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Prediction of Adverse Pregnancy Outcomes in Women with Systemic Lupus Erythematosus
AbstractSystemic lupus erythematosus (SLE) is a chronic, autoimmune disease associated with major obstetrical complications such as gestational loss, preterm delivery, fetal growth restriction (FGR) and preeclampsia. Published literature is not consensual regarding the main risk factors for each of these outcomes. Our goal with this study was to determine the most important predictors for each of the main adverse pregnancy outcomes in this population. We conducted a retrospective cohort study of unifetal pregnancies of women with the diagnosis of SLE followed in our unit between January 1994 and December 2016. We excluded ...
Source: Clinical Reviews in Allergy and Immunology - August 22, 2019 Category: Allergy & Immunology Source Type: research

Clinical Characteristics and Risk Factors of Diffuse Alveolar Hemorrhage in Systemic Lupus Erythematosus: a Systematic Review and Meta-Analysis Based on Observational Studies
AbstractDiffuse alveolar hemorrhage (DAH) is a rare but potentially deadly manifestation of systemic lupus erythematosus (SLE). The aim of this study was to investigate the clinical characteristics and risk factors of DAH in SLE. A systematic review and meta-analysis of previous observational studies compared the clinical characteristics and risk factors between DAH-SLE and SLE patients without DAH. A total of 5 observational studies were included in this meta-analysis. Compared with the SLE patients without DAH, DAH-SLE patients had a significantly higher incidence of neuropsychiatric events (OR  = 4.321, 95% CI (1.68...
Source: Clinical Reviews in Allergy and Immunology - August 21, 2019 Category: Allergy & Immunology Source Type: research

Extrarenal Immune-Mediated Disorders Linked with Acute Poststreptococcal Glomerulonephritis: a Systematic Review
AbstractStreptococcus A infections have been associated with immune-mediated sequelae including acute glomerulonephritis, acute rheumatic fever, thrombocytopenia, hemolytic anemia, Henoch-Sch önlein purpura, arthritis, uveitis, guttate psoriasis, and erythema nodosum. Available reviews do not report the occurrence of acute poststreptococcal glomerulonephritis in association with one of the mentioned conditions. We performed a systematic review of the literature on extrarenal immune-medi ated disorders associated with acute poststreptococcal glomerulonephritis. The principles recommended by the Economic and Social Research...
Source: Clinical Reviews in Allergy and Immunology - August 7, 2019 Category: Allergy & Immunology Source Type: research

Systemic Amyloidosis: a Contemporary Overview
AbstractAmyloidosis constitutes a large spectrum of diseases characterized by an extracellular deposition of a fibrillar aggregate, generating insoluble and toxic amasses that may be deposited in tissues in bundles with an abnormal cross- β-sheet conformation, known as amyloid. Amyloid may lead to a cell damage and an impairment of organ function. Several different proteins are recognized as able to produce amyloid fibrils with a different tissue tropism related to the molecular structure. The deposition of amyloid may occur as a c onsequence of the presence of an abnormal protein, caused by high plasma levels of a norma...
Source: Clinical Reviews in Allergy and Immunology - August 1, 2019 Category: Allergy & Immunology Source Type: research

Asthma Phenotypes as a Guide for Current and Future Biologic Therapies
AbstractAsthma has been increasingly recognized as being a heterogeneous disease with multiple distinct mechanisms and pathophysiologies. Evidence continues to build regarding the existence of different cell types, environmental exposures, pathogens, and other factors that produce a similar set of symptoms known collectively as asthma. This has led to a movement from a “one size fits all” symptom-based methodology to a more patient-centered, individualized approach to asthma treatment targeting the underlying disease process. A significant contributor to this shift to more personalized asthma therapy has been the incre...
Source: Clinical Reviews in Allergy and Immunology - July 28, 2019 Category: Allergy & Immunology Source Type: research

Fungi and Atopy
AbstractAtopy and fungi have a long associative history. Fungal spores were among the first substances to which humans were noted to be sensitized. Humans contact fungal spores in the outdoor, indoor, and occupational environments. As organisms, fungi have their own kingdom and are found in all environmental niches on earth. Currently, fungal exposure in the indoor environment especially related to wet housing conditions is of particular concern. Sensitization rates to fungi typically exceed 5% of the general public with higher rates among the atopic population. Alternaria is the best studied of the allergic fungi; however...
Source: Clinical Reviews in Allergy and Immunology - July 18, 2019 Category: Allergy & Immunology Source Type: research

Supporting a Healthy Microbiome for the Primary Prevention of Eczema
AbstractEczema is increasing worldwide with associated increases in health costs and decreases in quality of life. There are many factors that are speculated to interact in the development of eczema including genetics and environmental exposures. Prevention of the development of eczema may prevent the further development of food allergies and asthma. This concept has prompted a variety of research into the area of primary prevention of eczema in infants. This exploration includes a growing body of research examining infants supplemented with probiotics, prebiotics, or both (synbiotics) often compared with their breastfed c...
Source: Clinical Reviews in Allergy and Immunology - July 14, 2019 Category: Allergy & Immunology Source Type: research

Immunologic Adverse Effects of Biologics for the Treatment of Atopy
AbstractThe use of biologic agents as therapies for atopic diseases such as asthma and atopic dermatitis has increased greatly in recent years. The biological agents used to treat atopic diseases are for the most part monoclonal antibodies that suppress the immune response and reduce inflammation by targeting particular cytokines or other molecules involved in Th1, Th2, or Th17 immune reactions. Various side effects and rare complications have been reported from these agents. In this review, we discuss mechanisms of various adverse effects for the biologic agents currently in use or in development for atopic and inflammato...
Source: Clinical Reviews in Allergy and Immunology - July 12, 2019 Category: Allergy & Immunology Source Type: research

The Relationship Between Hypermobile Ehlers-Danlos Syndrome (hEDS), Postural Orthostatic Tachycardia Syndrome (POTS), and Mast Cell Activation Syndrome (MCAS)
AbstractIn recent years, an association between hypermobile Ehlers-Danlos syndrome (hEDS), mast cell activation syndrome (MCAS), and postural orthostatic tachycardia syndrome (POTS) has garnered attention and patients are increasingly presenting with this triad. However, a real relationship between these entities is unclear due to a lack of scientific validity. We conducted an extensive review of the literature using two different search strategies. A narrower strategy included 88 searches of various combinations of terms for each of the three conditions, yielding 19 unique papers. A broader search included 136 searches of...
Source: Clinical Reviews in Allergy and Immunology - July 1, 2019 Category: Allergy & Immunology Source Type: research

The Epidemiology and Clinical Manifestations of Autoimmunity in Selective IgA Deficiency
AbstractSelective immunoglobulin A deficiency (SIgAD) is the most common primary immunodeficiency, defined as an isolated deficiency of IgA (less than 0.07  g/L). Although the majority of people born with IgA deficiency lead normal lives without significant pathology, there is nonetheless a significant association of IgA deficiency with mucosal infection, increased risks of atopic disease, and a higher prevalence of autoimmune disease. To explain thes e phenomena, we have performed an extensive literature review to define the geoepidemiology of IgA deficiency and particularly the relative risks for developing systemic lup...
Source: Clinical Reviews in Allergy and Immunology - July 1, 2019 Category: Allergy & Immunology Source Type: research

Resolvins: Emerging Players in Autoimmune and Inflammatory Diseases
AbstractResolvins, belonging to the group of specialized proresolving mediators (SPMs), are metabolic products of omega-3 polyunsaturated fatty acids ( ω-3 PUFAs) and are synthesized during the initial phases of acute inflammatory responses to promote the resolution of inflammation. Resolvins are produced for termination of neutrophil infiltration, stimulation of the clearance of apoptotic cells by macrophages, and promotion of tissue remodeling a nd homeostasis. Metabolic dysregulation due to either uncontrolled activity of pro-inflammatory responses or to inefficient resolution of inflammation results in chronic inflamm...
Source: Clinical Reviews in Allergy and Immunology - July 1, 2019 Category: Allergy & Immunology Source Type: research

Role of Mast Cells in Shaping the Tumor Microenvironment
AbstractEarly mast cell (MC) infiltration has been reported in a wide range of human and animal tumors particularly malignant melanoma and breast and colorectal cancer. The consequences of their presence in the tumor microenvironment (TME) or at their margins still remain unclear as it is associated with a good or poor prognosis based on the type and anatomical site of the tumor. Within the tumor, MC interactions occur with infiltrated immune cells, tumor cells, and extracellular matrix (ECM) through direct cell-to-cell interactions or release of a broad range of mediators capable of remodeling the TME. MCs actively contri...
Source: Clinical Reviews in Allergy and Immunology - June 28, 2019 Category: Allergy & Immunology Source Type: research

Platelets and IgE: Shaping the Innate Immune Response in Systemic Lupus Erythematosus
AbstractSystemic lupus erythematosus (SLE) is a systemic and potentially fatal autoimmune disease. SLE pathophysiology is complex and involves the interplay between the innate and adaptive immune systems, with a particularly significant role for type I interferons. Recently, the participation of other actors such as platelets and IgE has been described in SLE. On the one hand, platelets activated by different stimuli (antiphospholipid antibodies, immune complexes …) participate in immune dysregulation through direct interactions with immune cells. On the other hand, autoreactive IgE can activate basophils, promoting a Th...
Source: Clinical Reviews in Allergy and Immunology - June 27, 2019 Category: Allergy & Immunology Source Type: research

Principles of Allergen Immunotherapy and Its Clinical Application in China: Contrasts and Comparisons with the USA
AbstractAllergen immunotherapy (AIT) for allergic rhinitis (AR), asthma, and other allergic diseases has developed quickly. House dust mite (HDM),Artemisia (wormwood),Humulus japonicus (Japanese hop),Alternaria alternata, andCladosporium herbarum are the five most common inhalant allergens in China. AIT has been performed in China for over 60  years. With the support of the Chinese Medical Association (CMA) and the Chinese Medical Doctors Association (CMDA), the Chinese College of Allergy and Asthma (CCAA) was established in 2016 as a specialized branch of CDMA and is the main certification authority for AIT. Chinese alle...
Source: Clinical Reviews in Allergy and Immunology - June 25, 2019 Category: Allergy & Immunology Source Type: research

Bee Venom Immunotherapy: Current Status and Future Directions
This article reviews preclinical and clinical evidence on the therapeutic potential of these new therapies. Among hypoallergenic derivatives, hybrid allergens showed a markedly reduced IgE reactivity in mouse models. Whether they will offer therapeutic benefit over extract, it is still not known since clinical trials have not been carried out yet. T cell epitope peptides have proven effective in small clinical trials. Major histocompatibility complex class II restriction was circumvented by using long overlapping or promiscuous T cell epitope peptides. However, the T cell –mediated late-phase adverse events have been rep...
Source: Clinical Reviews in Allergy and Immunology - June 25, 2019 Category: Allergy & Immunology Source Type: research