Biological therapy in the treatment of psoriatic arthritis: economic and epidemiological considerations.
Conclusion: The direct costs with anti-TNF agents were the main component of total costs. Outpatient and inpatient costs increase when medication persistence decreases. A considerable price reduction of anti-TNF agents has been observed over the years. PMID: 31192746 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Immunology)
Source: Expert Review of Clinical Immunology - June 15, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Additive immunosuppressive effect of leflunomide and hydroxychloroquine supports rationale for combination therapy for Sj ögren's syndrome.
Conclusion: A combination of LEF and HCQ at clinically applicable concentrations additively inhibits immune activation, supporting a potential implementation of this drug combination in pSS treatment. PMID: 31192747 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Immunology)
Source: Expert Review of Clinical Immunology - June 15, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

An update on pathogenesis of psoriatic arthritis and potential therapeutic targets.
Authors: Chimenti MS, Triggianese P, De Martino E, Conigliaro P, Fonti GL, Sunzini F, Caso F, Perricone C, Costa L, Perricone R Abstract Introduction: Innate immune response and bone remodeling are key factors contributing to the pathogenesis of psoriatic arthritis (PsA). Moreover, the evidence of autoantibodies in patients' sera suggests an autoimmune side in PsA. Besides the immune pathways, studies strongly support the role of genetic risk alleles in affecting the clinical heterogeneity of PsA as well as the response to therapy. A good clinical response to treatment, indeed, represents a challenge in PsA patient...
Source: Expert Review of Clinical Immunology - June 12, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Therapeutic drug monitoring with biologic agents in immune mediated inflammatory diseases.
Authors: Papamichael K, Vogelzang E, Lambert J, Wolbink G, Cheifetz AS Abstract Introduction: Biologic therapy has revolutionized the treatment of immune mediated inflammatory diseases (IMID), such as inflammatory bowel disease (IBD), rheumatoid and psoriatic arthritis, ankylosing spondylitis and psoriasis. Nevertheless, some patients exhibit primary nonresponse (PNR) or secondary loss of response (SLR) to biologics. Areas covered: This collaborative review provides data on the role of therapeutic drug monitoring (TDM) in IMID for optimizing biologic therapy including infliximab, adalimumab, certolizumab pegol etan...
Source: Expert Review of Clinical Immunology - June 12, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Allergic reactions to penicillins and cephalosporins: diagnosis, assessment of cross-reactivity and management.
Authors: Blanca-Lopez N, Jimenez-Rodriguez TW, Somoza ML, Gomez E, Al-Ahmad M, Perez-Sala D, Blanca M Abstract Introduction: Beta-lactams (BL) are the main cause of allergic drug reactions mediated by specific immunological mechanisms. Reactions can be IgE or effector T-cell mediated. The new antigenic determinants are recognized by the immunological system in the context of the common beta-lactam structure or the specific differences in the side chains of the antibiotics of this family plus the protein carrier. Areas covered: We have reviewed the recent clinical literature concerning new clinical entities, the pro...
Source: Expert Review of Clinical Immunology - June 6, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Artificial intelligence and immunotherapy.
Authors: Jabbari P, Rezaei N PMID: 31157571 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Immunology)
Source: Expert Review of Clinical Immunology - June 5, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Regulatory T cells: the future of autoimmune disease treatment.
Authors: Ryba-Stanisławowska M, Sakowska J, Zieliński M, Ławrynowicz U, Trzonkowski P Abstract INTRODUCTION: CD4+ T regulatory cells (Tregs) have been described as the most potent immunosuppressive cells in the human body. They have been found to control autoimmunity, and clinical attempts have been made to apply them to treat autoimmune diseases. Some specific pathways utilized by Tregs in the regulation of immune response or Tregs directly as cellular products are tested in the clinic. Areas covered: Here, we present recent advances in the research on the biology and clinical applications of Tregs in the treat...
Source: Expert Review of Clinical Immunology - May 21, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Metabolic syndrome and systemic lupus erythematosus: the connection.
Authors: Mok CC Abstract INTRODUCTION: The metabolic syndrome (MetS) is now recognized as a chronic proinflammatory and prothrombotic state that aggravates insulin resistance, oxidative injury and cardiovascular risk. MetS is more prevalent in patients with systemic lupus erythematosus (SLE), a prototype of systemic autoimmune disease associated with premature atherosclerosis that cannot be accounted by traditional vascular risk factors alone. Dysregulation of the cytokines and adipokines is a common feature in both SLE and MetS, suggesting a complex relationship among autoimmunity, obesity, inflammation and athero...
Source: Expert Review of Clinical Immunology - May 17, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Total threshold cytotoxicity of therapeutic antibodies for selective destruction of pathogenic memory T cells: implications for immunotherapy of autoimmune and allergenic disorders.
Authors: Seledtsov VI, Seledtsova GV Abstract INTRODUCTION: Pathogenic memory CD4+ T cells are the mainspring of autoimmune and allergic disorders, suggesting that effective pathogenetic immunotherapy should be primarily directed onto their direct inactivation without affecting normal cells. Areas covered: A novel immunotherapeutic concept is proposed that applies suboptimal doses of several cytotoxic antibodies (Abs) against membrane antigens (Ags) (such as CD4, СD45RO, СD69, CD103, CD27, CD38, DR etc.) with a view to achieve a threshold density of immune complexes on pathogenic memory CD4+ T cells for their sel...
Source: Expert Review of Clinical Immunology - May 12, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Recent developments in drug hypersensitivity in children.
Authors: Kulhas Celik I, Dibek Misirlioglu E, Kocabas CN Abstract INTRODUCTION: Drug allergy is an important public health problem that causes 0.4-10.3% of hospital admissions in children. The epidemiology, clinical spectrum, diagnosis, and management of drug hypersensitivity reactions (DHRs) differ in pediatric and adult patients. However, the same algorithms used in adults have often been applied in the pediatric population due to a lack of evidence in the literature. Areas covered: In this review, we aimed to discuss recent developments in the area of pediatric DHRs based on the growing body of literature advanc...
Source: Expert Review of Clinical Immunology - May 10, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Immune reconstitution following hematopoietic stem cell transplantation using different stem cell sources.
Authors: Elfeky R, Lazareva A, Qasim W, Veys P Abstract INTRODUCTION: Adequate immune reconstitution post-HSCT is crucial for the success of transplantation, and can be affected by both patient- and transplant-related factors. Areas covered: A systematic literature search in PubMed, Scopus, and abstracts of international congresses is performed to investigate immune recovery posttransplant. In this review, we discuss the pattern of immune recovery in the post-transplant period focusing on the impact of stem cell source (bone marrow, peripheral blood stem cells, and cord blood) on immune recovery and HSCT outcome. W...
Source: Expert Review of Clinical Immunology - May 10, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Pathophysiology of systemic sclerosis: current understanding and new insights.
Authors: Cutolo M, Soldano S, Smith V Abstract INTRODUCTION: Systemic sclerosis (SSc) is a complex autoimmune connective tissue disease characterized by chronic and progressive tissue and organ fibrosis with broad patient-to-patient variability. Some risk factors are known and include combination of persistent Raynaud's phenomenon, steroid hormone imbalance, selected chemicals, thermal or other injuries. Endogenous and/or exogenous environmental trigger/risk factors promote epigenetic mechanisms in genetically primed subjects. Disease pathogenesis presents early microvascular changes with endothelial cell dysfuncti...
Source: Expert Review of Clinical Immunology - May 4, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Sex and autoimmunity: proposed mechanisms of disease onset and severity.
Authors: Selmi C, Gershwin ME Abstract INTRODUCTION: Chronic autoimmune diseases affect 5-10% of the population worldwide and are largely predominant in women. Sex hormone changes have been widely investigated based on changes in the clinical phenotypes observed during pregnancy and menopause. It is known that females with autoimmune diseases manifest a higher rate of circulating leukocytes with a single X chromosome, and there have been several reports on the role of X chromosome gene dosage through inactivation or duplication in autoimmunity. However, it is also important not to overlook men with autoimmune disea...
Source: Expert Review of Clinical Immunology - April 30, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Tofacitinib for the treatment of rheumatoid arthritis: an update.
Authors: Yamaoka K Abstract INTRODUCTION: Tofacitinib selectively inhibits the Janus kinases, intracellular tyrosine kinases that are activated by cytokines involved in the pathophysiology of rheumatoid arthritis. Areas covered: Clinical trials of tofacitinib have revealed an anti-rheumatic effect of monotherapy and combination therapy with methotrexate (MTX). Post-hoc analysis of those clinical trials and real-world experiences will be reviewed to explore tofacitinib's efficacy and safety. Expert commentary: The efficacy of tofacitinib monotherapy has garnered much attention and has been initiated in a fairly larg...
Source: Expert Review of Clinical Immunology - April 20, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Novel understanding of high mobility group box-1 in the immunopathogenesis of incisional hernias.
Authors: Larsen NK, Reilly MJ, Thankam FG, Fitzgibbons RJ, Agrawal DK Abstract INTRODUCTION: Incisional hernias (IH) arise as a complication of patients undergoing a laparotomy. Current literature has assessed the role of extracellular matrix (ECM) disorganization, alterations in type I and type III collagen, matrix metalloproteinases, and tissue inhibitors of metalloproteases on IH. However, there is limited information on the underlying molecular mechanisms that lead to ECM disorganization. Areas covered: We critically reviewed the literature surrounding IH and ECM disorganization and offer a novel pathway that m...
Source: Expert Review of Clinical Immunology - April 17, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Baricitinib for the treatment of rheumatoid arthritis and systemic lupus erythematosus: a 2019 update.
Authors: Kubo S, Nakayamada S, Tanaka Y Abstract INTRODUCTION: JAK, which constitutively binds to some cytokine receptors, plays an important role in cytokine signaling. While JAK is comprised of JAK1, JAK2, JAK3, and Tyk2, more than 40 types of cytokines transmit signals through JAK. Baricitinib is reported to be highly effective in the treatment of rheumatoid arthritis (RA) and is the second drug launched as a JAK inhibitor for RA. Area covered: We provide an overview of the mechanisms of action of baricitinib and its clinical implications in RA and other autoimmune diseases based on recent reports. This review o...
Source: Expert Review of Clinical Immunology - April 17, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Cannabis allergy: what the clinician needs to know in 2019.
Authors: Decuyper II, Rihs HP, Van Gasse AL, Elst J, De Puysseleyr L, Faber MA, Mertens C, Hagendorens MM, Sabato V, Bridts C, De Clerck L, Ebo DG Abstract INTRODUCTION: Although the use of cannabis dates back millennia, the first description of cannabis allergy is relatively recent (1971). Recent large-scale data show that cannabis allergy can manifest severe and generalized symptoms with extensive cross-reactions. Thus, it is essential to become familiarized with its clinical presentation, diagnostic aids, and adequate therapeutic guidance. Areas covered: Here we provide a hands-on overview on cannabis allergy fo...
Source: Expert Review of Clinical Immunology - April 6, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Clinical outcomes and predictors of maternal and fetal complications in pregnancies of patients with systemic lupus erythematosus.
Authors: Larosa M, Del Ross T, Calligaro A, Favaro M, Zanatta E, Iaccarino L, Doria A Abstract INTRODUCTION: Systemic Lupus Erythematosus (SLE) mostly affects women during their childbearing years. Fertility is preserved in SLE patients, but pregnancy is often characterized by a high number of maternal and fetal complications. Adverse pregnancy outcomes (APO) have been widely studied over the last decades and several investigators have focused on the potential clinical and serological predictors of maternal and fetal complications. Areas covered: In this review we analyzed maternal and fetal complications in SLE pa...
Source: Expert Review of Clinical Immunology - April 3, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Epithelial physical barrier defects in chronic rhinosinusitis.
Authors: Jiao J, Wang C, Zhang L Abstract INTRODUCTION: Chronic rhinosinusitis (CRS) is a common upper airway disease with a prevalence of greater than 10% of the general population. Although the pathogenesis of CRS remains poorly understood, there is growing evidence indicating that epithelial physical barrier defects play an important role in CRS pathogenesis. Areas covered: Epithelial physical barriers are maintained by various intercellular junctions, especially tight junctions (TJs). Recent studies suggest that the expression of TJ molecules and epithelial barrier function in human nasal epithelium are modulat...
Source: Expert Review of Clinical Immunology - March 31, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Guselkumab for the treatment of adults with moderate to severe plaque psoriasis.
Authors: Puig L Abstract INTRODUCTION: IL-23 is the key regulatory cytokine of T17-mediated inflammation in psoriasis. Guselkumab is a subcutaneously administered monoclonal antibody that targets the p19 cytokine subunit in IL-23 and has been approved by the US Food and Drug Administration and the European Medicines Agency for the treatment of moderate-to-severe psoriasis in adult patients. Areas covered: This review outlines the pharmacologic properties, efficacy and safety of guselkumab for the treatment of moderate-to-severe plaque psoriasis in adults. A literature review was performed by searching PubMed. Exper...
Source: Expert Review of Clinical Immunology - March 30, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Mediterranean fever gene variants and colchicine therapy in periodic fever, aphthous stomatitis pharyngitis, adenitis syndrome in a Mediterranean region.
Authors: Haytoglu Z, Gundeslioglu OO Abstract OBJECTIVES: Periodic fever, aphthous stomatitis, pharyngitis, adenitis syndrome is characterized by recurrent episodes of fever. Attenuated disease severity was considered in patients with Mediterranean fever (MEFV) gene variations. Corticosteroids are highly effective in controlling the symptoms but usually cause more frequent episodes. Frequent fever episodes either initiated after the steroid therapy or as an initial disease characteristics are the most challenging feature. METHODS: Sixty-seven patients were prospectively followed from September 2015 to January 2...
Source: Expert Review of Clinical Immunology - March 21, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

The long-awaited "pseudo-DFS pattern".
The long-awaited "pseudo-DFS pattern". Expert Rev Clin Immunol. 2019 Mar 17;: Authors: Infantino M, Bizzaro N, Grossi V, Manfredi M PMID: 30879347 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Immunology)
Source: Expert Review of Clinical Immunology - March 20, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Implications for redefining the dense fine speckled and related indirect immunofluorescence patterns.
Authors: Mahler M, Andrade LE, Casiano CA, Malyavantham K, Fritzler MJ PMID: 30880500 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Immunology)
Source: Expert Review of Clinical Immunology - March 20, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Recent advances in our understanding of mast cell activation - or should it be mast cell mediator disorders?
Authors: Theoharides TC, Tsilioni I, Ren H Abstract INTRODUCTION: An increasing number of patients present with multiple symptoms affecting many organs including the brain due to multiple mediators released by mast cells. These unique tissue immune cells are critical for allergic reactions triggered by IgE, but are also stimulated (not activated) by immune, drug, environmental, food, infectious, and stress triggers, leading to secretion of multiple mediators often without histamine and tryptase. The presentation, diagnosis and management of the spectrum of mast cell disorders is very confusing. As a result, special...
Source: Expert Review of Clinical Immunology - March 20, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Prediction of treatment outcome and relapse in inflammatory bowel disease.
Authors: Kato J, Yoshida T, Hiraoka S Abstract INTRODUCTION: Prediction of treatment outcome and clinical relapse in patients with inflammatory bowel disease (IBD), either ulcerative colitis (UC) or Crohn's disease (CD), is particularly important because therapeutics for IBD are not always effective and patients in remission could frequently relapse. Because undergoing endoscopy for the purpose is sometimes invasive and burdensome to patients, the performance of surrogate biomarkers has been investigated. Areas covered: We particularly featured the performance of patient symptoms, blood markers including C-reactive...
Source: Expert Review of Clinical Immunology - March 17, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

The role of IL-17 in systemic lupus erythematosus and its potential as a therapeutic target.
Authors: Koga T, Ichinose K, Kawakami A, Tsokos GC Abstract INTRODUCTION: Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by autoantibodies production and immune complex deposition with systemic clinical manifestations. Interleukin (IL)-17-producing cells play a crucial role in disease pathogenesis and represent an attractive therapeutic target. Areas covered: This review provides an update on the possibility of targeting IL-17 in SLE. The rational for this approach as well as currently available and future targets are discussed. Expert opinion: Although human expression studies and animal...
Source: Expert Review of Clinical Immunology - March 17, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Predicting uveitis in juvenile idiopathic arthritis: from biomarkers to clinical practice.
Authors: Haasnoot AJW, Kuiper JJW, de Boer JH Abstract INTRODUCTION: Uveitis is a sight-threatening eye inflammation and common manifestation of juvenile idiopathic arthritis (JIA). New biomarkers that can predict uveitis are needed to alleviate personalized clinical screening. In this review, we outline clinical and molecular risk factors for uveitis and discuss their putative biology and value for clinical practice. Areas covered: The recent discovery of the YST-amino acid motif in the Human Leukocyte Antigen DRB1 gene exposed a strong genetic predisposition for uveitis in females and can be used to identify low-...
Source: Expert Review of Clinical Immunology - March 17, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Epicutaneous peanut patch device for the treatment of peanut allergy.
Authors: Langlois A, Graham F, Bégin P Abstract INTRODUCTION: Food allergy prevalence has increased in recent decades, which has mobilized efforts to develop treatment alternatives. Epicutaneous immunotherapy (EPIT) is a novel method that involves transdermal administration of peanut allergen with the objective to induce tolerance. Recent clinical trials have shown its efficacy at increasing the eliciting dose in children with a favorable safety profile. Areas covered: This review covers the proposed mechanism of action of EPIT in murine models and humans, efficacy and safety data from clinical trials with p...
Source: Expert Review of Clinical Immunology - March 14, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Avatrombopag for the treatment of immune thrombocytopenia.
Authors: Długosz-Danecka M, Zdziarska J, Jurczak W Abstract INTRODUCTION: Thrombopoietin-receptor agonists (TPO-RAs) are the only American Society of Hematology (ASH) guideline-advocated, second-line treatment for immune thrombocytopenia (ITP) that have been validated by randomized, controlled trials with a placebo comparator. Avatrombopag is a new candidate in this class that has been investigated as a treatment option for the treatment of ITP. Areas covered: In this Drug Profile, we provide a review of the clinical data of avatrombopag, which was approved in May 2018 by the Unites States Food and Drug Administra...
Source: Expert Review of Clinical Immunology - February 27, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

The molecular immunology of human susceptibility to fungal diseases: lessons from single gene defects of immunity.
Authors: Vinh DC Abstract INTRODUCTION: Fungal diseases are a threat to human health. Therapies targeting the fungus continue to lead to disappointing results. Strategies targeting the host response represent unexplored opportunities for innovative treatments. To do so rationally requires the identification and neat delineation of critical mechanistic pathways that underpin human antifungal immunity. The study of humans with single-gene defects of the immune system, i.e. inborn errors of immunity (IEIs), provides a foundation for these paragdims. Areas covered: A systematic literature search in PubMed, Scopus, and ...
Source: Expert Review of Clinical Immunology - February 20, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Short- and long-term real-world effectiveness of omalizumab in severe allergic asthma: systematic review of 42 studies published 2008-2018.
Authors: MacDonald KM, Kavati A, Ortiz B, Alhossan A, Lee CS, Abraham I Abstract INTRODUCTION: Omalizumab is a recombinant monoclonal anti-IgE antibody approved in the US as add-on treatment in moderate-to-severe allergic asthma (in severe allergic asthma [SAA] in Europe). A 2016 review of 24 real-world effectiveness studies in SAA published between 2008-2015 concluded that omalizumab was associated with significant improvements in objective and subjective outcomes with benefits extending beyond 2 years. Several new real-world studies have been published since, bringing the total to 42 studies. Areas covered: ...
Source: Expert Review of Clinical Immunology - February 15, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

The importance of early peanut ingestion in the prevention of peanut allergy.
This article describes the evolution of peanut introduction guidelines in infants in the US, as shaped by key research over the last 20-30 years and culminates in the landmark LEAP study It also compares and contrasts current iterations of peanut introduction guidelines in infants globally. Finally, the early successes and barriers of implementation of early peanut introduction guidelines are discussed. We included literature from original articles, reviews, and consensus guidelines found in database searches through December 2018. Expert opinion: LEAP guideline implementation has proven to be successful, in the study sett...
Source: Expert Review of Clinical Immunology - February 15, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Limits of traditional evidence-based medicine methodologies exemplified by the novel era in psoriatic arthritis drug development.
Authors: Leijten EF, Radstake TR, McInnes IB, Jacobs JW PMID: 30729823 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Immunology)
Source: Expert Review of Clinical Immunology - February 10, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Abatacept for the treatment of rheumatoid arthritis.
Authors: Pombo-Suarez M, Gomez-Reino JJ Abstract INTRODUCTION: Rheumatoid arthritis (RA) is a complex disease in which different mechanisms are involved. Studies suggest a key role for aberrant pathways of T-cell activation in the initiation and perpetuation of disease. Abatacept is a fusion protein composed of the Fc region of the immunoglobulin G1 (IgG1) fused to the extracellular domain of cytotoxic T lymphocyte-associated antigen (CTLA4). It has the ability to modulate T-cell activation by interfering with co-stimulation of these cells, a necessary step to become activated. This suggests that abatacept may play...
Source: Expert Review of Clinical Immunology - February 10, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Screening children for eosinophilic esophagitis: allergic and other risk factors.
Authors: Ruffner MA, Capucilli P, Hill DA, Spergel JM PMID: 30722709 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Immunology)
Source: Expert Review of Clinical Immunology - February 8, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

B-cell depleting immunotherapies: therapeutic opportunities and toxicities.
Authors: Del Bufalo F, Merli P, Alessi I, Locatelli F Abstract INTRODUCTION: The last few years have witnessed what can certainly be defined as a "period of renaissance" for immunotherapy in the field of hematological malignancies. In particular, antibody-mediated and cell-mediated immunotherapy have significantly changed the treatment approach of patients with B-cell lymphoproliferative disorders. These therapies, initially employed in patients with refractory/relapsed disease, are now integrated in the treatment of newly diagnosed patients. Together with the therapeutic success, we have also learnt that...
Source: Expert Review of Clinical Immunology - January 28, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

CD40 ligand deficiency: treatment strategies and novel therapeutic perspectives.
Authors: França TT, Barreiros LA, Al-Ramadi BK, Ochs HD, Cabral-Marques O, Condino-Neto A Abstract INTRODUCTION: CD40 ligand (CD40L) deficiency or X-linked Hyper-IgM syndrome is a severe primary immunodeficiency caused by mutations in the CD40L gene. Despite current available treatments, CD40L-deficient patients remain susceptible to life-threatening infections and have poor long term survival. Areas covered: Here, we discuss clinical and immunological characteristics of CD40L deficiency as well as current therapeutic strategies used for patient management. This review highlights that beyond B cell defects, ...
Source: Expert Review of Clinical Immunology - January 28, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Measuring and Managing Appearance Anxiety in Patients with Systemic Sclerosis.
Authors: Gholizadeh S, Meier A, Malcarne VL Abstract INTRODUCTION: Systemic sclerosis (SSc, scleroderma) is a progressive, autoimmune, connective tissue disease of unknown etiology that can cause changes in appearance in socially important areas of the body (e.g., face and hands). Social concerns related to changes in appearance can contribute to anxiety specific to situations where one's appearance will be evaluated, or appearance anxiety. Appearance anxiety is a relevant but underexplored construct in SSc. Areas Covered: We review the current knowledge on appearance anxiety in SSc, including assessment of the con...
Source: Expert Review of Clinical Immunology - January 28, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Diagnosing autoimmune encephalitis based on clinical features and autoantibody findings.
This article suggests how to make valid diagnoses. They should consist of three elements: the clinical syndrome, the associated antibody and the presumed cause or predisposition. Recently, an international consortium published formal clinical criteria for autoimmune encephalitides to enable diagnoses even if antibody testing is not (immediately) available and to prevent overinterpretation of questionable antibody results. Antibody testing has greatly benefitted from the introduction of cell-based assays for the demonstration of antibodies against surface antigens. Paraneoplastic or post-infectious situations, side effects ...
Source: Expert Review of Clinical Immunology - January 26, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Belatacept in kidney transplantation and its limitations.
Authors: Noble J, Jouve T, Janbon B, Rostaing L, Malvezzi P Abstract INTRODUCTION: Since the approval of belatacept in 2011 for use in the setting of de novo kidney transplantation, this CD80/86 - CD28 co-stimulation blocker has been shown to be a valuable treatment option for maintenance immunosuppression. Areas covered: In this setting, belatacept has been associated with superior glomerular filtration rate as compared to calcineurin inhibitor-based treatments because of the absence of nephrotoxicity. Additionally, belatacept avoids the cardiovascular side effects (e.g., hypertension and dyslipidemia) caused by a...
Source: Expert Review of Clinical Immunology - January 26, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Pain and affective distress in arthritis: relationship to immunity and inflammation.
Authors: Harth M, Nielson WR Abstract INTRODUCTION: Most arthritides are associated with pain and psychological distress (clinically significant depression and anxiety). Pain and depression are mutually exacerbating; both may continue even when joint involvement appears well controlled. Area covered: There is strong evidence that arthritis-related stress impacts the central nervous system and, together with peripheral inflammatory changes, can cause central sensitization that can lead to chronic pain and worsening of affective distress. Cytokines and chemokines participate both in joint inflammation and in central ...
Source: Expert Review of Clinical Immunology - January 25, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

B cells and Atherosclerosis in Systemic Lupus Erythematosus.
This article focuses on the contribution of B cells and of several autoantibodies in the pathogenesis of atherosclerosis in both general and lupus populations. Review of the published literature on experimental models has also been performed. Expert opinion: Distinct B cell subsets seem to exhibit separate effects on the progression of atherosclerosis, with B2 B cells displaying a mainly atherogenic phenotype, while B1 B cells are mostly viewed as atheroprotective. Selective B2 inhibition by anti-B cell therapies seems a promising therapeutic strategy against atherosclerosis development in the setting of lupus. PMID: 3...
Source: Expert Review of Clinical Immunology - January 19, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Canakinumab for the treatment of hyperimmunoglobulin D syndrome.
Authors: Sánchez-Manubens J, Iglesias E, Anton J Abstract INTRODUCTION: Mevalonate Kinase Deficiency (MKD) is a rare monogenic autoinflammatory disorder (AID) with autosomal recessive inheritance caused by mutations in the MVK gene. It includes hyperimmunoglobulinemia D syndrome (HIDS) and mevalonic aciduria (a severe form). Patients have recurrent inflammatory attacks with high fever, gastrointestinal symptoms, lymphadenopathy, splenomegaly, arthralgia, rash, pharyngitis, aphtosis and constitutional complaints. Heightened understanding of molecular mechanisms in monogenic autoinflammatory disorders has prov...
Source: Expert Review of Clinical Immunology - January 19, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Epidemiology, characterization and diagnosis of neuropsychiatric events in systemic lupus erythematosus.
Authors: de Amorim JC, Frittoli RB, Pereira D, Postal M, Dertkigil SSJ, Reis F, Costallat LT, Appenzeller S Abstract INTRODUCTION: Neuropsychiatric systemic lupus erythematosus (NPSLE) is characterized by a heterogeneity of clinical manifestations. The absence of diagnostic criteria and the lack of clinical trials is a challenge in clinical practice. Areas covered: A literature review was performed to describe epidemiology, characterization (clinical, immunological and imaging), diagnosis and treatment of NPSLE. Classification criteria have been the first step towards a uniform definition. More recently, different ...
Source: Expert Review of Clinical Immunology - January 12, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Clinically-useful serum biomarkers for diagnosis and prognosis of sarcoidosis.
Authors: Ramos-Casals M, Retamozo S, Sisó-Almirall A, Pérez-Alvarez R, Pallarés L, Brito-Zerón P Abstract INTRODUCTION: Sarcoidosis is a complex systemic disease with a silent, long-term evolution, and a heterogeneous clinical presentation. The diagnostic approach is complex with no single diagnostic test that may confirm the disease. Areas Covered: A large list of serum biomarkers has been tested during the last 40 years. In this review, we analyse the potential usefulness in the diagnosis and prognosis of sarcoidosis of serum biomarkers classified according to their corresponding cellu...
Source: Expert Review of Clinical Immunology - January 12, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Anti-DFS70 antibodies: an update on our current understanding and their clinical usefulness.
Authors: Mahler M, Andrade LE, Casiano CA, Malyavantham K, Fritzler MJ Abstract INTRODUCTION: Anti-DFS70 antibodies and their clinical associations remain an immunological paradox. Unlike other antinuclear antibodies (ANA), there is a growing body of evidence that anti-DFS70 antibodies, when present in high titres and in isolation (without accompanying other antibodies), are useful to aid in the exclusion of ANA associated rheumatic diseases. Areas covered: This review aims to analyse and interpret the current published knowledge and recent findings to provide guidance in the use of anti-DFS70 antibodies to analyse...
Source: Expert Review of Clinical Immunology - January 11, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Management of pregnant women with antiphospholipid antibodies.
Authors: Ruffatti A, Favaro M, Calligaro A, Zambon A, Del Ross T Abstract INTRODUCTION: Important advancements in pregnancy outcome have been reported in women with antiphospholipid antibodies (aPL), despite the fact that the treatment of aPL related pregnancy morbidity is not guided by consistent findings from well-designed trials. Areas covered: The current study draws a picture of the studies in the literature by performing a Medline search of relevant English language articles and reports our experience in managing different subsets of obstetric antiphospholipid syndrome (APS), defined on the basis of their cli...
Source: Expert Review of Clinical Immunology - January 9, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Exercise-induced anaphylaxis: causes, consequences and management recommendations.
Authors: Christensen MJ, Eller E, Kjaer HF, Broesby-Olsen S, Mortz CG, Bindslev-Jensen C Abstract INTRODUCTION: Exercise induced anaphylaxis (EIA) denotes a range of disorders where anaphylaxis occurs in relation to physical exercise. Typical symptoms include flushing, pruritus, urticaria, angioedema, respiratory symptoms, gastro-intestinal symptoms, hypotension, and collapse during or after exercise. The far best described entity within EIA is food-dependent exercise-induced anaphylaxis (FDEIA), where symptoms only occur in combination with food intake. Frequency and predictability of symptoms vary, and some patie...
Source: Expert Review of Clinical Immunology - January 3, 2019 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

The Immunomodulatory Role of Interleukin-35 in Fibrotic Diseases.
Authors: Luo M, Peng H, Chen P, Zhou Y Abstract INTRODUCTION: Fibrosis makes numerous diseases in all organs more complicated and leads to severe consequences in the lung, liver, heart, kidney and skin. In essence, fibrosis results from excessive, persistent and oftentimes nonreversible aggregation of extracellular matrix (ECM) or simply as collagen during the process of tissue injury and repair. Recent studies suggest the pathology of fibrosis, especially in pulmonary and liver fibrosis, involves various types of immune cells and soluble mediators including interleukin (IL)-35, a recently identified heterodimeric ...
Source: Expert Review of Clinical Immunology - December 30, 2018 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

Topical agents for the treatment of atopic dermatitis.
Authors: Diaz A, Guttman-Yassky E Abstract INTRODUCTION: Atopic dermatitis (AD) is perhaps the most common inflammatory skin disorder worldwide, with an increasing incidence in developed countries. The mainstay treatment for patients with AD are topical therapies, which are used not only by the mild patients, but also by the moderate-to-severe patients, in conjunction with systemic treatment. While topical steroids and calcineurin antagonists are widely used, these are associated with long-term cutaneous adverse effects (AEs) or a black box warning, preventing their chronic use. Areas covered: The aim of this revie...
Source: Expert Review of Clinical Immunology - December 29, 2018 Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research