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Food allergy: how expensive are they?
Purpose of review Food allergy remains a disease of global public health significance well known to impact social, emotional, and financial well being. This review aims to summarize the existing literature focused on the direct, indirect, and intangible costs of food allergy at the household and healthcare system levels, and begin to discuss how emerging treatment and prevention strategies may be leveraged to comprehensively care for the food allergic population with the efficient use of health resources. Recent findings Food allergy imposes significant costs to multiple stakeholders and largely impact families at the...
Source: Current Opinion in Allergy and Clinical Immunology - February 28, 2020 Category: Allergy & Immunology Tags: GENETICS AND EPIDEMIOLOGY: Edited by Isabella Annesi-Maesano and Antonella Cianferoni Source Type: research

Vitamin D: can the sun stop the atopic epidemic?
Purpose of review To review recent evidence on the capacity of vitamin D to prevent atopic disease, focussing on food allergy and asthma, and potential underlying mechanisms. Recent findings The incidence of allergic disease continues to increase worldwide. Vitamin D status is influenced by sun exposure and dietary intake. Vitamin D deficiency is linked to an increased incidence of allergic disease and asthma. These associations are generally strongest in early life. The capacity of vitamin D to enhance antimicrobial pathways, promote peripheral immunological tolerance and maintain mucosal barrier integrity may underl...
Source: Current Opinion in Allergy and Clinical Immunology - February 28, 2020 Category: Allergy & Immunology Tags: GENETICS AND EPIDEMIOLOGY: Edited by Isabella Annesi-Maesano and Antonella Cianferoni Source Type: research

Systemic hypereosinophilic syndromes: when autoimmunity is Th2 mediated
Purpose of review Clinical conditions associated with hypereosinophilia represent a field of particular interest, taking into account the epidemiological impact of the different primary and secondary forms. In addition to a classical Th1 response, also Th2 cells can be involved in the pathogenesis of autoimmune diseases, among them eosinophilic forms such as eosinophilic granulomatosis with polyangiitis. Recent findings In patients with severe asthma, recent evidence highlights the role of pathogenic autoantibodies against autologous eosinophil proteins (e.g. eosinophil peroxidase) suggest the role of autoimmune mecha...
Source: Current Opinion in Allergy and Clinical Immunology - February 28, 2020 Category: Allergy & Immunology Tags: GENETICS AND EPIDEMIOLOGY: Edited by Isabella Annesi-Maesano and Antonella Cianferoni Source Type: research

Food protein-induced enterocolitis syndrome: epidemiology and comorbidities
Purpose of review First described in the mid 20th century, it was just in the last decade that diagnostic and treatment guidelines for food protein-induced enterocolitis syndrome (FPIES) were established. Awareness of the diagnosis is improving, and epidemiologic data are emerging. Recent findings Recent studies suggest that FPIES may affect as many as 0.5% of children worldwide. FPIES in adults is usually triggered by seafood and may be more common than previously thought. Many patients with FPIES have other allergic disorders. Summary With refined diagnostic criteria and improved awareness, FPIES is now diagnosed...
Source: Current Opinion in Allergy and Clinical Immunology - February 28, 2020 Category: Allergy & Immunology Tags: GENETICS AND EPIDEMIOLOGY: Edited by Isabella Annesi-Maesano and Antonella Cianferoni Source Type: research

Allergen immunotherapy for pediatric asthma: current evidence and knowledge gaps
Purpose of review The introduction of high-quality and standardized extracts for immunotherapy has renewed the interest in the treatment of pediatric allergic asthma that represents a high-prevalence disease. Recent findings In addition to clinical trials, several systematic reviews and metaanalyses were published, confirming overall the clinical efficacy of allergen immunotherapy in pediatric asthma. In addition, new data on the preventive effect of the treatment on asthma onset were published. Despite this, many intriguing questions emerged, in parallel to the development of knowledge. Summary Allergen immunother...
Source: Current Opinion in Allergy and Clinical Immunology - February 28, 2020 Category: Allergy & Immunology Tags: PEDIATRIC ASTHMA AND DEVELOPMENT OF ATOPY: Edited by Andy Liu and Pasquale Comberiati Source Type: research

Childhood asthma in the new omics era: challenges and perspectives
Purpose of review Childhood asthma is a heterogeneous inflammatory disease comprising different phenotypes and endotypes and, particularly in its severe forms, has a large impact on the quality-of-life of patients and caregivers. The application of advanced omics technologies provides useful insights into underlying asthma endotypes and may provide potential clinical biomarkers to guide treatment and move towards a precision medicine approach. Recent findings The current article addresses how novel omics approaches have shaped our current understanding of childhood asthma and highlights recent findings from (pharmaco)...
Source: Current Opinion in Allergy and Clinical Immunology - February 28, 2020 Category: Allergy & Immunology Tags: PEDIATRIC ASTHMA AND DEVELOPMENT OF ATOPY: Edited by Andy Liu and Pasquale Comberiati Source Type: research

How molecular allergology can shape the management of allergic airways diseases
Purpose of review In allergy, personalized medicine passes through the assessment of molecular allergens sensitization profiles. Such technique may help to better diagnose and treat patients suffering from allergic respiratory diseases. Recent findings Different laboratory tests are available today to assess sensitization to molecular allergens, from singleplex assays, to unspecific, screening multiplex assays, mainly performed through microarrays or macroarrays. It is important to collect both results from specific IgE toward allergen extracts and toward molecular allergens, to collect the most complete information o...
Source: Current Opinion in Allergy and Clinical Immunology - February 28, 2020 Category: Allergy & Immunology Tags: PEDIATRIC ASTHMA AND DEVELOPMENT OF ATOPY: Edited by Andy Liu and Pasquale Comberiati Source Type: research

Host–microbiome intestinal interactions during early life: considerations for atopy and asthma development
Purpose of review The body's largest microbial community, the gut microbiome, is in contact with mucosal surfaces populated with epithelial, immune, endocrine and nerve cells, all of which sense and respond to microbial signals. These mutual interactions have led to a functional coevolution between the microbes and human physiology. Examples of coadaptation are anaerobes Bifidobacteria and Bacteroides, which have adjusted their metabolism to dietary components of human milk, and infant immune development, which has evolved to become reliant on the presence of beneficial microbes. Current research suggests that specific c...
Source: Current Opinion in Allergy and Clinical Immunology - February 28, 2020 Category: Allergy & Immunology Tags: PEDIATRIC ASTHMA AND DEVELOPMENT OF ATOPY: Edited by Andy Liu and Pasquale Comberiati Source Type: research

The role of atopy in asthma development and persistence
Purpose of review Asthma is the most common chronic disease in pediatric age. Childhood-onset asthma, as opposed to adult-onset asthma, is typically characterized by a personal and often a family history of atopy and related markers of type 2-mediated inflammation. However, the interplay between atopy and asthma development is more complex than a linear dose–response relationship. Recent findings Family and personal history of atopic diseases have been confirmed as major risk factors for asthma occurrence and persistence in children. Early life and multiple sensitizations to aeroallergens significantly increase the ...
Source: Current Opinion in Allergy and Clinical Immunology - February 28, 2020 Category: Allergy & Immunology Tags: PEDIATRIC ASTHMA AND DEVELOPMENT OF ATOPY: Edited by Andy Liu and Pasquale Comberiati Source Type: research

Diagnostic approach to occupational rhinitis: the role of nasal provocation tests
Purpose of review The diagnosis of occupational rhinitis is a challenge. Underdiagnosis is substantial as the clinical presentation is nonspecific and often no occupational history is taken. Detection of occupational rhinitis can be improved by including screening questions on occupational exposure in the assessment of every patient with adult-onset rhinitis. Recent findings Case reports, case series and epidemiological studies continuously demonstrate new sensitizers and irritants capable of inducing allergic or nonallergic (irritant-induced) occupational rhinitis. Recent reviews have focused on the value of immunolo...
Source: Current Opinion in Allergy and Clinical Immunology - February 28, 2020 Category: Allergy & Immunology Tags: OCCUPATIONAL DISEASE: Edited by Susan M. Tarlo and Piero Maestrelli Source Type: research

Mechanism and diagnosis of protein contact dermatitis
Purpose of review Protein contact dermatitis (PCD) is a chronic eczema because of immediate hypersensitivity to protein and not related to haptens. As it has to be diagnosed by prick tests, it is probably under-recorded and under-estimated that is why it is important for dermatologists, allergists and occupational physicians to better know this peculiar contact dermatitis. Recent findings Some recent series have emphasized that PCD is mainly an occupational dermatosis, mainly observed in food handlers. Summary PCD is a chronic eczematous dermatitis, possibly exacerbated by work, suggested if associated with inflamm...
Source: Current Opinion in Allergy and Clinical Immunology - February 28, 2020 Category: Allergy & Immunology Tags: OCCUPATIONAL DISEASE: Edited by Susan M. Tarlo and Piero Maestrelli Source Type: research

Current state of occupational latex allergy
Purpose of review During the 1980s, natural rubber latex (NRL) emerged as a major cause of occupational allergy and asthma, especially in healthcare workers using powdered NRL gloves. Increased recognition of NRL allergies and transfer of research findings into prevention strategies resulted into an almost elimination of this health problem. Here, the current knowledge on allergens, their use in diagnostics, prevalence data of occupational NRL allergy and the status of prevention strategy are summarized. Recent findings While the current studies conducted in high-income countries show that prevention measures have red...
Source: Current Opinion in Allergy and Clinical Immunology - February 28, 2020 Category: Allergy & Immunology Tags: OCCUPATIONAL DISEASE: Edited by Susan M. Tarlo and Piero Maestrelli Source Type: research

Occupational exposures and idiopathic pulmonary fibrosis
Purpose of review A recent meta-analysis of data from international case–control studies reports a population attributable fraction of 16% for occupational factors in the cause of idiopathic pulmonary fibrosis (IPF). Smoking, genetic factors and other prevalent diseases only partly explain IPF, and so this review aims to summarize recent progress in establishing which occupational exposures are important in cause. Recent findings IPF is a rare disease, although it is the commonest idiopathic interstitial pneumonia. Epidemiological study suggests that incidence of IPF is increasing, particularly in older men. There a...
Source: Current Opinion in Allergy and Clinical Immunology - February 28, 2020 Category: Allergy & Immunology Tags: OCCUPATIONAL DISEASE: Edited by Susan M. Tarlo and Piero Maestrelli Source Type: research

Prevention of baker's asthma
Purpose of review Baker's allergy and asthma continue to represent an important contributor of occupational asthma globally. This review identified recent studies related to the prevention of baker's allergy and asthma. Recent findings Studies with respect to regulatory exposure standards, workplace control measures aimed at reduction of flour dust exposures, surveillance programmes (exposure monitoring, medical surveillance) and workplace information, education and training programmes were identified. Summary Detailed knowledge on risk factors and detection methods to assess exposure and early identification of hi...
Source: Current Opinion in Allergy and Clinical Immunology - February 28, 2020 Category: Allergy & Immunology Tags: OCCUPATIONAL DISEASE: Edited by Susan M. Tarlo and Piero Maestrelli Source Type: research

Occupational aspects of irritable larynx syndrome
Purpose of review The aim of this article is to provide an update on occupational aspects of irritable larynx syndrome (ILS). Recent findings It is being increasingly recognized that ILS is common amongst certain occupations. This is particularly true of occupations that require frequent voice use such as teachers; where there is exposure to workplace irritants such as World Trade Center responders; or mechanical factors that cause laryngeal dysfunction such as elite athletes. Work associated ILS impacts on quality of life but responds to speech and language therapy focusing on education, vocal hygiene, and laryngeal ...
Source: Current Opinion in Allergy and Clinical Immunology - February 28, 2020 Category: Allergy & Immunology Tags: OCCUPATIONAL DISEASE: Edited by Susan M. Tarlo and Piero Maestrelli Source Type: research