The Role of Epigenetics in the Chronic Sinusitis with Nasal Polyp
AbstractPurpose of ReviewChronic rhinosinusitis with nasal polyps (CRSwNP) is a common and heterogeneous inflammatory disease. The underlying epigenetic mechanisms and treatment of CRSwNP are partially understood. Of the different epigenetic changes in CRSwNP, histone deacetylases (HDACs), methylation of DNA, and the levels of miRNA are widely studied. Here, we review the human studies of epigenetic mechanisms in CRSwNP.Recent FindingsThe promoters of COL18A1, PTGES, PLAT, and TSLP genes are hypermethylated in CRSwNP compared with those of controls, while the promoters of PGDS, ALOX5AP, LTB4R, IL-8, and FZD5 genes are hypo...
Source: Current Allergy and Asthma Reports - November 24, 2020 Category: Allergy & Immunology Source Type: research

Investigating Health Literacy in Systemic Lupus Erythematosus: a Descriptive Review
AbstractPurpose of ReviewInadequate health literacy is common among American adults, but little is known about the impact of health literacy in rheumatic diseases. The purpose of this article is to review studies investigating health literacy and its association with clinical outcomes in systemic lupus erythematosus (SLE).Recent FindingsSeveral validated health literacy measures have been examined in SLE patients. Low health literacy is associated with worse patient-reported outcomes and lower numeracy with higher disease activity. Two studies found no association of low health literacy with medication adherence. One rando...
Source: Current Allergy and Asthma Reports - November 12, 2020 Category: Allergy & Immunology Source Type: research

Olfactory Dysfunction in a Mexican Population Outside of COVID-19 Pandemic: Prevalence and Associated Factors (the OLFAMEX Study)
AbstractPurpose of ReviewTo study the prevalence of olfactory loss and its associated factors in a Mexican population a cross-sectional analytical study based on a  population interviewed about health, epidemiologic aspects, and sense of smell (tested with four scents: rose, banana, perfume, and gas) was conducted to evaluate olfactory detection, memory, and identification. Levels of sense of smell perception were determined when the participants detected, r ecognized, or identified all (normosmia), 1–3 (hyposmia), or none (anosmia) of the odorants. Associated factors of olfactory dysfunction were iden...
Source: Current Allergy and Asthma Reports - November 8, 2020 Category: Allergy & Immunology Source Type: research

Oral Immunotherapy for Food Allergy —a US Regulatory Perspective
AbstractThe recent approval of Palforzia for treatment of peanut allergy by the US Food and Drug Administration (USFDA) predicts that additional products for oral immunotherapy (OIT) are on the horizon. In this article, the authors review the legal framework by which the USFDA regulates products for OIT of food allergy and the clinical data that demonstrated that the safety and effectiveness profile of Palforzia supported approval and conclude with a discussion of oral food challenge (OFC) as a clinical endpoint to demonstrate safety and effectiveness of OIT products. (Source: Current Allergy and Asthma Reports)
Source: Current Allergy and Asthma Reports - October 15, 2020 Category: Allergy & Immunology Source Type: research

Frequency and Clinical Utility of Olfactory Dysfunction in COVID-19: a Systematic Review and Meta-analysis
ConclusionFrequency of OD in COVID-19 differs greatly across studies. Nevertheless, patients with reported OD were significantly more likely to test positive for COVID-19. Patient-reported OD is a highly specific symptom of COVID-19 which should be included as part of the pre-test screening of suspect patients. (Source: Current Allergy and Asthma Reports)
Source: Current Allergy and Asthma Reports - October 13, 2020 Category: Allergy & Immunology Source Type: research

Cutaneous Manifestations in Adult Patients with COVID-19 and Dermatologic Conditions Related to the COVID-19 Pandemic in Health Care Workers
AbstractPurpose of ReviewCOVID-19 (coronavirus viral disease 2019), due to the novel SARS-CoV-2, may present with different types of cutaneous manifestations of varying pathophysiology. During the ongoing pandemic, publications reporting dermatologic findings in COVID-19 continue to emerge.Recent FindingsCutaneous vasculopathy and microthrombus-related changes including acral and sacral lesions, retiform purpura, livedo reticularis, and cutaneous vasculitis are notable findings in adult patients. Other exanthems include urticaria or angioedema, morbilliform/maculopapular exanthems, erythema multiforme, and vesicular erupti...
Source: Current Allergy and Asthma Reports - October 12, 2020 Category: Allergy & Immunology Source Type: research

The Role of Environmental Exposures in Atopic Dermatitis
AbstractPurpose of ReviewAlthough genetic factors clearly play a role in the development of atopic dermatitis (AD), the recent dramatic increase in the prevalence of AD in low- and middle-income countries is not consistent with only a role of genetic factors. These findings strongly suggest that environmental factors may play an important role in the pathogenesis of AD.Recent FindingsWe reviewed the role of gene-environment studies; in utero exposures including tobacco smoke, alcohol, maternal stress, various digestive supplements, and gestational diabetes; early-life exposures including diet, gut microbiota, antibiotics, ...
Source: Current Allergy and Asthma Reports - October 12, 2020 Category: Allergy & Immunology Source Type: research

Coding Telemedicine Visits for Proper Reimbursement
AbstractPurpose of ReviewCoding for patient visits and monitoring via telehealth have expanded over the past years with a wide acceptance of telemedicine as a consequence of the coronavirus pandemic. Coding topics of interest to the allergist/immunologist in regard to services provided via telemedicine will be of increasing importance in the coming years.Recent FindingsCPT coding for telephone as well as synchronous face-to-face telehealth visits has changed over the past few years. With the need for distancing and patient protection during the coronavirus pandemic, telehealth services have increased dramatically. The intr...
Source: Current Allergy and Asthma Reports - October 1, 2020 Category: Allergy & Immunology Source Type: research

A Review of Patient and Provider Satisfaction with Telemedicine
AbstractPurpose of ReviewThe purpose of this review is to describe the determinants of satisfaction with telemedicine (TM) and how they compare with in-person visits from both the perspective of patients and of providers.Recent FindingsThe use of TM will expand only if patients and providers are at least as satisfied with it as they are with in-person visits. Since deviations from expected care can result in reduced satisfaction regardless of the quality of the visit or objective medical outcomes, it is important to understand and to help form those expectations when possible. Patients consistently report 95 –100% sa...
Source: Current Allergy and Asthma Reports - September 21, 2020 Category: Allergy & Immunology Source Type: research

Correction to: Alpha-1 Antitrypsin Deficiency: a Rare Disease?
The original version of this article contained errors in Table 3 on page 6. (Source: Current Allergy and Asthma Reports)
Source: Current Allergy and Asthma Reports - September 11, 2020 Category: Allergy & Immunology Source Type: research

Pulmonary Surfactants: a New Therapeutic Target in Asthma
AbstractPurpose of ReviewLung tissues are highly susceptible to airway inflammation as they are inevitably exposed to inhaled pathogens and allergens. In the lungs, clearance of infectious agents and regulation of inflammatory responses are important for the first-line defense, where surfactants play a role in host defense mechanisms. In this review, clinical significance of pulmonary surfactants in asthma has been highlighted.Recent FindingsSurfactants, such as surfactant protein A (SP-A) and SP-D released from alveolar epithelium, reduce pathogen infection and control immune-cell activation. Especially, SP-D directly bin...
Source: Current Allergy and Asthma Reports - September 10, 2020 Category: Allergy & Immunology Source Type: research

Safety of Intranasal Steroids: an Updated Perspective
AbstractPurpose of ReviewIntranasal corticosteroid sprays have been available as over-the-counter (OTC) medications since 2013. As such, clinicians need to be up-to-date with the risks and the safety of INS, as patients may have concerns and detailed questions. The following is a review of the recent medical literature regarding the safety profile, adverse reactions, and special populations using INS.Recent FindingsThe latest research on intranasal steroid sprays (INS) continue to confirm that INS rarely have significant local side effects, such as severe and persistent epistaxis. Recent studies looking at systemic side ef...
Source: Current Allergy and Asthma Reports - September 6, 2020 Category: Allergy & Immunology Source Type: research

Clinical Evidence and Biomarkers Linking Allergy and Acute or Chronic Rhinosinusitis in Children: a Systematic Review
AbstractPurpose of the ReviewWe provide a systematic review of experimental and clinical evidences linking allergy to acute, including common cold, and chronic rhinosinusitis in children. Furthermore, we questioned if anti-allergy treatment may prevent the occurrence of rhinosinusitis or improve outcomes of its specific management.Recent FindingsAllergic rhinitis is a common childhood disease in industrialized countries that is responsible for a major impact on quality of life and healthcare resources. Over the years many authors tried to correlate allergy with comorbidities and in particular to the onset of rhinosinusitis...
Source: Current Allergy and Asthma Reports - September 4, 2020 Category: Allergy & Immunology Source Type: research

Traditional Chinese Medicine (TCM) and Allergic Diseases
AbstractPurpose of ReviewThis paper purports to review recent relevant publications on the efficacy of traditional Chinese medicine in treating allergic diseases, to illustrate the  pertinent mechanisms of action of TCM, and to explore the possible role of TCM in the management of allergic diseases in the foreseeable future. As TCM embodies multiple treatment modalities, only the most popular two, namely CHM (Chinese herbal medicine) and acupuncture, were discussed. Publicat ions, especially reviews involving randomized controlled trials (RCTs) on the use of TCM on allergic diseases, published up to June 201...
Source: Current Allergy and Asthma Reports - September 1, 2020 Category: Allergy & Immunology Source Type: research

Asking the Right Questions —Human Factors Considerations for Telemedicine Design
AbstractPurpose of ReviewThe goal of this paper was to provide a narrative review of human factors considerations for telemedicine. It also sought to provide readers a foundation of human factors thinking and methods that could be employed within their own practice.Recent FindingsThere are only a handful of articles that discuss the importance of user-centered design and human factors principles in relation to telemedicine systems.SummaryMost articles come to the conclusion that design flaws could have been avoided by involving stakeholders in the design and implementation of telemedicine. However, many of them lack the gu...
Source: Current Allergy and Asthma Reports - August 28, 2020 Category: Allergy & Immunology Source Type: research

The Child with Elevated IgE and Infection Susceptibility
AbstractPurpose of ReviewOver the last 13  years, the genetic etiologies have been determined for multiple conditions causing elevated serum IgE, infection susceptibilities, and variable other features. In this review, we discuss the clinical presentation, laboratory features, and genetics of these diseases caused by mutations in STAT3, DO CK8, PGM3, IL6ST, ZNF341, IL6R, IL6ST, CARD11, and CARD14, with particular focus given to STAT3LOF and DOCK8 deficiency.Recent FindingsDefining the phenotype of each of these syndromes with high IgE and infection susceptibility shows that some have a pronounced connective tissue phe...
Source: Current Allergy and Asthma Reports - August 23, 2020 Category: Allergy & Immunology Source Type: research

B Cell Disorders in Children: Part II
AbstractPurpose of ReviewB cell disorders result in decreased levels or function of immunoglobulins in an individual. Genetic mutations have been reported in a variety of B cell disorders. This review, in follow-up to a previous review, describes some rare B cell disorders as well as their known underlying genetic etiologies.Recent FindingsGenetic studies identify and permit precise classification of an increasing number of B cell disorders, leading to a greater understanding of B cell development and function.SummaryThe B cell disorders are rare diseases. While clinicians are most familiar with X-linked agammaglobulinemia...
Source: Current Allergy and Asthma Reports - August 20, 2020 Category: Allergy & Immunology Source Type: research

Expression and Clinical Significance of Mucin Gene in Chronic Rhinosinusitis
AbstractPurpose of ReviewThis review highlights the expression and regulation of mucin in CRS and discusses its clinical implications.Recent FindingsChronic rhinosinusitis (CRS) is common chronic nasal disease; one of its main manifestations and important features is mucus overproduction. Mucin is the major component of mucus and plays a critical role in the pathophysiological changes in CRS. The phenotype of CRS affects the expression of various mucins, especially in nasal polyps (NP). Corticosteroids(CS), human neutrophil elastase (HNE), and transforming growth factor- β1 (TGF-β1) are closely related to the tis...
Source: Current Allergy and Asthma Reports - August 17, 2020 Category: Allergy & Immunology Source Type: research

Current E-Cigarette Research in the Context of Asthma
AbstractPurpose of ReviewThe purpose of this review is to integrate recent research on the respiratory immune effects of e-cigarettes with the pathogenesis of asthma to better understand how e-cigarettes may affect asthmatics and to note critical knowledge gaps regarding the effects of e-cigarettes on asthmatics.Recent FindingsHuman, rodent, and cell culture studies show that key cellular functions of epithelial cells, macrophages, and neutrophils are altered by e-cigarette exposure.SummaryBecause respiratory immunity is already dysregulated in asthma, further alteration of cellular function by e-cigarettes could impact as...
Source: Current Allergy and Asthma Reports - August 7, 2020 Category: Allergy & Immunology Source Type: research

The Loss of Smell and Taste in the COVID-19 Outbreak: a Tale of Many Countries
AbstractPurpose of ReviewOlfactory dysfunction in upper airway viral infections (common cold, acute rhinosinusitis) is common (>  60%). During the COVID-19 outbreak, frequency of sensory disorders (smell and/or taste) in affected patients has shown a high variability from 5 to 98%, depending on the methodology, country, and study.Recent FindingsA sudden, severe, isolated loss of smell and/or taste, in the absence of other upper airway inflammatory diseases (allergic rhinitis, chronic rhinosinusitis, nasal polyposis), should alert individuals and physicians on being potentially affected by COVID-19. The evaluation...
Source: Current Allergy and Asthma Reports - August 2, 2020 Category: Allergy & Immunology Source Type: research

Telemedicine Pays: Billing and Coding Update
AbstractPurpose of ReviewTelemedicine is a rapidly growing healthcare sector that can improve access to care for underserved populations and offer flexibility and convenience to patients and clinicians alike. However, uncertainty about insurance coverage and reimbursement policies for telemedicine has historically been a major barrier to adoption, especially among physicians in private practice (the majority of practicing allergists).Recent FindingsThe COVID-19 public health emergency has highlighted the importance of telehealth as a safe and effective healthcare delivery model, with governments and payers rapidly expandin...
Source: Current Allergy and Asthma Reports - July 26, 2020 Category: Allergy & Immunology Source Type: research

Otitis Media and Inborn Errors of Immunity
AbstractPurpose of ReviewThe aim of this review is as follows: (1) to present the role of otitis as a warning sign for inborn errors of immunity (IEI), (2) to establish which patients presenting otitis should be investigated for IEI, (3) to review data about main IEI associated with otitis-prone patients.Recent FindingsOtitis media is a very common infection in general population. The concept of otitis-prone children established a certain frequency of the infections in order to look for conditions leading to them. The confirmation of middle ear impairment by specialists has demonstrated better confiability. The hallmarks f...
Source: Current Allergy and Asthma Reports - July 10, 2020 Category: Allergy & Immunology Source Type: research

Antigen 5 Allergens of Hymenoptera Venoms and Their Role in Diagnosis and Therapy of Venom Allergy
AbstractPurpose of ReviewStings of Hymenoptera of the superfamily Vespoidea such as yellow jackets, paper wasps or stinging ants are common triggers for severe and even fatal allergic reactions. Antigen 5 allergens are potent allergens in the majority of these venoms with major importance for diagnosis and therapy. Reviewed here are the characteristics of antigen 5 allergens, their role in component-resolved diagnostics as well as current limitations of the available diagnostics for proper therapeutic decisions.Recent FindingsAntigens 5 are proteins of unknown function in Hymenoptera venoms with high allergenic potency. Th...
Source: Current Allergy and Asthma Reports - July 8, 2020 Category: Allergy & Immunology Source Type: research

Role of Allergy in Eustachian Tube Dysfunction
AbstractPurpose of ReviewEustachian tube dysfunction (ETD) presents with symptoms of aural fullness and pressure, muffled hearing, tinnitus, and otalgia. When severe, it can lead to many common ear disorders such as otitis media with effusion, tympanic membrane retraction/perforation, and cholesteatoma. These diseases are prevalent in both the pediatric and adult population and significantly impact quality of life. The pathophysiology of ETD in the absence of an obstructive lesion has long been debated but is thought to be related to functional obstruction (i.e., inefficient tensor veli palatini muscle) and/or nasal cavity...
Source: Current Allergy and Asthma Reports - July 8, 2020 Category: Allergy & Immunology Source Type: research

Olfactory Dysfunction in Traumatic Brain Injury: the Role of Neurogenesis
AbstractPurpose of ReviewOlfactory functioning disturbances are common following traumatic brain injury (TBI) having a significant impact on quality of life. A spontaneous recovery of the olfactory function over time may occur in TBI patients. Although there is no standard treatment for patients with posttraumatic olfactory loss, olfactory training (OT) has shown some promise beneficial effects. However, the mechanisms underlying spontaneous recovery and olfactory improvement induced by OT are not completely known.Recent FindingsThe spontaneous recovery of the olfactory function and the improvement of olfactory function af...
Source: Current Allergy and Asthma Reports - July 8, 2020 Category: Allergy & Immunology Source Type: research

Localized Granulomatous with Polyangiitis (GPA): Varied Clinical Presentations and Update on Treatment
The objective of this review is to summarize the various clinical manifestations of localized disease in GPA and their treatment.Recent FindingsSinonasal disease is seen in up to 90% of patients. Otologic and ocular involvement is also commonly seen. Laryngeal and tracheal disease although less common is associated with significant morbidity and can be therapeutically challenging. Clinicians need to be aware of these localized GPA manifestations as they may be presenting disease features in the absence of other systemic findings. Treatment of localized GPA involves both immunosuppressive and surgical interventions for spec...
Source: Current Allergy and Asthma Reports - July 8, 2020 Category: Allergy & Immunology Source Type: research

Update on DNA-Double Strand Break Repair Defects in Combined Primary Immunodeficiency
AbstractPurpose of ReviewThe most serious DNA damage, DNA double strand breaks (DNA-dsb), leads to mutagenesis, carcinogenesis or apoptosis if left unrepaired. Non-homologous end joining (NHEJ) is the principle repair pathway employed by mammalian cells to repair DNA-dsb. Several proteins are involved in this pathway, defects in which can lead to human disease. This review updates on the most recent information available for the specific diseases associated with the pathway.Recent FindingsA new member of the NHEJ pathway, PAXX, has been identified, although no human disease has been associated with it. The clinical phenoty...
Source: Current Allergy and Asthma Reports - July 8, 2020 Category: Allergy & Immunology Source Type: research

Scribes, EHRs, and Workflow Efficiencies in Allergy Practices
AbstractPurpose of ReviewIn the ever-changing healthcare system, along with new advancements in the field of allergy, the workflow for the allergist continues to evolve requiring more time spent doing non-clinical duties such as documentation and reviewing reimbursement challenges in the midst of busy clinics. The use of electronic medical records and medical scribes has emerged as tactics to aid the clinic ’s workflow and efficiency in the modern allergy and immunology clinic.Recent FindingsThe practicing allergist can implement various additional strategies in their office workflow to maximize and synthesize good m...
Source: Current Allergy and Asthma Reports - July 8, 2020 Category: Allergy & Immunology Source Type: research

B Cell Disorders in Children —Part I
AbstractPurpose of ReviewThe advent of enhanced genetic testing has allowed for the discovery of gene defects underlying two broad categories of antibody deficiency in children: agammaglobulinemia and common variable immunodeficiency (CVID). This review describes the underlying gene defects and the clinical manifestations.Recent FindingsBecause novel monogenetic defects have been discovered in both categories, a strict dichotomous classification of B cell disorders as either X-linked agammaglobulinemia or common variable immunodeficiency is no longer appropriate.SummaryAdvances in genetic testing technology and the decreas...
Source: Current Allergy and Asthma Reports - June 22, 2020 Category: Allergy & Immunology Source Type: research

Alpha-1 Antitrypsin Deficiency: a Rare Disease?
AbstractPurpose of ReviewCommonly categorized as a rare disease, alpha-1 antitrypsin deficiency (AATD) is neither rare, when compared to many other genetic disorders, nor an actual disease, but rather a predisposition toward a wide variety of diseases. It is one of the most common genetic disorders which can lead to a spectrum of clinical manifestations, ranging from no symptoms to progressively debilitating systemic disease, most commonly affecting the lung and liver. It is therefore imperative for clinicians to recognize and be familiar with the spectrum of presentations, methods of diagnosis, and clinical management of ...
Source: Current Allergy and Asthma Reports - June 21, 2020 Category: Allergy & Immunology Source Type: research

Itch in Organs Beyond the Skin
AbstractPurpose of ReviewThe purpose of this review was to explore mechanisms, causes, and therapies of itchy conditions involving organs beyond the skin including the eyes, ears, nose, and genital region.Recent FindingsConditions which cause itch in these locations vary from skin diseases that extend to these areas (i.e., atopic dermatitis, seborrheic dermatitis, and psoriasis) to allergic conditions (i.e., allergic rhinitis and conjunctivitis) and to neuropathic conditions that relate to afferent nerve fiber damage (i.e., lumbosacral radiculopathies in genital disease) as well as some psychological components. Similar to...
Source: Current Allergy and Asthma Reports - June 18, 2020 Category: Allergy & Immunology Source Type: research

Update on House Dust Mite Allergen Avoidance Measures for Asthma
AbstractPurpose of ReviewTo critically review the evidence in favor or against the use of house dust mite (HDM) allergen avoidance measures in patients with asthma.Recent FindingsSystematic reviews and meta-analyses suggested no positive effect of mite allergen avoidance strategies on asthma outcomes, resulting in a lack of consensus regarding the utility of these measures. However, such analyses have a number limitations and might not be the most adequate tool to evaluate current evidence and to derive clinical recommendations regarding mite allergen avoidance in asthmatic patients. We should not disproportionately rely o...
Source: Current Allergy and Asthma Reports - June 18, 2020 Category: Allergy & Immunology Source Type: research

Cogan ’s Syndrome: Clinical Presentations and Update on Treatment
This article will review the varying clinical presentations of CS and emerging information of systemic disease associated with CS. We will also review recently published promising treatment outcomes using immune modulating medications.SummaryAs our framework for recognizing the markers of CS and the associated systemic disorders expands, more effective guidelines and treatment options may emerge. (Source: Current Allergy and Asthma Reports)
Source: Current Allergy and Asthma Reports - June 15, 2020 Category: Allergy & Immunology Source Type: research

Role of Environmental Adjuvants in Asthma Development
AbstractPurpose of ReviewThis review summarizes recent progress in our understanding how environmental adjuvants promote the development of asthma.Recent FindingsAsthma is a heterogeneous set of lung pathologies with overlapping features. Human studies and animal models suggest that exposure to different environmental adjuvants activate distinct immune pathways, which in turn give rise to distinct forms, or endotypes, of allergic asthma. Depending on their concentrations, inhaled TLR ligands can activate either type 2 inflammation, or Th17 differentiation, along with regulatory responses that function to attenuate inflamma...
Source: Current Allergy and Asthma Reports - June 15, 2020 Category: Allergy & Immunology Source Type: research

Role of the Microbiome in Allergic Disease Development
AbstractPurpose of ReviewEvidence suggests that the microbiome of the skin, gastrointestinal tract, and airway contribute to health and disease. As we learn more about the role that the microbiota plays in allergic disease development, we can develop therapeutics to alter this pathway.Recent FindingsEpidemiologic studies reveal that an association exists between environmental exposures, which alter the microbiota, and developing atopic dermatitis, food allergy, and/or asthma. In fact, samples from the skin, gastrointestinal tract, and respiratory tract reveal distinct microbiotas compared with healthy controls, with microb...
Source: Current Allergy and Asthma Reports - June 15, 2020 Category: Allergy & Immunology Source Type: research

The Indoor Environment and Childhood Asthma
AbstractPurpose of ReviewSensitization and exposure to triggers in the indoor environment, including aeroallergens, indoor air pollution, and environmental tobacco smoke, have a significant role in asthma development and morbidity. This review discusses indoor environmental exposures and their effect on children with asthma as well as environmental interventions and their role in improving asthma morbidity.Recent FindingsRecent research has emphasized the role of aeroallergen sensitization and exposure in asthma morbidity and the importance of the school indoor environment.SummaryThere is an established association between...
Source: Current Allergy and Asthma Reports - June 15, 2020 Category: Allergy & Immunology Source Type: research

Allergic Contact Dermatitis in Children: Recommendations for Patch Testing
AbstractPurpose of ReviewAllergic contact dermatitis (ACD) affects 20% of children. However, diagnosis of ACD may be underreported in children due to lack of recognition. Patch testing is the gold standard for evaluation of ACD in children but poses unique challenges in this population.Recent FindingsRecent studies highlight the significance of ACD and the utility of patch testing in children. Evaluation of ACD in children is difficult and requires knowledge of a child ’s exposure history, careful selection of allergens, and knowledge of specialized patch testing considerations to minimize irritation and maximize coo...
Source: Current Allergy and Asthma Reports - June 15, 2020 Category: Allergy & Immunology Source Type: research

Sublingual Versus Subcutaneous Immunotherapy for Allergic Rhinitis: What Are the Important Therapeutic and Real-World Considerations?
AbstractPurpose of ReviewAllergen immunotherapy has been used for over 100  years in the treatment of allergic rhinitis. With two major options for administering this disease-modifying therapy, SCIT, and SLIT, what is our current understanding of the efficacy and safety of each one? How do we determine who is the appropriate candidate for each one in the real world?Recent FindingsSCIT and SLIT show significant improvement in clinical symptoms and need for medication in the treatment of allergic rhinitis. In recent meta-analyses, there is no significant difference in the efficacy between the two treatments, but SLIT ha...
Source: Current Allergy and Asthma Reports - June 15, 2020 Category: Allergy & Immunology Source Type: research

The Honeybee Venom Major Allergen Api m 10 (Icarapin) and Its Role in Diagnostics and Treatment of Hymenoptera Venom Allergy
AbstractPurpose of ReviewIn Hymenoptera venom allergy, the research focus has moved from whole venoms to individual allergenic molecules. Api m 10 (icarapin) has been described as a major allergen of honeybee venom (HBV) with potentially high relevance for diagnostics and therapy of venom allergy. Here, we review recent studies on Api m 10 characteristics as well as its role in component-resolved diagnostics and potential implications for venom-specific immunotherapy (VIT).Recent FindingsApi m 10 is a major allergen of low abundance in HBV. It is an obviously unstable protein of unknown function that exhibits homologs in o...
Source: Current Allergy and Asthma Reports - June 15, 2020 Category: Allergy & Immunology Source Type: research

Management of Severe Asthma Beyond the Guidelines
AbstractPurpose of ReviewAsthma is one of the most common chronic respiratory diseases worldwide, yet only a small percentage of patients are categorized as having severe disease. Severe asthmatics, however, are responsible for the largest burden of healthcare costs and lost productivity. Several recent guidelines have addressed disease pathogenesis and treatment modalities for these complex patients. Herein, we review the severe asthma guidelines, compare the existing guidelines, address key areas that are yet to be addressed in the guidelines, and discuss future directions for severe asthma research.Recent FindingsThis i...
Source: Current Allergy and Asthma Reports - June 15, 2020 Category: Allergy & Immunology Source Type: research

The Role of New IL-1 Family Members (IL-36 and IL-38) in Atopic Dermatitis, Allergic Asthma, and Allergic Rhinitis
AbstractPurpose of ReviewSince the discovery of its very first member in 1974, the IL-1 family has expanded into a group of 11 potent molecules which are essential in both innate and acquired immunity. Pro-inflammatory cytokines IL-36 α, IL-36β, and IL-36γ and their receptor antagonists IL-36Ra and IL-38, which belong to the IL-36 subfamily, are some of the most recently identified members. Recent studies show that these members possess pro-inflammatory and anti-inflammatory activities and may take part in the pathogenesis of allergy. In this review, the involvement and importance of these newly described ...
Source: Current Allergy and Asthma Reports - June 11, 2020 Category: Allergy & Immunology Source Type: research

Proton Pump Inhibitors in Children: the Good, the Bad, and the Ugly
AbstractPurpose of ReviewThe evidence supporting or contesting the prescription of proton pump inhibitors (PPIs) for children and updates on side effects are reviewed.Recent FindingsPPIs remain an important therapeutic option for esophagitis and gastritis. However, recent studies demonstrate no benefit when prescribing PPIs for chronic cough, infantile reflux, asthma, or functional gastrointestinal disorders. Recent studies suggest adverse effects on microbiome diversity and immune function, resulting in increased rates of gastrointestinal infections, bone fractures, and atopic disorders. PPIs influence a variety of cell t...
Source: Current Allergy and Asthma Reports - June 9, 2020 Category: Allergy & Immunology Source Type: research

Allergy and Otitis Media in Clinical Practice
AbstractPurpose of ReviewOtitis media (OM) is a disease with very high prevalence in infancy, substantial burden on healthcare resources, and relevant impact on the quality of life of families. The link between OM and allergy is controversial and still debated. However, a fundamental premise has to be placed before introducing this topic: there is the need to use clear and unambiguous terms. Literature abounds with misleading terms that significantly affect the methodology and consequently the outcomes. Moreover, it is essential to differentiate patients according to the OM type (i.e., acute OM, OM with effusion, and chron...
Source: Current Allergy and Asthma Reports - June 5, 2020 Category: Allergy & Immunology Source Type: research

Biologics for Allergic Dermatologic Diseases
AbstractPurpose of ReviewAtopic dermatitis (AD), chronic spontaneous urticaria (CSU), and allergic contact dermatitis (ACD) represent three important allergic dermatoses with many unmet therapeutic needs. The development of biologic agents has opened the door to both new treatment options and improved understanding of the underlying pathophysiology, both shared and unique for these entities. With several FDA-approved medications available and many more in development, the biologic revolution has begun for allergic dermatoses.Recent FindingsThis is a narrative review on the current state of pathomechanisms and appropriately...
Source: Current Allergy and Asthma Reports - June 5, 2020 Category: Allergy & Immunology Source Type: research

Eosinophilic Esophagitis: Existing and Upcoming Therapies in an Age of Emerging Molecular and Personalized Medicine
AbstractPurpose of ReviewRecent research efforts have spurred great progress in the diagnosis and management of eosinophilic esophagitis (EoE). Nonetheless, challenges remain in addressing disease burden and impairment in the growing EoE population. We highlight work from the Cincinnati Center for Eosinophilic Disorders, the Consortium of Eosinophilic Gastrointestinal Disease Researchers, and others that address these ongoing challenges.Recent FindingsNew tools for characterizing EoE disease activity include the EoE Histology Scoring System (EoEHSS), endoscopic alternatives, validated patient-reported outcome (PRO) questio...
Source: Current Allergy and Asthma Reports - June 5, 2020 Category: Allergy & Immunology Source Type: research

Utility of Environmental Exposure Unit Challenge Protocols for the Study of Allergic Rhinitis Therapies
AbstractPurpose of ReviewThis paper explores how the Environmental Exposure Unit (EEU) experimental model can be used to further our understanding of pharmacotherapies and immunotherapies for the treatment of allergic rhinitis (AR).Recent FindingsEEUs are used increasingly for the study of combination therapies, immunotherapies, and novel AR treatments. A combined antihistamine/corticosteroid nasal spray formulation was seen to have a faster onset of action relative to the therapies individually in the Environmental Exposure Chamber. House dust mite sublingual immunotherapy tablets are both safe and efficacious as evaluate...
Source: Current Allergy and Asthma Reports - June 5, 2020 Category: Allergy & Immunology Source Type: research

Wearable Technology and How This Can Be Implemented into Clinical Practice
AbstractPurpose of ReviewOur day-to-day life is saturated with health data that was previously out of reach. Over the last decade, new devices and fitness technology companies are attempting to tap into this data, uncovering a treasure trove of useful information that, when applied correctly, has the potential to revolutionize the way we approach healthcare and chronic conditions like asthma, especially in the wake of the COVID-19 pandemic.Recent FindingsBy harnessing exciting developments in personalization, digitization, wellness, and patient engagement, care providers can improve health outcomes for our patients in a wa...
Source: Current Allergy and Asthma Reports - June 5, 2020 Category: Allergy & Immunology Source Type: research

Occupational Exposure to Metals and Solvents: Allergy and Airway Diseases
AbstractPurpose of ReviewOccupational allergic diseases (OAD) such as occupational contact dermatitis (OCD), occupational asthma (OA), and occupational rhinitis (OR) are the most prevalent occupational diseases in industrialized countries. The purpose of this review is to provide an update about the main occupational metal and solvent exposures related to allergy and airway diseases and to discuss newly defined causative agents and industries in this field.Recent FindingsCurrently for over 400 causative agents for OA and OCD, several hundreds of agents for OR have been identified. Although many studies have reported an ove...
Source: Current Allergy and Asthma Reports - June 5, 2020 Category: Allergy & Immunology Source Type: research

Pediatric Versus Adult Chronic Rhinosinusitis
This article reviews the similarities and differences between pediatric and adult CRS.Recent FindingsRhinosinusitis is an inflammatory disease of the nose and the paranasal sinuses. In adults, inflammation in CRS without polyps (CRSsNP) mainly manifests with T-helper 1 lymphocytes while in CRS with polyps (CRSwNP) manifests with T-helper 2 lymphocytes and eosinophilic inflammation. In children, CRS inflammation manifests with neutrophils, macrophages, and lymphocytes. The associations between the ostiomeatal complex occlusion and CRS are revealed in adults but are not so evident in children. Although the relationship betwe...
Source: Current Allergy and Asthma Reports - June 5, 2020 Category: Allergy & Immunology Source Type: research

The External Exposome and Food Allergy
AbstractPurpose of ReviewThe recent increase in childhood food allergy prevalence strongly suggests that environmental exposures are contributing to food allergy development. This review summarizes current knowledge about the role of the external exposome in food allergy.Recent FindingsThere is growing evidence that environmental exposure to food antigens in house dust through non-oral routes contributes to food sensitization and allergy. Co-exposure to environmental adjuvants in house dust, such as microbial products and fungal allergens, may also facilitate allergic sensitization. While a high-microbe environment is asso...
Source: Current Allergy and Asthma Reports - June 5, 2020 Category: Allergy & Immunology Source Type: research