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Rationale for Development of Work-Related Asthma Educational Tools for Asthmatics
Opinion statementCurrently, young asthmatics have little knowledge of the potential effects of work exposures on their asthma. We expect that education of young asthmatics about the potential effects of the working environment on their asthma and appropriate steps to reduce work-related exacerbations will provide these individuals with skills to better control their asthma. Currently, there is no formal process for this education to our knowledge. Since the Internet is readily available and widely used by most young asthmatics, it may provide a useful forum for such education. Our preliminary studies with development and e...
Source: Current Treatment Options in Allergy - May 3, 2017 Category: Allergy & Immunology Source Type: research

Precision Medicine in Allergic Disorders
(Source: Current Treatment Options in Allergy)
Source: Current Treatment Options in Allergy - May 2, 2017 Category: Allergy & Immunology Source Type: research

Mental Health in Allergic Rhinitis: Depression and Suicidal Behavior
Opinion statementA high proportion of suicides visit their medical provider in the month prior to death, but depression, suicidal thoughts, and substance use are seldom addressed. For the clinicians routinely treating a substantial patient population with allergic diseases, there are additional concerns, as allergy has been linked with both depression and suicidal behavior. While psychotropic medications may affect diagnosis of allergies, medications used to treat allergies impact mood and behavior. Thus, we present an overview of the overlap of allergic rhinitis with depression and suicidal behavior in adults, based on cl...
Source: Current Treatment Options in Allergy - March 25, 2017 Category: Allergy & Immunology Source Type: research

Update on Biomarkers to Monitor Clinical Efficacy Response During and Post Treatment in Allergen Immunotherapy
Opinion statementAllergen immunotherapy (AIT) is an immune modulating treatment for allergic diseases. Although highly effective, some patients do not respond to the treatment. To date there are no surrogate biomarkers that are predictive of the clinical response to AIT. More and more is known about the underlying immunological mechanism involved in AIT. Through modulation of both innate and adaptive immune responses, involving reduced ILC2 and enhanced Treg and Breg induction and functionality, along with induction of IgG4 antibody production which have the capacity to inhibit both allergen-induced basophil responsiveness...
Source: Current Treatment Options in Allergy - March 9, 2017 Category: Allergy & Immunology Source Type: research

Allergic Rhinitis and Sexual Dysfunction
Opinion StatementSexual dysfunction is perhaps an important co-morbidity of allergic rhinitis and other upper airway diseases in adults; however, its prevalence and importance are underestimated mainly due to lack of assessment by the physician and lack of reporting by the patients. The clue for a successful treatment relies in adequate diagnosis and understanding of the mechanisms involved in the generation of the symptoms. (Source: Current Treatment Options in Allergy)
Source: Current Treatment Options in Allergy - March 9, 2017 Category: Allergy & Immunology Source Type: research

Oral Immunotherapy, Sublingual Immunotherapy, or Epicutaneous Immunotherapy: Which Is the Right Solution?
Opinion statementThe current standard of care treatment for food allergy relies on avoidance. However, as outlined in this review, over the past decade, the literature has grown significantly showing promising results for interventional therapies for IgE-mediated food allergies utilizing oral immunotherapy (OIT), sublingual immunotherapy (SLIT), and epicutaneous immunotherapy (EPIT). Within the near future, we expect to have multiple FDA-approved products on the market for treatment of life-threatening food allergies and will have options to present to our patients. As we move into this next phase of our practice, we will ...
Source: Current Treatment Options in Allergy - February 27, 2017 Category: Allergy & Immunology Source Type: research

The Role of Synthetic Peptide Immuno-Regulatory Epitope (SPIRE) in the Treatment of Allergic Disease
Opinion statementImmunotherapy has been used for over a century for the treatment of allergic rhinitis, starting with the administration of whole allergens which are still in use today. Up-titration of allergen concentrations is thought to induce immune-tolerance, reducing symptoms upon exposure of the same allergen in the natural environment. More recently, peptide immunotherapy research aims to reduce sensitization to the allergen while utilizing a much shorter treatment schedule and avoiding the risk of anaphylactic reactions associated with whole allergen administration. Other immunotherapies undergoing clinical trials...
Source: Current Treatment Options in Allergy - February 26, 2017 Category: Allergy & Immunology Source Type: research

Dust Mite Tablet Immunotherapy: How Does It Compare and Where Does It Fit?
Opinion StatementHouse dust mite (HDM) sensitization plays a major role in allergic rhinitis and asthma worldwide. Sublingual immunotherapy (SLIT) in its various formulations has been increasingly utilized for the treatment of these conditions in the past several years. HDM-SLIT tablets have been recently introduced with three formulations currently under investigation. SLIT tablets offer the advantage of a more standardized dose than liquid SLIT products. Several studies suggest that HDM-SLIT tablets may be safe and effective in the treatment of allergic rhinitis and asthma in adults, though further investigations will be...
Source: Current Treatment Options in Allergy - February 23, 2017 Category: Allergy & Immunology Source Type: research

Nasal Provocation Tests With Allergens: Just a Research Tool or Suitable for Everyday Clinical Practice?
Opinion statementNasal provocation test (NPT) with allergens is a simple and safe technique recommended in different diagnostic and research settings. In the daily practice, NPT has proved to be very useful when there are discrepancies between patient ’s symptoms and the results of skin or blood testing, for confirming the clinical relevance of a certain allergen in polysensitized patients and also for the diagnosis of new rhinitis phenotypes such as local allergic rhinitis (LAR). In the research field, nasal provocation test with allergens has been widely used in the study of mechanisms of inflammation and allergic resp...
Source: Current Treatment Options in Allergy - February 22, 2017 Category: Allergy & Immunology Source Type: research

Pharmacologic Management of Allergic Rhinitis During Pregnancy
Opinion StatementAllergic rhinitis is a common condition that affects women during pregnancy and causes them great discomfort at this stage of life. Although there are many medications available to be indicated with the aim of reducing the symptoms so annoying, the doctor must very conscientiously evaluate the drug that causes the control of symptoms and obviously must do this minimizing the potential risks of birth defects. As the population is vulnerable, it is practically impossible to test the use of drugs during pregnancy in the context of clinical research for the consequent occurrence of birth defects. Apart from en...
Source: Current Treatment Options in Allergy - February 19, 2017 Category: Allergy & Immunology Source Type: research

Update on Biomarkers to Predict Responders to Allergen Immunotherapy
Opinion statementMost investigations aiming to identify biomarkers (BMKs) have focused on immunological changes reflecting our understanding of allergen-specific immunotherapy (AIT) mechanisms of action. The upregulation of allergen-specific regulatory CD4+ T cells, the downregulation or anergy of Th2 cells, the induction of specific “blocking” IgG4s, and the decrease of basophil activation are all thought to contribute to AIT efficacy. To this date, however, none of these immunological alterations can be used to predict AIT efficacy. Changes in the blood at the level of dendritic cells (DCs) reflecting the induction o...
Source: Current Treatment Options in Allergy - February 13, 2017 Category: Allergy & Immunology Source Type: research

Mast Cell Clonal Disorders: Classification, Diagnosis and Management
AbstractMast cell clonal disorders are characterized by the clonal proliferation of pathological mast cells as a result of somatic mutations in the KIT gene, most commonly the D816V mutation. Accumulation and degranulation of these cells causes a wide variety of symptoms. Mast cell clonal disorders can be divided into mastocytosis and monoclonal mast cell activation syndrome, depending of the level of clonality. The severity of mastocytosis varies from an indolent variant with a good prognosis, to an aggressive condition with short life expectancy. Diagnosis is based on demonstration of clonality and accumulation in the sk...
Source: Current Treatment Options in Allergy - November 7, 2016 Category: Allergy & Immunology Source Type: research

Optimizing Allergen Immunotherapy Safety: What Do We Know and What Are the Unmet Needs
Opinion StatementSubcutaneous immunotherapy (SCIT) is generally safe yet there remains a small risk of fatal and near-fatal injections. Factors that should be considered in the initial risk assessment for systemic reactions to SCIT include poorly controlled asthma, high degree of allergen sensitivity, history of prior systemic reactions, comorbid illness, and building up injections during the height of pollen season. Future studies should evaluate the aforementioned risk factors and also assess protocol modifications including antihistamine pretreatment, lower or higher starting doses (silver [1:10,000  v/v] vs red [1:100...
Source: Current Treatment Options in Allergy - October 27, 2016 Category: Allergy & Immunology Source Type: research

Venom Immunotherapy: Risk Factors, Predictors, Duration, and Other Unmet Needs
This article will review new and recent advances in venom immunotherapy for the treatment of hymenoptera venom allergy. Advances include the identification of new risk factors for adverse reactions with immunotherapy, the expanded use of laboratory tests to identify those at highest risk of adverse reactions, the use of novel recombinant allergens for the diagnosis and treatment of venom allergic patients, and an update on known risk factors and predictors of immunotherapy failure. We also review the latest advances on emerging delivery mechanisms and alternate dosing schedules that aim to improve safety, tolerability, and...
Source: Current Treatment Options in Allergy - October 23, 2016 Category: Allergy & Immunology Source Type: research

Biomarkers for the Phenotyping and Monitoring of Asthma in Children
Opinion statementAn important issue in relation to the utility and reliability of biomarkers for asthma monitoring is how asthma is defined and characterized. What kind of asthma, or at what stage of the disease is a particular biomarker supposed to add information? Often, the purpose, or usefulness of a biomarker is not made clear. Diagnosis, severity evaluation, and monitoring are all different clinical uses for a biomarker, and confusion may arise when a biomarker is suitable for one of these but not another. When the utility of available biomarkers are discussed, these different roles need to be clarified. Our opinion ...
Source: Current Treatment Options in Allergy - October 19, 2016 Category: Allergy & Immunology Source Type: research