Immunology and Allergy Clinics of North America This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Management of Advanced Systemic Mastocytosis and Associated Myeloid Neoplasms
Advanced systemic mastocytosis (AdvSM) is a heterogeneous group of disorders characterized by neoplastic mast cell-related organ damage and frequently associated with a myeloid neoplasm. The 3 clinical entities that comprise AdvSM are aggressive SM (ASM), SM-associated hematologic neoplasm, and mast cell leukemia. A gain-of-function  KIT D816 V mutation is the primary oncogenic driver found in about 90% of all patients with AdvSM. Midostaurin, an oral multikinase inhibitor with activity against KIT D816V, and avapritinib, an oral selective KIT D816V inhibitor are approved for AdvSM. (Source: Immunology and Allergy Cl...
Source: Immunology and Allergy Clinics of North America - June 4, 2023 Category: Allergy & Immunology Authors: Tsewang Tashi, Michael W. Deininger Source Type: research

Management of Mediator Symptoms, Allergy, and Anaphylaxis in Mastocytosis
Mastocytosis is characterized by expansion and activation of clonally aberrant mast cells (MCs) in one or more organ systems. Inappropriate MC activation is a key finding in both allergy and mastocytosis; therefore, symptoms in both conditions show some degree of overlap. When mediator release is excessive and involves multiple systems, anaphylaxis may occur. In mastocytosis, the prevalence of atopy is similar to those of the general population, whereas the incidence of anaphylaxis is significantly higher. The purpose of this review is to discuss features of allergy and anaphylaxis as well as the principles of managing MC ...
Source: Immunology and Allergy Clinics of North America - June 4, 2023 Category: Allergy & Immunology Authors: Theo Gulen Source Type: research

Effect of Gender and Special Considerations for Women in Mastocytosis and Anaphylaxis
This article reviews the effects of gender on anaphylaxis in general and focuses on mastocytosis-specific issues. Incidence of anaphylaxis is increased in female compared with male patients during the pubertal years through the fifth decade of life, in which these disparities decrease. Estrogen is thought to increase the severity of anaphylaxis through increased endothelial nitric oxide synthase release. Despite this, all-cause fatal anaphylaxis does not appear to show a gender predilection. Systemic mastocytosis incidence is higher in women; however, mortality is increased in men owing to increased molecular and cytogenet...
Source: Immunology and Allergy Clinics of North America - May 26, 2023 Category: Allergy & Immunology Authors: Sara S. Ellingwood, Anna Kovalszki Source Type: research

Drug and Venom Allergy in Mastocytosis
Patients with mastocytosis have an increased risk for mast cell activation events including anaphylaxis when exposed to certain drugs and Hymenoptera venom. Hypotension and cardiovascular collapse without skin or other systemic manifestations can occur after Hymenoptera stings, during the perioperative period, and after exposure to nonsteroidal ntiinflammatory drugs, opioids, and other mast cell activating medications, including vancomycin and quinolones. This chapter reviews the epidemiology, mechanisms, diagnosis, management, and treatment options for Hymenoptera venom and drug-induced reactions in patients with mastocyt...
Source: Immunology and Allergy Clinics of North America - May 22, 2023 Category: Allergy & Immunology Authors: Matthew P. Giannetti, Jennifer Nicoloro-SantaBarbara, Grace Godwin, Julia Middlesworth, Andrew Espeland, Mariana C. Castells Source Type: research

Measuring Symptom Severity and Quality of Life in Mastocytosis
Mastocytosis is a heterogeneous disease with a wide spectrum of signs, symptoms, and concomitant disorders, such as skin lesions, anaphylaxis, osteoporosis, gastrointestinal involvement, and organomegaly. Disease specificity for frequently reported symptoms, such as fatigue, headache, anxiety, and brain fog, is poorly defined and need to be addressed in further studies. Patients with CM and non-AdvSM are mostly affected by mast cell mediator –related symptoms, whereas in AdvSM symptoms also result from organ damage, which makes their assessment challenging. In this paper we discuss approaches currently used to measure sy...
Source: Immunology and Allergy Clinics of North America - May 21, 2023 Category: Allergy & Immunology Authors: Polina Pyatilova, Frank Siebenhaar Source Type: research

Update on Mast Cell Proteases as Drug Targets
Mast cell granules are packed with proteases, which are released with other mediators by degranulating stimuli. Several of these proteases are targets of potentially therapeutic inhibitors based on hypothesized contributions to diseases, notably asthma and ulcerative colitis for β-tryptases, heart and kidney scarring for chymases, and airway infection for dipeptidyl peptidase-I. Small-molecule and antibody-based β-tryptase inhibitors showing preclinical promise were tested in early-phase human trials with some evidence of benefit. Chymase inhibitors were given safely in P hase II trials without demonstrating benefits, wh...
Source: Immunology and Allergy Clinics of North America - May 21, 2023 Category: Allergy & Immunology Authors: George H. Caughey Source Type: research

Anaphylaxis, Angioedema, and Other Immunologic Emergencies
We are honored that this issue of Immunology and Allergy Clinics of North America consists of the articles that we curated for the February 2022 issue of Emergency Medicine Clinics of North America. The topics contained within this issue are of great importance to emergency medicine practitioners as well as to allergists and immunologists. Our specialties share a dedication to providing up-to-date, evidence-based medical care to patients, which is highlighted by the conditions covered in this issue: anaphylaxis, angioedema, immune-based therapies, and other immunologic disorders. (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - May 21, 2023 Category: Allergy & Immunology Authors: R. Gentry Wilkerson, Salvador Suau Tags: Preface Source Type: research

Pediatric and Hereditary Mastocytosis
To a large extent, the clinical picture of pediatric mastocytosis depends on the age at which it is diagnosed. A neonate with diffuse cutaneous mastocytosis may frequently present in a severe state requiring treatment. Toddlers may require long-term anti-mediator therapy, and this may lead to concerns such as organizing preschool education due to the need for epinephrine injections. A teenager may have to face cutaneous disease persistence or a diagnosis of systemic mastocytosis. Further studies are needed to refine the available treatment options and prognosis for different age groups. (Source: Immunology and Allergy Clin...
Source: Immunology and Allergy Clinics of North America - May 19, 2023 Category: Allergy & Immunology Authors: Joanna Renke, Ninela Irga-Jaworska, Magdalena Lange Source Type: research

Gastrointestinal Disease in Mastocytosis
Gastrointestinal symptoms are prevalent in patients with systemic mastocytosis and contribute to morbidity. In indolent disease, the symptoms, which include heartburn, abdominal pain, and diarrhea, are largely due to release of mast cell mediators but may be due to other factors. A thorough evaluation that incorporates abdominal imaging and endoscopy with intestinal biopsy assists with diagnosis and management. Patients with advanced mastocytosis experience signs and symptoms of gastrointestinal dysfunction owing to the massive infiltration of clonal mast cells in the tissues. The gastrointestinal symptoms in systemic mast...
Source: Immunology and Allergy Clinics of North America - May 19, 2023 Category: Allergy & Immunology Authors: Matthew J. Hamilton Source Type: research

A Framework for Understanding Maternal Immunity
This is an alternative and controversial framing of the data relevant to maternal immunity. It argues for a departure from classical theory to view, interrogate and interpret existing data. (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - April 15, 2023 Category: Allergy & Immunology Authors: Elizabeth A. Bonney Source Type: research

Eosinophilic Lung Diseases
The eosinophilic lung diseases may manifest as chronic eosinophilic pneumonia, acute eosinophilic pneumonia, or as the L öffler syndrome (generally of parasitic etiology). The diagnosis of eosinophilic pneumonia is made when both characteristic clinical-imaging features and alveolar eosinophilia are present. Peripheral blood eosinophils are generally markedly elevated; however, eosinophilia may be absent at presentat ion. Lung biopsy is not indicated except in atypical cases after multidisciplinary discussion. The inquiry to possible causes (medications, toxic drugs, exposures, and infections especially parasitic) must be...
Source: Immunology and Allergy Clinics of North America - April 12, 2023 Category: Allergy & Immunology Authors: Vincent Cottin Source Type: research

Lymphangioleiomyomatosis and Other Cystic Lung Diseases
Cysts and cavities in the lung are commonly encountered on chest imaging. It is necessary to distinguish thin-walled lung cysts ( ≤2 mm) from cavities and characterize their distribution as focal or multifocal versus diffuse. Focal cavitary lesions are often caused by inflammatory, infectious, or neoplastic processes in contrast to diffuse cystic lung diseases. An algorithmic approach to diffuse cystic lung disease can help narrow the differential diagnosis, and additional testing such as skin biopsy, serum biomarkers, and genetic testing can be confirmatory. An accurate diagnosis is essential for the management and dis...
Source: Immunology and Allergy Clinics of North America - April 12, 2023 Category: Allergy & Immunology Authors: Matthew Koslow, David A. Lynch, Carlyne D. Cool, Steve D. Groshong, Gregory P. Downey Source Type: research

Hypersensitivity Pneumonitis
Hypersensitivity pneumonitis (HP) is a heterogenous disease entity characterized by an aberrant immune response to inhalational antigens. Disease modification hinges on early antigen remediation with a goal to attenuate immune dysregulation. Disease severity and progression are mediated by an interface between degree, type and chronicity of exposure, genetic predisposition, and biochemical properties of the inducing agent. Guidelines have provided a standardized approach; however, decision-making remains with many clinical dilemmas. The delineation of fibrotic and nonfibrotic HP is crucial to identify the differences in cl...
Source: Immunology and Allergy Clinics of North America - April 12, 2023 Category: Allergy & Immunology Authors: Sahil M. Pandya, Aarti P. Pandya, Daffolyn Rachael Fels Elliott, Mark J. Hamblin Source Type: research

Interstitial Lung Disease: 150 Years of Progress
In 1873, von Buhl published one of the earliest histologic descriptions of interstitial lung disease (ILD) in Tuberkulose und Schwindsucht.1 He described a disorder pathologically characterized by “degeneration and desquamation of alveolar and bronchiolar epithelium” likely caused by tuberculosis or syphilis and coined the term “chronic interstitial pneumonia.” The first histologic description of what today we call idiopathic pulmonary fibrosis (IPF) was published in 1897 by Rindfleis ch, calling the new entity “Cirrhosis Cystica Pulmonum. (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - April 12, 2023 Category: Allergy & Immunology Authors: Joshua J. Solomon, Kevin K. Brown Tags: Preface Source Type: research

Interstitial Lung Disease
IMMUNOLOGY AND ALLERGY CLINICS OF NORTH AMERICA (Source: Immunology and Allergy Clinics of North America)
Source: Immunology and Allergy Clinics of North America - April 12, 2023 Category: Allergy & Immunology Authors: Joshua J. Solomon, Kevin K. Brown Source Type: research