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Severe allergic asthma

Kian Fan Chung, Ian M Adcock
Although the complex disease of asthma has been defined as being heterogeneous, the extent of its endophenotypes remain unclear. The pharmacological approach to initiating treatment has, until recently, been based on disease control and severity. The introduction of antibody therapies targeting the Type2 inflammation pathway for patients with severe asthma has resulted in the recognition of an allergic and an eosinophilic phenotype, which are not mutually exclusive. Concomitantly, molecular phenotyping based on a transcriptomic analysis of bronchial epithelial and sputum cells has identified a Type-2-high inflammation cluster characterised by eosinophilia and recurrent exacerbations, as well as Type-2-low clusters linked with IL-6 trans-signalling, interferon pathways, inflammasome activation and mitochondrial oxidative phosphorylation pathways...
March 13, 2019: Allergy
Herman Meurs, Johan Zaagsma, Harm Maarsingh, Marcel van Duin
Asthma is a chronic inflammatory disease characterized by recurrent airways obstruction, airway hyperresponsiveness (AHR), airway inflammation and airway remodeling, which is often associated with allergy and allergic rhinitis. Many patients with asthma are poorly controlled by current drug treatment, particularly a subgroup of patients with difficult-to-treat severe asthma, characterized by chronic symptoms, severe exacerbations, progressive loss of lung function and resistance to corticosteroids. New therapeutic options are therefore highly warranted...
March 13, 2019: Allergy
Jina Won, Chan Hee Gil, Ara Jo, Hyun Jik Kim
The possibility has been suggested that interferon (IFN)-λs can be induced rapidly for restricting respiratory viral infection in asthmatic mice and may modulate Th2-related immune responses that underlie the pathogenesis of asthma. We sought to determine the in vivo contribution of IFN-λs on decrease of Th2 cytokines in the respiratory tract of in vivo asthma. Lungs of asthmatic mice were severely inflamed, with extensive inflammatory cell infiltration and increased goblet cell metaplasia with higher total lung resistance...
March 9, 2019: Cytokine
Hui Gan, Ling Wang, Wei Fu, Jinjin Zhang, Mingxia Yu, Guanghui Liu
WHAT IS KNOWN AND OBJECTIVE: Omalizumab is effective as an add-on drug to treat severe persistent allergic asthma. However, delayed hypersensitivity reactions to omalizumab may deprive patients of its use. Rapid subcutaneous desensitization could be a solution. CASE DESCRIPTION: A 61-year-old man developed a delayed allergy to omalizumab after the first injection. A 14-step desensitization procedure was applied to the patient and was successful. WHAT IS NEW AND CONCLUSION: Delayed hypersensitivity reactions to omalizumab are rare, but they may cause the interruption of drug usage...
March 11, 2019: Journal of Clinical Pharmacy and Therapeutics
Marcello Albanesi, Carlo Pasculli, Lucia Giliberti, Maria Pia Rossi, Danilo Di Bona, Maria Filomena Caiaffa, Luigi Macchia
Introduction: Onion (Allium cepa) handling can induce contact dermatitis, rhinoconjunctivitis and asthma. However, only sporadic reports exist on allergic reactions to onion consumption. Aim: We describe herein a case of a 35-year-old man who had an episode of anaphylaxis following cooked onion ingestion. We evaluated onion-specific IgE, the possible cross-reactivity between onion and peach and lymphocyte proliferation in response to onion. Material and methods: Specific IgE was evaluated using two techniques: skin test and ImmunoCAP technology...
February 2019: Postȩpy Dermatologii i Alergologii
Olga Růžičková Kirchnerová, Tomáš Valena, Jakub Novosad, Milan Teřl
Introduction: This was a sub-group analysis of patients with uncontrolled persistent allergic asthma (AA) in the healthcare setting of the Czech Republic, from a global non-interventional, 2-year post-marketing, observational eXpeRience registry. Aim: To evaluate the real-life effectiveness and safety of omalizumab. Material and methods: Patients with uncontrolled persistent AA (currently defined by the Global Initiative for Asthma (GINA) as uncontrolled severe AA) who started omalizumab treatment 15 weeks before inclusion in the registry were analysed for physicians' global evaluation of treatment effectiveness (GETE), asthma symptoms, corticosteroid use, exacerbation rate, asthma control, quality of life, healthcare utilisation and safety during a 24-month observation period...
February 2019: Postȩpy Dermatologii i Alergologii
Diaddin Hamdan, Christophe Leboeuf, Christine Le Foll, Guilhem Bousquet, Anne Janin
Docetaxel is a major anticancer drug that can induce hypersensitivity reactions leading to deleterious treatment interruptions. Blood hypereosinophilia could be a biological sign, potentially lethal, of delayed visceral hypersensitivity reactions. We hypothesized this biological event is probably underreported. In this prospective observational study, we followed up 149 patients treated with docetaxel monotherapy for breast or lung cancer. For each patient, blood eosinophil counts were recorded during docetaxel treatment and up to 3 months after the end of docetaxel treatment...
March 10, 2019: Cancer Medicine
Saloomeh Fouladi, Mohsen Masjedi, Mazdak Ganjalikhani Hakemi, Nahid Eskandari
Allergic asthma is the most common type of allergy which have become increasingly prevalent in all around the world. Airway eosinophilic inflammation is a major feature of allergic asthma. Glycyrrhiza uralensis (licorice) is one of the regular herbs in traditional Chinese medicine (TCM) as it has many effects on the immune system such as anti-inflammatory and immune regulatory activity; antiviral and antitumor effects. This review focuses on the "licorice" components, mainly glycyrrhizic acid (GA) and derivatives structure that evaluate its effects on the allergic asthma...
February 2019: Iranian Journal of Allergy, Asthma, and Immunology
Jacek Smereka, Marcin Aluchna, Alicja Aluchna, Łukasz Szarpak
BACKGROUND: Medical emergencies in dental offices are considered a problem in most countries owing to dentists' concerns about emergency preparedness, practical skills, lifesaving equipment and staff availability. The prevalence of medical emergencies in dental offices and dentists' preparedness have been analysed in several countries but have never been studied in Poland. AIM: To assess the prevalence of medical emergencies in dental offices in Poland, as well as dentists' preparedness and attitudes towards medical emergencies...
March 7, 2019: International Dental Journal
Lisa M Walter, Knarik Tamanyan, Lauren Nisbet, Aidan J Weichard, Margot J Davey, Gillian M Nixon, Rosemary S C Horne
PURPOSE: Allergic rhinitis (AR) is a common risk factor for sleep disordered breathing (SDB) in children. Allergy to pollen is a trigger for allergic rhinitis, causing nasal inflammation, upper airway congestion and obstruction. We aimed to determine if the pollen count on the day of diagnostic polysomnography for SDB affected the result. METHODS: Children (3-18 years; n = 90) who participated in research studies between 1 October and 31 December, when daily regional pollen counts were available, in the years 2005-2016 were eligible for inclusion...
March 5, 2019: Sleep & Breathing
Uta Jappe, Christian Schwager, Andra B Schromm, Nestor González Roldán, Karina Stein, Holger Heine, Katarzyna A Duda
Molecular allergology research has provided valuable information on the structure and function of single allergenic molecules. There are several allergens in food and inhalant allergen sources that are able to interact with lipid ligands via different structural features: hydrophobic pockets, hydrophobic cavities, or specialized domains. For only a few of these allergens information on their associated ligands is already available. Several of the allergens are clinically relevant, so that it is highly probable that the individual structural features with which they interact with lipids have a direct effect on their allergenic potential, and thus on allergy development...
2019: Frontiers in Immunology
Tuula Vasankari, Tommi Härkänen, Annette Kainu, Katri Sääksjärvi, Tiina Mattila, Pekka Jousilahti, Tarja Laitinen
In the present study we aimed to investigate the incidence and predictors of spirometry based airway obstruction in a representative population-based sample. Altogether 3,863 subjects, 1,651 males and 2,212 females aged ≥30 years had normal spirometry in year 2000. Fifty-three percent of them were never and 23% current smokers. A re-spirometry was performed 11 years later. Several characteristics, such as level of education, use of alcohol, physical activity, diet using Alternate healthy eating (AHEI) index, body mass index, circumwaist, sensitive C reactive protein (CRP) and cotinine of the laboratory values and co-morbidities including asthma, allergic rhinitis, sleep apnoea and chronic bronchitis, as potential risk factors for airway obstruction were evaluated...
March 1, 2019: COPD
Ritesh Agarwal, Inderpaul S Sehgal, Sahajal Dhooria, Ashutosh N Aggarwal
Fungal asthma broadly encompasses the presence of fungal sensitization or fungal allergy in patients with asthma. The clinical presentation of fungal asthma can vary from fungal-sensitized asthma at one end to allergic bronchopulmonary mycosis at the other end of the spectrum. Here we present five cases that illustrate some of the most challenging aspects of the diagnosis and management of fungal asthma. The cases are aimed at elucidating complex clinical presentations in fungal asthma such as allergic bronchopulmonary mycosis presenting with normal immunoglobulin E (IgE) values, the role of several different fungi in causing allergic mycosis, newer treatments like omalizumab (and mepolizumab), and a complication of long-standing allergic bronchopulmonary aspergillosis, namely, chronic pulmonary aspergillosis...
April 1, 2019: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Hanan Ahmed, Maria B Ospina, Kyriaki Sideri, Harissios Vliagoftis
Background: Sensitization to common environmental aeroallergens plays a significant role in the pathogenesis and severity of respiratory allergic disorders, specifically asthma and allergic rhinitis. Understanding sensitization patterns helps clinicians tailor care more effectively. This study examines patterns of sensitization to aeroallergens in subjects suspected of having an allergic disease in Edmonton and catchment area. Methods: Retrospective chart review of skin prick test (SPT) results to 11 environmental aeroallergens performed between January 1st and June 30th 2014 at a University-based clinic, where patients are referred for SPT by allergists, respirologists, otolaryngologists, internists and general practitioners...
2019: Allergy, Asthma, and Clinical Immunology
Carlo Cavaliere, Cristoforo Incorvaia, Franco Frati, Daniela Messineo, Mario Ciotti, Antonio Greco, Marco de Vincentiis, Simonetta Masieri
Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) frequently presents with dysfunction or loss of the sense of smell, resulting in a significant impairment in quality of life. The medical treatments currently available may improve the olfactory function in patients with CRSwNP, but such an outcome is generally only transitory. We report the case of a patient with CRSwNP who completely recovered from smell sense loss by treatment with mepolizumab. Case presentation: The patient was a 62-year-old female who has severe asthma induced by allergy to Dermatophagoides and concomitant CRSwNP...
2019: Clinical and Molecular Allergy: CMA
Johanna Huoman, Georgia Papapavlou, Anna Pap, Johan Alm, Lennart J Nilsson, Maria C Jenmalm
BACKGROUND: Immunomodulatory effects of sublingual immunotherapy on systemic and mucosal mediators in allergic children are largely unexplored. The aim of this study was to investigate allergy related cytokine and chemokine levels, as well as IgA responses upon a three-year treatment with timothy grass pollen sublingual immunotherapy in children with allergic rhinoconjunctivitis. METHODS: From children included in the GRAZAX® asthma prevention study, blood and saliva samples were analyzed at inclusion, after three years of treatment and two years after treatment ending...
February 25, 2019: Pediatric Allergy and Immunology
Ewelina Russjan, Katarzyna Kaczyńska
Asthma is a chronic inflammatory disorder of the respiratory tract that is characterized by reversible airflow obstruction and airway hyperresponsiveness. The non-atopic variant of asthma that appears later in life has no allergic background and is more severe and resistant to standard treatment. Hapten-induced asthma models can be utilized to investigate mechanisms behind the development of non-atopic and occupational asthma, in which non-allergic processes seems to play significant role. The development of adequate animal models of non-allergic asthma is a necessary prerequisite both for understanding the pathophysiology of non-allergic asthma and for the possibility of testing new therapies...
December 1, 2018: Toxicology
Yossi Rosman, Alon Y Hershko, Keren Meir-Shafrir, Ron Kedem, Idit Lachover-Roth, Yoseph A Mekori, Ronit Confino-Cohen
BACKGROUND: Although chronic spontaneous urticaria (CSU) affects all age groups, data regarding CSU in adolescents is scarce. OBJECTIVE: To characterize the epidemiology, demographics and co-morbidities associated with CSU in a large cross-sectional, nationwide, population of adolescents. METHODS: Medical records of 16-year-old candidate conscripts to the Israeli Defense Forces were reviewed. Data were collected on the prevalence and severity of CSU as well as the demographics, medical comorbidities, medication use, and blood test results of affected individuals...
February 21, 2019: Journal of the American Academy of Dermatology
Alessandro Fiocchi, Maria Cristina Artesani, Carla Riccardi, Maurizio Mennini, Valentina Pecora, Vincenzo Fierro, Veronica Calandrelli, Lamia Dahdah, Rocco Luigi Valluzzi
BACKGROUND: The effects of omalizumab on food allergy thresholds have been little studied. OBJECTIVE: To assess the real-life effects of omalizumab on food threshold tolerability in children treated for severe asthma. METHODS: In this observational, real-life, efficacy study, we reviewed the food allergen thresholds of patients with severe asthma, as well as their immediate reactions to 2+ foods before and after a 4-month treatment with omalizumab...
February 20, 2019: Journal of Allergy and Clinical Immunology in Practice
Lien Van Hoecke, Kenny Roose
In 1975, Milstein and Köhler revolutionized the medical world with the development of the hybridoma technique to produce monoclonal antibodies. Since then, monoclonal antibodies have entered almost every branch of biomedical research. Antibodies are now used as frontline therapeutics in highly divergent indications, ranging from autoimmune disease over allergic asthma to cancer. Wider accessibility and implementation of antibody-based therapeutics is however hindered by manufacturing challenges and high development costs inherent to protein-based drugs...
February 22, 2019: Journal of Translational Medicine
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