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Current Opinion in Allergy and Clinical Immunology

Giulia De Feo, Roberta Parente, Massimo Triggiani
PURPOSE OF REVIEW: Anaphylaxis is an acute medical emergency characterized by sudden presentation of life-threatening respiratory and cardiovascular symptoms. Rapid diagnosis of anaphylaxis is crucial to implement an appropriate treatment and management plan. However, mistakes in the diagnosis of anaphylaxis may occur because of the limited time during which the diagnosis must be made, the stressful environment of the emergency room, the often aspecific or incomplete clinical features of early anaphylaxis and the lack of useful laboratory markers...
July 19, 2018: Current Opinion in Allergy and Clinical Immunology
Luciana Kase Tanno, Ignacio Ansotegui, Pascal Demoly
PURPOSE OF REVIEW: To understand the impact of globalization in the management of anaphylaxis and identify potential strategies to improve patients' care and prevention. RECENT FINDINGS: Developments in the field of anaphylaxis have been consistently following these globalization trends offering possibilities of collaborations of the allergy community and integrated international initiatives to reach quality care of allergic patients worldwide. SUMMARY: Globalization is the process of interaction and integration between people, companies, and governments worldwide...
July 16, 2018: Current Opinion in Allergy and Clinical Immunology
Marcelo V Aun, Jorge Kalil, Pedro Giavina-Bianchi
PURPOSE OF REVIEW: Despite many international guidelines have been published in the last 10 years, anaphylaxis continues to be underdiagnosed, undernotified, and undertreated. Anaphylactic reactions in adults and children in emergency departments are frequently not recognized, leading to underutilization of epinephrine, and a higher risk of death. RECENT FINDINGS: A few studies have been recently published showing that educational intervention for both physicians and other healthcare professionals improve diagnosis and treatment of anaphylaxis...
July 16, 2018: Current Opinion in Allergy and Clinical Immunology
Hadas Ben-Eli, Abraham Solomon
PURPOSE OF REVIEW: To address the current trends of therapeutic mechanisms for treatment of allergic conjunctivitis (AC), based on topical antihistamines and mast cell stabilizers (MCS). RECENT FINDINGS: The antihistamine drug alcaftadine has H4 receptor inverse agonism, anti-inflammatory and MCS activities. The antihistamines levocabastine and azelastine are more effective than placebo in treatment of AC symptoms in randomized controlled trials (RCTs). The topical dual-action antihistamines/MCS olopatadine, azelastine, ketotifen, and epinastine are commonly used in Europe and in the United States for mild subtypes of AC...
July 16, 2018: Current Opinion in Allergy and Clinical Immunology
Arianna Prince, Matthew R Norris, Leonard Bielory
PURPOSE OF REVIEW: The purpose of the article is to provide a historical overview of literature regarding pollen sensitization and ocular allergy with an emphasis on developments that have occurred over the past 5 years. RECENT FINDINGS: Currently, pollen studies have examined the molecular and cellular pathways involved in initiating allergic conjunctivitis to find targets for therapeutics. Studies have also documented the threshold, linear increase and plateau point in the relationship between pollen levels and allergic conjunctivitis symptoms...
July 16, 2018: Current Opinion in Allergy and Clinical Immunology
Julian Schröder, Ralph Mösges
PURPOSE OF REVIEW: The conjunctival provocation test (CPT) is often used to clearly identify the specific allergen causing the symptoms of allergic rhinoconjunctivitis but also to assess the clinical efficacy of an allergen immunotherapy (AIT). As there is no consensus about its predictive value, the aim of this publication is to evaluate under which conditions the CPT can predict the symptom severity during the allergy season after previous AIT. RECENT FINDINGS: Three out of four randomized controlled trials (RCTs) showed a correlation between CPT reactivity and symptoms occurring under natural allergen exposure after previous AIT...
July 16, 2018: Current Opinion in Allergy and Clinical Immunology
Matthew R Norris, Leonard Bielory
PURPOSE OF REVIEW: The purpose of this review was to explore recent developments in the study of ocular cosmetics, as they pertain to adverse reactions that can be attributed to them. RECENT FINDINGS: Immunologically mediated adverse reactions to cosmetics are most commonly the result of sensitization to preservatives, fragrances and dyes used in these products. Metals such as nickel, cobalt, chromium and lead are used in products such as eye shadows and eye liners as well as toy makeup sets in amounts greater than the recommended amount of 1 ppm...
July 16, 2018: Current Opinion in Allergy and Clinical Immunology
Stefania Arasi, Maurizio Mennini, Rocco Valluzzi, Carla Riccardi, Alessandro Fiocchi
PURPOSE OF REVIEW: To familiarize the reader with the concept of precision medicine in food allergy through the most recent insights in the diagnosis, prognosis, and management of the disease. RECENT FINDINGS: With the advent of omics sciences, a new era is commencing. Food protein allergens characterization and quantification together with the immunoglobulin E epitope mapping will contribute to the diagnosis/prognosis of food allergy and will lead to a better safety assessment of foods...
July 13, 2018: Current Opinion in Allergy and Clinical Immunology
Edoardo Villani, Giovanni Rabbiolo, Paolo Nucci
PURPOSE OF REVIEW: To provide an overview of the pathogenic mechanisms underlying the correlation between ocular allergy and dry eye disease (DED), highlighting how the first condition may be a risk factor for the second one. RECENT FINDINGS: Recent advances in our comprehension of the pathogenesis of ocular allergy and DED allow identifying several pathways of interaction between these two conditions. A growing body of evidence supports the role of ocular allergy as a risk factor for DED...
July 13, 2018: Current Opinion in Allergy and Clinical Immunology
Emek Kocatürk, Torsten Zuberbier
PURPOSE OF REVIEW: Symptomatic management of chronic spontaneous urticaria (CSU) basically depends on second-generation H1 antihistamines and omalizumab. Omalizumab is a game changer in the management, but still there is a need for new targets and new biologics targeting new pathways in the treatment which will provide long-lasting remission, which will be given orally and which will be cheaper. This review will focus on new biologics that are underway of production or are already under use for different disorders but could be beneficial for the treatment of Chronic urticaria...
July 13, 2018: Current Opinion in Allergy and Clinical Immunology
Xiaoli Meng, Daniel Yerly, Dean J Naisbitt
PURPOSE OF REVIEW: Delayed-type or nonimmediate drug hypersensitivity reactions often involve the activation of drug-specific T cells. As such, the molecular initiating event is an interaction between HLA proteins, HLA-binding peptides and the drug. For many years, the formation of covalently modified drug protein adducts was assumed to be a prerequisite for T-cell activation. The purpose of this article is to review recent studies using human PBMC, T-cell lines and clones, which show that drugs are in fact loaded onto HLA molecules in different forms to activate T cells...
August 2018: Current Opinion in Allergy and Clinical Immunology
Sowmya Nagarajan, Paul Whitaker
PURPOSE OF REVIEW: Tuberculosis (TB) is the commonest infectious cause of death globally. Adverse reactions to first-line tuberculosis antibiotics are common and have a major impact on the outcomes of patients as second-line antibiotics are less effective and more toxic. The present review addresses the most recent literature regarding epidemiology, investigating reactions, and reintroducing treatment in patients who have had their treatment interrupted. RECENT FINDINGS: Studies have demonstrated that up to 60% of patients experience adverse reactions to TB treatment; around a third of these are idiosyncratic and may relate to immune sensitization...
August 2018: Current Opinion in Allergy and Clinical Immunology
Joan Bartra, Giovanna Araujo, Rosa Muñoz-Cano
PURPOSE OF REVIEW: To assess the studies that focus on the study of food-dependent exercise-induced anaphylaxis (FDEIA) and food-dependent NSAID-induced anaphylaxis (FDNIA). RECENT FINDINGS: Cofactors, as exercise and nonsteroidal anti-inflammatory drugs (NSAIDs), are relevant in up to 30% of episodes of anaphylaxis. Gliadin and lipid transfer proteins are the main allergens involved. The attempts to reproduce FDEIA and FDNIA in a controlled setting have an important failure rate...
August 2018: Current Opinion in Allergy and Clinical Immunology
Andrew Gibson, Monday Ogese, Munir Pirmohamed
PURPOSE OF REVIEW: Defining predisposition to allergic drug reactions has largely focussed on HLA associations, but other genetic and nongenetic factors are also likely to be involved. RECENT FINDINGS: Polymorphic genetic variants in cytokine genes, including IL-10, and co-signalling pathways, including CTLA4, have been associated with allergic drug reactions, but the effect size is lower than with HLA alleles and most associations have not been replicated. Although TCR specificity seems to be important for CBZ-induced SJS/TEN in South East Asian patients, a distinct repertoire may not play a role in reactions to other drugs...
August 2018: Current Opinion in Allergy and Clinical Immunology
Miguel Blanca, Paul Whitaker
No abstract text is available yet for this article.
August 2018: Current Opinion in Allergy and Clinical Immunology
Natalia Blanca-Lopez, Maria L Somoza-Alvarez, Teresa Bellon, Gemma Amo, Gabriela Canto, Miguel Blanca
PURPOSE OF REVIEW: NSAIDs are the drugs most frequently involved in hypersensitivity reactions (HSR). These are frequently prescribed at all ages. HSR are of great concern and can affect people at any age. These drugs can induce reactions by stimulating the adaptive immune system (IgE or T cell), known as selective responders or more frequently by abnormalities in biochemical pathways related with prostaglandin metabolism. These are known as cross-intolerant. With some exceptions, skin testing and in-vitro studies are of little value in selective responders...
August 2018: Current Opinion in Allergy and Clinical Immunology
Sangeeta Dhami, Arnav Agarwal
PURPOSE OF REVIEW: Cat allergy can manifest as allergic rhinitis, conjunctivitis and/or asthma. With widespread cat ownership and exposure, cat allergy has emerged as a major cause of morbidity. Cat allergen immunotherapy is a potential disease modifying treatment for patients with cat allergy. We examine evidence on the effectiveness, cost-effectiveness and safety of cat allergen immunotherapy and consider the clinical contexts in which it should be prescribed. RECENT FINDINGS: The European Association of Allergy and Clinical Immunology systematic reviews on allergic rhinitis and asthma along with the accompanying guidelines on allergic rhinitis were used as primary sources of evidence...
August 2018: Current Opinion in Allergy and Clinical Immunology
Yael Renert-Yuval, Emma Guttman-Yassky
PURPOSE OF REVIEW: To evaluate the treatment revolution atopic dermatitis, the most common inflammatory skin disease, has been going through in recent years, thanks to breakthroughs in disease understanding, delineating the immune fingerprint of atopic dermatitis. RECENT FINDINGS: The treatment for moderate-to-severe atopic dermatitis patients has been largely unchanged for decades and relied on broad-acting immunosuppressants. A huge unmet need existed for effective, well tolerated and narrow-targeted therapeutics...
August 2018: Current Opinion in Allergy and Clinical Immunology
François Graham, Sophia Tsabouri, Jean-Christoph Caubet
PURPOSE OF REVIEW: To present the most recent evidence on beta-lactam hypersensitivity reactions in children. RECENT FINDINGS: Drug provocation tests (DPTs) are the gold standard when investigating beta-lactam allergy in children and evidence is increasingly supporting DPTs without skin tests as a safe approach when evaluating children with nonimmediate mild reactions to beta-lactams. Of note, data are limited in the adolescent population, and this attitude may not apply to this age group...
August 2018: Current Opinion in Allergy and Clinical Immunology
Carmen Rondón, Ibon Eguiluz-Gracia, Paloma Campo
PURPOSE OF REVIEW: To examine the recent advances on epidemiological studies, diagnostic approach and clinical management of local allergic rhinitis (LAR) in adults and children. RECENT FINDINGS: Evidence about LAR is growing especially in pediatric and Asian populations. The prevalence of LAR is lower in Asian countries compared with western countries in both children and adults. LAR is considered a chronic condition and an independent rhinitis phenotype that affects up to 26...
August 2018: Current Opinion in Allergy and Clinical Immunology
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