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Current Opinion in Allergy and Clinical Immunology

Sandra Nora Gonzalez-Diaz, Rosalaura Virginia Villarreal-Gonzalez, Cindy Elizabeth De Lira-Quezada, Rosa Ivett Guzman-Avilan
PURPOSE OF REVIEW: Asthma is a chronic heterogeneous respiratory disease which is characterized by airflow limitation and variable respiratory symptoms. Asthma in patients more than 65 years of age has an important negative impact on quality of life. The pathophysiology and treatment of asthma in older patients are not as well identified as in younger groups of ages. In this review we intend to outline characteristics found in elderly adults which distinguish them from other age groups of patients with asthma...
February 8, 2019: Current Opinion in Allergy and Clinical Immunology
Luciana Kase Tanno, Pascal Demoly
PURPOSE OF REVIEW: To review and understand the impact of the outcome measures of allergic and hypersensitivity conditions for the WHO's International Classification of Diseases (ICD) and its impact in the management of anaphylaxis and identify potential strategies to improve patients' care and prevention. RECENT FINDINGS: The pioneer chapter addressed to allergic and hypersensitivity conditions in the 11th version of the WHO's ICD is the result of the evidence-based academic technical actions consistently following of collaborations of the allergy community and integrated international initiatives in order to reach quality outcomes measures of allergies worldwide...
February 5, 2019: Current Opinion in Allergy and Clinical Immunology
Louise Selby, Sejal Saglani
PURPOSE OF REVIEW: Children with poor asthma control despite maximal maintenance therapy have problematic severe asthma (PSA). A step-wise approach including objective adherence monitoring and a detailed multidisciplinary team assessment to identify modifiable factors contributing to poor control is needed prior to considering therapy escalation. Pathophysiological phenotyping in those with true severe therapy-resistant asthma (STRA) and the current array of add-on therapies will be discussed...
January 31, 2019: Current Opinion in Allergy and Clinical Immunology
Luis Felipe Ensina, Ana Paula Cusato-Ensina, Ricardo Cardona
PURPOSE OF REVIEW: We reviewed in this article, the recent advances in CSU physiopathology and potential clinical and laboratory biomarkers in CSU. RECENT FINDINGS: In addition to the central role of mast cells in urticaria physiopathology, increased interest in basophils has arisen. Recent data corroborate the autoimmunity pathway as one of the main pathways in mast cell activation. The association of inflammatory cytokines, heat shock proteins and staphylococcal infection with CSU are also reviewed...
January 22, 2019: Current Opinion in Allergy and Clinical Immunology
Juan M Inclan-Rico, John J Ponessa, Mark C Siracusa
PURPOSE OF REVIEW: Allergic diseases represent a growing global health concern, especially among pediatric populations. Current strategies for the treatment of allergies and asthma focus on limiting the severity of the symptoms; however, additional research investigating the mechanisms promoting inflammation in the context of allergic reactions may lead to the development of more effective therapeutic strategies. RECENT FINDINGS: Novel studies have highlighted the contributions of innate lymphocytes to the induction of inflammatory responses to allergens...
January 21, 2019: Current Opinion in Allergy and Clinical Immunology
Elise M Slob, Anke-Hilse Maitland-Van der Zee, Gerard H Koppelman, Mariëlle W Pijnenburg
PURPOSE OF REVIEW: Childhood asthma is a heterogeneous disease and many children have uncontrolled disease. Therefore an individualized approach is needed to improve asthma outcomes in children. Precision medicine using clinical characteristics, biomarkers, and the rapidly involving field of genomics and pharmacogenomics aims to achieve asthma control and reduce future risks with less side-effects in individual children with asthma. RECENT FINDINGS: It is not yet possible to select treatment options on clinical characteristics...
January 14, 2019: Current Opinion in Allergy and Clinical Immunology
Brooke I Polk, Chitra Dinakar
PURPOSE OF REVIEW: Asthma exacerbations are associated with a significant burden to both the individual patient and to the healthcare system. Patients often step-up home therapies in response to increased asthma symptoms, and the asthma action plan was created to empower patients to self-manage their asthma care. The yellow (intermediate) zone of the asthma action plan is frequently poorly defined, and current Expert Panel Report 3 guideline recommendations are not effective for all patients...
January 14, 2019: Current Opinion in Allergy and Clinical Immunology
Ferran Morell, Iñigo Ojanguren, María-Jesús Cruz
PURPOSE OF REVIEW: To discuss the diagnostic methods currently used in the study of patients with hypersensitivity pneumonitis, with special emphasis on the most recent contributions published in the medical literature regarding the diagnosis of occupational hypersensitivity pneumonitis (OHP). This review presents an update of the use of these diagnostic tests, a controversial issue among experts. RECENT FINDINGS: In spite of the multiple attempts at systematization and the publication of expert consensus statements, standardizing and diagnostic methods and criteria remain particularly difficult...
January 14, 2019: Current Opinion in Allergy and Clinical Immunology
Ekaterina Safroneeva, Alain M Schoepfer
PURPOSE OF REVIEW: In adults with eosinophilic esophagitis (EoE), a chronic, inflammatory immune-mediated condition of the esophagus, both inflammation and fibrosis are likely associated with symptom generation. Therefore, assessing symptom-based patient-reported outcomes (PROs), defined by US Food and Drug Administration as 'any report of the status of a patient's health condition that comes directly from the patients, without interpretation of the patient's response by a clinician or anyone else', is important in the context of trials and observational studies of emerging therapies...
January 14, 2019: Current Opinion in Allergy and Clinical Immunology
Christina G Kwong, Leonard B Bacharier
PURPOSE OF REVIEW: The purpose of this review is to provide an overview of the identified phenotypes of preschool wheezing. RECENT FINDINGS: Early life wheezing patterns have been described in multiple populations, with several commonalities found between cohorts. Early life environmental exposures have been found to be differentially associated with preschool wheezing phenotypes and their future trajectories. These include allergen and microbe exposure, environmental tobacco smoke exposure, and maternal stress and depression...
January 10, 2019: Current Opinion in Allergy and Clinical Immunology
Ug Nalin, Sean Stout, Jay M Portnoy
PURPOSE OF REVIEW: Asthma affects more than 25 million people worldwide and continues to grow in prevalence. According to a center for disease control and prevention (CDC) report, the total annual cost of asthma in the United States between 2008 and 2013, including medical care, absenteeism, and mortality, was $81.9 billion. Although the National Institute of Health guidelines recommend fixed inhaled corticosteroid (ICS) dosing, the 2008-2010 Medical Expenditure Panel Survey showed that asthma is still poorly controlled...
January 10, 2019: Current Opinion in Allergy and Clinical Immunology
Lamia Dahdah, Stefania Arasi, Rocco Luigi Valluzzi, Vincenzo Fierro, Alessandro Fiocchi
PURPOSE OF REVIEW: Allergic diseases are increasing worldwide and are considered an important public health problem causing severe and even life-threatening reactions. The creation of guidelines aims to help clinicians improving the quality of diagnosis and management of such diseases. Clinical practice guidelines alone are not sufficient and there is a need for implementation strategies for their introduction into daily practice. We report here the main international allergy guidelines with a more focused look on the Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guidelines and their effect on clinical practice...
January 9, 2019: Current Opinion in Allergy and Clinical Immunology
Augusto A Litonjua
PURPOSE OF REVIEW: To review the literature of the past 18 months (April 2017 through September, 2018) relating to vitamin D and childhood asthma. RECENT FINDINGS: A combined analysis of two clinical trials of maternal vitamin D supplementation trials showed a significant protective effect of vitamin D supplementation trials in the primary prevention of asthma and recurrent wheeze up to age 3 years. Secondary analyses from these trials have also suggested that initial maternal vitamin D status could affect the response to supplementation during pregnancy, with the biggest protective effect in children born to mothers with initial 25hydroxyvitamin D (25OHD) levels of at least 30 ng/ml...
January 2, 2019: Current Opinion in Allergy and Clinical Immunology
Jason E Lang
PURPOSE OF REVIEW: Asthma is one of the most common chronic diseases in children and adults in developed countries around the world. Despite international treatment guidelines, poor asthma control remains a frequent problem leading to missed school and work, and emergency room visits and hospitalizations. Many patients with asthma report exercise as a trigger for their asthma, which likely leads to exercise avoidance as a means to control symptoms. Evolving research has suggested that routine exercise may actually help improve some aspects of asthma control...
December 27, 2018: Current Opinion in Allergy and Clinical Immunology
Jacek M Mazurek, Paul K Henneberger
PURPOSE OF REVIEW: Work-related asthma has been associated with poorer asthma control and frequent unscheduled healthcare visits, and can be fatal. Case reports of work-related asthma deaths are rare, but can initiate efforts to prevent additional cases. We reviewed relevant literature and data sources to evaluate whether analyzing mortality data at the population level can help identify potential sources of exposures that contribute to work-related asthma. RECENT FINDINGS: A limited number of population-based studies have addressed work-related asthma mortality...
December 27, 2018: Current Opinion in Allergy and Clinical Immunology
Youngwoo Choi, Youngsoo Lee, Hae-Sim Park
PURPOSE OF REVIEW: The aim of this review is to emphasize the role of neutrophils in patients with occupational asthma. This review facilitates a better understanding, accurate diagnosis, and proper management of asthmatic reactions provoked at the workplace. RECENT FINDINGS: Increased recruitment and infiltration of neutrophils are found in patients with occupational asthma. Activated neutrophils release several mediators including pro-inflammatory cytokines and extracellular traps, leading to stimulation of airway epithelium and other inflammatory cells...
December 27, 2018: Current Opinion in Allergy and Clinical Immunology
Rosialzira Natasha Vera-Berrios, Johanna Feary, Paul Cullinan
PURPOSE OF REVIEW: There is an unmet need for better immunological tests in cases of suspected occupational asthma to many workplace chemicals; here we consider the basophil activation test (BAT), a potential alternative to the detection of specific IgE antibodies. RECENT FINDINGS: BAT is fairly widely used in general allergy services; and there is increasing experience of its use in the diagnosis of occupational allergy to low molecular weight agents and chemicals including wood dusts, persulphates, antibiotics and latex...
December 20, 2018: Current Opinion in Allergy and Clinical Immunology
Michelle C Maciag, Wanda Phipatanakul
PURPOSE OF REVIEW: To describe important precipitants of asthma and allergic disease, to highlight the links between these triggers and modifications within the immune system, and to examine innovative research regarding asthma prevention with focus on attenuating the atopic march. RECENT FINDINGS: Allergen avoidance, allergen immunotherapy, IgE antagonists, prevention and treatment of respiratory infections, as well as management of gastrointestinal and respiratory dysbiosis have been considered as strategies in asthma prevention...
November 29, 2018: Current Opinion in Allergy and Clinical Immunology
Peggy S Lai, David C Christiani
PURPOSE OF REVIEW: Recent evidence suggests that environmental exposures change the adult human microbiome. Here, we review recent evidence on the impact of the work microbiome and work-related chemical, metal and particulate exposures on the human microbiome. RECENT FINDINGS: Prior literature on occupational microbial exposures has focused mainly on the respiratory effects of endotoxin, but a recent study suggests that not all endotoxin is the same; endotoxin from some species is proinflammatory, whereas endotoxin from other species is anti-inflammatory...
November 29, 2018: Current Opinion in Allergy and Clinical Immunology
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February 2019: Current Opinion in Allergy and Clinical Immunology
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