jan de monchy - Academia.edu (original) (raw)
Papers by jan de monchy
Nederlands Tijdschrift voor Geneeskunde, 1996
Item does not contain fulltext2 p
Clinical and translational allergy, Jan 2, 2012
ABSTRACT: In less than half a century, allergy, originally perceived as a rare disease, has becom... more ABSTRACT: In less than half a century, allergy, originally perceived as a rare disease, has become a major public health threat, today affecting the lives of more than 60 million people in Europe, and probably close to one billion worldwide, thereby heavily impacting the budgets of public health systems. More disturbingly, its prevalence and impact are on the rise, a development that has been associated with environmental and lifestyle changes accompanying the continuous process of urbanization and globalization. Therefore, there is an urgent need to prioritize and concert research efforts in the field of allergy, in order to achieve sustainable results on prevention, diagnosis and treatment of this most prevalent chronic disease of the 21st century.The European Academy of Allergy and Clinical Immunology (EAACI) is the leading professional organization in the field of allergy, promoting excellence in clinical care, education, training and basic and translational research, all with t...
Clinical Immunology, 2012
From 1997, plasma-derived C1-inhibitor concentrate (Cetor®) has been available to HAE and AAE pat... more From 1997, plasma-derived C1-inhibitor concentrate (Cetor®) has been available to HAE and AAE patients. Recently, a virus reducing 15 nm nanofiltration step has been introduced in the production process. A randomized, double-blind controlled cross-over study was performed to compare the pharmacokinetics (PK) of nanofiltered (C1-INH-NF) with conventional C1-inhibitor (C1-INH). Efficacy and safety were investigated in an open-label, on-demand and a prophylactic study. No differences in pharmacokinetic parameters between C1-INH and C1-INH-NF were found (13 non-symptomatic HAE patients). Both C1-inhibitor products equally increased plasma C4 levels. In the on-demand study, 14 acute angioedema attacks in 8 patients were analyzed. In the prophylactic study, 1 AAE and 5 HAE patients experienced in total 31 attacks during 748 observation days. In total 180,000 units of C1-INH-NF were administered. No product-related adverse events occurred, and no anti-C1-antibodies were induced. Nanofiltration in the production process of C1-inhibitor did not affect the pharmacokinetics, efficacy, and safety.
Clinical and experimental immunology, 1983
Circulating immune complexes after a test meal were measured with three methods (PEG precipitatio... more Circulating immune complexes after a test meal were measured with three methods (PEG precipitation, Clq-ELISA and the indirect granulocyte phagocytosis test) in 10 controls, two symptomless persons with selective IgA deficiency and 14 patients with various types of glomerulonephritis, of which two patients (with idiopathic membranous glomerulopathy and local focal glomerulonephritis) also had selective IgA deficiency. The PEG and Clq-ELISA test did not show significant differences between the groups. In the two symptomless persons with selective IgA deficiency and in the patient with local focal glomerulonephritis and selective IgA deficiency the indirect granulocyte phagocytosis test (IGFT) showed a reproducible increase in IgG, IgM and complement containing immune complexes. In the last patient multiple food antigens were probably responsible for this phenomenon, a rapid amelioration of kidney function could be induced three times by giving an antigen free diet.
Respiratory Medicine, 2004
Background: Many epidemiological studies have assessed the prevalence of respiratory allergic dis... more Background: Many epidemiological studies have assessed the prevalence of respiratory allergic disorders in confined geographical locations. However, no study has yet established nationally prevalence data in a uniform manner representing whole countries and, thus, enabling cross-national comparisons. Methods: In 10 European countries, screening of random, representative samples of telephone numbers identified the target population aged 16-60. The inclusion criteria were a positive reporting of respiratory allergy to named allergens and, concomitantly, an unassisted description of appropriate symptoms. To obtain a truly representative, national prevalence of each country, the data were weighted against the actual sex and age composition. Results: 31,065 screening interviews were performed. The nationally balanced prevalence varied significantly among the 10 countries (Po0:001) from 11.7% in Spain to 33.6% in Italy. The overall weighted prevalence for Europe was 24.4%. Comparing males and females, overall, the odds-ratio was 0.874 (Po0:001). For age intervals of 16-29, 30-49, and 50-60 years, the odds-ratios for males were 1.104 (Po0:088), 0.827 (Po0:001), and 0.658 (Po0:001), respectively. The prevalence correlated inversely with age. Conclusions: Respiratory allergic disorders constitute a huge health problem in Europe, and the impact may be increasing as the prevalence is highest among young people.
Journal of Allergy and Clinical Immunology, 1994
Nederlands tijdschrift voor geneeskunde, 1981
Allergy, 1982
The protective activity of cromoglycate in histamine and propranolol bronchial provocation tests ... more The protective activity of cromoglycate in histamine and propranolol bronchial provocation tests was studied in seven asthmatic patients by inhalation of increasing doses of histamine and propranolol in the absence and presence of inhaled cromoglycate. Cromoglycate showed a significant protective effect on the propranolol challenge, whereas no protection against histamine challenge could be observed.
Journal of Allergy and Clinical Immunology, 1984
Bronchoalveolar lavage was performed in a patient during an acute stage of allergic bronchopulmon... more Bronchoalveolar lavage was performed in a patient during an acute stage of allergic bronchopulmonary aspergillosis (ABPA) and repeated 17 mo later during a remission stage and cessation of corticosteroid therapy. Measurement of protein concentrations (albumin, IgG, IgA, and IgM) by laser nephelometry and crossed immunoelectrophoresis indicates that transudation of proteins occurs from the circulation into the lung compartment during the acute stage of ABPA. Furthermore, comparing total Ig concentrations and titers of ELISA IgG, IgA, and IgM antibodies against Aspergillus fumigatus with the corresponding values of serum measurements indicates a preferential local production of IgA antibodies and IgM to a lesser extent. No indications were found for a local production of either IgG, total IgE, or IgE against A. fumigatus. During remission of the ABPA, titers of antibodies in the bronchoalveolar fluid (BAF) decreased to normal levels except IgA against A. fumigatus that remained elevated. The elevated titers of IgA in the BAF and IgE antibodies in the serum against A. fumigatus together with the elevated numbers of granulocytes in the BAF during the remission stage indicate that the immunologic situation is not yet normalized.
Allergy, 2012
Background: Risk indicators of indolent systemic mastocytosis (ISM) in adults with clinical suspi... more Background: Risk indicators of indolent systemic mastocytosis (ISM) in adults with clinical suspicion of ISM without accompanying skin lesions [urticaria pigmentosa (UP)] are lacking. This study aimed at creating a decision tree using clinical characteristics, serum tryptase, and the urinary histamine metabolites methylimidazole acetic acid (MIMA) and methylhistamine (MH) to select patients for bone marrow investigations to diagnose ISM. Methods: Retrospective data analysis of all adults, in whom bone marrow investigations were performed to diagnose ISM, was carried out. Results: In total, 142 patients were included. SM was absent in all 44 patients with tryptase <10 lg/l, in 45 of 98 (46%) patients with tryptase 10 lg/l and in 18 of 52 patients (35%) with tryptase >20 lg/l. Above 43 lg/l, all patients had ISM (n = 11). Male gender, insect venom anaphylaxis as presenting symptom, tryptase, MIMA, and MH were independent ISM predictors. If tryptase was 10 lg/l, the diagnostic accuracy of MIMA and MH was high (areas under the ROC curve 0.92). Conclusions: In suspected patients without UP, the ISM risk is very low (if present at all) if tryptase is <10 lg/l. If tryptase is 10 lg/l, this risk depends on MIMA and MH, being low if these are normal, but high if these are elevated. Male gender and insect venom anaphylaxis are additional risk indicators. We recommend refraining from bone marrow examinations in suspected patients without UP if tryptase is <10 lg/l. Our results question the reliability of the minor diagnostic World Health Organization criterion of tryptase >20 lg/l. Mastocytosis is characterized by a clonal proliferation of abnormal mast cells. Manifestations are because of release of mast cell mediators or mast cell infiltration in tissues. In many adult patients, the first sign of mastocytosis is typical red to brown macules and plaques, known as urticaria pigmentosa (UP). In systemic mastocytosis (SM), mast cells accumulate in bone marrow and other extra-dermal tissues. The large majority of the adults with SM have the indolent form (ISM). Some patients with SM lack UP (1). Without UP, a number of clinical conditions may lead to suspicion of SM, such as unexplained anaphylaxis, osteopathy (e.g. osteoporosis), neurological or constitutional symptoms, ulcerative gastrointestinal disease or chronic diarrhea, or an unexplained
Journal of Allergy and Clinical Immunology
Allergy, Jan 20, 2016
Genome wide association studies (GWAS) of asthma have identified single nucleotide polymorphisms ... more Genome wide association studies (GWAS) of asthma have identified single nucleotide polymorphisms (SNPs) that modestly increase the risk for asthma. This could be due to phenotypic heterogeneity of asthma. Bronchial hyperresponsiveness (BHR) is a phenotypic hallmark of asthma. We aim to identify susceptibility genes for asthma combined with BHR and analyse the presence of cis-eQTLs among replicated SNPs. Secondly, we compare the genetic association of SNPs previously associated with (doctor diagnosed) asthma to our GWAS of asthma with BHR. A GWAS was performed in 920 asthmatics with BHR and 980 controls. Top SNPs of our GWAS were analysed in four replication cohorts and lung cis-eQTL analysis was performed on replicated SNPs. We investigated association of SNPs previously associated with asthma in our data. 368 SNPs were followed up for replication. Six SNPs in genes encoding ABI3BP, NAF1, MICA and the 17q21 locus replicated in one or more cohorts, with one locus (17q21) achieving ge...
Nederlands Tijdschrift Voor Geneeskunde, 2011
Scandinavian journal of gastroenterology, 2015
Background and aims. Mesalazine is a key drug in the treatment of ulcerative colitis (UC). Intole... more Background and aims. Mesalazine is a key drug in the treatment of ulcerative colitis (UC). Intolerance to mesalazine has been described, including fever and gastrointestinal symptoms. Several case reports reported successful desensitization of patients with mesalazine intolerance. The aim was to assess the number of UC patients who are persistently intolerant to mesalazine after single-blinded rechallenge and to test the effectiveness of a rapid desensitization protocol in UC patients demonstrated mesalazine intolerance. Methods. This is a prospective, singlie-blind randomized study in UC patients who discontinued mesalazine because of intolerance. Patients with severe reactions were excluded. Eligible patients underwent a skin patch test with mesalazine followed by a single-blinded randomized crossover rechallenge with 500 mg mesalazine or placebo. Patients with symptoms upon rechallenge were admitted to the hospital for 3 days oral desensitization. Results. Nine of the 37 identifi...
Nederlands Tijdschrift voor Geneeskunde, 1996
Item does not contain fulltext2 p
Clinical and translational allergy, Jan 2, 2012
ABSTRACT: In less than half a century, allergy, originally perceived as a rare disease, has becom... more ABSTRACT: In less than half a century, allergy, originally perceived as a rare disease, has become a major public health threat, today affecting the lives of more than 60 million people in Europe, and probably close to one billion worldwide, thereby heavily impacting the budgets of public health systems. More disturbingly, its prevalence and impact are on the rise, a development that has been associated with environmental and lifestyle changes accompanying the continuous process of urbanization and globalization. Therefore, there is an urgent need to prioritize and concert research efforts in the field of allergy, in order to achieve sustainable results on prevention, diagnosis and treatment of this most prevalent chronic disease of the 21st century.The European Academy of Allergy and Clinical Immunology (EAACI) is the leading professional organization in the field of allergy, promoting excellence in clinical care, education, training and basic and translational research, all with t...
Clinical Immunology, 2012
From 1997, plasma-derived C1-inhibitor concentrate (Cetor®) has been available to HAE and AAE pat... more From 1997, plasma-derived C1-inhibitor concentrate (Cetor®) has been available to HAE and AAE patients. Recently, a virus reducing 15 nm nanofiltration step has been introduced in the production process. A randomized, double-blind controlled cross-over study was performed to compare the pharmacokinetics (PK) of nanofiltered (C1-INH-NF) with conventional C1-inhibitor (C1-INH). Efficacy and safety were investigated in an open-label, on-demand and a prophylactic study. No differences in pharmacokinetic parameters between C1-INH and C1-INH-NF were found (13 non-symptomatic HAE patients). Both C1-inhibitor products equally increased plasma C4 levels. In the on-demand study, 14 acute angioedema attacks in 8 patients were analyzed. In the prophylactic study, 1 AAE and 5 HAE patients experienced in total 31 attacks during 748 observation days. In total 180,000 units of C1-INH-NF were administered. No product-related adverse events occurred, and no anti-C1-antibodies were induced. Nanofiltration in the production process of C1-inhibitor did not affect the pharmacokinetics, efficacy, and safety.
Clinical and experimental immunology, 1983
Circulating immune complexes after a test meal were measured with three methods (PEG precipitatio... more Circulating immune complexes after a test meal were measured with three methods (PEG precipitation, Clq-ELISA and the indirect granulocyte phagocytosis test) in 10 controls, two symptomless persons with selective IgA deficiency and 14 patients with various types of glomerulonephritis, of which two patients (with idiopathic membranous glomerulopathy and local focal glomerulonephritis) also had selective IgA deficiency. The PEG and Clq-ELISA test did not show significant differences between the groups. In the two symptomless persons with selective IgA deficiency and in the patient with local focal glomerulonephritis and selective IgA deficiency the indirect granulocyte phagocytosis test (IGFT) showed a reproducible increase in IgG, IgM and complement containing immune complexes. In the last patient multiple food antigens were probably responsible for this phenomenon, a rapid amelioration of kidney function could be induced three times by giving an antigen free diet.
Respiratory Medicine, 2004
Background: Many epidemiological studies have assessed the prevalence of respiratory allergic dis... more Background: Many epidemiological studies have assessed the prevalence of respiratory allergic disorders in confined geographical locations. However, no study has yet established nationally prevalence data in a uniform manner representing whole countries and, thus, enabling cross-national comparisons. Methods: In 10 European countries, screening of random, representative samples of telephone numbers identified the target population aged 16-60. The inclusion criteria were a positive reporting of respiratory allergy to named allergens and, concomitantly, an unassisted description of appropriate symptoms. To obtain a truly representative, national prevalence of each country, the data were weighted against the actual sex and age composition. Results: 31,065 screening interviews were performed. The nationally balanced prevalence varied significantly among the 10 countries (Po0:001) from 11.7% in Spain to 33.6% in Italy. The overall weighted prevalence for Europe was 24.4%. Comparing males and females, overall, the odds-ratio was 0.874 (Po0:001). For age intervals of 16-29, 30-49, and 50-60 years, the odds-ratios for males were 1.104 (Po0:088), 0.827 (Po0:001), and 0.658 (Po0:001), respectively. The prevalence correlated inversely with age. Conclusions: Respiratory allergic disorders constitute a huge health problem in Europe, and the impact may be increasing as the prevalence is highest among young people.
Journal of Allergy and Clinical Immunology, 1994
Nederlands tijdschrift voor geneeskunde, 1981
Allergy, 1982
The protective activity of cromoglycate in histamine and propranolol bronchial provocation tests ... more The protective activity of cromoglycate in histamine and propranolol bronchial provocation tests was studied in seven asthmatic patients by inhalation of increasing doses of histamine and propranolol in the absence and presence of inhaled cromoglycate. Cromoglycate showed a significant protective effect on the propranolol challenge, whereas no protection against histamine challenge could be observed.
Journal of Allergy and Clinical Immunology, 1984
Bronchoalveolar lavage was performed in a patient during an acute stage of allergic bronchopulmon... more Bronchoalveolar lavage was performed in a patient during an acute stage of allergic bronchopulmonary aspergillosis (ABPA) and repeated 17 mo later during a remission stage and cessation of corticosteroid therapy. Measurement of protein concentrations (albumin, IgG, IgA, and IgM) by laser nephelometry and crossed immunoelectrophoresis indicates that transudation of proteins occurs from the circulation into the lung compartment during the acute stage of ABPA. Furthermore, comparing total Ig concentrations and titers of ELISA IgG, IgA, and IgM antibodies against Aspergillus fumigatus with the corresponding values of serum measurements indicates a preferential local production of IgA antibodies and IgM to a lesser extent. No indications were found for a local production of either IgG, total IgE, or IgE against A. fumigatus. During remission of the ABPA, titers of antibodies in the bronchoalveolar fluid (BAF) decreased to normal levels except IgA against A. fumigatus that remained elevated. The elevated titers of IgA in the BAF and IgE antibodies in the serum against A. fumigatus together with the elevated numbers of granulocytes in the BAF during the remission stage indicate that the immunologic situation is not yet normalized.
Allergy, 2012
Background: Risk indicators of indolent systemic mastocytosis (ISM) in adults with clinical suspi... more Background: Risk indicators of indolent systemic mastocytosis (ISM) in adults with clinical suspicion of ISM without accompanying skin lesions [urticaria pigmentosa (UP)] are lacking. This study aimed at creating a decision tree using clinical characteristics, serum tryptase, and the urinary histamine metabolites methylimidazole acetic acid (MIMA) and methylhistamine (MH) to select patients for bone marrow investigations to diagnose ISM. Methods: Retrospective data analysis of all adults, in whom bone marrow investigations were performed to diagnose ISM, was carried out. Results: In total, 142 patients were included. SM was absent in all 44 patients with tryptase <10 lg/l, in 45 of 98 (46%) patients with tryptase 10 lg/l and in 18 of 52 patients (35%) with tryptase >20 lg/l. Above 43 lg/l, all patients had ISM (n = 11). Male gender, insect venom anaphylaxis as presenting symptom, tryptase, MIMA, and MH were independent ISM predictors. If tryptase was 10 lg/l, the diagnostic accuracy of MIMA and MH was high (areas under the ROC curve 0.92). Conclusions: In suspected patients without UP, the ISM risk is very low (if present at all) if tryptase is <10 lg/l. If tryptase is 10 lg/l, this risk depends on MIMA and MH, being low if these are normal, but high if these are elevated. Male gender and insect venom anaphylaxis are additional risk indicators. We recommend refraining from bone marrow examinations in suspected patients without UP if tryptase is <10 lg/l. Our results question the reliability of the minor diagnostic World Health Organization criterion of tryptase >20 lg/l. Mastocytosis is characterized by a clonal proliferation of abnormal mast cells. Manifestations are because of release of mast cell mediators or mast cell infiltration in tissues. In many adult patients, the first sign of mastocytosis is typical red to brown macules and plaques, known as urticaria pigmentosa (UP). In systemic mastocytosis (SM), mast cells accumulate in bone marrow and other extra-dermal tissues. The large majority of the adults with SM have the indolent form (ISM). Some patients with SM lack UP (1). Without UP, a number of clinical conditions may lead to suspicion of SM, such as unexplained anaphylaxis, osteopathy (e.g. osteoporosis), neurological or constitutional symptoms, ulcerative gastrointestinal disease or chronic diarrhea, or an unexplained
Journal of Allergy and Clinical Immunology
Allergy, Jan 20, 2016
Genome wide association studies (GWAS) of asthma have identified single nucleotide polymorphisms ... more Genome wide association studies (GWAS) of asthma have identified single nucleotide polymorphisms (SNPs) that modestly increase the risk for asthma. This could be due to phenotypic heterogeneity of asthma. Bronchial hyperresponsiveness (BHR) is a phenotypic hallmark of asthma. We aim to identify susceptibility genes for asthma combined with BHR and analyse the presence of cis-eQTLs among replicated SNPs. Secondly, we compare the genetic association of SNPs previously associated with (doctor diagnosed) asthma to our GWAS of asthma with BHR. A GWAS was performed in 920 asthmatics with BHR and 980 controls. Top SNPs of our GWAS were analysed in four replication cohorts and lung cis-eQTL analysis was performed on replicated SNPs. We investigated association of SNPs previously associated with asthma in our data. 368 SNPs were followed up for replication. Six SNPs in genes encoding ABI3BP, NAF1, MICA and the 17q21 locus replicated in one or more cohorts, with one locus (17q21) achieving ge...
Nederlands Tijdschrift Voor Geneeskunde, 2011
Scandinavian journal of gastroenterology, 2015
Background and aims. Mesalazine is a key drug in the treatment of ulcerative colitis (UC). Intole... more Background and aims. Mesalazine is a key drug in the treatment of ulcerative colitis (UC). Intolerance to mesalazine has been described, including fever and gastrointestinal symptoms. Several case reports reported successful desensitization of patients with mesalazine intolerance. The aim was to assess the number of UC patients who are persistently intolerant to mesalazine after single-blinded rechallenge and to test the effectiveness of a rapid desensitization protocol in UC patients demonstrated mesalazine intolerance. Methods. This is a prospective, singlie-blind randomized study in UC patients who discontinued mesalazine because of intolerance. Patients with severe reactions were excluded. Eligible patients underwent a skin patch test with mesalazine followed by a single-blinded randomized crossover rechallenge with 500 mg mesalazine or placebo. Patients with symptoms upon rechallenge were admitted to the hospital for 3 days oral desensitization. Results. Nine of the 37 identifi...