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  1. Article ; Online: Drug allergy desensitization is not a unique recipe.

    Madrigal-Burgaleta, Ricardo / Guzman-Melendez, Maria Antonieta / Alvarez-Cuesta, Emilio

    Current opinion in allergy and clinical immunology

    2022  Volume 22, Issue 3, Page(s) 167–174

    Abstract: Purpose of review: Drug desensitization is the only therapeutic option for patients with drug allergies who need to receive the drugs they are allergic to, and it is especially critical in patients with an urgent need for chemotherapy, biologics, or ... ...

    Abstract Purpose of review: Drug desensitization is the only therapeutic option for patients with drug allergies who need to receive the drugs they are allergic to, and it is especially critical in patients with an urgent need for chemotherapy, biologics, or antibiotics, where equally effective alternatives might not be available. However, drug desensitization is not a cookbook where anyone with no experience or specific training can find a general recipe. This review article will approach the singularities that make personalized and highly specialized care essential in this field.
    Recent findings: Drug desensitization needs to be personalized for each individual patient bearing in mind countless factors. Recent articles have tried to define the optimal resources and the most important factors to account for in personalization. However, drug desensitization is only a tool within the wider management pathway, and we will discuss recent findings in allergy delabelling in chemotherapy, biologics, and antibiotics.
    Summary: Risk-assessment, delabelling, and desensitization protocols, as a part of wider management pathways, can be adapted locally along with comprehensive and multifactorial risk-management strategies. These high-complexity and high-risk procedures, such as drug desensitization, need to be managed by expert allergists who can provide personalization, innovation, continuous improvement, research, and teaching in expert centres.
    MeSH term(s) Anti-Bacterial Agents/adverse effects ; Biological Products ; Desensitization, Immunologic/methods ; Drug Hypersensitivity/diagnosis ; Drug Hypersensitivity/therapy ; Humans
    Chemical Substances Anti-Bacterial Agents ; Biological Products
    Language English
    Publishing date 2022-02-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2088710-3
    ISSN 1473-6322 ; 1528-4050
    ISSN (online) 1473-6322
    ISSN 1528-4050
    DOI 10.1097/ACI.0000000000000821
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  2. Article ; Online: Noonan-Syndrom mit multiplen Lentigines und ausgeprägter Keratosis pilaris.

    Fernández-Canga, Paula / Vázquez-Osorio, Igor / Álvarez-Cuesta, César Cosme / Rodríguez-Díaz, Eloy

    Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG

    2019  Volume 17, Issue 7, Page(s) 748–751

    Language English
    Publishing date 2019-04-09
    Publishing country Germany
    Document type Letter
    ZDB-ID 2093479-8
    ISSN 1610-0387 ; 1610-0379
    ISSN (online) 1610-0387
    ISSN 1610-0379
    DOI 10.1111/ddg.13880_g
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  3. Article ; Online: Noonan syndrome with multiple lentigines and prominent keratosis pilaris.

    Fernández-Canga, Paula / Vázquez-Osorio, Igor / Álvarez-Cuesta, César Cosme / Rodríguez-Díaz, Eloy

    Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG

    2019  Volume 17, Issue 7, Page(s) 749–751

    MeSH term(s) Abnormalities, Multiple/genetics ; Child ; Darier Disease/genetics ; Eyebrows/abnormalities ; Genotype ; Humans ; LEOPARD Syndrome/genetics ; Male ; Mutation
    Language English
    Publishing date 2019-06-18
    Publishing country Germany
    Document type Case Reports ; Letter
    ZDB-ID 2093479-8
    ISSN 1610-0387 ; 1610-0379
    ISSN (online) 1610-0387
    ISSN 1610-0379
    DOI 10.1111/ddg.13880
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  4. Article ; Online: Still disease with persistent atypical dermatomyositis-like skin eruption: two cases associated with macrophage activation syndrome.

    Fernández Camporro, Ángel / Rodriguez Diaz, Eloy / Beteta Gorriti, Valia / Gonzalvo Rodríguez, Pablo / Alvarez-Cuesta, César

    Clinical and experimental dermatology

    2022  Volume 47, Issue 11, Page(s) 1991–1994

    Abstract: The typical rash of Still disease is an asymptomatic, salmon-coloured, macular, or maculopapular eruption that appears along with the fever spikes and fades when the body temperature drops. Although not included in the diagnostic criteria, there are ... ...

    Abstract The typical rash of Still disease is an asymptomatic, salmon-coloured, macular, or maculopapular eruption that appears along with the fever spikes and fades when the body temperature drops. Although not included in the diagnostic criteria, there are other frequent, persistent, pruritic and polymorphic skin manifestations of Still disease that have distinctive clinical features and specific histological findings. Among these atypical persistent pruritic eruptions (PPEs), periorbital erythema and linear flagellate papules and plaques can resemble the cutaneous manifestations of dermatomyositis (DM). The presence of these lesions in adult-onset Still disease has been associated with worse prognosis and higher mortality rates, perhaps due to the development of a secondary macrophage activation syndrome (MAS). We report two cases of Still disease with persistent atypical DM-like eruption, one in a paediatric patient (a very underreported finding) and the other in an adult. Both cases developed a secondary MAS.
    MeSH term(s) Humans ; Adult ; Child ; Macrophage Activation Syndrome/etiology ; Macrophage Activation Syndrome/complications ; Dermatomyositis/complications ; Dermatomyositis/diagnosis ; Dermatomyositis/pathology ; Exanthema/pathology ; Still's Disease, Adult-Onset/complications ; Still's Disease, Adult-Onset/diagnosis ; Still's Disease, Adult-Onset/pathology ; Arthritis, Juvenile/complications ; Pruritus/pathology
    Language English
    Publishing date 2022-08-11
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 195504-4
    ISSN 1365-2230 ; 0307-6938
    ISSN (online) 1365-2230
    ISSN 0307-6938
    DOI 10.1111/ced.15294
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  5. Article ; Online: Programming controlled adhesion of E. coli to target surfaces, cells, and tumors with synthetic adhesins.

    Piñero-Lambea, Carlos / Bodelón, Gustavo / Fernández-Periáñez, Rodrigo / Cuesta, Angel M / Álvarez-Vallina, Luis / Fernández, Luis Ángel

    ACS synthetic biology

    2014  Volume 4, Issue 4, Page(s) 463–473

    Abstract: ... properties of E. coli. SAs have a modular structure comprising a stable β-domain for outer membrane anchoring ... from large repertoires. SAs are constitutively and stably expressed in an E. coli strain lacking a conserved ... antigenic surfaces and cells. We demonstrate the functionality of SAs in vivo, showing that, compared to wild type E ...

    Abstract In this work we report synthetic adhesins (SAs) enabling the rational design of the adhesion properties of E. coli. SAs have a modular structure comprising a stable β-domain for outer membrane anchoring and surface-exposed immunoglobulin domains with high affinity and specificity that can be selected from large repertoires. SAs are constitutively and stably expressed in an E. coli strain lacking a conserved set of natural adhesins, directing a robust, fast, and specific adhesion of bacteria to target antigenic surfaces and cells. We demonstrate the functionality of SAs in vivo, showing that, compared to wild type E. coli, lower doses of engineered E. coli are sufficient to colonize solid tumors expressing an antigen recognized by the SA. In addition, lower levels of engineered bacteria were found in non-target tissues. Therefore, SAs provide stable and specific adhesion capabilities to E. coli against target surfaces of interest for diverse applications using live bacteria.
    MeSH term(s) Adhesins, Escherichia coli/biosynthesis ; Adhesins, Escherichia coli/genetics ; Animals ; Bacterial Adhesion/genetics ; Escherichia coli/genetics ; Escherichia coli/metabolism ; Female ; HeLa Cells ; Humans ; Mice ; Mice, Nude ; Neoplasms, Experimental/metabolism ; Neoplasms, Experimental/pathology ; Neoplasms, Experimental/therapy ; Protein Engineering
    Chemical Substances Adhesins, Escherichia coli
    Language English
    Publishing date 2014-07-29
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2161-5063
    ISSN (online) 2161-5063
    DOI 10.1021/sb500252a
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  6. Article ; Online: Idiopathic facial aseptic granuloma: Usefulness of cutaneous ultrasound.

    Vázquez-Osorio, I / Álvarez-Cuesta, C C / Rodríguez-González, L / Rodríguez-Díaz, E

    Actas dermo-sifiliograficas

    2017  Volume 108, Issue 3, Page(s) 266–268

    Title translation Granuloma aséptico facial idiopático. Utilidad de la ecografía cutánea.
    Language Spanish
    Publishing date 2017-04
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 390255-9
    ISSN 1578-2190 ; 0001-7310 ; 1138-8196
    ISSN (online) 1578-2190
    ISSN 0001-7310 ; 1138-8196
    DOI 10.1016/j.ad.2016.09.017
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  7. Article ; Online: Controversies in Allergy: Chemotherapy Reactions, Desensitize, or Delabel?

    Hong, David I / Madrigal-Burgaleta, Ricardo / Banerji, Aleena / Castells, Mariana / Alvarez-Cuesta, Emilio

    The journal of allergy and clinical immunology. In practice

    2020  Volume 8, Issue 9, Page(s) 2907–2915.e1

    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Drug Hypersensitivity/drug therapy ; Drug Hypersensitivity/therapy ; Humans ; Skin Tests
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2020-08-14
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2843237-X
    ISSN 2213-2201 ; 2213-2198
    ISSN (online) 2213-2201
    ISSN 2213-2198
    DOI 10.1016/j.jaip.2020.08.005
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    Zs.A 7086: Show issues Location:
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  8. Article: Standards for practical intravenous rapid drug desensitization & delabeling: A WAO committee statement.

    Alvarez-Cuesta, Emilio / Madrigal-Burgaleta, Ricardo / Broyles, Ana D / Cuesta-Herranz, Javier / Guzman-Melendez, Maria Antonieta / Maciag, Michelle C / Phillips, Elizabeth J / Trubiano, Jason A / Wong, Johnson T / Ansotegui, Ignacio

    The World Allergy Organization journal

    2022  Volume 15, Issue 6, Page(s) 100640

    Abstract: Drug hypersensitivity reactions (DHRs) to intravenous drugs can be severe and might leave patients and doctors in a difficult position where an essential treatment or intervention has to be suspended. Even if virtually any intravenous medication can ... ...

    Abstract Drug hypersensitivity reactions (DHRs) to intravenous drugs can be severe and might leave patients and doctors in a difficult position where an essential treatment or intervention has to be suspended. Even if virtually any intravenous medication can potentially trigger a life-threatening DHR, chemotherapeutics, biologics, and antibiotics are amongst the intravenous drugs most frequently involved in these reactions. Admittedly, suspending such treatments may negatively impact the survival outcomes or the quality of life of affected patients. Delabeling pathways and rapid drug desensitization (RDD) can help reactive patients stay on first-choice therapies instead of turning to less efficacious, less cost-effective, or more toxic alternatives. However, these are high-complexity and high-risk techniques, which usually need expert teams and allergy-specific techniques (skin testing,
    Language English
    Publishing date 2022-05-31
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2581968-9
    ISSN 1939-4551
    ISSN 1939-4551
    DOI 10.1016/j.waojou.2022.100640
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  9. Article ; Online: Medical algorithm: Diagnosis and treatment of hypersensitivity reactions to cancer chemotherapy.

    Madrigal-Burgaleta, Ricardo / Vazquez-Revuelta, Paula / Marti-Garrido, Jaume / Lleonart-Bellfill, Ramon / Ali, Fawzia Runa / Alvarez-Cuesta, Emilio

    Allergy

    2021  Volume 76, Issue 8, Page(s) 2636–2640

    MeSH term(s) Algorithms ; Anaphylaxis ; Drug Hypersensitivity/diagnosis ; Drug Hypersensitivity/etiology ; Drug Hypersensitivity/therapy ; Humans ; Hypersensitivity ; Neoplasms/drug therapy
    Language English
    Publishing date 2021-05-20
    Publishing country Denmark
    Document type Letter
    ZDB-ID 391933-x
    ISSN 1398-9995 ; 0105-4538
    ISSN (online) 1398-9995
    ISSN 0105-4538
    DOI 10.1111/all.14810
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  10. Article ; Online: Desensibilización a levotiroxina. Caso clínico.

    Guzmán, María Antonieta / Sepúlveda, Cecilia / Liberman, Claudio / Cornejo, Rodrigo / Roizen, Gigia / Cereceda, Daniela / Lara, María Fernanda / Álvarez-Cuesta, Emilio

    Revista medica de Chile

    2018  Volume 146, Issue 3, Page(s) 394–398

    Abstract: We report a 39-year-old female who underwent a total thyroidectomy as treatment for a thyroid papillary cancer. She suffered several episodes of mild angioedema in lips and tongue, after using different commercial Levothyroxine formulations, with and ... ...

    Title translation Successful oral desensitization to levothyroxine. Report of one case.
    Abstract We report a 39-year-old female who underwent a total thyroidectomy as treatment for a thyroid papillary cancer. She suffered several episodes of mild angioedema in lips and tongue, after using different commercial Levothyroxine formulations, with and without excipients. Given the need to use this drug, the patient was admitted in our hospital and we proceeded to desensitize her with oral Levothyroxine. The patient fasted throughout the whole procedure, was properly monitored and had an adequate peripheral venous access. On the first day of the procedure, a 15-step protocol was performed, first administering placebo and then, compounded formulations of Levothyroxine starting from 0.01 ug, followed by doubling doses every 15 minutes until the cumulative dose of 111.95 ug was completed, corresponding to the daily dose of Levothyroxine her endocrinologist prescribed (112 ug). The patient was monitored at baseline, between each dose and up to 3 hours after the procedure was completed. There were no incidents such as urticaria, angioedema, or others. On the second day, the patient received a single-full dose of 112 ug on an empty stomach. The medication was successfully tolerated and she was discharged. Thereafter, she tolerates daily Levothyroxine.
    MeSH term(s) Adult ; Desensitization, Immunologic/methods ; Drug Hypersensitivity/etiology ; Drug Hypersensitivity/immunology ; Drug Hypersensitivity/prevention & control ; Female ; Humans ; Skin Tests ; Thyroidectomy ; Thyroxine/adverse effects ; Thyroxine/immunology
    Chemical Substances Thyroxine (Q51BO43MG4)
    Language Spanish
    Publishing date 2018-03
    Publishing country Chile
    Document type Case Reports ; Journal Article
    ZDB-ID 732136-3
    ISSN 0717-6163 ; 0034-9887
    ISSN (online) 0717-6163
    ISSN 0034-9887
    DOI 10.4067/s0034-98872018000300394
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