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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 9, 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 9, 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 17, 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 17, 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 15, 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 6, 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 5, 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 plasma ...
Source: Current Treatment Options in Allergy - October 30, 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 27, 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 rare ...
Source: Current Treatment Options in Allergy - October 21, 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 20, 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 12, 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 8, 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) can be hel...
Source: Current Treatment Options in Allergy - September 8, 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 4, 2019 Category: Allergy & Immunology Source Type: research