Small Airway Disease in Pediatric Asthma: the Who, What, When, Where, Why, and How to Remediate. A Review and Commentary
AbstractAsthma affects all portions of the airways. Small airways, however, comprise a substantial component of the conducting lung air flow. In asthma, inflammatory processes can affect the whole respiratory tract, from central to peripheral/small airways. The emphasis in adult and pediatric respiratory disease clinics is to focus on large airway obstruction and reversibility. This information, although valuable, underemphasizes a large portion of the conduction airway of asthmatics. Standard descriptions of asthma management focus on a multiple medication approaches. We particularly focused on the management of asthma in...
Source: Clinical Reviews in Allergy and Immunology - November 26, 2020 Category: Allergy & Immunology Source Type: research

The Application of Single-Cell RNA Sequencing in Studies of Autoimmune Diseases: a Comprehensive Review
AbstractComplex composition is one of the most important features of the immune system, involving many types of organs, tissues, cells, and molecules that perform immune functions. The normal function of each component of the immune system is the guarantee for maintaining the relatively stable immune function of the body. When the self-immune tolerance mechanism of the body is unregulated or destroyed, the immune system reacts to autoantigens, resulting in damage to self-tissues and organs or an immunopathological state with abnormal functions. Autoimmune diseases are diverse, and their pathogenesis is complicated. Various...
Source: Clinical Reviews in Allergy and Immunology - November 25, 2020 Category: Allergy & Immunology Source Type: research

Inflammasomes and Childhood Autoimmune Diseases: A Review of Current Knowledge
AbstractInflammasomes are multiprotein complexes capable of sensing pathogen-associated molecular patterns (PAMPs), danger-associated molecular patterns (DAMPs), and cellular perturbations. Upon stimulation, the inflammasomes activate the production of the pro-inflammatory cytokines IL-1 β and IL-18 and induce gasdermin D-mediated pyroptosis. Dysregulated inflammasome signaling could lead to hyperinflammation in response to environmental triggers, thus contributing to the pathogenesis of childhood autoimmune/autoinflammatory diseases. In this review, we group childhood rheumatic di seases into the autoinflammation to ...
Source: Clinical Reviews in Allergy and Immunology - November 25, 2020 Category: Allergy & Immunology Source Type: research

IL-23/IL-17 Axis in Inflammatory Rheumatic Diseases
AbstractIn inflammatory rheumatic disorders, the immune system attacks and damages the connective tissues and invariably internal organs. During the past decade, remarkable advances having been made towards our understanding on the cellular and molecular mechanisms involved in rheumatic diseases. The discovery of IL-23/IL-17 axis and the delineation of its important role in the inflammation led to the introduction of many needed new therapeutic tools. We will present an overview of the rationale for targeting therapeutically the IL-23/IL-17 axis in rheumatic diseases and the clinical benefit which has been realized so far....
Source: Clinical Reviews in Allergy and Immunology - November 13, 2020 Category: Allergy & Immunology Source Type: research

Immunometabolic Pathways and Its Therapeutic Implication in Autoimmune Diseases
AbstractAutoimmune diseases (AIDs) are characterized with aberrant immune responses and their respective signaling pathways controlling cell differentiation, death, and survival. Cell metabolism is also an indispensable biochemical process that provides the very fundamental energy and materials. Accumulating evidences implicate that metabolism pathways have critical roles in determining the function of different immune subsets. Mechanisms of how immunometabolism participate in the pathogenesis of AIDs were also under intensive exploration. Here, in this review, we summarize the metabolic features of immune cells in AIDs an...
Source: Clinical Reviews in Allergy and Immunology - November 12, 2020 Category: Allergy & Immunology Source Type: research

Distinctive Clinical Characteristics and Outcome of ILD-Onset Rheumatoid Arthritis and ACPA-Positive ILD: a Longitudinal Cohort of 282 Cases
AbstractThe aim of this study is to investigate the clinical features and outcome of interstitial lung disease (ILD)-onset rheumatoid arthritis (RA) and anti-citrullinated protein antibody (ACPA)-positive ILD-only patients. Arthritis-onset and ILD-onset RA-ILD and ACPA-positive ILD-only patients consecutively admitted to Peking Union Medical College Hospital from January 2008 to December 2017 were enrolled and followed-up. Their demographic, clinical, and laboratory features as well as outcome were collected and analyzed. Compared with arthritis-onset RA-ILD (n = 166, median arthritis-to-ILD interval: 60 mon...
Source: Clinical Reviews in Allergy and Immunology - November 10, 2020 Category: Allergy & Immunology Source Type: research

The AGE-RAGE Axis and RAGE Genetics in Chronic Obstructive Pulmonary Disease
AbstractChronic obstructive pulmonary disease (COPD) is a heterogeneous group of lung diseases limiting the airflow due to narrowing of airways, chronic bronchitis and emphysema that leads to difficulties in breathing. Chronic inflammation is another important characteristic of COPD which leads to immune cell infiltration and helps in the alveolar destruction. Pathology of COPD is driven by various environmental and genetic factors. COPD is mainly associated with the inhalation of toxic agents mainly the cigarette smoke. Receptor for advanced glycation end products (RAGE) has emerged as a pattern recognition receptor and i...
Source: Clinical Reviews in Allergy and Immunology - November 10, 2020 Category: Allergy & Immunology Source Type: research

Management of Severe Refractory Systemic Lupus Erythematosus: Real-World Experience and Literature Review
AbstractSystemic lupus erythematosus (SLE) is a highly heterogeneous disease affecting multiple organs and is characterized by an aberrant immune response. Although the mortality of SLE has decreased significantly since the application of glucocorticoids, severe or refractory SLE can potentially cause irreversible organ damage and contribute to the disease morbidity and mortality. Early recognition of severe SLE or life-threatening conditions is of great challenge to clinicians since the onset symptoms can be rapid and aggressive, involving the visceral organs of the neuropsychiatric, gastrointestinal, hematologic, renal, ...
Source: Clinical Reviews in Allergy and Immunology - November 7, 2020 Category: Allergy & Immunology Source Type: research

Neutrophils in the Pathogenesis of Rheumatic Diseases: Fueling the Fire
AbstractSystemic rheumatic diseases are a heterogeneous group of disorders characterized by profound immune dysregulation. Recent discoveries have led to a significant resurgence of interest in neutrophils as shapers of immune dysregulation and as triggers of organ damage in rheumatic diseases. Neutrophils contribute to the initiation, promotion, and perpetuation of immune dysregulation through a variety of mechanisms including synthesis of proinflammatory cytokines, direct tissue damage through degranulation and synthesis of reactive oxygen species, and the formation of neutrophil extracellular traps (NETs). The identific...
Source: Clinical Reviews in Allergy and Immunology - November 5, 2020 Category: Allergy & Immunology Source Type: research

Predictive Features and Clinical Presentation of Interstitial Lung Disease in Inflammatory Myositis
AbstractInterstitial lung disease (ILD) represents one of the most severe extra-muscular features of idiopathic inflammatory myositis (IIM). We aimed to identify any clinical and serological predictors of ILD in a monocentric cohort of 165 IIM patients.ILD+ patients were defined as having restrictive impairment in lung function tests and signs of ILD at chest high-resolution computed tomography (HRCT). Available HRCT images were centralized and classified in different ILD patterns: non-specific interstitial pneumonia (NSIP), organizing pneumonia (OP), usual interstitial pneumonia-like (UIP), indeterminate for UIP, and inte...
Source: Clinical Reviews in Allergy and Immunology - November 3, 2020 Category: Allergy & Immunology Source Type: research

Use of Ultraviolet Blood Irradiation Against Viral Infections
AbstractUltraviolet blood irradiation (UBI) was used with success in the 1930s and 1940s for a variety of diseases. Despite the success, the lack of understanding of the detailed mechanisms of actions, and the achievements of antibiotics, phased off the use of UBI from the 1950s. The emergence of novel viral infections, from HIV/AIDS to Ebola, from SARS and MERS, and SARS-CoV-2, bring back the attention to this therapeutical opportunity. UBI has a complex virucidal activity, mostly acting on the immune system response. It has effects on lymphocytes (T-cells and B-cells), macrophages, monocytes, dendritic cells, low-density...
Source: Clinical Reviews in Allergy and Immunology - October 6, 2020 Category: Allergy & Immunology Source Type: research

Equine Hypersensitivity: the Dark Horse of Allergy
AbstractA significant amount of medical literature has been published on the prevalence and treatment modalities of allergies to common household pets like dogs and cats. Although sensitization rates to horses are high in many urban areas, allergies to horses are rarely discussed. In order for allergists to treat effectively horse-allergic patients, they must be aware of various clinical presentations and treatment modalities that exist. A literature search was conducted in PubMED using the terms horse, immunotherapy, inhalant allergies, and food allergy limited to human studies from any period. What follows is a review of...
Source: Clinical Reviews in Allergy and Immunology - September 1, 2020 Category: Allergy & Immunology Source Type: research

Are Physicochemical Properties Shaping the Allergenic Potency of Plant Allergens?
AbstractThis review searched for published evidence that could explain how different physicochemical properties impact on the allergenicity of food proteins and if their effects would follow specific patterns among distinct protein families. Owing to the amount and complexity of the collected information, this literature overview was divided in two articles, the current one dedicated to protein families of plant allergens and a second one focused on animal allergens. Our extensive analysis of the available literature revealed that physicochemical characteristics had consistent effects on protein allergenicity for allergens...
Source: Clinical Reviews in Allergy and Immunology - September 1, 2020 Category: Allergy & Immunology Source Type: research

Clinical Manifestations and Management of Pediatric Beh çet’s Disease
AbstractBeh çet’s disease (BD) is a chronic, vasculitic disorder affecting all sizes of vessels. The disease rarely onsets at childhood and an early diagnosis is often challenging. Oral ulceration and fever of unknown cause are common initial manifestations that might confuse other inflammatory disorders. Th e clinical manifestation pattern in pediatric BD is heterogeneous and varies in different genders, ethnicities, and geographic regions. There are also some differences in clinical presentations and prognosis between pediatric and adult BD. The disease also affects children at an extremely young age with mo...
Source: Clinical Reviews in Allergy and Immunology - August 6, 2020 Category: Allergy & Immunology Source Type: research

A Review of Neutrophil Extracellular Traps (NETs) in Disease: Potential Anti-NETs Therapeutics
AbstractActivated neutrophils release neutrophil extracellular traps (NETs) in response to a variety of stimuli. NETosis is driven by protein-arginine deiminase type 4, with the release of intracellular granule components that function by capturing and destroying microbes, including viral, fungal, bacterial, and protozoal pathogens. The positive effects of pathogen control are countered by pro-inflammatory effects as demonstrated in a variety of diseases. Components of NETS are non-specific, and other than controlling microbes, they cause injury to surrounding tissue by themselves or by increasing the pro-inflammatory resp...
Source: Clinical Reviews in Allergy and Immunology - July 31, 2020 Category: Allergy & Immunology Source Type: research

Autoimmunity in 2019
AbstractBased on the PubMed data, we have been performing a yearly evaluation of the publications related to autoimmune diseases and immunology to ascertain the relative weight of the former in the scientific literature. It is particularly intriguing to observe that despite the numerous new avenues of immune-related mechanisms, such as cancer immunotherapy, the proportion of immunology manuscripts related to autoimmunity continues to increase and has been approaching 20% in 2019. As in the previous 13  years, we performed an arbitrary selection of the peer-reviewed articles published by the major dedicated Journals an...
Source: Clinical Reviews in Allergy and Immunology - July 28, 2020 Category: Allergy & Immunology Source Type: research

Fish Allergy: Fishing for Novel Diagnostic and Therapeutic Options
AbstractFish allergy is one of the most common food allergies. The currently recommended treatment commonly consists of avoiding all fish species. Recent literature suggests that these recommendations are overprotective for the majority of fish-allergic patients. This review summarizes recent findings and provides practical information regarding management of fish allergy in the individual patient. After precise history taking supported by additional specific IgE measurements and/or skin prick tests, fish-allergic patients can generally be categorized into the following clinical clusters: (A) poly-sensitized patients react...
Source: Clinical Reviews in Allergy and Immunology - July 24, 2020 Category: Allergy & Immunology Source Type: research

Interleukin-35 Promotes Th9 Cell Differentiation in IgG4-Related Disorders: Experimental Data and Review of the Literature
In conclusion, our data demonstrate that IL-35 actively participates in the process of inflammation and plays an important role in Th9 differentiation resulting in an immunoglobulin class switch towards IgG4. (Source: Clinical Reviews in Allergy and Immunology)
Source: Clinical Reviews in Allergy and Immunology - July 24, 2020 Category: Allergy & Immunology Source Type: research

Machine Learning in Rheumatic Diseases
AbstractWith advances in information technology, the demand for using data science to enhance healthcare and disease management is rapidly increasing. Among these technologies, machine learning (ML) has become ubiquitous and indispensable for solving complex problems in many scientific fields, including medical science. ML allows the development of guidelines and framing of the evaluation system for complex diseases based on massive data. In the analysis of rheumatic diseases, which are chronic and remarkably heterogeneous, ML can be anticipated to be extremely helpful in deciphering and revealing the inherent interrelatio...
Source: Clinical Reviews in Allergy and Immunology - July 16, 2020 Category: Allergy & Immunology Source Type: research

Current and Future Monoclonal Antibodies in the Treatment of Atopic Dermatitis
AbstractAtopic dermatitis is a common immunologic skin disease. Mild atopic dermatitis can be managed with emollients and topical therapies such as low potency topical steroids, which have a favorable safety profile. Severe atopic dermatitis, in contrast, is a challenging disease to treat. Topical therapies are typically inadequate for control of severe atopic dermatitis. When topical therapies fail, the mainstay of therapy for severe atopic dermatitis has traditionally been phototherapy or off-label use of systemic immunosuppressant treatment, yet systemic immunosuppressants all have significant potential toxicities, drug...
Source: Clinical Reviews in Allergy and Immunology - July 1, 2020 Category: Allergy & Immunology Source Type: research

Treatments for Childhood Atopic Dermatitis: an Update on Emerging Therapies
AbstractAtopic dermatitis (AD) is generally considered a T helper type 2 –dominated disease. Pediatric AD is usually less severe than adult AD, but it may present as moderate to severe lesions that are inadequately managed by current modalities including emollients/moisturizers, topical corticosteroids (TCSs), topical calcineurin inhibitors (TCIs), and even systemic im munosuppressants (such as cyclosporine, azathioprine, methotrexate, and mycophenolate mofetil). In addition, systemic immunosuppressants are often not recommended for childhood AD by the current guidelines due to their toxicities. Therefore, there is s...
Source: Clinical Reviews in Allergy and Immunology - June 29, 2020 Category: Allergy & Immunology Source Type: research

Health Effects of Trimellitic Anhydride Occupational Exposure: Insights from Animal Models and Immunosurveillance Programs
AbstractAcid anhydrides are used by chemical industries as plasticizers. Trimellitic acid (TMA) is an acid anhydride widely utilized in factories to produce paints, varnishes, and plastics. In addition to causing direct irritant effects, TMA can augment antibody responses in exposed factory workers leading to occupational asthma. Therefore, industries producing TMA have implemented occupational immunosurveillance programs (OISPs) to ensure early diagnosis and medical management, involving exposure reduction/ complete removal of sensitized workers from exposure areas. Multiple animal models (mice strains, rat stains, guinea...
Source: Clinical Reviews in Allergy and Immunology - June 26, 2020 Category: Allergy & Immunology Source Type: research

Type I Interferons in the Pathogenesis and Treatment of Autoimmune Diseases
AbstractType I interferons (IFN-Is) are a very important group of cytokines that are produced by innate immune cells but also  act on adaptive immune cells. IFN-Is possess antiviral, antitumor, and anti-proliferative effects, as well are associated with the initiation and maintenance of autoimmune disorders. Studies have shown that aberrantly expressed IFN-Is and/or type I IFN-inducible gene signatures in the serum or tis sues of patients with autoimmune disorders are linked to their pathogenesis, clinical manifestations, and disease activity. Type I interferonopathies with mutations in genes impacting the type I IFN ...
Source: Clinical Reviews in Allergy and Immunology - June 16, 2020 Category: Allergy & Immunology Source Type: research

Chronic Granulomatous Disease: a Comprehensive Review
AbstractChronic granulomatous disease (CGD) is a primary immunodeficiency of phagocyte function due to defective NADPH oxidase (phox). Compared with the common types ofCYBB/gp91phox,NCF1/p47phox, andCYBA/p22phox deficiency,NCF4/p40phox deficiency is a mild and atypical form of CGD without invasive bacterial or fungal infections. It can be diagnosed using serum-opsonizedE.coli as a stimulus in dihydrorhodamine (DHR) assay. Patients withCYBC1/Eros deficiency, a new and rare form of CGD, present as loss of respiratory burst and gp91phox expression in phagocytes. Neutrophils from patients with CGD are deficient in neutrophil e...
Source: Clinical Reviews in Allergy and Immunology - June 9, 2020 Category: Allergy & Immunology Source Type: research

Specialized Pro-Resolving Lipid Mediators: Emerging Therapeutic Candidates for Multiple Sclerosis
AbstractMultiple sclerosis (MS) is a neuroinflammatory disease in which unresolved and uncontrolled inflammation disrupts normal cellular homeostasis and leads to a pathological disease state. It has long been recognized that endogenously derived metabolic by-products of omega fatty acids, known as specialized pro-resolving lipid mediators (SPMs), are instrumental in resolving the pathologic inflammation. However, there is minimal data available on the functional status of SPMs in MS, despite the fact that MS presents a classical model of chronic inflammation. Studies to date indicate that dysfunction of the SPM biosynthet...
Source: Clinical Reviews in Allergy and Immunology - June 2, 2020 Category: Allergy & Immunology Source Type: research

Cytoskeletal Organization and Cell Polarity in the Pathogenesis of Crohn ’s Disease
AbstractCrohn ’s disease (CD) is a type of inflammatory bowel disease (IBD) and affects diverse segments of the entire gastrointestinal tract. Although the underlying causes of CD are not completely known, it is believed that disruption of the intestinal barrier and cell polarity may contribute to pathogenesis. The formation of the intestinal epithelial barrier, which is mainly regulated by cytoskeletal modulations, and apico-basal cell polarity are two major and mutually dependent features of the intestinal epithelial layer. As this layer serves as an important barrier between the external environment an d the inter...
Source: Clinical Reviews in Allergy and Immunology - May 29, 2020 Category: Allergy & Immunology Source Type: research

COVID-19 and Asthma: Reflection During the Pandemic
AbstractCoronavirus disease 2019 (COVID-19) is a global pandemic infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), and abnormal, overactivated innate immunity and “cytokine storms” have been proposed as potential pathological mechanisms for rapid COVID-19 progression. Theoretically, asthmatic patients should have increased susceptibility and severity for SARS-CoV-2 infection due to a deficient antiviral immune response and the tendency for exacerbation el icited by common respiratory viruses. However, existing studies have not shown an expected prevalence of asthmatic in...
Source: Clinical Reviews in Allergy and Immunology - May 27, 2020 Category: Allergy & Immunology Source Type: research

Omalizumab Updosing in Chronic Spontaneous Urticaria: an Overview of Real-World Evidence
AbstractChronic spontaneous urticaria (CSU) is defined as the spontaneous development of itchy hives and/or angioedema due to known or unknown causes that last for at least 6  weeks. At any given time, CSU is believed to affect 0.5–1% of the global population. Omalizumab (a recombinant, humanized anti-immunoglobulin-E antibody) is the only approved treatment for antihistamine refractory CSU. However, ~ 30% of patients remain symptomatic at licensed doses of omalizum ab 150 mg and 300 mg, even after a treatment period of over 6 months. In the recent years, there have been several studies on ...
Source: Clinical Reviews in Allergy and Immunology - May 15, 2020 Category: Allergy & Immunology Source Type: research

Immunobiology of T Cells in Sj ögren’s Syndrome
AbstractSj ögren’s syndrome (SjS) is a systemic autoimmune disease marked by xerostomia (dry mouth), keratoconjunctivitis sicca (eye dryness), and other systematic disorders. Its pathogenesis involves an inflammatory process that is characterized by lymphocytic infiltration into exocrine glands and other ti ssues. Although the development of ectopic lymphoid tissue and overproduction of autoantibodies by hyperactive B cells suggest that they may promote SjS development, treatment directed towards them fails to induce significant laboratory or clinical improvement. T cells are overwhelming infiltrators in most ph...
Source: Clinical Reviews in Allergy and Immunology - May 10, 2020 Category: Allergy & Immunology Source Type: research

Cutaneous Vasculitis: Review on Diagnosis and Clinicopathologic Correlations
AbstractCutaneous vasculitis is an inflammatory disease affecting the dermal blood vessel walls. The skin is a privileged organ in the setting of vasculitis since it is easily accessible for physical examination and safe biopsy, allowing an accurate characterization of inflammatory lesions. The skin is often involved. Also, cutaneous vasculitis can reflect a cutaneous component of a systemic vasculitis, a skin-limited or skin-dominant expression or variant of a systemic vasculitis, or be a single-organ vasculitis per se. Vasculitis lesions are multiple and polymorphic. They may induce a wide spectrum of clinical manifestat...
Source: Clinical Reviews in Allergy and Immunology - May 5, 2020 Category: Allergy & Immunology Source Type: research

Resolving Clinical Phenotypes into Endotypes in Allergy: Molecular and Omics Approaches
AbstractAllergic diseases are highly complex with respect to pathogenesis, inflammation, and response to treatment. Current efforts for allergic disease diagnosis have focused on clinical evidence as a binary outcome. Although outcome status based on clinical phenotypes (observable characteristics) is convenient and inexpensive to measure in large studies, it does not adequately provide insight into the complex molecular determinants of allergic disease. Individuals with similar clinical diagnoses do not necessarily have similar disease etiologies, natural histories, or responses to treatment. This heterogeneity contribute...
Source: Clinical Reviews in Allergy and Immunology - May 5, 2020 Category: Allergy & Immunology Source Type: research

Anti-inflammatory Action of Statins in Cardiovascular Disease: the Role of Inflammasome and Toll-Like Receptor Pathways
AbstractAtherosclerosis is one type of cardiovascular disease (CVD) in which activation of the NLRP3 inflammasome and toll-like receptor (TLR) pathways is implicated. One of the most effective treatments for atherosclerosis is the use of statin medications. Recent studies have indicated that statins, in addition to their lipid-lowering effects, exert inhibitory and/or stimulatory effects on the NLRP3 inflammasome and TLRs. Some of the statins lead to activation of the inflammasome and subsequently cause secretion of IL-1 β and IL-18. Thus, these actions may further aggravate the disease. On the other hand, some statin...
Source: Clinical Reviews in Allergy and Immunology - May 5, 2020 Category: Allergy & Immunology Source Type: research

Clinical Pathway for Early Diagnosis of COVID-19: Updates from Experience to Evidence-Based Practice
AbstractThe COVID-19 pandemic is a significant global event in the history of infectious diseases. The SARS-CoV-2 appears to have originated from bats but is now easily transmissible among humans, primarily through droplet or direct contact. Clinical features of COVID-19 include high fever, cough, and fatigue which may progress to ARDS. Respiratory failure can occur rapidly after this. The primary laboratory findings include lymphopenia and eosinopenia. Elevated D-dimer, procalcitonin, and CRP levels may correlate with disease severity. Imaging findings include ground-glass opacities and patchy consolidation on CT scan. Mo...
Source: Clinical Reviews in Allergy and Immunology - April 23, 2020 Category: Allergy & Immunology Source Type: research

Influence of Cosmetic Type and Distribution Channel on the Presence of Regulated Fragrance Allergens: Study of 2044 Commercial Products
AbstractContact dermatitis linked to cosmetic products is a very common reason for visits to the dermatologist, and in more than half the cases, it is due to an allergic reaction. Fragrances are most often the culprit. The aim of the study was to describe the common fragrance allergens in different categories of cosmetic products available on the European market. We wanted to assess the influence of cosmetic type and distribution channel on the presence of fragrance allergens. There are the allergens whose concentration exceeds 0.001% in leave-on products and 0.01% in rinse-off products. A total of 2044 commercial hygiene,...
Source: Clinical Reviews in Allergy and Immunology - April 21, 2020 Category: Allergy & Immunology Source Type: research

The Aryl Hydrocarbon Receptor (AHR) as a Potential Target for the Control of Intestinal Inflammation: Insights from an Immune and Bacteria Sensor Receptor
AbstractThe aryl hydrocarbon receptor (AHR) is widely expressed in immune and non-immune cells of the gut and its activation has been correlated to the outcome of inflammatory bowel diseases (IBD). In ulcerative colitis and Crohn ’s disease, there is an excessive chronic inflammation with massive accumulation of leukocytes in the gut, in an attempt to constrain the invasion of pathogenic microorganisms on the damaged organ. Accordingly, it is known that dietary components, xenobiotics, and some chemicals or metabolites can activate AHR and induce the modulation of inflammatory responses. In fact, the AHR triggering b...
Source: Clinical Reviews in Allergy and Immunology - April 10, 2020 Category: Allergy & Immunology Source Type: research

New Insights into Asthma Inflammation: Focus on iNKT, MAIT, and γδT Cells
AbstractAsthma is a chronic immunological disease affecting all age groups, but often starting in childhood. Although it has long been ascribed to a single pathology, recent studies have highlighted its heterogeneity due to the potential involvement of various pathogenic mechanisms. Here, we present our current understanding of the role of innate-like T (ILT) cells in asthma pathogenesis. These cells constitute a specific family mainly comprising γδT, invariant natural killer (iNKT) and mucosal-associated invariant (MAIT) T cells. They all share the ability to massively secrete a wide range of cytokines in a T-...
Source: Clinical Reviews in Allergy and Immunology - April 2, 2020 Category: Allergy & Immunology Source Type: research

JAK Inhibitors: Prospects in Connective Tissue Diseases
AbstractThe dysregulation of the JAK –STAT pathway is associated with various immune disorders. Four JAK inhibitors have been approved for rheumatoid arthritis (RA), and numerous JAK inhibitors are currently being tested in phase II and III trials for the treatment of various autoimmune inflammatory diseases. In this narrative review , we elucidate the involvement of the JAK–STAT signaling pathway in the pathogenesis of connective tissue diseases (CTDs). We also discuss the efficacy of the first- and second-generation JAK inhibitors (tofacitinib, baricitinib, ruxolitinib, peficitinib, filgotinib, upadacitinib, ...
Source: Clinical Reviews in Allergy and Immunology - March 27, 2020 Category: Allergy & Immunology Source Type: research

Crosstalk Between Mast Cells and Adipocytes in Physiologic and Pathologic Conditions
AbstractExcessive fatty acids and glucose uptake support the infiltration of adipose tissue (AT) by a variety of immune cells including neutrophils, pro-inflammatory M1 macrophages, and mast cells (MCs). These cells promote inflammation by releasing pro-inflammatory mediators. The involvement of MCs in AT biology is supported by their accumulation in the AT of obese individuals along with significantly higher serum levels of MC-derived tryptase. AT-resident MCs under the influence of locally derived adipokines such as leptin become activated and release pro-inflammatory cytokines including TNF α that worsens the infl...
Source: Clinical Reviews in Allergy and Immunology - March 24, 2020 Category: Allergy & Immunology Source Type: research

New Concepts and Technological Resources in Patient Education and Asthma Self-Management
AbstractAsthma is a chronic disease that is associated with significant morbidity and mortality. In general, the use of technology resources or electronic health (e-health) has been shown to have beneficial effects on patients with asthma. E-health can impact a broad section of patients and can be cost-effective and associated with high patient satisfaction. E-health may enable remote delivery of care, as well as timely access to health care, which are some of the common challenges faced by patients with asthma. Web-based asthma self-management systems have been found to improve quality of life, self-reported asthma sympto...
Source: Clinical Reviews in Allergy and Immunology - March 24, 2020 Category: Allergy & Immunology Source Type: research

Immunogenetics of Kawasaki disease
AbstractKawasaki disease (KD) is a medium vessel vasculitis that affects young children. Despite extensive research over the last 50  years, the etiology of KD remains an enigma. Seasonal change in wind patterns was shown to have correlation with the epidemics of KD in Japan. Occurrence of disease in epidemiological clusters, seasonal variation, and a very low risk of recurrence suggest that KD is triggered by an infectious agen t. The identification of oligoclonal IgA response in the affected tissues suggests an antigen-driven inflammation. The recent identification of a viral antigen in the cytoplasm of bronchial ci...
Source: Clinical Reviews in Allergy and Immunology - March 20, 2020 Category: Allergy & Immunology Source Type: research

Correction to: Targeted Anti-IL-5 Therapies and Future Therapeutics for Hypereosinophilic Syndrome and Rare Eosinophilic Conditions
Conclusion” section. (Source: Clinical Reviews in Allergy and Immunology)
Source: Clinical Reviews in Allergy and Immunology - March 17, 2020 Category: Allergy & Immunology Source Type: research

Maternal Nutritional Status and Development of Atopic Dermatitis in Their Offspring
AbstractAtopic dermatitis (AD) is the leading chronic skin inflammatory disease and the initial manifestation of atopic march. Available evidence supports the notion that primary prevention early in life leads to a decreased incidence of AD, thus possibly decreasing the subsequent occurrence of atopic march. Nutritional status is essential to a proper functioning immune system and is valued for its important role in AD. Essential nutrients, which include carbohydrates, proteins, lipids, vitamins, and minerals, are transferred from the mother to the fetus through the placenta during gestation. Various nutrients, such as pol...
Source: Clinical Reviews in Allergy and Immunology - March 9, 2020 Category: Allergy & Immunology Source Type: research

The Role of Mast Cells in IgE-Independent Lung Diseases
AbstractMast cells (MCs) are granular cells of the innate immune system which develop from CD34+/CD117+ progenitors and play a role in orchestrating adaptive immune responses. They have a well-known role in allergic reactions following immunoglobulin (Ig)E-mediated activation of the cell-surface expressed IgE high-affinity receptor (Fc εRI). MCs can also respond to various other stimuli due to the expression of a variety of receptors including toll-like receptors (TLRs), immunoglobulin (IgG) receptors (FcγR), complement receptors such as C5a (CD88) expressed by skin MCs, neuropeptides receptors including nerv...
Source: Clinical Reviews in Allergy and Immunology - February 20, 2020 Category: Allergy & Immunology Source Type: research

Animal Models of Autoimmune Liver Diseases: a Comprehensive Review
AbstractAutoimmune liver diseases (AILDs) are potentially life-threatening chronic liver diseases which include autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, and recently characterized IgG4-related sclerosing cholangitis. They are caused by immune attack on hepatocytes or bile ducts, with different mechanisms and clinical manifestations. The etiologies of AILDs include a susceptible genetic background, environment insults, infections, and changes of commensal microbiota, but remain complicated. Understanding of the underlying mechanisms of AILDs is mandatory for early diagnosis and inte...
Source: Clinical Reviews in Allergy and Immunology - February 18, 2020 Category: Allergy & Immunology Source Type: research

Using Baseline and Peak Serum Tryptase Levels to Diagnose Anaphylaxis: a Review
AbstractThe diagnosis of anaphylaxis relies on a suggestive clinical history after exposure to a potential triggering factor. Serum tryptase concentrations increase on degranulation of mast cells and therefore serum tryptase levels are measured to diagnose anaphylaxis. There is no standardized method for assessing total serum mast cell tryptase (MCT) in anaphylaxis. The Working Conference in 2010 proposed a consensus equation (peak MCT should be>  1.2x baseline tryptase + 2 ng/L) to diagnose acute mast cell activation (aMCA). Our objective was to narratively review the literature since the Working Con...
Source: Clinical Reviews in Allergy and Immunology - February 6, 2020 Category: Allergy & Immunology Source Type: research

The Current State of Biologic Therapies for Treatment of Refractory Asthma
AbstractAsthma is a heterogeneous disease, with the immune processes behind the chronic inflammation underlying this disorder differing between the various identified asthma endotypes. In addition to heterogeneity in underlying disease pathophysiology, asthmatics fall across a broad spectrum of disease severity and can vary greatly in their response to convention asthma therapies. A small percentage of patients with severe persistent asthma will remain uncontrolled despite treatment with high-dose inhaled corticosteroids and a long-acting beta-agonist. Less than two decades ago, there were few options for these treatment-r...
Source: Clinical Reviews in Allergy and Immunology - January 23, 2020 Category: Allergy & Immunology Source Type: research

Targeted Anti-IL-5 Therapies and Future Therapeutics for Hypereosinophilic Syndrome and Rare Eosinophilic Conditions
AbstractEosinophilic inflammation is a component of many atopic diseases such as asthma, and biologics targeting eosinophils have been shown to be effective in subsets of these patients. However, there also are conditions in which eosinophils are the key inflammatory cells responsible for driving tissue damage. In these eosinophilic diseases such as hyper-eosinophilic syndrome, eosinophilic esophagitis, and eosinophilic granulomatosis with polyangiitis (EGPA), the development of biologics inhibiting eosinophilic inflammation have offered targeted therapeutic strategies for patients that have not responded well to typical f...
Source: Clinical Reviews in Allergy and Immunology - January 8, 2020 Category: Allergy & Immunology Source Type: research

Eczema Herpeticum: Clinical and Pathophysiological Aspects
AbstractAtopic dermatitis (AD) is the most common chronic inflammatory skin disease in the world. AD is a complex pathology mainly characterized by an impaired skin barrier, immune response dysfunction, and unbalanced skin microbiota. Moreover, AD patients exhibit an increased risk of developing bacterial and viral infections. One of the most current, and potentially life-threatening, viral infection is caused by herpes simplex virus (HSV), which occurs in about 3% of AD patients under the name of eczema herpeticum (EH). Following a first part dedicated to the clinical features, virological diagnosis, and current treatment...
Source: Clinical Reviews in Allergy and Immunology - December 12, 2019 Category: Allergy & Immunology Source Type: research

The Immunopathology of Complement Proteins and Innate Immunity in Autoimmune Disease
AbstractThe complement is a powerful cascade of the innate immunity and also acts as a bridge between innate and acquired immune defence. Complement activation can occur via three distinct pathways, the classical, alternative and lectin pathways, each resulting in the common terminal pathway. Complement activation results in the release of a range of biologically active molecules that significantly contribute to immune surveillance and tissue homeostasis. Several soluble and membrane-bound regulatory proteins restrict complement activation in order to prevent complement-mediated autologous damage, consumption and exacerbat...
Source: Clinical Reviews in Allergy and Immunology - December 12, 2019 Category: Allergy & Immunology Source Type: research

Mast Cell Biology at Molecular Level: a Comprehensive Review
AbstractMast cells (MCs) are portions of the innate and adaptive immune system derived from bone marrow (BM) progenitors that are rich in cytoplasmic granules. MC maturation, phenotype, and function are determined by their microenvironment. MCs accumulate at inflammatory sites associated with atopy, wound healing, and malignancies. They interact with the external environment and are predominantly located in close proximity of blood vessels and sensory nerves. MCs are key initiators and modulators of allergic, anaphylactic, and other inflammatory reactions, by induction of vasodilation, promoting of vascular permeability, r...
Source: Clinical Reviews in Allergy and Immunology - December 11, 2019 Category: Allergy & Immunology Source Type: research