Controversies in drug allergy: consensus documents from the world experts
(Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - December 19, 2018 Category: Allergy & Immunology Source Type: research

Important questions in drug allergy and hypersensitivity: consensus papers from the 2018 AAAAI/WAO international drug allergy symposium
This article is one of a series of international consensus documents developed from the International Drug Allergy Symposium held at the Joint Congress of the American Academy of Allergy, Asthma& Immunology/World Allergy Organization on March 1, 2018, in Orlando, Florida, USA. The symposium was sponsored by The Journal of Allergy and Clinical Immunology, The Journal of Allergy and Clinical Immunology:In Practice, and The World Allergy Organization Journal and chaired by Mariana Castells, MD, PhD, and Pascal Demoly, MD, PhD. (Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - December 19, 2018 Category: Allergy & Immunology Source Type: research

Skin as an immune organ and clinical applications of skin-based immunotherapy
ConclusionsTaken together, the reviewed literature supports the concept that EPIT activates the natural desensitization pathway of the skin, offering a progressive, possibly sustained response. EPIT offers a potential alternative for allergen immunotherapy that is less invasive and carries a lower risk for systemic reactions than oral immunotherapy. (Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - December 7, 2018 Category: Allergy & Immunology Source Type: research

The North-Western Italian experience with anti IL-5 therapy amd comparison with regulatory trials
AbstractBackgroundThe severe forms of asthma represent a major burden, because of severity of symptoms, costs and impact on everyday life. Recently, Mepolizumab (MEP) was approved and marketed for the treatment of hypereosinophilic severe asthma. This anti-IL-5 monoclonal antibody reduced exacerbation rates and oral corticosteroid (OCS) use in well selected patients. The aim of this study was to evaluate the characteristics of patients receiving MEP in a real-life setting. Thus, we describe a retrospective analysis of patients treated with MEP in six centres in North  Western Italy, including those who participated in...
Source: World Allergy Organization Journal - December 6, 2018 Category: Allergy & Immunology Source Type: research

Test for Respiratory and Asthma Control in Kids (TRACK): validation of the Portuguese version
AbstractBackgroundTRACK (Test for Respiratory and Asthma Control in Kids) questionnaire is an instrument developed and validated in English to evaluate the control of respiratory symptoms in children under 5 years of age.ObjectiveTo validate the Portuguese version of the TRACK questionnaire.MethodsThe validation was done in an observational, prospective and multicenter evaluation (six centers in Brazil) in children with recurrent respiratory symptoms. Children were classified according to symptoms, GINA criteria and medical evaluation. Parents and doctors rated child respiratory symptom control in the last month (VAS). App...
Source: World Allergy Organization Journal - December 5, 2018 Category: Allergy & Immunology Source Type: research

Comparison of microbiota and allergen profile in house dust from homes of allergic and non-allergic subjects- results from the GUSTO study
AbstractBackgroundThe prevalence of allergic diseases, such as asthma, allergic rhinitis, eczema and food allergy, has been increasing worldwide, as shown in a large number of studies, including the International Study of Asthma and Allergies in Childhood (ISAAC). However, there is significant variation in the prevalence of these diseases in different regions, suggesting that there may be location-specific factors such as environment and microbial exposure affecting allergic disease prevalence. Hence, in this study we determine if there is a difference in microbiota composition and allergen concentration of household dust ...
Source: World Allergy Organization Journal - December 5, 2018 Category: Allergy & Immunology Source Type: research

Intake of a fermented plant product attenuates allergic symptoms without changing systemic immune responses in a mouse model of Japanese cedar pollinosis
ConclusionsOur results suggest that FPP intake could attenuate JCP symptoms without change of systemic immune responses. (Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - December 4, 2018 Category: Allergy & Immunology Source Type: research

Omalizumab in the treatment of eosinophilic granulomatosis with polyangiitis (EGPA): single-center experience in 18 cases
ConclusionsOmalizumab improved asthma control in some patients with EGPA with uncontrolled asthma by reducing asthma exacerbations and oral steroid requirement. However, more data are needed before recommending widespread use of omalizumab in patients with EGPA. (Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - December 3, 2018 Category: Allergy & Immunology Source Type: research

Allergen-specific IgE and IgG4 patterns among patients with different allergic diseases
ConclusionAllergen-specific IgE and IgG4 patterns that are relevant to concrete allergic diseases differ by sIgE and sIgG4 prevalences to defined allergens. (Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - December 3, 2018 Category: Allergy & Immunology Source Type: research

Impact of a digital health intervention on asthma resource utilization
AbstractDigital health interventions have been associated with reduced rescue inhaler use and improved controller medication adherence. This quality improvement project assessed the benefit of these interventions on asthma-related healthcare utilizations, including hospitalizations, emergency department (ED) utilization and outpatient visits. The intervention consisted of electronic medication monitors (EMMs) that tracked rescue and controller inhaler medication use, and a digital health platform that presented medication use information and asthma control status to patients and providers. In 224 study patients, the number...
Source: World Allergy Organization Journal - December 3, 2018 Category: Allergy & Immunology Source Type: research

Prevalence and treatment of allergies in rural areas of Bavaria, Germany: a cross-sectional study
ConclusionsBased on the study results, there is a need for prevention programs and establishment of treatments for certain allergies to minimize long-term health effects. Moreover, more studies are needed to analyze the prevalence of allergies in farmers who had a higher prevalence of allergies compared to previously reported prevalence in literature reviews.Trial registrationsThe study was approved by the ethical review committee of the Technical University Munich (EC number 548/16S). (Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - November 19, 2018 Category: Allergy & Immunology Source Type: research

Differences in chronic spontaneous urticaria between Europe and Central/South America: results of the multi-center real world AWARE study
This study descriptively compares these aspects among CU patients residing in Europe (EU) and Central and South America (C/SA).MethodsAWARE (A World-wide Antihistamine-Refractory chronic urticaria patient Evaluation) is a global prospective, non-interventional study of CU in the real-world setting. Patients were  ≥ 18 years with a diagnosis of H1-antihistamine-refractory CU for>  2 months. Differences between the EU and C/SA regions in demographic and clinical characteristics, quality of life (QoL), work and activity impairment, pharmacological treatment, and healthcare resource use wer...
Source: World Allergy Organization Journal - November 16, 2018 Category: Allergy & Immunology Source Type: research

Confounders of severe asthma: diagnoses to consider when asthma symptoms persist despite optimal therapy
AbstractAsthma can often be challenging to diagnose especially when patients present with atypical symptoms. Therefore, it is important to have a broad differential diagnosis for asthma to ensure that other conditions are not missed. Clinicians must maintain a high index of suspicion for asthma mimickers, especially when patients fail to respond to conventional therapy. The purpose of this review is to briefly review some of the more common causes of asthma mimickers that clinicians should consider when the diagnosis of asthma is unclear. (Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - November 14, 2018 Category: Allergy & Immunology Source Type: research

Health care costs and resource utilization for different asthma severity stages in Colombia: a claims data analysis
This study estimated direct medical costs and health care resource utilization (HCRU) in patients with asthma according to severity in Colombia.MethodsThis study identified all-age patients who had at least one medical event linked to an asthma diagnosis (CIE-10: J45-J46) between 2004 and 2014. Patients were selected if they had a continuous enrollment and uninterrupted insurance coverage between January 1 –2015 and December 31–2015 and were categorized into 4 different severity levels using a modified algorithm based on Leidy criteria. Healthcare utilization and costs were estimated in a 1-year period after th...
Source: World Allergy Organization Journal - November 12, 2018 Category: Allergy & Immunology Source Type: research

Probiotics as treatment for food allergies among pediatric patients: a meta-analysis
ConclusionAnalysis of available evidence shows moderate certainty that the use of probiotics can relieve symptoms of children with cow ’s milk allergy. The reduction in certainty is due to imprecise results. Moreover, there is low certainty that probiotics can induce tolerance among children with cow’s milk allergy, due to problems of imprecision and attrition bias. In the subgroup analysis,Lactobacillus rhamnosus GG administration likely results in inducing tolerance among infants with suspected cow ’s milk allergy. Only studies on CMA were analyzed since no studies were found on probiotics as treatment ...
Source: World Allergy Organization Journal - November 6, 2018 Category: Allergy & Immunology Source Type: research

Improvement of patient-reported outcomes in severe allergic asthma by omalizumab treatment: the real life observational PROXIMA study
AbstractBackgroundData on the prevalence of perennial versus seasonal allergic asthma in Italy are lacking; moreover, there is limited evidence on the effect of omalizumab on patient-reported outcomes in Italian patients with severe allergic asthma. PROXIMA, an observational, multicenter study, was designed to assess the prevalence of perennial versus seasonal allergic asthma (cross-sectional phase) and the effect of omalizumab on improving illness perception, quality of life (QoL) and asthma control of Italian patients with severe allergic asthma (longitudinal phase).MethodsThe study included a cross-sectional phase (n&th...
Source: World Allergy Organization Journal - November 1, 2018 Category: Allergy & Immunology Source Type: research

Potential new targets for drug development in severe asthma
AbstractIn recent years there has been increasing recognition of varying asthma phenotypes that impact treatment response. This has led to the development of biological therapies targeting specific immune cells and cytokines in the inflammatory cascade. Currently, there are two primary asthma phenotypes, Type 2 hi and Type 2 lo, which are defined by eosinophilic and neutrophilic/pauci- granulocytic pattern of inflammation respectively. Most biologics focus on Type 2 hi asthma, including all four biologics approved for treatment of uncontrolled asthma in the United States — omalizumab, mepolizumab, reslizumab, and ben...
Source: World Allergy Organization Journal - October 25, 2018 Category: Allergy & Immunology Source Type: research

Brazilian experience with atopy patch tests for Dermatophagoides pteronyssinus , Dermatophagoides farinae and Blomia tropicalis
ConclusionThe APT should be considered as an additional test when the SPT and specific serum IgE tests are negative in patients with clinical histories of allergies. (Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - October 24, 2018 Category: Allergy & Immunology Source Type: research

The connection of pollen concentrations and crowd-sourced symptom data: new insights from daily and seasonal symptom load index data from 2013 to 2017 in Vienna
ConclusionMore than just the seasonal pollen index has to be considered when the SLI of a selected pollen season has to be explained. Cross-reactivity to other pollen types, allergen content and air pollution could play a considerable role. The similar behavior of the SLI in Vienna and a whole region indicate the feasibility of a possible symptom forecast in future and justifies the use of a single pollen monitoring station within a city of the size of Vienna. (Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - October 16, 2018 Category: Allergy & Immunology Source Type: research

Increasing trends of anaphylaxis-related events: an analysis of anaphylaxis using nationwide data in Taiwan, 2001 –2013
ConclusionThe incidence rate of anaphylaxis in Taiwan  has increased at an average rate of 5% annually since 2001, paralleling the rising trends in several Western countries. (Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - October 10, 2018 Category: Allergy & Immunology Source Type: research

Clinical efficacy of sublingual immunotherapy is associated with restoration of steady-state serum lipocalin 2 after SLIT: a pilot study
AbstractBackgroundSo far, only a  few biomarkers in allergen immunotherapy exist that are associated with a clinical benefit. We thus investigated in a pilot study whether innate molecules such as the molecule lipocalin-2 (LCN2), with implications in immune tolerance demonstrated in other fields, may discriminate A) between allerg ic and non-allergic individuals, and B) between patients clinically responding or non-responding to sublingual allergen immunotherapy (SLIT) with house dust mite (HDM) extract. Moreover, we assessed haematological changes potentially correlating with allergic symptoms.MethodsLCN2-concentrati...
Source: World Allergy Organization Journal - October 1, 2018 Category: Allergy & Immunology Source Type: research

Allergy diagnosis from symptoms to molecules, or from molecules to symptoms: a comparative clinical study
ConclusionsFor the diagnostic verification of clinically suspected allergy, the novel concept “from molecules to clinic” offers a reliable diagnostic workup in shorter time. Due to lower skin test numbers it is especially applicable for young children and seniors, in atopic patients, and whenever skin tests get difficult or unreliable. (Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - September 11, 2018 Category: Allergy & Immunology Source Type: research

Anaphylaxis triggers in a large tertiary care hospital in Qatar: a retrospective study
This study aims to examine the common triggers of anaphylaxis in Qatar.MethodsA total of 1068 electronic medical records were audited using power chart system: 446 from the medical coding system of anaphylaxis and 622 from the epinephrine auto-injectors (EAIs) dispensed during January 2012 –December 2017.ResultsOf 1068 patients, 574 (53.5%) had anaphylaxis; male to female ratio was 1.2, and 300 patients (77.9%) were less than  10 years old. The common triggers were food (n = 316, 55.0%), insect stings (n = 161, 28.0%), and drugs (n = 103, 17.9%). Common anaphylaxis food ...
Source: World Allergy Organization Journal - September 4, 2018 Category: Allergy & Immunology Source Type: research

The impact of allergen exposure and specific immunotherapy on circulating blood cells in allergic rhinitis
AbstractAllergic rhinitis (AR) is an IgE-mediated inflammatory disease of the nasal mucosa with well described local immune responses during allergen exposure. The frequent association of AR with general extra-nasal symptoms and other allergic conditions, such as conjunctivitis and asthma, however, support a more systemic disease impact. In addition to acute elevation of soluble inflammatory mediators in periphery blood, a growing number of studies have reported changes in circulating blood cells after specific nasal allergen challenge or environmental allergen exposure. These findings imply an involvement of specific bloo...
Source: World Allergy Organization Journal - August 15, 2018 Category: Allergy & Immunology Source Type: research

Appropriateness of chronic asthma management and medication adherence in patients visiting ambulatory clinic of Gondar University Hospital: a cross-sectional study
ConclusionThe findings of the study showed more than half of asthmatic patients received inappropriate treatment. Nevertheless, a  larger proportion of the patients claimed to be highly adherent to their medications. (Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - August 10, 2018 Category: Allergy & Immunology Source Type: research

Epidemiology of allergic rhinitis and associated risk factors in Asia
AbstractThis review article aims to present the epidemiology and associated risk factors of allergic rhinitis (AR) in Asia. AR-related literature published on Asia was systematically reviewed and the associated risk factors were investigated.The prevalence of AR in Asia varied considerably depending on the geographical location, study design and population involved. Several risk factors were observed to have strong association with disease presentation across multiple studies. Among these, family income, family size, daily personal computer usage time, personal and parental education attainment, and stress level have shown...
Source: World Allergy Organization Journal - August 6, 2018 Category: Allergy & Immunology Source Type: research

Prevalence of food allergy in Vietnam: comparison of web-based with traditional paper-based survey
ConclusionsThe consistency of the WBS results with the PBS indicates a promising application of online surveys as an economic and validated model for future epidemiological studies, specifically in developing countries. (Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - July 23, 2018 Category: Allergy & Immunology Source Type: research

Geolocation with respect to personal privacy for the Allergy Diary app - a MASK study
Discussionk-anonymity is an acceptable method for the anonymization of MASK data and results can be used for other databases. (Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - July 16, 2018 Category: Allergy & Immunology Source Type: research

Management of chronic spontaneous urticaria: a worldwide perspective
AbstractBackgroundThe approaches to the diagnosis and treatment of chronic spontaneous urticaria (CSU) differ in various parts of the world. We sought to determine the adherence to international and national urticaria guidelines as well as the motives to deviate from the guidelines among physicians worldwide.MethodsA web-based questionnaire was created and launched via e-mail by the World Allergy Organization (WAO) to representatives of all WAO Member Societies, the members of the American Academy of Allergy, Asthma& Immunology (AAAAI) and the members of the WAO Junior Members Group (JMG), regardless of the specialty, ...
Source: World Allergy Organization Journal - July 4, 2018 Category: Allergy & Immunology Source Type: research

Type 2 immunity in asthma
AbstractType 2-immunity represents the typical adaptive response to allergen exposure in atopic individuals. It mainly involves Th2 cells and immunoglobulin E, as the main orchestrators of type 2-inflammation. Recently, it has been highlighted that allergens may be responsible for a Th2 response beside specific IgE activation and that a number of other environmental stimuli, such as viruses and pollutants, can trigger the same pattern of inflammation beyond atopy. Emerging data sustain a substantial role of the so-called epithelial dysfunction in asthma pathogenesis, both from anatomic and functional point of view. Further...
Source: World Allergy Organization Journal - June 26, 2018 Category: Allergy & Immunology Source Type: research

Prenatal omega-3 LCPUFA and symptoms of allergic disease and sensitization throughout early childhood – a longitudinal analysis of long-term follow-up of a randomized controlled trial
AbstractBackgroundRandomized controlled trials of prenatal omega ( ω-3) long chain polyunsaturated fatty acid (LCPUFA) supplementation are suggestive of some protective effects on allergic sensitization and symptoms of allergic disease in childhood. Due to the nature of the atopic march, investigation of any effects of this prenatal intervention may be most inform ative when consistently assessed longitudinally during childhood.MethodsFollow-up of children (n = 706) with familial risk of allergy from the Docosahexaenoic Acid to Optimize Mother Infant Outcome (DOMInO) trial. The intervention group receiv...
Source: World Allergy Organization Journal - June 15, 2018 Category: Allergy & Immunology Source Type: research

Debates in Allergy Medicine: Does oral immunotherapy  shorten the duration of milk and egg allergy? The pro argument
AbstractThe development of oral tolerance or food allergy is an active process, related to dynamic interactions between host immune cells, microbiome, dietary factors, and food allergens. Oral tolerance is the default immune response in the gut. A food allergy occurs when this process fails and a pathologic Th2 response is activated. Oral food immunotherapy (OIT) aims to restore immune tolerance in food-allergic individuals. The stimulation of Tregs production seems to represent a crucial step in inducing long-term tolerance, but other mechanisms (e.g., the suppression of mast cell and basophil reactivity, changes in aller...
Source: World Allergy Organization Journal - June 15, 2018 Category: Allergy & Immunology Source Type: research

Debates in Allergy Medicine: Oral immunotherapy shortens the duration of milk and egg allergy - the con argument
AbstractOral immunotherapy (OIT) has been shown to be effective for inducing desensitization in children with cow ’s milk and egg allergy. In contrast, there is limited evidence that OIT can induce tolerance or sustained unresponsiveness in food allergic patients. Sustained unresponsiveness, determined by a food challenge following a period of secondary avoidance, has been suggested to reflect a more enduring state of tolerance and is pertinent when considering the ability of OIT to shorten the duration of food allergy. While it has been shown that children who tolerate baked forms of egg and milk are more likely to ...
Source: World Allergy Organization Journal - June 15, 2018 Category: Allergy & Immunology Source Type: research

Prenatal omega-3 LCPUFA and symptoms of allergic disease and sensitization throughout early childhood – a longitudinal analysis of long-term follow-up of a randomized controlled trial
AbstractBackgroundRandomized controlled trials of prenatal omega ( ω-3) long chain polyunsaturated fatty acid (LCPUFA) supplementation are suggestive of some protective effects on allergic sensitization and symptoms of allergic disease in childhood. Due to the nature of the atopic march, investigation of any effects of this prenatal intervention may be most inform ative when consistently assessed longitudinally during childhood.MethodsFollow-up of children (n = 706) with familial risk of allergy from the Docosahexaenoic Acid to Optimize Mother Infant Outcome (DOMInO) trial. The intervention group receiv...
Source: World Allergy Organization Journal - June 15, 2018 Category: Allergy & Immunology Source Type: research

Debates in Allergy Medicine: Does oral immunotherapy  shorten the duration of milk and egg allergy? The pro argument
AbstractThe development of oral tolerance or food allergy is an active process, related to dynamic interactions between host immune cells, microbiome, dietary factors, and food allergens. Oral tolerance is the default immune response in the gut. A food allergy occurs when this process fails and a pathologic Th2 response is activated. Oral food immunotherapy (OIT) aims to restore immune tolerance in food-allergic individuals. The stimulation of Tregs production seems to represent a crucial step in inducing long-term tolerance, but other mechanisms (e.g., the suppression of mast cell and basophil reactivity, changes in aller...
Source: World Allergy Organization Journal - June 15, 2018 Category: Allergy & Immunology Source Type: research

Debates in Allergy Medicine: Oral immunotherapy shortens the duration of milk and egg allergy - the con argument
AbstractOral immunotherapy (OIT) has been shown to be effective for inducing desensitization in children with cow ’s milk and egg allergy. In contrast, there is limited evidence that OIT can induce tolerance or sustained unresponsiveness in food allergic patients. Sustained unresponsiveness, determined by a food challenge following a period of secondary avoidance, has been suggested to reflect a more enduring state of tolerance and is pertinent when considering the ability of OIT to shorten the duration of food allergy. While it has been shown that children who tolerate baked forms of egg and milk are more likely to ...
Source: World Allergy Organization Journal - June 15, 2018 Category: Allergy & Immunology Source Type: research

High burden of atopy in immigrant families in substandard apartments in Sweden – on the contribution of bad housing to poor health in vulnerable populations
ConclusionsThe atopic burden in this selected immigrant population was high, and results point to unmet medical needs. Health care systems caring for such populations need to be aware of their specific health needs; comprehensive asthma and allergy care should include consideration of harmful environmental exposures, adhering to the precautionary principle. (Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - May 15, 2018 Category: Allergy & Immunology Source Type: research

The importance of allergic disease in public health: an iCAALL statement
(Source: World Allergy Organization Journal)
Source: World Allergy Organization Journal - April 27, 2018 Category: Allergy & Immunology Source Type: research