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Expert Review of Clinical Immunology

Marwin Gutierrez, Gurjit S Kaeley, Chiara Bertolazzi, Carlos Pineda
Ultrasound (US) is a rapidly evolving technique that is gaining increasing success in the assessment of psoriatic arthritis (PsA). Recently, new research avenues have been opened, and these are focused on the potential of US for the assessment of extra musculoskeletal areas such as skin and nails. This permits work on the concept of 'holistic US assessment of PsA'. Areas covered: Here, we analyze the potential role of US in the global assessment of PsA. Additionally, we provide the current evidence supporting its application in routine clinical practice...
December 2, 2016: Expert Review of Clinical Immunology
Nikoleta Brankov, Sharon E Jacob
No abstract text is available yet for this article.
December 2, 2016: Expert Review of Clinical Immunology
Dana M Roque, Alessandro D Santin
No abstract text is available yet for this article.
December 1, 2016: Expert Review of Clinical Immunology
Cosimo Bruni, Emanuela Praino, Yannick Allanore, Oliver Distler, Armando Gabrielli, Florenzo Iannone, Marco Matucci-Cerinic
Systemic sclerosis (SSc) is a systemic autoimmune disease characterized by vasculopathy, inflammation and fibrosis. These three main disease-determining pathways are the target of the currently available treatments used to possibly modify the progression of disease-related manifestations, although this synergy has not been fully applied on SSc joint, skin or lung involvement yet. Areas covered: we describe the current status of SSc treatment/therapy performing a literature search in MEDLINE/Pubmed and Thomson Reuter's Web of Science for articles published until March 2016...
November 30, 2016: Expert Review of Clinical Immunology
Giovanni Prezioso, Laura Comegna, Concetta Di Giulio, Simone Franchini, Francesco Chiarelli, Annalisa Blasetti
In type 1 diabetes (T1D), several genetic factors are associated to β-cell autoimmunity onset and clinical progression. HLA-genes play a major role in susceptibility and initiation of β-cell autoimmunity, whereas non-HLA genes may influence the destruction rate. Areas covered: Our review focuses on the possible role of the PTPN22 C1858T variant as a prognostic factor, given its influence on disease variability. Moreover, we present the potential role of C1858T as a target for tertiary prevention trials and new therapeutic strategies, such as the LYP inhibitors...
November 28, 2016: Expert Review of Clinical Immunology
Beatriz Costa-Carvalho, Maria González-Serrano, Sara Espinosa-Padilla, Gesmar Segundo
diagnosis of primary immunodeficiency diseases (PID) is still a challenge in many countries in Latin America (LA), especially those that face social and economic problems. The creation of a society was fundamental to combine efforts that resulted in an effective educational program, establishment of a registry and a network to improve diagnosis. Areas covered: The focus of this article is to portray the scenario of PID in LA covering different aspects from different countries. For this, a questionnaire was sent to countries that participate in the Latin American Society for Immunodeficiencies (LASID) registry, with questions related to PID challenges in LA...
November 21, 2016: Expert Review of Clinical Immunology
Ajesh B Maharaj, Vinod Chandran
Recent advances in the therapeutics of psoriatic arthritis (PsA) have provided more options to clinicians managing PsA. The purpose of this review is to update the reader on treatment options for PsA using conventional synthetic disease modifying agents (csDMARDs) and novel therapies including tumour necrosis factor alpha inhibitors, interleukin 12/23 inhibitor (ustekinumab), the interleukin 17 antagonists including secukinumab, brodalumab, ixekizumab, and the phosphodiesterase-4 inhibitor, apremilast. Areas covered: We reviewed published articles on the treatment of PsA...
November 18, 2016: Expert Review of Clinical Immunology
Matea Deliu, Danielle Belgrave, Matthew Sperrin, Iain Buchan, Adnan Custovic
Asthma is no longer thought of as a single disease, but rather a collection of varying symptoms expressing different disease patterns. One of the ongoing challenges is understanding the underlying pathophysiological mechanisms that may be responsible for the varying responses to treatment. Areas Covered: This review provides an overview of our current understanding of the asthma phenotype concept in childhood and describes key findings from both conventional and data-driven methods. Expert Commentary: With the vast amounts of data generated from cohorts, there is hope that we can elucidate distinct pathophysiological mechanisms, or endotypes...
November 18, 2016: Expert Review of Clinical Immunology
Pedro Mota, Venkat Reddy, David Isenberg
Rituximab-based B-cell depletion (BCD) therapy is effective in refractory rheumatoid arthritis (RA) and although used to treat patients with refractory systemic lupus erythematosus (SLE) in routine clinical practice, rituximab failed to meet the primary endpoints in two large randomised controlled trials (RCTs) of non-renal (EXPLORER) and renal (LUNAR) SLE. Areas covered: We review how BCD could be improved to achieve better clinical responses in RA and SLE. Insights into the variability in clinical response to BCD in RA and SLE may help develop new therapeutic strategies...
November 14, 2016: Expert Review of Clinical Immunology
Justin Greiwe, Jonathan A Bernstein
Chronic urticaria affects up to 1-3% of the general population and contributes to significant direct and indirect medical costs as well as decreased quality of life, which has a significant economic impact on our health care system. Areas covered: Given the prevalence of this condition on a large sector of the population, finding lasting relief for refractory cases is essential and is the focus of this review. Expert commentary: The choice of appropriate therapy in chronic refractory urticaria is not a 'one-size fits all' approach...
November 3, 2016: Expert Review of Clinical Immunology
László Maródi
Immunopathological diseases have traditionally been classified as autoimmune/inflammatory, allergic, and primary immunodeficiency (PID) conditions. Different clinical disciplines have been established along with these classifications resulting in artificial separation of immune disorders in clinical practice and the establishment of professional societies and journals focusing on these seemingly different areas of clinical medicine. Understanding better the genetics of human immunity and immunopathology has changed our approach to such a classification...
November 1, 2016: Expert Review of Clinical Immunology
Ladislav Šenolt
No abstract text is available yet for this article.
October 28, 2016: Expert Review of Clinical Immunology
Paolo Lissoni
Despite its apparent failure in cancer therapy, IL-2 still remains fundamental in the activation of antitumor immunity. Areas covered: The aim of this review is the reinterpretation of the role of IL-2 in anticancer immunity, according to knowledge gained of the cytokine network, by highlighting its importance in inducing T helper-1 (TH1) cell proliferation, natural killer (NK) actHivation and IL-12 secretion. However, its main negative effect is the stimulation of regulatory T cells (Tregs), which in contrast suppresses anticancer immunity...
October 26, 2016: Expert Review of Clinical Immunology
D T Laura Vo Ngoc, Lizette Krist, Frans J van Overveld, Ger T Rijkers
The most common humoral immunodeficiency is IgA deficiency. One of the first papers addressing the cellular and molecular mechanisms underlying IgA deficiency indicated that immature IgA-positive B-lymphocytes are present in these patients. This suggests that the genetic background for IgA is still intact and that class switching can take place. At this moment, it cannot be ruled out that genetic as well as environmental factors are involved. Areas covered: A clinical presentation, the biological functions of IgA, and the management of IgA deficiency are reviewed...
October 25, 2016: Expert Review of Clinical Immunology
Michael A Goodman, Donya Moradi Manesh, Punam Malik, Marc E Rothenberg
No abstract text is available yet for this article.
October 24, 2016: Expert Review of Clinical Immunology
Daniela Pugliese, Carla Felice, Alfredo Papa, Antonio Gasbarrini, Gian Lodovico Rapaccini, Luisa Guidi, Alessandro Armuzzi
Anti TNF-α agents have become a significant advance in the management of ulcerative colitis, proving to induce, with rapid onset, clinical and endoscopic remission. However, there is still a considerable unmet medical need in ulcerative colitis. Areas covered: The aim of this review was to summarize the patterns of use and the effectiveness of anti TNF-α in ulcerative colitis, highlighting their current position in treatment algorithms. Moreover, we set out a five-year view hypothesizing different treatment strategies...
October 14, 2016: Expert Review of Clinical Immunology
M Galluzzo, S D'Adamio, L Bianchi, M Talamonti
Psoriasis is a complex disease in which the alteration of the IL-23/Th17 axis appears to be crucial for its pathogenic mechanisms, and anti-IL17 agents are rapidly becoming important therapeutic tools. Brodalumab, a fully human Chinese hamster ovary cell-derived immunoglobulin G2 (IgG2) anti-IL-17RA monoclonal antibody, is currently the most-developed treatment that binds to the IL-17RA. The authors review and provide updates of efficacy and safety by several studies on brodalumab. Areas covered: A PubMed search was performed for relevant literature...
October 10, 2016: Expert Review of Clinical Immunology
Maureen C Turina, Robert Landewé, Dominique Baeten
Early diagnosis, monitoring of disease activity, prediction of treatment response, and structural outcome remain major challenges in spondyloarthritis (SpA). Biomarkers could play a role in addressing these challenges, but in SpA there is a lack of suitable biomarkers. Areas covered: As SpA is clinically and pathophysiologically closely related to psoriasis and inflammatory bowel disease (IBD), we reviewed in literature, the value of serum biomarkers in these conditions with the aim to find potential candidates for assessing SpA...
October 5, 2016: Expert Review of Clinical Immunology
Franceso Zulian, Marta Balzarin, Carolina Birolo
Juvenile Systemic Sclerosis (JSSc) is one of the most severe multi-systemic connective tissue conditions encountered in pediatric rheumatology. Due to its high morbidity and mortality rate, early diagnosis, proper assessment and effective treatment are crucial. Areas covered: In this review, we will focus on the recent advances on the classification and general management of JSSc based on the literature search and on the Authors' experience. Expert Commentary: Classification criteria for the pediatric forms of systemic sclerosis, the new proposed assessment tools, such as the juvenile systemic sclerosis severity score, named J4S, and new techniques for the internal organs assessment, will facilitate both daily practice and research projects...
October 3, 2016: Expert Review of Clinical Immunology
Wang Sin Gina Tan, Stephen Kelly, Constantino Pitzalis
Biologic therapy has revolutionized treatment pathways in psoriatic joint and skin disease. It has also provided a useful tool with which pathological pathways of this condition may be explored. Areas Covered: This review presents data on the clinical and biological effects of targeted therapy in psoriatic arthritis and psoriasis. Therapeutic agents covered include inhibitors of TNFα, inhibitors of the IL-23/IL-17 axis and inhibitors of intracellular small molecules involved in the transduction of the inflammatory signal...
October 3, 2016: Expert Review of Clinical Immunology
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