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Trends and determinants of epinephrine prescriptions: a proxy of anaphylaxis epidemiology?
Purpose of review Epinephrine autoinjectors (EAIs) are recommended to all patients previously experiencing anaphylaxis reaction in order to prevent further reactions and fatalities. Under that perspective, EAI prescription could be considered as a proxy of anaphylaxis epidemiology. Nevertheless EAI prescription rates are still unacceptably low. Recent findings The review focuses on potential determinants, in addition to clinical indications, which might impact EAI prescription rates by exploring the scientific literature published within the past 18 months, wherever available. Although some controversial results...
Source: Current Opinion in Allergy and Clinical Immunology - November 4, 2022 Category: Allergy & Immunology Tags: SPECIAL COMMENTARIES Source Type: research

Anaphylaxis in elderly people
Purpose of review Anaphylaxis is common in old-age adults but is insufficiently understood by physicians, and may be underdiagnosed. This review discusses the specificities of anaphylaxis in this age group and stresses the importance of adrenaline in its management. Recent findings Data from the European Anaphylaxis Registry on elderly patients is a major finding. Other findings include the prevention of possible anaphylactic reactions in coronavirus disease 2019 vaccination as well as some new epidemiologic data. Summary The most common risk factors are hymenoptera venom and food and drug allergy. Cardio...
Source: Current Opinion in Allergy and Clinical Immunology - November 4, 2022 Category: Allergy & Immunology Tags: SPECIAL COMMENTARIES Source Type: research

Allergen immunotherapy, cancer, and immune disorders
Purpose of review The purpose of this review is to provide an update on the intriguing relationships between allergies, allergen immunotherapy, cancer, and immune disorders. Allergic diseases and cancer are increasing in incidence and prevalence and a potential relationship, or not, between these diseases have been suggested for many years. Recent findings Recent findings suggest that there may be some causative effects between certain types of cancer and allergic diseases, as described in the text. Some types of cancer may be more linked to the presence of an allergic disease, than others. However, epigenetic f...
Source: Current Opinion in Allergy and Clinical Immunology - November 4, 2022 Category: Allergy & Immunology Tags: IMMUNOTHERAPY AND NEW TREATMENTS: Edited by Giovanni Passalacqua and Robert Bush Source Type: research

An overview of the current state of food desensitization
Purpose of review To highlight the current evidence on food desensitization in children with food allergy. Recent findings Food Allergen Specific Immunotherapy (FA-AIT) is currently recognised as a treatment option for treating children with allergy at least to the main common foods (i.e. milk, egg and peanut). The oral route of administration has been proven to be the most effective in achieving desensitisation. Efforts are devoted to overcome the current unmet needs mainly related to safety issues and long-term efficacy, as well as adherence to the treatment and improvement of health-related quality of life. I...
Source: Current Opinion in Allergy and Clinical Immunology - November 4, 2022 Category: Allergy & Immunology Tags: IMMUNOTHERAPY AND NEW TREATMENTS: Edited by Giovanni Passalacqua and Robert Bush Source Type: research

MicroCrystalline Tyrosine-adsorbed immunotherapy
Purpose of review The purpose of this article is to provide an overview of the literature pertaining to the use of MicroCrystalline Tyrosine (MCT) in the immunotherapy with an emphasis on recent developments. Recent findings In addition to significant effectiveness and safety profiles, additional aspects of interest such as booster immunotherapy concepts, sustained clinical effects, long-term efficacy and disease-modifying effects are being focused on in the recently published studies. The depot adjuvant MCT also shows potential in promising disease-challenge models such as for malaria and melanoma. Summary ...
Source: Current Opinion in Allergy and Clinical Immunology - November 4, 2022 Category: Allergy & Immunology Tags: IMMUNOTHERAPY AND NEW TREATMENTS: Edited by Giovanni Passalacqua and Robert Bush Source Type: research

Is allergy immunotherapy-induced anaphylaxis still a real problem?
Purpose of review The current review describes the incidence and risk for anaphylaxis due to allergy injections. Recent findings The incidence of fatal anaphylaxis occurs with approximately one in 7.2 million injection visits. Severe anaphylaxis may occur once in every 160 000 visits. The major risk for fatal anaphylaxis is severe and uncontrolled asthma. Summary Understanding risk factors for anaphylaxis to allergy injections has led to clinic protocols aimed at preventing such events. The efficacy of these preventive measures remains to be determined in future studies. (Source: Current Opinion in Alle...
Source: Current Opinion in Allergy and Clinical Immunology - November 4, 2022 Category: Allergy & Immunology Tags: IMMUNOTHERAPY AND NEW TREATMENTS: Edited by Giovanni Passalacqua and Robert Bush Source Type: research

The new indications for biologicals in type 2 diseases: perspectives
Purpose of review To provide a literature review of what is on the market and under study for some diseases treated with drugs targeting type 2 (T2) inflammation. Recent findings Literature data have shown that drugs targeting type 2 inflammation are effective in asthma and nasal polyposis, conditions for which they are on the market, and have promising expectations in the case of eosinophilic esophagitis, especially using anti-IL-5/IL-5 receptor and IL-4 receptor antibodies, while concerning eosinophilic granulomatosis with polyangitis (EGPA), mepolizumab (MEP) was approved by FDA and EMA as a drug for the trea...
Source: Current Opinion in Allergy and Clinical Immunology - November 4, 2022 Category: Allergy & Immunology Tags: IMMUNOTHERAPY AND NEW TREATMENTS: Edited by Giovanni Passalacqua and Robert Bush Source Type: research

Is immunotherapy safe for treatment of severe asthma
Purpose of review The benefits of allergen immunotherapy (AIT), including subcutaneous allergen immunotherapy (SCIT) and sublingual allergen immunotherapy (SLIT), for IgE-mediated asthma are well established, especially for dust mite. This review will explore whether the benefits of AIT outweigh the risks in severe asthmatic patients. Recent findings Studies have mostly included mild and moderate asthmatic patients, but at least a few studies do show improvements in asthma symptoms and medication use in severe asthmatic patients. Asthma, and especially uncontrolled asthma, is a major risk factor for severe and f...
Source: Current Opinion in Allergy and Clinical Immunology - November 4, 2022 Category: Allergy & Immunology Tags: IMMUNOTHERAPY AND NEW TREATMENTS: Edited by Giovanni Passalacqua and Robert Bush Source Type: research

Strengthening the case for intralymphatic immunotherapy
Purpose of review Intralymphatic immunotherapy (ILIT) is a promising novel method of immunotherapy, that is short and convenient, and may be very effective. Results have been varied, and efforts to unravel the real value of the treatment are ongoing. Methods used to assess the effect in clinical trials have been so varied that it is difficult to compare studies with each other. Recent findings Some advances have been made; the importance of injecting into the lymph node has been illustrated, and treatment with a range of medicines has proven to be successful. In meta-analyses the treatment has been shown to have...
Source: Current Opinion in Allergy and Clinical Immunology - November 4, 2022 Category: Allergy & Immunology Tags: IMMUNOTHERAPY AND NEW TREATMENTS: Edited by Giovanni Passalacqua and Robert Bush Source Type: research

Do bacterial vaccines/adjuvants prevent wheezing episodes in children?
Purpose of review To discuss recently discovered mechanisms of action of some bacterial vaccines that may account for their clinical benefit in the prevention of recurrent wheezing and asthma exacerbations in infants and early childhood. Recent findings Trained immunity has been shown to confer innate immune cells with a quite long-term nonspecific protection against a broad spectrum of pathogens. Inducers of trained immunity include some bacterial vaccines. Trained immunity-based vaccines (TIbV) of bacterial origin have the capability to induce nonspecific responses to a variety of pathogens, including respirat...
Source: Current Opinion in Allergy and Clinical Immunology - November 4, 2022 Category: Allergy & Immunology Tags: IMMUNOTHERAPY AND NEW TREATMENTS: Edited by Giovanni Passalacqua and Robert Bush Source Type: research

Immunodeficient patient experience of emergency switch from intravenous to rapid push subcutaneous immunoglobulin replacement therapy during coronavirus disease 2019 shielding
Purpose of review Welsh immunodeficient patients on immunoglobulin replacement therapy (IgRT) who were considered high risk for severe coronavirus disease 2019 (COVID-19) were directed to shield. Consequently, patients receiving hospital-based intravenous immunoglobulin (IVIg) quickly transitioned to home-based self-administered subcutaneous immunoglobulin (SCIg). This evaluation aimed to assess patients’ perceptions and experiences and laboratory outcomes of emergency IgRT transition during COVID-19. Recent findings A quick transition from in-hospital IVIg to home-based rapid push SCIg is achievable, however,...
Source: Current Opinion in Allergy and Clinical Immunology - November 4, 2022 Category: Allergy & Immunology Tags: PRIMARY IMMUNE DEFICIENCY DISEASE: Edited by M. Teresa de la Morena and Stephen Jolles Source Type: research

Recent advances in the treatment of hemophagocytic lymphohistiocytosis and macrophage activation syndrome
Purpose of review The approach to treating patients with hemophagocytic lymphohistiocytosis (HLH) and macrophage activation syndrome (MAS) has shifted in recent years with the aim to limit exposure to genotoxic agents, such as etoposide, yet dampen hyperinflammation by targeting the activity of specific HLH/MAS-associated cytokines. In this review, we discuss recent efforts to reduce the dose of etoposide and/or incorporate cytokine-targeted therapies for the treatment of HLH/MAS. Recent findings There is emerging evidence that reduced-dose etoposide and/or cytokine-targeted therapies, including agents that neut...
Source: Current Opinion in Allergy and Clinical Immunology - November 4, 2022 Category: Allergy & Immunology Tags: PRIMARY IMMUNE DEFICIENCY DISEASE: Edited by M. Teresa de la Morena and Stephen Jolles Source Type: research

Updates of cancer hallmarks in patients with inborn errors of immunity
Purpose of review The development of cancer in patients with genetically determined inborn errors of immunity (IEI) is much higher than in the general population. The hallmarks of cancer are a conceptualization tool that can refine the complexities of cancer development and pathophysiology. Each genetic defect may impose a different pathological tumor predisposition, which needs to be identified and linked with known hallmarks of cancer. Recent findings Four new hallmarks of cancer have been suggested, recently, including unlocking phenotypic plasticity, senescent cells, nonmutational epigenetic reprogramming, a...
Source: Current Opinion in Allergy and Clinical Immunology - November 4, 2022 Category: Allergy & Immunology Tags: PRIMARY IMMUNE DEFICIENCY DISEASE: Edited by M. Teresa de la Morena and Stephen Jolles Source Type: research

Autoimmune and autoinflammatory manifestations in inborn errors of immunity
Purpose of review Autoimmune and inflammatory complications have been shown to arise in all age groups and across the spectrum of inborn errors of immunity (IEI). This review aims to highlight recent ground-breaking research and its impact on our understanding of IEI. Recent findings Three registry-based studies of unprecedented size revealed the high prevalence of autoimmune, inflammatory and malignant complications in IEI. Two novel IEI were discovered: an autoinflammatory relopathy, cleavage-resistant RIPK1-induced autoinflammatory syndrome, as well as an inheritable phenocopy of PD-1 blockade-associated comp...
Source: Current Opinion in Allergy and Clinical Immunology - November 4, 2022 Category: Allergy & Immunology Tags: PRIMARY IMMUNE DEFICIENCY DISEASE: Edited by M. Teresa de la Morena and Stephen Jolles Source Type: research

Bronchiectasis and obstructive lung diseases in primary antibody deficiencies and beyond: update on management and pathomechanisms
Purpose of review Pulmonary complications are among the most frequent manifestations in patients with primary antibody deficiency (PAD), contributing significantly to morbidity and mortality. Here, we focus on recent findings in obstructive pulmonary disease and bronchiectasis in PAD. Since specific data on patients with PAD is limited and management mostly follows general recommendations, this review also aims to summarize data from the immunocompetent population. Recent findings Potential risk factors for the development and progression of bronchiectasis include reduced immunoglobulins and lower CD4 cells. In ...
Source: Current Opinion in Allergy and Clinical Immunology - November 4, 2022 Category: Allergy & Immunology Tags: PRIMARY IMMUNE DEFICIENCY DISEASE: Edited by M. Teresa de la Morena and Stephen Jolles Source Type: research