence, this warrants the need for relevant and convenient animal models to test for adequate immunotherapies. Materials & methods: In this study, we compared three mouse strains: CD1, BALB/c and C57, to select a model of peanut allergy. After that, we conducted then a therapeutic study using an immunogenic peanut extract encapsulated in nanoparticles made with polymer Gantrez((R)) following the solvent displacement method. Results & conclusion: After implementing a dosing schedule with oral commercial peanut butter, the antibody responses, cytokine profiles and, above all, the anaphylaxis induced after a challenge with peanut proteins, showed that the outbred CD1 strain was the most susceptible to peanut sensitization. CD1 sensitized mice were orally immunized with three doses of the nanoparticle formulation capable of protecting them against the severe anaphylactic symptoms induced by the peanut challenge.
Autores: Del Cuvillo, A.; Santos, V.; Montoro, J. ; et al.
Revista: RHINOLOGY
ISSN 0300-0729  Vol. 55  Nº 1  2017  págs. 34 - 38
Background: Allergic rhinitis is a global healthcare problem due to its high prevalence, impact on individuals and socioeconomic burden for the nations. Allergic rhinitis severity evaluation is the key to a correct treatment, prevention of comorbidities and improving the quality of life of patients. This evaluation should be made with a simple, easy, fast but accurate and reliable methodology, both in a primary care and specialist setting. The visual analogue scale (VAS) meets all requirements to be the ideal tool to assess allergic rhinitis severity and has already been validated by using a single cut-off point, but this classification in two degrees of severity suffer from not allocating the patients uniformly and from giving a blind interval to classify the patients when the score is between 5 to 6 cm. Methodology:The main objective of our study is to describe the optimal cut-off points by using a VAS to discriminate between three degrees of allergic rhinitis severity (mild, moderate, and severe) following the ARIA modified severity criteria that has been previously validated. Sensitivity, specificity, positive and negative predictive values just like receiver operating characteristic curves were used to select the best cut-off values. Results: In a cross-sectional multicentre study with 3,572 patients included we have found that VAS has a significant correlation with nasal symptom score and quality of life and that the best cut-off points to differentiate between mild, moderate an severe allergic rhinitis are a VAS score of 4 and 7, respectively. Conclusions: Allergic rhinitis severity could be assessed in three degrees by using VAS in a simple, easy, and accurate method.
Autores: Serrano-Candelas, Eva; Martínez-Aranguren, Rubén; et al.
Revista: SCIENTIFIC REPORTS
ISSN 2045-2322  Vol. 7  Nº 1  2017  págs. 8985
Omalizumab (OmAb) is a humanized anti-IgE antibody approved for the treatment of chronic spontaneous urticaria (CSU). OmAb's mechanism of action is known to include actions on free IgE and on pre-bound IgE. However, OmAb is equally and rapidly effective against autoimmune and non-autoimmune urticaria where IgE involvement is not clear, suggesting the involvement of additional mechanisms of action. In this study, we sought to investigate the ability of OmAb to inhibit mast cell and basophil degranulation induced by sera from CSU patients. For this purpose, we performed a comparison between the in vitro incubation of sera from CSU patients treated with OmAb and the in vivo administration of OmAb in a clinical trial. We found that OmAb added in vitro to sera from CSU patients did not modify the ability of the sera to induce cell degranulation. Similarly, the sera from patients treated with OmAb in the context of the clinical trial who had a good clinical outcome maintained the capacity to activate mast cells and basophils. Thus, we conclude that the beneficial activity of OmAb does not correlate with the ability of patient sera to induce cell degranulation
Autores: Gimenez Arnau, A.; Ferrer, Marta; Bartra, J.; et al.
Revista: ALLERGOLOGIA ET IMMUNOPATHOLOGIA
ISSN 0301-0546  Vol. 45  Nº 2  2017  págs. 134 - 144
Background: Chronic spontaneous urticaria (CSU) is a frequent clinical entity that often presents a diagnostic and therapeutic challenge. Objective: To explore the degree of agreement that exists among the experts caring for patients with CSU diagnosis, evaluation, and management. Methods: An online survey was conducted to explore the opinions of experts in CSU, address controversial issues, and provide recommendations regarding its definition, natural history, diagnosis, and treatment. A modified Delphi method was used for the consensus. Results: The questionnaire was answered by 68 experts (dermatologists, allergologists, and primary care physicians). A consensus was reached on 54 of the 65 items posed (96.4%). The experts concluded that CSU is a difficult-to-control disease of unpredictable evolution. Diagnostic testsshould be limited and based on clinical history and should not be indiscriminate. Autoinflammatory syndromes and urticarial vasculitis must be ruled out in the differential diagnosis. A cutaneous biopsy is only recommended when wheals last more than 24h, to rule out urticarial vasculitis. The use of specific scales to assess the severity of the disease and the quality of life is recommended. In patients with severe and resistant CSU, second -generation H1 -antihistamines could be used at doses up to four times the standard dose before giving second-line treatments. Omalizumab is a safe and effective treatment for CSU that is refractory to H1 -antihistamines treatment. In general, diagnosis and treatment recommendations given for adults could be extrapolated to children. Conclusions: This work offers consensus recommendations that may be useful in the management of CSU. (C) 2016 SEICAP. Published by Elsevier Espana, S.L.U. All rights reserved.
Autores: Izquierdo-Dominguez, A.; Jauregui, I.; del Cuvillo, A.; et al.
Revista: RHINOLOGY
ISSN 0300-0729  Vol. 55  Nº 4  2017  págs. 326 - 331
Background: Allergic rhinitis (AR) is a highly prevalent disease worldwide. Although a number of studies have described AR, no studies compared children and adult AR populations. The objective was to compare the AR characteristics between two AR cohorts of children and adults. Methods: Two AR cohorts (children and adults) from Spain were studied through observational cross-sectional multicentre studies. AR was classified based on classical (allergen exposure), original (o-ARIA), and modified (m-ARIA) ARIA criteria. AR was evaluated by Total 4-Symptoms Score (T4SS), and disease severity by Visual Analogue Scale (VAS, 0-100 mm). AR comorbidities were also evaluated. Results: A total of 5,405 patients (1,275 children, 4,130 adults) were studied. According to symptom's duration, intermittent AR was more frequent in children than in adults. Using o-ARIA severity, more children than adults had moderate/severe AR while, using m-ARIA, more children than adults had severe AR. T4SS was higher in adults than in children. Moreover, VAS was also higher in adults than in children. In addition, asthma atopic dermatitis and conjunctivitis were more associated to children than adults with AR, the frequency of this comorbidities increasing according to higher severity. Conclusions: AR in children was more intermittent, severe, with less symptoms but with more comorbidities than in adults. These results suggest AR has similarities but also significant differences between children and adults.
Autores: Jáuregui, I.; Azofra, J; Díaz, C; et al.
Revista: CLINICAL AND EXPERIMENTAL DERMATOLOGY
ISSN 0307-6938  Vol. 42  Nº 4  2017  págs. 431 - 432
Autores: Jauregui, I., (Autor de correspondencia); Azofra, J.; Diaz, C.; et al.
Revista: CLINICAL AND EXPERIMENTAL DERMATOLOGY
ISSN 0307-6938  Vol. 42  Nº 4  2017  págs. 431 - 432
Autores: Bernad, Amalia; Goikoetxea, María José; D'Amelio, Carmen Mariana ; et al.
Revista: ALLERGY
ISSN 0105-4538  Vol. 72  Nº Supl 103  2017  págs. 175
Autores: Ferrer, Marta; et al.
Revista: JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
ISSN 0091-6749  Vol. 139  Nº 2  2017  págs. AB245
Autores: Valero, A.; Ferrer, Marta; Gimenez-Arnau, A.; et al.
Revista: ALLERGY
ISSN 0105-4538  Vol. 72  Nº Supl 3  2017  págs. 716 - 717
Autores: Gimenez-Arnau, A.; Ferrer, Marta; Saldana, D.; et al.
Revista: JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
ISSN 0190-9622  Vol. 76  Nº 6  2017  págs. AB202
Autores: Eberlein B.; Santos AF.; Mayorga C.; et al.
Revista: ALLERGO JOURNAL INTERNATIONAL
ISSN 2197-0378  Vol. 25  Nº 4  2016  págs. 106-13
The nature of basophil activation as an ex vivo challenge makes it a multifaceted and promising tool for the allergist. Through the development of flow cytometry, discovery of activation markers such as CD63 and markers identifying basophil granulocytes, the basophil activation test (BAT) has become a pervasive test. BAT measures basophil response to allergen crosslinking IgE on between 150 and 2,000 basophil granulocytes with remarkable analytical sensitivity in < 0.1 ml fresh blood. Dichotomous activation is assessed as the fraction of reacting basophils. In patients with food-, insect venom-, and drug allergy and patients with chronic urticaria BAT can be part of the diagnostic evaluation in addition to history, skin prick testing, and specific IgE determination. BAT may also be helpful in determining the clinically relevant allergen. Basophil sensitivity may be used to monitor patients on allergen immunotherapy, anti-IgE treatment, or in the natural resolution of allergy. The test may use fewer resources and be more reproducible than oral, sting, nasal or bronchial challenge testing. BAT may be useful before challenge testing as it is less stressful for the patient and avoids severe allergic reactions. It may be useful before challenge testing. An important next step is to standardize BAT and make it available in diagnostic laboratories. This article provides an overview of the practical and technical details as well as the utility of BAT in diagnosis and management of al
Autores: Hoffmann, Hans Jürgen; Knol, Edward F.; Ferrer, Marta; et al.
Revista: CURRENT ALLERGY AND ASTHMA REPORTS
ISSN 1529-7322  Vol. 16  Nº 8  2016  págs. 56
There are many tools available to assess the presence and severity of allergic diseases in patients. For 50 years, peripheral blood basophils have been used as tools to study these diseases. It is a very accessible cell that binds IgE antibody and secretes the classical mediators responsible for the symptoms of allergic reactions. In the last decade, an even more accessible methodology, using flow cytometry, has been developed to enhance the ability to use basophils for both mechanistic and clinical diagnostics. Basophil testing has been included in diagnostics for different forms of allergies as well as to monitor disease status. A variety of studies have begun to establish both precise methods and their clinical relevance for disease diagnosis, but there remain some important questions on how to take optimal advantage of the behaviours of basop
Autores: Guillen-Aguinaga, S.; Jauregui Presa, I.; Aguinaga-Ontoso, E.; et al.
Revista: BRITISH JOURNAL OF DERMATOLOGY
ISSN 0007-0963  Vol. 175  Nº 6  2016  págs. 1153 - 1165
There is a lack of large, randomized, double-blind studies that address antihistamine updosing for chronic spontaneous urticaria (CSU). The objective of this systematic review is to explore and analyse available data to provide clinical evidence for the efficacy of antihistamine updosing. We searched the literature in Medline, Scopus, Google Scholar, Embase, Web of Science and Cochrane databases using the keywords 'chronic, urticaria, antihistamines' to identify studies published between January 1990 and November 2014. We assessed quality using the Jadad score that evaluates quality of randomization, double-blinding and losses to follow-up. We identified 1042 articles and 15 articles were included in the final evaluation. We performed two meta-analyses, one that included studies that analysed treatment response among groups receiving different antihistamine dosages vs. placebo, and another that analysed antihistamine updosing in those patients who did not respond to standard dosages. Only five articles obtained a high quality level score. We did not find significant differences in response rates or number of weals in those patients who received a standard dosage vs. a high dosage. We found a significant improvement only in the pruritus variable of the Urticaria Activity Score scale. The estimated relative risk for improvement by increasing the antihistamine dosage was 2.27 [95% confidence interval (CI) 1.68-3.06]; however, there was significant heterogeneity. The proportion of nonrespondent patients with CSU who responded to antihistamine updosing was 63.2% (95% CI 57-69.6). We found that updosing antihistamines significantly improved control of pruritus but not weal number. However, the relative weakness of the studies and the significant heterogeneity among them made it difficult to reach a final conclusion.
Autores: Guillén-Aguinaga, S.; Jáuregui Presa, I.; Aguinaga-Ontoso, E.; et al.
Revista: BRITISH JOURNAL OF DERMATOLOGY
ISSN 0007-0963  Vol. 175  Nº 6  2016  págs. 1153-1165
There is a lack of large, randomized, double-blind studies that address antihistamine updosing for chronic spontaneous urticaria (CSU). The objective of this systematic review is to explore and analyse available data to provide clinical evidence for the efficacy of antihistamine updosing. We searched the literature in Medline, Scopus, Google Scholar, Embase, Web of Science and Cochrane databases using the keywords 'chronic, urticaria, antihistamines' to identify studies published between January 1990 and November 2014. We assessed quality using the Jadad score that evaluates quality of randomization, double-blinding and losses to follow-up. We identified 1042 articles and 15 articles were included in the final evaluation. We performed two meta-analyses, one that included studies that analysed treatment response among groups receiving different antihistamine dosages vs. placebo, and another that analysed antihistamine updosing in those patients who did not respond to standard dosages. Only five articles obtained a high quality level score. We did not find significant differences in response rates or number of weals in those patients who received a standard dosage vs. a high dosage. We found a significant improvement only in the pruritus variable of the Urticaria Activity Score scale. The estimated relative risk for improvement by increasing the antihistamine dosage was 2·27 [95% confidence interval (CI) 1·68-3·06]; however, there was significant heterogeneity. The proportion o
Autores: Rodríguez, María Cristina; Alegre, Manuel; Díez, María de las Nieves; et al.
Revista: BMC MEDICAL EDUCATION
ISSN 1472-6920  Vol. 16  Nº 1  2016  págs. 47
The formal quality of the MIR exam items has improved over the last five years with regard to testwiseness. A more detailed revision of the items submitted, checking systematically for the presence of technical flaws, could improve the validity and discriminatory power of the exam, without increasing its difficulty.
Autores: Langdon, C; Guilemany, JM; Valls, M; et al.
Revista: PEDIATRIC ALLERGY AND IMMUNOLOGY
ISSN 0905-6157  Vol. 27  Nº 8  2016  págs. 867-870
Children with allergic rhinitis present a mild-moderate loss of smell frequency and intensity which is clearly related to the disease duration and severity. The loss of smell can be considered, as in adults, a clinical marker of disease severity.
Autores: D'Amelio, Carmen Mariana ; Gastaminza, Gabriel; et al.
Revista: PEDIATRIC ALLERGY AND IMMUNOLOGY
ISSN 0905-6157  Vol. 28  Nº 1  2016  págs. 96-99
Autores: Miranda, D. S.; Ferrer, Marta; Janssens, N.; et al.
Revista: VALUE IN HEALTH
ISSN 1098-3015  Vol. 19  Nº 7  2016  págs. A378
Autores: Ferrer, Marta;
Revista: CLINICAL AND TRANSLATIONAL ALLERGY
ISSN 2045-7022  Vol. 5  Nº 30  2015 
Chronic spontaneous urticaria (CSU) is a highly debilitating skin disease associated with systemic features. We have made significant progress in several aspects relating to this condition. However, the exact physiopathology remains unknown. There is mounting evidence for an autoimmune basis, demonstrated by the CSU serum ability to activate healthy donors skin mast cells and blood basophils. However, it is only seen among 35-40% of patients. Mast cells and basophils play an important role in this skin condition. Both cells in CSU patients have unique features that differentiate them from basophils and mast cells from healthy donors. In the case of basophils, basopenia is typically found in CSU patients. Basophils from CSU patients also tend to be hyporesponsive to stimuli that act through the IgE receptor, responsive to other stimuli as MCP-1 or C5a, and hyperesponsive when incubated with sera. Eosinophils are also present in CSU skin biopsies, yet their exact role has not yet been defined. Likewise, endothelial cells also play a function, as indirectly demonstrated by an increase of vasoactive peptides in skin and plasma of CSU patients' samples. All these facts orchestrate a systemic inflammation response producing a significant increase of several inflammatory markers. Unfortunately, we lack a unitary model that could explain the exact role of each of these players. In this review, we will describe the history and discover the pathway to the present knowledge on the immun
Autores: Moisés Labrador-Horrillo; Ferrer, Marta;
Revista: DRUG DESIGN, DEVELOPMENT AND THERAPY
ISSN 1177-8881  Vol. 9  2015  págs. 4909-4915
Chronic spontaneous urticaria (CSU) is a disease with significant morbidity and relative prevalence that has important effects on the quality of life (QoL) of those who suffer from it. Omalizumab is a recombinant humanized anti-immunoglobulin E (IgE) antibody that binds to the C¿3 domain of the IgE heavy chain and prevents it from binding to its high-affinity receptor Fc¿RI. It has been largely studied in the field of asthma and is currently approved for the treatment of both adult and pediatric (children; >6-year-old) patients. In addition, in recent, well-controlled clinical trials in patients with CSU resistant to antihistamines, add-on therapy with subcutaneous omalizumab significantly reduced the severity of itching, and the number and size of hives, and increased patients' health-related QoL and the proportion of days free from angioedema compared with placebo, with an excellent tolerance. Thus, omalizumab is an effective and well-tolerated add-on therapy for patients with CSU who are symptomatic despite background therapy with H1 antihistamines. In this review, we cover the following points: epidemiology, pathogenesis, assessment of activity, impact on QoL, and treatment of CSU, and finally, we focus on omalizumab in the treatment of CSU including the pharmacokinetic properties and mechanism of action, and use in pregnant women, nursing infants, and children
Autores: Hoffmann, H.J.; Santos, A.F.; Mayorga, C.; et al.
Revista: ALLERGY
ISSN 0105-4538  Vol. 70  Nº 11  2015  págs. 1393-1405
The basophil activation test (BAT) has become a pervasive test for allergic response through the development of flow cytometry, discovery of activation markers such as CD63 and unique markers identifying basophil granulocytes. Basophil activation test measures basophil response to allergen cross-linking IgE on between 150 and 2000 basophil granulocytes in <0.1 ml fresh blood. Dichotomous activation is assessed as the fraction of reacting basophils. In addition to clinical history, skin prick test, and specific IgE determination, BAT can be a part of the diagnostic evaluation of patients with food-, insect venom-, and drug allergy and chronic urticaria. It may be helpful in determining the clinically relevant allergen. Basophil sensitivity may be used to monitor patients on allergen immunotherapy, anti-IgE treatment or in the natural resolution of allergy. Basophil activation test may use fewer resources and be more reproducible than challenge testing. As it is less stressful for the patient and avoids severe allergic reactions, BAT ought to precede challenge testing. An important next step is to standardize BAT and make it available in diagnostic laboratories. The nature of basophil activation as an ex vivo challenge makes it a multifaceted and promising tool for the allergist. In this EAACI task force position paper, we provide an overview of the practical and technical details as well as the clinical utility of BAT in diagnosis and management of allergic diseases
Autores: Serrano-Candelas, E.; Martínez-Aranguren, R.; Valero, A.; et al.
Revista: CLINICAL AND EXPERIMENTAL ALLERGY
ISSN 0954-7894  Vol. 46  Nº 1  2015  págs. 92-102
Our data prove the existence of common mechanisms of action of OmAb in mast cells and basophils that would explain its effectiveness and rapid effect in chronic urticaria and provide a basis for its use in other diseases mediated by these cells.
Autores: Echechipía, S.; Villarreal, O.; Iriarte, P.; et al.
Revista: CONTACT DERMATITIS
ISSN 0105-1873  Vol. 73  Nº 3  2015  págs. 186-187
Autores: Lafuente, Alberto; et al.
Revista: ANESTHESIA AND ANALGESIA
ISSN 0003-2999  Vol. 121  Nº 1  2015  págs. 117-23
Perioperative reactions are more common than previously reported. Mild hypersensitivity perioperative reactions-involving only skin-should be considered in evaluating patients because a substantial number of these reactions are IgE mediated.
Autores: Goikoetxea, María José; Cabrera, Paula Karin; et al.
Revista: JOURNAL OF INVESTIGATIONAL ALLERGOLOGY AND CLINICAL IMMUNOLOGY
ISSN 1018-9068  Vol. 25  Nº 4  2015  págs. 283-7
Fifteen of 201 patients with negative results for LTP in the SPT were sensitized to this allergen in the in vitro tests, and 18 of 41 patients with positive results for LTP in the SPT were not sensitized according to the in vitro tests. Seventeen of 186 patients with negative results for profilin in the SPT were sensitized to Phl p 12 by serum sIgE, and 30 out of 56 patients with positive results for profilin in SPT were not sensitized to Phl p 12 according to the other tests. Moderate agreement was observed between the 3 techniques studied. CONCLUSIONS: SPT is a sensitive technique for detecting sensitization to LTP and profilin. Its results are similar to those of in vitro techniques, especially in patients with negative SPT results for peach LTP and palm tree profilin.
Autores: Kaplan, A.; Ferrer, Marta; Bernstein, J.A.; et al.
Revista: JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
ISSN 0091-6749  Vol. 137  Nº 2  2015  págs. 474-81
Benefits of omalizumab treatment were evident early (before week 4) in some patients and persisted to week 24. Use of 300 mg of omalizumab demonstrated best results in controlling CIU/CSU symptoms.
Autores: Azofra, J.; Díaz, C.; Antépara, I.; et al.
Revista: ANNALS OF ALLERGY ASTHMA AND IMMUNOLOGY
ISSN 1081-1206  Vol. 114  Nº 5  2015  págs. 418-9
Autores: Rodríguez, María Cristina; Artaiz, M; et al.
Revista: REVISTA DE LA FUNDACION EDUCACION MEDICA
ISSN 2014-9832  Vol. 18  Nº 1  2015  págs. 35 - 38
Objetivo. Conocer la valoración de los estudiantes respecto a la simulación como herramienta de formación y la opinión sobre la figura del alumno instructor. Sujetos y métodos. El taller se realizó en el Centro de Simulación y tuvo una duración aproximada de 90 minutos. En cada sesión estaba el alumno instructor con diez compañeros. Los alumnos instructores fueron formados previamente por un profesor de cardiología. Al finalizar la sesión, los estudiantes cumplimentaron un cuestionario de satisfacción anónimo que contenía preguntas relacionadas con el aprendizaje basado en la simulación y sobre la capacidad de sus compañeros para actuar como formadores. Resultados. Se obtuvieron encuestas de 291 estudiantes: 150 de quinto y 141 de sexto curso (82,4% y 71,2% de los matri - culados, respectivamente). Los datos obtenidos del cuestionario de satisfacción respecto a la metodología de aprendizaje obtuvieron puntuaciones entre 3,64 y 4,75 sobre 5. Las preguntas que valoraban la opinión acerca de los alumnos forma - dores obtuvieron valores entre 4,88 y 4,93 sobre 5. Conclusiones. La simulación es una herramienta docente complementaria muy valiosa. La participación de alumnos ins - tructores podría ser una ayuda adicional en los talleres de simulación de exploración cardiológica.
Autores: Rodríguez, María Cristina; Díez, María de las Nieves; Alegre, Manuel; et al.
Revista: ATENCION PRIMARIA
ISSN 0212-6567  Vol. 48  Nº 3  2015  págs. 210 - 212
Autores: Gamazo, C; Gastaminza, Gabriel; Ferrer, Marta; et al.
Revista: IMMUNOTHERAPY
ISSN 1750-743X  Vol. 6  Nº 7  2014  págs. 885-897
Allergic diseases are one of the most prevalent diseases, reaching epidemic proportions in developed countries. An allergic reaction occurs after contact with an environmental protein, such as inhalants allergens (pollen, animal dander, house dust mites), or food proteins. This response is known as part of the type 2 immunity that is counterbalanced by Type 1 immunity and Tregs. Widely used allergen-specific immunotherapy (IT) is a long term treatment to induce such switch from Th2 to Th1 response. However, conventional IT requires multiple allergen injections over a long period of time and is not free of risk of producing allergic reactions. As a consequence, new safer and faster immunotherapeutic methods are required. This review deals with allergen IT using nanoparticles as allergen delivery system that will allow a different way of administration, reduce dose and diminish allergen exposure to IgE bound to mast cells or basophils.
Autores: Ferrer, Marta; Bartra, J.; Giménez-Arnau, A.; et al.
Revista: CLINICAL AND EXPERIMENTAL ALLERGY
ISSN 0954-7894  Vol. 45  Nº 4  2014  págs. 731-43
In spite of being an old disease and apparently easy to diagnose, chronic spontaneous urticaria (CSU) is still perceived as an uncontrollable and difficult to manage disease. The perception of the patient is that his/her condition is not well understood and that is suffering from a disorder with hidden causes that doctors are not able to tackle. Sometimes patients go through a number of clinicians until they found some CSU expert who is familiar with the disease. It is surprising that myths and believes with no scientific support still persist. Guidelines are not widely implemented, and recent tools to assess severity are infrequently used. European and American recent guidelines do not agree in several key points related to diagnosis and treatment, which further contributes to confusion. With the aim to clarify some aspects of the CSU picture, a group of allergists and dermatologists from the Spanish Dermatology and Allergy societies developed a Frequent Asked Questions leaflet that could facilitate physicians work in daily practice and contribute to a better knowledge of common clinical scenarios related to patients with CSU.
Autores: I. Jauregui; FJ Ortiz de Frutos; Ferrer, Marta; et al.
Revista: JOURNAL OF INVESTIGATIONAL ALLERGOLOGY AND CLINICAL IMMUNOLOGY
ISSN 1018-9068  Vol. 24  Nº 2  2014  págs. 80-86
Chronic urticaria (CU) is very prevalent in the general population and, despite its low mortality, can have devastating effects on the quality of life (QoL) of those who experience it.Therefore, consensus documents on its classification, diagnosis, and treatment have become a necessity. The intensity of urticaria is currently evaluated using indices such as the Urticaria Activity Score and visual analog scales to assess itch or the degree of itch associated with the use of antihistamines. QoL is evaluated using various generic questionnaires and specific tools for skin disease and for CU. In recent years, attempts have been made to combine these evaluations to create a specific tool that would enable us to simultaneously evaluate the severity of the condition and the impact of symptoms on QoL. One such tool is the Urticaria Severity Score, which also allows us to compare global changes brought about by different treatments
Autores: Bolla, M; Zenoni, S; Scheurer, S; et al.
Revista: INTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY
ISSN 1018-2438  Vol. 164  Nº 1  2014  págs. 112-21
By 2-D electrophoresis, we could separate different nsLTP isoforms possessing different IgE-binding properties, which might reflect peculiar allergenic potencies. The contribution of Pru p 3 to prime sensitization is not central as in other plant nsLTPs.
Autores: Irache, Juan M.; Camacho, Ana Isabel; et al.
Revista: CLINICAL AND VACCINE IMMUNOLOGY
ISSN 1556-6811  Vol. 21  Nº 8  2014  págs. 1106 - 1112
In the last decade, peanut allergy has increased substantially. Significant differences in the prevalence among different countries are attributed to the type of thermal processing. In spite of the high prevalence and the severe reaction induced by peanuts, there is no immunotherapy available. The aim of this work was to evaluate the potential application of poly(anhydride) nanoparticles (NPs) as immunoadjuvants for peanut oral immunotherapy. NPs loaded with raw or roasted peanut proteins were prepared by a solvent displacement method and dried by either lyophilization or spray-drying. After physicochemical characterization, their adjuvant capacity was evaluated after oral immunization of C57BL/6 mice. All nanoparticle formulations induced a balanced T(H)1 and T(H)2 antibody response, accompanied by low specific IgE induction. In addition, oral immunization with spray-dried NPs loaded with peanut proteins was associated with a significant decrease in splenic T(H)2 cytokines (interleukin 4 [IL-4], IL-5, and IL-6) and enhancement of both T(H)1 (gamma interferon [IFN-¿]) and regulatory (IL-10) cytokines. In conclusion, oral immunization with poly(anhydride) NPs, particularly spray-dried formulations, led to a pro-T(H)1 immune response.
Autores: Jáuregui, I.; Ferrer, Marta; Montoro, J.; et al.
Revista: JOURNAL OF INVESTIGATIONAL ALLERGOLOGY AND CLINICAL IMMUNOLOGY
ISSN 1018-9068  Vol. 23  Nº Supl. 1  2013  págs. 27-34
The most commonly occurring allergic diseases can involve a daytime drowsiness associated with the condition itself. The antihistamines used in their treatment can also have central effects and affect certain occupations concerned with risk, road safety and maritime and air navigation. Cognitive tests, experimental studies and epidemiological data recommend avoiding 1st generation antihistamines for people who must drive regularly and/or professions concerned with safety. Although there are no comparative studies on real driving between 1st and 2nd generation antihistamines, in this type of patients there should be a preference for prescribing those with least possible central effect, especially those which are a good substrate for transmembrane transporter pumps such as P-glycoprotein and therefore have a low capacity for crossing the hematoencephalic barrier, thus allowing a broader window for therapy. In this sense, bilastine is a good P-glycoprotein substrate and shows good tolerance at CNS level, in both psychometric trials and real driving test protocols, even at double the dose recommended in the technical file
Autores: Montoro, J.; Bartra, J.; Sastre, J.; et al.
Revista: JOURNAL OF INVESTIGATIONAL ALLERGOLOGY AND CLINICAL IMMUNOLOGY
ISSN 1018-9068  Vol. 23  Nº Supl. 1  2013  págs. 17-26
Antihistamines (AH) have been classified into first and second generation according to their pharmacokinetic properties, structural characteristics and adverse effects. The effects on the central nervous system (CNS) are determined basically by their capacity to cross the hematoencephalic barrier and attach to central H1 receptors. Benzodiazepines (BZD) are drugs with effects on the CNS following their union to the specific location of GABA receptors type A. At low doses, the BZD have sedative and anticonvulsive effects, and as the dose increases it leads to sedation, amnesia and finally unconsciousness. Various studies have been made on the possible interaction between the BZD and the AH H1 with special attention to their effect on the CNS. In some cases these were studies to assess the safety of this association and in others, the aim was different: to see if their joint administration gives a better therapeutic result in pathology related with anxiety syndrome or insomnia. In general it can be said that first generation AH interact with the BZD increasing the sedative effects of the latter. However, second generation AH do not increase these sedative effects, which makes them the chosen drugs to treat allergic rhinitis/rhino-conjunctivitis and urticaria in patients also receiving BZD.
Autores: Jáuregui, I.; Ferrer, Marta; Bartra, J.; et al.
Revista: EXPERT OPINION ON PHARMACOTHERAPY
ISSN 1465-6566  Vol. 14  Nº 11  2013  págs. 1537-44
Once-daily treatment with bilastine 20 mg is effective in managing symptoms and improving patient's quality of life in chronic urticaria, with at least comparable efficacy to levocetirizine. As far as studies in healthy volunteers, clinical assays, and recent clinical experience can establish, bilastine's safety profile is adequate, appearing to be entirely free from cardiovascular effects, and not impairing psychomotor performance or actual driving, even at twice the therapeutic dose.
Autores: Dávila, I.; Del Cuvillo, A-; Mullol, J.; et al.
Revista: JOURNAL OF INVESTIGATIONAL ALLERGOLOGY AND CLINICAL IMMUNOLOGY
ISSN 1018-9068  Vol. 23  Nº Supl. 1  2013  págs. 1-16
Antihistamine drugs are one of the therapeutic classes most used at world level, at all ages and in multiple situations. Although in general they have a good safety profile, only the more recent drugs (second generation antihistamines) have been studied specifically with regard to the more important safety aspects. Given the variety of antihistamine drugs, they cannot all be considered equivalent in application to various special clinical situations, so that the documented clinical experience must be assessed in each case or, in the absence of such, the particular pharmacological characteristics of each molecule for the purpose of recommendation in these special situations. In general, there are few clinical studies published for groups of patients with kidney or liver failure, with concomitant multiple pathologies (such as cardiac pathology), in extremes of age (paediatrics or geriatrics) and in natural stages such as pregnancy or lactation, but these are normal situations and it is more and more frequent (among the elderly) for antihistamine drugs to be recommended. This review sets out the more relevant details compiled on the use of antihistamines in these special situations.
Autores: Valero, A; Izquierdo, I; Sastre, J; et al.
Revista: Journal of investigational allergology & clinical immunology
ISSN 1018-9068  Vol. 23  Nº 1  2013  págs. 14 - 19
Autores: Díez, María de las Nieves; Rodríguez, María Cristina; et al.
Revista: SIMULATION IN HEALTHCARE
ISSN 1559-2332  Vol. 8  Nº 4  2013  págs. 234 - 241
Introduction: Current European Resuscitation Guidelines 2010 recommend the use of prompt/feedback devices when training for cardiopulmonary resuscitation (CPR). We aimed to assess the quality of CPR training among second-year medical students with a voice advisory mannequin (VAM) compared to guidance provided by an instructor. Methods: Forty-three students received a theoretical reminder about CPR followed by a 2-minute pretest on CPR (compressions/ventilations cycle) with Resusci Anne SkillReporter (Laerdal Medical). They were then randomized into a control group (n = 22), trained by an instructor for 4 minutes per student, and an intervention group (n = 21) trained individually with VAM CPR mannequin for 4 minutes. After training, the students performed a 2-minute posttest, with the same method as the pretest. Results: Participants in the intervention group (VAM) performed more correct hand position (73% vs. 37%; P = 0.014) and tended to display better compression rate (124 min-1 vs. 135 min-1; P = 0.089). In a stratified analyses by sex we found that only among women trained with VAM was there a significant improvement in compression depth before and after training (36 mm vs. 46 mm, P = 0.018) and in the percentage of insufficient compressions before and after training (56% vs. 15%; P = 0.021). Conclusions: In comparison to the traditional training method involving an instructor, training medical students in CPR with VAM improves the quality of chest compressions in hand position and in compression rate applied to mannequins. Only among women was VAM shown to be superior in compression depth training. This technology reduces costs in 14% in our setup and might potentially release instructors' time for other activities.
Autores: G. N. Konstantinou; R. Asero; Ferrer, Marta; et al.
Revista: ALLERGY
ISSN 0105-4538  Vol. 68  Nº 1  2013  págs. 27-36
An autoimmune subset of chronic spontaneous urticaria is increasingly being recognized internationally, based on laboratory and clinical evidence that has accrued over the last 20 years. This evidence has been reviewed by a taskforce of the Dermatology section of the European Academy of Allergy and Clinical Immunology. Functional autoantibodies in chronic urticaria (CU) patient sera have been demonstrated against IgE and Fc¿RI¿ by basophil and mast cell histamine release assays and by basophil activation assays. Antibody specificity has been confirmed by immunoassay, but there is a poor correlation between functionality and immunoreactivity. Approximately 25% of CU patients have a positive basophil histamine release assay and show autoreactivity (a positive autologous serum skin test), whereas 50% are negative regarding both. Functionality of CU sera appears to be complement dependent on mast cells but not exclusively on basophils. Basophil activation by CU sera is predominantly restricted to IgG1 and IgG3 subclasses. Circumstantial evidence for CU being an autoimmune disease comes from an observed association with other autoimmune diseases, a strong association between serum functionality and HLA-DR4 haplotype and the good response of CU patients to immunotherapies. It was proposed that a study should be undertaken to prospectively validate potentially relevant clinical criteria (from the history, examination and routinely available clinical investigations) against a new 'go
Autores: Idoate, Miguel Ángel; Echeveste, José Ignacio; Gil, María Pilar; et al.
Revista: JOURNAL OF INVESTIGATIONAL ALLERGOLOGY AND CLINICAL IMMUNOLOGY
ISSN 1018-9068  Vol. 23  Nº 6  2013  págs. 392 - 397
Background: 2D7 and BB1 are thought to be basophil-specific markers. In this study, we tested both antibodies in different skin and mast cell disorders with the aim of determining whether it was possible to differentiate between benign and aggressive presentations of mastocytosis. Methods: Using the antibodies 2D7, BB 1, and c-Kit, we performed an immunohistochemical study of skin biopsy specimens from patients with cutaneous mastocytosis (15 urticaria pigmentosa and telangiectatic macularis eruptive perstans) and liver or bone marrow biopsy specimens from patients with systemic mastocytosis. A basophil leukemia cell line was used as a reference. Peripheral blood basophils from healthy donors were used as controls. Results: We observed intense expression of 2D7 and BB1 in all skin biopsy specimens from patients with cutaneous mastocytosis. Immunostaining of liver and bone marrow specimens from patients with systemic mastocytosis with 2D7 and BB1 antibodies was negative. Specimens from patients with either type of mastocytosis showed similarly strong expression of c-Kit. The basophil cell line showed a 2D7 and a BB1 profile, with intense expression of c-Kit. Peripheral blood basophils exhibited notable immunostaining for 2D7, BB1, and c-Kit. Conclusions: 2D7 and BB1 are expressed in cutaneous mastocytosis, although this expression is lost when mast cell proliferation is systemic, thus reflecting either a different cellular differentiation stage or the presence of basophils in these skin diseases.
Autores: Lafuente, Alberto; et al.
Revista: CLINICAL AND EXPERIMENTAL ALLERGY
ISSN 0954-7894  Vol. 44  Nº 2  2013  págs. 270 - 277
Anaesthetic hypersensitivity reactions can be IgE- or not IgE-mediated and are a challenge to find the causal agent. Histamine and tryptase determination are classically considered useful in the diagnosis of these reactions. The aim of our study was to assess the diagnostic usefulness of plasma histamine and different cut-off points of serum tryptase. MethodsPatients suffering a reaction suggestive of hypersensitivity during general anaesthesia in Clinica Universidad de Navarra (2008-2012) were included. Serum tryptase and plasma histamine were measured at the time of the reaction and 2h later. Baseline tryptase was also determined. Four to eight weeks after the reaction an allergological study was performed to all the drugs or products involved in the reaction. ResultsSixty-five patients suffered an immediate hypersensitivity reaction during the period of the study. Thirty-seven patients (20 male) with median age 48years (12-79) were included because they completed allergological study, and histamine and tryptase were correctly obtained. Elevated plasma histamine was observed in 34 cases (92%). Tryptase exceeded twice the basal values in 10 patients (31%). Using different cut-off points of tryptase, the number of patients with elevated tryptase would be 15 patients (41%) for a cut-off point of 5g/L; 12 patients (32%) for a cut-off point of 8.23g/L; nine patients (24%) for 10.5g/L; and eight patients (22%) for 11.4g/L. The median tryptase level for the IgE-mediated reactions was 9.0g/L (2-70g/L) and 4.0g/L (3-13g/L) in non-IgE-mediated reactions (P<0.01). Median tryptase levels were higher in more severe reactions (grade 2 or 3) in comparison with grade 1. The best ratio for serum-tryptase-during-reaction/basal-serum-tryptase to discriminate between IgE and non-IgE reactions was 2.0. ConclusionThe best criterion for discriminating IgE- and non IgE-mediated hypersensitivity reactions in anaesthesia was a tryptase value exceeding twice the basal one.
Autores: Labrador-Hornillo M; Valero A; Velasco M; et al.
Revista: EXPERT OPINION ON BIOLOGICAL THERAPY
ISSN 1471-2598  Vol. 13  Nº 9  2013  págs. 1225-8
Omalizumab shows excellent efficacy and safety profile in a large series of CSU patients in real-life practice. This drug will contribute to settle the debt with CSU patients contributing to restore their quality of life.
Autores: María Dolores Ibáñez; Antonio Luis Valero; Javier Montoro; et al.
Revista: PEDIATRIC ALLERGY AND IMMUNOLOGY
ISSN 0905-6157  Vol. 24  Nº 7  2013  págs. 678-84
Comorbidities are frequent in children with AR, supporting the notion of allergy as a systemic disease. Severity and duration of AR were significantly associated with presence of most of comorbidities. The most common drugs used for AR treatment were oral antihistamines, followed by nasal corticosteroids and a combination of both used on demand.
Autores: De Souza Rebouças , J; Ferrer, Marta; et al.
Revista: JOURNAL OF BIOMEDICINE AND BIOTECHNOLOGY
ISSN 1110-7243  2012  págs. 474605
Autores: Ferrer, Marta; Sanz, María Luisa; Gastaminza, Gabriel; et al.
Revista: ANALES DEL SISTEMA SANITARIO DE NAVARRA
ISSN 1137-6627  Vol. 35  Nº 1  2012  págs. 41 - 51
La inmunoterapia para el tratamiento de enfermedades alérgicas implica ciertas desventajas, que pueden ser reducidas si se emplean adyuvantes adecuados, que sean capaces de amplificar la respuesta inmune con un efecto alergénico mínimo. En ese contexto, las formas farmacéuticas más prometedoras para aumentar la eficacia y seguridad de la inmunoterapia, parecen ser las micro y nanopartículas, de polímeros biodegradables y liposomas. En esta revisión describimos estudios previos de nuestro grupo en los que empleamos como adyuvante nanopartículas Gantrez® AN y demostramos su capacidad de estimular el sistema inmune. Empleamos dos tipos de nanopartículas, con y sin lipopolisacárido de Brucella ovis como inmunomodulador en un modelo de ratón alérgico a L. perenne. Encontramos que los ratones sensiblizados a Phleum cuando recibían inmunoterapia con nanopartículas Lolium-Gantrez® estaban protegidos de la anafilaxia inducida por el alérgeno tanto en las tasas de mortalidad como en los niveles de MCP-1. Probamos asimismo estas formulaciones por vía oral en un modelo animal sensibilizado a ovoalbúmina y comprobamos que les protegía también del shock anafiláctico.
Autores: Montoro, J; del Cuvillo, A; Mullol, J; et al.
Revista: ALLERGY
ISSN 0105-4538  Vol. 67  Nº 11  2012  págs. 1437 - 1442
Autores: Irache, Juan M.; Camacho, Ana Isabel; et al.
Revista: EUROPEAN JOURNAL OF PHARMACEUTICS AND BIOPHARMACEUTICS
ISSN 0939-6411  Vol. 82  Nº 2  2012  págs. 241-249
Allergen-specific immunotherapy is based on the administration of allergens with the main disadvantage of inducing an allergic reaction. Within this context, we report the generation of an adjuvant and allergen-delivery system for peanut allergen immunotherapy with reduced IgE induction. Therefore, we prepared and characterized poly(anhydride) nanoparticles loaded with peanut proteins using the solvent displacement method, with some modifications in the manufacturing process. The precipitation of polymer was performed with either a mixture of ethanol and water or water. The resultant nanoparticles were dried by either freeze-drying or spray-drying, respectively. Poly(anhydride) nanoparticles loaded with peanut proteins were successfully developed, achieving both high encapsulation efficiency (70-80%) and manufacturing yield (60-80%). After intradermal immunization of mice (C57Bl/6) with peanut proteins incorporated into poly(anhydride) nanoparticles, a strong mixed T(H)1/T(H)2-type immune response was observed. Furthermore, we also provide, to our knowledge for the first time, clear evidence of the influence of formulation design on the immunostimulatory properties of nanoparticles. Taken together, our findings indicate that poly(anhydride) nanoparticles are efficient stimulators of immune responses and promising adjuvants and allergen-delivery systems applied for immunotherapy. (C) 2012 Elsevier B.V. All rights reserved.
Autores: Irache, Juan M.; Ferrer, Marta; Espuelas, S; et al.
Revista: Journal of investigational allergology & clinical immunology
ISSN 1018-9068  Vol. 22  Nº Suppl 1  2012  págs. 7 - 15
Autores: Goikoetxea, María José; García Núñez, I.; et al.
Revista: JOURNAL OF INVESTIGATIONAL ALLERGOLOGY AND CLINICAL IMMUNOLOGY
ISSN 1018-9068  Vol. 22  Nº 7  2012  págs. 508-13
The determination of sIgE to Ara h 9 using FEIA and BAT offers high sensitivity and specificity in the diagnosis of peanut allergy in the Spanish population. The CRD103 version of ISAC is not of value in our region as it does not include the most common allergen, Ara h 9.
Autores: Goikoetxea, María José; García Nuñez, I.; et al.
Revista: JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
ISSN 0091-6749  Vol. 130  Nº 6  2012  págs. 1432 - 1434
Autores: Dávila, I.; Sastre, J.; Mullol, J.; et al.
Revista: Journal of investigational allergology & clinical immunology
ISSN 1018-9068  Vol. 21  Nº Suppl 3  2011  págs. 2 - 8
Autores: del Cuvillo, A; Sastre, J; Bartra, J; et al.
Revista: Journal of investigational allergology & clinical immunology
ISSN 1018-9068  Vol. 21  Nº Suppl 3  2011  págs. 40 - 45
Autores: Jáuregui, I; Bartra, J; del Cuvillo, A; et al.
Revista: Journal of investigational allergology & clinical immunology
ISSN 1018-9068  Vol. 21  Nº Suppl 3  2011  págs. 16 - 23
Autores: Bartra, J; Mullol, J; Montoro, J; et al.
Revista: Journal of investigational allergology & clinical immunology
ISSN 1018-9068  Vol. 21  Nº Suppl 3  2011  págs. 24 - 33
Autores: Ferrer, Marta; Sastre, J; Jáuregui, I; et al.
Revista: Journal of investigational allergology & clinical immunology
ISSN 1018-9068  Vol. 21  Nº Suppl 3  2011  págs. 34 - 39
Autores: Montoro, J; Mullol, J; Dávila, I; et al.
Revista: Journal of investigational allergology & clinical immunology
ISSN 1018-9068  Vol. 21  Nº Suppl 3  2011  págs. 9 - 15
Autores: Cabrera, Paula Karin; Goikoetxea, María José; et al.
Revista: Clinical & Experimental Allergy (print)
ISSN 0954-7894  Vol. 41  Nº 10  2011  págs. 1440 - 1446
Component-based microarray ISAC CRD103 and whole-allergen CAP showed high Se and Sp diagnosing equally grass and cypress pollen allergy. The cut-off point for each allergen should be properly applied for both techniques.
Autores: Cabrera, Paula Karin; Ferrer, Marta; Martínez, Rubén Mario; et al.
Revista: Journal of investigational allergology & clinical immunology
ISSN 1018-9068  Vol. 21  Nº 2  2011  págs. 158 - 159
Autores: Gastaminza, Gabriel; Goikoetxea, María José; et al.
Revista: Journal of investigational allergology & clinical immunology
ISSN 1018-9068  Vol. 21  Nº 2  2011  págs. 108 - 112
Desensitization is a useful procedure in patients who are allergic to their chemotherapy agents..
Autores: Jáuregui, Ignacio; Dávila, Ignacio; Sastre, Joaquín; et al.
Revista: PEDIATRIC ALLERGY AND IMMUNOLOGY
ISSN 0905-6157  Nº 22  2011  págs. 388 - 392
Autores: Ferrer, Marta;
Revista: EXPERT OPINION ON DRUG METABOLISM AND TOXICOLOGY
ISSN 1742-5255  Vol. 7  Nº 8  2011  págs. 1035 - 1047
Autores: Ferrer, Marta; Gamboa, Pedro; Sanz, María Luisa; et al.
Revista: Journal of Allergy and Clinical Immunology
ISSN 0091-6749  Vol. 127  Nº 5  2011  págs. 1300 - 1302
Autores: del Cuvillo, Alfonso; Montoro, Javier; Bartra, Joan; et al.
Revista: RHINOLOGY
ISSN 0300-0729  Vol. 48  Nº 2  2010  págs. 201 - 205
Autores: Ferrer, Marta; Morais-Almeida, M.; Guizova, M.; et al.
Revista: Clinical drug investigation
ISSN 1173-2563  Vol. 30  Nº 1  2010  págs. 15 - 34
Autores: Ferrer, Marta; Núñez, Jorge María; et al.
Revista: Clinical & Experimental Allergy (print)
ISSN 0954-7894  Vol. 40  Nº 12  2010  págs. 1760 - 1766
Autores: Betlloch, I; Izu, R; Lleonart, M; et al.
Revista: ACTAS DERMO-SIFILIOGRAFICAS
ISSN 0001-7310  Vol. 101  Nº 2  2010  págs. 143-50
Treatments used by patients for an outbreak of AD are similar to those prescribed by dermatologists in recent outbreaks.
Autores: Ferrer, Marta; Gamazo, C; Irache, Juan M.; et al.
Revista: Journal of Allergy and Clinical Immunology
ISSN 0091-6749  Vol. 125  Nº 2 Supl.1  2010  págs. AB 220
RATIONALE: In order to develop a suitable peanut allergen immunotherapy we need to depict the immune response to different forms of the same allergen. METHODS: We analyzed protein content and allergen distribution in four different types of peanut extract: crude, crude delipidated, roasted and roasted delipidated. We then identified in the same extracts allergen components using SDS-PAGE technique. Furthermore, we immunized six week-old C57BL/6 mice, intradermal or orally with each extract. Serum and fece samples were obtained on days 0, 7, 14, 21, 28, 35 and 42 after immunization and measured peanut specific IgG1 and IgG2 through indirect ELISA. RESULTS: Protein content in crude peanut extract was 30% higher than roasted extract. No differences were observed in protein content between lipid and non-lipid extract. When allergens were studied, we only observed a significant increase in Arah3 in roasted peanut extract. Regarding the immune response, all four extracts induced a Th2 response (IgG1) through both administration routes. Intradermal sensitization induced higher IgG1 and IgG2 levels than oral sensitization. Maximum IgG1 and IgG2 peak was reached on the 3rd and 4rd week. Roasted delipidated extract induced a significant stronger immune reaction than the other extracts. CONCLUSIONS: The immune response seems to be more dependent on the allergen rather than the route of administration. Roasting peanut increases significantly in both intradermal and oral route its allergen potency.
Autores: Quan, Paola Leonor; D'Amelio, Carmen Mariana ; Gastaminza, Gabriel; et al.
Libro:  101 casos clínicos en dermatitis de contacto
2019  págs. 290 - 293
Autores: Ferrer, Marta; De la Hoz Caballer, Belén;
Libro:  Alergia básica
2017  págs. 433-443
Autores: Ferrer, Marta; Veleiro Pérez, B.; Jáuregui Presa, I.;
Título: Urticaria
Libro:  Tratado de alergología
Nº Volumen 2  2016  págs. 751 - 767
Autores: González de Olano, D; Álvarez Twose, I; Castells Guitart, MC; et al.
Libro:  Tratado de alergología.
Vol. IV  2016  págs. 1315-1330
Autores: D'Amelio, Carmen Mariana ; Goikoetxea, María José; Ferrer, Marta; et al.
Libro:  Casos clínicos en dermatitis de contacto
2015  págs. 90-93
Autores: Goikoetxea, María José; Ferrer, Marta;
Libro:  Balcells. La clínica y el laboratorio
2015  págs. 453-466
Autores: Ferrer, Marta;
Libro:  Libro de las Enfermedades Alérgicas de la Fundación BBVA
2012  págs. 185-191
Autores: Ferrer, Marta; Idoate, Miguel Ángel; Gil, María Pilar; et al.
Libro:  Environmental and genetic actors in allergy and clinical immunology. Proceedings of the 27th environmental and genetic factors in allergy and clinical immunology; proceedings of the 27 symposium of the Collegium Internationale Allergologicum (CIA)
2010  págs. 72-71
Autores: Sanz, María Luisa; M., Padro; E., Blanca; et al.
Libro:  Anaphylaxis. Chemical Immunology Allergy
Vol. 95  2010  págs. 125 - 140