Oral and Sublingual Immunotherapy for Treatment of IgE-Mediated Food Allergy
AbstractDevelopment of active therapies for IgE-mediated food allergy is a critical action step toward alleviating the adverse medical, psychosocial, and economic burdens on affected patients and families. Significant progress has been observed specifically in the application of single-allergen oral and sublingual immunotherapy for treatment of IgE-mediated food allergy, with emphasis on milk, egg, and peanut as the primary allergens. Oral immunotherapy (OIT) has demonstrated efficacy in promoting immunomodulatory effects that lead to the clinical outcome of desensitization, defined as reduced reactivity while on active OI...
Source: Clinical Reviews in Allergy and Immunology - April 14, 2018 Category: Allergy & Immunology Source Type: research

Correction to: Inflammation, Atherosclerosis, and Psoriasis
AbstractFollowing publication of this article [1] it came to our attention that we neglected to reference an article by Ishwarlal Jialal published in Critical Pathways in Cardiology [2]. (Source: Clinical Reviews in Allergy and Immunology)
Source: Clinical Reviews in Allergy and Immunology - March 19, 2018 Category: Allergy & Immunology Source Type: research

The Impact of Baked Egg and Baked Milk Diets on IgE- and Non-IgE-Mediated Allergy
AbstractBaked milk (BM) and baked egg (BE) diets are increasingly used in the management of milk and egg allergy, rather than avoidance. Children with tolerance versus reactivity to BM and BE may have smaller skin prick test and lower specific IgE, and BM-tolerant children have less basophil reactivity and more peripheral T regulatory cells. However, most milk- and egg-allergic children tolerate BM and BE and an individual ’s reactivity is unpredictable. Non-reactivity is due to conformational changes in the allergens. Significant differences in the published advice about methods of introduction exist from graded int...
Source: Clinical Reviews in Allergy and Immunology - March 8, 2018 Category: Allergy & Immunology Source Type: research

Effectiveness, Tolerability, and Safety of Belimumab in Patients with Refractory SLE: a Review of Observational Clinical-Practice-Based Studies
AbstractTo date, belimumab is the only biological drug approved for the treatment of patients with active refractory SLE. We compared and critically analyzed the results of 11 observational clinical-practice-based studies, conducted in SLE referral centers. Despite the differences in endpoints and follow-up duration, all studies remarked that belimumab provides additional benefits when used as an add-on to existing treatment, allowing a higher rate of patients to reach remission and to taper or discontinue corticosteroids. In the OBSErve studies, 2 –9.6% of patients discontinued corticosteroids and 72–88.4% ach...
Source: Clinical Reviews in Allergy and Immunology - March 6, 2018 Category: Allergy & Immunology Source Type: research

Mechanisms of Oral Tolerance
AbstractOral tolerance is a state of systemic unresponsiveness that is the default response to food antigens in the gastrointestinal tract, although immune tolerance can also be induced by other routes, such as the skin or inhalation. Antigen can be acquired directly by intestinal phagocytes, or pass through enterocytes or goblet cell-associated passages prior to capture by dendritic cells (DCs) in the lamina propria. Mucin from goblet cells acts on DCs to render them more tolerogenic. A subset of regulatory DCs expressing CD103 is responsible for delivery of antigen to the draining lymph node and induction of Tregs. These...
Source: Clinical Reviews in Allergy and Immunology - February 27, 2018 Category: Allergy & Immunology Source Type: research

The Immunologic Paradoxes of IgG4-Related Disease
AbstractIgG4-related disease (IgG4-RD), which usually occurs in middle-aged and elderly men, is a newly recognized fibroinflammatory condition characterized by swelling and sclerosis of involved organs, increased IgG4-positive plasma cell infiltration in lesions, and elevated IgG4 concentration in serum. Despite growing interest in the research, the pathophysiological mechanism remains elusive. Most IgG4-RD patients respond well to steroid therapy initially, but recurrent and refractory cases are common, especially in advanced fibrotic stage. Recent studies have documented the heterogeneity of the B cell lineages, which su...
Source: Clinical Reviews in Allergy and Immunology - February 19, 2018 Category: Allergy & Immunology Source Type: research

Eosinophilic Esophagitis: an Important Comorbid Condition of Asthma?
AbstractEosinophilic esophagitis and asthma are frequently found as comorbid conditions in children and adults along with other manifestations of atopic diathesis. These two conditions have similar T helper 2 responses-driven pathophysiology and share common management strategies such as using systemic corticosteroids and targeted anti-cytokine biologic therapies. Review of the literature finds that asthma is often a comorbid condition in eosinophilic esophagitis in both children and adults; however, the EoE-asthma relationship remains poorly characterized mechanistically and clinically. EoE and asthma commonly share sever...
Source: Clinical Reviews in Allergy and Immunology - February 18, 2018 Category: Allergy & Immunology Source Type: research

The Use of Biomarkers to Predict Aero-Allergen and Food Immunotherapy Responses
AbstractThe incidence of allergic conditions has continued to rise over the past several decades, with a growing body of research dedicated toward the treatment of such conditions. By driving a complex range of changes in the underlying immune response, immunotherapy is the only therapy that modulates the immune system with long-term effects and is presently utilized for the treatment of several atopic conditions. Recent efforts have focused on identifying biomarkers associated with these changes that may be of use in predicting patients with the highest likelihood of positive clinical outcomes during allergen immunotherap...
Source: Clinical Reviews in Allergy and Immunology - February 17, 2018 Category: Allergy & Immunology Source Type: research

Eosinophilic Esophagitis Through the Flexible Endoscope and the Lens of a Photographer in the Amazon
AbstractEosinophilic esophagitis (EoE) is a disorder that has been identified recently, thus knowledge about it, its pathogenesis, and potential etiologies has spread in an era where the medical community and the public are receiving the information and discussing it as it appears in the medical literature. Because physiology, pathology, and pathophysiology are difficult to explain in layman terms, the author has used photographs taken in remote areas of the Amazon to create visual similes within a narrative that brings the scientific and medical concepts of the knowledge on EoE to a level that allows both medical and non-...
Source: Clinical Reviews in Allergy and Immunology - February 9, 2018 Category: Allergy & Immunology Source Type: research

Sex and Management of Rheumatoid Arthritis
AbstractRheumatoid arthritis (RA) is a chronic and progressive autoimmune disease more common in women than men (3:1). Although sex-based differences may play a complex role in promoting an autoimmune dysfunction, to date the comprehensive knowledge of the link between sex and RA is still partially lacking. Furthermore, males and females have been demonstrated to differently deal with their chronic pathologies, modifying the perceived sex-based burden of disease. Gender medicine is a newly approach focusing on the impact of gender differences on human physiology, pathophysiology, and clinical features of diseases, analyzin...
Source: Clinical Reviews in Allergy and Immunology - January 26, 2018 Category: Allergy & Immunology Source Type: research

Biological Therapies for Eosinophilic Esophagitis: Where Do We Stand?
AbstractEosinophilic esophagitis (EoE) is an immune-mediated, chronic esophageal disease characterized by esophageal symptoms and esophageal eosinophilia. It is triggered by foods and possibly by environmental allergens. Currently, there are no FDA-approved therapies for EoE. Commonly used treatments include dietary restrictions and topical corticosteroids. Many of these therapies are suboptimal in their efficacy, have side effects, or diminish patients ’ quality of life. Biologic therapies for EoE have therefore been sought as an alternative. The mechanism by which food allergens trigger EoE is thought to be a T hel...
Source: Clinical Reviews in Allergy and Immunology - January 25, 2018 Category: Allergy & Immunology Source Type: research

Peptide and Recombinant Allergen Vaccines for Food Allergy
AbstractFood allergy is a significant public health problem, with no suitable treatments available for patients. Currently, patients are limited to avoidance and the use of readily available emergency medications. Immunotherapy is an appealing therapeutic strategy for inducing tolerance. Studies with whole native allergens have demonstrated the efficacy of immunotherapy for food allergy; however, the risk of IgE-mediated reactions with such treatment is significant. Advances in molecular biology techniques, including purification, sequencing, and cloning, have allowed researchers to identify specific allergen components an...
Source: Clinical Reviews in Allergy and Immunology - January 24, 2018 Category: Allergy & Immunology Source Type: research

Does Aeroallergen Sensitization Cause or Contribute to Eosinophilic Esophagitis?
AbstractEosinophilic esophagitis is an atopic disease defined clinically by esophageal symptoms in combination with a dense esophageal eosinophilia. EoE is triggered and maintained by exposure to certain foods and it is known that dietary modification controls symptoms and achieves disease remission. Recently, aeroallergens have been implicated in the pathogenesis of EoE. To examine the role of aeroallergens in EoE, we reviewed the published literature. Sensitization and production of IgE antibodies to foods and aeroallergens in subjects with EoE has been demonstrated. However, the evidence suggests only a minor role for I...
Source: Clinical Reviews in Allergy and Immunology - January 22, 2018 Category: Allergy & Immunology Source Type: research

Cutaneous Granulomatosis: a Comprehensive Review
AbstractCutaneous granulomatosis is a heterogeneous group of diseases, characterized by a skin inflammatory reaction triggered by a wide variety of stimuli, including infections, foreign bodies, malignancy, metabolites, and chemicals. From a pathogenic point of view, they are divided into non-infectious and infectious granulomas. Pathophysiological mechanisms are still poorly understood. Non-infectious granulomatous skin diseases include granuloma annulare, necrobiosis lipoidica, rheumatic nodules, foreign body granulomas, cutaneous sarcoidosis, and interstitial granulomatous dermatitis. Necrobiosis lipoidica is more frequ...
Source: Clinical Reviews in Allergy and Immunology - January 19, 2018 Category: Allergy & Immunology Source Type: research

Current Perspectives on Erythema Multiforme
AbstractRecognition and timely adequate treatment of erythema multiforme remain a major challenge. In this review, current diagnostic guidelines, potential pitfalls, and modern/novel treatment options are summarized with the aim to help clinicians with diagnostic and therapeutic decision-making. The diagnosis of erythema multiforme, that has an acute, self-limiting course, is based on its typical clinical picture of targetoid erythematous lesions with predominant acral localization as well as histological findings. Clinically, erythema multiforme can be differentiated into isolated cutaneous and combined mucocutaneous form...
Source: Clinical Reviews in Allergy and Immunology - January 19, 2018 Category: Allergy & Immunology Source Type: research

Psoriasis: from Pathogenesis to Targeted Therapies
AbstractOver the last decade, the management of psoriasis has witnessed a paradigm shift. Thanks to the increasing knowledge about the pathogenesis of psoriasis, targeted treatments with monoclonal antibodies have been developed. These antibodies, which target the pathogenic TNF/IL-23/IL-17-pathway, were shown to be safe and efficacious in the management of most patients with moderate to severe chronic plaque psoriasis. Recently, molecular and genetic studies in pustular and erythrodermic psoriasis have identified additional inflammatory pathways, providing evidence that psoriasis is a heterogeneous disease and highlightin...
Source: Clinical Reviews in Allergy and Immunology - January 18, 2018 Category: Allergy & Immunology Source Type: research

Pathophysiology of Eosinophilic Esophagitis
AbstractEosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus associated with an atopic predisposition which appears to be increasing in prevalence over the last few decades. Symptoms stem from fibrosis, swelling, and smooth muscle dysfunction. In the past two decades, the etiology of EoE has been and is continuing to be revealed. This review provides an overview of the effects of genetics, environment, and immune function including discussions that touch on microbiome, the role of diet, food allergy, and aeroallergy. The review further concentrates on the pathophysiology of the disease with par...
Source: Clinical Reviews in Allergy and Immunology - January 13, 2018 Category: Allergy & Immunology Source Type: research

Myeloid Cells and Chronic Liver Disease: a Comprehensive Review
AbstractMyeloid cells play a major role in the sensitization to liver injury, particularly in chronic inflammatory liver diseases with a biliary or hepatocellular origin, and the interplay between myeloid cells and the liver may explain the increased incidence of hepatic osteodystrophy. The myeloid cell-liver axis involves several mature myeloid cells as well as immature or progenitor cells with the complexity of the liver immune microenvironment aggravating the mist of cell differentiation. The unique positioning of the liver at the junction of the peripheral and portal circulation systems underlines the interaction of my...
Source: Clinical Reviews in Allergy and Immunology - January 8, 2018 Category: Allergy & Immunology Source Type: research

Pemphigus: a Comprehensive Review on Pathogenesis, Clinical Presentation and Novel Therapeutic Approaches
AbstractPemphigus is a group of rare, potentially devastating autoimmune diseases of the skin and mucous membranes with high morbidity and potentially lethal outcome. The major clinical variant, pemphigus vulgaris (PV) is caused by a loss of intercellular adhesion of epidermal keratinocytes which is induced by IgG autoantibodies against components of desmosomes. Specifically, IgG against the desmosomal adhesion proteins, desmoglein 3 (Dsg3) and desmoglein 1 (Dsg1), preferentially target their ectodomains which are presumably critical for the transinteraction and signalling function of these adhesion molecules. There is a c...
Source: Clinical Reviews in Allergy and Immunology - January 8, 2018 Category: Allergy & Immunology Source Type: research

Sex in Respiratory and Skin Allergies
AbstractA bulk of literature demonstrated that respiratory allergy, and especially asthma, is prevalent in males during childhood, while it becomes more frequent in females from adolescence, i.e., after menarche, to adulthood. The mechanisms underlying the difference between females and males are the effects on the immune response of female hormones and in particular the modulation of inflammatory response by estrogens, as well as the result of the activity of various cells, such as dendritic cells, innate lymphoid cells, Th1, Th2, T regulatory (Treg) and B regulatory (Bregs) cells, and a number of proteins and cytokines, ...
Source: Clinical Reviews in Allergy and Immunology - January 6, 2018 Category: Allergy & Immunology Source Type: research

Eosinophilic Esophagitis Clinical Manifestations and Differential Diagnosis
This article addresses the disease ’s clinical manifestations, endoscopic findings, diagnosis, and differential diagnoses. In addition to the current diagnostic criteria, we summarize some recently emerging procedures that promise of enhancing more precise diagnosis and institution of early appropriate management, with consequent b etter quality of life and reduction of complications. (Source: Clinical Reviews in Allergy and Immunology)
Source: Clinical Reviews in Allergy and Immunology - December 30, 2017 Category: Allergy & Immunology Source Type: research

Pediatric Eosinophilic Esophagitis Endotypes: Are We Closer to Predicting Treatment Response?
AbstractEosinophilic esophagitis (EoE) is a chronic, food antigen-driven gastrointestinal disease that is characterized by esophageal eosinophilia. Currently, there are no Food and Drug Administration (FDA)-approved treatments for EoE, but the two most commonly prescribed therapies include topical corticosteroids and food elimination diets. Clinical trials have revealed a significant proportion of cases that are resistant to topical corticosteroids, and although we define EoE as a food antigen-driven disease, not all patients with EoE respond to elimination diets or even elemental diets. The varied response to treatments h...
Source: Clinical Reviews in Allergy and Immunology - December 21, 2017 Category: Allergy & Immunology Source Type: research

Dietary Therapy for Eosinophilic Esophagitis: Elimination and Reintroduction
AbstractEosinophilic esophagitis (EoE) is a food antigen-mediated disorder of the esophagus characterized by eosinophil predominant inflammation and symptoms of esophageal dysfunction. Dietary antigen elimination induces clinical and histological remission in patients with EoE. The most restrictive of elimination diets (the elemental diet) removes all possible food antigens while empiric elimination diets remove all (or a subset) of food antigens most commonly reported to cause esophageal eosinophilia and food allergies (milk, egg, wheat, soy, peanuts, tree nuts, fish, or legumes). Elimination diets are effective treatment...
Source: Clinical Reviews in Allergy and Immunology - December 14, 2017 Category: Allergy & Immunology Source Type: research

Monoclonal Antibodies for Treatment of Eosinophilic Esophagitis
AbstractEosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus affecting both children and adults, with debilitating and progressive symptoms. EoE has shown an explosive epidemiological rise in the past few decades. Many patients experience a poor level of disease control despite maximal use of available guideline-based therapies, which seriously hampers their quality of life. Diet restrictions and systemic and topical corticosteroids are the current mainstays of EoE therapy, but are associated with significant efficacy, treatment compliance, and safety issues such as oral or esophageal candidias...
Source: Clinical Reviews in Allergy and Immunology - December 12, 2017 Category: Allergy & Immunology Source Type: research

Current Perspectives on Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
AbstractStevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered a delayed-type hypersensitivity reaction to drugs. They represent true medical emergencies and an early recognition and appropriate management is decisive for the survival. SJS/TEN manifest with an “influenza-like” prodromal phase (malaise, fever), followed by painful cutaneous and mucous membrane (ocular, oral, and genital) lesions, and other systemic symptoms. The difference between SJS, SJS/TEN overlap, and TEN is defined by the degree of skin detachment: SJS is defined as skin involvem ent of  30%, and SJS/TEN ov...
Source: Clinical Reviews in Allergy and Immunology - November 29, 2017 Category: Allergy & Immunology Source Type: research

Geoepidemiology of Primary Biliary Cholangitis: Lessons from Switzerland
AbstractNo data on primary biliary cholangitis (PBC) are available in Switzerland. We established a national patient cohort to obtain information on PBC phenotypes and disease course in Switzerland. Local databases in all university hospitals and in two large secondary centers were searched for case finding. In addition, all primary care physicians, gastroenterologists, rheumatologists, and dermatologists were invited to contribute patients from their own medical records. PBC diagnosis was centrally reviewed. Five hundred one PBC patients were identified, 474 were included in data analysis, and 449 of them were enrolled by...
Source: Clinical Reviews in Allergy and Immunology - November 27, 2017 Category: Allergy & Immunology Source Type: research

Dermatological Complications After Solid Organ Transplantation
AbstractOrgan transplant recipients (OTRs) are a population at high risk for cutaneous adverse events. Their early recognition and appropriate treatment is an important component of the clinical management of OTRs and should be optimally dealt with by dermatologists working in the context of a transplant dermatology clinic. Skin examination should be a standard procedure before performing organ transplantation to assess conditions which may be difficult to manage after the transplant procedure has been performed or which may represent a contraindication to transplantation, e.g., malignant melanoma. It also offers an opport...
Source: Clinical Reviews in Allergy and Immunology - November 25, 2017 Category: Allergy & Immunology Source Type: research

The Clinical Significance of GP73 in Immunologically Mediated Chronic Liver Diseases: Experimental Data and Literature Review
In conclusion, GP73 is an effective and reliable serological marker for the diagnosis of advanced fibrosis and prediction of appearance of cirrhosis. (Source: Clinical Reviews in Allergy and Immunology)
Source: Clinical Reviews in Allergy and Immunology - November 24, 2017 Category: Allergy & Immunology Source Type: research

A Comprehensive Review on Mustard-Induced Allergy and Implications for Human Health
AbstractMustard is widely used in a variety of foods/food products to enhance the flavor and nutritional value that subsequently raise the risk of hypersensitivity reactions. Mustard allergy has been reported for many years and is increasing gradually especially in the areas where its consumption is comparatively higher, and it may be considered among the most important food allergies. A number of relevant clinical studies focused on mustard-induced allergic manifestations are summarized in the current review. In addition, the knowledge regarding the immunological as well as biochemical characteristics of mustard allergens...
Source: Clinical Reviews in Allergy and Immunology - November 20, 2017 Category: Allergy & Immunology Source Type: research

Neonatal Systemic Lupus Erythematosus Syndrome: a Comprehensive Review
AbstractNeonatal lupus erythematosus is an uncommon syndrome, which is caused by transplacental passage of maternal autoantibodies to Sj ögren’s syndrome A or B autoantigens. The clinical presentation includes distinctive cutaneous lesions resembling those seen in systemic lupus erythematosus, hepatobiliary disease, and cytopenias, which disappear with the clearance of maternal autoantibodies. The most severe presentation is a tot al atrioventricular heart block, which begins during the second trimester of gestation and is irreversible. The risk of having a child with neonatal lupus erythematosus in mothers who ...
Source: Clinical Reviews in Allergy and Immunology - November 8, 2017 Category: Allergy & Immunology Source Type: research

Cutaneous Manifestations of Dermatomyositis: a Comprehensive Review
AbstractDermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by the presence of skin lesions and inflammation of skeletal muscles; however, this feature may be absent in amyopathic DM. DM is a rare disease, occurring at any age, and has two peaks of incidence: one in childhood between 5 and 15  years of age and one in adulthood between 40 and 60 years, with a female preponderance. DM has been associated with malignancy; therefore, every newly diagnosed patient should undergo screening investigations, but evidence-based guidelines on their extension are lacking. The etiopathogenesis is s till ...
Source: Clinical Reviews in Allergy and Immunology - October 31, 2017 Category: Allergy & Immunology Source Type: research

The Current State of Epicutaneous Immunotherapy for Food Allergy: a Comprehensive Review
AbstractThe food allergy epidemic of recent years has led to the search for safe and effective methods of immunotherapy for foods. Studies of epicutaneous immunotherapy (EPIT) in mice have shown promising safety and efficacy data. Murine models have also identified probable mechanisms for the development of tolerance to food allergens, including the induction of regulatory T cells. Clinical data is lacking, but relatively small and early studies among peanut and cow ’s milk allergic subjects suggest that EPIT has an excellent safety profile, particularly compared to other methods of specific allergen immunotherapy. E...
Source: Clinical Reviews in Allergy and Immunology - October 28, 2017 Category: Allergy & Immunology Source Type: research

Review: Diagnosing Common Variable Immunodeficiency Disorder in the Era of Genome Sequencing
AbstractCommon variable immunodeficiency disorders (CVID) are an enigmatic group of often heritable conditions, which may manifest for the first time in early childhood or as late as the eighth decade of life. In the last 5  years, next generation sequencing (NGS) has revolutionised identification of genetic disorders. However, despite the best efforts of researchers around the globe, CVID conditions have been slow to yield their molecular secrets. We have previously described the many clinical advantages of identifyi ng the genetic basis of primary immunodeficiency disorders (PIDs). In a minority of CVID patients, mo...
Source: Clinical Reviews in Allergy and Immunology - October 14, 2017 Category: Allergy & Immunology Source Type: research

Skin Manifestations Associated with Autoimmune Liver Diseases: a Systematic Review
AbstractAutoimmune liver diseases, which include mainly autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, and the variant syndromes, are often associated with extrahepatic autoimmune diseases. However, the association with cutaneous diseases is less well described. In the present article, we provide a systematic literature review on skin manifestations linked to each of these four autoimmune liver diseases, excluding skin manifestations of systemic diseases. The association of autoimmune hepatitis with vitiligo is well known, with a particular striking association with type 2 autoimmune hep...
Source: Clinical Reviews in Allergy and Immunology - October 9, 2017 Category: Allergy & Immunology Source Type: research

Sexual Dimorphism in Innate Immunity
AbstractSexual dimorphisms account for differences in clinical manifestations or incidence of infectious or autoimmune diseases and malignancy between females and males. Females develop enhanced innate and adaptive immune responses than males and are less susceptible to many infections of bacterial, viral, parasitic, and fungal origin and malignancies but in contrast, they are more prone to develop autoimmune diseases. The higher susceptibility to infections in males is observed from birth to adulthood, suggesting that sex chromosomes and not sex hormones have a major role in sexual dimorphism in innate immunity. Sex-based...
Source: Clinical Reviews in Allergy and Immunology - September 30, 2017 Category: Allergy & Immunology Source Type: research

Immunotherapy of Food Allergy: a Comprehensive Review
AbstractFood allergy imposes a severe global health burden, and thus, there is a dire need for safe and effective treatments. Allergen-specific immunotherapy (AIT) is currently the only approach to restore immune tolerance through administrating increasing doses of allergen extracts. Unfortunately, the development of AIT for food allergies has been impeded by the frequent anaphylactic side effects during the course of treatment. The emergence of component-resolved diagnosis has greatly improved our ability to identify causative allergens and revolutionized the design of AIT. Molecular features such as IgE-binding epitopes ...
Source: Clinical Reviews in Allergy and Immunology - September 19, 2017 Category: Allergy & Immunology Source Type: research

Role of Mast Cells in Regulation of T Cell Responses in Experimental and Clinical Settings
AbstractMast cells secrete a wide spectrum of stored or newly synthesized pro-inflammatory, anti-inflammatory, and/or immunosuppressive mediators and express several costimulatory and inhibitory surface molecules. Mast cells finely tune activities of T cells, B cells, and regulatory cells and effectively contribute to the development of different T cell-associated responses by influencing their recruitment, activation, proliferation, and differentiation. The interaction between mast cells and T cells, with regard to cellular functionality and immune responses, can be assessed in both activating and inhibitory regulations. ...
Source: Clinical Reviews in Allergy and Immunology - September 19, 2017 Category: Allergy & Immunology Source Type: research

Cannabis-Associated Asthma and Allergies
AbstractInhalation of cannabis smoke is its most common use and the pulmonary complications of its use may be the single most common form of drug-induced pulmonary disease worldwide. However, the role of cannabis consumption in asthma patients and allergic clinical situations still remains controversial. To review the evidence of asthma and allergic diseases associated with the use of marijuana, we conducted a search of English, Spanish, and Portuguese medical using the search terms asthma, allergy, marijuana, marihuana, and cannabis. Entries made between January 1970 and March 2017 were retrieved. Several papers have show...
Source: Clinical Reviews in Allergy and Immunology - September 18, 2017 Category: Allergy & Immunology Source Type: research

Unmet Needs in the Pathogenesis and Treatment of Vasculitides
AbstractDespite the progress in the last years on the field of vasculitides, there are several unmet needs regarding classification, disease activity assessment, predictors of flares and complications, and type of treatment for the different forms. The 1990 American College of Rheumatology (ACR) classification criteria currently used to define giant cell arteritis and Takayasu arteritis were designed to discriminate between different types of vasculitides but not to differentiate vasculitis from other disorders. Recently, efforts have been made to overcome the shortcomings of the ACR criteria. The lack of an accepted defin...
Source: Clinical Reviews in Allergy and Immunology - September 11, 2017 Category: Allergy & Immunology Source Type: research

Cutaneous and Mucosal Manifestations of Sj ögren’s Syndrome
In conclusion, a strict collaboration between the dermatologist and th e rheumatologist is essential in the adequate management of Sjögren’s syndrome skin and mucosal manifestations. (Source: Clinical Reviews in Allergy and Immunology)
Source: Clinical Reviews in Allergy and Immunology - September 4, 2017 Category: Allergy & Immunology Source Type: research

Unmet Needs in Systemic Sclerosis Understanding and Treatment: the Knowledge Gaps from a Scientist ’s, Clinician’s, and Patient’s Perspective
AbstractSystemic sclerosis (SSc) is a highly heterogeneous disease caused by a complex molecular circuitry. For decades, clinical and molecular research focused on understanding the primary process of fibrosis. More recently, the inflammatory, immunological and vascular components that precede the actual onset of fibrosis, have become a matter of increasing scientific scrutiny. As a consequence, the field has started to realize that the early identification of this syndrome is crucial for optimal clinical care as well as for understanding its pathology. The cause of SSc cannot be appointed to a single molecular pathway but...
Source: Clinical Reviews in Allergy and Immunology - September 2, 2017 Category: Allergy & Immunology Source Type: research

Unmet Needs in the Pathogenesis and Treatment of Systemic Lupus Erythematosus
AbstractSystemic lupus erythematosus (SLE) is an autoimmune rheumatic disease with a prevalence of approximately 1 in 1000. Over the last 30  years, advances in treatment such as use of corticosteroids and immunosuppressants have improved life expectancy and quality of life for patients with lupus and the key unmet needs have therefore changed. With the reduced mortality from disease activity, development of cardiovascular disease (CVD) has become an increasingly important cause of death in patients with SLE. The increased CVD risk in these patients is partly, but not fully explained by standard risk factors, and abno...
Source: Clinical Reviews in Allergy and Immunology - August 29, 2017 Category: Allergy & Immunology Source Type: research

Sex and Cardiovascular Involvement in Inflammatory Joint Diseases
AbstractThe term inflammatory joint disease (IJD) encompasses a group of chronic conditions with predominant joint involvement. They share an increased risk of cardiovascular (CV) complications. However, the implication of the sex in the risk of CV disease in IJD has not been specifically addressed. The aim of this work is to assess the influence of sex on the clinical expression of CV manifestations associated to IJD. With this objective, an update of the current knowledge of the sex influence on CV disease in patients with IJD was conducted. A PubMed database search of the most relevant literature on this topic was perfo...
Source: Clinical Reviews in Allergy and Immunology - August 29, 2017 Category: Allergy & Immunology Source Type: research

Unmet Needs in IBD: the Case of Fatigue
AbstractFatigue is a highly prevalent but relatively ignored problem in IBD patients. It is one of the most burdensome symptoms to the patient with an important impact on the quality of life. Therefore, fatigue is a highly relevant patient-reported outcome that should be included not only in disease activity measurement but also in the endpoints of clinical trials in IBD. However, most of the currently available scoring systems to quantify fatigue are not specifically designed for patients with IBD and none of them has undergone a complete validation process for IBD-related fatigue. Fatigue is more prevalent in patients wi...
Source: Clinical Reviews in Allergy and Immunology - August 29, 2017 Category: Allergy & Immunology Source Type: research

Sex Differences in Pediatric Rheumatology
AbstractAutoimmune diseases affect up to 10% of the world's population and, as a whole, they are far more common in females, although differences exist according to the single disease and also in different age groups. In childhood-onset autoimmune diseases, the sex bias is generally less evident than in adults, probably for the different hormonal milieau, being estrogens strongly implicated in the development of autoimmunity. Still, some rheumatic conditions, such as juvenile idiopathic arthritis (JIA), show a strong predilection for girls (F:M  = 3–6.6:1), and differences may coexist between males and fema...
Source: Clinical Reviews in Allergy and Immunology - August 28, 2017 Category: Allergy & Immunology Source Type: research

Cutaneous Manifestations of Small-Vessel Leukocytoclastic Vasculitides in Childhood
AbstractIn childhood, cutaneous small-vessel vasculitides include Henoch –Schönlein syndrome, a systemic vasculitis, and Finkelstein–Seidlmayer syndrome, a skin-limited vasculitis. Both Henoch–Schönlein and Finkelstein–Seidlmayer syndromes are seen more frequently in white or Asian compared with black children and occur especially in winter and spring with a ma le-to-female ratio of approximately 2:1. In everyday clinical practice, both conditions are diagnosed on clinical grounds without histological confirmation. The characteristic cutaneous hallmarks of Henoch–Schönlein syndr...
Source: Clinical Reviews in Allergy and Immunology - August 24, 2017 Category: Allergy & Immunology Source Type: research

Sex, Symptom Severity, and Quality of Life in Rheumatology
AbstractInflammatory rheumatic diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) show a striking female predominance ranging from 3:1 in RA up to 9:1 in SLE. The background for those gender bias is not fully understood yet, but seems to be the result of a complex interaction between sex hormones, (epi-)genetics, and possibly even the composition of gut microbiota. Moreover, time of disease onset, the clinical phenotype including co-morbidities as well as the course of the diseases during life differ between genders. The patient ’s sex therefore plays an emerging role for individual the...
Source: Clinical Reviews in Allergy and Immunology - August 9, 2017 Category: Allergy & Immunology Source Type: research

Common Variable Immunodeficiency and Liver Involvement
AbstractCommon variable immunodeficiency (CVID) is a primary B-cell immunodeficiency disorder, characterized by remarkable hypogammaglobulinemia. The disease can develop at any age without gender predominance. The prevalence of CVID varies widely worldwide. The underlying causes of CVID remain largely unknown; primary B-cell dysfunctions, defects in T cells and antigen-presenting cells are involved. Although some monogenetic defects have been identified in some CVID patients, it is likely that CVID is polygenic. Patients with CVID develop recurrent and chronic infections (e.g., bacterial infections of the respiratory or ga...
Source: Clinical Reviews in Allergy and Immunology - August 7, 2017 Category: Allergy & Immunology Source Type: research

Unmet Needs in the Field of Psoriasis: Pathogenesis and Treatment
AbstractIn times of targeted therapies, innovative therapeutics become tools to further unravel the pathogenesis of the treated disease, thus influencing current pathogenetic concepts. Based on such paradigm shifts, the next generation of novel therapeutic targets might be identified. Psoriasis is a good example for the resulting most fruitful dialog between clinical and fundamental research. As a result of this, the key role of Th17 lymphocytes, some of their effector molecules, as well as mediators contributing to their maturation have been identified, many of these being targeted by some of the most effective drugs curr...
Source: Clinical Reviews in Allergy and Immunology - August 6, 2017 Category: Allergy & Immunology Source Type: research

Autoimmune Subepidermal Bullous Diseases of the Skin and Mucosae: Clinical Features, Diagnosis, and Management
AbstractAutoimmune subepidermal blistering diseases of the skin and mucosae constitute a large group of sometimes devastating diseases, encompassing bullous pemphigoid, gestational pemphigoid, mucous membrane pemphigoid, epidermolysis bullosa acquisita, and anti-p200 pemphigoid. Their clinical presentation is polymorphic. These autoimmune blistering diseases are associated with autoantibodies that target distinct components of the basement membrane zone of stratified epithelia. These autoantigens represent structural proteins important for maintenance of dermo-epidermal integrity. Bullous pemphigoid (BP) is the most common...
Source: Clinical Reviews in Allergy and Immunology - August 4, 2017 Category: Allergy & Immunology Source Type: research