Managing Food ProteinInduced Enterocolitis Syndrome During the Coronavirus Disease 2019 Pandemic Anna NowakWegrzyn MD PhD Antonella Cianferoni MD PhD JA Bird MD Alessandro Fiocchi MD ID: 932730
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Slide1
Slide2Ann Allergy Asthma Immunol. July 2020;125(1):14-16
Managing Food Protein–Induced Enterocolitis Syndrome During the Coronavirus Disease 2019 Pandemic
Anna Nowak-Wegrzyn, MD, PhD
Antonella Cianferoni, MD, PhD
J.A. Bird, MD
Alessandro Fiocchi, MD
Jean Christoph Caubet, MD
on behalf of the Medical Advisory Board
of the International FPIES Association
Slide3Modified Management Algorithm for Acute Food Protein-Induced Enterocolitis Syndrome During the Coronavirus Disease 2019 Pandemic
Nowak-Wegrzyn A, et al. Ann Allergy Asthma Immunol. July 2020;125(1):14-16
Slide4Ann Allergy Asthma Immunol. July 2020;125(1):17-27
Key Steps in Vaccine Development
Peter L. Stern, PhD
Slide5Key Steps in Vaccine Development
Key Messages
A detailed knowledge of the pathogen structure, biology, associated disease epidemiology and its clinical characteristics is highly influential to vaccine design.
Vaccination aims to prime the immune response to generate immune memory to facilitate adequate control of the pathogen with natural infection and thus prevent clinical disease but not necessarily infection.
Whole pathogen based vaccines can be
reactogenic
and while partial fractionation can reduce the latter there is often a loss of immunogenicity (through removal of natural PAMPs), reducing vaccine effectiveness which can be improved by the addition of adjuvants that act to
optimise
the adaptive immune response.
Animal models that accurately mimic human disease can establish vaccine proof of principle in preclinical studies but clinical trials are always required to provide evidence of immunogenicity, efficacy and safety.
For maximal impact on disease reduction sufficient population coverage adds the indirect effects on unimmunized individuals (herd immunity) which requires understanding of population demography, age of maximal disease susceptibility and biological and social factors which influence the pathogen's transmission and replication.
Stern PL. Ann Allergy Asthma Immunol. July 2020;125(1):17-27
Slide6The Immune Control of Infection (The Art of War by Sun Tzu)
Stern PL. Ann Allergy Asthma Immunol. July 2020;125(1):17-27
Slide7The Kinetics of the Immune Response and How Vaccination Prevents an Infection
Outunning
Control & Leading to Overt Disease
Stern PL. Ann Allergy Asthma Immunol. July 2020;125(1):17-27
Slide8Vaccine Strategies to Prevent HPV Associated Disease
Stern PL. Ann Allergy Asthma Immunol. July 2020;125(1):17-27
Slide9Virus-Like Particles in the Formulation of HPV Vaccines
Stern PL. Ann Allergy Asthma Immunol. July 2020;125(1):17-27
Slide10A Vaccine Strategy to Help Prevent Malaria
Stern PL. Ann Allergy Asthma Immunol. July 2020;125(1):17-27
Slide11Vaccine Development Phases
Stern PL. Ann Allergy Asthma Immunol. July 2020;125(1):17-27
Slide12Ann Allergy Asthma Immunol. July 2020;125(1):28-35
Host Immune Response–Inspired Development of the Influenza Vaccine
Angela Choi, MSc
Adolfo García-Sastre, PhD
Michael Schotsaert, PhD
Slide13Host Immune Response–Inspired Development of the Influenza Vaccine
Key Messages
Influenza is a major public health concern.
Influenza is a vaccine-preventable disease.
Currently, licensed influenza vaccines need yearly reformulation and come with variable vaccine efficacy.
Host immune responses to influenza virus infection or influenza vaccination can guide influenza vaccine development.
Choi A, et al. Ann Allergy Asthma Immunol. July 2020;125(1):28-35
Slide14Schematic Representation of Influenza A Virion
Choi A, et al. Ann Allergy Asthma Immunol. July 2020;125(1):28-35
Slide15Study of Host-Virus and Host-Vaccine Responses can Drive Influenza Virus Vaccine Development
Choi A, et al. Ann Allergy Asthma Immunol. July 2020;125(1):28-35
Slide16Ann Allergy Asthma Immunol. July 2020;125(1):36-46
The Journey to a Respiratory Syncytial Virus Vaccine
Asuncion Mejias, MD, PhD
Rosa Rodríguez-Fernández, MD, PhD
Silvia Oliva, MD, PhD
Mark E. Peeples, PhD
Octavio Ramilo, MD
Slide17The Journey to a Respiratory Syncytial Virus Vaccine
Key Messages
Respiratory syncytial virus (RSV) is a major global health problem associated with significant morbidity and mortality in low- and middle-income countries.
There are several vaccine candidates in the pipeline directed toward different target populations: infants younger than 6 months, children older than 6 months to 2- to 5-year-old children, and the elderly.
To protect the young infant from severe RSV infection, a combined strategy using passive and active immunization with maternal vaccination and high-potency, extended half-life monoclonal antibodies may be needed.
Vaccines will have the opportunity to decrease not only the burden of acute RSV disease but also the long-term respiratory morbidity associated with this infection.
Mejias A, et al. Ann Allergy Asthma Immunol. July 2020;125(1):36-46
Slide18The Respiratory Syncytial Virus (RSV) Virion
Mejias A, et al. Ann Allergy Asthma Immunol. July 2020;125(1):36-46
Slide19Antigenic Sites of the Respiratory Syncytial Virus Fusion (F) Protein and Monoclonal Antibodies (
mAbs
)
Mejias A, et al. Ann Allergy Asthma Immunol. July 2020;125(1):36-46
Slide20Target Populations and Respiratory Syncytial Virus Vaccine Types
Mejias A, et al. Ann Allergy Asthma Immunol. July 2020;125(1):36-46
Slide21Ann Allergy Asthma Immunol. July 2020;125(1):47-54
Exercise-Induced Bronchoconstriction
in Elite or Endurance Athletes:
Pathogenesis and Diagnostic Considerations
Taylor J. Atchley, MD
Derek M. Smith, MD
Slide22Exercise-Induced Bronchoconstriction
in Elite or Endurance Athletes
Key Messages
A greater understanding of EIB and its diagnosis is needed among providers caring for these patients, because it is likely inadequately considered.
Exercise-induced bronchoconstriction (EIB) is a transient narrowing of the airways in response to exercise, and should be classified as occurring with underlying asthma (
EIBa
) or without underlying asthma (
EIBwa
).
EIB may present with or without respiratory symptoms of cough, wheezing, increased mucus production, chest tightness, and dyspnea during or after exercise; it also may present with vague symptoms such as fatigue, decreased athletic performance, “feeling out of shape,” and muscle cramps.
The pathogenesis of EIB involves stressors to the airway encountered during exercise, including the osmotic effects of inhaled dry air, temperature variations, autonomic nervous system dysregulation, sensory nerve reactivity, and airway epithelial injury. Deposition of allergens, particulate matter, and gaseous pollutants into the airway also contribute.
Diagnosis of
EIBwa
should take into account the athlete's individual clinical scenario and the results of
bronchoprovocative challenges, which ideally should replicate the competitive environment in which symptoms occur as closely as possible.Further research is needed to validate bronchoprovocative challenges' individual predictive values.
Atchley T and Smith D. Ann Allergy Asthma Immunol. July 2020;125(1):47-54
Slide23Stressors on the Airway During Intense, Prolonged Exercise Leading to Airway Epithelial Damage and Bronchoconstriction
Atchley T and Smith D. Ann Allergy Asthma Immunol. July 2020;125(1):47-54
Slide24Proposed Diagnostic Algorithm for Evaluation of Exercise-Induced Bronchoconstriction in the Elite or Endurance Athlete
Atchley T and Smith D. Ann Allergy Asthma Immunol. July 2020;125(1):47-54
Slide25Alternative Diagnoses to Consider in the Evaluation of Exercise-Induced Bronchoconstriction
Atchley T and Smith D. Ann Allergy Asthma Immunol. July 2020;125(1):47-54