Immediate and Delayed Hypersensitivity Reactions to Beta-Lactam Antibiotics
AbstractBeta-lactam antibiotics are the most commonly reported drug allergy in adults and children. More than 95% of those with reported allergy labels to beta lactams are not confirmed when subjected to allergy testing. Beta lactam antibiotics are associated with a wide spectrum of immediate and delayed drug hypersensitivity reactions. The latency period to symptoms and clinical presentation aids in the causality assessment. Risk stratification based on diagnosis and timing then allows for appropriate management and evaluation. Skin prick testing, intradermal testing and oral challenge are well established for evaluation ...
Source: Clinical Reviews in Allergy and Immunology - November 12, 2021 Category: Allergy & Immunology Source Type: research

The Mortality from Hereditary Angioedema Worldwide: a Review of the Real-World Data Literature
This study aims to review the global mortality secondary to laryngeal edema in patients diagnosed with hereditary angioedema and their relatives over the years, as well as to describe epidemiological and clinical findings associated with this outcome. An extensive search of the literature was made in PubMed, Scopus, and Embase to identify mortality rates secondary to laryngeal edema in patients with hereditary angioedema. The search was carried out in September of 2020 and in April of 2021, and keywords based on the MeSH terms were searched in three databases. The filter of language was used for finding only articles in En...
Source: Clinical Reviews in Allergy and Immunology - October 23, 2021 Category: Allergy & Immunology Source Type: research

A Review of Post-treatment Lyme Disease Syndrome and Chronic Lyme Disease for the Practicing Immunologist
AbstractLyme disease is an infection caused byBorrelia burgdorferi sensu lato, which is transmitted to humans through the bite of an infected Ixodes tick. The majority of patients recover without complications with antibiotic therapy. However, for a minority of patients, accompanying non-specific symptoms can persist for months following completion of therapy. The constellation of symptoms such as fatigue, cognitive dysfunction, and musculoskeletal pain that persist beyond 6  months and are associated with disability have been termed post-treatment Lyme disease syndrome (PTLDS), a subset of a broader term “chron...
Source: Clinical Reviews in Allergy and Immunology - October 23, 2021 Category: Allergy & Immunology Source Type: research

Antimitochondrial Antibodies: from Bench to Bedside
AbstractAnti-mitochondrial antibodies (AMA) are directed against the E2 subunits of the 2-oxo acid dehydrogenase complexes (PDC-E2) and are the typical biomarkers of primary biliary cholangitis (PBC), being present in 90 –95% of patients, with increasing sensitivity at increasing titers. Albeit being highly specific for PBC diagnosis, AMA can be detected in less than 1% of healthy subjects, and thus the management subjects with no sign or symptom of liver disease is still a challenge and data concerning clinical r isk of developing PBC in this subgroup of patients are controversial. Moreover, AMA can also be detected...
Source: Clinical Reviews in Allergy and Immunology - September 29, 2021 Category: Allergy & Immunology Source Type: research

Combining Anti-IgE Monoclonal Antibodies and Oral Immunotherapy for the Treatment of Food Allergy
AbstractImmunoglobulin E (IgE)-mediated food allergy is a real public health problem worldwide. The prevalence of food allergy is particularly high in children. Patients with food allergy experience high morbidity with a change in quality of life due to the risk of severe anaphylaxis. Current treatment options are poor. Allergen avoidance is widely recommended but exposes patients to accidental ingestion. Oral immunotherapy is also used in patients with food allergies to the most common allergens. Oral immunotherapy consists of a daily administration of small, gradually increasing amounts of allergens to induce desensitisa...
Source: Clinical Reviews in Allergy and Immunology - September 22, 2021 Category: Allergy & Immunology Source Type: research

Different Phenotypes in Asthma: Clinical Findings and Experimental Animal Models
AbstractAsthma is a respiratory allergic disease presenting a high prevalence worldwide, and it is responsible for several complications throughout life, including death. Fortunately, asthma is no longer recognized as a unique manifestation but as a very heterogenic manifestation. Its phenotypes and endotypes are known, respectively, as pathologic and molecular features that might not be directly associated with each other. The increasing number of studies covering this issue has brought significant insights and knowledge that are constantly expanding. In this review, we intended to summarize this new information obtained ...
Source: Clinical Reviews in Allergy and Immunology - September 20, 2021 Category: Allergy & Immunology Source Type: research

The Therapeutic Strategies for SLE by Targeting Anti-dsDNA Antibodies
AbstractSystemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by diverse serological autoantibodies. Anti-dsDNA antibodies are involved in multiple organ damage, especially the kidney, skin, and central nervous system. Anti-dsDNA antibodies play a pivotal role in SLE, and researchers have developed therapeutic strategies targeting these antibodies. Approaches to reduce anti-dsDNA antibodies via B cell targeted biologics against B cell surface antigens, B cell survival factors, or Bruton ’s tyrosine kinase have effectively eliminated B cells. However, their non-specific depletion hampers nor...
Source: Clinical Reviews in Allergy and Immunology - September 20, 2021 Category: Allergy & Immunology Source Type: research

Immunology of Aging: the Birth of Inflammaging
AbstractThe inflammaging concept was introduced in 2000 by Prof. Franceschi. This was an evolutionary or rather a revolutionary conceptualization of the immune changes in response to a lifelong stress. This conceptualization permitted to consider the lifelong proinflammatory process as an adaptation which could eventually lead to either beneficial or detrimental consequences. This dichotomy is influenced by both the genetics and the environment. Depending on which way prevails in an individual, the outcome may be healthy longevity or pathological aging burdened with aging-related diseases. The concept of inflammaging has a...
Source: Clinical Reviews in Allergy and Immunology - September 18, 2021 Category: Allergy & Immunology Source Type: research

The Role of IgE in Upper and Lower Airway Disease: More Than Just Allergy!
AbstractImmunoglobulin E (IgE) is a well-known key factor in allergic airway disease; however, its central role in non-allergic airway inflammation is often underestimated. In some airway diseases, IgE is produced as a result of allergic sensitization. However, in others, IgE production occurs despite the lack of a specific allergen. Although multiple pathways contribute to the production of IgE in airway disease, it is its activity in mediating the inflammatory response that is associated with disease. Therefore, an understanding of IgE as the unifying component of upper and lower airway diseases has important implication...
Source: Clinical Reviews in Allergy and Immunology - September 18, 2021 Category: Allergy & Immunology Source Type: research

Public Health Measures and the Control of COVID-19 in China
AbstractIn December 2019, the COVID-19 pandemic quickly spread throughout China and beyond, posing enormous global challenges. With prompt, vigorous, and coordinated control measures, mainland China contained the spread of the epidemic within two months and halted the epidemic in three months. Aggressive containment strategy, hierarchical management, rational reallocation of resources, efficient contact tracing, and voluntary cooperation of Chinese citizens contributed to the rapid and efficient control of the epidemic, thus promoting the rapid recovery of the Chinese economy. This review summarizes China ’s preventi...
Source: Clinical Reviews in Allergy and Immunology - September 18, 2021 Category: Allergy & Immunology Source Type: research

Chronic Urticaria: Advances in Understanding of the Disease and Clinical Management
AbstractChronic urticaria (CU) is a common skin condition characterized by the recurrence of wheals, with or without angioedema, which lasts for at least 6  weeks. Owing to its pruritus and incurability, this disease adversely affects the patients’ physical and mental health and diminishes the quality of life. CU is generally classified into two subtypes based on the relevance of eliciting factors: chronic spontaneous urticaria (CSU) and chronic ind ucible urticaria (CIndU), the latter of which is further divided into several subtypes. To improve the understanding and clinical management of this highly heterogen...
Source: Clinical Reviews in Allergy and Immunology - September 16, 2021 Category: Allergy & Immunology Source Type: research

Clinical Manifestations of Pediatric Food Allergy: a Contemporary Review
AbstractFood allergies (FAs) are an emerging health care issue, and a “second wave of the allergy epidemic” was named. There are extensive data that documented the prevalence rate as high as approximately 10%. FAs are immunological adverse reactions, including IgE-mediated mechanisms, cell-mediated mechanisms, or mixed IgE- and cell-mediated mechanisms. A diagnosi s of FA is made by specific symptoms encounter with food, detailed past history, sensitization tests, and oral food challenges (OFCs) if necessary. The component-resolved diagnostics (CRD) test can distinguish true or cross-reaction. “Minimal el...
Source: Clinical Reviews in Allergy and Immunology - September 14, 2021 Category: Allergy & Immunology Source Type: research

Systemic Lupus Erythematosus and Pregnancy: a Portuguese Case –Control Study
AbstractPregnancy in systemic lupus erythematosus (SLE) patients is associated with an increased risk of adverse outcomes. During pregnancy, SLE patients have a higher rate of miscarriage, stillbirth, preterm delivery, fetal growth restriction, or hypertensive disorders of pregnancy. To date, only a few case –control studies were published with the purpose to evaluate the magnitude of risk associated with pregnancy in lupus patients. The aim of our study was to evaluate the maternal and fetal outcomes in a cohort of Portuguese SLE patients and to compare it with a group of healthy pregnant women. We c onducted a retr...
Source: Clinical Reviews in Allergy and Immunology - September 14, 2021 Category: Allergy & Immunology Source Type: research

Autoantibodies in Rheumatoid Arthritis: Historical Background and Novel Findings
AbstractAutoantibodies represent a hallmark of rheumatoid arthritis (RA), with the rheumatoid factor (RF) and antibodies against citrullinated proteins (ACPA) being the most acknowledged ones. RA patients who are positive for RF and/or ACPA ( “seropositive”) in general display a different etiology and disease course compared to so-called “seronegative” patients. Still, the seronegative patient population is very heterogeneous and not well characterized. Due to the identification of new autoantibodies and advancements in the diagn osis of rheumatic diseases in the last years, the group of seronegativ...
Source: Clinical Reviews in Allergy and Immunology - September 8, 2021 Category: Allergy & Immunology Source Type: research

Autoimmune Hepatitis: Serum Autoantibodies in Clinical Practice
AbstractCirculating autoantibodies are a key diagnostic tool in autoimmune hepatitis (AIH), being positive in 95% of the cases if tested according to dedicated guidelines issued by the International Autoimmune Hepatitis Group. They also allow the distinction between type 1 AIH, characterized by positive anti-nuclear and/or anti-smooth muscle antibody, and type 2 AIH, characterized by positive anti-liver kidney microsomal type 1 and/or anti-liver cytosol type 1 antibody. Anti-soluble liver antigen is the only AIH-specific autoantibody, and is found in 20 –30% of both type 1 and type 2 AIH. Anti-neutrophil cytoplasmic ...
Source: Clinical Reviews in Allergy and Immunology - September 7, 2021 Category: Allergy & Immunology Source Type: research

Current Concepts on the Pathogenesis of Systemic Sclerosis
AbstractFrom the clinical standpoint, systemic sclerosis (SSc) is characterized by skin and internal organ fibrosis, diffuse fibroproliferative vascular modifications, and autoimmunity. Clinical presentation and course are highly heterogenous and life expectancy variably affected mostly dependent on lung and heart involvement. SSc touches more women than men with differences in disease severity and environmental exposure. Pathogenetic events originate from altered homeostasis favored by genetic predisposition, environmental cues and a variety of endogenous and exogenous triggers. Epigenetic modifications modulate SSc patho...
Source: Clinical Reviews in Allergy and Immunology - September 6, 2021 Category: Allergy & Immunology Source Type: research

Challenge of Nail Psoriasis: An Update Review
AbstractNail psoriasis is a refractory disease that affects 50 –79% skin psoriasis patients and up to 80% of patients with psoriatic arthritis (PsA). The pathogenesis of nail psoriasis is still not fully illuminated, although some peculiar inflammatory cytokines and chemokines seems to be the same as described in psoriatic skin lesions. Psoriatic nail involvi ng matrix can cause pitting, leukonychia, red spots in lunula, and nail plate crumbling, while nail bed involvement can result in onycholysis, oil-drop discoloration, nail bed hyperkeratosis, and splinter hemorrhages. The common assessment methods of evaluating ...
Source: Clinical Reviews in Allergy and Immunology - September 3, 2021 Category: Allergy & Immunology Source Type: research

Therapeutic Approaches to Systemic Sclerosis: Recent Approvals and Future Candidate Therapies
AbstractSystemic sclerosis is the rheumatic disease with the highest individual mortality. The severity of the disease is determined by the extent of fibrotic changes to cutaneous and internal organ tissues, the most life-threatening visceral manifestations being interstitial lung disease, SSc-associated-pulmonary arterial hypertension and myocardial involvement. The heterogeneity of the disease has initially hindered the design of successful clinical trials, but considerations on classification criteria have improved patient selection in trials, allowing the identification of more homogeneous groups of patients based on p...
Source: Clinical Reviews in Allergy and Immunology - September 1, 2021 Category: Allergy & Immunology Source Type: research

Serum ANCA as Disease Biomarkers: Clinical Implications Beyond Vasculitis
AbstractUsually associated with autoimmune diseases, anti-neutrophil cytoplasmic antibodies are also detected in other conditions, such as infections, malignancies, and after intake of certain drugs. Even if the mechanisms of production and their pathogenic role have not been fully elucidated yet, ANCA are widely recognized as a clinically alarming finding due to their association with various disorders. While ANCA target several autoantigens, proteinase-3, and myeloperoxidase are the ones proved to be most frequently related to chronic inflammation and tissue damage in murine models. Albeit these autoantibodies could be p...
Source: Clinical Reviews in Allergy and Immunology - August 30, 2021 Category: Allergy & Immunology Source Type: research

Defects of the Innate Immune System and Related Immune Deficiencies
AbstractThe innate immune system is the host ’s first line of defense against pathogens. Toll-like receptors (TLRs) are pattern recognition receptors that mediate recognition of pathogen-associated molecular patterns. TLRs also activate signaling transduction pathways involved in host defense, inflammation, development, and the production of inflammatory cytokines. Innate immunodeficiencies associated with defective TLR signaling include mutations inNEMO,IKBA,MyD88, andIRAK4. Other innate immune defects have been associated with susceptibility to herpes simplex encephalitis, viral infections, and mycobacterial diseas...
Source: Clinical Reviews in Allergy and Immunology - August 21, 2021 Category: Allergy & Immunology Source Type: research

Alopecia Areata: an Update on Etiopathogenesis, Diagnosis, and Management
AbstractAlopecia areata (AA) is a common chronic tissue-specific autoimmune disease, resulting in hair loss, that affects up to 2% of the general population. The exact pathobiology of AA has still remained elusive, while the common theory is the collapse of the immune privilege of the hair follicle caused by immunological mechanism. Multiple genetic and environment factors contribute to the pathogenesis of AA. There are several clinical treatments for AA, varying from one or multiple well-defined patches to more diffuse or total hair loss of the scalp (alopecia totalis) or hair loss of the entire body (alopecia universalis...
Source: Clinical Reviews in Allergy and Immunology - August 17, 2021 Category: Allergy & Immunology Source Type: research

Correction to: Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo
(Source: Clinical Reviews in Allergy and Immunology)
Source: Clinical Reviews in Allergy and Immunology - August 6, 2021 Category: Allergy & Immunology Source Type: research

Comparison of Guidelines for Management of Pemphigus: a Review of Systemic Corticosteroids, Rituximab, and Other Immunosuppressive Therapies
AbstractPemphigus is a severe autoimmune bullous dermatosis that affects the skin and/or mucosa, and it may be life-threatening without proper treatment. The guidelines and/or consensus statements for treatment vary widely between groups. We selected 6 guidelines and consensus statements established by different associations about the management of pemphigus vulgaris (PV) and/or pemphigus foliaceus (PF) to review, compare, and contrast the similarities and differences of these recommendations and provide optimal management suggestions to physicians. Corticosteroids remain a first-line therapy for pemphigus, but there are m...
Source: Clinical Reviews in Allergy and Immunology - August 4, 2021 Category: Allergy & Immunology Source Type: research

Update on the Pathogenesis and Therapy of Atopic Dermatitis
AbstractAtopic dermatitis (AD) is a common inflammatory skin disorder characterized by recurrent eczematous lesions and intense itch. Although it most often starts in infancy and affects children, it is also highly prevalent in adults. In this article, the main aspects of AD have been updated, with a focus on the pathogenetic and therapeutic aspects. The pathogenesis of AD is complex, and it is evident that a strong genetic predisposition, epidermal dysfunction, skin microbiome abnormalities, immune dysregulation, and the neuroimmune system are critical in AD development. Mutations in the genes associated with disrupted ep...
Source: Clinical Reviews in Allergy and Immunology - August 2, 2021 Category: Allergy & Immunology Source Type: research

Systemic Contact Dermatitis: The Routes of Allergen Entry
AbstractSystemic contact dermatitis (SCD) is a generalized reactivation of type IV hypersensitivity skin diseases in individuals with previous sensitization after a contact allergen is administered systemically. Patients with SCD may consider their dermatitis unpredictable and recalcitrant since the causative allergens are difficult to find. If a patient has a pattern of dermatitis suggestive of SCD but fails to improve with conventional treatment, SCD should be taken into consideration. If doctors are not familiar with the presentations of SCD and the possible routes of allergen sensitization and exposure, the diagnosis o...
Source: Clinical Reviews in Allergy and Immunology - August 2, 2021 Category: Allergy & Immunology Source Type: research

Hypersensitivity Reactions to Platinum Agents and Taxanes
AbstractHypersensitivity reactions (HSRs) to chemotherapy agents can present a serious challenge to treating patients with preferred or first-line therapies. Allergic reactions through an immunologic mechanism have been established for platinum and taxane agents, which are used to treat a wide variety of cancers including gynecologic cancers. Platin HSRs typically occur after multiple cycles of chemotherapy, reflecting the development of drug IgE sensitization, while taxane HSRs often occur on first or second exposure. Despite observed differences between platin and taxane HSRs, drug desensitization has been an effective m...
Source: Clinical Reviews in Allergy and Immunology - August 2, 2021 Category: Allergy & Immunology Source Type: research

Hypersensitivity and Immune-related Adverse Events in Biologic Therapy
AbstractBiologic medications are an expanding field of therapeutics for various medical conditions including cancer and inflammatory diseases. Due to their targeted approach to therapy, biologics can be less toxic than traditional systemic medications. However, as use becomes more widespread, adverse effects from biologic administration have also become apparent. Immune-related adverse events are a common mechanism by which biologics can cause on-target immune-related toxicities and both immediate and delayed-type hypersensitivity reactions. Immediate hypersensitivity reactions can be mediated by cytokine release or antibo...
Source: Clinical Reviews in Allergy and Immunology - July 28, 2021 Category: Allergy & Immunology Source Type: research

Newborn Screening in the Diagnosis of Primary Immunodeficiency
This article provides an overview of newborn screening for SCID, recommended steps for follow-up testing and early intervention as well as long-term follow-up. Numerous challenges remain, including the development of clinical consensus regarding confirmatory and diagnostic testing, early interventions, and best practices for immune reconstitution in affected infants. (Source: Clinical Reviews in Allergy and Immunology)
Source: Clinical Reviews in Allergy and Immunology - July 22, 2021 Category: Allergy & Immunology Source Type: research

Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo
AbstractVitiligo is an autoimmune disease of the skin characterized by epidermal melanocyte loss resulting in white patches, with an approximate prevalence of 0.5 –2% worldwide. Several precipitating factors by chemical exposure and skin injury present commonly in patients with vitiligo. Although the diagnosis appears to be straightforward for the distinct clinical phenotype and specific histological features, vitiligo provides many challenges including chr onicity, treatment resistance, frequent relapse, associated profound psychosocial effect, and negative impact on quality of life. Multiple mechanisms are involved...
Source: Clinical Reviews in Allergy and Immunology - July 20, 2021 Category: Allergy & Immunology Source Type: research

Current Perspectives on Severe Drug Eruption
Abstract Adverse drug reactions involving the skin are commonly known as drug eruptions. Severe drug eruption may cause severe cutaneous adverse drug reactions (SCARs), which are considered to be fatal and life-threatening, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalized exanthematous pustulosis (AGEP), and drug reaction with eosinophilia and systemic symptoms (DRESS). Although cases are relatively rare, approximately 2% of hospitalized patients are affected by SCARs. There is an incidence of 2 to 7 cases/million per year of SJS/TEN and 1/1000 to 1/10,000 exposures to offendi...
Source: Clinical Reviews in Allergy and Immunology - July 17, 2021 Category: Allergy & Immunology Source Type: research

Contact Dermatitis: Classifications and Management
AbstractContact dermatitis (CD) is a common inflammatory skin disease caused by exposure to contact allergens and irritants. It is also the most common reason of occupational dermatitis and contributes greatly to hand dermatitis and facial dermatitis. Besides the two major forms of contact dermatitis: allergic contact dermatitis and irritant contact dermatitis, other subtypes of CD have been recognized including immediate skin reactions, photoinduced contact dermatitis, systemic contact dermatitis, and non-eczematous contact dermatitis. CD is a great imitator which can mimic many kinds of skin diseases, such as atopic derm...
Source: Clinical Reviews in Allergy and Immunology - July 15, 2021 Category: Allergy & Immunology Source Type: research

Perioperative Anaphylaxis: Evaluation and Management
AbstractPerioperative anaphylaxis (PA) is a rare but life-threatening condition that poses diagnostic and management challenges in the operating room. The incidence of severe perioperative reactions is estimated to be approximately 1:7000 –10,000. Management involves both immediate stabilization of the patient and identifying the culprit agent. Identification is essential to prevent recurrence of the event in subsequent surgeries and to avoid unnecessary labeling of drug allergy. Identifying all possible exposures including medicat ions, disinfectants, latex, and dyes and choosing the appropriate tests are essential ...
Source: Clinical Reviews in Allergy and Immunology - July 10, 2021 Category: Allergy & Immunology Source Type: research

Agammaglobulinemia: from X-linked to Autosomal Forms of Disease
AbstractInterruptions or alterations in the B cell development pathway can lead to primary B cell immunodeficiency with resultant absence or diminished immunoglobulin production. While the most common cause of congenital agammaglobulinemia is X-linked agammaglobulinemia (XLA), accounting for approximately 85% of cases, other genetic forms of agammaglobulinemia have been identified. Early recognition and diagnosis of these conditions are pivotal for improved outcomes and prevention of sequelae and complications. The diagnosis of XLA is often delayed, and can be missed if patient has a mild phenotype. The lack of correlation...
Source: Clinical Reviews in Allergy and Immunology - July 9, 2021 Category: Allergy & Immunology Source Type: research

Comparison of Diagnostic Criteria for Common Variable Immunodeficiency Disorders (CVID) in the New Zealand CVID Cohort Study
AbstractCommon variable immunodeficiency disorders (CVID) are the most frequent symptomatic primary immune deficiencies in adults and children. In addition to recurrent and severe infections, patients with CVID are susceptible to autoimmune and inflammatory complications. The aetiologies of these uncommon conditions are, by definition, unknown. When the causes of complex disorders are uncertain, diagnostic criteria may offer valuable guidance to the management of patients. Over the last two decades, there have been four sets of diagnostic criteria for CVID in use. The original 1999 European Society for Immunodeficiencies a...
Source: Clinical Reviews in Allergy and Immunology - July 8, 2021 Category: Allergy & Immunology Source Type: research

Improving the Efficacy of Regulatory T Cell Therapy
AbstractAutoimmunity is caused by an unbalanced immune system, giving rise to a variety of organ-specific to system disorders. Patients with autoimmune diseases are commonly treated with broad-acting immunomodulatory drugs, with the risk of severe side effects. Regulatory T cells (Tregs) have the inherent capacity to induce peripheral tolerance as well as tissue regeneration and are therefore a prime candidate to use as cell therapy in patients with autoimmune disorders. (Pre)clinical studies using Treg therapy have already established safety and feasibility, and some show clinical benefits. However, Tregs are known to be ...
Source: Clinical Reviews in Allergy and Immunology - July 5, 2021 Category: Allergy & Immunology Source Type: research

Risk Factors for the Development of the Disease in Antiphospholipid Antibodies Carriers: A Long-term Follow-up Study
The objectives of the present study were (a) to study the probability of developing clinical criteria of antiphospholipid syndrome (APS), (b) to identify potential risk factors for developing thrombosis and/or obstetric complications, (c) to study the association between the antibody profile and development of APS, and (d) to determine the efficacy of primary prophylaxis. We retrospectively analyzed 138 subjects with positive aPL who did not fulfill clinical criteria for APS. The mean follow-up time was 138  ± 63.0 months. Thirteen patients (9.4%) developed thrombosis after an average period of 73.0&n...
Source: Clinical Reviews in Allergy and Immunology - July 3, 2021 Category: Allergy & Immunology Source Type: research

Sulfonamide Hypersensitivity
AbstractSulfonamides, particularly antimicrobial sulfonamides, have been implicated as a common cause of a spectrum of hypersensitivity reactions. Immediate IgE-mediated reactions have been reported but are much less common than delayed cutaneous reactions. Delayed cutaneous reactions range from benign exanthems to severe cutaneous reactions such as Stevens Johnson syndrome, toxic epidermal necrolysis, or drug reaction with eosinophilia and systemic symptoms. Sulfonamides can be subclassified as antimicrobial sulfonamides and non-antimicrobial sulfonamides, which are also distinguished by key structural differences, result...
Source: Clinical Reviews in Allergy and Immunology - July 1, 2021 Category: Allergy & Immunology Source Type: research

Correction to: Mitigating Disparity in Healthcare Resources Between Countries for Management of Hereditary Angioedema
(Source: Clinical Reviews in Allergy and Immunology)
Source: Clinical Reviews in Allergy and Immunology - July 1, 2021 Category: Allergy & Immunology Source Type: research

Precision Medicine in the Treatment of Primary Immune Deficiency Patients With Disorders of Immune Dysregulation
AbstractThere are now more than 450 described monogenic germline mutations for inborn errors of immunity that result in the loss of expression, loss of function (LOF), or gain in function (GOF) of the encoded protein. Molecular characterization of these inborn errors of immunity has not only allowed us to characterize on a genetic basis these immune deficiency disorders but has provided a better understanding of the immunobiology of these inborn errors of immunity. More recently, these advances have allowed us to apply targeted therapy or precision medicine in their treatment. Of particular interest related to this review ...
Source: Clinical Reviews in Allergy and Immunology - June 24, 2021 Category: Allergy & Immunology Source Type: research

Nickel Hypersensitivity to Atrial Septal Occluders: Smoke Without Fire?
AbstractNickel is one of the most common contact allergens worldwide; it is used as the main component of the devices used for atrial septal defects (ASDs) and patent foramen ovale (PFO) closure. Developing nickel hypersensitivity after PFO/ASD occlusion is significantly rarer described in medical literature than typical nickel contact sensitization. The exact pathophysiological mechanism of this “device syndrome” remains unknown, and many question the real incidence or even the existence of this clinical entity. Nevertheless, it has been associated with a wide spectrum of symptoms, including chest pain, migrai...
Source: Clinical Reviews in Allergy and Immunology - June 15, 2021 Category: Allergy & Immunology Source Type: research

Autoantibodies in Neuropsychiatric Systemic Lupus Erythematosus (NPSLE): Can They Be Used as Biomarkers for the Differential Diagnosis of This Disease?
AbstractSystemic lupus erythematosus is a complex immunological disease where both environmental factors and genetic predisposition lead to the dysregulation of important immune mechanisms. Eventually, the combination of these factors leads to the production of self-reactive antibodies that can target any organ or tissue of the human body. Autoantibodies can form immune complexes responsible for both the organ damage and the most severe complications. Involvement of the central nervous system defines a subcategory of the disease, generally known with the denomination of neuropsychiatric systemic lupus erythematosus. Neurop...
Source: Clinical Reviews in Allergy and Immunology - June 11, 2021 Category: Allergy & Immunology Source Type: research

A Contemporary Review of Behcet ’s Syndrome
AbstractBehcet ’s syndrome (BS) is a chronic systemic inflammatory vasculitis with a wide range of clinical manifestations including recurrent oral and genital ulcers; cutaneous lesions; and ophthalmic, neurologic, and gastrointestinal involvement. BS has a global distribution but is particularly prevalent in so -called Silk Road populations. Disease onset is usually around the third or fourth decade of life, and the sex ratio is roughly 1:1. Both environmental and genetic factors contribute to the etiology of BS, although the detailed mechanisms remain unclear. At present, there is no laboratory examinatio n with di...
Source: Clinical Reviews in Allergy and Immunology - June 2, 2021 Category: Allergy & Immunology Source Type: research

High Estrogen States in Hereditary Angioedema: a Spectrum
AbstractSex differences have been well documented within hereditary angioedema (HAE) over the past several decades. Females often experience more frequent and more intense attacks compared to their male counterparts. Additionally, elevated estrogen levels —as seen in pregnancy and use of oral contraceptives—is a widely known trigger for angioedema attacks. In this review article, we will outline how estrogens’ downstream effects increase bradykinin, a potent vasodilator and key mediator of HAE. Estrogen-dependent HAE is a rare disorder that pro vides insight into the relationship between HAE and estrogens...
Source: Clinical Reviews in Allergy and Immunology - June 1, 2021 Category: Allergy & Immunology Source Type: research

Global View on Ant Venom Allergy: from Allergenic Components to Clinical Management
This article provides a global view on allergic reactions to the venoms of stinging ants and the contemporary approach to diagnose and manage ant venom allergy. (Source: Clinical Reviews in Allergy and Immunology)
Source: Clinical Reviews in Allergy and Immunology - June 1, 2021 Category: Allergy & Immunology Source Type: research

Roles of Immune Cells in Hereditary Angioedema
AbstractHereditary angioedema (HAE) is a rare genetic disease, characterized by recurrent and unexpected potentially life-threatening mucosal swelling. HAE may be further classified into HAE with C1 ‐inhibitor deficiency (C1‐INH‐HAE) and HAE with normal C1‐INH activity (nlC1‐INH‐HAE), mostly due to mutations leading to increased vascular permeability. Recent evidence implicates also the innate and adaptive immune responses in several aspects of angioedema pathophysiology. Monocytes/ macrophages, granulocytes, lymphocytes, and mast cells contribute directly or indirectly to the pathophysiology of angioedema. Imm...
Source: Clinical Reviews in Allergy and Immunology - May 29, 2021 Category: Allergy & Immunology Source Type: research

Significance of Mast Cell Formed Extracellular Traps in Microbial Defense
AbstractMast cells (MCs) are critically involved in microbial defense by releasing antimicrobial peptides (such as cathelicidin LL-37 and defensins) and phagocytosis of microbes. In past years, it has become evident that in addition MCs may eliminate invading pathogens by ejection of web-like structures of DNA strands embedded with proteins known together as extracellular traps (ETs). Upon stimulation of resting MCs with various microorganisms, their products (including superantigens and toxins), or synthetic chemicals, MCs become activated and enter into a multistage process that includes disintegration of the nuclear mem...
Source: Clinical Reviews in Allergy and Immunology - May 22, 2021 Category: Allergy & Immunology Source Type: research

Mitigating Disparity in Health-care Resources Between Countries for Management of Hereditary Angioedema
AbstractHereditary angioedema (HAE) is a rare genetic disorder characterized by recurrent episodes of skin and mucosal edema. The main treatment goal is to enable a “normal life” for all patients. However, due to high costs, there are limited options for the management of HAE in most developing and low-income countries. As a result, most of the recommended first-line treatments are not available. In this review, we attempt to highlight the disparities in he alth-care resources for the management of patients with HAE amongst different countries. Data was collected from HAE experts in countries who provide tabula...
Source: Clinical Reviews in Allergy and Immunology - May 18, 2021 Category: Allergy & Immunology Source Type: research

Blood Clotting and the Pathogenesis of Types I and II Hereditary Angioedema
AbstractThe plasma contact system is the initiator of the intrinsic pathway of coagulation and the main producer of the inflammatory peptide bradykinin. When plasma is exposed to a negatively charged surface the two enzymes factor XII (FXII) and plasma prekallikrein (PK) bind to the surface alongside the co-factor high molecular weight kininogen (HK), where PK is non-covalently bound to. Here, FXII and PK undergo a reciprocal activation feedback loop that leads to full contact system activity in a matter of seconds. Although naturally occurring negatively charged surfaces have shown to be involved in the role of the contac...
Source: Clinical Reviews in Allergy and Immunology - May 6, 2021 Category: Allergy & Immunology Source Type: research

Perspective: Application of the American College of Medical Genetics Variant Interpretation Criteria to Common Variable Immunodeficiency Disorders
AbstractCommon variable immunodeficiency disorders (CVIDs) are rare primary immunodeficiency diseases (PIDs) mostly associated with late onset antibody failure leading to immune system failure. Patients with CVID are predisposed to disabling complications such as bronchiectasis and systemic autoimmunity. In recent years a large number of genetic defects have become associated with these disorders. Patients with a causative mutation are deemed to have CVID-like disorders, while those with mutations predisposing to or modifying disease severity remain within the spectrum of CVID as defined by current diagnostic criteria. Nex...
Source: Clinical Reviews in Allergy and Immunology - April 5, 2021 Category: Allergy & Immunology Source Type: research

The Global Registry for Hereditary Angioedema due to C1-Inhibitor Deficiency
In conclusion, the establishment of a registry for C1-INH-HAE allowed collection of a large amount of data that may help to better understand the clinica l characteristics of this disease. This information may enhance patient care and guide future therapeutic decisions. (Source: Clinical Reviews in Allergy and Immunology)
Source: Clinical Reviews in Allergy and Immunology - March 31, 2021 Category: Allergy & Immunology Source Type: research