| 1. |
- Petersson, Christina, 1975-, et al.
(författare)
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Discovering aspects of health-experiences of a web-based health diary among adults with primary immunodeficiency
- 2018
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 5:4, s. 642-648
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Advances in technology generate new opportunities to develop e-health tools to help individuals in self-management by assessing symptoms of illness and its relation to treatments. Self-management is central when living with primary immunodeficiency diseases. The aim was to explore the experiences of people living with primary immunodeficiency, who used a pilot version of the web-based health diary.Design: Explorative design.Methods: In total, 16 participants (median age 59) attended one of three focus groups. Inductive content analysis was used.Results: The participants could be encouraged to discover aspects of their health by contributing to documentation which could support the health concept. A greater understanding about their own health and communicating with healthcare professionals during encounters was expressed. The web-based health diary is a helpful tool to discover aspects of health that affects the individuals’ life situation and assists the self-management of a long-term condition such as immunodeficiency.
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| 2. |
- Ahlbeck, Lars, 1964-
(författare)
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Intralymphatic Immunotherapy : A Novel Route to Ameliorate Allergic Rhinitis Due to Pollen
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Allergy to pollen and animal dander is a major public health problem. Close to 30% of the population have symptoms from the upper and/or lower respiratory tract when they meet fur animals or pollen. Whereas symptom-relieving medications have a good to sufficient effect on about 80% of those affected, a large group of 10–20% have severe symptoms, despite medication, with an impact on well-being and ability to work. In Sweden, the annual cost of allergy was calculated at €1.3 billion in 2014.Immunotherapy is effective in treating and preventing pollen allergy and allergic asthma, but is expensive, complicated, requiring 40 injections, and takes more than three years to complete if subcutaneous injections are used. Tablets placed under the tongue are another method, with one tablet taken every day for three years. Only 1.5‰ receive such treatment, yet just over 3% would need it.With intralymphatic immunotherapy, a small dose of allergen is given in a lymph node in the groin on 3 occasions, one month apart. As this method takes only eight weeks, it is a much faster and less costly treatment. However, although several studies have shown that the treatment is safe, its efficacy remains the subject of doubt.Our pilot study in 2012, with a 3-year follow-up to 2015, showed encouraging results, and was followed by a double-blind randomised study with 72 participants from 2014 to 2018. The research subjects then received treatment with birch and grass pollen extract or one extract and a placebo. Regardless of treatment, symptoms, quality of life and medication consumption improved during the birch and grass pollen seasons in the 3 years after treatment. Increased frequencies of T-regulatory lymphocytes may explain the non-specific effects.In 2017 to 2018, we conducted a double-blind study with 38 participants, half of whom received placebo and half, active treatment. In this study, we saw no difference between the treatment groups in the first year after treatment. However, after discontinuation and unblinding in 2019, i.e., two years after treatment, the actively treated group improved in terms of symptoms, and quality of life was improved compared with the placebo group despite less need for medication. T-regulatory lymphocytes increased one year after treatment only in the actively treated group.A long-term follow-up of the research subjects from our two larger studies in 2022, i.e., five to eight years after treatment, showed in the double-blind study without a pure placebo that the scores for symptoms, medication use, and quality of life remained as low as after the first three years. In the placebo-controlled study, a statistically significant improvement in symptoms remained during the grass pollen season. Analysing the two studies together, symptom improvement was significant even during the birch pollen season. Thus, although the effect does not seem to diminish, those who did not receive birch, but only grass, needed to use more medication during the birch pollen season in 2022, seven to eight years after treatment. Moreover, those who did not receive grass but only birch needed more medication during the grass pollen season. This may suggest that the non-specific effect begins to wane after seven to eight years.Allergy to pollen is a major problem for individuals and society, where symptom-relieving treatment with drugs is not enough for many. They can be helped with immunotherapy, which takes at least three years, is expensive and fraught with side effects. In contrast, intralymphatic immunotherapy involves three injections over eight weeks. Our three studies show that the treatment is safe and indicate that it has a clinical effect up to eight years after treatment. T-regulatory cells appear to be important to the immunological mechanism, leading to tolerance to pollen.
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| 3. |
- Björkander, Janne, 1946, et al.
(författare)
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Sublingual immunterapi: Varför och för vem?
- 2014
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Ingår i: Allergi i praxis. - 0806-5462. ; :2, s. 30-35
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Tidskriftsartikel (refereegranskat)abstract
- Sublingual immunterapi (SLIT) är en ny form av immunterapi som utvecklats under 1980-talet och det första alternativet sedan Noon introducerade subkutan immunterapi 1911 (SCIT). I Sverige finns SLIT för närvarande tillgängligt endast för behandling av gräsallergi. Trots upprepade placebokontrollerade studier, upprepade konsensusrapporter från WHO och ARIA samt Cochrane-rapporter har en vidare användning av behandlingen i Sverige försvårats av formella hinder. Behandlingen är säkrare, enklare och billigare än SCIT och i många fall finns, på grund av bristande sjukvårdsresurser, inte de möjligheter till SCIT som läkemedelsverket rekommenderar som alternativ. Vi allergologer behöver ställa upp för våra patienter för att kunna ge dem en behandling som inte bara lindrar för stunden utan också har immunologiska effekter, som kan förhindra både nya sjukdomar och nya sensibiliseringar. Typfallet är en ungdom med björksnuva. Vi kan med immunterapi minska risken för björkastma genom behandling, liksom vidare insjuknade för andra pollen och kanske även för djur. Detta gäller både för SCIT liksom för SLIT, men om vi har hinder för den ena behandlingsformen, SCIT, så måste vi väl ändå få tillstånd av Läkemedelsverket att använda den andra, säkrare behandlingsformen, SLIT?
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| 4. |
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| 5. |
- Friman, Vanda, 1952, et al.
(författare)
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Aberrant IgG2 antibody response to Neisseria meningitidis polysaccharide A after vaccination in frequently infected compared to healthy IgA-deficient individuals.
- 2004
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Ingår i: Scandinavian journal of immunology. - : Wiley. - 0300-9475 .- 1365-3083. ; 60:3, s. 292-8
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Tidskriftsartikel (refereegranskat)abstract
- In search for a possible explanation of the phenotypic heterogeneity in selective immunoglobulin (Ig)A deficiency, we studied the IgG2 antibody response to meningococcal polysaccharide A (PSA) in IgA-deficient (IgAd) individuals after vaccination with meningococcal A + C polysaccharide vaccine. Two groups of IgAd individuals, one frequently infected and one clinically apparently healthy, as well as healthy controls, were studied. In response to meningococcal A + C polysaccharide vaccine, a significant titre increase of specific IgG2 anti-PSA was found in 71% of the control individuals, in 50% of the healthy and in 42% of the infection-prone IgAd individuals. The specific IgG2 response against meningococcal PSA was significantly lower in the infection-prone IgAd individuals compared to the controls (P < 0.05). Among the IgAd individuals who responded with a significant IgG2 antibody increase, the IgG2 antibody response was significantly lower in the infection-prone than in the healthy IgAd individuals (P < 0.05). Thus, a limited capacity to mount a specific IgG2 response may suggest a more profound antibody maturation defect in infection-prone IgAd patients compared to healthy IgAd individuals.
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| 6. |
- Hahn-Zoric, Mirjana, 1949, et al.
(författare)
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Antibody response to the Haemophilus influenzae type b-tetanus toxoid conjugate vaccine in healthy and infection-prone individuals with IgG3 subclass deficiency.
- 2004
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Ingår i: Journal of clinical immunology. - 0271-9142. ; 24:5, s. 561-70
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Tidskriftsartikel (refereegranskat)abstract
- Searching for a possible explanation for the phenotypic heterogeneity in IgG3 deficiency, we studied the antibody response to a polysaccharide and a protein antigen in IgG3-deficient (IgG3d) adults after vaccination with Haemophilus influenzae type b capsular polysaccharide (Hib CP) conjugated to tetanus toxoid. Distribution of isotypes, idiotypes, clonotypes, and Gm allotypes were compared. All the vaccinated individuals, irrespective of the level of IgG3 and proneness to infections, developed protective levels of anti-Hib CP. Significantly lower prevaccination levels of IgG2 (p < 0.05) and IgG4 anti-Hib CP (p < 0.04 and p < 0.03) were noted among the infection-prone compared to the healthy IgG3d individuals and/or controls. Seventy percent of the IgG3d patients and none of the controls had the low responding Gm(ga-n/ga-n) genotype, while the majority of the controls had the alternative Gm(bfn/bfn) genotype. The conjugate ACT-HIB vaccine efficiently overcomes the IgG3 subclass deficiency state and the genetic predisposition for lower responsiveness, providing protection against Hib and tetanus infections. The proneness to infection in some IgG3d individuals may relate to their low prevaccination antibody levels.
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| 7. |
- Hahn-Zoric, M, et al.
(författare)
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Variable increases of IgG and IgM antibodies in milk of IgA deficient women.
- 1997
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Ingår i: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. - 0905-6157. ; 8:3, s. 127-33
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Tidskriftsartikel (refereegranskat)abstract
- Serum, milk and saliva from seven IgA deficient mothers were studied for the presence of IgA, IgG and IgM antibodies to Escherichia coli and poliovirus antigens. Different variable patterns were obtained. One mother had very much increased IgM and IgG antibodies in milk and saliva against both antigens; the milk IgG antibodies were 11-14 times higher than the reference milk pool. Another mother showed also striking increases of both IgM and IgG antibodies in milk, as well as in saliva where the increases were much higher for the poliovirus than the E. coli antibodies. Yet another mother showed a certain increase of IgM but not of IgG antibodies in the milk. The uneven appearance of IgG and IgM antibodies in serum and secretions suggests local production. So do the differences of antibody avidities, the variations in IgG subclass distribution of antibodies and different patterns after isoelectric focusing (IEF)/immunoblotting analysis of antibody spectrotypes in secretions and serum. The study illustrates the variable patterns of compensatory increases of IgG and IgM antibodies which may occur in IgA deficiency. It also shows that the milk from IgA deficient mothers can still be rich in antibodies, in spite of the lack of secretory IgA.
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| 8. |
- Kutti, Jack, et al.
(författare)
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Successful treatment of refractory autoimmune haemolytic anaemia by plasmapheresis.
- 1984
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Ingår i: Scandinavian journal of haematology. - 0036-553X. ; 32:2, s. 149-52
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Tidskriftsartikel (refereegranskat)abstract
- A 16-year-old female was admitted because of rapidly progressive fatigue, severe anaemia and icterus. The S-bilirubin was 190 mumol/l, COHb 7.3% and high amounts of free Hb in plasma were present. The Coombs' direct test was strongly positive with anti-IgG but negative with anti-IgM and anti-C3. Conventional therapy with very high doses of hydrocortisone i.v., cyclophosphamide, azathioprine, and transfusions of washed packed red cells proved ineffective. During 5 consecutive days she also received i.v. infusions of gamma-globulin (25 g each day). Nevertheless, her condition deteriorated and 3 plasma exchanges were carried out with impressive clinical and laboratory effects. After the 3rd plasma exchange, the patient did not require further transfusions of packed red cells. Therapy with corticosteroids could be rapidly reduced and she was discharged after 5 weeks with a normal blood picture. Since then she has remained in excellent health.
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| 9. |
- Olinder-Nielsen, A. M., et al.
(författare)
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Immunoglobulin prophylaxis in 350 adults with IgG subclass deficiency and recurrent respiratory tract infections: a long-term follow-up
- 2007
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Ingår i: Scand J Infect Dis. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 39:1, s. 44-50
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Tidskriftsartikel (refereegranskat)abstract
- 350 adult patients in Sweden were included in a retrospective study covering more than 2000 patient-y, to evaluate the efficacy of immunoglobulin (Ig) prophylaxis. All patients had selective or combined IgG subclass deficiency, without IgA deficiency, and suffered from recurrent respiratory tract infections (RTIs). The patients had been given Ig prophylaxis for 0.5-21 y (mean 5.5 y). In total, 164/350 of the patients had a concomitant lung disease. Because of the heterogeneity of this retrospective material we evaluated only those patients with 4 or more antibiotic-demanding (i.e. presumably bacterial) episodes of RTI per y treated with an Ig dose of about 100 mg/kg/week (132/350). The frequency of antibiotic treated RTIs prior to and during latest y/s of Ig prophylaxis was compared. No difference in response could be found between patients with and without chronic lung diseases. In 92/132 a > or = 50% reduction of the rate of episodes of antibiotic-demanding RTIs was recorded (p < 0.001). The overall reduction of the RTI frequency was for IgG1 57%, IgG2 59%, IgG3 63% and for the combinations 61% (all p<0.001).
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| 10. |
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