Publications by authors named "Alexander Troelnikov"

5 Publications

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J Allergy Clin Immunol 2021 Jun 25. Epub 2021 Jun 25.

Immunology Department, Royal Adelaide Hospital, Adelaide, Australia. Electronic address:

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http://dx.doi.org/10.1016/j.jaci.2021.06.003DOI Listing
June 2021

Basophil reactivity to BNT162b2 is mediated by PEGylated lipid nanoparticles in patients with PEG allergy.

J Allergy Clin Immunol 2021 07 12;148(1):91-95. Epub 2021 May 12.

SA Pathology, Adelaide, Australia; Immunology Department, Royal Adelaide Hospital, Adelaide, Australia. Electronic address:

Background: The mechanisms underpinning allergic reactions to the BNT162b2 (Pfizer) COVID-19 vaccine remain unknown, with polyethylene glycol (PEG) contained in the lipid nanoparticle suspected as being the cause.

Objective: Our aim was to evaluate the performance of skin testing and basophil activation testing to PEG, polysorbate 80, and the BNT162b2 (Pfizer) and AZD1222 (AstraZeneca) COVID-19 vaccines in patients with a history of PEG allergy.

Methods: Three known individuals with PEG allergy and 3 healthy controls were recruited and evaluated for hypersensitivity to the BNT162b2 and AZD1222 vaccines, and to related compounds by skin testing and basophil activation, as measured by CD63 upregulation using flow cytometry.

Results: We found that the BNT162b2 vaccine induced positive skin test results in patients with PEG allergy, whereas the result of traditional PEG skin testing was negative in 2 of 3 patients. One patient was found to be cosensitized to both the BNT162b2 and AZD1222 vaccines because of cross-reactive PEG and polysorbate allergy. The BNT162b2 vaccine, but not PEG alone, induced dose-dependent activation of all patients' basophils ex vivo. Similar basophil activation could be induced by PEGylated liposomal doxorubicin, suggesting that PEGylated lipids within nanoparticles, but not PEG in its native state, are able to efficiently induce degranulation.

Conclusions: Our findings implicate PEG, as covalently modified and arranged on the vaccine lipid nanoparticle, as a potential trigger of anaphylaxis in response to BNT162b2, and highlight shortcomings of current skin testing protocols for allergy to PEGylated liposomal drugs.
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http://dx.doi.org/10.1016/j.jaci.2021.04.032DOI Listing
July 2021

A case of urethrovaginal fistula caused by granulomatosis with polyangiitis mimicking malignancy.

ANZ J Surg 2021 Apr 1. Epub 2021 Apr 1.

Department of Immunology, The Royal Adelaide Hospital, Adelaide, South Australia, Australia.

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http://dx.doi.org/10.1111/ans.16794DOI Listing
April 2021

Virtual Global Transplant Laboratory Standard Operating Protocol for Donor Alloantigen-specific Interferon-gamma ELISPOT Assay.

Transplant Direct 2016 Nov 20;2(11):e111. Epub 2016 Oct 20.

Section of Transplantation, Department of Surgery, The University of Chicago, Chicago, IL.

The quantification of frequency of IFN-γ-producing T cells responding to donor alloantigen using the IFN-γ enzyme linked immunosorbent spot (ELISPOT) holds potential for pretransplant and posttransplant immunological risk stratification. The effectiveness of this assay, and the ability to compare results generated by different studies, is dependent on the utilization of a standardized operating procedure (SOP). Key factors in assay standardization include the identification of primary and secondary antibody pairs, and the reading of the ELISPOT plate with a standardized automated algorithm. Here, we describe in detail, an SOP that should provide low coefficient of variation results. For multicenter trials, it is recommended that groups perform the ELISPOT assays locally but use a centralized ELISPOT reading facility, as this has been shown to be beneficial in reducing coefficient of variation between laboratories even when the SOP is strictly adhered to.
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http://dx.doi.org/10.1097/TXD.0000000000000621DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5096438PMC
November 2016

Peripheral natural killer cell and allo-stimulated T-cell function in kidney transplant recipients associate with cancer risk and immunosuppression-related complications.

Kidney Int 2015 Dec 12;88(6):1374-1382. Epub 2015 Aug 12.

Centre for Clinical and Experimental Transplantation (CCET), Central Northern Adelaide Renal and Transplantation Services (CNARTS), Royal Adelaide Hospital, Adelaide, SA, Australia.

Reducing immunosuppression has been proposed as a means of preventing cancer in kidney transplant recipients but this can precipitate graft rejection. Here we tested whether anti-tumor natural killer (NK) cell and allo-responsive T-cell function in kidney transplant recipients may predict cancer risk and define risk of rejection. NK cell function was measured by the release of lactate dehydrogenase and T-cell allo-response by interferon-γ quantification using a panel of reactive T-cell enzyme-linked immunospot (ELISPOT) in 56 kidney transplant recipients with current or past cancer and 26 kidney transplant recipients without cancer. NK function was significantly impaired and the allo-response was significantly lower in kidney transplant recipients with cancer. With prospective follow-up, kidney transplant recipients with poor NK cell function had a hazard ratio of 2.1 (95% confidence interval 0.97-5.00) for the combined end point of metastatic cancer, cancer-related death, or septic death. Kidney transplant recipients with low interferon-γ release were also more likely to reach this combined end point. Thus, posttransplant monitoring of allo-immunity and NK cell function is useful for assessing the risk of over immunosuppression for the development of malignancy and/or death from cancer or sepsis.
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http://dx.doi.org/10.1038/ki.2015.237DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4950672PMC
December 2015