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Adverse Reactions to Anti-Infective Vaccines: an Emerging Problem in the COVID-19 Era
AbstractPurpose of reviewVaccines are an essential tool for preventing infectious diseases and reducing associated morbidity and mortality. Vaccination has a significant impact at both individual and community levels, and COVID ‐19 vaccination programs are a new example of the great value of this public health strategy. However, adverse reactions, especially severe reactions such as anaphylaxis, prevent these programs from progressing properly, thus limiting vaccination uptake in the population.Recent findingsThe frequency of reactions and types of vaccine components, with special attention to COVID-19 vaccines studies, ...
Source: Current Treatment Options in Allergy - June 25, 2022 Category: Allergy & Immunology Source Type: research

New Technical Aspects Used in the Management of Desensitization to Antineoplastic Drugs
AbstractPurpose of ReviewThis review will focus on the most recent technical developments in rapid drug desensitization to antineoplastic agents (chemotherapy and biologics). It is designed as an update for the initiated and not a review of fundamental concepts.Recent FindingsThe recent publication of several international guidelines on diagnosing and managing drug hypersensitivity reactions to chemotherapy and biologics is set to revolutionize this field for allergy specialists. These guidelines resulted from leading groups coming together and collaborating to facilitate that allergy departments worldwide could expand the...
Source: Current Treatment Options in Allergy - July 25, 2022 Category: Allergy & Immunology Source Type: research

Making a Diagnosis in Allergic Reactions Occurring in the Operating Room
Opinion statementTo summarize the current knowledge of diagnosis in immediate perioperative hypersensitivity reactions (PHR). There is a growing interest in the diagnosis and management of PHR. Recently several clinical guidelines published on PHR; however, its implementation is unknown. The diagnosis and management of PHR is a challenge for both allergologists and anesthesiologists. They are life-threatening and rare reactions, difficult to diagnose for its clinical heterogenic presentation, simultaneous use of many drugs, and the significant pharmacological effects of some drugs. Allergy investigation purpose is to ident...
Source: Current Treatment Options in Allergy - October 20, 2022 Category: Allergy & Immunology Source Type: research

Therapeutic Patient Education
Opinion statement Patient education in atopic dermatitis (AD) represents an essential therapeutic tool, which should be offered in addition to routine care, since previous studies have revealed that AD outpatients are often insufficiently treated and show severe limitations of quality of life. Considering the multifactorial pathogenesis of this chronic skin disease, the success of therapeutic patient education seems to depend on the involvement of a multidisciplinary team of professionals. The training program should include aspects on dermatology and allergy, but also on diet and nursing, as well as on disease-sp...
Source: Current Treatment Options in Allergy - September 18, 2014 Category: Allergy & Immunology Source Type: research

Management of Idiopathic Anaphylaxis: When Is Bone Marrow Examination Essential?
Opinion statement Idiopathic anaphylaxis is not an uncommon entity within the Allergy and Immunology field. Management of such patients can be extremely challenging at times. A thorough history, including an emphasis on possible mast cell disease, is an absolute necessity. A bone marrow biopsy is not only appropriate, but essential, when evaluating patients with recurrent anaphylaxis if a clonal mast cell disease is suspected as the underlying etiology. Clinical predictors for underlying clonal mast cell disease have been studied and include an elevated baseline tryptase, presence of hypotensive syncopal episodes...
Source: Current Treatment Options in Allergy - September 1, 2014 Category: Allergy & Immunology Source Type: research

Update on Antihistamine Treatment for Chronic Urticaria in Children
Opinion statement Urticaria is a heterogeneous group of diseases, which may have different causes and mechanisms but share similar clinical features. It is clinically defined by the presence of wheals and/or angioedema. The diagnosis of urticaria is based on the evaluation of clinical manifestations. Urticaria is conventionally classified as acute or chronic. Chronic urticaria (CU) has been defined as daily or nearly daily occurrence of wheals and/or angioedema lasting longer than 6 weeks. Very little is known of the epidemiology of urticaria in infants and children, and still less is known of the prevalence of ...
Source: Current Treatment Options in Allergy - September 1, 2014 Category: Allergy & Immunology Source Type: research

Is The Allergen Really Needed in Allergy Immunotherapy?
This article will focus on the function of VLPs loaded with DNA rich in nonmethylated CG motifs (CpGs) and the clinical experience gained in the treatment of allergic rhinitis, demonstrating clinical efficacy also if administered without allergens. Several published studies have demonstrated a beneficial impact on allergic symptoms by treatment with CpG-loaded VLPs. Subcutaneous injection of VLPs loaded with CpGs was tested with or without the adjuvant alum in the presence or absence of an allergen. The results encourage further investigation of VLPs and CpG motifs in immunotherapy, either as a stand-alone product or as ad...
Source: Current Treatment Options in Allergy - December 6, 2014 Category: Allergy & Immunology Source Type: research

Local Allergic Rhinitis: Is There a Role for Systemic Allergy Immunotherapy?
Opinion statement Allergen immunotherapy (AIT), the etiologic treatment of allergic rhinoconjunctivitis and allergic asthma, has been shown to be an effective and safe treatment in patients with allergic respiratory disease. The efficacy of AIT in reducing symptoms and medication requirements has been demonstrated not only during treatment but also after it is discontinued. AIT is the only treatment that has the ability to modify the natural course of allergic rhinoconjunctivitis and asthma. In recent years, a new entity—local allergic rhinitis (LAR)—has been reported, which is characterized by the presence of...
Source: Current Treatment Options in Allergy - January 10, 2015 Category: Allergy & Immunology Source Type: research

Hypersensitivity Reactions to Proton Pump Inhibitors
Opinion Statement Proton pump inhibitors (PPIs) are drugs widely used and usually well tolerated. However, cases of immediate or cell-mediated hypersensitivity reactions due to all PPIs, with the exception of the newest dexlansoprazole and tenatoprazole, have been described. In the case of suspected IgE-mediated reaction skin test (prick test and intradermal test) with nonirritant drug concentration published is safe and highly specific (100 %) with a PPV of 100 %. Thus, oral provocation test should be performed only in case of negative results to rule out definitely the diagnosis. In the case of possible cell-m...
Source: Current Treatment Options in Allergy - March 20, 2015 Category: Allergy & Immunology Source Type: research

Food-Induced Anaphylaxis Year in Review
Opinion statement Food allergy is increasing; as a consequence, food-induced anaphylaxis is also becoming a growing problem. Our understanding of the mechanisms of tolerance is still basic and requires much more research before it becomes helpful in guiding our interventions. However, empirical approaches with oral immunotherapy and food introduction manipulation appear promising, although standardization is required before employing them on a large scale. Furthermore, education and public health measures can be helpful for the increasing proportion of the population at risk.
Source: Current Treatment Options in Allergy - May 24, 2015 Category: Allergy & Immunology Source Type: research

Use of Component-Resolved Diagnosis (CRD) for Allergen Immunotherapy (AIT)
Opinion statement Allergen immunotherapy (AIT) is presently the only treatment able to modify the natural history of respiratory allergic disease. The essential condition for AIT to be effective is that the right allergen(s) is/are administered. The proportion of allergic patients showing multiple sensitizations to distinct airborne allergen sources has dramatically increased during the last decades, and this fact, along with the frequent co-recognition of highly cross-reacting pollen panallergens (i.e., profilin and polcalcin), may make a correct diagnosis virtually impossible by using the traditional allergen ex...
Source: Current Treatment Options in Allergy - January 25, 2016 Category: Allergy & Immunology Source Type: research

Corticosteroids for Allergic Rhinitis
Opinion statement Allergic rhinitis (AR) is one of the most common allergic diseases. Globally, it is estimated to affect more than 500 million people. The burden of allergic rhinitis is overwhelming due to costs caused by sickness absence, medication, and suboptimal performance by the affected population. AR is characterized by a type I allergic reaction in the epithelium of the nose including both an acute phase reaction and a late phase reaction. The allergic reaction causes exudation, itching, sneezing, and later blocking of the nose. Very often, the nasal symptoms are accompanied by eye symptoms (itching and ...
Source: Current Treatment Options in Allergy - February 5, 2016 Category: Allergy & Immunology Source Type: research

Hypersensitivity Reactions to Fluoroquinolones
Opinion statement Fluoroquinolones (FQs) are important antibiotics for the treatment of a wide range of infectious diseases. However, while FQs are generally well-tolerated, both IgE and T cell-mediated hypersensitivity reactions can occur. Moreover, there has been an increase in the prevalence of these reactions in recent decades, probably due to higher levels of consumption. The diagnosis of allergy to FQs is complex and is based on clinical history, skin tests (STs), and determination of the drug-specific IgE using both immunoassays and basophil activation tests (BATs). However, these approaches have sub-optima...
Source: Current Treatment Options in Allergy - March 30, 2016 Category: Allergy & Immunology Source Type: research

Hypersensitivity Reactions to Biologicals: True Allergy?
Opinion statement Biological agents are a growing class of drugs that have modified the treatment of multiple chronic immune-mediated and tumor diseases. Despite these positive aspects, some issues may exist during the treatment with biologicals such as an increased risk of infections as well as the occurrence of infusion reactions, which in some cases could be severe and life-threatening. Concerning infusion reactions, it is important that allergists recognize the symptoms and know their underling pathogenic mechanisms in order to perform a correct diagnosis. The safety profile of biologicals is negatively impact...
Source: Current Treatment Options in Allergy - May 29, 2016 Category: Allergy & Immunology Source Type: research

Drug-Induced Anaphylaxis: Clinical Scope, Management, and Prevention
Opinion statement Drug-induced anaphylaxis (DIA) is a severe, life-threatening reaction occurring after drug exposure. It is an important cause of anaphylaxis and accounts for up to one third of drug hypersensitivity reactions. As in other anaphylaxis reactions, immunoglobulin E (IgE) has an important role in its mechanism, but other non-immunological reactions may also occur in DIA. Cutaneous and respiratory symptoms are present in a majority of patients, and cardiovascular events are more common in elderly patients. A complete work up is recommended not just to offer safe alternatives, but also to avoid incorrec...
Source: Current Treatment Options in Allergy - July 4, 2016 Category: Allergy & Immunology Source Type: research

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