Progress in Anisakis Allergy Research: Milestones and Reversals
AbstractPurpose of the reviewAnisakis has gained cosmopolitan celebrity mainly through its potential to induce allergic disease. In the last two decades, several regions in the world, including the Mediterranean region, Japan, or Korea have reported high numbers of Anisakiasis-accompanied allergic symptoms: Gastro-allergic Anisakiasis.Recent findingsRecent wide-scale epidemiological studies highlight the global scenario ofAnisakis for human health, and awareness is the main contributing factor. After two decades of research in the field ofAnisakis allergy, in the last years, molecular studies ofAnisakis allergens including...
Source: Current Treatment Options in Allergy - September 10, 2020 Category: Allergy & Immunology Source Type: research

Current Management of Juvenile Nasopharyngeal Angiofibroma
AbstractPurpose of reviewThe purpose of this article is to provide a current review of the most important management principles for evaluation and treatment of juvenile nasopharyngeal angiofibroma.Recent findingsNumerical staging systems have been adapted many times over the years, but a new nominal staging system based on specific anatomical site involvement and residual internal carotid artery vascularization helps to provide a more comprehensive alternative for evaluation. An expanding body of evidence supports the use of an endoscopic surgical approach to reduce risk of tumor recurrence and reduce intraoperative blood ...
Source: Current Treatment Options in Allergy - August 28, 2020 Category: Allergy & Immunology Source Type: research

The Present and Future Burden of Contact Dermatitis from Acrylates in Manicure
AbstractPurpose of Review(Meth)acrylates are chemical compounds used in a wide variety of settings such as nail esthetics and the medical field. A progressive increase in the frequency of acrylate-induced sensitization likely caused by the popularity and wide-spread use of semi-permanent polishes has been described.Recent FindingsSeveral factors contribute to such scenario including the insufficient training of beauticians regarding the risks posed by the manipulation of acrylate-based manicure materials, the fact that some consumers end up self-applying these products at home, and the poor training of the general dermatol...
Source: Current Treatment Options in Allergy - August 18, 2020 Category: Allergy & Immunology Source Type: research

The Role of Biologics and Precision-Based Medicine in Treating Atopic Diseases in Children
AbstractPurpose of ReviewChildren with atopic diseases such as asthma and atopic dermatitis often have poorly controlled disease, which can occur as a result of noncompliance from the concern of side effects from prolonged use of medications. This fear is not unfounded as often increasing doses of inhaled, topical, or oral steroids are required for control and carry a cumulative risk burden for growth and development in this population. The availability of biologics in this patient population has been pivotal in expanding options to reduce disease burden and unfavorable side effects.Recent FindingsIn addition to biologics ...
Source: Current Treatment Options in Allergy - August 17, 2020 Category: Allergy & Immunology Source Type: research

Skin Barrier Dysfunction in Contact Dermatitis and Atopic Dermatitis-Treatment Implications
AbstractPurpose of reviewA variety of skin diseases are associated with impaired barrier function. The crucial pillars in therapy of previously mentioned conditions are avoidance of triggers, skin protection and individually adapted medical therapy. Until recently, besides of topical corticosteroids, the treatment options were limited. However, a variety of new therapies of skin barrier-related skin diseases became available over the last years. Our goal was to investigate new findings and treatment options in skin diseases with barrier dysfunction, emphasizing on contact dermatitis, hand eczema and atopic dermatitis.Recen...
Source: Current Treatment Options in Allergy - August 3, 2020 Category: Allergy & Immunology Source Type: research

Management of Pediatric Chronic Rhinosinusitis
AbstractPurpose of ReviewChronic pediatric rhinosinusitis is a common entity, with an annual incidence of 4% in the US schoolchildren ’s population. The predominant contributing factor in younger children is adenoid pathology and in older children, allergic rhinitis. Recent research on sinus microbiome, biofilm, inflammatory response, and therapeutic alternatives is providing new insights in this prevalent disease.Recent FindingsAdenoid size does not correlate with the severity of the disease suggesting that it is due to the biofilms observed in both adenoiditis and hypertrophic adenoids. There is new consensus among...
Source: Current Treatment Options in Allergy - July 21, 2020 Category: Allergy & Immunology Source Type: research

Filaggrin Gene Mutations with Special Reference to Atopic Dermatitis
AbstractPurpose of reviewMutations in the filaggrin gene can cause absent or reduced filaggrin protein, leading to impaired keratinization and skin barrier defect, which produce characteristic phenotypes. In this short review, we report current evidence on the topic with special reference to atopic dermatitis, suggest future directions, and discuss therapeutic implications.Recent findingsNumerous candidate gene association studies, genome-wide association studies, studies on copy number variations, and, most recently, sequencing studies have confirmed the robust association of mutations in the filaggrin gene with atopic de...
Source: Current Treatment Options in Allergy - July 10, 2020 Category: Allergy & Immunology Source Type: research

The Efficacy to Prevent Irritant Hand Eczema: an Overview of the Interventional Procedures
AbstractPurpose of reviewInterventional procedures to prevent hand eczema (HE), comprising educational programs, are widely used for primary, secondary, and tertiary prevention of irritant contact dermatitis on the hands. This review gives an overview of randomized controlled trials (RCTs) addressing the efficacy of interventional procedures and educational programs in HE prevention.Recent findingsRCTs on HE prevention differ with respect to form and implementation of interventions, populations, and follow-up times. Overall, the education has focused on use of moisturizers, gloves, and substitution of hand washes with alco...
Source: Current Treatment Options in Allergy - July 3, 2020 Category: Allergy & Immunology Source Type: research

Shrimp-Induced Anaphylaxis
AbstractPurpose of ReviewShrimp and other crustaceans and molluscs are one of the most frequent causes of food allergy and anaphylaxis at all ages. Molecular biology has paved the way to a better understanding of the allergen profile of invertebrates that is much more complex than thought only one decade ago.Recent FindingsWhile tropomyosin has been traditionally considered as the dominating major allergen in crustaceans and other invertebrates, recent research demonstrated that IgE to this allergen can be detected in about 50% of shrimp-allergic patients only. Many of these allergens are conserved ones and, hence, potenti...
Source: Current Treatment Options in Allergy - June 29, 2020 Category: Allergy & Immunology Source Type: research

Current Management of Craniopharyngiomas
This article reviews current treatment modalities and surgical risks, highlighting differences between endoscopic versus transcranial surgical approaches. (Source: Current Treatment Options in Allergy)
Source: Current Treatment Options in Allergy - June 26, 2020 Category: Allergy & Immunology Source Type: research

Diagnosis and Management of Pediatric Nasal CSF Leaks and Encephaloceles
AbstractPurpose of reviewTo describe the clinical presentation, diagnosis, and management of pediatric nasal encephaloceles.Recent findingsEncephaloceles and meningoencephaloceles are on the differential diagnosis for congenital midline nasal masses. These lesions are treated surgically to prevent craniofacial deformities and meningitis and to address symptoms such as a nasal obstruction, feeding difficulties, and cerebrospinal fluid (CSF) rhinorrhea. With the advent of endoscopic skull base approaches and instruments, surgical treatment of nasal encephaloceles have transitioned from large bicoronal external approaches to ...
Source: Current Treatment Options in Allergy - June 18, 2020 Category: Allergy & Immunology Source Type: research

Quinolone-Induced Anaphylaxis
AbstractPurpose of reviewQuinolones are the second most common antibiotic class that may induce IgE and non-IgE-mediated immediate hypersensitivity reactions. The prevalence of true quinolone allergy still remains unknown, but its incidence has increased in recent years, probably due to the extensive utilization of this antibiotic class and the introduction of moxifloxacin.Recent findingsQuinolones may also induce nonallergic reactions through the MRGPRX2 receptor. The diagnosis of hypersensitivity reactions to quinolones is complex, since clinical history is often doubtful, skin tests can induce false-positive results, an...
Source: Current Treatment Options in Allergy - June 2, 2020 Category: Allergy & Immunology Source Type: research

Implication of T Helper Cytokines in Contact Dermatitis and Atopic Dermatitis
AbstractPurpose of reviewCytokines play a key role in lesion development in inflammatory skin diseases such as contact dermatitis and atopic dermatitis and are of great interest as therapeutic targets. This is reflected in the increasing number of clinical studies and case reports as well as preclinical mouse models that provide substantial data on the participation of cytokines in these pathologies. In this review, we provide a detailed and comprehensive account of the advances in the field.Recent resultsThe importance and therapeutic potential of Th2 cytokines in allergic contact dermatitis (ACD) and atopic dermatitis (A...
Source: Current Treatment Options in Allergy - May 21, 2020 Category: Allergy & Immunology Source Type: research

Past, Present, and Future of Contact Dermatitis Registries in the Internet Era
AbstractPurpose of reviewDigital data are invading all areas of our lives including medical practice. Digital technology grows up exponentially. Technical concerns as memory storage or processor speed are not limitations in medical data management and huge medical registries will be created in a short period of time. Epidemiological surveillance has been one of the most important issues in contact dermatitis research networks and adaptation to the new advances is mandatory.Recent findingsDigital technology can provide enough software to achieve research epidemiologic goals that were impossible 20  years ago. Legal con...
Source: Current Treatment Options in Allergy - May 20, 2020 Category: Allergy & Immunology Source Type: research

Allergic Contact Dermatitis of the Face: a Review of the Common Agents Involved and Differential Diagnosis
AbstractPurpose of reviewAllergic contact dermatitis is a common form of type IV hypersensitivity reaction in response to exogenous agents directly or indirectly applied to the skin. Although any part of the body may be affected, the face ’s frequent exposition to environment, and consumer products, makes it one of the most commonly affected sites by the disease.Recent findingsAs the consumer products are increasing worldwide, the list of potential allergens that may induce an allergic contact dermatitis of the face continues to grow. A correct diagnosis, and identification of the involved allergens, requires a caref...
Source: Current Treatment Options in Allergy - May 15, 2020 Category: Allergy & Immunology Source Type: research

Revival of AHR Agonist for the Treatment of Atopic Dermatitis: Tapinarof
AbstractPurpose of reviewThe aryl hydrocarbon receptor (AHR) system is a sensitive sensor for small-molecule, xenobiotic chemicals of exogenous and endogenous origin, including dioxins, phytochemicals, microbial bioproducts, and tryptophan photoproducts. Once activated, the AHR signal strengthens skin barrier functions and accelerates epidermal terminal differentiation by upregulating filaggrin expression.Recent findingsCoal tar and glyteer are crude mixtures of compounds that have been used for inflammatory skin diseases such as type 2 cytokine-dominant atopic dermatitis (AD). Both of them are antioxidative AHR ligands an...
Source: Current Treatment Options in Allergy - May 11, 2020 Category: Allergy & Immunology Source Type: research

A Precision Medicine Approach to SARS-CoV-2 Pandemic Management
AbstractPurpose of reviewPrecision medicine (PM) represents a new paradigm in disease diagnosis, prevention, and treatment. To apply PM premises in an emerging coronavirus pandemic acquires potentially greater relevance in order to allow the selection of specific preventive measures as well as biomarkers that will be useful in disease management.Recent findingsThe identification of the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the responsible for the coronavirus disease 2019 (COVID-19) pandemic had led to a plethora of strategies to contain viral dissemination, affecting life styles an...
Source: Current Treatment Options in Allergy - May 8, 2020 Category: Allergy & Immunology Source Type: research

Perioperative Anaphylaxis
AbstractPurpose of the reviewPerioperative anaphylaxis is a severe, systemic hypersensitivity reaction of rapid onset, that is generally unpredictable, may be life-threatening, and occurs after the use of different drugs, substances, or stimuli during an anesthetic or surgical procedure.Recent findingsThe potential causes of reactions during procedures depend on the moment it occurs. In the induction phase, neuromuscular blockers, intravenous antibiotics, and opioids should be considered. During the procedure, along with antibiotics and opioids, other causes include local anesthetics, nonsteroidal anti-inflammatory agents ...
Source: Current Treatment Options in Allergy - April 27, 2020 Category: Allergy & Immunology Source Type: research

Recommendations for Diagnosing and Management of Patients with Perioperative Drug Reactions
AbstractPurpose of ReviewTo summarize the current knowledge of diagnosis and management of patients with perioperative immediate hypersensitivity reactions (POH)Recent FindingsThe diagnosis and management of POH is a challenge for both allergologists and anesthesiologists. They are rare entities; its difficulty lies in its poor clinical specificity, at the time of the acute event, and also in the lack of standardization of its etiological study, which favors that multiple reactions are not adequately studied, with the subsequent risk of re-exposure to the causative agent.SummaryPOH investigation aims are to identify a culp...
Source: Current Treatment Options in Allergy - March 30, 2020 Category: Allergy & Immunology Source Type: research

Exacerbating Factors in Chronic Spontaneous Urticaria
AbstractPurpose of reviewChronic spontaneous urticaria (CSU) is frequently associated with autoimmunity and is often exacerbated by several factors. These include stress, infections, colourings and preservatives in pre-packaged foods, as well as deficiency of vitamin D3 and iron. While chronic underlying infection and mental and emotional stress have been known to precede the onset of CSU, it is now clear that they can also aggravate the severity of the symptoms and perpetuate the condition. It is unclear how gastrointestinal dysbiosis affects CSU. Vitamin D3, however, can increase T regulatory function which can control a...
Source: Current Treatment Options in Allergy - March 30, 2020 Category: Allergy & Immunology Source Type: research

Chronic Rhinosinusitis in Pediatric Immunodeficiency
AbstractPurpose of ReviewChronic rhinosinusitis and other sinopulmonary infections can be a hallmark of impaired immunity in children. Rhinosinusitis in the setting of immunodeficiency can often be chronic and refractory, and involve opportunistic pathogens. We review the evaluation and management of pediatric chronic rhinosinusitis in the context of primary immunodeficiency diseases.Recent FindingsImmunodeficiencies found to be associated with chronic rhinosinusitis include common variable immune deficiency, X-linked agammaglobulinemia, antibody deficiencies, hyper-IgM syndrome, hyper-IgE syndrome, Wiskott –Aldrich ...
Source: Current Treatment Options in Allergy - March 24, 2020 Category: Allergy & Immunology Source Type: research

Anaphylaxis Attended in Emergency Departments: a Reliable Picture of Real-world Anaphylaxis
AbstractPurpose of reviewThe aim of this document is to review the epidemiology of anaphylaxis in the emergency departments (EDs) (burden and temporal trends), the generally deficient management of anaphylaxis in the ED, and the measures and interventions tested in different settings to improve management of anaphylaxis in the ED.Recent findingsThe population attended for anaphylaxis episodes is low (0.009 to 0.4%). Recent studies report an increase in anaphylaxis episodes attended in the ED. Discordance has been observed between the diagnosis of anaphylaxis in the ED and the diagnosis confirmed in allergy units; this can ...
Source: Current Treatment Options in Allergy - March 23, 2020 Category: Allergy & Immunology Source Type: research

In Vitro Diagnosis of Anaphylaxis: an Update
AbstractPurpose of reviewThe management of anaphylaxis, after a rapid clinical-based hypothesis and prompt treatment introduction, includes diagnosis confirmation. We reviewed main laboratory methods available for diagnosing anaphylaxis and its etiology. Then, we searched for new methods that can gain utility in the next few years.Recent findingsSerum tryptase is still the most accurate and available method for diagnosis during the acute phase, although it is necessary to measure baseline levels after a period of time. However, measurement of other mediators, such as histamine and lipid metabolites, is available in many si...
Source: Current Treatment Options in Allergy - March 21, 2020 Category: Allergy & Immunology Source Type: research

Delabelling Antibiotic Hypersensitivity in Children Is Critical for Future Treatments
AbstractPurpose of ReviewAntibiotics are most commonly prescribed drugs in children; among them, beta-lactams are the most frequently used antibiotics. Antibiotic allergy mislabelling is a considerable public health problem which is associated with adverse health and economic outcomes. In this review, the actual antibiotic allergy prevalence, the reasons for overdiagnosis, and the consequences of mislabelling are summarized.Recent FindingsThe physicians should consider the use of drug provocation tests without prior skin testing in the cases of non-immediate mild cutaneous reactions due to antibiotics as proposed by Pediat...
Source: Current Treatment Options in Allergy - March 16, 2020 Category: Allergy & Immunology Source Type: research

Unresponsiveness to Omalizumab in Chronic Spontaneous Urticaria
AbstractPurpose of the ReviewOmalizumab has become the mainstay of the treatment of severe CSU, but a subset of patients seems completely unresponsive to the drug. This review tried to understand the reasons for this different behavior.Recent FindingsGrowing evidence shows that IgE-mediated autoimmunity to an array of autoallergens is common in CSU, while IgG-mediated autoimmunity to IgE or to the high-affinity IgE receptor, which has been known for many years, seems to be involved in a minority of patients. This may explain the different responsiveness to anti-IgE therapy.SummaryCSU is probably an autoimmune disease in mo...
Source: Current Treatment Options in Allergy - March 3, 2020 Category: Allergy & Immunology Source Type: research

A Precision Medicine Approach to Rhinitis Evaluation and Management
AbstractPurpose of ReviewPrecision medicine (PM) represents a new paradigm in disease diagnosis, prevention, and treatment. The PM approach focuses on the characterization of different phenotypes and pathogenic pathways in order to allow the selection of specific biomarkers that will be useful in disease management. Rhinitis is a highly prevalent and heterogeneous disease, both in terms of underlying endotypes and clinical presentations. Therefore, to apply the PM principles to the various rhinitis subtypes rise as a meaningful strategy to improve evaluation and treatment.Recent FindingsThe technology of recombinant allerg...
Source: Current Treatment Options in Allergy - February 21, 2020 Category: Allergy & Immunology Source Type: research

Irritant Contact Dermatitis: Why It Happens, Who Suffers It and How to Manage
AbstractPurpose of ReviewIrritant contact dermatitis (ICD) is defined as a localized skin reaction to irritants which does not require prior sensitization of the immune adaptative system. ICD is a consequence of direct toxic effect of physical or chemical agents resulting in keratinocyte damage. The purpose of this review was to highlight the various aspects of ICD to improve its management.Recent FindingsIt is now known that ICD is a complex reaction that involved both endogenous and exogenous factors, and does not represent a homogenous entity but can cover various clinical subtypes. The management of ICD is based on its...
Source: Current Treatment Options in Allergy - February 19, 2020 Category: Allergy & Immunology Source Type: research

How Mechanism Knowledge Can Help to Management of Drug Hypersensitivity
AbstractPurpose of reviewTo describe the mechanisms involved in the heterogeneous drug hypersensitivity reactions and how a better understanding of them can help in the correct diagnosis, the improvement of the in vitro diagnostic methods, and the management of the reaction.Recent findingsWe know that drug hypersensitivity reactions are mediated by different mechanisms and until now some drugs have been reported to be able to activate the immune system by a single mechanism while other drugs can be involved in different mechanisms. Moreover, studies show that important clinical aspects such as risk factors, predictability,...
Source: Current Treatment Options in Allergy - February 4, 2020 Category: Allergy & Immunology Source Type: research

Perioperative Reactions to Sugammadex
AbstractPurpose of the reviewThe γ-cyclodextrin sugammadex, chemically modified to encapsulate the steroidal muscle relaxant rocuronium, was introduced into anesthesia as the first selective relaxant binding agent to reverse neuromuscular blockade. In the face of sugammadex’s alleged propensity to cause anaphylaxis, the agent wa s finally approved by the FDA in 2015. With its steadily increasing usage, it has become apparent that there is a small but concerning incidence of perioperative anaphylaxis to sugammadex and some reactions that are anaphylactic like but where diagnosis has not been definitive. The purp...
Source: Current Treatment Options in Allergy - February 3, 2020 Category: Allergy & Immunology Source Type: research

Anaphylaxis Induced by Magnetic Resonance Imaging (MRI) Contrast Media
Opinion statementPurpose of reviewThe aim of this document is to review the epidemiology, diagnosis, and treatment of immediate and anaphylactic reactions to gadolinium-based contrast agents (GBCA) most commonly used in magnetic resonance imaging (MRI).Recent findingsThe frequency of adverse reactions to GBCA ranges from 0.04 to 2.2%. Most reactions are mild (47% –95%) and the frequency of anaphylactic shock is 0.004%–0.01%. Mortality due to anaphylaxis induced by GBCAs has been 0.0019%.Allergic reactions are more frequent in patients with a previous reaction, in females, using macrocycle estructure GBCA and wi...
Source: Current Treatment Options in Allergy - January 30, 2020 Category: Allergy & Immunology Source Type: research

Childhood Anaphylaxis: State of the Art
AbstractPurpose of the ReviewAnaphylaxis is a systemic immunologic reaction of immediate hypersensitivity that occurs as consequence of an interaction between antigen and immunoglobulin E (IgE) and may be potentially fatal. Anaphylaxis symptoms usually occur minutes or seconds after the exposure to the causing allergen. The sooner the reaction is established, the more severe it is. The main causes in children are food (cow ’s milk, peanut, egg) and insect bite. Its clinical manifestations usually vary. They can be mild, presenting with hives, angioedema, abdominal pain; or severe, presenting with hypotension or shock...
Source: Current Treatment Options in Allergy - January 27, 2020 Category: Allergy & Immunology Source Type: research

Hypersensitivity Reactions to Biologicals: from Bench to Bedside
AbstractPurpose of ReviewBiologic agents are new treatment options for chronic inflammatory diseases and cancers. As a result of their unique mechanism of action, they are more effective and less toxic treatment option and their clinical usage is increasing. While they are more commonly used, various adverse effects have been observed including life-threatening ones, including anaphylaxis. The aim of this review is to distinguish the anaphylaxis from other hypersensitivity reactions (HSR) and provide a management algorithm for the anaphylactic reactions induced by biological agents.Recent FindingsMany case reports and seri...
Source: Current Treatment Options in Allergy - January 18, 2020 Category: Allergy & Immunology Source Type: research

The Roadmap From Allergic Rhinitis to Asthma
AbstractPurpose of reviewUpper and lower airways display some common characteristic described as a holistic model. Because rhinitis may proceed asthma, it is imperative to understand the mechanisms and risk factors responsible for the progression from rhinitis to asthma.Recent findingsSubclinical lower airway abnormalities have been observed in patients with rhinitis without asthma. Recent evidence indicates that these patients may have an increased risk of developing asthma. Environmental and genetic factors can contribute to enhance this possibility. The treatments of rhinitis have also been shown to be beneficial to the...
Source: Current Treatment Options in Allergy - January 15, 2020 Category: Allergy & Immunology Source Type: research

Vitamin-Induced Anaphylaxis
AbstractPurpose of reviewThis paper aimed to summarize and review the known data on anaphylaxis and hypersensitivity reactions to vitamins.Recent FindingsVitamins A, C, D, and E seem to be extremely safe compounds, with few or no related case of anaphylaxis to them. Vitamin B1 is considered the most allergenic vitamin. Immediate reactions are unusual, but urticaria and anaphylaxis to thiamine intravenous administration have been described. Vitamin B12 hypersensitivity is also infrequent. Reactions occur mostly in patients receiving long-term supplementation. Desensitization is mandatory for patients with hypersensitivity t...
Source: Current Treatment Options in Allergy - January 14, 2020 Category: Allergy & Immunology Source Type: research

Importance of Diagnostics Prior to Desensitization in New Drug Hypersensitivity: Chemotherapeutics and Biologicals
AbstractPurpose of reviewIn this review article, we intend to summarize the diagnostic tools available for the study of drug hypersensitivity reactions to chemotherapy and biologicals, based on the experience and controversies of the main research groups leading the topic.Recent findingsRecent publications with large cohorts of patients reacting to these drugs are allowing for a better understanding of phenotyping, endotyping, and optimally managing these patients.SummaryThere is a remarkable heterogeneity on the diagnostic and therapeutic approach among the different groups, and yet this has allowed for very interesting d...
Source: Current Treatment Options in Allergy - January 10, 2020 Category: Allergy & Immunology Source Type: research

Management of Patients During Acute Reaction Induced by Drugs
AbstractPurpose of reviewAnaphylaxis is the most severe form of an allergic reaction and is characterized by being rapid in onset with potentially life-threatening airway, breathing, or circulatory problems; medications are able to provoke immediate acute reactions whose severity varies from mild (i.e., urticaria) to severe reactions (anaphylaxis). The management and prevention of anaphylactic reactions represent a crucial challenge for allergists that must perfectly know the symptoms and the best treatments of this severe disease.Recent findingsAcute treatment of anaphylaxis is based on the immediate administration of adr...
Source: Current Treatment Options in Allergy - December 10, 2019 Category: Allergy & Immunology Source Type: research

Evidence-Based Medicine and Real-World Data in Allergen Immunotherapy Today and in the Future: Quality or Quantity?
AbstractPurpose of the reviewData obtained from controlled clinical trials remains the gold standard for the evaluation of treatment efficacy and safety. This information is used in systematic reviews and meta-analysis providing data for evidence-based medicine (EBM) statements and conclusions which are preferred by regulatory and academic groups when decisions and recommendations need to be given.Recent findings:The quantity and diversity of real-world data (RWD) have been increasing exponentially as technology and integrated electronic medical records have made this information increasingly accessible and useful for outc...
Source: Current Treatment Options in Allergy - November 18, 2019 Category: Allergy & Immunology Source Type: research

Update on Desensitization
AbstractPurpose of reviewRapid drug desensitization (RDD) is a high-risk protocol that allows patients with hypersensitivity reactions to remain on first-line therapy for their underlying conditions through titration of dose increments and infusion rates. The aim of this paper is to review the most recent desensitization protocols available for drugs that are commonly used in clinical practice settings and to provide algorithms for their appropriate usage.Recent findingsRDD protocols involve identification of phenotypes and endotypes during the initial reaction, risk stratification, skin testing, and specific biomarkers. P...
Source: Current Treatment Options in Allergy - November 18, 2019 Category: Allergy & Immunology Source Type: research

Asthma and the Biologics Revolution, Part 2: Failures and the Future Potential
AbstractPurpose of this reviewTo highlight the evidence behind the various biologics that are being developed for asthma along with their specific targets in the inflammatory cascade and the potential role they serve in the management of allergic asthma.Recent findingsThe mainstay of asthma management for the majority of asthmatics is inhaled corticosteroids with or without long-acting beta-agonists and/or leukotriene modifiers and/or tiotropium. However, in the small group of individuals with severe asthma uncontrolled with conventional therapy, biologics have emerged as an effective therapeutic option.SummaryAsthma is a ...
Source: Current Treatment Options in Allergy - November 16, 2019 Category: Allergy & Immunology Source Type: research

Asthma and the Biologics Revolution, Part 1: Here and Now
AbstractPurpose of This ReviewTo highlight the evidence behind the various approved biologics indicated for asthma along with their specific targets in the inflammatory cascade and the role they serve in the management of allergic asthma.Recent FindingsThe mainstay of asthma management for the majority of asthmatics is inhaled corticosteroids with or without long-acting beta-agonists and/or leukotriene modifiers and/or tiotropium. However, in the small group of individuals with severe asthma uncontrolled with conventional therapy, biologics have emerged as an effective therapeutic option.SummaryAsthma is a chronic heteroge...
Source: Current Treatment Options in Allergy - November 7, 2019 Category: Allergy & Immunology Source Type: research

IL-25: Regulator of Type 2 Inflammation in Allergic Nasal Mucosa
AbstractPurpose of reviewAllergic nasal mucosal inflammation generally refers to the development of allergic rhinitis characterized by IgE-mediated mast cell responses, eosinophil infiltration, and augmented Th2 cytokines/chemokine production in the nasal mucosa. However, due to the complexity of the disease, its detailed mechanism has yet to be fully elucidated. Hence, in this review, we aim to collate the studies of IL-25 pertaining to its role in allergic mucosal inflammation to help drive future research of IL-25 in utilizing it as a potential target in the management of allergic sinonasal diseases.Recent findingsAt th...
Source: Current Treatment Options in Allergy - November 6, 2019 Category: Allergy & Immunology Source Type: research

House-Dust Mite Immunotherapy in Asthma: Uncertainties and Therapeutic Strategies
AbstractPurpose of reviewThe prevalence of house dust mites (HDM)-sensitization is high in allergic asthma (AA), especially in tropical/subtropical countries in Asia and South America. As HDM-sensitization can contribute to the subsequent development of HDM-driven asthma, poor asthma control and exacerbations, allergen immunotherapy (AIT) might reduce the growing global burden of allergic asthma.Recent findingsAIT builds immunotolerance via upregulation of T-regulatory (reg) cells, leading to increase secretion of IL-10 and TGF- β which suppress the Th2 response to allergens. IL-10 also induces the class-switch to pla...
Source: Current Treatment Options in Allergy - October 31, 2019 Category: Allergy & Immunology Source Type: research

Fish Allergy Management: From Component-Resolved Diagnosis to Unmet Diagnostic Needs
AbstractPurpose of reviewFish is a common elicitor of IgE-mediated food allergy. Fish includes a large variety of foods, in terms of species and food processing, with marked distinction in local diets around the globe. Fish-allergic patients present with phenotypic diversity and major differences in levels of clinical cross-reactivity, features that pose an important challenge for the clinical diagnosis and management.Recent findingsParvalbumin is the major fish allergen. However, a single molecule is not sufficient but several homologs, allergens different from parvalbumin and allergen extracts, are needed for IgE-based d...
Source: Current Treatment Options in Allergy - October 28, 2019 Category: Allergy & Immunology Source Type: research

Geographical Variations in Food Protein-Induced Enterocolitis Syndrome
AbstractPurpose of ReviewFood protein-induced enterocolitis syndrome (FPIES) is considered a rare, non-IgE-mediated food allergy that typically presents in infancy. As there is not a specific biological marker of the disease, diagnosis of FPIES is based on typical symptoms that improve once the offending food is removed from the diet. The most common causative foods are cow ’s milk, soy, and rice. For years, we have thought that the typical symptoms and the triggering foods were the same around the world.Recent FindingsThe epidemiological data are scarce and variable but recent studies suggests that FPIES is not as r...
Source: Current Treatment Options in Allergy - October 22, 2019 Category: Allergy & Immunology Source Type: research

Premedication for Iodinated Contrast Media Induced Immediate Hypersensitivity Reactions
AbstractPurpose of the reviewPremedication using antihistamines and/or corticosteroids has been widely used to prevent reoccurrence of immediate hypersensitivity reactions (iHR) after iodinated contrast media (ICM). However, efficacy has been debated, especially in high-risk patients. Novel findings on the role and risks of premedication and preventive strategies are summarized.Recent findingsThe rate and severity of iHR occurring despite premedication indicate that premedication is not a panacea and the intensity usually reflects that of the initial reaction. Next, the number needed to treat (NNT) to prevent one serious I...
Source: Current Treatment Options in Allergy - September 21, 2019 Category: Allergy & Immunology Source Type: research

World Allergy Organization Grading System for Systemic Allergic Reactions: it Is Time to Speak the Same Language When it Comes to Allergic Reactions
AbstractPurpose of reviewTo discuss current methods for grading severe allergic reactions (SARs) in view of the new WAO modified classification system.Recent findingsWhile there is not universally accepted system for classifying SAR severity, and due to the high degree of heterogeneity and difficulties for comparisons between the various methods, the new WAO proposal is simple, suitable for use in clinical practice and universally applicable for all allergic reactions, covering the full spectrum of possible grades of severity.SummaryThere is a requirement for a simple and comprehensive system to classify systemic allergic ...
Source: Current Treatment Options in Allergy - September 13, 2019 Category: Allergy & Immunology Source Type: research

A Case-Based Review on the Diagnosis and Treatment Options for Recurrent Wheezing and Asthma in Preschool Children
AbstractPurpose of reviewTo summarize the recent evidence on the various wheezing patterns in early life and provide a case-based review with insights into clinical application of individualized therapy in preschool children with recurrent wheezing.Recent findingsPreschool wheezing is often characterized predominantly by the risk domain with exacerbations and relatively limited impairment. In children with intermittent disease and a positive Modified Asthma Predictive Index, intermittent therapy with inhaled corticosteroids (ICSs) should be considered as an initial therapy to prevent exacerbations. Early administration of ...
Source: Current Treatment Options in Allergy - September 9, 2019 Category: Allergy & Immunology Source Type: research

Are Inhaled Corticosteroids and Inhaled Corticosteroids/Long-acting β-Agonist of Use in Acute Asthma: an Update on Evidence
AbstractPurpose of reviewTreatment of acute asthma exacerbations involves using systemic corticosteroids and short-acting β2-agonists (SABA). In an effort to limit the burden of systemic steroids, recent studies suggest benefit with the use of inhaled corticosteroids in an acute asthma exacerbation.Recent findingsRecent data has demonstrated benefit from the addition of inhaled corticosteroids to systemic steroids, increasing inhaled corticosteroid dose, and adding a separate inhaled corticosteroid inhaler during an exacerbation. Additionally, inhaled corticosteroid and fast-acting long-acting β-agonist (LABA) ca...
Source: Current Treatment Options in Allergy - September 9, 2019 Category: Allergy & Immunology Source Type: research

House Dust Mite-Induced Allergic Rhinitis: Is Prevention an Option?
AbstractPurpose of reviewThe aim of this paper is to review and summarise the current knowledge of prevention of house dust mite (HDM)-induced allergic rhinitis (AR).Recent findingsAR can be either classified as seasonal/intermittent (for example hay fever occurring summer and autumn) or perennial/persistent (occurring throughout the year). The commonest trigger for seasonal AR is pollen whereas HDMs are the key allergic trigger for perennial AR. HDMs are a recognised indoor allergen that is crucial in the development of AR, asthma, and atopic dermatitis.SummaryPreventive strategies have gained acceptance for the managemen...
Source: Current Treatment Options in Allergy - September 5, 2019 Category: Allergy & Immunology Source Type: research

The Explosion of OTC Management of Allergic Rhinitis: Costs and Risks
AbstractPurpose of the ReviewTo review self-medication and the increasing use of over-the-counter (OTC) medications in the treatment of allergic rhinitis in the last years.Recent FindingsThanks to recent research and the use of mHealth tools, the preferences of patients, the role of primary care physicians, pharmacists, and specialists in the management of this prevalent condition have been known.SummarySuccessful self-management of AR requires that patients be fully informed about the available treatment options, the proper use of nasal spray devices, the need for therapy based on prevention, and avoidance of allergens. T...
Source: Current Treatment Options in Allergy - September 3, 2019 Category: Allergy & Immunology Source Type: research