Publications by authors named "Knulst A"
Article Synopsis
- Long-term effectiveness and safety of omalizumab for Chronic Inducible Urticaria (CIndU) were evaluated in a large cohort across 14 specialized centers, revealing it to be highly effective for most patients.
- Out of 234 patients, 73% reported significant improvements while the median treatment duration exceeded 5 years, mainly due to disease control.
- Patient age was a predictor of treatment continuation, with older patients less likely to discontinue due to well-controlled disease, and CIndU subtype did not impact treatment response or duration.
. This article details the development and use of a low-cost, custom RMST device for a patient with long COVID who had received positive airway flow support during ICU treatment. By sharing our successful management of respiratory muscle weakness in a severe COVID-19 patient, we aim to contribute to the broader conversation around effective long COVID management.
View Article and Find Full Text PDFImportance: Treating patients with chronic urticaria using omalizumab has been shown to be safe and effective in randomized clinical trials. Multinational studies on long-term omalizumab performance in chronic urticaria in clinical practice settings are lacking, especially on drug survival. Drug survival, which refers to the length of time that patients are treated with a specific drug, is a comprehensive outcome covering effectiveness, safety, and patient and physician preferences.
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- The SQ tree SLIT-tablet is a special medicine used to treat allergies from certain trees and is approved in 21 European countries.
- A study looked at how safe this medicine is when real people use it in everyday life, checking for any bad reactions and how patients feel after taking it.
- The study found that most people had mild to moderate side effects, but many experienced improvement in their allergy symptoms, and using this medicine alongside others didn't make things worse.
Background: Birch pollen-related food allergy (BPFA) is the most common type of food allergy in birch-endemic areas such as Western and Central Europe. Currently, there is no treatment available for BPFA. Due to the cross-reactivity between birch pollen and a range of implicated plant foods, birch pollen allergen immunotherapy (AIT) may be effective in the treatment of BPFA.
View Article and Find Full Text PDFBackground: Half (49%) of clinically diagnosed allergic rhinitis (AR) patients are sensitized to house dust mite (HDM). If allergen avoidance and symptomatic medication fail, allergen immunotherapy may be indicated.
Objective: We investigated safety and tolerability of HDM-sublingual immunotherapy by HDM-SLIT tablets in Dutch daily clinical practice.
Background: Pru p 3 and Pru p 7 have been implicated as risk factors for severe peach allergy. This study aimed to establish sensitization patterns to five peach components across Europe and in Japan, to explore their relation to pollen and foods and to predict symptom severity.
Methods: In twelve European (EuroPrevall project) and one Japanese outpatient clinic, a standardized clinical evaluation was conducted in 1231 patients who reported symptoms to peach and/or were sensitized to peach.
Since the discovery of immunoglobulin E (IgE) as a mediator of allergic diseases in 1967, our knowledge about the immunological mechanisms of IgE-mediated allergies has remarkably increased. In addition to understanding the immune response and clinical symptoms, allergy diagnosis and management depend strongly on the precise identification of the elicitors of the IgE-mediated allergic reaction. In the past four decades, innovations in bioscience and technology have facilitated the identification and production of well-defined, highly pure molecules for component-resolved diagnosis (CRD), allowing a personalized diagnosis and management of the allergic disease for individual patients.
View Article and Find Full Text PDFBackground: Food allergy to peanut and soybean, both legumes, is highly prevalent. The consumption of other legumes and legume protein isolates, some of which may be considered novel foods, is increasing. This may lead to an increase in sensitization and allergy and may pose a risk for legume-allergic (e.
View Article and Find Full Text PDFAccidental allergic reactions to food are one of the major problems in adult patients diagnosed with food allergy. Such reactions occur frequently, are often severe and are associated with higher medical and non-medical costs. The aim of this Perspective is to provide insight into the different factors involved in the occurrence of accidental allergic reactions and to present an overview of practical implications for effective preventive measures.
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- The study aims to understand why peanut allergy (PA) severity differs among patients by analyzing data from 393 cases, focusing on clinical profiles and predictive factors for severity.* -
- Results indicate that factors such as female sex, age of onset, and specific allergies (e.g., atopic dermatitis, latex) are linked to more severe PA, while birch pollen allergy is associated with milder cases.* -
- Although some IgE levels (like those to peanut extract and specific components) correlate with PA severity, clinical background factors remain the most effective predictors of an individual patient's risk for severe allergic reactions.*
Objectives: The use of systemic glucocorticoids (SGCs) is traditionally discouraged in the treatment of PsA and psoriasis due to the risk of psoriatic flares. However, despite this recommendation, SGCs are frequently prescribed for these patients. In this study we reappraise the old paradigm that SGCs are contra-indicated in the treatment of PsA and psoriasis.
View Article and Find Full Text PDFBackground: After a positive food challenge (FC), patients receive dietary advice regarding avoidance of the culprit food. We examined the frequency and variables associated with dietary adherence after a positive FC in adults.
Methods: In this prospective daily practice study, adults with a positive FC were included.
Background: Component-resolved diagnostics (CRD) help predict hazelnut allergy (HA) in children, but are of unknown diagnostic value in adults. This study aimed to evaluate the diagnostic accuracy of IgE to hazelnut extract and components in adults.
Methods: A Dutch population of consecutively presenting adults suspected of HA, who underwent a double-blind placebo-controlled food challenge, were included.
Background: The heterogeneity and lack of validation of existing severity scores for food allergic reactions limit standardization of case management and research advances. We aimed to develop and validate a severity score for food allergic reactions.
Methods: Following a multidisciplinary experts consensus, it was decided to develop a food allergy severity score (FASS) with ordinal (oFASS) and numerical (nFASS) formats.
Article Synopsis
- Legislation requires the labeling of major allergens in food, but does not address unintended allergens from shared production, leading to widespread use of "may contain" labels that food-allergic individuals often overlook.
- Efforts to standardize allergen risk management have been hampered by lack of agreement, resulting in inconsistent regulations and labeling practices across food businesses.
- The authors suggest establishing international reference doses for allergens to determine when "may contain" labels are unnecessary, using peanut as a benchmark due to extensive research on its low-level exposure risks.
Article Synopsis
- The study evaluated the effectiveness of a specific IgE test for diagnosing peanut allergies in children, aiming to reduce reliance on more invasive food challenge tests.
- It involved 150 children aged 3.5 to 18 in the Netherlands, comparing results from the IgE test with actual peanut ingestion to determine allergy status.
- The findings showed high diagnostic accuracy for the IgE test, identifying patients as peanut-tolerant or allergic, and potentially saving healthcare costs by using this method instead of national guidelines.
Background: Understanding consumers' interpretation of allergy information is crucial for effective food safety policies. We evaluated consumer understanding of allergy information on foods in controlled, experimental studies.
Method: Using 18 packaged foods, we evaluated consumer understanding of information about allergens in two experiments: First, a comparison of foods with no stated allergen versus allergen as a stated ingredient versus a precautionary allergen label (PAL); second, a comparison of three common variants of PAL.