Publications
291 results found
Turner PJ, Southern J, Andrews N, et al., 2015, Safety of live attenuated influenza vaccine in young people with egg allergy: multicentre prospective cohort study, British Medical Journal, Vol: 351, Pages: 1-7, ISSN: 1468-5833
Study question How safe is live attenuated influenza vaccine (LAIV), which contains egg protein, in young people with egg allergy?Methods In this open label, phase IV intervention study, 779 young people (2-18 years) with egg allergy were recruited from 30 UK allergy centres and immunised with LAIV. The cohort included 270 (34.7%) young people with previous anaphylaxis to egg, of whom 157 (20.1%) had experienced respiratory and/or cardiovascular symptoms. 445 (57.1%) had doctor diagnosed asthma or recurrent wheeze. Participants were observed for at least 30 minutes after vaccination and followed-up by telephone 72 hours later. Participants with a history of recurrent wheeze or asthma underwent further follow-up four weeks later. The main outcome measure was incidence of an adverse event within two hours of vaccination in young people with egg allergy.Study answer and limitations No systemic allergic reactions occurred (upper 95% confidence interval for population 0.47% and in participants with anaphylaxis to egg 1.36%). Nine participants (1.2%, 95% CI 0.5% to 2.2%) experienced mild symptoms, potentially consistent with a local, IgE mediated allergic reaction. Delayed events potentially related to the vaccine were reported in 221 participants. 62 participants (8.1%, 95% CI for population 6.3% to 10.3%) experienced lower respiratory tract symptoms within 72 hours, including 29 with parent reported wheeze. No participants were admitted to hospital. No increase in lower respiratory tract symptoms occurred in the four weeks after vaccination (assessed with asthma control test). The study cohort may represent young people with more severe allergy requiring specialist input, since they were recruited from secondary and tertiary allergy centres.What this study adds LAIV is associated with a low risk of systemic allergic reactions in young people with egg allergy. The vaccine seems to be well tolerated in those with well controlled asthma or recurrent wheeze.
Turner PJ, Allen KJ, Mehr S, et al., 2015, Knowledge, practice, and views on precautionary allergen labeling for the management of patients with IgE-mediated food allergy - a survey of Australasian and UK health care professionals, Journal of Allergy and Clinical Immunology: In Practice, Vol: 4, Pages: 165-167.e14, ISSN: 2213-2198
Umasunthar T, Leonardi-Bee J, Turner PJ, et al., 2015, Incidence of food anaphylaxis in people with food allergy: a systematic review and meta-analysis., Clinical & Experimental Allergy, Vol: 45, Pages: 1621-1636, ISSN: 1365-2222
BACKGROUND: Food allergy is a common cause of anaphylaxis, but the incidence of anaphylaxis in food allergic people is unknown. METHODS: We undertook a systematic review and meta-analysis, using the inverse variance method. Two authors selected studies by consensus, independently extracted data and assessed study quality using the Newcastle-Ottawa assessment scale. We searched Medline, Embase, PsychInfo, CINAHL, Web of Science, LILACS and AMED between January 1946 and September 2012, and recent conference abstracts. We included registries, databases or cohort studies which described the number of food anaphylaxis cases in a defined population and time period, and applied an assumed population prevalence of food allergy. RESULTS: We included data from 34 studies. There was high heterogeneity between study results, possibly due to variation in study populations, anaphylaxis definition and data collection methods. In food allergic people, medically-coded food anaphylaxis had an incidence rate of 0.14 per 100 person years (95% CI 0.05, 0.35; range 0.01, 1.28). In sensitivity analysis using different estimated food allergy prevalence, the incidence varied from 0.11 to 0.21 per 100 person years. At age 0-19 the incidence rate for anaphylaxis in food allergic people was 0.20 (95%CI 0.09, 0.43; range 0.01, 2.55; sensitivity analysis 0.08, 0.39). At age 0-4 an incidence rate of up to 7.00 per 100 person years has been reported. In food allergic people, hospital admission due to food anaphylaxis had an incidence rate of 0.09 (95% CI 0.01, 0.67; range 0.02, 0.81) per 1000 person years; 0.20 (95% CI 0.10, 0.43; range 0.04, 2.25) at age 0-19 and 0.50 (0.26, 0.93; range 0.08, 2.82) at age 0-4. CONCLUSION: In food allergic people, the incidence of food allergic reactions which are coded as anaphylaxis by healthcare systems is low at all ages, but appears to be highest in young children. This article is protected by copyright. All rights reserved.
Moonesinghe H, Mackenzie H, Chin YT, et al., 2015, Fish and shellfish allergy: an in-depth investigation of adults in the UK, Congress of the European-Academy-of-Allergy-and-Clinical-Immunology, Publisher: WILEY-BLACKWELL, Pages: 599-599, ISSN: 0105-4538
Ruiz Garcia M, Hayward C, Sim M, et al., 2015, Electrocardiographic changes during acute peanut allergic reactions in adults, Congress of the European-Academy-of-Allergy-and-Clinical-Immunology, Publisher: WILEY-BLACKWELL, Pages: 492-492, ISSN: 0105-4538
Garcia RM, Wilson E, Clark A, et al., 2015, Cardiovascular haemodynamic changes during acute peanut allergic reactions in adults, Congress of the European-Academy-of-Allergy-and-Clinical-Immunology, Publisher: WILEY-BLACKWELL, Pages: 32-33, ISSN: 0105-4538
Turner PJ, Ruiz-Garcia M, Parkin R, et al., 2015, Basophil activation during - but not prior to - IgE-mediated allergic reactions to peanut correlates with symptom severity, Congress of the European-Academy-of-Allergy-and-Clinical-Immunology, Publisher: WILEY-BLACKWELL, Pages: 48-48, ISSN: 0105-4538
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- Citations: 1
Dua S, Ruiz-Garcia M, Bond S, et al., 2015, Thresholds reactivity and clinical evaluation (TRACE) study: investigation of the effect of extrinsic factors on peanut allergic reactions, Congress of the European-Academy-of-Allergy-and-Clinical-Immunology, Publisher: WILEY-BLACKWELL, Pages: 183-184, ISSN: 0105-4538
Turner PJ, Mehr S, Shamji MH, et al., 2015, Boiled oral peanut immunotherapy (BOPI) - a novel means of safer therapy for peanut allergy?, Congress of the European-Academy-of-Allergy-and-Clinical-Immunology, Publisher: WILEY-BLACKWELL, Pages: 110-110, ISSN: 0105-4538
DunnGalvin A, Chan C-H, Crevel R, et al., 2015, Precautionary allergen labelling: perspectives from key stakeholder groups, ALLERGY, Vol: 70, Pages: 1039-1051, ISSN: 0105-4538
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- Citations: 113
Turner PJ, Southern J, Andrews NJ, et al., 2015, Safety of live attenuated influenza vaccine in atopic children with egg allergy, Journal of Allergy and Clinical Immunology, Vol: 136, Pages: 376-381, ISSN: 1097-6825
BackgroundLive attenuated influenza vaccine (LAIV) is an intranasal vaccine recently incorporated into the United Kingdom immunization schedule. However, it contains egg protein and, in the absence of safety data, is contraindicated in patients with egg allergy. Furthermore, North American guidelines recommend against its use in asthmatic children.ObjectiveWe sought to assess the safety of LAIV in children with egg allergy.MethodsWe performed a prospective, multicenter, open-label, phase IV intervention study involving 11 secondary/tertiary centers in the United Kingdom. Children with egg allergy (defined as a convincing clinical reaction to egg within the past 12 months and/or >95% likelihood of clinical egg allergy as per published criteria) were recruited. LAIV was administered under medical supervision, with observation for 1 hour and telephone follow-up 72 hours later.ResultsFour hundred thirty-three doses were administered to 282 children with egg allergy (median, 4.9 years; range, 2-17 years); 115 (41%) had experienced prior anaphylaxis to egg. A physician's diagnosis of asthma/recurrent wheezing was noted in 67%, and 51% were receiving regular preventer therapy. There were no systemic allergic reactions (upper 95% CI for population, 1.3%). Eight children experienced mild self-limiting symptoms, which might have been due an IgE-mediated allergic reaction. Twenty-six (9.4%; 95% CI for population, 6.2% to 13.4%) children experienced lower respiratory tract symptoms within 72 hours, including 13 with parent-reported wheeze. None of these episodes required medical intervention beyond routine treatment.ConclusionsIn contrast to current recommendations, LAIV appears to be safe for use in children with egg allergy. Furthermore, the vaccine appears to be well tolerated in children with a diagnosis of asthma or recurrent wheeze.
Umasunthar T, Procktor A, Hodes M, et al., 2015, Patients' ability to treat anaphylaxis using adrenaline autoinjectors: a randomized controlled trial, ALLERGY, Vol: 70, Pages: 855-863, ISSN: 0105-4538
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- Citations: 45
Turner PJ, Dawson TC, Skypala IJ, et al., 2015, Management of pollen food and oral allergy syndrome by health care professionals in the United Kingdom, ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, Vol: 114, Pages: 427-+, ISSN: 1081-1206
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- Citations: 12
Brough HA, Turner PJ, Wright T, et al., 2015, Dietary management of peanut and tree nut allergy: what exactly should patients avoid?, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 45, Pages: 859-871, ISSN: 0954-7894
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- Citations: 41
Turner PJ, Gowland MH, Sharma V, et al., 2015, Increase in anaphylaxis-related hospitalizations but no increase in fatalities: An analysis of United Kingdom national anaphylaxis data, 1992-2012, Journal of Allergy and Clinical Immunology, Vol: 135, Pages: 956-963.e1, ISSN: 0091-6749
BackgroundThe incidence of anaphylaxis might be increasing. Data for fatal anaphylaxis are limited because of the rarity of this outcome.ObjectiveWe sought to document trends in anaphylaxis admissions and fatalities by age, sex, and cause in England and Wales over a 20-year period.MethodsWe extracted data from national databases that record hospital admissions and fatalities caused by anaphylaxis in England and Wales (1992-2012) and crosschecked fatalities against a prospective fatal anaphylaxis registry. We examined time trends and age distribution for fatal anaphylaxis caused by food, drugs, and insect stings.ResultsHospital admissions from all-cause anaphylaxis increased by 615% over the time period studied, but annual fatality rates remained stable at 0.047 cases (95% CI, 0.042-0.052 cases) per 100,000 population. Admission and fatality rates for drug- and insect sting–induced anaphylaxis were highest in the group aged 60 years and older. In contrast, admissions because of food-triggered anaphylaxis were most common in young people, with a marked peak in the incidence of fatal food reactions during the second and third decades of life. These findings are not explained by age-related differences in rates of hospitalization.ConclusionsHospitalizations for anaphylaxis increased between 1992 and 2012, but the incidence of fatal anaphylaxis did not. This might be due to increasing awareness of the diagnosis, shifting patterns of behavior in patients and health care providers, or both. The age distribution of fatal anaphylaxis varies significantly according to the nature of the eliciting agent, which suggests a specific vulnerability to severe outcomes from food-induced allergic reactions in the second and third decades.
Turner PJ, McMahon O, Switzer A, et al., 2015, Marked Increase in Basophil Activation during Non-Anaphylactic Allergic Reactions to Peanut in Man, Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology (AAAAI), Publisher: MOSBY-ELSEVIER, Pages: AB33-AB33, ISSN: 0091-6749
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- Citations: 3
Boyle RJ, Procktor A, Hodes M, et al., 2015, Epinephrine Autoinjector Use One Year after Training: A Randomised Controlled Comparison of Two Different Devices, Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology (AAAAI), Publisher: MOSBY-ELSEVIER, Pages: AB209-AB209, ISSN: 0091-6749
Turner PJ, Campbell DE, 2014, A food allergy syndrome by any other name?, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 44, Pages: 1458-1460, ISSN: 0954-7894
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- Citations: 8
Turner PJ, Erlewyn-Lajeunesse M, 2014, Intranasal live-attenuated influenza vaccine (LAIV) is unlikely to cause egg-mediated allergic reactions in egg-allergic children, JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, Vol: 3, Pages: 312-313, ISSN: 2213-2198
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- Citations: 6
Turner PJ, Kumar K, Fox AT, 2014, Skin testing with raw egg does not predict tolerance to baked egg in egg-allergic children, PEDIATRIC ALLERGY AND IMMUNOLOGY, Vol: 25, Pages: 657-661, ISSN: 0905-6157
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- Citations: 18
Lee E, Mehr S, Turner PJ, et al., 2014, Adherence to extensively heated egg and cow's milk after successful oral food challenge, JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, Vol: 3, Pages: 125-+, ISSN: 2213-2198
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- Citations: 17
Mehr S, Turner PJ, Joshi P, et al., 2014, Safety and clinical predictors of reacting to extensively heated cow's milk challenge in cow's milk-allergic children, ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, Vol: 113, Pages: 425-429, ISSN: 1081-1206
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- Citations: 43
Kumar K, Turner PJ, Fox AT, 2014, Ratio of egg extract : raw egg skin prick testing as a predictor of tolerance to baked egg at formal food challenge, British Society for Allergy & Clinical Immunology Annual Meeting 2014, Publisher: Wiley, ISSN: 0954-7894
Turner PJ, Mehr S, Joshi P, et al., 2014, Safety and clinical predictors of reacting to extensively-heated cow's milk challenge in cow's milk-allergic children: a prospective cohort study, ALLERGY, Vol: 69, Pages: 382-382, ISSN: 0105-4538
Mehr S, Joshi P, Turner PJ, et al., 2014, SAFETY AND CLINICAL PREDICTORS OF REACTING TO EXTENSIVELY-HEATED COW'S MILK CHALLENGE IN COW'S MILK-ALLERGIC CHILDREN: A PROSPECTIVE COHORT STUDY, INTERNAL MEDICINE JOURNAL, Vol: 44, Pages: 17-17, ISSN: 1444-0903
Mehr S, Turner PJ, Campbell DE, et al., 2014, TOLERANCE TO BOILED PEANUT IN PEANUT-ALLERGIC CHILDREN, INTERNAL MEDICINE JOURNAL, Vol: 44, Pages: 17-17, ISSN: 1444-0903
Lee E, Mehr S, Turner PJ, et al., 2014, ADHERENCE TO EXTENSIVELY HEATED EGG AND COW'S MILK FOLLOWING SUCCESSFUL ORAL FOOD CHALLENGE, INTERNAL MEDICINE JOURNAL, Vol: 44, Pages: 5-5, ISSN: 1444-0903
Mehr S, Allen R, Boros C, et al., 2014, CRYOPYRIN ASSOCIATED PERIODIC SYNDROMES: PREVALENCE, CLINICAL FEATURES, TREATMENT AND OUTCOMES IN AUSTRALIAN CHILDREN AND ADULTS, INTERNAL MEDICINE JOURNAL, Vol: 44, Pages: 15-16, ISSN: 1444-0903
Turner PJ, Mehr S, Sayers R, et al., 2014, Tolerance to boiled peanut in peanut-allergic children: potential for oral immunotherapy?, European-Academy-of-Allergy-and-Clinical-Immunology Congress, Publisher: WILEY-BLACKWELL, Pages: 382-382, ISSN: 0105-4538
Turner PJ, Mehr S, Sayers R, et al., 2014, Loss of allergenic proteins during boiling explains tolerance to boiled peanut in peanut allergy, JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, Vol: 134, Pages: 751-753, ISSN: 0091-6749
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- Citations: 38
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