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Clinical Reviews in Allergy & Immunology

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https://www.readbyqxmd.com/read/27878451/beyond-genetics-what-causes-type-1-diabetes
#1
REVIEW
Zhen Wang, Zhiguo Xie, Qianjin Lu, Christopher Chang, Zhiguang Zhou
Type 1 diabetes (T1D) is an autoimmune disease resulting from T cell-mediated β cell destruction in the pancreas of genetically susceptible individuals. Extensive familial and population genetic studies uncovered the strong linkage and association between HLA gene variants and T1D. Non-HLA genes have also been associated with T1D, such as INS, CTLA4, and PTPN22. T1D is considered as one of the most heritable common diseases. However, evidence that monozygotic twins have incomplete concordance of disease susceptibility provides convincing proof that environmental factors also play important roles in the pathogenesis of the disease...
November 22, 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27873163/an-update-on-the-use-of-immunomodulators-in-primary-immunodeficiencies
#2
REVIEW
Pandiarajan Vignesh, Amit Rawat, Surjit Singh
The genomic revolution in the past decade fuelled by breathtaking advances in sequencing technologies has defined several new genetic diseases of the immune system. Many of these newly characterized diseases are a result of defects in genes involved in immune regulation. The discovery of these diseases has opened a vista of new therapeutic possibilities. Immunomodulatory agents, a hitherto unexplored therapeutic option in primary immunodeficiency diseases have been tried in a host of these newly described maladies...
November 21, 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27687891/epigenetic-variability-of-cd4-cd25-tregs-contributes-to-the-pathogenesis-of-autoimmune-diseases
#3
Ye Shu, Qinghua Hu, Hai Long, Christopher Chang, Qianjin Lu, Rong Xiao
Autoimmune diseases are characterized by aberrant immune responses against healthy cells and tissues. However, the exact mechanisms underlying the development of these conditions remain unknown. CD4+CD25+ regulatory T cells (Tregs) are a subset of mature T cells which have an important role in maintaining immune homeostasis and preventing autoimmune diseases. Forkhead box p3 (Foxp3), a member of the fork head transcription factor family, is recognized as a marker of CD4+CD25+ Tregs. The decreased number and/or function of CD4+CD25+ Tregs in peripheral blood and related tissues has been demonstrated in systemic lupus erythematosus, systemic sclerosis, and other autoimmune diseases, which are at least partially regulated by epigenetic mechanisms...
September 29, 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27677501/diagnostic-potential-of-extracellular-microrna-in-respiratory-diseases
#4
Dhamotharan Pattarayan, Rajesh K Thimmulappa, Vilwanathan Ravikumar, Subbiah Rajasekaran
Lack of markers of subclinical disease state and clinical phenotype other than pulmonary function test has made the diagnosis and interventions of environmental respiratory diseases a major challenge. MicroRNAs (miRNAs), small non-coding single stranded RNAs, have emerged as potential disease-modifier in various environmental respiratory diseases. They can also be found in various body fluids and are remarkably stable. Because of their high stability, disease-specific expression, and the ease to detect and quantify them have raised the potential of miRNAs in body fluids to be useful clinical diagnostic biomarkers for lung disease phenotyping...
September 27, 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27677500/neutralization-versus-reinforcement-of-proinflammatory-cytokines-to-arrest-autoimmunity-in-type-1-diabetes
#5
Ayelet Kaminitz, Shifra Ash, Nadir Askenasy
As physiological pathways of intercellular communication produced by all cells, cytokines are involved in the pathogenesis of inflammatory insulitis as well as pivotal mediators of immune homeostasis. Proinflammatory cytokines including interleukins, interferons, transforming growth factor-β, tumor necrosis factor-α, and nitric oxide promote destructive insulitis in type 1 diabetes through amplification of the autoimmune reaction, direct toxicity to β-cells, and sensitization of islets to apoptosis. The concept that neutralization of cytokines may be of therapeutic benefit has been tested in few clinical studies, which fell short of inducing sustained remission or achieving disease arrest...
September 27, 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27677499/anti-interleukin-5-therapy-for-eosinophilic-asthma-a-meta-analysis-of-randomized-clinical-trials
#6
Fa-Ping Wang, Xiao-Feng Xiong, Ting Liu, Su-Yun Li, De-Yun Cheng, Hui Mao
Recently, more and more clinical trials have been performed to evaluate the effects of anti-interleukin (IL)-5 antibodies in eosinophilic asthma. However, a confirm conclusion has not been well established. We therefore sought to conduct a meta-analysis to assess the overall efficacy and safety of anti-interleukin 5 treatments in eosinophilic asthma. RCTs of anti-interleukin 5 treatments in eosinophilic asthma published up to June 2016 in PubMed, Embase, Cochrane library databases, and CBM, which reported pulmonary functions, quality-of-life scores, asthmatic exacerbations, and adverse events were included...
September 27, 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27672078/efficacy-of-treatment-of-non-hereditary-angioedema
#7
Mignon van den Elzen, M F C L Go, A C Knulst, M A Blankestijn, H van Os-Medendorp, H G Otten
Non-hereditary angioedema (AE) with normal C1 esterase inhibitor (C1INH) can be presumably bradykinin- or mast cell-mediated, or of unknown cause. In this systematic review, we searched PubMed, EMBASE, and Scopus to provide an overview of the efficacy of different treatment options for the abovementioned subtypes of refractory non-hereditary AE with or without wheals and with normal C1INH. After study selection and risk of bias assessment, 61 articles were included for data extraction and analysis. Therapies were described for angiotensin-converting enzyme inhibitor-induced AE (ACEi-AE), for idiopathic AE, and for AE with wheals...
September 27, 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27628237/female-infertility-and-serum-auto-antibodies-a-systematic-review
#8
Alban Deroux, Chantal Dumestre-Perard, Camille Dunand-Faure, Laurence Bouillet, Pascale Hoffmann
On average, 10 % of infertile couples have unexplained infertility. Auto-immune disease (systemic lupus erythematosus, anti-phospholipid syndrome) accounts for a part of these cases. In the last 20 years, aspecific auto-immunity, defined as positivity of auto-antibodies in blood sample without clinical or biological criteria for defined diseases, has been evoked in a subpopulation of infertile women. A systematic review was performed (PUBMED) using the MESH search terms "infertility" and "auto-immunity" or "reproductive technique" or "assisted reproduction" or "in vitro fertilization" and "auto-immunity...
September 14, 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27459852/hae-pathophysiology-and-underlying-mechanisms
#9
REVIEW
Bruce L Zuraw, Sandra C Christiansen
Remarkable progress in understanding the pathophysiology and underlying mechanisms of hereditary angioedema has led to the development of effective treatment for this disorder. Progress in three separate areas has catalyzed our understanding of hereditary angioedema. The first is the recognition that HAE type I and type II result from a deficiency in the plasma level of functional C1 inhibitor. This observation has led to a detailed understanding of the SERPING1 mutations responsible for this deficiency as well as the molecular regulation of C1 inhibitor expression and function...
October 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27388236/the-humanistic-societal-and-pharmaco-economic-burden-of-angioedema
#10
REVIEW
Hilary Longhurst, Anette Bygum
Hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE) is a rare disorder characterized by intermittent and unpredictable episodes of swelling which cause disfigurement, disability, pain, or, in case of laryngeal swelling, risk of death. Historical factors, including the intermittent nature of the disorder, the lack of awareness of this ultra-rare condition amongst medical personnel, lack of specialist centers, and limited treatment options have contributed to under-diagnosis and under-treatment of the condition...
October 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27300248/the-effect-of-tnf-inhibitors-on-cardiovascular-events-in-psoriasis-and-psoriatic-arthritis-an-updated-meta-analysis
#11
Zheng-Sheng Yang, Ning-Ning Lin, Li Li, Yang Li
TNF inhibitors have been used in psoriasis (Pso) and psoriatic arthritis (PsA), which were associated with increased risk of cardiac and cerebrovascular events. However, whether TNF inhibitors reduce cardiovascular event is still unclear. Therefore, we aimed to evaluate the effect of TNF inhibitors on adverse cardiovascular events (CVEs) in Pso with or without PsA. We undertook a meta-analysis of clinical trials identified in systematic searches of MEDLINE, EMBASE, Wanfang database, Cochrane Database, and Google scholar through December 31, 2015...
October 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27287037/the-story-of-angioedema-from-quincke-to-bradykinin
#12
REVIEW
Avner Reshef, Mona Kidon, Iris Leibovich
The term "swelling" has been used in the old scriptures to illustrate a change of normal figure and, as such, an expression of illness. It should be noted that in ancient times, human diseases were very often regarded a punishment from God. Hence, it is not surprising that one of the oldest tests for infidelity involved swelling as an inflicted punishment. The great Greek physician Hippocrates (377-460 BC), considered one of the most outstanding figures in the history of medicine and "Father of the Western Medicine," already used the term oídēma to describe swelling of organs...
October 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27273087/complement-kinins-and-hereditary-angioedema-mechanisms-of-plasma-instability-when-c1-inhibitor-is-absent
#13
REVIEW
Allen P Kaplan, Kusumam Joseph
Plasma of patients with types I and II hereditary angioedema is unstable if incubated in a plastic (i.e., inert) vessel at 37 °C manifested by progressively increasing formation of bradykinin. There is also a persistent low level of C4 in 95 % of patients even when they are symptomatic. These phenomena are due to the properties of the C1r subcomponent of C1, factor XII, and the bimolecular complex of prekallikrein with high molecular weight kininogen (HK). Purified C1r auto-activates in physiologic buffers, activates C1s, which in turn depletes C4...
October 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27207174/a-decade-of-change-recent-developments-in-pharmacotherapy-of-hereditary-angioedema-hae
#14
REVIEW
Konrad Bork
Hereditary angioedema (HAE) due to C1 esterase inhibitor (C1-INH) deficiency (HAE-C1-INH) is a rare but medically significant disease that can be associated with considerable morbidity and mortality. Research into the pathogenesis of HAE-C1-INH has expanded greatly in the last six decades and has led to new clinical trials with novel therapeutic agents and treatment strategies. Mechanisms of pharmacotherapy include (a) supplementing C1-INH, the missing serine-protease inhibitor in HAE; (b) inhibiting the activation of the contact system and the uncontrolled release of proteases in the kallikrein-kinin system, by blocking the production/function of its components; (c) inhibiting the fibrinolytic system by blocking the production/function of its components; and (d) inhibiting the function of bradykinin at the endothelial level...
October 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27142368/-nuts-and-bolts-of-laboratory-evaluation-of-angioedema
#15
REVIEW
Henriette Farkas, Nóra Veszeli, Erika Kajdácsi, László Cervenak, Lilian Varga
Angioedema, as a distinct disease entity, often becomes a clinical challenge for physicians, because it may cause a life-threatening condition, whereas prompt and accurate laboratory diagnostics may not be available. Although the bedside diagnosis needs to be established based on clinical symptoms and signs, family history, and the therapeutic response, later, laboratory tests are available. Currently, only for five out of the nine different types of angioedema can be diagnosed by laboratory testing, and these occur only in a minority of the patient population...
October 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27129449/review-of-select-practice-parameters-evidence-based-treatment-algorithms-and-international-guidelines-for-hereditary-angioedema
#16
REVIEW
Jaison Jose, Jamie Zacharias, Timothy Craig
Hereditary angioedema (HAE) is a rare bradykinin-mediated disease that is characterized by recurrent attacks of subcutaneous or submucosal edema, which can be life threatening. HAE affects all ethnic groups equally and does not differentiate between age, sex, or race. However, the availability of therapies varies amongst countries resulting in a lack of uniformity of care. Not only is there a disparity of medication availability, but since HAE is a rare disease, it is frequently overlooked and the diagnosis is missed...
October 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27122021/bradykinin-inflammatory-product-of-the-coagulation-system
#17
REVIEW
Zonne Hofman, Steven de Maat, C Erik Hack, Coen Maas
Episodic and recurrent local cutaneous or mucosal swelling are key features of angioedema. The vasoactive agents histamine and bradykinin are highly implicated as mediators of these swelling attacks. It is challenging to assess the contribution of bradykinin to the clinical expression of angioedema, as accurate biomarkers for the generation of this vasoactive peptide are still lacking. In this review, we will describe the mechanisms that are responsible for bradykinin production in hereditary angioedema (HAE) and the central role that the coagulation factor XII (FXII) plays in it...
October 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27116602/genetics-of-hereditary-angioedema-revisited
#18
REVIEW
Anastasios E Germenis, Matthaios Speletas
Contemporary genetic research has provided evidences that angioedema represents a diverse family of disorders related to kinin metabolism, with a much greater genetic complexity than was initially considered. Convincing data have also recently been published indicating that the clinical heterogeneity of hereditary angioedema due to C1 inhibitor deficiency (classified as C1-INH-HAE) could be attributed at least in part, either to the type of SERPING1 mutations or to mutations in genes encoding for enzymes involved in the metabolism and function of bradykinin...
October 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27113957/angioedema-phenotypes-disease-expression-and-classification
#19
REVIEW
Maddalena Alessandra Wu, Francesca Perego, Andrea Zanichelli, Marco Cicardi
Due to marked heterogeneity of clinical presentations, comprehensive knowledge of angioedema phenotypes is crucial for correct diagnosis and choosing the appropriate therapeutic approach. One of the ways to a meaningful clinical distinction can be made between forms of angioedema occurring "with or without wheals." Angioedema with wheals (rash) is a hallmark of urticaria, either acute or chronic, spontaneous or inducible. Angioedema without wheals may still be manifested in about 10 % of patients with urticaria, but it may also occur as a separate entity...
October 2016: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/27585580/cashew-nut-allergy-clinical-relevance-and-allergen-characterisation
#20
Cíntia Mendes, Joana Costa, António A Vicente, Maria Beatriz P P Oliveira, Isabel Mafra
Cashew plant (Anacardium occidentale L.) is the most relevant species of the Anacardium genus. It presents high economic value since it is widely used in human nutrition and in several industrial applications. Cashew nut is a well-appreciated food (belongs to the tree nut group), being widely consumed as snacks and in processed foods by the majority of world's population. However, cashew nut is also classified as a potent allergenic food known to be responsible for triggering severe and systemic immune reactions (e...
September 1, 2016: Clinical Reviews in Allergy & Immunology
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