Publications by authors named "Gompels M"
CVID (common variable immunodeficiency) is associated with a variety of gastrointestinal disorders including those mimicking Crohn's disease and ulcerative colitis. At present there is no clear trial data for the treatment of CVID enteropathy. There are no specific recommendations for treatment; however, it is commonly treated in a similar manner to inflammatory bowel disease, with corticosteroids, 5-aminosalicylates (5-ASA), azathioprine and anti-TNF therapy all being used.
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- Common Variable Immunodeficiency Disorders (CVID) are characterized by recurrent infections and a range of non-infectious complications, with this study focusing on the differences in these complications in patients with and without interstitial lung disease (ILD).
- In a study of 129 patients, it was found that 62% had chronic lung issues, with bronchiectasis being particularly common, leading to worse lung function among those with CVID-ILD compared to those without.
- The research underscores the importance of a multidisciplinary approach to managing CVID, given the high prevalence of lung complications and the need for targeted treatments, such as immunosuppressive therapies, especially in those with ILD.
Background: Hereditary angioedema is a rare disorder characterized by episodic, potentially life-threatening swelling caused by kallikrein-kinin dysregulation. Long-term prophylaxis can stabilize this system. Donidalorsen, an antisense oligonucleotide, specifically reduces prekallikrein expression.
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- Angioedema (AE) is a condition characterized by localized swelling in the skin or mucous membranes and can be hereditary or acquired, making its classification complex due to various underlying mechanisms and taxonomies.
- The DANCE initiative, involving 91 experts from 35 countries, aimed to create a unified consensus on the definition, acronyms, and classification of AE through an extensive online discussion and voting process over 16 months.
- The resulting DANCE classification introduces five types of AE, standardizes terminology, and is designed to enhance research and patient care while complementing existing clinical guidelines without replacing them.
A Core Outcome Set for Efficacy of Acute Treatment of Hereditary Angioedema.
J Allergy Clin Immunol Pract
June 2024
Background: Clinical trials investigating drugs for the acute treatment of hereditary angioedema attacks have assessed many different outcomes. This heterogeneity limits the comparability of trial results and may lead to selective outcome reporting bias and a high burden on trial participants.
Objective: To achieve consensus on a core outcome set composed of key outcomes that ideally should be used in all clinical efficacy trials involving the acute treatment of hereditary angioedema attacks.
Introduction: Yard and garden tools are increasingly used by Americans. Despite the growing popularity of gardening as a leisure activity, the rate of injury associated with these tools remains remarkedly high. Previous research has highlighted the risks associated with improper handling of tools and associated potential long-term consequences.
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- Exercise is crucial for health but has seen a rise in craniofacial injuries, particularly during weightlifting, prompting an analysis of trends and demographics over the past decade.
- A review of National Electronic Injury Surveillance System data revealed nearly 583,000 injuries from 2013 to 2022, with males and adolescents aged 15-19 being the most affected groups.
- Findings highlight the necessity for targeted injury prevention strategies and increased awareness of the risks linked to craniofacial injuries during exercise, especially for certain vulnerable populations.
Article Synopsis
- Hereditary angioedema (HAE) is a rare genetic disorder leading to recurrent swelling, which can be life-threatening, and its treatment includes both on-demand and preventive options.
- The last UK consensus on HAE was in 2014, but new medications have emerged, and there's a call for long-term prophylaxis (LTP) to effectively manage the condition and enhance patient quality of life.
- A recent Delphi process revealed that current UK access criteria for LTP based solely on attack frequency are too simplistic and may overlook patients who could benefit, emphasizing the need for expert care and improved monitoring practices.
Background: Treatment-simplification strategies are important tools for patient-centred management. We evaluated long-term outcomes from a PI monotherapy switch strategy.
Methods: Eligible participants attending 43 UK treatment centres had a viral load (VL) below 50 copies/ml for at least 24 weeks on combination ART.
The aim of this study is to identify the factors associated with peripheral neuropathy and to explore neurofilament light chain (NfL) as a biomarker for peripheral neuropathy (PN) in effectively virologically suppressed adults living with HIV. All protease inhibitor monotherapy versus ongoing triple therapy in the long-term management of HIV infection (PIVOT) trial participants with data on PN at baseline were included in the study. NfL plasma levels (pNfL) were measured in a sub-set of participants.
View Article and Find Full Text PDFIntroduction: Water-related recreational activities, including swimming and diving, are widespread. However, they carry a significant risk of craniofacial injuries. Despite the popularity of these activities, comprehensive data on injuries beyond drowning remain scant.
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- - The American Academy of Pediatrics has recommended halting trampoline sales in the U.S. due to documented injury risks, yet trampoline parks continue to be popular and are associated with serious injuries, particularly craniofacial trauma among youth.
- - A study reviewing data from 2013 to 2022 found approximately 206,866 trampoline-related craniofacial injuries, with males affected more often than females, and common injury types including lacerations and internal injuries.
- - There is a notable increase in head and facial injuries, especially among children aged 3 to 11, highlighting the need for better regulations and targeted safety measures to prevent these injuries in trampoline activities.
Human skin aging is associated with functional deterioration on multiple levels of physiology, necessitating the development of effective skin senotherapeutics. The well-tolerated neurohormone melatonin unfolds anti-aging properties in vitro and in vivo, but it remains unclear whether these effects translate to aged human skin ex vivo. We tested this in organ-cultured, full-thickness human eyelid skin (5-6 donors; 49-77 years) by adding melatonin to the culture medium, followed by the assessment of core aging biomarkers via quantitative immunohistochemistry.
View Article and Find Full Text PDFBackground: B cells play an important role in protection against viral infections, not only through the production of antibodies but also through their ability to act as antigen-presenting cells and produce cytokines.
Objectives: To assess whether there is a link between low circulating B-cell counts and a predisposition to viral infections in immunocompromised individuals, we performed a retrospective cohort analysis at 2 National Health Service Clinical Immunology sites in England.
Methods: Eligible patients were adults who were either diagnosed with or under investigation for an immunodeficiency and had recorded circulating B-cell counts.
Objectives: The main objective of this analysis was to evaluate the impact of pre-existing drug resistance by next-generation sequencing (NGS) on the risk of treatment failure (TF) of first-line regimens in participants enrolled in the START study.
Methods: Stored plasma from participants with entry HIV RNA >1000 copies/mL were analysed using NGS (llumina MiSeq). Pre-existing drug resistance was defined using the mutations considered by the Stanford HIV Drug Resistance Database (HIVDB v8.
Article Synopsis
- The NEAT022 trial found that switching from boosted protease inhibitors to dolutegravir in people with HIV and high cardiovascular risk led to positive changes in various cardiovascular-related biomarkers over 96 weeks.
- Out of 415 participants, significant improvements were observed in biomarkers linked to inflammation, immune activation, and myocardial injury, despite a concerning reduction in adiponectin, indicating higher insulin resistance.
- However, no significant differences in carotid intima-media thickness progression were detected between the treatment groups.
Objectives: Maraviroc may reduce hepatic inflammation in people with HIV and non-alcoholic fatty liver disease (HIV-NAFLD) through CCR5-receptor antagonism, which warrants further exploration.
Methods: We performed an open-label 96-week randomised-controlled feasibility trial of maraviroc plus optimised background therapy (OBT) versus OBT alone, in a 1:1 ratio, for people with virologically-suppressed HIV-1 and NAFLD without cirrhosis. Dosing followed recommendations for HIV therapy in the Summary of Product Characteristics for maraviroc.
Article Synopsis
- - Participants with HIV at high cardiovascular risk who switched to dolutegravir showed no significant difference in hypertension incidence compared to those who continued protease inhibitors over 96 weeks.
- - Both groups experienced a small but significant increase in diastolic blood pressure during the first 48 weeks after switching to dolutegravir.
- - Factors like existing health conditions, rather than the treatment itself, were more closely linked to the development of hypertension in the study participants.
Objective: The objective was to review COVID-19 vaccine allergy advice and guidance requests received and assess the impact of advice outcome on vaccination outcome.
Design: A retrospective analysis of requests for advice and guidance regarding COVID-19 vaccine allergy was completed using an electronic referral system from February 2021 to January 2022.
Participants: A total of 1265 independent patient requests for advice were received from primary care.
Article Synopsis
- The NEAT022 trial explored the effects of switching from protease inhibitors to dolutegravir in HIV patients with high cardiovascular risk, revealing that both immediate (DTG-I) and delayed (DTG-D) switches resulted in similar viral suppression and reduced cardiovascular risks.
- A post hoc analysis focused on weight and body mass index (BMI) changes over 48 and 96 weeks, finding that participants experienced significant weight increases in the first 48 weeks, but weight stabilized afterwards.
- The modest weight gain was primarily seen in those who were normal-weight or underweight before the switch, with no adverse effects on metabolic health observed during the study period.