The Use of Molecular Allergy Diagnosis in Anaphylaxis: a Literature Review
AbstractPurpose of the reviewAnaphylaxis can be caused mainly by drugs, foods, and hymenoptera or it can be idiopathic, when no cause is identified. The identification of the cause(s) of an anaphylactic reaction can be made by using both top-down (i.e., from patients ’ history to MAD) and bottom-up (from MAD screening to the patients’ characterization) strategies.Recent findingsIndependently from the strategy, the patients ’ history, skin prick test, second, third, and fourth level in vitro serum or cellular assays, and in vivo challenge tests are mandatory. The diagnosis is based on the results of these ...
Source: Current Treatment Options in Allergy - June 10, 2019 Category: Allergy & Immunology Source Type: research

Anaphylaxis Induced by Biologics
AbstractPurpose of reviewBiologic agents are increasingly utilized in the medical management of many conditions. Their safety has become an important topic as a myriad of reactions can occur due to the immune-modulating properties of these agents. Of these, anaphylaxis remains a substantial concern, but its incidence and pathophysiology have not been comprehensively reviewed.Recent findingsOver the past two decades, a multitude of case reports and series have been published describing anaphylactic reactions to biologic agents, although the true incidence and prevalence remains unknown for the vast majority of them. Based o...
Source: Current Treatment Options in Allergy - May 12, 2019 Category: Allergy & Immunology Source Type: research

Risk Factors for Adverse Reactions During OIT
AbstractPurpose of reviewOral immunotherapy (OIT) can have a major positive impact on patients with IgE-mediated food allergies, increasing reaction thresholds and reducing the need for dietary and lifestyle limitations. However, patients experience more frequent allergic reactions during OIT than when following dietary avoidance, and 10 –75% of patients on OIT may experience anaphylaxis to treatment doses. Our ability to identify patients at higher risk of more severe or frequent reactions during OIT is limited. We review the current data available and highlight the gaps in knowledge which impede our ability to pred...
Source: Current Treatment Options in Allergy - May 1, 2019 Category: Allergy & Immunology Source Type: research

Potential Role of Endothelin-1 in Atopic Dermatitis
AbstractPurpose of reviewAtopic dermatitis (AD) is a chronic eczematous skin disease associated with intense pruritus and skin barrier dysfunction. Not only histamine, but also various pruritogens can induce itch in the skin of AD patients. Among them, one of the potentially endogenous pruritogens in the skin is endothelin-1 (ET-1). To understand the mechanism of action, production, and roles of ET-1 in the skin of AD, we reviewed recent advances in the understanding of ET-1.Recent findingsRecently, functions of ET-1 related to inflammation other than itch have been reported. The expression of ET-1 and IL-25 was found to b...
Source: Current Treatment Options in Allergy - April 30, 2019 Category: Allergy & Immunology Source Type: research

Current Treatment of Angioedema Induced by ACE Inhibitors
The objective of this review was to evaluate the evidence for treatment of ACE inhibitor–induced angioedema by means of drugs intervening in the bradykinin system.Recent FindingsWe searched in the literature for double-blind placebo-controlled trials using either inhibitors of production of kallikrein, bradykinin receptor antagonists, C1 inhibitor concentrate, or fresh frozen plasma as treatment for ACE inhibitor –induced angioedema. The reference list of retrieved articles was checked for articles with the same subject (snowballing). The evidence for each treatment was evaluated by IT and DMC.SummaryDouble-bli...
Source: Current Treatment Options in Allergy - February 21, 2019 Category: Allergy & Immunology Source Type: research

Practical Advice to Correctly Perform Patch Test
The objective of this review is to provide a series of general recommendations to adequately perform this test, and so the results are reliable and allow proper management of the patient.Recent findingsAlthough used for more than 120  years, the patch test procedure is performed with variability around the world. Although the procedure is broadly similar to the original method, it is not uncommon to observe differences in the results reported by the different observers. This may be influenced, among other factors, for differenc es in the methodology used by the physician who perform it.SummaryThere are numerous potent...
Source: Current Treatment Options in Allergy - February 14, 2019 Category: Allergy & Immunology Source Type: research

Phenotypes and Natural Evolution of Drug Hypersensitivity
AbstractsPurpose of reviewDrug hypersensitivity reactions (DHRs) are adverse effects that clinically resemble allergy. They belong to type B adverse drug reactions, which are dose-independent and unpredictable. Misclassification of DHR may lead to under and/or overdiagnosis, which affects the management of patients, leading to higher risk of suffering an allergic reaction or the use of alternative more-expensive and potentially less-effective drugs. A precise phenotype of DHR is required for a better evaluation and proper management of patients experiencing DHR. The purpose of this review is to summarise the different phen...
Source: Current Treatment Options in Allergy - February 8, 2019 Category: Allergy & Immunology Source Type: research

Textile Contact Dermatitis: How Fabrics Can Induce Dermatitis
AbstractPurpose of the reviewTextile dermatitis can sometimes be difficult to diagnose due to the fact that it is difficult to clinically suspect, and when allergic, patch test correctly and advice the patient as to what garments to avoid.Recent findingsThe textile fibres as such are rarely the causative agent. Allergic contact dermatitis due to textiles is primarily caused by substances that are used to give the material certain qualities or performances. The textile dye mix, now in the baseline series, has proven to be a useful tool in diagnosing allergic contact dermatitis but additional patch testing with own material ...
Source: Current Treatment Options in Allergy - February 8, 2019 Category: Allergy & Immunology Source Type: research

Diagnostic Approximation to Delabeling Beta-Lactam Allergic Patients
AbstractPurpose of reviewBeta-lactam antibiotics constitute first-choice drugs for bacterial infections, although the high rate of hypersensitivity reactions constitutes a worldwide health problem. The public health implications of beta-lactam (BL) allergy are enormous as the self-reported penicillin allergy has been associated with antimicrobial resistance, increased cost to health systems, intensive care admission, and death. Therefore, an accurate and rapid diagnosis is crucial.Recent findingsThe diagnostic work-up is mainly based on the performance of an accurate clinical history, skin tests, drug provocation tests and...
Source: Current Treatment Options in Allergy - February 1, 2019 Category: Allergy & Immunology Source Type: research

New Insights of Biomarkers in IgE and Non-IgE-Mediated Drug Hypersensitivity
AbstractBackground Drug hypersensitivity reactions (DHRs) occurring less than 6  h after the drug intake are named immediate reactions. They include allergic reactions, and pseudo-allergic or non-allergic reactions, and despite their similar clinical manifestations, the underlying mechanism is different. Its identification is essential for their management. In IgE-mediated-DHR s, the best biomarker is drug-specific IgE, which can be determined by in vivo and in vitro tests. Identifying the culprit drug is critical for the design of avoidance strategies and the recommendation of safe alternatives for future treatments....
Source: Current Treatment Options in Allergy - February 1, 2019 Category: Allergy & Immunology Source Type: research

Usefulness of Cutaneous Provocation Tests to Study Drugs Responsible for Cutaneous Adverse Drug Reactions
AbstractPurpose of ReviewCutaneous adverse drug reactions, particularly immune-mediated idiosyncratic reactions, are a very challenging area of Dermatology. For confirming the culprit drug, after a complete history of drug exposure with its chronologic relation with the eruption and characterization of the pattern of the drug eruption, skin provocation tests can be performed after resolution of the acute phase.Recent FindingsPatch tests are indicated in the study of non-immediate T cell –mediated drug eruptions (maculopapular exanthema, drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens–John...
Source: Current Treatment Options in Allergy - January 30, 2019 Category: Allergy & Immunology Source Type: research

An Update on Fragrance Contact Dermatitis
AbstractBackgroundFragrances are a group of substances present in many cosmetic products, which are one of the most common sources of allergic contact dermatitis (ACD) in Europe. Their widespread distribution, the presence of these substances as combinations, their ability to transform into more reactive substances, and the relatively recent regulations regarding these products are the main reasons for this high prevalence. In the last few years, advances on knowledge about haptens in fragrances have made possible to discover new allergens, to state that current fragrance markers are not enough to detect most of fragrance ...
Source: Current Treatment Options in Allergy - January 23, 2019 Category: Allergy & Immunology Source Type: research

Pharmacogenomics as a Tool for Management of Drug Hypersensitivity Reactions
AbstractPurpose of reviewDrug hypersensitivity reactions constitute an unpredictable, serious problem for health care systems as they interfere with drug treatment, limit therapeutic options, and may be life-threatening. In addition to specific patient factors, they are also influenced by a genetic component. Indeed, a considerable body of knowledge supports the participation of genetic variants in their underlying mechanisms.Recent findingsLatest research on this topic confirms the involvement of specific HLA alleles in non-immediate reactions. Two well-known examples are the HLA-B*58:01 allele in severe allopurinol-trigg...
Source: Current Treatment Options in Allergy - January 18, 2019 Category: Allergy & Immunology Source Type: research

Primary Prevention of Airway Allergy
AbstractPurpose of reviewThe aim of this paper is to review and summarize the current knowledge of prevention of airway allergy.Recent findingsAllergic rhinitis and asthma are allergic airway diseases. Due to their increasing incidence and socioeconomic burden, allergic airway diseases have recently gained attention worldwide. The primary prevention of allergic airway diseases focuses on offspring ’s gestational and childhood environment, such as maternal smoking and diet during pregnancy and breastfeeding as well as exposure to environmental microbes and irritants.SummaryAsthma and allergic rhinitis are a major publ...
Source: Current Treatment Options in Allergy - November 5, 2018 Category: Allergy & Immunology Source Type: research

Recent Evidence on the Use of Tiotropium Bromide in Pediatric Asthma: Summary Results of Eight Clinical Trials
AbstractPurpose of ReviewTo collect the existing information on tiotropium as an add-on treatment for asthma in children and adolescents.Recent FindingsThe use of tiotropium bromide in children between 1 and 6  years old.SummaryAsthma is a disease that can be difficult to control. For the treatment of this, there is a combination of medications, but often complete control of the disease is not achieved. The addition of tiotropium, a long-acting muscarinic antagonist, to treatment with inhaled corticosteroids has been recommended to improve lung function in adults and adolescents who have uncontrolled asthma. Here we p...
Source: Current Treatment Options in Allergy - November 3, 2018 Category: Allergy & Immunology Source Type: research

Primary Prevention of Asthma: Will It Be Possible in the Future?
AbstractPurpose of ReviewAsthma is a major public health problem in both the developed and developing world. Asthma is a complex heterogeneous disease with a multifactorial etiology involving genetic, epigenetic, viral, microbial and environmental exposures.Recent FindingsNew studies have provided significant novel information on the interplay between inherited and modifiable risk factors in the development of asthma, suggesting possible primary preventive measures.SummaryMulti-faceted interventional strategies targeted to the personalized risk profile will likely be most effective in primary prevention of asthma. (Source:...
Source: Current Treatment Options in Allergy - October 29, 2018 Category: Allergy & Immunology Source Type: research

Diagnosis and Management of Shellfish Allergy: Current Approach and Future Needs
AbstractPurpose of reviewShellfish allergy is an increasing health concern worldwide with over 2% of the population affected and higher rates in countries with high consumption. Shellfish includes both crustaceans and mollusks and constitutes one of the major food groups triggering allergic reactions.Recent findingsShrimp is the best-studied crustacean, in which the major shellfish allergen, tropomyosin, was initially characterized. Nevertheless, several other allergens have been identified and should be considered despite prevalence of sensitization being lower than tropomyosin (e.g., arginine kinase, myosin light chain, ...
Source: Current Treatment Options in Allergy - October 29, 2018 Category: Allergy & Immunology Source Type: research

Induction of Tolerance Through Early Weaning and Oral Immunotherapy
AbstractPurpose of reviewThe increase in IgE-mediated food allergy in the world with prevalence of egg, milk, peanut, and wheat allergies presenting and coexisting as multiple food allergies in young children.Recent findingsEarlier initiation in weaning and timing of exposure of specific food allergens to an atopic infant appears to affect the trajectory and progression of acquiring tolerance in these children for specific foods. In this review, the allergen-specific strategies for increasing tolerance (desensitization) and hastening the resolution of food allergy (SU) are reviewed for treatment of food allergy.SummaryPhen...
Source: Current Treatment Options in Allergy - October 29, 2018 Category: Allergy & Immunology Source Type: research

House Dust Mite Tablets Now Officially Accepted as Treatment in GINA: What Is the Evidence and What ’s Next?
AbstractPurpose of ReviewThis review analyzes the growing evidence regarding the standardized quality house dust mite (SQ-HDM) sublingual immunotherapy (SLIT) tablets as a valuable therapeutic option in asthma, as recently included in the treatment algorithm of the Global Initiative for Asthma (GINA) as an add-on treatment for adult patients with allergic asthma not well controlled with inhaled corticosteroids (ICS).Recent FindingsEvidence from well-designed randomized placebo-controlled clinical trials shows that the SQ-HDM SLIT tablet is effective vs. placebo in reducing both asthma symptoms and the need for ICS, as well...
Source: Current Treatment Options in Allergy - October 29, 2018 Category: Allergy & Immunology Source Type: research

Nemolizumab and Atopic Dermatitis: the Interaction Between Interleukin-31 and Interleukin-31 Receptor as a Potential Therapeutic Target for Pruritus in Patients With Atopic Dermatitis
AbstractPurpose of ReviewAtopic dermatitis (AD) is a chronic eczematous skin disease associated with intense pruritus and skin barrier dysfunction. Interleukin-31 (IL-31), which is preferentially produced by T helper 2 (Th2) cells, has attracted attention as a pruritogen in patients with AD. To understand the mechanism of action, production, and roles of IL-31, we reviewed recent advances of the knowledge of IL-31, its receptor as well as results of recent clinical trials targeting IL-31/IL-31R signaling for pruritus in patients with AD.Recent FindingsActivation of many cytokine pathways has been reported in AD, suggesting...
Source: Current Treatment Options in Allergy - October 24, 2018 Category: Allergy & Immunology Source Type: research

Review and Perspectives of the Recent International Guidelines on Treatment of Chronic Urticaria
AbstractPurpose of reviewManagement of urticaria can be challenging, and various guidelines have been published by national and international societies. The most recent set of international guidelines, the EAACI/GA2LEN/EDF/WAO guideline, seeks to define and classify urticaria as well as recommend diagnostic and therapeutic approaches in common subtypes of urticaria. This review aims to summarize treatment recommendations and provide additional perspectives on these recommendations.Recent findingsThe EAACI/GA2LEN/EDF/WAO guideline recommends a four-step approach to treatment of chronic urticaria: (1) second-generation antih...
Source: Current Treatment Options in Allergy - October 17, 2018 Category: Allergy & Immunology Source Type: research

Specialty Infant Formulas for Milk Allergy: Current Choices and Unmet Needs
AbstractPurpose of ReviewLiterature on the different options for the management of cow ’s milk allergy (CMA) was reviewed. Literature was searched using databases to find original papers and reviews on this topic.Recent FindingsAmino acid based infant formula (AAF) is the most effective dietary treatment of CMA. However, because of the high cost, guidelines recommend extensively hydrolyzed formula (eHF) with a clinical proof of efficacy as the first choice option. In many parts of the world, rice hydrolysates are an alternative option. Soy infant formula can sometimes still be considered, in the absence of more suita...
Source: Current Treatment Options in Allergy - October 8, 2018 Category: Allergy & Immunology Source Type: research

Scope and Efficacy of Preventive Measures in Contact Dermatitis
AbstractPurpose of reviewTo describe the scope and review the efficacy of interventions to prevent contact dermatitis.Recent findingsUniversal measures to prevent contact dermatitis start at the population level with legislation regulating exposure to skin irritants and sensitizers. Primary measures include health education on skin care and protection, use of moisturisers and proper use of protective gloves. The overall epidemiological evidence regarding the efficacy of such preventive measures varies from low to moderate. Secondary prevention comprises the application of specific diagnostic procedures and early interventi...
Source: Current Treatment Options in Allergy - October 5, 2018 Category: Allergy & Immunology Source Type: research

Role of TF-Triggered Activation of the Coagulation Cascade in the Pathogenesis of Chronic Spontaneous Urticaria
AbstractPurpose of ReviewTo overview recent understanding of the relationship between the blood coagulation cascade and chronic spontaneous urticaria (CSU).Recent FindingsThe relationship between severities of CSU and the increase of coagulation markers, and the effectiveness of anti-coagulants, such as warfarin, suggest a causative role of the blood coagulation in the pathogenesis of CSU. However, mechanisms of the initiation of blood coagulation, and the link between blood coagulation and wheal formation in urticaria, remained unclear. In blood vessels, vascular endothelial cells and eosinophils may express tissue factor...
Source: Current Treatment Options in Allergy - October 5, 2018 Category: Allergy & Immunology Source Type: research

Dietary and Nutritional Influences on Allergy Prevention
AbstractPurpose of ReviewNutritional status has a profound effect on immune function, and vitamin D, omega-3 fats, and other nutrients have long been suspected of influencing the development of the allergic march, and the incidence and severity of allergic conditions. This review provides an overview of research and opinion published during the past decade and summarizes clinically actionable information about dietary and nutritional influences on allergy prevention.Recent FindingsThere is now enough evidence of effects of vitamin D, omega-3 fats, the Mediterranean diet, and antioxidants to recommend their use in routine c...
Source: Current Treatment Options in Allergy - October 1, 2018 Category: Allergy & Immunology Source Type: research

Nutritional Management of Patients With Pollen Food Syndrome: Is There a Need?
AbstractPurpose of reviewPollen food syndrome (PFS) is a highly prevalent condition causing mild oropharyngeal reactions to plant foods due to recognition by pollen-specific antibodies. It is most frequent in adults, but it can also occur in children. This review aims to establish the pitfalls of diagnosis and the nutritional consequences, and whether individuals with PFS require an individualised dietary and nutritional management strategy.Recent findingsThe diagnosis of PFS can be made through history alone but is greatly enhanced by undertaking component-resolved diagnostic (CRD) tests to individual allergens in birch p...
Source: Current Treatment Options in Allergy - October 1, 2018 Category: Allergy & Immunology Source Type: research

Food Allergy and Asthma: Is There a Link?
AbstractPurpose of reviewTo describe and understand the links and interactions between food allergy and asthmaRecent findingsFood allergy and asthma are characterized by an increasing prevalence. Moreover, food allergy and asthma often coexist. Both conditions are associated with each other in different ways. It has been shown that food allergy is a risk factor of developing asthma. Atopic dermatitis appears to be the common denominator in this interaction. Loss-of-function variants of the filaggrin mutation result in an impaired epidermal barrier function and have been shown to be a risk factor for the development of atop...
Source: Current Treatment Options in Allergy - October 1, 2018 Category: Allergy & Immunology Source Type: research

Dietary and Nutritional Influences on Allergy Prevention
AbstractPurpose of ReviewNutritional status has a profound effect on immune function, and vitamin D, omega-3 fats, and other nutrients have long been suspected of influencing the development of the allergic march, and the incidence and severity of allergic conditions. This review provides an overview of research and opinion published during the past decade and summarizes clinically actionable information about dietary and nutritional influences on allergy prevention.Recent FindingsThere is now enough evidence of effects of vitamin D, omega-3 fats, the Mediterranean diet, and antioxidants to recommend their use in routine c...
Source: Current Treatment Options in Allergy - October 1, 2018 Category: Allergy & Immunology Source Type: research

Nutritional Management of Patients With Pollen Food Syndrome: Is There a Need?
AbstractPurpose of reviewPollen food syndrome (PFS) is a highly prevalent condition causing mild oropharyngeal reactions to plant foods due to recognition by pollen-specific antibodies. It is most frequent in adults, but it can also occur in children. This review aims to establish the pitfalls of diagnosis and the nutritional consequences, and whether individuals with PFS require an individualised dietary and nutritional management strategy.Recent findingsThe diagnosis of PFS can be made through history alone but is greatly enhanced by undertaking component-resolved diagnostic (CRD) tests to individual allergens in birch p...
Source: Current Treatment Options in Allergy - October 1, 2018 Category: Allergy & Immunology Source Type: research

Food Allergy and Asthma: Is There a Link?
AbstractPurpose of reviewTo describe and understand the links and interactions between food allergy and asthmaRecent findingsFood allergy and asthma are characterized by an increasing prevalence. Moreover, food allergy and asthma often coexist. Both conditions are associated with each other in different ways. It has been shown that food allergy is a risk factor of developing asthma. Atopic dermatitis appears to be the common denominator in this interaction. Loss-of-function variants of the filaggrin mutation result in an impaired epidermal barrier function and have been shown to be a risk factor for the development of atop...
Source: Current Treatment Options in Allergy - October 1, 2018 Category: Allergy & Immunology Source Type: research

Allergen Immunotherapy for the Prevention of Allergic Asthma
AbstractPurpose of review:Children with allergic rhinitis (AR) have a high risk of developing asthma. An effect beyond end of allergen immunotherapy (AIT) has been demonstrated, and moreover a preventive effect on the development of asthma in children with AR is suggested. The aim of this review is to discuss the evidence for the asthma preventive capacity of AIT.Recent findings:According to the recently published systematic review and clinical practice AIT guideline from The European Academy of Allergy and Clinical Immunology (EAACI), there is sufficient evidence to recommend a 3-year course of AIT for children and adoles...
Source: Current Treatment Options in Allergy - September 21, 2018 Category: Allergy & Immunology Source Type: research

What Do We Really Know About Intralymphatic Immunotherapy?
AbstractPurpose of reviewAllergen-specific immunotherapy (AIT) is the only causal treatment method of IgE-mediated allergies that may lead to long-term symptom amelioration even after the end of treatment, positively interfere with the course of disease, and improve the immunological situation of the patient. While AIT in general requires treatment periods over 3 up to 5  years, intralymphatic immunotherapy (ILIT) needs only three ultrasound-guided injections of low allergen doses into inguinal lymph nodes with 4-week time interval making the entire treatment possible within 2 months.Recent findingsThe number of ...
Source: Current Treatment Options in Allergy - September 15, 2018 Category: Allergy & Immunology Source Type: research

Duration of Allergen Immunotherapy for Long-Term Efficacy in Allergic Rhinoconjunctivitis
AbstractRationaleSubcutaneous and sublingual immunotherapy are effective for allergic rhinitis. An important question is whether allergen immunotherapy provides a sustained clinical effect after treatment cessation. In view of potential side effects, cost and the necessary patient commitment, long-term benefit is an important consideration for the recommendation of immunotherapy over standard pharmacotherapy.Purpose of reviewIn this review, we analyse the existing evidence for long-term effects of both routes of administration in the context of double-blind, placebo-controlled, randomised clinical trials that included a fo...
Source: Current Treatment Options in Allergy - September 1, 2018 Category: Allergy & Immunology Source Type: research

Nettle Allergy: a Review and Clinical Perspective
The objectives of this article are to review the available literature regarding the geographic distribution of nettle, allergen(s) involved, cross-reactivity, role in allergic rhinitis, immunotherapy efficacy, and provide a clinical perspective on the evaluation and treatment of nettle sensitized patients.Recent findingsStinging nettle (Urtica dioica) is a bi-annual pollinator with worldwide distribution and wide use in homeopathy. Limited data suggest that nettle pollen allergens may be considered clinically relevant and that nettle pollen allergy may be underestimated. More recent allergomic analysis of nettle pollen has...
Source: Current Treatment Options in Allergy - September 1, 2018 Category: Allergy & Immunology Source Type: research

Mechanism of Synthetic Peptide Immuno-Regulatory Epitopes and Their Clinical Efficacy in the Treatment of Allergic Disease
AbstractPurpose of reviewPeptide immunotherapy with synthetic peptide immuno-regulatory epitopes (SPIREs) is a safer alternative to conventional allergen immunotherapy (AIT) owing to the reduced risk of IgE-mediated adverse reactions and shorter treatment schedules. Over the last 5  years, significant advances have been made in evaluating SPIREs for the treatment of allergic rhinitis. This review includes a summary of recent phase II and III clinical trials evaluating the efficacy of SPIREs and a brief discussion on their mechanism of action.Recent findingsTo date, SPIREs have been developed for cat, house dust mite (...
Source: Current Treatment Options in Allergy - September 1, 2018 Category: Allergy & Immunology Source Type: research

Contact Urticaria and Protein Contact Dermatitis —a Frequently Hidden Diagnosis
AbstractPurpose of reviewWe hope that this review can assist in the classification, diagnosis, prevention, and treatment of a contact urticaria syndrome (CUS), a syndrome in which the understanding of such is still evolving.Recent findingsCUS and protein contact dermatitis (PCD) can be defined as an immediate inflammatory reaction of the skin following contact with an external substance. Erythema, wheals, and eczema, as well as other manifestations can occur as a result of this inflammatory reaction. Many low molecular weight substances and proteins are known to produce these immediate skin contact reactions. These reactio...
Source: Current Treatment Options in Allergy - September 1, 2018 Category: Allergy & Immunology Source Type: research

Duration of Allergen Immunotherapy for Long-Term Efficacy in Allergic Rhinoconjunctivitis
AbstractRationaleSubcutaneous and sublingual immunotherapy are effective for allergic rhinitis. An important question is whether allergen immunotherapy provides a sustained clinical effect after treatment cessation. In view of potential side effects, cost and the necessary patient commitment, long-term benefit is an important consideration for the recommendation of immunotherapy over standard pharmacotherapy.Purpose of reviewIn this review, we analyse the existing evidence for long-term effects of both routes of administration in the context of double-blind, placebo-controlled, randomised clinical trials that included a fo...
Source: Current Treatment Options in Allergy - August 31, 2018 Category: Allergy & Immunology Source Type: research

Mechanism of Synthetic Peptide Immuno-Regulatory Epitopes and Their Clinical Efficacy in the Treatment of Allergic Disease
AbstractPurpose of reviewPeptide immunotherapy with synthetic peptide immuno-regulatory epitopes (SPIREs) is a safer alternative to conventional allergen immunotherapy (AIT) owing to the reduced risk of IgE-mediated adverse reactions and shorter treatment schedules. Over the last 5  years, significant advances have been made in evaluating SPIREs for the treatment of allergic rhinitis. This review includes a summary of recent phase II and III clinical trials evaluating the efficacy of SPIREs and a brief discussion on their mechanism of action.Recent findingsTo date, SPIREs have been developed for cat, house dust mite (...
Source: Current Treatment Options in Allergy - July 18, 2018 Category: Allergy & Immunology Source Type: research

Nettle Allergy: a Review and Clinical Perspective
The objectives of this article are to review the available literature regarding the geographic distribution of nettle, allergen(s) involved, cross-reactivity, role in allergic rhinitis, immunotherapy efficacy, and provide a clinical perspective on the evaluation and treatment of nettle sensitized patients.Recent findingsStinging nettle (Urtica dioica) is a bi-annual pollinator with worldwide distribution and wide use in homeopathy. Limited data suggest that nettle pollen allergens may be considered clinically relevant and that nettle pollen allergy may be underestimated. More recent allergomic analysis of nettle pollen has...
Source: Current Treatment Options in Allergy - July 16, 2018 Category: Allergy & Immunology Source Type: research

The Association Between Ambient Air Pollution and Allergic Rhinitis Inception and Control
This article summarizes the main consequences of the complex relationship that exists between allergic rhinitis, environmental pollution, and climate change and presents some potential measures aiming at modifying some aspects of this intriguing relationship to achieve a clinical benefit in patients suffering from allergic diseases, especially allergic rhinitis. (Source: Current Treatment Options in Allergy)
Source: Current Treatment Options in Allergy - June 1, 2018 Category: Allergy & Immunology Source Type: research

Food-Dependent Exercise-Induced Anaphylaxis
AbstractPurpose of reviewFood-dependent exercise-induced anaphylaxis (FDEIA) is a form of anaphylaxis that occurs associated with exercise, in which symptoms develop by the combination of food ingestion and physical activity. We aimed to review and discuss the main clinical recommendations for management of FDEIA, focusing on individual factors.Recent findingsNew diagnostic strategies have been developed to optimize the accuracy of provocation challenges, taking in consideration augmenting factors, such as alcohol or non-steroidal anti-inflammatory drugs. However, FDEIA is still insufficiently diagnosed and a high index of...
Source: Current Treatment Options in Allergy - June 1, 2018 Category: Allergy & Immunology Source Type: research

Are Large Local Reactions Useful to Predict Future Anaphylaxis to Hymenoptera Stings?
AbstractPurpose of reviewUnaware of the natural history of large local reactions caused by Hymenoptera stings, patients and clinicians are often concerned when faced with these reactions. These concerns include the difficulty in avoiding stings, the local discomfort, and the fear that the local reaction portends systemic, potentially life-threatening subsequent reactions. This review presents the historical studies that have assessed the natural history of large local reactions caused by Hymenoptera stings and, in doing so, provides rationale for the current consensus guidelines for the management of these reactions.Recent...
Source: Current Treatment Options in Allergy - June 1, 2018 Category: Allergy & Immunology Source Type: research

ARIA 2017: a Review of Major Changes and Innovations
ConclusionARIA guideline has evolved to a technology-based implementation strategy to help rhinitis sufferers to have an active and healthy life and to reduce health and social inequalities caused by this very common disease, irrespective of their age, sex, or socio-economic status. (Source: Current Treatment Options in Allergy)
Source: Current Treatment Options in Allergy - June 1, 2018 Category: Allergy & Immunology Source Type: research

Use of a Combination of Allergen Immunotherapy and Omalizumab for Prevention of Anaphylaxis
AbstractPurpose of reviewAllergen immunotherapy (AIT) is aimed at the etiological treatment of respiratory allergy and Hymenoptera venom allergy, while it is still under investigation for food allergy. The incidence of anaphylactic reactions to AIT is generally low, but may hamper its completion and makes needed preventive treatment.Recent findingsSeveral studies focused the attention on the use of the anti-IgE antibody omalizumab to prevent anaphylaxis in patients at high risk of systemic reactions, that is especially elevated during food allergy AIT and, in certain circumstances, during venom immunotherapy (VIT).SummaryW...
Source: Current Treatment Options in Allergy - June 1, 2018 Category: Allergy & Immunology Source Type: research

Impact and Assessment of Sleep Disturbance in Adults and Children with Allergic Rhinitis
AbstractPurpose of ReviewIn this article, we review the impact and the treatment of sleep disturbance caused by allergic rhinitis (AR) in adult and pediatric patients.Recent FindingsAlthough intranasal corticosteroids (INS) remain the mainstay treatments for AR-induced sleep disturbance, allergen immunotherapy (AIT) has been suggested to be effective in altering the course and progression of moderate-to-severe AR that is refractory to pharmacotherapy. MP-AzeFlu is a recently developed formulation containing azelastine, an intranasal antihistamine (INAH), and fluticasone propionate, an INS. MP-AzeFlu has been reported to ha...
Source: Current Treatment Options in Allergy - June 1, 2018 Category: Allergy & Immunology Source Type: research

Risk Factors and Cofactors for Severe Anaphylaxis
AbstractPurpose of reviewSevere anaphylaxis is a generalized reaction in which cardiovascular and respiratory involvement lead to a fatal or near-fatal outcome. Triggers of severe anaphylaxis differ from one age group to another and are mostly represented by drugs and hymenoptera stings in adults and food in children. Several risk factors and cofactors can increase the odds of severe anaphylaxis by different and still undefined mechanisms.Recent findingsMajor risk factors for severe anaphylaxis include old age, male sex, and preexisting medical conditions such as mast cell disorders, cardiovascular diseases, and uncontroll...
Source: Current Treatment Options in Allergy - June 1, 2018 Category: Allergy & Immunology Source Type: research

Diagnosis and Management of Allergic Conjunctivitis
AbstractPurpose of the reviewThe purpose of this review is to define the classification, diagnosis, and management in adults and children with allergic conjunctivitis with emphasis on recent findings.Recent findingsCurrent literature divides allergic conjunctivitis according to severity and frequency, facilitating its diagnosis, study, and treatment choices. Novel pharmacological therapies aim at inhibiting inflammatory pathways at a specific molecular level and include selective glucocorticoid receptor agonists, kinase inhibitors, and IL-1 receptor antagonists.SummaryOcular allergies are a group of heterogeneous diseases ...
Source: Current Treatment Options in Allergy - June 1, 2018 Category: Allergy & Immunology Source Type: research

An Update on the Management of Anaphylaxis
AbstractPurpose of reviewTo highlight the latest evidence supporting management recommendations in anaphylaxis and discuss the implications for further research in anaphylaxis management.Recent findingsThe acute management of anaphylaxis is largely centered on resuscitation and administration of epinephrine. There is little evidence to support the use of antihistamines and corticosteroids in the acute management of anaphylaxis.SummaryAnaphylaxis is an acute, systemic, potentially life-threatening reaction caused by the release of mast cell and basophil mediators that could lead to distributive shock. Anaphylaxis is associa...
Source: Current Treatment Options in Allergy - June 1, 2018 Category: Allergy & Immunology Source Type: research