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Exanthematous reactions to drugs in children
Purpose of review The true exanthematous reactions to drugs in children are rare and overdiagnosed. Drugs may cause exanthema either due to inducing an immune response or because of their interaction with viruses, if drugs are taken in the course of a viral infection. Also, viral infections are very often in children and they can provoke an exanthema which is difficult to differentiate from exanthematous reactions to drugs. Consequently, the majority of children are incorrectly labeled as ‘allergic’. Recent findings The correct diagnosis of exanthematous drug reactions in children is still an important and h...
Source: Current Opinion in Allergy and Clinical Immunology - July 14, 2021 Category: Allergy & Immunology Tags: DRUG ALLERGY: Edited by Miguel Blanca and Paul Whitaker Source Type: research

Role of pharmacogenomics in T-cell hypersensitivity drug reactions
Purpose of review An update of the pharmacogenetic risk factors associated with T-cell-mediated delayed hypersensitivity reactions. Recent findings Recent HLA associations relevant to our understanding of immunopathogenesis and clinical practice include HLA-B∗13:01 with co-trimoxazole-induced SCAR, and HLA-A∗32:01 with vancomycin-DRESS, for which an extended HLA class II haplotype is implicated in glycopeptide antibiotic cross-reactivity. Hypoactive variants of ERAP1, an enzyme-trimming peptide prior to HLA loading, are now associated with protection from abacavir-hypersensitivity in HLA-B∗57:01+ patients,...
Source: Current Opinion in Allergy and Clinical Immunology - July 14, 2021 Category: Allergy & Immunology Tags: DRUG ALLERGY: Edited by Miguel Blanca and Paul Whitaker Source Type: research

Role of clinical history in beta-lactam hypersensitivity
Purpose of Review Understand how the clinical history has been used to risk stratify patients reporting a beta-lactam allergy, both in clinical care pathways and predictive models. Recent findings Drug allergy clinical care pathways have emerged as a safe and effective method of stratifying patients with a reported beta-lactam allergy into risk categories, with ‘low-risk’ patients able to proceed straight to direct challenges or test doses. These methods have streamlined antibiotic stewardship policies and penicillin allergy de-labeling. However, how to define ‘low-risk’ has been subject to much debate. ...
Source: Current Opinion in Allergy and Clinical Immunology - July 14, 2021 Category: Allergy & Immunology Tags: DRUG ALLERGY: Edited by Miguel Blanca and Paul Whitaker Source Type: research

Editorial: Advances in drug hypersensitivity reactions
No abstract available (Source: Current Opinion in Allergy and Clinical Immunology)
Source: Current Opinion in Allergy and Clinical Immunology - July 14, 2021 Category: Allergy & Immunology Tags: DRUG ALLERGY: Edited by Miguel Blanca and Paul Whitaker Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Allergy and Clinical Immunology)
Source: Current Opinion in Allergy and Clinical Immunology - July 14, 2021 Category: Allergy & Immunology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Probiotics in food allergy
Purpose of review To perform a nonsystematic review of the literature on the possible role of probiotics for food allergy (FA). Recent findings Animal model and in vitro evidence suggest that the gut microbiome could protect against FA and that probiotics could be a valid instrument. There is no consistent evidence in identifying the specific species, the dosage, and the optimal duration to obtain the correct immunomodulation. Early life supplementation with specific ‘missing’ immunomodulatory microbes – derived from machine learning approach to birth cohort studies – might represent a novel approach to ...
Source: Current Opinion in Allergy and Clinical Immunology - April 30, 2021 Category: Allergy & Immunology Tags: FOOD ALLERGY: Edited by Alessandro Fiocchi and Motohiro Ebisawa Source Type: research

Biologicals for the prevention of anaphylaxis
Purpose of review To review the use of biological agents (BA) in the treatment of anaphylaxis in the view of the new knowledge in the field to support the quality of care and prevention. Recent findings Some BA, as a single medication or as combined therapy to food or venom immunotherapy, are effectively able to reduce most of the severe anaphylactic reactions. Summary Anaphylaxis is a recognized clinical emergency, which requires prompt identification and treatment. Several biologic therapies and new devices are emerging as a potential preventive treatment for anaphylaxis. However, adrenaline (epinephrin...
Source: Current Opinion in Allergy and Clinical Immunology - April 30, 2021 Category: Allergy & Immunology Tags: FOOD ALLERGY: Edited by Alessandro Fiocchi and Motohiro Ebisawa Source Type: research

Biologics in atopic dermatitis
Purpose of review Until recently there have been limited options for systemic therapy in atopic dermatitis, which is unresponsive to topical treatments. However, the last few years have seen a rapid progression in this field. The purpose of this review is to summarise some of the recent literature and ongoing studies in the field of biologicals in atopic dermatitis. Recent findings Dupilumab has been shown to be effective in moderate to severe atopic dermatitis and is now licensed in the USA and Europe. Tralokinumab is currently under review by the Food and Drug Administration and the European Medicines agency. ...
Source: Current Opinion in Allergy and Clinical Immunology - April 30, 2021 Category: Allergy & Immunology Tags: FOOD ALLERGY: Edited by Alessandro Fiocchi and Motohiro Ebisawa Source Type: research

Biologics in eosinophilic esophagitis
Purpose of review Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the oesophagus whose incidence is on the rise. Despite maximal use of guideline-based therapies including food elimination diets and steroids, many patients remain symptomatic. This review serves to summarize safety and efficacy of monoclonal antibodies in treatment of EoE. Recent findings There has been an increasing number of biologics under consideration for EoE and several that have undergone clinical trials. mAbs that target specific effectors involved in the disease may offer additional clinical and histologic benefit. In...
Source: Current Opinion in Allergy and Clinical Immunology - April 30, 2021 Category: Allergy & Immunology Tags: FOOD ALLERGY: Edited by Alessandro Fiocchi and Motohiro Ebisawa Source Type: research

Omalizumab as monotherapy for food allergy
Purpose of review To familiarize the reader with the most recent insights in the use of Omalizumab (monoclonal anti-immunoglobulin E) monotherapy in the treatment of patients with severe food allergy. Recent findings The current data from early stage clinical trials show that Omalizumab may be safe and effective by itself in providing desensitization to one or several foods without requiring allergen exposure. Summary In the near future, advances in knowledge will guide the adoption and implementation of any new therapy for food allergy and allow the development of a personalized treatment tailored on the...
Source: Current Opinion in Allergy and Clinical Immunology - April 30, 2021 Category: Allergy & Immunology Tags: FOOD ALLERGY: Edited by Alessandro Fiocchi and Motohiro Ebisawa Source Type: research

Omalizumab as an adjuvant in food allergen immunotherapy
Purpose of review To review the most relevant studies in the rapidly advancing field of omalizumab as an adjunct to food allergen oral immunotherapy (OIT). Recent findings Clinical trials have primarily focused on milk, peanut, and multiallergen OIT combined with omalizumab. These studies suggest that omalizumab in addition to OIT can decrease the time required to reach maintenance OIT dosing and adverse events; however, serious adverse events did still occur. There is limited long-term data but available information suggests that individuals are at risk for increased reactivity after stopping omalizumab, and ma...
Source: Current Opinion in Allergy and Clinical Immunology - April 30, 2021 Category: Allergy & Immunology Tags: FOOD ALLERGY: Edited by Alessandro Fiocchi and Motohiro Ebisawa Source Type: research

Wheat oral immunotherapy
Purpose of review The prevalence of food allergy is increasing on a global scale, and therefore increased attention is being paid to specific food allergy epidemiology and management. There has been a large amount of progress made in the last decade on human trials of wheat oral immunotherapy (WOIT). Recent findings To date, there has been one multicenter, double-blind, randomized controlled trial of WOIT, one randomized, noncontrolled trial of WOIT, and several smaller, nonrandomized clinical trials of WOIT. WOIT trials are generally limited by smaller sample sizes, affecting the demographic skew of evaluated p...
Source: Current Opinion in Allergy and Clinical Immunology - April 30, 2021 Category: Allergy & Immunology Tags: FOOD ALLERGY: Edited by Alessandro Fiocchi and Motohiro Ebisawa Source Type: research

Emerging developments in the forefront of peanut oral immunotherapy
Purpose of review Despite the COVID-19 pandemic, progress continued in the field of peanut oral immunotherapy over the past 12 to 18 months. Of importance, the first oral immunotherapy product for the treatment of peanut allergy was approved by the US Food and Drug Administration in January 2020. Recent findings Suggested modifications to the practice of oral immunotherapy, some of which may have lasting impacts, were circulated as a result of the pandemic. New advances in pathophysiology, sustained unresponsiveness, quality of life, safety, and cost effectiveness were also published. Summary During 202...
Source: Current Opinion in Allergy and Clinical Immunology - April 30, 2021 Category: Allergy & Immunology Tags: FOOD ALLERGY: Edited by Alessandro Fiocchi and Motohiro Ebisawa Source Type: research

Editorial: Food allergy: from defense to attack
No abstract available (Source: Current Opinion in Allergy and Clinical Immunology)
Source: Current Opinion in Allergy and Clinical Immunology - April 30, 2021 Category: Allergy & Immunology Tags: FOOD ALLERGY: Edited by Alessandro Fiocchi and Motohiro Ebisawa Source Type: research

Atopic endotypes as a modulating factor for SARS-CoV-2 infection: mechanisms and implications
Purpose of review Asthma patients are typically at increased risk for severe outcomes from viral respiratory infections. However, asthma and atopy do not appear to be overrepresented comorbidities in COVID-19 patients, and hypotheses attempt to explain this observation. As COVID-19 continues to spread globally, it is imperative to understand how disease outcomes may be influenced in this population to guide patient care. Recent findings Angiotensin converting enzyme 2 (ACE2) is the principal host cell receptor for SARS-CoV-2 entry and Transmembrane Protease Serine 2 (TMRSS2) is the main priming protease. Models ...
Source: Current Opinion in Allergy and Clinical Immunology - April 30, 2021 Category: Allergy & Immunology Tags: PERSONALIZED MEDICINE: Edited by Henry Milgrom and René Maximiliano Gómez Source Type: research