The international WAO/EAACI guideline for the management of hereditary angioedema – the 2017 revision and update

Abstract Hereditary Angioedema (HAE) is a rare and disabling disease. Early diagnosis and appropriate therapy are essential. This update and revision of the global guideline for HAE provides up-to-date consensus recommendations for the management of HAE. In the development of this update and revision of the guideline, an international expert panel reviewed the existing evidence and developed 20 recommendations that were discussed, finalized and consented during the guideline consensus conference in June 2016 in Vienna. The final version of this update and revision of the guideline incorporates the contributions of a board of expert reviewers and the endorsing societies. The goal of this guideline update and revision is to provide clinicians and their patients with guidance that will assist them in making rational decisions in the management of HAE with deficient C1-inhibitor (type 1) and HAE with dysfunctional C1-inhibitor (type 2). The key clinical questions covered by these recommendations are: 1) How should HAE-1/2 be defined and classified?, 2) How should HAE-1/2 be diagnosed?, 3) Should HAE-1/2 patients receive prophylactic and/or on-demand treatment and what treatment options should be used?, 4) Should HAE-1/2 management be different for special HAE-1/2 patient groups such as pregnant/lactating women or children?, and 5) Should HAE-1/2 management incorporate self-administration of therapies and patient support measures? This article is co-published with permission in Allergy and the World Allergy Organization Journal

Thermal behaviour of Anopheles stephensi in response to infection with malaria and fungal entomopathogens

<p>Abstract</p> <p>Background</p> <p>Temperature is a critical determinant of the development of malaria parasites in mosquitoes, and hence the geographic distribution of malaria risk, but little is known about the thermal preferences of <it>Anopheles</it>. A number of other insects modify their thermal behaviour in response to infection. These alterations can be beneficial for the insect or for the infectious agent. Given current interest in developing fungal biopesticides for control of mosquitoes, <it>Anopheles stephensi </it>were examined to test whether mosquitoes showed thermally-mediated behaviour in response to infection with fungal entomopathogens and the rodent malaria, <it>Plasmodium yoelii</it>.</p> <p>Methods</p> <p>Over two experiments, groups of <it>An. stephensi </it>were infected with one of three entomopathogenic fungi, and/or <it>P. yoelii</it>. Infected and uninfected mosquitoes were released on to a thermal gradient (14 – 38°C) for "snapshot" assessments of thermal preference during the first five days post-infection. Mosquito survival was monitored for eight days and, where appropriate, oocyst prevalence and intensity was assessed.</p> <p>Results and conclusion</p> <p>Both infected and uninfected <it>An. stephensi </it>showed a non-random distribution on the gradient, indicating some capacity to behaviourally thermoregulate. However, chosen resting temperatures were not altered by any of the infections. There is thus no evidence that thermally-mediated behaviours play a role in determining malaria prevalence or that they will influence the performance of fungal biopesticides against adult <it>Anopheles</it>.</p

Role of MicroRNA Profile Modifications in Hepatitis C Virus-Related Mixed Cryoglobulinemia

Hepatitis C virus infection is closely related to lymphoproliferative disorders (LPDs), including mixed cryoglobulinemia (MC) and some lymphomas. Modification of the expression of specific microRNAs (miRNAs) has been associated with different autoimmune diseases and/or LPDs. No data exist about the modifications in miRNA expression in HCV-associated LPDs. The aim of this study was to analyze the expression levels of a panel of miRNAs previously associated with autoimmune/LPDs in a large population of HCV patients with and without MC or non-Hodgkin’s lymphoma (NHL), to identify potential markers of evolution of HCV infection. PBMC expression of miR-Let-7d, miR-16, miR-21, miR-26b, miR-146a and miR-155 was evaluated by real-time PCR in 167 HCV patients (75 with MC [MC-HCV], 11 with HCV-associated NHL [NHL-HCV], 81 without LPD [HCV]) and in 35 healthy subjects (HS). A significant increase in miR-21 (p<0.001), miR-16 (p<0.01) and miR-155 (p<0.01) expression was detected in PBMCs from only NHL patients whereas a significant decrease in miR-26b was detected in both MC and NHL subjects (p<0.01) when compared to HS and HCV groups. A restoration of miR-26b levels was observed in the post-treatment PBMCs of 35 HCV-MC patients experiencing complete virological and clinical response following antiviral therapy. This study, for the first time, shows that specific microRNAs in PBMC from HCV patients who developed MC and/or NHL are modulated differently. The specific, reversible downregulation of miR-26b strongly suggests the key role it plays in the pathogenesis of HCV-related LPDs and its usefulness as a biomarker of the evolution of HCV infection to these disorders

The impact of the locust control insecticide fipronil on termites and ants in two contrasting habitats in northern Australia

Termites and ants are key ecosystem engineers and nutrient re-cyclers. Extensive spraying of insecticidespresents a hazard to these insects. Using a control-treatment paired design comprising 3 replicate pairs ofplots per soil type, we quantified the impact of fipronil on termite consumption of cardboard and woodbaits, termite repair of deliberately damaged mounds as well as ant community composition and abundancein two different habitats (black vertisol and red kandosol soil) when applied aerially at a dose raterecommended for locust control in Australia. The studywas conducted from 2006 to 2008. The diversity oftermites and ants was higher and side-effects were more pronounced on kandosol than on vertisol soil.Overall termite consumption of cardboard baitswas significantly greater in unsprayed than in sprayed plotswhile losses were significantly greater in only one (vertisol) or two (kandosol) sprayed plots, respectively,compared to paired unsprayed plots. In the first year, termite consumption of wood baits was generallysignificantly greater on unsprayed than on sprayed kandosol while only marginally significant onunsprayed vertisol. Again, losses were significantly greater in one (vertisol) and two (kandosol) sprayedplots, respectively, compared to paired unsprayed plots. Overall termite consumption of wood baits wassimilar among plots in the second year post-spray although consumption remained significantly depressedin one pair of sprayed plots in each habitat. The capacity of the mound-building termite, Drepanotermesrubriceps (Froggatt) unique to kandosol, to repair damaged mounds was significantly reduced by fipronil.Furthermore, colonies of Iridomyrmex greensladei Shattuck, an ant species associated with mounds of D.rubriceps, were not re-located five months post-spray. Ant communities were also adversely affected. Onvertisol, species richness and relative abundance were similar among treatments, but significantly fewerspecies were caught in one individual sprayed plot. In contrast on kandosol, species richness and relativeabundance were significantly reduced by fipronil. A drop in species richnesswas observed in all and a dropin relative abundance in two sprayed plots. On vertisol, abundances of two species were significantly lowerin sprayed than in paired unsprayed plots. Likewise on kandosol, abundances of five species were significantlyreduced in sprayed plots, and one species was not caught at all. The weight of evidence of ourfindings indicate that fipronil, even at a low rate, will have substantial adverse impacts on the diversity andactivity of termites and ants, especially if applied within one to two years of earlier applications

New strategies in locust control

xi, 522 p. : ill. (some col.), maps ; 24 cm