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Expert Review of Clinical Immunology

Silvia Sedda, Gerolamo Bevivino, Giovanni Monteleone
Interleukin (IL)-23, a cytokine produced by antigen presenting cells, targets both T cells and non-T cell types with the down-stream effect of enhancing inflammatory pathways. Genome-wide association studies and data from human and mouse models of intestinal inflammation support the pathogenic role of IL-23 in Crohn's disease (CD), an immune-mediated disorder that can involve any part of the gastrointestinal tract. Areas covered: This review summarizes the available data on the role of IL-23 in CD and discusses the therapeutic relevance of blocking the function of IL-23 in this disorder...
September 18, 2018: Expert Review of Clinical Immunology
Thorvardur Jon Love, Arthur Kavanaugh
Psoriatic arthritis is an inflammatory arthritis that can be aggressive and destructive, resulting in significant morbidity. While many new agents have been approved for the treatment of psoriatic arthritis over the past decade, TNF inhibitors remain an anchor treatment, in part based on extensive clinical experience. Recently, the TNF inhibitor golimumab was approved for intravenous use in psoriatic arthritis. Areas covered: This expert review presents an overview of the currently available treatment options for psoriatic arthritis with a focus on the evidence from clinical trials supporting the use of golimumab in psoriatic arthritis...
September 17, 2018: Expert Review of Clinical Immunology
Aaron Lerner, Torsten Matthias
No abstract text is available yet for this article.
September 15, 2018: Expert Review of Clinical Immunology
Alexandra Ladouceur, Sasha Bernatsky, Rosalind Ramsey-Goldman, Ann E Clarke
INTRODUCTION: Numerous studies have clearly demonstrated that there is an altered cancer risk profile in patients with systemic lupus erythematous (SLE) versus the general population. This includes a higher risk of certain cancers (e.g. hematologic, lung) and a decreased risk of others (e.g. breast cancer). Several determinants could be behind this altered risk; these include immunosuppressant drugs, viral exposures, genetic factors, and other variables. Area covered: We review what is known regarding specific risk profiles and risk factors for some key cancers in SLE, including hematologic malignancies and lung cancers...
September 14, 2018: Expert Review of Clinical Immunology
Iris L A Bodewes, Marjan A Versnel
Primary Sjögren's syndrome (pSS) is one of the most common systemic autoimmune diseases. At the moment, there is no cure for this disease and its etiopathology is complex. Interferons (IFNs) play an important role in the pathogenesis of this disease and are a potential treatment target. Areas covered: Here we discuss the role of IFNs in pSS pathogenesis, complications encountered upon studying IFN-induced gene expression, and comment on the current knowledge on easy clinical applicable 'IFN signatures'. The current treatment options targeting IFNs in pSS are summarized and the perspective of potential new strategies discussed...
September 14, 2018: Expert Review of Clinical Immunology
Anna Valerieva, Sonia Caccia, Marco Cicardi
Hereditary angioedema (HAE) due to C1 inhibitor (C1-INH) deficiency is a debilitating and potentially lethal disease. Management includes on-demand treatment of angioedema and their prophylaxis. Plasma derived C1-INH is an established treatment for both on demand and prophylaxis of HAE. Conestat alfa is a recombinant form of human C1-INH (rhC1-INH) produced in transgenic rabbits. It has granted drug's registration as treatment option for acute HAE attacks in adults and adolescents in Europe, America, and other countries...
September 13, 2018: Expert Review of Clinical Immunology
Wilma Barcellini, Bruno Fattizzo, Anna Zaninoni
Autoimmune hemolytic anemia (AIHA) is a heterogeneous disease mainly due to autoantibody-mediated destruction of erythrocytes but also involves complement activation, dysregulation of cellular and innate immunity, and defective bone marrow compensatory response. Several drugs targeting these mechanisms are under development in addition to standard therapies. Areas covered: The following targeted therapies are illustrated: drugs acting on CD20 (rituximab, alone or in association with bendamustine and fludarabine) and CD52 (alemtuzumab), B cell receptor and proteasome inhibitors (ibrutinib, bortezomib), complement inhibitors (eculizumab, BIVV009, APL-2), and other drugs targeting T lymphocytes (subcutaneous IL-2, belimumab, and mTOR inhibitors), IgG driven extravascular hemolysis (fostamatinib), and bone marrow activity (luspatercept)...
September 11, 2018: Expert Review of Clinical Immunology
Luciana K Tanno, Pascal Demoly
No abstract text is available yet for this article.
September 11, 2018: Expert Review of Clinical Immunology
Rosanne M Smits, Dieuwke S Veldhuijzen, Nico M Wulffraat, Andrea W M Evers
Placebo effects are powerful modulators in clinical outcomes and can either result in treatment benefits or harms, known as placebo and nocebo effects. To harness these outcomes, it is important to focus on the underlying processes that steer these effects, namely by learning through expectations and conditioning. In this review, we focus on the influence of placebo effects on subjective and physiological levels of immune-related conditions (e.g. lymphocyte proliferation, cytokine production or other inflammatory markers)...
September 10, 2018: Expert Review of Clinical Immunology
Vivien C Obiakor, Hein M Tun, Sarah L Bridgman, Marie-Claire Arrieta, Anita L Kozyrskyj
Greater prescribing of antibiotics to infants has coincided with an epidemic of allergic disease. Through meta-analytic synthesis, accumulating evidence from prospective or database cohorts suggests a link between infant antibiotic treatment and the development of atopy. Stronger associations seen with multiple course and broad-spectrum antibiotic treatment add to biological plausibility. A major bias, confounding by indication, has been addressed in studies on antibiotic treatment of conditions which do not precede allergic disease...
September 8, 2018: Expert Review of Clinical Immunology
Lorena Ruiz, Patricia López, Ana Suárez, Borja Sánchez, Abelardo Margolles
The role of the human intestinal microbiota in the maintenance of a healthy physiological condition, as well as its relation to the development of disease, remains to be clarified. Current evidence suggests that intestinal microbes could be involved in the initiation and amplification of autoimmune diseases, including rheumatoid arthritis and systemic lupus erythematosus (SLE). Despite recent progress in understanding how these microbes influence the pathophysiology of lupus, studies are still limited. Areas covered: In this review, we have tried to summarize the most relevant findings that have contributed to our understanding of the links between the human intestinal microbiota and the development of lupus...
September 8, 2018: Expert Review of Clinical Immunology
Carla Felice, Daniela Pugliese, Luigi Giovanni Papparella, Fabrizio Pizzolante, Eugenia Onori, Antonio Gasbarrini, Gian Lodovico Rapaccini, Luisa Guidi, Alessandro Armuzzi
Spondyloarthritis (SpA) is the most common extra-intestinal manifestation in patients with inflammatory bowel diseases (IBD). Articular disorders may also appear as 'paradoxical' effects during biologic therapy with anti-tumor necrosis factor (TNF). Areas covered: In this narrative review, we report the current knowledge about the pathogenesis, the diagnosis and the therapeutic management of articular diseases occurring in patients with IBD. Expert commentary: Evidence-based recommendations for the management of IBD-associated SpA and paradoxical arthritis are lacking...
September 8, 2018: Expert Review of Clinical Immunology
Eric J Campbell, Anne Clarke, Rosalind Ramsey-Goldman
Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disorder with systemic manifestations and multi-organ involvement. Although primarily diagnosed, and managed in the outpatient setting, it can occasionally present with life threatening complications that require rapid assessment, and urgent aggressive therapy. Areas Covered: In our review, we explore three organ systems that are often affected in SLE, but have the potential to present as medical emergencies; these are the kidney, the central nervous system, and the hematologic system...
September 1, 2018: Expert Review of Clinical Immunology
Lieven Pouillon, Marie Socha, Beatrice Demore, Nathalie Thilly, Vered Abitbol, Silvio Danese, Laurent Peyrin-Biroulet
The nocebo effect is defined as a negative effect of a pharmacological or non-pharmacological medical treatment that is induced by patients' expectations, and that is unrelated to the physiological action of the treatment. The nocebo effect is an important clinical challenge in the current era of biosimilars. Areas covered: This review aims to answer five key questions about the nocebo effect, namely to reveal its definition, pathophysiology, clinical relevance, contributing factors, and management. Expert commentary: The nocebo effect lowers patients' quality of life and negatively affects treatment adherence rates in biosimilar-treated patients...
August 30, 2018: Expert Review of Clinical Immunology
(no author information available yet)
No abstract text is available yet for this article.
August 29, 2018: Expert Review of Clinical Immunology
Lacey B Robinson, Carlos A Camargo
Acid suppressant medications (ASMs), such as proton pump inhibitors and histamine-2 receptor antagonists, are used often and throughout the lifespan. These medications have been linked to the development of a variety of allergic diseases. Areas covered: This review discusses prior studies investigating the association between acid ASM exposure and the development of allergic diseases. We performed a thorough literature search to identify potentially relevant studies for inclusion. In summary, exposure to these medications prenatally, in childhood and in adulthood, may increase the risk of allergic diseases...
August 24, 2018: Expert Review of Clinical Immunology
Enrico Heffler, Luca Malvezzi, Monica Boita, Luisa Brussino, Armando De Virgilio, Matteo Ferrando, Francesca Puggioni, Francesca Racca, Niccolò Stomeo, Giuseppe Spriano, Giorgio Walter Canonica
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common and quality-of-life impacting disorder, with an underlying immunological mechanism similar to other conditions such as eosinophilic asthma or atopic eczema. Areas covered: This review article summarizes the most recent evidence on the main immunological mechanisms involved in the pathogenesis and the perpetuation of CRSwNP, with a particular focus on the key role of epithelium-derived inflammation as a consequence of the interaction with the airborne environment...
August 22, 2018: Expert Review of Clinical Immunology
Fabiola Atzeni, Rossella Talotta, Valeria Nucera, Francesca Marino, Elisabetta Gerratana, Donatella Sangari, Ignazio Francesco Masala, Piercarlo Sarzi-Puttini
A new class of oral synthetic drugs has been developed for the treatment of rheumatoid arthritis (RA) with the aim of blocking the Janus kinase/signal transducer and activator of transcription (JAK-STAT) system. Tofacitinib and baricitinib have been approved for the treatment RA patients who inadequately respond to methotrexate or anti-tumor necrosis factor drugs. The aim of this narrative review is to summarize the data concerning the drugs' basic mechanisms and clinical trial results in order to inform clinicians about the serious and non-serious adverse events associated with JAK inhibitors...
August 21, 2018: Expert Review of Clinical Immunology
Anna Berekmeri, Farrouq Mahmood, Miriam Wittmann, Philip Helliwell
Psoriasis and psoriatic arthritis (PsA) are inflammatory immune mediated conditions which can cause considerable disability and reduced quality of life. Management can be complex as clinical heterogeneity may lead to different treatment pathways. Tofacitinib is a novel, oral janus kinase (JAK) inhibitor with proven efficacy in rheumatoid arthritis. Areas covered: This review analyses recent studies of tofacitinib in psoriatic disease treatment. The relevant literature was identified using, PubMed and Google Scholar...
August 17, 2018: Expert Review of Clinical Immunology
John H Werner, John H Rosenberg, Kristen L Keeley, Devendra K Agrawal
Wear debris-induced osteolysis is a common cause of arthroplasty failure in several joints including the knee, hip and intervertebral disc. Debris from the prosthesis can trigger an inflammatory response that leads to aseptic loosening and prosthesis failure. In the spine, periprosthetic pain also occurs following accumulation of wear debris through neovascularization of the disc. The role of the immune system in the pathobiology of periprosthetic osteolysis of joint replacements is debatable. Areas covered: We discussed the stimulation of pro-inflammatory and pro-protective and pro-regenerative pathways due to debris from the prosthetics...
August 2018: Expert Review of Clinical Immunology
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