Therapeutic Antibodies for Nasal Polyposis Treatment: Where Are We Headed?
AbstractThis review article aims to outline what is known in the pathophysiology of chronic rhinosinusitis with nasal polyposis (CRSwNP) and describe the mechanism of the biologic agents being investigated for this disease. Chronic rhinosinusitis with nasal polyposis is an inflammatory disease of the nasal and paranasal mucosa, which causes symptoms of nasal obstruction, hyposmia, and rhinorrhea. Conventional therapy for CRSwNP includes intranasal corticosteroids (INCS) and polypectomy, but INCS offer only modest benefits, and recurrence after surgery is common. Therefore, effective pharmacologic therapies for CRSwNP are being actively sought. Monoclonal antibodies have been successful in other chronic diseases involving eosinophilic inflammation, such as chronic urticaria and asthma. Thus, researchers have begun expanding their scope and investigating the efficacy of these drugs in the treatment of nasal polyposis. The monoclonal antibodies under investigation (omalizumab (anti IgE), dupilumab (anti IL-4/IL-13), and reslizumab and mepolizumab (both anti IL-5), benralizumab (anti IL-5R α), and etokimab (anti IL-33)) target key players in the pathophysiology of nasal polyposis (NP). Dupilumab has just completed phase III trials for CRSwNP with positive results, while omalizumab, mepolizumab, and benralizumab are currently in phase III trials for this indication. At this time, whil e there are no FDA-approved biologics for use in NP, research has highlighted the contribut...
CONCLUSION: The 16-day desensitization protocol seemed to be safe and effective in the non-immediate type DHRs caused by lenalidomide. PMID: 31400463 [PubMed - as supplied by publisher]
CONCLUSIONS: The rate of anaphylaxis in patients with ColdU in a tropical country was lower than those reported by other studies conducted intemperate climates. On the other hand, the number of female patients, mean age at symptom onset, atopy rate, rate of concomitant chronic spontaneous urticaria and mean CTT were higher. PMID: 31172722 [PubMed]
Shanshan Zhang1, Dongli Yuan2 and Ge Tan1* 1Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China 2The Institute of Medical Information, Chongqing Medical University, Chongqing, China Primary systemic vasculitis can affect every structure in both the central and peripheral nervous system, causing varied neurological manifestations of neurological dysfunction. Early recognition of the underlying causes of the neurological symptoms can facilitate timely treatment and improve the prognosis. This review highlights the clinical manifestations of primary systemic vasc...
Conclusions: In the CAR registry, patients with SAA treated with omalizumab showed a significant positive effect of anti-IgE therapy not only on the asthma control, but also on allergic comorbidities. PMID: 30429711 [PubMed]
A 5-year-old girl is seen for asthma and food allergies to peanut and tree nuts. Since her last visit, she had one allergic reaction during which she developed hives and wheezing after taking a bite of a muffin cross-contaminated with peanut. This incident was treated with epinephrine. This past winter, she had multiple upper respiratory tract infections that required 2 courses of oral corticosteroids. Her asthma is currently well controlled with daily inhaled fluticasone, with no nighttime awakenings.
CONCLUSIONS: This study provides detailed information that facilitates studying CRS and its main phenotypes. However, patient distribution of this study does not necessarily reflect disease distribution in the general population. PMID: 29911211 [PubMed - as supplied by publisher]
refers to sudden, potentially life-threatening episodes of subcutaneous and/or submucosal swelling. It may be related to allergic diseases and urticaria through the release of mast cell mediators. Bradykinin-mediated angioedema (BK-AE), which is rather uncommon, does not typically respond to epinephrine, antihistamines, or corticosteroids, and obstruction of upper airways or involvement of the gastrointestinal tract may lead to life-threatening situations. BK-AE is usually caused by C1 inhibitor (C1Inh) deficiency, which is hereditary with variants in the SERPING1 gene (types I and II; OMIM 106100) or acquired.
CONCLUSION: CD is a common inflammatory skin disease and should be suspected in patients presenting acute, subacute or chronic dermatitis. The gold standard for diagnosing allergic CD is PT. This article provides practical recommendations for the diagnosis and management of CD commonly seen by the allergist in their practice. PMID: 29522811 [PubMed - as supplied by publisher]
Conclusions: Patients with severe asthma treated with omalizumab showed positive effect of anti-IgE therapy not only on the clinical symptoms of asthma, but also on other allergic comorbidities. Most patients with allergic rhinitis, atopic dermatitis, chronic urticaria and food allergy experienced either improvement or complete remission of symptoms of these diseases.
Discussion Angioedema is edema that is non-pitting, self-limited occurring in non-dependent areas usually in an asymmetric distribution usually on the lips, face, hands, feet, genitals and also in the bowel. It usually develops over minutes to hours (often 1-2 hours) with resolution usually within 24-48 hours. Angioedema often occurs with urticaria but 20% of patients may have isolated angioedema. Acute allergic angioedema is often caused by drugs (including antibiotics and non-steroidal anti-inflammatory drugs), foods, infections, insects, various organic substances (i.e. latex, preservatives, formaldehyde, etc.), and oth...