Precision medicine in atopic diseases

Purpose of review To analyze the status of precision medicine in atopic diseases. Recent findings Atopic diseases are increasingly recognized as heterogeneous in nature and they can be quite different in severity, response to therapy, triggers, genetic back ground, ancestral risk and type of inflammation. This significant variability in the landscape of atopic diseases is not reflected in the common treatment guidelines that follow ‘one fits all’ approach for their management. Such an approach is largely based on minimal ‘phenotype’ elements, such as severity of disease and response to therapy and does not reflect the information accumulate in the last 20 years about particular pathogenic pathways (endotypes) leading to disease (phenotypes) based on biomolecular analysis of the single individuals. Accumulating data have defined asthma allergic rhinitis, food allergy based on their endotypes and clinically relevant phenotypes. In general, atopic diseases can be largely classified as high or low Th2 inflammatory status, which may explain the severity and response to therapy. Summary Precision medicine is aiming to use known endotype phenotype to guide specific individualized treatment. The work aimed in deep characterization of diseases to guide the disease management is crucial in light of the availability of ever more precise treatment able to target specific pathways.
Source: Current Opinion in Allergy and Clinical Immunology - Category: Allergy & Immunology Tags: PRECISION MEDICINE Source Type: research

Related Links:

We examined our primary care birth cohort of 158,510 pediatric patients, of whom 214 patients met 2017 FPIES diagnostic criteria. We measured the influence of FPIES on developing subsequent atopic disease.ResultsPediatric FPIES incidence was between 0.17% and 0.42% depending on birth year. As in prior reports, most patients had an acute presentation (78%), and milk, soy, oat, rice, potato, and egg were common triggers. The mean age of diagnosis was 6.8 months. Atopic comorbidity was higher in patients with FPIES compared with healthy children (AD, 20.6% vs 11.7%; IgE-FA, 23.8% vs 4.0%; asthma, 26.6% vs 18.4%; AR, 28.0% vs 16.7%; P
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Allergic diseases such as atopic dermatitis (AD), food allergy (FA), asthma and allergic rhinitis (AR) are common; according to a national birth cohort study in Japan, almost half of pregnant women reported a history of allergic disease.1 Given that genetic factors, including family history, are predictors of allergic diseases in offspring, we expect the birth of many infants who carry a high risk of developing allergies. Among allergy prevention strategies, the effectiveness of primary prevention of eczema in high-risk infants by the topical application of emollient during the neonatal period has been demonstrated in two ...
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Letters Source Type: research
We examined our primary care birth cohort of 158,510 pediatric patients, of which 214 patients met 2017 FPIES diagnostic criteria. We measured the influence of FPIES on developing subsequent atopic disease.ResultsPediatric FPIES incidence was between 0.17% and 0.42% depending on birth year. As in prior reports, most patients had an acute presentation (78%) and milk, soy, oat, rice, potato, and egg were common triggers. The mean age of diagnosis was 6.8 months. Atopic comorbidity was higher in FPIES patients compared to healthy children (AD, 20.6% vs. 11.7%; IgE-FA, 23.8% vs. 4.0%; asthma, 26.6% vs. 18.4%; AR, 28.0% vs. 16.7%; p
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Conclusions: Thus, dermato-respiratory syndrome as a manifestation of food allergy in children characterized by polyvalent sensitization to food allergens with a predominance of sensitization to ovalbumin, casein and gliadin.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
Objective: to evaluate the clinical efficacy and safety of long-term anti-IgE therapy patients with severe uncontrolled asthma.Materials and Methods: in Chelyabinsk city from November 2016 35 patients regularly receive omalizumab therapy - 9 men (26%) and 26 women (74%), the average age 44.5±14.1 years, the duration of asthma - 25.2±11.5 years. All patients had allergic pathology: allergic rhinitis - 100%, pollinosis - 79.4%, food allergy - 44.1%, atopic dermatitis - 26.5%. The level of total IgE in the blood is from 72 to 787 IU/ml, high sesitization to household (88.6%), epidermal (62.9%), pollen (74.3%) al...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Airway pharmacology and treatment Source Type: research
The objective of this study was to test the hypothesis that comorbid type 2 immune diseases confer protection against morbidity and mortality due to acute infection. Design: Retrospective cohort study of patients hospitalized with an acute infection between November 2008 and January 2016 using electronic health record data. Setting: Single tertiary-care academic medical center. Patients: Admissions to the hospital through the emergency department with likely infection at the time of admission who may or may not have had a type 2 immune-mediated disease, defined as asthma, allergic rhinitis, atopic dermatitis, or f...
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Clinical Investigations Source Type: research
Patient is a 9-year-old male with a history of moderate/severe atopic dermatitis, allergic rhinitis and eosinophilic esophagitis (EoE). He initially presented to an outside gastroenterologist at 3 years of age due to poor growth and picky eating. He had an endoscopy performed, which demonstrated esophageal eosinophilia. At the time of EoE diagnosis, patient was without IgE mediated food allergies, specifically tolerating dairy products regularly without symptoms. His initial management of eosinophilic esophagitis included the 4-food elimination diet.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Source Type: research
Despite being classified as an allergy, the epidemiologic relationships between food protein-induced enterocolitis syndrome (FPIES) and other allergic manifestations (atopic dermatitis, AD; IgE-mediated food allergy, IgE-FA; asthma; allergic rhinitis, AR) are not well understood.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Food Allergy Source Type: research
Atopic dermatitis (AD) is a chronic, relapsing disease that typically manifests in childhood and improves with age. Studies have demonstrated that the presence of AD increases the risk of developing food allergy, allergic rhinitis, and asthma later in life. Although children with AD are more likely to produce allergen-specific immunoglobulin E, there is conflicting evidence that allergen avoidance improves disease severity. Furthermore, food-elimination diets in patients with AD may increase the risk of developing immediate, life-threatening reactions to the removed food. The most effective treatments of AD aim to repair a...
Source: Immunology and Allergy Clinics of North America - Category: Allergy & Immunology Authors: Source Type: research
To evaluate the role of atopy (i.e. atopic dermatitis, allergic rhinitis, asthma, and food allergies) and its consequences on developing meatal stenosis in boys.
Source: Journal of Pediatric Surgery - Category: Surgery Authors: Source Type: research
More News: Allergy | Allergy & Immunology | Asthma | Food Allergy | Genetics | Hay Fever