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Allergy, Asthma, and Clinical Immunology

Stephanie C Erdle, Edmond S Chan, Hyungjun Yang, Bruce A Vallance, Christopher Mill, Tiffany Wong
Background: Ginseng is a perennial herb used in traditional Chinese medicine, which has become increasingly popular world-wide due to its proposed medicinal effects. There are two major species of ginseng, Panax ginseng (Korean or Asian ginseng), and Panax quinquefolius (American ginseng). Although cases of allergy due to Korean ginseng have been reported in adults, there are no reported cases of allergy to American ginseng, and no reported cases of ginseng allergy in pediatric patients...
2018: Allergy, Asthma, and Clinical Immunology
Natalia Ukleja-Sokołowska, Ewa Gawrońska-Ukleja, Kinga Lis, Magdalena Żbikowska-Gotz, Łukasz Sokołowski, Zbigniew Bartuzi
Background: An allergy to mango is extremely rare. The antigenic composition of the fruit is not fully known. Profilin from mango has a structure similar to birch tree profiling: it is responsible for cross-reactions between mango and pear, apple, and peach. A panallergen with a structure similar to mugwort defensin (Art v 1) which cross-reacts with celery, carrot, peanuts, pepper, aniseed, and caraway has been previously described. Case study: A female patient, 30 years old, was admitted in February 2017 because of recurrent allergic reactions following consumption of various foods...
2018: Allergy, Asthma, and Clinical Immunology
Rajiva de Silva, Dhanushka Dasanayake, Manouri Senanayake, Ramya Ediriweera, Savithri Dias, Chandima Karunatilleke, Karen Brocas, Fariba Tahami, Suranjith Seneviratne
Background: Hyper IgE recurrent infection syndrome (HIES) is a rare immune deficiency, characterized by recurrent staphylococcal skin and lung abscesses, pneumonia and increased IgE levels. The majority of autosomal dominant HIES (AD HIGE) is due to hypomorphic mutations in the signal transducer and the activator of transcription 3 (STAT3) gene. Case presentation: Five patients were diagnosed with HIES, based on the clinical criteria and scoring system developed at the National Institutes of Health (NIH), USA...
2018: Allergy, Asthma, and Clinical Immunology
Rozlyn C T Boutin, Zach Dwyer, Kyle Farmer, Chris Rudyk, Mark R Forbes, Shawn Hayley
Background: Accumulating evidence suggests that the gut microbiota shapes developmental processes within the immune system. Early life antibiotic use is one factor which may contribute to immune dysfunction and the recent surge in allergies by virtue of its effects on gut microbiota. Objective and methods: As a first step towards determining whether a relationship exists between perinatal antibiotic induced changes in the gut microbiota and the later development of a peanut allergy, we exposed newborn mice to either the broad-spectrum antibiotic vancomycin or to a vehicle for 6 weeks and then used a novel murine model of peanut allergy...
2018: Allergy, Asthma, and Clinical Immunology
Anna Valerieva, Marco Cicardi, James Baraniuk, Maria Staevska
Background: Hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE) is a rare autosomal dominant disease characterized by episodes of acute subcutaneous swelling, and/or recurrent severe abdominal pain. The disease is potentially fatal if the upper-airway is involved. Iatrogenic harm can occur if HAE is not considered in the differential diagnosis, the specialists are not aware of the natural history, diagnosis and treatment of HAE, or as a result of unnecessary surgical and other iatrogenic interventions...
2018: Allergy, Asthma, and Clinical Immunology
Keisuke Miki, Mari Miki, Kenji Yoshimura, Kazuyuki Tsujino, Hiroyuki Kagawa, Yohei Oshitani, Yuko Ohara, Yuki Hosono, Ryuya Edahiro, Hiroyuki Kurebe, Seigo Kitada
Background: Bronchial thermoplasty (BT) is a bronchoscopic treatment that can ameliorate the symptoms of severe asthma. However, little is known about the mechanism by which BT improves exertional dyspnea without significantly changing the resting pulmonary function in asthmatics. To understand the mechanism, cardiopulmonary variables were investigated using cardiopulmonary exercise testing (CPET) in a patient with severe asthma before and after BT. Case presentation: A 57-year-old Japanese man visited our hospital for consultation of the intractable asthma, which we managed with three treatment sessions of BT...
2018: Allergy, Asthma, and Clinical Immunology
Polliana Mihaela Leru, Vlad Florin Anton, Horia Bumbea
Background: Angioedema due to acquired deficiency of C1-inhibitor (C1-INH-AAE) is a rare disease sharing some clinical and laboratory similarities with hereditary angioedema, but with late onset and no positive family history. The underlining cause may be malignant or due to autoimmune diseases, but some cases remain idiopathic. Case presentation: We report a case of a 75 year old woman suffering from recurrent episodes of angioedema since the age of 66, considered first induced by treatment with angiotensin-converting-enzyme inhibitors (ACEI)...
2018: Allergy, Asthma, and Clinical Immunology
Lianne Soller, Sebastien La Vieille, Edmond S Chan
Background: Lupine is a member of the legume family and is often used in many food products in Europe (e.g. pasta, pizza, sauces, etc.) as a wheat or soy substitute. Lupine cross-reacts with peanut, and cases of allergic reactions to lupine in peanut-allergic patients have been reported in Europe mainly. In contrast, lupine as an ingredient in food products is relatively new to the Canadian market. Case presentation: We describe a 10-year old boy with diagnosed peanut and tree-nut allergy, who developed anaphylaxis to lupine flour in May 2017...
2018: Allergy, Asthma, and Clinical Immunology
John Dempster
Background: Hereditary angioedema (HAE) due to C1 esterase inhibitor (C1-INH) deficiency is characterized by recurrent swelling attacks that can be life-threatening if left untreated. Prompt treatment is vital during acute attacks; plasma-derived C1-INH (Berinert® ) is one treatment currently licensed for the intravenous treatment of acute HAE attacks in adults, adolescents and children. A new, volume-reduced formulation, of C1-INH is currently available which aims to reduce the time to treatment, and provide greater convenience to patients and healthcare professionals...
2018: Allergy, Asthma, and Clinical Immunology
Blake Murdoch, Eric M Adams, Timothy Caulfield
Background: There is ongoing controversy surrounding the appropriate standards and limits of accommodation of children with food allergies in schools. We identify and explain how relevant Canadian common law, legislation, constitutional law and human rights policy can inform future school policy around allergy, disability and food bans. Main body: The Canadian Charter of Rights and Freedoms applies to governmental laws or policies, including the policies of schools, and grants every individual the right to freedom from discrimination based on, among other things, disability...
2018: Allergy, Asthma, and Clinical Immunology
Leisa Rebecca Watson, Charlotte A Slade, Samar Ojaimi, Sara Barnes, Pasquale Fedele, Prudence Smith, Justine Marum, Sebastian Lunke, Zornitza Stark, Matthew F Hunter, Vanessa L Bryant, Michael Sze Yuan Low
Background: Daclizumab is a humanized monoclonal antibody that blocks CD25, the high affinity alpha subunit of the interleukin-2 receptor. Daclizumab therapy targets T regulatory cell and activated effector T cell proliferation to suppress autoimmune disease activity, in inflammatory conditions like relapsing and remitting multiple sclerosis. Here, we present the first report of agranulocytosis with daclizumab therapy in a patient with relapsing and remitting multiple sclerosis. Case presentation: Our patient was a 24-year-old Australian female with a clinical history of atopy, lymphocytic enteritis complicated by B12 deficiency, relapsing and remitting multiple sclerosis, recurrent lower respiratory tract infections, vulval/cervical intraepithelial neoplasia and melanoma...
2018: Allergy, Asthma, and Clinical Immunology
Yao-Tung Wang, Hsu-Chung Liu, Hui-Chen Chen, Yen-Ching Lee, Tung-Chou Tsai, Hsiao-Ling Chen, Hueng-Chuen Fan, Chuan-Mu Chen
Background: Allergen-specific immunotherapy (ASIT) has the potential to modify allergic diseases, and it is also considered a potential therapy for allergic asthma. House dust mite (HDM) allergens, a common source of airborne allergen in human diseases, have been developed as an immunotherapy for patients with allergic asthma via the subcutaneous and sublingual routes. Oral immunotherapy with repeated allergen ingestion is emerging as another potential modality of ASIT. The aim of this study was to evaluate the therapeutic efficacy of the oral ingestion of HDM extracts in a murine model of allergic asthma...
2018: Allergy, Asthma, and Clinical Immunology
Núria Piqué, Barbara De Servi
Background: To assess the effects of Rhinosectan® spray, a medical device containing xyloglucan, on nasal ciliary function (in MucilAir™Nasal cells). Methods: MucilAir™Nasal, a three-dimensional organotypic airway tissue model (with different cell types), was treated with Rhinosectan® (30 µl) or with a control (saline solution). The effects of Rhinosectan® were evaluated at 15 and 60 min post-exposure by: measurement of the cilia beating frequency (Hz), mucin detection (Enzyme-Linked Lectin Assay-ELLA), mucociliary clearance (µm/s) and phagocytosis assay (fluorescence)...
2018: Allergy, Asthma, and Clinical Immunology
Przemyslaw Zdziarski, Andrzej Gamian, Jacek Majda, Agnieszka Korzeniowska-Kowal
[This corrects the article DOI: 10.1186/s13223-017-0213-x.].
2018: Allergy, Asthma, and Clinical Immunology
Tresa George, Mainak Chakraborty, Mark A Giembycz, Robert Newton
Background: Asthma exacerbations are associated with the recruitment of neutrophils to the lungs. These cells release proteases and mediators, many of which act at G protein-coupled receptors (GPCRs) that couple via Gq to promote bronchoconstriction and inflammation. Common asthma therapeutics up-regulate expression of the regulator of G protein signalling (RGS), RGS2. As RGS2 reduces signaling from Gq-coupled GPCRs, we have defined role(s) for this GTPase-activating protein in an acute neutrophilic model of lung inflammation...
2018: Allergy, Asthma, and Clinical Immunology
Christine McCusker, Julia Upton, Richard Warrington
Primary immunodeficiency disorder (PID) refers to a large heterogeneous group of disorders that result from defects in immune system development and/or function. PIDs are broadly classified as disorders of adaptive immunity (i.e., T cell, B-cell or combined immunodeficiencies) or of innate immunity (e.g., phagocyte and complement disorders). Although the clinical manifestations of PIDs are highly variable, many disorders involve an increased susceptibility to infection. Early consultation with a clinical immunologist is essential, as timely diagnosis and treatment are imperative for preventing significant disease-associated morbidity...
2018: Allergy, Asthma, and Clinical Immunology
Richard Warrington, Fanny Silviu-Dan, Tiffany Wong
Drug allergy encompasses a spectrum of immunologically-mediated hypersensitivity reactions with varying mechanisms and clinical presentations. This type of adverse drug reaction not only affects patient quality of life, but may also lead to delayed treatment, unnecessary investigations, and even mortality. Given the myriad of symptoms associated with the condition, diagnosis is often challenging. Therefore, referral to an allergist experienced in the identification, diagnosis and management of drug allergy is recommended if a drug-induced allergic reaction is suspected...
2018: Allergy, Asthma, and Clinical Immunology
Stuart Carr, Edmond S Chan, Wade Watson
Eosinophilic esophagitis (EoE) is an atopic condition of the esophagus that has become increasingly recognized over the last 15 years. Diagnosis of the disorder is dependent on the patient's clinical manifestations, and must be confirmed by histologic findings on esophageal mucosal biopsies. Patients with EoE should be referred to an allergist for optimal management, which may include dietary modifications and pharmacologic agents such as corticosteroids, and for the diagnosis and management of comorbid atopic conditions...
2018: Allergy, Asthma, and Clinical Immunology
Edmond S Chan, Elissa M Abrams, Kyla J Hildebrand, Wade Watson
Food allergy is a growing public health problem, and in many affected individuals, the food allergy begins early in life and persists as a lifelong condition (e.g., peanut allergy). Although early clinical practice guidelines recommended delaying the introduction of peanut and other allergenic foods in children, this may have in fact contributed to the dramatic increase in the prevalence of food allergy in recent decades. In January 2017, new guidelines on peanut allergy prevention were released which represented a significant paradigm shift in early food introduction...
2018: Allergy, Asthma, and Clinical Immunology
Lori Connors, Andrew O'Keefe, Lana Rosenfield, Harold Kim
Non-immunoglobulin E (IgE)-mediated food hypersensitivity includes a spectrum of disorders that predominantly affect the gastrointestinal tract. This review will focus on the following more common non-IgE-mediated food hypersensitivity syndromes: food protein-induced enterocolitis syndrome (FPIES), allergic proctocolitis (AP), food protein-induced enteropathy (FPE) and celiac disease. FPIES, AP and FPE typically present in infancy and are most commonly triggered by cow's milk protein or soy. The usual presenting features are profuse emesis and dehydration in FPIES; blood-streaked and mucousy stools in AP; and protracted diarrhea with malabsorption in FPE...
2018: Allergy, Asthma, and Clinical Immunology
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