Innate Immune Responses to Fungal Allergens
AbstractPurpose of ReviewIn this review, we describe innate immunity to fungi and the ability of pattern recognition receptors (PRRs) to recognize fungal-associated molecular patterns (FAMPs) and danger-associated molecular patterns (DAMPs).Recent FindingsProtective responses against fungal antigens can be divided into two parts: innate immunity and adaptive immunity. Detection of foreign substance by the innate immune system is mediated by a variety of genetically encoded receptors known as pattern recognition receptors (PRRs). These PRRs bind to PAMPs (pathogen-associated molecular patterns) and more specifically to fung...
Source: Current Allergy and Asthma Reports - August 13, 2016 Category: Allergy & Immunology Source Type: research

Capsaicin for Rhinitis
AbstractRhinitis is a multifactorial disease characterized by symptoms of sneezing, rhinorrhea, postnasal drip, and nasal congestion. Non-allergic rhinitis is characterized by rhinitis symptoms without systemic sensitization of infectious etiology. Based on endotypes, we can categorize non-allergic rhinitis into an inflammatory endotype with usually eosinophilic inflammation encompassing at least NARES and LAR and part of the drug induced rhinitis (e.g., aspirin intolerance) and a neurogenic endotype encompassing idiopathic rhinitis, gustatory rhinitis, and rhinitis of the elderly. Patients with idiopathic rhinitis have a ...
Source: Current Allergy and Asthma Reports - August 3, 2016 Category: Allergy & Immunology Source Type: research

Hypersensitivity Pneumonitis Due to Metalworking Fluid Aerosols
Abstract Purpose of Review This review summarises the clinical knowledge of hypersensitivity pneumonitis in workers exposed to aerosols of metalworking fluid, reviewing published outbreaks and clinical cases. Recent Findings Metalworking fluid exposure has become the commonest recognised cause of occupational hypersensitivity pneumonitis, having been rare before 2000. There are many possible agents in the metalworking fluid which may be the cause of disease including bacteria, mycobacteria, fungae, biocides, emulsifiers, reodorants and dissolved chrome and cobalt. Causes are likely to be different in different outbrea...
Source: Current Allergy and Asthma Reports - July 29, 2016 Category: Allergy & Immunology Source Type: research

Botulinum Toxin for Rhinitis
Abstract Purpose of Review Rhinitis is a common clinical entity. Besides nasal obstruction, itching, and sneezing, one of the most important symptoms of rhinitis is nasal hypersecretion produced by nasal glands and exudate from the nasal vascular bed. Allergic rhinitis is an IgE-mediated inflammatory reaction of nasal mucosa after exposure to environmental allergens. Idiopathic rhinitis describes rhinitis symptoms that occur after non-allergic, noninfectious irritants. Specific allergen avoidance, topical nasal decongestants, nasal corticosteroids, immunotherapy, and sinonasal surgery are the main treatment options. Beca...
Source: Current Allergy and Asthma Reports - July 26, 2016 Category: Allergy & Immunology Source Type: research

New Insights Into the Relationship Between Chitinase-3-Like-1 and Asthma
Abstract Purpose of Review CHI3L1 (also known as YKL-40), a member of “mammalian chitinase-like proteins,” is a serum protein lacking enzymatic activity. Although the protein is highly conserved in mammals, a consensus regarding its role in human pathologies is currently lacking. In an attempt to shed light on the many physiological functions of the protein, specifically with regard to asthma, a comprehensive overview of recent studies is provided. Recent Findings In asthma, CHI3L1 is secreted from macrophages and airway epithelial cel...
Source: Current Allergy and Asthma Reports - July 20, 2016 Category: Allergy & Immunology Source Type: research

Pros and Cons of Clinical Basophil Testing (BAT)
Abstract Purpose of Review We review basophil testing by flow cytometry with an emphasis on advantages and disadvantages. Recent Findings There are many tools available to assess the presence and severity of allergic diseases in patients. For 50 years, peripheral blood basophils have been used as tools to study these diseases. It is a very accessible cell that binds IgE antibody and secretes the classical mediators responsible for the symptoms of allergic reactions. In the last decade, an even more accessible methodology, using flow cytometry...
Source: Current Allergy and Asthma Reports - July 13, 2016 Category: Allergy & Immunology Source Type: research

Immune Gamma Globulin Therapeutic Indications in Immune Deficiency and Autoimmunity
Abstract Immune gamma globulin (IgG) has a long history in the treatment of both primary immune deficiency and autoimmune disorders. Disease indications continue to expand and new-generation products increase the versatility of delivery. This review encompasses a historical perspective as well as current and future implications of human immune globulin for the treatment of immune-mediated illness. (Source: Current Allergy and Asthma Reports)
Source: Current Allergy and Asthma Reports - July 11, 2016 Category: Allergy & Immunology Source Type: research

What Ancestry Can Tell Us About the Genetic Origins of Inter-Ethnic Differences in Asthma Expression
Abstract Differences in asthma prevalence have been described across different populations, suggesting that genetic ancestry can play an important role in this disease. In fact, several studies have demonstrated an association between African ancestry with increased asthma susceptibility and severity, higher immunoglobulin E levels, and lower lung function. In contrast, Native American ancestry has been shown to have a protective role for this disease. Genome-wide association studies have allowed the identification of population-specific genetic variants with varying allele frequency among populations. Additional...
Source: Current Allergy and Asthma Reports - July 8, 2016 Category: Allergy & Immunology Source Type: research

Eosinophil ETosis and DNA Traps: a New Look at Eosinophilic Inflammation
Abstract The traditional paradigm of eosinophils as end-stage damaging cells has mainly relied on their release of cytotoxic proteins. Cytokine-induced cell survival and secretion of granular contents from tissue-dwelling eosinophil are thought to be important mechanisms for eosinophilic inflammatory disorders, although the occurrence of cytolysis and its products (i.e., free extracellular granules) has been observed in affected lesions. Recent evidence indicates that activated eosinophils can exhibit a non-apoptotic cell death pathway, namely extracellular trap cell death (ETosis) that mediates the eosinophil cy...
Source: Current Allergy and Asthma Reports - July 8, 2016 Category: Allergy & Immunology Source Type: research

Airway Microbiota and the Implications of Dysbiosis in Asthma
Abstract The mucosal surfaces of the human body are typically colonized by polymicrobial communities seeded in infancy and are continuously shaped by environmental exposures. These communities interact with the mucosal immune system to maintain homeostasis in health, but perturbations in their composition and function are associated with lower airway diseases, including asthma, a developmental and heterogeneous chronic disease with various degrees and types of airway inflammation. This review will summarize recent studies examining airway microbiota dysbioses associated with asthma and their relationship with the...
Source: Current Allergy and Asthma Reports - July 8, 2016 Category: Allergy & Immunology Source Type: research

Natural (Mineral, Vegetable, Coconut, Essential) Oils and Contact Dermatitis
Abstract Natural oils include mineral oil with emollient, occlusive, and humectant properties and the plant-derived essential, coconut, and other vegetable oils, composed of triglycerides that microbiota lipases hydrolyze into glycerin, a potent humectant, and fatty acids (FAs) with varying physico-chemical properties. Unsaturated FAs have high linoleic acid used for synthesis of ceramide-I linoleate, a barrier lipid, but more pro-inflammatory omega-6:-3 ratios above 10:1, and their double bonds form less occlusive palisades. VCO FAs have a low linoleic acid content but shorter and saturated FAs that form a more ...
Source: Current Allergy and Asthma Reports - July 4, 2016 Category: Allergy & Immunology Source Type: research

Lipid Mediators of Allergic Disease: Pathways, Treatments, and Emerging Therapeutic Targets
Abstract Bioactive lipids are critical regulators of inflammation. Over the last 75 years, these diverse compounds have emerged as clinically-relevant mediators of allergic disease pathophysiology. Animal and human studies have demonstrated the importance of lipid mediators in the development of asthma, allergic rhinitis, urticaria, anaphylaxis, atopic dermatitis, and food allergy. Lipids are critical participants in cell signaling events which influence key physiologic (bronchoconstriction) and immune phenomena (degranulation, chemotaxis, sensitization). Lipid-mediated cellular mechanisms including: (1) for...
Source: Current Allergy and Asthma Reports - June 22, 2016 Category: Allergy & Immunology Source Type: research

The Perception of Asthma Severity in Children
Abstract The ability to perceive the onset and severity of symptoms of worsening asthma is important, not only for initial diagnosis but also for early identification of an asthma exacerbation and prompt management. There are subjective and objective methods for identifying symptoms. Symptom perception is affected by multiple mechanisms, and not all patients can accurately perceive symptoms of airflow limitation. Hyperperceivers will report substantial discomfort in the face of minimal bronchoconstriction, and poor perceivers will report no symptoms even in the presence of severe obstruction. The use of objective...
Source: Current Allergy and Asthma Reports - June 22, 2016 Category: Allergy & Immunology Source Type: research

Immediate Drug Hypersensitivity
Abstract Drug allergy affects a large percentage of the general population. A listed drug allergy can also have broad implications for many aspects of patient care. Here, we will review recent advances in the arena of drug allergies with a focus on antibiotics, monoclonals, NSAIDs, and chemotherapeutics. (Source: Current Allergy and Asthma Reports)
Source: Current Allergy and Asthma Reports - June 22, 2016 Category: Allergy & Immunology Source Type: research

The Prevalence and Natural History of Food Allergy
Abstract Numerous studies have demonstrated that the prevalence of food allergy is increasing. Not only are more children being diagnosed with food allergies, but studies suggest that when people outgrow their food allergies, it is taking longer than was previously thought. Studies in recent years have noted factors that may lead to a lower likelihood of developing a food allergy, including the early introduction of common food allergens, having a sufficient vitamin D level, or having a higher maternal intake of peanut early in pregnancy. Given a recent report that sensitization to common food allergens did not i...
Source: Current Allergy and Asthma Reports - June 22, 2016 Category: Allergy & Immunology Source Type: research

Unintended Immunological Consequences of Biologic Therapy
Abstract Recent advances in the understanding of immune dysregulation in autoimmune diseases have enabled the development of new monoclonal antibody-based drugs called biologics. Biologics have been used to target aberrant immune responses in many diseases, but patients with rheumatologic and other autoimmune diseases have benefited the most and improvements in outcomes have been significant. The use of biologics is not without hazard, however, as these agents block immune pathways adapted to protect the host. This has been borne out by increased rates of infections as well as induction of new autoimmune and hema...
Source: Current Allergy and Asthma Reports - June 21, 2016 Category: Allergy & Immunology Source Type: research

The Developmental History of IgE and IgG4 Antibodies in Relation to Atopy, Eosinophilic Esophagitis, and the Modified T H 2 Response
Abstract A common reaction from anyone confronted with allergy is the question: what prevents universal allergy? We will discuss recent findings in the mouse system that have provided us with clues on why allergy is not more common. We will also address one crucial aspect of atopic allergy in humans, which is absent in most mouse model systems, an IgG/IgE ratio
Source: Current Allergy and Asthma Reports - May 24, 2016 Category: Allergy & Immunology Source Type: research

Adverse Effects of Nonsystemic Steroids (Inhaled, Intranasal, and Cutaneous): a Review of the Literature and Suggested Monitoring Tool
Abstract Inhaled, intranasal, and cutaneous steroids are prescribed by physicians for a plethora of disease processes including asthma and rhinitis. While the high efficacy of this class of medication is well known, the wide range of adverse effects, both local and systemic, is not well elucidated. It is imperative to monitor total steroid burden in its varied forms as well as tracking for possible side effects that may be caused by a high cumulative dose of steroids. This review article highlights the adverse effects of different steroid modalities as well as suggests a monitoring tool to determine steroid total...
Source: Current Allergy and Asthma Reports - May 20, 2016 Category: Allergy & Immunology Source Type: research

Indoor Allergens and Allergic Respiratory Disease
Abstract Purpose of review The purpose of this review is to evaluate the most recent findings on indoor allergens and their impact on allergic diseases. Recent findings Indoor allergens are present inside buildings (home, work environment, school), and given the chronic nature of the exposures, indoor allergies tend to be associated with the development of asthma. The most common indoor allergens are derived from dust mites, cockroaches, mammals (including wild rodents and pets), and fungi. The advent of molecular biology and proteomics has led to...
Source: Current Allergy and Asthma Reports - May 16, 2016 Category: Allergy & Immunology Source Type: research

Common and Rare Manifestations of Neuromyelitis Optica Spectrum Disorder
Abstract The discovery of a highly specific biomarker of neuromyelitis optica (NMO)—the anti-aquaporin-4 (AQP4) antibody—has opened new paths to understanding disease pathogenesis and afforded a way to confirm the diagnosis in clinical practice. An important consequence of the discovery is the broadening of the spectrum of syndromes seen in the context of AQP4 autoimmunity. These syndromes have been subsumed under the rubric of NMO spectrum disorder (NMOSD). The current classification recognizes not only optic neuritis and myelitis as core syndromes of NMOSD but also cerebral, diencephalic, brainstem,...
Source: Current Allergy and Asthma Reports - May 11, 2016 Category: Allergy & Immunology Source Type: research

Olfaction in Chronic Rhinosinusitis
Abstract Olfactory dysfunction is a frequent complaint in chronic rhinosinusitis patients and has a significant impact on quality of life. Therefore, it is essential that clinicians are aware of the importance of olfactory dysfunction in chronic rhinosinusitis (CRS) patients and know how to deal with it. Notably, the evaluation of olfactory function (i.e., using psychophysical testing) and imagery of olfactory bulb play an important role in the evaluation of patients and give essential information about the “baseline” olfactory function. Because the high impact of olfactory function on quality of life...
Source: Current Allergy and Asthma Reports - April 30, 2016 Category: Allergy & Immunology Source Type: research

Skin Biomes
Abstract The cutaneous microbiome has been investigated broadly in recent years and some traditional perspectives are beginning to change. A diverse microbiome exists on human skin and has a potential to influence pathogenic microbes and modulate the course of skin disorders, e.g. atopic dermatitis. In addition to the known dysfunctions in barrier function of the skin and immunologic disturbances, evidence is rising that frequent skin disorders, e.g. atopic dermatitis, might be connected to a dysbiosis of the microbial community and changes in the skin microbiome. As a future perspective, examining the skin micro...
Source: Current Allergy and Asthma Reports - April 7, 2016 Category: Allergy & Immunology Source Type: research

Gene Therapy for the Treatment of Primary Immune Deficiencies
Abstract The use of gene therapy in the treatment of primary immune deficiencies (PID) has advanced significantly in the last decade. Clinical trials for X-linked severe combined immunodeficiency, adenosine deaminase deficiency (ADA), chronic granulomatous disease, and Wiskott-Aldrich syndrome have demonstrated that gene transfer into hematopoietic stem cells and autologous transplant can result in clinical improvement and is curative for many patients. Unfortunately, early clinical trials were complicated by vector-related insertional mutagenic events for several diseases with the exception of ADA-deficiency SCI...
Source: Current Allergy and Asthma Reports - April 7, 2016 Category: Allergy & Immunology Source Type: research

Quality of Life Among Food Allergic Patients and Their Caregivers
Abstract Food allergy is increasing in prevalence worldwide. This review summarizes progress made studying relationships between food allergy and quality of life (QOL), with an emphasis on recent work in the field. Early work examining QOL among food allergy patients established that stress and anxiety associated with continuous allergen avoidance and the looming threat of anaphylaxis were associated with significantly impaired food allergy quality of life (FAQOL) for children with food allergy and their caregivers. Recent clinical studies suggest that undergoing oral food challenge to confirm food allergy and or...
Source: Current Allergy and Asthma Reports - April 5, 2016 Category: Allergy & Immunology Source Type: research

Food Allergy: Our Evolving Understanding of Its Pathogenesis, Prevention, and Treatment
Abstract Food allergy is defined as an IgE-mediated hypersensitivity response to ingested food with allergic symptoms ranging from urticaria to life-threatening anaphylaxis. Food allergy is thought to develop because of (1) failed induction of tolerance upon initial exposure to food antigen or (2) breakdown of established tolerance to food antigen. We review current understanding of the pathogenesis, epidemiology, and natural history of food allergy, including the unconventional IgE-mediated food allergy to mammalian meat known as alpha-gal food allergy. We highlight emerging data on food allergy treatment and pr...
Source: Current Allergy and Asthma Reports - April 4, 2016 Category: Allergy & Immunology Source Type: research

Pearls and Pitfalls in Diagnosing IgE-Mediated Food Allergy
Abstract The term “food allergy” is used by many patients and clinicians to describe a range of symptoms that occur after ingestion of specific foods. However, not all symptoms occurring after food exposure are due to an allergic, or immunologic, response. It is important to properly evaluate and diagnose immunoglobulin E (IgE)-mediated food allergy as this results in reproducible, immediate onset, allergic reactions that can progress toward life-threatening anaphylaxis. Proper diagnosis requires understanding of the common foods that cause these reactions in addition to key historical elements such a...
Source: Current Allergy and Asthma Reports - April 2, 2016 Category: Allergy & Immunology Source Type: research

Peanut Allergy: New Developments and Clinical Implications
Abstract Food allergies have increased in prevalence over the past 20 years, now becoming an important public health concern. Although there are no therapies currently available for routine clinical care, recent reports have indicated that immunotherapies targeting the mucosal immune system may be effective. Oral immunotherapy is conducted by administering small, increasing amounts of food allergen; it has shown promise for desensitizing individuals with peanut, egg, or milk allergies. Sublingual immunotherapy also desensitizes allergic patients to foods—two major studies have examined the effects of s...
Source: Current Allergy and Asthma Reports - April 2, 2016 Category: Allergy & Immunology Source Type: research

Epigenetic Dysfunction in Turner Syndrome Immune Cells
Abstract Turner syndrome (TS) is a chromosomal condition associated with partial or complete absence of the X chromosome that involves characteristic findings in multiple organ systems. In addition to well-known clinical characteristics such as short stature and gonadal failure, TS is also associated with T cell immune alterations and chronic otitis media, suggestive of a possible immune deficiency. Recently, ubiquitously transcribed tetratricopeptide repeat on the X chromosome (UTX), a histone H3 lysine 27 (H3K27) demethylase, has been identified as a downregulated gene in TS immune cells. Importantly, UTX is an...
Source: Current Allergy and Asthma Reports - April 2, 2016 Category: Allergy & Immunology Source Type: research

Asthma in Urban Children: Epidemiology, Environmental Risk Factors, and the Public Health Domain
Abstract Asthma is the most commonly reported chronic condition of childhood in developed countries, with 6.5 million children affected in the USA. A disparate burden of childhood asthma is seen among socioeconomically disadvantaged youth, often concentrated in urban areas with high poverty rates. Host factors that predispose a child to asthma include atopy, male gender, parental history of asthma, and also race, ethnicity, and genetic and epigenetic susceptibilities. Environmental factors, such as improved hygiene, ambient air pollution, and early life exposures to microbes and aeroallergens, also influence the ...
Source: Current Allergy and Asthma Reports - March 30, 2016 Category: Allergy & Immunology Source Type: research

Pollen Allergens for Molecular Diagnosis
Abstract Pollen allergens are one of the main causes of type I allergies affecting up to 30 % of the population in industrialized countries. Climatic changes affect the duration and intensity of pollen seasons and may together with pollution contribute to increased incidences of respiratory allergy and asthma. Allergenic grasses, trees, and weeds often present similar habitats and flowering periods compromising clinical anamnesis. Molecule-based approaches enable distinction between genuine sensitization and clinically mostly irrelevant IgE cross-reactivity due to, e. g., panallergens or carbohydrate determi...
Source: Current Allergy and Asthma Reports - March 22, 2016 Category: Allergy & Immunology Source Type: research

Baked Egg and Milk Exposure as Immunotherapy in Food Allergy
Abstract Baked milk and egg have the potential to act as a form of oral immunotherapy (OIT). Clinical studies have shown that a majority of milk- and egg-allergic children can tolerate these allergens modified in baked form, and immunologic changes reported in subjects ingesting baked milk and egg mirror those seen in food allergy OIT trials. In addition, several studies have indicated that resolution of milk and egg allergies occur sooner in populations regularly ingesting baked milk and egg. Oral food challenges remain the best method for determining tolerability of baked milk and egg since baseline characteris...
Source: Current Allergy and Asthma Reports - March 22, 2016 Category: Allergy & Immunology Source Type: research

Rhinoviruses and Their Receptors: Implications for Allergic Disease
Abstract Human rhinoviruses (RVs) are picornaviruses that can cause a variety of illnesses including the common cold, lower respiratory tract illnesses such as bronchitis and pneumonia, and exacerbations of asthma. RVs are classified into three species, RV-A, B, and C, which include over 160 types. They utilize three major types of cellular membrane glycoproteins to gain entry into the host cell: intercellular adhesion molecule 1 (ICAM-1) (the majority of RV-A and all RV-B), low-density lipoprotein receptor (LDLR) family members (12 RV-A types), and cadherin-related family member 3 (CDHR3) (RV-C). CDHR3 is a memb...
Source: Current Allergy and Asthma Reports - March 9, 2016 Category: Allergy & Immunology Source Type: research

Diagnosis and Management of Rhinosinusitis: Highlights from the 2015 Practice Parameter
Abstract Rhinosinusitis is a commonly diagnosed disease in the USA. Rhinosinusitis is classified as acute, recurrent, or chronic (with or without nasal polyps). While acute rhinosinusitis is diagnosed by history and physical examination, chronic rhinosinusitis and recurrent acute rhinosinusitis are diagnosed based on symptoms and the presence of disease on either a sinus CT scan and/or endoscopy. Management of uncomplicated acute rhinosinusitis includes analgesics, saline irrigation, and/or intranasal steroids. Antibiotics and intranasal steroids are recommended for acute bacterial rhinosinusitis. Intranasal and ...
Source: Current Allergy and Asthma Reports - March 7, 2016 Category: Allergy & Immunology Source Type: research

Current and Emerging Therapies for IgE-Mediated Food Allergy
Abstract Food allergies are a growing clinical problem leading to increased health care utilization and decreases in patient quality of life. Current treatment recommendations include strict dietary avoidance of the offending food as well as use of self-injectable epinephrine in case of accidental exposure with allergic reaction. Although many individuals will eventually outgrow their food allergies, a substantial number will not. Significant effort has been made to find novel treatments that protect patients from food-triggered reactions as well as to develop immune-modulating therapies that could lead to tolera...
Source: Current Allergy and Asthma Reports - March 4, 2016 Category: Allergy & Immunology Source Type: research

T Regulatory Cell Biology in Health and Disease
Abstract Regulatory T (Treg) cells that express the transcription factor forkhead box protein P3 (FOXP3) play an essential role in enforcing immune tolerance to self tissues, regulating host-commensal flora interaction, and facilitating tissue repair. Their deficiency and/or dysfunction trigger unbridled autoimmunity and inflammation. A growing number of monogenic defects have been recognized that adversely impact Treg cell development, differentiation, and/or function, leading to heritable diseases of immune dysregulation and autoimmunity. In this article, we review recent insights into Treg cell biology and fun...
Source: Current Allergy and Asthma Reports - February 29, 2016 Category: Allergy & Immunology Source Type: research

Mucosal Lesions in an Allergy Practice
Abstract The diagnosis and treatment of mucosal disease with an allergic pathogenesis are challenging. Oral allergy is often a hypersensitivity reaction with variable symptoms and physical exam findings. Clinical diagnosis requires a history of prior allergen exposure, a delay from exposure to clinical findings, and improvement following allergen removal. The past decades have seen great contributions to the field of oral allergy. The aim of this review is to provide an approach to the diagnosis and treatment of oral dermatologic disease with a focus on diseases with an investigated allergic pathogenesis. (Source...
Source: Current Allergy and Asthma Reports - February 27, 2016 Category: Allergy & Immunology Source Type: research

The Heterogeneity of Oral Immunotherapy Clinical Trials: Implications and Future Directions
Abstract Food allergy is a potentially life-threatening disease which affects up to 8 % of children and 2–3 % of adults. Increasing food allergy prevalence poses a major public health concern. Induction of desensitization to food allergens through oral immunotherapy (OIT) is an expanding area of study encompassing peanut, egg, milk, and other food allergens. OIT consists of administering incremental doses of food allergen to food-allergic patients, to induce a state of desensitization. Safety, tolerability, and efficacy all remain ongoing concerns. Clinical trials for oral immunotherapy have encom...
Source: Current Allergy and Asthma Reports - February 27, 2016 Category: Allergy & Immunology Source Type: research

Cross-Reactivity among Beta-Lactams
Abstract Penicillins and cephalosporins are the major classes of beta-lactam (BL) antibiotics in use today and one of the most frequent causes of hypersensitivity reactions to drugs. Monobactams, carbapenems, oxacephems, and beta-lactamase inhibitors constitute the four minor classes of BLs. This review takes into account mainly the prospective studies which evaluated cross-reactivity among BLs in subjects with a well-demonstrated hypersensitivity to a certain class of BLs by performing allergy tests with alternative BLs and, in case of negative results, administering them. In subjects with either IgE-mediated or...
Source: Current Allergy and Asthma Reports - February 22, 2016 Category: Allergy & Immunology Source Type: research

Potential Mechanisms for IgG4 Inhibition of Immediate Hypersensitivity Reactions
Abstract IgG4 is the least abundant IgG subclass in human serum, representing less than 5 % of all IgG. Increases in IgG4 occur following chronic exposure to antigen and are generally associated with states of immune tolerance. In line with this, IgG4 is regarded as an anti-inflammatory antibody with a limited ability to elicit effective immune responses. Furthermore, IgG4 attenuates allergic responses by inhibiting the activity of IgE. The mechanism by which IgG4 inhibits IgE-mediated hypersensitivity has been investigated using a variety of model systems leading to two proposed mechanisms. First by sequest...
Source: Current Allergy and Asthma Reports - February 18, 2016 Category: Allergy & Immunology Source Type: research

Standardization and Regulation of Allergen Products in the European Union
Abstract Product-specific standardization is of prime importance to ensure persistent quality, safety, and efficacy of allergen products. The regulatory framework in the EU has induced great advancements in the field in the last years although national implementation still remains heterogeneous. Scores of methods for quantification of individual allergen molecules are developed each year and also the challenging characterization of chemically modified allergen products is progressing. However, despite the unquestionable increase in knowledge and the subsequent improvements in control of quality parameters of alle...
Source: Current Allergy and Asthma Reports - February 13, 2016 Category: Allergy & Immunology Source Type: research

Classification of Food Allergens and Cross-Reactivity
Abstract Patients with specific food allergies are commonly sensitized to related foods, for example, shrimp with other shellfish and peanut with other legumes. In some instances, this represents a true allergy to the related food, defined as cross-reactivity, while in other instances, it represents a positive skin or IgE test only, in a patient who can eat the related food without difficulty. This is defined as cross-sensitization. It is extremely important that the clinician recognize these patterns of cross-sensitization and cross-reactivity, both to counsel patients on foods that should be avoided and to make...
Source: Current Allergy and Asthma Reports - February 13, 2016 Category: Allergy & Immunology Source Type: research

Autoimmune and Lymphoproliferative Complications of Common Variable Immunodeficiency
Abstract Common variable immunodeficiency (CVID) is frequently complicated by the development of autoimmune and lymphoproliferative diseases. With widespread use of immunoglobulin replacement therapy, autoimmune and lymphoproliferative complications have replaced infection as the major cause of morbidity and mortality in CVID patients. Certain CVID complications, such as bronchiectasis, are likely to be the result of immunodeficiency and are associated with infection susceptibility. However, other complications may result from immune dysregulation rather than immunocompromise. CVID patients develop autoimmunity, ...
Source: Current Allergy and Asthma Reports - February 8, 2016 Category: Allergy & Immunology Source Type: research

Immediate and Delayed Hypersensitivity Reactions to Corticosteroids: Evaluation and Management
Abstract Corticosteroids are anti-inflammatory medications used widely to treat allergic inflammation. Although the endocrine and gastrointestinal side effects of corticosteroids have been described, the occurrence of immediate hypersensitivity reactions and delayed contact dermatitis due to corticosteroids remains under-recognized. Hypersensitivity reactions can occur to a corticosteroid itself, or to the additives and vehicles in corticosteroid preparations. Skin testing and oral graded challenge can help confirm the suspected culprit agent in immediate hypersensitivity reactions and help identify an alternativ...
Source: Current Allergy and Asthma Reports - February 8, 2016 Category: Allergy & Immunology Source Type: research

Mast Cells and Anaphylaxis
Abstract For half a century, it has been known that the mast cell is the cell responsible for the majority of anaphylactic events. Its mediators, taken as a whole, are capable of producing all of the clinical manifestations of these events. With the discovery of immunoglobulin E (IgE), it was originally felt that the vast majority of anaphylactic episodes were due to antigen coupling with two cell-bound IgE molecules. More recently it has been learned that many episodes are produced by direct activation of mast cells, not involving antigen binding to IgE, and that monomeric IgE under certain conditions can also c...
Source: Current Allergy and Asthma Reports - February 8, 2016 Category: Allergy & Immunology Source Type: research

Immediate and Delayed Hypersensitivity Reactions to Proton Pump Inhibitors: Evaluation and Management
Abstract PPIs are among the most commonly administered medications in the USA and are generally well tolerated. Immediate and delayed immune-mediated hypersensitivity reactions are rare but increasingly recognized adverse effects of proton pump inhibitors (PPIs). Immediate hypersensitivity reactions can occur due to IgE-mediated hypersensitivity to PPIs and can be evaluated by immediate hypersensitivity skin testing and oral provocation challenge testing. A desensitization protocol can be used when PPI use cannot be avoided in an allergic patient. Delayed hypersensitivity reactions to PPIs have also been reported...
Source: Current Allergy and Asthma Reports - January 25, 2016 Category: Allergy & Immunology Source Type: research

Risk Factors and Comorbidities in Chronic Rhinosinusitis
Abstract Chronic rhinosinusitis (CRS) is a heterogeneous disorder that creates a significant burden on the healthcare system. It is caused by a combination of inflammatory, environmental, and host factors; however, the precise mechanism of how each factor leads to CRS continues to be a source of debate. Previous data regarding this topic is often inconsistent or of lower quality. In this article, we review the recent literature on the risk factors and comorbidities in CRS. Large population-based studies have helped establish smoking as a significant risk factor for CRS. The focus has now shifted towards smoking a...
Source: Current Allergy and Asthma Reports - January 22, 2016 Category: Allergy & Immunology Source Type: research

The Cloning and Expression of Human Monoclonal Antibodies: Implications for Allergen Immunotherapy
Abstract Allergic responses are dependent on the highly specific effector functions of IgE antibodies. Conversely, antibodies that block the activity of IgE can mediate tolerance to allergen. Technologies that harness the unparalleled specificity of antibody responses have revolutionized the way that we diagnose and treat human disease. This area of research continues to advance at a rapid pace and has had a significant impact on our understanding of allergic disease. This review will present an overview of humoral responses and provide an up-to-date summary of technologies used in the generation of human monoclo...
Source: Current Allergy and Asthma Reports - January 16, 2016 Category: Allergy & Immunology Source Type: research

Immune-Microbiota Interactions: Dysbiosis as a Global Health Issue
Abstract Throughout evolution, microbial genes and metabolites have become integral to virtually all aspects of host physiology, metabolism and even behaviour. New technologies are revealing sophisticated ways in which microbial communities interface with the immune system, and how modern environmental changes may be contributing to the rapid rise of inflammatory noncommunicable diseases (NCDs) through declining biodiversity. The implications of the microbiome extend to virtually every branch of medicine, biopsychosocial and environmental sciences. Similarly, the impact of changes at the immune-microbiota interfa...
Source: Current Allergy and Asthma Reports - January 14, 2016 Category: Allergy & Immunology Source Type: research

T Cell Epitope Peptide Therapy for Allergic Diseases
Abstract Careful selection of dominant T cell epitope peptides of major allergens that display degeneracy for binding to a wide array of MHC class II molecules allows induction of clinical and immunological tolerance to allergen in a refined treatment strategy. From the original concept of peptide-induced T cell anergy arising from in vitro studies, proof-of-concept murine models and flourishing human trials followed. Current randomized, double-blind, placebo-controlled clinical trials of mixtures of T cell-reactive short allergen peptides or long contiguous overlapping peptides are encouraging with intradermal a...
Source: Current Allergy and Asthma Reports - January 14, 2016 Category: Allergy & Immunology Source Type: research

The Immunologic Mechanisms of Eosinophilic Esophagitis
Abstract Eosinophilic esophagitis (EoE) is a chronic allergic inflammatory disease that is triggered by food and/or environmental allergens and is characterized by a clinical and pathologic phenotype of progressive esophageal dysfunction due to tissue inflammation and fibrosis. EoE is suspected in patients with painful swallowing, among other symptoms, and is diagnosed by the presence of 15 or more eosinophils per high-power field in one or more of at least four esophageal biopsy specimens. The prevalence of EoE is increasing and has now reached rates similar to those of other chronic gastrointestinal disorders s...
Source: Current Allergy and Asthma Reports - January 13, 2016 Category: Allergy & Immunology Source Type: research