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Renal Disease and Systemic Sclerosis: an Update on Scleroderma Renal Crisis
AbstractScleroderma renal crisis (SRC) is a life-threatening complication of systemic sclerosis (SSc) with a mortality of 20% at 6  months. Once the leading cause of mortality in scleroderma (SSc), it remains a serious complication, often necessitating level three care for patients affected. Whilst renal outcomes have significantly improved following the advent of angiotensin-converting enzyme inhibitor (ACEi) therapy, SRC rem ains a precarious challenge for clinicians, due to lack of preventative measures and the fact that patients can rapidly decline despite best medical management. Large cohort studies spanning decades...
Source: Clinical Reviews in Allergy and Immunology - June 1, 2022 Category: Allergy & Immunology Source Type: research

Autoimmunity in Primary Immunodeficiencies (PID)
AbstractPrimary immunodeficiency (PID) may impact any component of the immune system. The number of PID and immune dysregulation disorders is growing steadily with advancing genetic detection methods. These expansive recognition methods have changed the way we characterize PID. While PID were once characterized by their susceptibility to infection, the increase in genetic analysis has elucidated the intertwined relationship between PID and non-infectious manifestations including autoimmunity. The defects permitting opportunistic infections to take hold may also lead the way to the development of autoimmune disease. In some...
Source: Clinical Reviews in Allergy and Immunology - June 1, 2022 Category: Allergy & Immunology Source Type: research

Microbial Dysbiosis Tunes the Immune Response Towards Allergic Disease Outcomes
AbstractThe hygiene hypothesis has been popularized as an explanation for the rapid increase in allergic disease observed over the past 50  years. Subsequent epidemiological studies have described the protective effects that in utero and early life exposures to an environment high in microbial diversity have in conferring protective benefits against the development of allergic diseases. The rapid advancement in next generation sequenc ing technology has allowed for analysis of the diverse nature of microbial communities present in the barrier organs and a determination of their role in the induction of allergic disease. H...
Source: Clinical Reviews in Allergy and Immunology - June 1, 2022 Category: Allergy & Immunology Source Type: research

Inflammaging and Frailty in Immune-Mediated Rheumatic Diseases: How to Address and Score the Issue
AbstractFrailty is a new concept in rheumatology that can help identify people more likely to have less favorable outcomes. Sarcopenia and inflammaging can be regarded as the biological foundations of physical frailty. Frailty is becoming more widely accepted as an indicator of ageing and is linked to an increased risk of negative outcomes such as falls, injuries, and mortality. Frailty identifies a group of older adults that seem poorer and more fragile than their age-matched counterparts, despite sharing similar comorbidities, demography, sex, and age. Several studies suggest that inflammation affects immune-mediated pat...
Source: Clinical Reviews in Allergy and Immunology - May 21, 2022 Category: Allergy & Immunology Source Type: research

Autoantibodies and Cancer Association: the Case of Systemic Sclerosis and Dermatomyositis
AbstractSeveral rheumatic diseases have a perplexing association with cancer. Unraveling this mysterious connection is likely to provide deeper understanding regarding mechanisms governing the onset of both autoimmunity and cancer immunity, in addition to providing clinicians much needed guidance around whom and when to screen for occult malignancy. Systemic sclerosis (scleroderma) and dermatomyositis are two diseases in which the association with internal malignancy is well-described and can be considered as models from which to gain important insights that likely have broader applicability. The past 15 years have witness...
Source: Clinical Reviews in Allergy and Immunology - May 20, 2022 Category: Allergy & Immunology Source Type: research

Infections or Vaccines Associated with Finkelstein-Seidlmayer Vasculitis: Systematic Review
In conclusion, most cases of Finkelstein-Seidlmayer vasculitis are preceded by an infection. In a minority of cases, this skin vasculitis develops before resolution of the infe ction. In most cases, however, this vasculitis develops after resolution of the infection. More rarely, this vasculitis is preceded by a vaccination. (Source: Clinical Reviews in Allergy and Immunology)
Source: Clinical Reviews in Allergy and Immunology - May 12, 2022 Category: Allergy & Immunology Source Type: research

Allergy to Local Anesthetics is a Rarity: Review of Diagnostics and Strategies for Clinical Management
AbstractLocal anesthetics (LA) are commonly used in procedures and in topical agents for pain management. With the increasing use of LA drugs, the management of LA reactions is more frequently encountered in the office and in operating rooms. True allergic reactions involving IgE-mediated reactions and anaphylaxis are rare; they have only been identified in case reports and account for less than 1% of adverse LA reactions. Most reactions are non-allergic or are a result of hypersensitivity to other culprits such as preservatives, excipients, or other exposures. LA reactions that are misclassified as true allergies can lead...
Source: Clinical Reviews in Allergy and Immunology - April 28, 2022 Category: Allergy & Immunology Source Type: research

Real-Life Effectiveness of Benralizumab, Mepolizumab and Omalizumab in Severe Allergic Asthma Associated with Nasal Polyps
AbstractBiological therapies are available for the treatment of the severe allergic asthma (SAA) with blood eosinophil count  ≥ 0.3 × 109/L. Several of them also showed benefits on nasal polyps (NP), one of the most frequent comorbidities of the severe asthma, but comparative studies on their effectiveness in the association SAA-NP are currently lacking. The aim of this study is to compare the effectiveness of benralizumab, mepolizumab and omalizumab in patients with SAA-NP in real-life settings. A retrospective, observational, multicenter real-life study was realized including patients with SAA-NP treated by be...
Source: Clinical Reviews in Allergy and Immunology - April 14, 2022 Category: Allergy & Immunology Source Type: research

Thoracic Involvement in Systemic Autoimmune Rheumatic Diseases: Pathogenesis and Management
AbstractThoracic involvement is one of the main determinants of morbidity and mortality in patients with autoimmune rheumatic diseases (ARDs), with different prevalence and manifestations according to the underlying disease. Interstitial lung disease (ILD) is the most common pulmonary complication, particularly in patients with systemic sclerosis (SSc), idiopathic inflammatory myopathies (IIMs) and rheumatoid arthritis (RA). Other thoracic manifestations include pulmonary arterial hypertension (PAH), mostly in patients with SSc, airway disease, mainly in RA, and pleural involvement, which is common in systemic lupus erythe...
Source: Clinical Reviews in Allergy and Immunology - March 18, 2022 Category: Allergy & Immunology Source Type: research

Diagnostic Modalities in Primary Immunodeficiency
AbstractAs the field of inborn errors of immunity expands, providers continually update and fine-tune their diagnostic approach and selection of testing modalities to increase diagnostic accuracy. Here, we first describe a mechanistic consideration of laboratory testing, highlighting both benefits and drawbacks of currently clinically available testing modalities. Next, we provide methods in evaluation of patients presenting with concern for inborn errors of immunity as defined by the International Union of Immunological Societies 2019 phenotypic categories: primary antibody deficiencies, cellular and humoral immune defici...
Source: Clinical Reviews in Allergy and Immunology - March 15, 2022 Category: Allergy & Immunology Source Type: research

The Airway Microbiome-IL-17 Axis: a Critical Regulator of Chronic Inflammatory Disease
AbstractThe respiratory tract is home to a diverse microbial community whose influence on local and systemic immune responses is only beginning to be appreciated. Increasing reports have linked changes in this microbiome to a range of pulmonary and extrapulmonary disorders, including asthma, chronic obstructive pulmonary disease and rheumatoid arthritis. Central to many of these findings is the role of IL-17-type immunity as an important driver of inflammation. Despite the crucial role played by IL-17-mediated immune responses in protection against infection, overt Th17 cell responses have been implicated in the pathogenes...
Source: Clinical Reviews in Allergy and Immunology - March 11, 2022 Category: Allergy & Immunology Source Type: research

Dupilumab-Associated Adverse Events During Treatment of Allergic Diseases
AbstractAmong the new biological therapies for atopic diseases, dupilumab is a fully human monoclonal antibody directed against IL-4R α, the common chain of interleukin-4 and interleukin-13 receptors. Dupilumab showed clinical improvements in patients with atopic dermatitis, asthma, and chronic rhinosinusitis and is currently under development for other indications. While dupilumab is considered to be well tolerated, a number of recent publications have reported various adverse events. This review aims to summarize the current knowledge about these adverse events, which may help clinicians to improve the follow-up of pati...
Source: Clinical Reviews in Allergy and Immunology - March 11, 2022 Category: Allergy & Immunology Source Type: research

Premedication Protocols to Prevent Hypersensitivity Reactions to Chemotherapy: a Literature Review
AbstractHypersensitivity reactions (HSRs) to chemotherapy may prevent patients from receiving the most effective therapy. This review was undertaken to identify evidence-based preventive premedication strategies that reduce the likelihood of HSR in the first instance and improve the safety of subsequent infusions in patients who have demonstrated HSR to a certain class of chemotherapy.  PubMed was searched until October 2021 using the key words: “hypersensitivity to chemotherapeutic drugs,” “hypersensitivity to antineoplastic agents,” “taxanes hypersensitivity,” “platinum compound hypersensitivity,” “pre...
Source: Clinical Reviews in Allergy and Immunology - March 8, 2022 Category: Allergy & Immunology Source Type: research

Clinical Significance of Antinucleolar Antibodies: Biomarkers for Autoimmune Diseases, Malignancies, and others
AbstractNucleolar staining is one of the standard patterns in immunofluorescence antinuclear antibodies (ANA), seen in 5 –9% of ANA in various conditions. Antinucleolar antibodies (ANoA) are classified into 3 patterns in the International Consensus on ANA Patterns (ICAP) classification; AC-8 homogeneous pattern, AC-9 clumpy pattern, and AC-10 punctate pattern. Specificities known to show AC-8 include anti-Th/To, -PM -Scl, -nucleophosmin/B23, -nucleolin/C23, -No55, and others. AC-9 is seen by anti-fibrillarin/U3RNP and AC-10 by anti-RNA polymerase I and hUBF/NOR-90. ANoA has been classically known to be associated with sc...
Source: Clinical Reviews in Allergy and Immunology - March 8, 2022 Category: Allergy & Immunology Source Type: research

A Narrative Review of Pathogenetic and Histopathologic Aspects, Epidemiology, Classification Systems, and Disease Outcome Measures in Systemic Sclerosis
AbstractSystemic sclerosis (SSc) is a rare systemic autoimmune disease, characterized by the presence of three main actors: vasculopathy, immune activation, and fibrosis. This pathologic process is then translated in a clinical picture with great variability among different patients in terms of type of organ involvement, disease severity and prognosis. This heterogeneity is a main feature of SSc, which, in addition to the presence of early phases of the disease characterized by mild symptoms, can explain the high difficulty in establishing classification criteria, and in defining patients ’ subsets and disease outcomes. ...
Source: Clinical Reviews in Allergy and Immunology - March 7, 2022 Category: Allergy & Immunology Source Type: research