Vaccines in Patients with Primary Immune Deficiency
Evaluation of antibodies produced after immunization is central to immune deficiency diagnosis. This includes assessment of responses to routine immunizations as well as to vaccines administered specifically for diagnosis. Here, we present the basic concepts of the humoral immune response and their relevance for vaccine composition and diagnosis of immune deficiency. Current vaccines are discussed, including nonviable protein and glycoprotein vaccines, pure polysaccharide vaccines, polysaccharide –protein conjugate vaccines, and live agent vaccines. Diagnostic and therapeutic applications of vaccine antibody measurem...
Source: Immunology and Allergy Clinics of North America - July 10, 2020 Category: Allergy & Immunology Authors: Francisco A. Bonilla Source Type: research

Asplenia and Hyposplenism
The number of disorders associated with congenital or acquired asplenia and functional hyposplenism has increased substantially over the past couple decades. Previously, screening for asplenia and hyposplenism was a barrier to identifying patients at risk. Recent methods for measuring splenic function have emerged as accurate and reliable. Identifying patients prevents overwhelming postsplenectomy infection or invasive pneumococcal disease. Approaches to protect patients with asplenia or hyposplenism include patient education of risks and signs/symptoms of infection, vaccination, and antibiotic prophylaxis. Physicians have...
Source: Immunology and Allergy Clinics of North America - July 10, 2020 Category: Allergy & Immunology Authors: Jacqueline D. Squire, Mandel Sher Source Type: research

Precision Therapy for the Treatment of Primary Immunodysregulatory Diseases
This article reviews targeted precision-based therapy for treatment of cytotoxic T-lymphocyte antigen haploinsufficiency, lipopolysaccharide-responsive beige-like anchor deficiency, activated PI3K defic iency syndrome, signal transducer and activator of transcription– 1 and -3 – gain-of-function disorders, and disorders of inflammasome activation. (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - July 10, 2020 Category: Allergy & Immunology Authors: Deepak Chellapandian, Maria Chitty-Lopez, Jennifer W. Leiding Source Type: research

IKAROS Family Zinc Finger 1 ‚ÄďAssociated Diseases in Primary Immunodeficiency Patients
Ikaros zinc finger 1 (IKZF1 or Ikaros) is a hematopoietic zinc finger DNA-binding transcription factor that acts as a critical regulator of lymphocyte and myeloid differentiation. Loss-of-function germline heterozygous mutations in IKZF1 affecting DNA-binding were described as causative of 2 distinct primary immunodeficiency (PID)/inborn error of immunity diseases. Mutations acting by haploinsufficiency present with a common variable immune deficiency-like phenotype mainly characterized by increased susceptibility to infections. Mutations acting in a dominant negative fashion present with a combined immunodeficiency phenot...
Source: Immunology and Allergy Clinics of North America - July 10, 2020 Category: Allergy & Immunology Authors: Cristiane J. Nunes-Santos, Hye Sun Kuehn, Sergio D. Rosenzweig Source Type: research

Immunodeficiencies
Immunol Allergy Clin N Am (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - July 10, 2020 Category: Allergy & Immunology Authors: Mark Ballow, Elena E. Perez Source Type: research

Copyright
ELSEVIER (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - July 10, 2020 Category: Allergy & Immunology Source Type: research

Contributors
LINDA S. COX, MD, FACP, AAAAI (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - July 10, 2020 Category: Allergy & Immunology Source Type: research

Contents
Mark Ballow and Elena E. Perez (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - July 10, 2020 Category: Allergy & Immunology Source Type: research

Immunology and Allergy Clinics of North America
Biologics for the Treatments of Allergic Conditions (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - July 10, 2020 Category: Allergy & Immunology Source Type: research

Chronic Lung Disease in Primary Antibody Deficiency
Chronic lung disease is a complication of primary antibody deficiency (PAD) associated with significant morbidity and mortality. Manifestations of lung disease in PAD are numerous. Thoughtful application of diagnostic approaches is imperative to accurately identify the form of disease. Much of the treatment used is adapted from immunocompetent populations. Recent genomic and translational medicine advances have led to specific treatments. As chronic lung disease has continued to affect patients with PAD, we hope that continued advancements in our understanding of pulmonary pathology will ultimately lead to effective method...
Source: Immunology and Allergy Clinics of North America - June 9, 2020 Category: Allergy & Immunology Authors: Paul J. Maglione Source Type: research

Diagnosis and management of Specific Antibody Deficiency
Specific antibody deficiency is a primary immunodeficiency disease recognized by the International Union of Immunology Societies and defined by recurrent respiratory infections with normal immunoglobulins, but diminished antibody responses to polysaccharide antigens after vaccination with the 23 valent pneumococcal polysaccharide vaccine. Clinical immunologists struggle with diagnosis and treatment, because the definition of an adequate response to immunization remains controversial. Specific antibody deficiency is managed clinically with close follow-up and prompt treatment of infections, antibiotic prophylaxis, or immune...
Source: Immunology and Allergy Clinics of North America - June 9, 2020 Category: Allergy & Immunology Authors: Elena E. Perez, Mark Ballow Source Type: research

Nuts and Bolts of Subcutaneous Therapy
This article summarizes the dosing, administration, and adverse event management of SCIG infusions. (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - June 9, 2020 Category: Allergy & Immunology Authors: Carla Duff, Mark Ballow Source Type: research

Defining Common Variable Immunodeficiency Disorders in 2020
Common variable immunodeficiency disorders (CVID) are the most frequent symptomatic primary immune deficiency in adults. Because there is no known cause for these conditions, there is no single clinical feature or laboratory test that can confirm the diagnosis with certainty. If a causative mutation is identified, patients are deemed to have a CVID-like disorder caused by a specific primary immunodeficiency/inborn error of immunity. In the remaining patients, the explanation for these disorders remains unclear. The understanding of CVID continues to evolve and the authors review recent studies, which have addressed some of...
Source: Immunology and Allergy Clinics of North America - June 7, 2020 Category: Allergy & Immunology Authors: Rohan Ameratunga, Caroline Allan, See-Tarn Woon Source Type: research

The Importance of Primary Immune Deficiency Registries
The importance of registries is vital for almost every human disease but crucial for rare disorders, where the centralized collection, organization, and quality check of data create a platform from where multiple analyses and scientific advances are possible. In this article, the authors review the creation of the United States Immunodeficiency Network registry, its role, and the numerous scientific achievements generated from the collective effort of many. (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - June 7, 2020 Category: Allergy & Immunology Authors: Joao Pedro Lopes, Charlotte Cunningham-Rundles Source Type: research

Hemophagocytic Lymphohistiocytosis
Hemophagocytic lymphohistiocytosis (HLH) is a rare but severe form of immune dysregulation often presenting as unremitting fever, cytopenia, hepatosplenomegaly, coagulopathy, and elevation of typical HLH biomarkers. HLH is universally fatal, if left untreated. The HLH-2004 criteria are widely used to diagnose this condition, but there is growing concerns across different settings that its application may result in undertreatment of certain patients. There is an expanding spectrum of genetic conditions that can be complicated by HLH. This review summarizes the current concepts in HLH, the lessons learned from the past, and ...
Source: Immunology and Allergy Clinics of North America - June 7, 2020 Category: Allergy & Immunology Authors: Deepak Chellapandian Source Type: research

Primary Immune Deficiencies: Update on an Evolving Clinical Discipline
Every 2 years starting in the 1970s, the International Union of Immunological Societies publishes a list of human inborn errors of immunodeficiency and autoinflammatory disorders. The latest publication in January 2020 lists 416 inborn errors of immunity, including 64 gene defects identified in just the past 2 years since the previous update. The advances in molecular biology, especially next-generation sequencing, have contributed greatly to the rapid identification of novel gene defects. These advances have contributed greatly to our understanding of the immune system, and to a better understanding of the cellular, molec...
Source: Immunology and Allergy Clinics of North America - June 7, 2020 Category: Allergy & Immunology Authors: Mark Ballow, Elena E. Perez Tags: Preface Source Type: research

Rhinosinusitis
IMMUNOLOGY AND ALLERGY CLINICS OF NORTH AMERICA (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - April 9, 2020 Category: Allergy & Immunology Authors: Sandra Y. Lin Source Type: research

Copyright
ELSEVIER (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - April 9, 2020 Category: Allergy & Immunology Source Type: research

Contributors
LINDA S. COX, MD, FACP, AAAAI (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - April 9, 2020 Category: Allergy & Immunology Source Type: research

Contents
Linda S. Cox (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - April 9, 2020 Category: Allergy & Immunology Source Type: research

Forthcoming Issues
Immunodeficiencies (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - April 9, 2020 Category: Allergy & Immunology Source Type: research

Rhinosinusitis Diagnosis and Management: The Hoops and Hurdles
In my nearly 3 decades of clinical practice as an allergist/immunologist, I can think of no other condition more difficult and frustrating than chronic rhinosinusitis (CRS). Most of my CRS patients were refractory to treatment. At times, in frustration, I would “throw the kitchen sink at them” (ie, oral corticosteroids, topical and oral antibiotics, topical antifungal agents) to try to improve their quality of life. There are several reasons CRS diagnosis and management are so challenging. CRS is a complex, heterogeneous disease with several subgroups (also known as endotypes), which are defined by biomarkers t...
Source: Immunology and Allergy Clinics of North America - February 26, 2020 Category: Allergy & Immunology Authors: Linda S. Cox Tags: Foreword Source Type: research

What is the Role of Air Pollution in Chronic Rhinosinusitis?
Chronic rhinosinusitis (CRS) is a heterogeneous inflammatory disorder, and several environmental factors may be contributing to disease pathophysiology, including air pollutants. Tobacco smoke and occupational exposures also have been associated with CRS, and environmental exposures may contribute to the variability seen in disease endotype. Animal models that investigate the potential of air pollutants to induce chronic inflammation provide further insight into plausible triggers and modifiers of disease, including contributions to barrier disruption, alterations in the microbiome, and immune dysfunction. Additional studi...
Source: Immunology and Allergy Clinics of North America - February 20, 2020 Category: Allergy & Immunology Authors: Hannah L. Schwarzbach, Leila J. Mady, Stella E. Lee Source Type: research

Chronic Rhinosinusitis: An Evolution of Knowledge
Chronic rhinosinusitis (CRS) is a common medical problem, frequently seen by those in primary care, allergy, and otolaryngology. Our understanding of chronic sinusitis is continuously evolving, with some recent substantial advancements in the knowledge of the pathophysiology of CRS and new treatment options. For example, there is a greater understanding of how the environment, through allergic rhinitis, air pollution, and the patient ’s own microbiome, may play a role in the development of CRS. The recognition of CRS as an inflammatory disease state has been further refined, but trying to define the disease in terms ...
Source: Immunology and Allergy Clinics of North America - February 18, 2020 Category: Allergy & Immunology Authors: Sandra Y. Lin Tags: Preface Source Type: research

Current Concepts in the Management of Allergic Fungal Rhinosinusitis
Allergic fungal rhinosinusitis (AFRS) represents a subtype of chronic rhinosinusitis with nasal polyposis that exhibits a unique, often striking clinical presentation. Since its initial description more than a quarter century ago, a more sophisticated understanding of the pathophysiology of AFRS has been achieved and significant advancements in improving clinical outcomes made. This review focuses on the latest developments involving the pathophysiology and clinical management of this fascinating disease. (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - January 29, 2020 Category: Allergy & Immunology Authors: Matthew A. Tyler, Amber U. Luong Source Type: research

Nasal Polyposis and Aspirin-Exacerbated Respiratory Disease
Aspirin-exacerbated respiratory disease (AERD) is characterized by eosinophilic chronic rhinosinusitis with nasal polyps, asthma, and upper-/lower-respiratory tract reactions to nonsteroidal antiinflammatory drugs. Persistent, severe disease, anosmia, and alcohol sensitivity is typical. AERD is mediated by multiple pathways, including aberrant arachidonic acid metabolism leading to elevated leukotriene E4 and decreased prostaglandin E2. Mast cell mediators (prostaglandin D2) and unique properties of eosinophils and type 2 innate lymphoid cells, along with receptor-mediated signaling, also contribute to AERD pathogenesis. P...
Source: Immunology and Allergy Clinics of North America - January 27, 2020 Category: Allergy & Immunology Authors: Kathleen Luskin, Hiral Thakrar, Andrew White Source Type: research

Measuring Success in the Treatment of Patients with Chronic Rhinosinusitis
Chronic rhinosinusitis (CRS) has a substantial impact on patients ’ quality of life (QOL). Among the many metrics available for measuring treatment success in CRS, patient-reported outcome measures that quantify changes in QOL are the most widely used methods. In addition, objective data from imaging, endoscopy, and olfactory testing are useful adjunct measures to diagnose and prevent progression of disease, although these metrics have mixed correlations with symptoms and QOL. In the future, molecular biology, and multiomics techniques may change how successful CRS treatment is defined. (Source: Immunology and Allerg...
Source: Immunology and Allergy Clinics of North America - January 22, 2020 Category: Allergy & Immunology Authors: Naweed Chowdhury, Timothy L. Smith, Daniel M. Beswick Source Type: research

Management of Sinusitis in the Cystic Fibrosis Patient
Chronic rhinosinusitis (CRS) is present in up to 100% of patients with cystic fibrosis (CF). CF-associated CRS is particularly recalcitrant, and sinus disease can have important implications in the health of the lower airways and overall quality of life in these patients. Both medical and surgical management play important roles in treating CF-associated CRS, but guidelines are lacking. This review summarizes the current literature on both medical and surgical management of this disease to provide an up-to-date analysis and recommendations on the treatment of CF-associated CRS. (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - January 22, 2020 Category: Allergy & Immunology Authors: Somtochi Okafor, Kathleen M. Kelly, Ashleigh A. Halderman Source Type: research

Odontogenic Sinusitis
Odontogenic sinusitis is a unique cause of sinus disease that deserves special consideration. An astute clinician can elicit historical findings such as recent dental work, and symptoms such as unilateral facial pain and foul drainage, despite a relatively benign oral cavity examination. Otolaryngologists and dental professionals who care for these patients must be able to interpret imaging studies for dental disorder such as periapical abscesses and periodontal disease. Treatment is frequently some combination of antibiotic therapy, dental procedures, and endoscopic sinus surgery. More prospective studies are needed to de...
Source: Immunology and Allergy Clinics of North America - January 22, 2020 Category: Allergy & Immunology Authors: Hillary A. Newsome, David M. Poetker Source Type: research

Topical Irrigations for Chronic Rhinosinusitis
As the understanding of the primary cause of chronic rhinosinusitis has shifted away from infection toward inflammation, topical corticosteroid sprays and saline irrigations have become mainstays of treatment. Topical corticosteroid irrigations are recommended particularly in the postoperative setting, but further research on their effect and possible hypothalamic-pituitary-adrenal axis suppression is needed. The popularity of topical antibiotics has subsequently waned with their use reserved for recalcitrant cases. Further research is needed on the effect of topical antifungals in allergic fungal rhinosinusitis. Topical a...
Source: Immunology and Allergy Clinics of North America - January 22, 2020 Category: Allergy & Immunology Authors: Victoria S. Lee Source Type: research

Primary Immunodeficiency and Rhinosinusitis
This article reviews primary immunodeficiencies contributing to chronic rhinosinusitis, including a proposed diagnostic work-up and the evidence for treatment in this unique population. (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - January 18, 2020 Category: Allergy & Immunology Authors: Camille Huwyler, Sandra Y. Lin, Jonathan Liang Source Type: research

The Role of Macrolides and Doxycycline in Chronic Rhinosinusitis
This article reviews the clinical applications for macrolide and doxycycline use in CRS, considerations for dosing and duration of treatment, and important side effects and drug interactions ass ociated with these medications. (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - January 18, 2020 Category: Allergy & Immunology Authors: Katherine A. Lees, Richard R. Orlandi, Gretchen Oakley, Jeremiah A. Alt Source Type: research

The Microbiome and Chronic Rhinosinusitis
Chronic rhinosinusitis (CRS) is persistent inflammation and/or infection of the nasal cavity and paranasal sinuses. Recent advancements in culture-independent molecular techniques have enhanced understanding of interactions between sinus microbiota and upper airway microenvironment. The dysbiosis hypothesis —alteration of microbiota associated with perturbation of the local ecological landscape—is suggested as a mechanism involved in CRS pathogenesis. This review discusses the complex role of the microbiota in health and in CRS and considerations in sinus microbiome investigation, dysbiosis of sinu s microbiota...
Source: Immunology and Allergy Clinics of North America - January 16, 2020 Category: Allergy & Immunology Authors: Do-Yeon Cho, Ryan C. Hunter, Vijay R. Ramakrishnan Source Type: research

Olfactory Dysfunction and Chronic Rhinosinusitis
Olfactory dysfunction (OD) is one of the cardinal symptoms of chronic rhinosinusitis (CRS), and its prevalence ranges from 60% to 80% in patients with CRS. It is much more common in CRS with nasal polyposis patients compared to CRS without nasal polyposis. Decreased olfactory function is associated with significant decreases in patient-reported quality of life (QOL), and notably, depression and the enjoyment of food. Objective measures can help detail the degree of OD, whereas subjective measures can help to determine in the impact on patient. There is variable treatment response to OD with both medical and surgical therap...
Source: Immunology and Allergy Clinics of North America - January 16, 2020 Category: Allergy & Immunology Authors: Omar G. Ahmed, Nicholas R. Rowan Source Type: research

Personalized Medicine in Chronic Rhinosinusitis
Chronic rhinosinusitis (CRS) is a heterogeneous disease process with a complex underlying cause. Improved understanding of CRS pathophysiology has facilitated new approaches to management of the patient with CRS that rely on targeting patient-specific characteristics and individual inflammatory pathways. A more personalized approach to care will ultimately incorporate a combination of phenotypic and endotypic classification systems to guide treatment. This review summarizes current evidence with respect to CRS phenotypes and endotypes, as well as the identification of potential biomarkers with potential to guide current an...
Source: Immunology and Allergy Clinics of North America - January 14, 2020 Category: Allergy & Immunology Authors: Ashley M. Bauer, Justin H. Turner Source Type: research

The Role of Allergic Rhinitis in Chronic Rhinosinusitis
This literature review collates and summarizes recent literature to explore the relationship between chronic rhinosinusitis (CRS) and allergy. The relationship between CRS and allergy is not fully understood. However, current evidence suggests a relationship between allergy and specific endotypes of CRS with nasal polyposis, including allergic fungal rhinosinusitis and central compartment atopic disease. Specific endotypes of CRS with nasal polyps seem to have an association with allergy. More evidence is necessary to better characterize this relationship. Level of evidence: 5. (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - January 14, 2020 Category: Allergy & Immunology Authors: Samuel N. Helman, Emily Barrow, Thomas Edwards, John M. DelGaudio, Joshua M. Levy, Sarah K. Wise Source Type: research

The Role of Biologics in the Treatment of Nasal Polyps
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heteromorphic disease with both medical and surgical aspects to its treatment. CRSwNP is a chronic inflammatory condition with exacerbations that can be controlled through surgical and/or medical interventions, including biological agents. The role of biological agents in the treatment of CRSwNP as well as the patient characteristics that make suitable candidates for biologics are discussed. (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - January 13, 2020 Category: Allergy & Immunology Authors: Christine B. Franzese Source Type: research

Subcutaneous Immunotherapy Safety
Subcutaneous immunotherapy (SCIT) is effective for allergic rhinitis and conjunctivitis, asthma, and insect venom hypersensitivity. The risk of severe allergic reactions induced by SCIT remains low, and mild systemic reactions have recently shown a tendency to decline. However, near-fatal and fatal anaphylactic reactions may occur. Clinicians administering allergen-specific immunotherapy should receive specialized training and be aware of risk factors and preventive measures to avoid severe allergic reactions induced by SCIT. (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - November 22, 2019 Category: Allergy & Immunology Authors: Mario S √°nchez-Borges, David I. Bernstein, Chris Calabria Source Type: research

The Cost-Effectiveness of Allergen Immunotherapy Compared with Pharmacotherapy for Treatment of Allergic Rhinitis and Asthma
This article evaluates the cost-effectiveness of allergy immunotherapy (AIT) in the treatment of allergic rhinitis, asthma, and other allergic conditions. An extensive search of the PubMed and Medline databases (up to December 2018) was conducted. There is strong evidence in the collective literature, which included individual studies and systematic reviews, that AIT is cost-effective in the management of allergic rhinitis and asthma as compared with standard drug treatment alone. The magnitude of AIT ’s cost-effectiveness is likely underestimated because most of the studies considered during-treatment costs and not ...
Source: Immunology and Allergy Clinics of North America - November 22, 2019 Category: Allergy & Immunology Authors: Linda S. Cox, Andrew Murphey, Cheryl Hankin Source Type: research

Novel Therapies for Treatment of Food Allergy
Food allergy prevalence has increased over the past 2  decades and is estimated to affect 8% of children and 4% to 10% of adults. There is an unmet need to evaluate new therapeutic modalities that may decrease the risk of food-induced anaphylaxis and improve patients’ quality of life. Oral, epicutaneous, and sublingual food immunotherapies have diff erent safety and efficacy profiles, and their long-term outcome and applicability are unclear. Food allergy trials are currently evaluating different biologics (given as monotherapy or adjunct to immunotherapy), modified food proteins, DNA vaccines, and fecal microbi...
Source: Immunology and Allergy Clinics of North America - November 22, 2019 Category: Allergy & Immunology Authors: Sultan Albuhairi, Rima Rachid Source Type: research

Sublingual and Patch Immunotherapy for Food Allergy
This article reviews research advances for sublingual and patch immunotherapy for food allergy with a focus on peanut allergy. Published studies on sublingual immunotherapy (SLIT) and epicutaneous immunotherapy (EPIT) were summarized in this review. Sublingual and epicutaneous methods have emerged as alternatives to oral immunotherapy. SLIT studies have shown modest desensitization with a robust safety profile. EPIT studies have high adherence rates, an excellent safety profile, and potential for desensitization in children. Advances in food immunotherapy with SLIT and EPIT studies have shown promise as viable alternatives...
Source: Immunology and Allergy Clinics of North America - November 22, 2019 Category: Allergy & Immunology Authors: Jamie Waldron, Edwin H. Kim Source Type: research

Risk Reduction in Peanut Immunotherapy
This article covers the epidemiology of unexpected allergic reactions to peanut, and outlines definitions of risk and risk reduction with quantitative risk assessment examples. Well-acknowledged future areas of research still exist, especially in the area of longer-term clinical trials or commercial data, which will strengthen the knowledge surrounding risk and potential options for risk reduction in those with peanut allergy. (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - November 22, 2019 Category: Allergy & Immunology Authors: Benjamin C. Remington, Joseph L. Baumert Source Type: research

Leaps and Bounds in Allergen Immunotherapy
It has been almost one hundred ten years since allergen immunotherapy (AIT) was first recognized as a treatment for allergic diseases by the English physicians, Noon and Freeman. However, it was applied thousands of years earlier. Snake handlers learned that if they swam in snake-infested waters, they would acquire immunity to the cobra ’s venom.1 This was likely the first use of oral immunotherapy (OIT) because the snake-infested waters contained venom, and the snake handlers swallowed it as they swam. (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - November 22, 2019 Category: Allergy & Immunology Authors: Linda S. Cox, Anna Nowak-Wegrzyn Tags: Preface Source Type: research

Allergy Immunotherapy: Are We Making Progress or Just Standing Still?
It has been over a century since Noon and Freeman began injecting allergic patients with allergens.1-4 Their rationale was based on the work of Edward Jenners, who had demonstrated that injecting cow pox conveyed immunity to smallpox. Surprisingly, Noon and Freeman were right. Not only did they “cure” many of their patients, they did not kill any of them. However, they did have to administer epinephrine a few times during “rapid desensitization.” Interesting, they realized early on that “leisurely inoculations” (ie, conventional buildup schedules) were inconvenient for the pati ents and ...
Source: Immunology and Allergy Clinics of North America - November 22, 2019 Category: Allergy & Immunology Authors: Linda S. Cox Tags: Foreword Source Type: research

Update on Immunotherapy for Aeroallergens, Foods, and Venoms
Immunology and allergy clinics of north america (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - November 22, 2019 Category: Allergy & Immunology Authors: Linda S. Cox, Anna Nowak-Wegrzyn Source Type: research

Copyright
ELSEVIER (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - November 22, 2019 Category: Allergy & Immunology Source Type: research

Contributors
LINDA S. COX, MD, FACP, AAAAI (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - November 22, 2019 Category: Allergy & Immunology Source Type: research

Contents
Linda S. Cox (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - November 22, 2019 Category: Allergy & Immunology Source Type: research

Forthcoming Issues
Rhinosinusitis (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - November 22, 2019 Category: Allergy & Immunology Source Type: research

Venom Immunotherapy
Questions and controversies regarding venom immunotherapy (VIT) remain. It is important to recognize risk factors for severe sting anaphylaxis that guide the recommendation for testing, epinephrine injectors, and VIT. Premedication, rush VIT, and omalizumab are successful in overcoming recurrent systemic reactions to VIT. A maintenance dose is adequate in children, but higher doses are needed in high-risk patients. The consensus on risk of β-blockers and angiotensin-converting enzyme inhibitors in patients on VIT has shifted to the belief that risk is small. The decision to stop VIT after 5 years rests on known r...
Source: Immunology and Allergy Clinics of North America - November 6, 2019 Category: Allergy & Immunology Authors: David B.K. Golden Source Type: research