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Journal of Asthma and Allergy

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https://www.readbyqxmd.com/read/29950874/economic-considerations-in-the-treatment-of-systemic-allergic-reactions
#1
REVIEW
Emma Westermann-Clark, Amber N Pepper, Richard F Lockey
Epinephrine is a life-saving medication used to treat systemic allergic reactions including anaphylaxis. Epinephrine autoinjectors (EAIs) are expensive and worldwide availability is limited. Epinephrine prefilled syringes and epinephrine kits are potentially lower-cost alternatives to EAIs. Advantages, disadvantages, and costs of available products are discussed. The socioeconomic factors impacting access to EAIs are described.
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29950873/underuse-of-epinephrine-for-the-treatment-of-anaphylaxis-missed-opportunities
#2
REVIEW
Benjamin T Prince, Irene Mikhail, David R Stukus
Epinephrine is the only effective treatment for anaphylaxis but studies routinely show underutilization. This is especially troubling given the fact that fatal anaphylaxis has been associated with delayed administration of epinephrine. Many potential barriers exist to the proper use of epinephrine during an anaphylactic reaction. This article will explore both patient-and physician-related factors, as well as misconceptions that all contribute to the underuse of epinephrine for the treatment of anaphylaxis.
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29950872/anaphylaxis-in-the-21st-century-phenotypes-endotypes-and-biomarkers
#3
REVIEW
Teodorikez Wilfox Jimenez-Rodriguez, Marlene Garcia-Neuer, Leila A Alenazy, Mariana Castells
Anaphylaxis is the most serious of all allergic reactions and can be fatal. The diagnosis is frequently delayed, and misdiagnosis often occurs with asthma or urticaria. Biomarkers such as tryptase are not routinely checked, and appropriate treatment with epinephrine is not administered in a majority of cases, increasing the risk of poor outcomes. The objective of this review is to provide a better understanding of the pathophysiology of anaphylaxis with a description of phenotypes, endotypes, and biomarkers available in both the clinical and research settings...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29950871/food-allergy-and-anaphylaxis
#4
REVIEW
David Yue, Amanda Ciccolini, Ernie Avilla, Susan Waserman
Anaphylaxis is a severe and potentially life-threatening allergic reaction. There are numerous potential causes, with food allergy being the leading cause in children and the focus of this review. Most reactions involve an IgE-mediated mechanism, although non-IgE-mediated and nonimmunologic reactions can occur. Various cofactors to be discussed can place certain individuals at an increased risk of severe or fatal anaphylaxis. The clinical manifestations of anaphylaxis are broad and may involve multiple body systems...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29950870/anaphylaxis-getting-to-the-point-and-price-of-diagnosis-and-treatment
#5
EDITORIAL
Ronald B Moss
No abstract text is available yet for this article.
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29950869/omalizumab-in-allergic-bronchopulmonary-aspergillosis-in-patients-with-cystic-fibrosis
#6
Moshe Ashkenazi, Saray Sity, Ifat Sarouk, Bat El Bar Aluma, Adi Dagan, Yael Bezalel, Lea Bentur, Kris De Boeck, Ori Efrati
Background: Allergic bronchopulmonary aspergillosis (ABPA) is a condition characterized by a Th2 response, serum eosinophilia, and increased total serum IgE to Aspergillus fumigatus . ABPA occurs in cystic fibrosis (CF) and asthma. Omalizumab is a humanized recombinant monoclonal antibody against IgE. Previous studies reported borderline results when treating ABPA with omalizumab. Methods: A retrospective study to investigate the efficacy of omalizumab in the treatment of ABPA in CF patients was conducted at 3 CF centers in Israel and Belgium...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29785128/methacholine-challenge-testing-comparative-pharmacology
#7
REVIEW
Beth E Davis, Christianne M Blais, Donald W Cockcroft
Standardization of the methacholine inhalation challenge, the most common direct bronchoprovocation test, is important. One aspect of standardization is the appropriate washout period for pharmacologic agents which affect the response. This review summarizes the available data on pharmacologic inhibition of the methacholine response. Specific (anti-muscarinic) agents demonstrate marked bronchoprotection (up to 7 days for the long-acting drugs) which lasts longer than the duration of bronchodilation. The functional antagonist (beta 2 agonist class of medications) shows marked, but less, bronchoprotection which is relatively short lived and is similar to the duration of bronchodilator efficacy...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29719412/acute-effects-of-smoke-exposure-on-airway-and-systemic-inflammation-in-forest-firefighters
#8
Niki Gianniou, Charilena Giannakopoulou, Efrossini Dima, Matina Kardara, Paraskevi Katsaounou, Alexandros Tsakatikas, Charis Roussos, Nikolaos Koulouris, Nikoletta Rovina
Introduction: The aim of this study was to assess respiratory health and airway and systemic inflammation in professional forest firefighters post firefighting. Methods: A total of 60 firefighters who participated in forest firefighting operations in Greece during 2008 were included in the study. A questionnaire consisting of symptoms and exposure, pulmonary function, atopy, bronchial hyperresponsiveness, and markers of inflammation in induced sputum, serum, and bronchoalveolar lavage (BAL) fluid was assessed...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29692617/both-fractional-exhaled-nitric-oxide-and-sputum-eosinophil-were-associated-with-uncontrolled-asthma
#9
Jie Gao, Zhaocheng Chen, Xiang Jie, Ruihua Ye, Feng Wu
Background: Sputum eosinophil and fractional exhaled nitric oxide (FeNO), noninvasive biomarkers of local eosinophilic airway inflammation, can be used to assess asthma outcome. Nevertheless, the clinical application of the association between FeNO and sputum eosinophil is controversial. The aim of the study was to investigate the predictive relationship between FeNO and sputum eosinophil in uncontrolled asthmatic patients and the correlation between sputum eosinophil and FeNO in bronchial reversibility and bronchial hyperresponsiveness (BHR)...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29670379/assessment-of-an-accessorized-pre-filled-syringe-for-home-administered-benralizumab-in-severe-asthma
#10
Gary T Ferguson, Adel H Mansur, Joshua S Jacobs, Jacques Hebert, Corbin Clawson, Wenli Tao, Yanping Wu, Mitchell Goldman
Background: Patients prefer at-home subcutaneous administration of biologics across different diseases, yet no biologic is approved for at-home use for severe, uncontrolled asthma. Objective: We assessed at-home functionality, reliability, and performance of an accessorized pre-filled syringe (APFS) for subcutaneous benralizumab administration, an anti-eosinophil monoclonal antibody indicated for add-on maintenance treatment of patients with severe eosinophilic asthma...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29662320/omalizumab-for-severe-asthma-toward-personalized-treatment-based-on-biomarker-profile-and-clinical-history
#11
REVIEW
Farnaz Tabatabaian, Dennis K Ledford
Asthma is a heterogeneous syndrome with numerous underlining molecular and inflammatory mechanisms contributing to the wide spectrum of clinical phenotypes. Multiple therapies targeting severe asthma with type 2 (T2) high inflammation are or soon will be available. T2 high inflammation is defined as inflammation associated with atopy or eosinophilia or an increase in cytokines associated with T-helper 2 lymphocytes. Omalizumab is a humanized anti-IgE monoclonal antibody and the first biologic therapy approved for moderate-severe allergic asthma...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29618933/current-perspectives-on-tree-nut-allergy-a-review
#12
REVIEW
Tamar Weinberger, Scott Sicherer
Tree nut (TN) allergy is common and often severe. It has become an important health concern as availability and consumption have increased. Prevalence varies by age and geographic region and appears to have increased in children. Accidental ingestion of TNs is common. Unfortunately, there is a lower likelihood of resolution of TN allergy, roughly 10%. TN-specific skin tests and serum immunoglobulin E levels can help aid in the diagnosis of TN allergy, but a careful medical history is important because a positive test in isolation is not typically diagnostic...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29615844/bepotastine-besilate-ophthalmic-solution-1-5-for-alleviating-nasal-symptoms-in-patients-with-allergic-conjunctivitis
#13
Megan E Cavet, Paul J Gomes, Warner W Carr, Jon I Williams
Background: Bepotastine besilate ophthalmic solution (BBOS) 1.5% is a topical antihistamine for the treatment of ocular itching associated with allergic conjunctivitis (AC). Allergic rhinitis and AC are common comorbid conditions. We explored the efficacy of BBOS 1.5% in alleviating nasal symptoms in an integrated analysis of two Phase III conjunctival allergen challenge (CAC) studies and a Phase IV environmental allergen study. Methods: In the Phase III trials, a CAC was performed 15 minutes, 8 hours, and 16 hours following ocular instillation of BBOS 1...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29445292/late-onset-asthma-current-perspectives
#14
REVIEW
Tsunahiko Hirano, Kazuto Matsunaga
Because the pathophysiology of asthma has diverse characteristics, to manage the disease effectively, it is important for clinicians to distinguish among the clinical phenotypes. Among them, adult-onset asthma, that is, late-onset asthma (LOA), is increasing because of the aging of the population. The phenotype of LOA is largely divided into two types according to the presence or absence of eosinophilic inflammation, T-helper (Th)2- and non-Th2-associated LOA. Especially in Th2 LOA related to rhinosinusitis, as pulmonary function at onset is poor and asthma exacerbations occur frequently, it is important to detect this phenotype in the early phase by using a biomarker of Th2-type inflammation such as fractional exhaled nitric oxide (FENO )...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29398922/severe-bronchial-asthma-in-children-a-review-of-novel-biomarkers-used-as-predictors-of-the-disease
#15
REVIEW
Samuel N Uwaezuoke, Adaeze C Ayuk, Joy N Eze
Severe asthma or therapy-resistant asthma in children is a heterogeneous disease that affects all age-groups. Given its heterogeneity, precision in diagnosis and treatment has become imperative, in order to achieve better outcomes. If one is thus able to identify specific patient phenotypes and endotypes using the appropriate biomarkers, it will assist in providing the patient with more personalized and appropriate treatment. However, there appears to be a huge diagnostic gap in severe asthma, as there is no single test yet that accurately determines disease phenotype...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29296089/elevated-fractional-exhaled-nitric-oxide-and-blood-eosinophil-counts-are-associated-with-a-17q21-asthma-risk-allele-in-adult-subjects
#16
Elizabeth A Schwantes, Michael D Evans, Alex Cuskey, Alex Burford, Judith A Smith, Robert F Lemanske, Nizar N Jarjour, Sameer K Mathur
Background and objectives: Genome-wide association studies identified single-nucleotide polymorphisms (SNPs) at the 17q21 locus conferring increased risk for childhood-onset asthma. Little is known about how these SNPs impact adult asthma patients. We sought to examine an adult population for associations between rs7216389 (17q21-associated SNP) and features of asthma including fractional exhaled nitric oxide (FeNO), eosinophil counts, and age of asthma onset. Methods: Subjects were genotyped at SNP rs7216389...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29290688/recovery-of-hypothalamo-pituitary-adrenal-axis-suppression-during-treatment-with-inhaled-corticosteroids-for-childhood-asthma
#17
Arundoss Gangadharan, Paul McCoy, Aye Phyo, Michael P McGuigan, Poonam Dharmaraj, Renuka Ramakrishnan, Paul S McNamara, Joanne Blair
Objective: To describe recovery of adrenal insufficiency in asthmatic children treated with inhaled corticosteroids (ICS) and cortisol replacement therapy. Design: Retrospective, observational study. Patients: A total of 113 patients, 74 male; age 10.4 (3.3-16.5) years; beclomethasone-equivalent ICS dose, 800 μg, (100-1,000), tested by low dose short Synacthen (tetracosactide) test (LDSST), were studied. Test results were classified by basal and peak cortisol concentration: "normal" (basal >100 nmol/L, peak >500 nmol/L), "suboptimal" (basal >100 nmol/L, peak 350-499 nmol/L), "abnormal" (basal <100 nmol/L and/or peak <350 nmol/L)...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29238209/transplant-acquired-food-allergy-current-perspectives
#18
REVIEW
Shweta S Hosakoppal, Paul J Bryce
Mechanisms that regulate the tolerance to dietary proteins or the loss of this and subsequent development of disease are poorly understood. In food allergy, there is growing awareness of the urgency in understanding these events to aid in the development of next-generation therapies and interventions. This review focuses on the accumulating evidence related to food allergy that develops after transplantation. This intriguing immunological phenomenon has been described in several different types of transplant settings and to variety of different foods...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29238208/is-it-severe-asthma-or-asthma-with-severe-comorbidities
#19
Luisa Brussino, Paolo Solidoro, Giovanni Rolla
Severe asthma is defined as asthma that requires treatment with high-dose inhaled corticosteroids (ICSs) plus a second controller and/or systemic corticosteroids to prevent it from becoming uncontrolled or that remains uncontrolled despite this therapy. This definition has limitations: 1) it does not define any biological characteristic that distinguishes severe asthma from asthma in general and 2) it relies on the clinical interpretation of asthma symptoms that are not specific. Actually, wheezing, dyspnea, cough and chest tightness may be caused by the comorbidities (such as rhinosinusitis, obesity and vocal cord dysfunction [VCD]) which are associated with asthma...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29158683/animal-models-of-asthma-utility-and-limitations
#20
REVIEW
Marcelo Vivolo Aun, Rafael Bonamichi-Santos, Fernanda Magalhães Arantes-Costa, Jorge Kalil, Pedro Giavina-Bianchi
Clinical studies in asthma are not able to clear up all aspects of disease pathophysiology. Animal models have been developed to better understand these mechanisms and to evaluate both safety and efficacy of therapies before starting clinical trials. Several species of animals have been used in experimental models of asthma, such as Drosophila , rats, guinea pigs, cats, dogs, pigs, primates and equines. However, the most common species studied in the last two decades is mice, particularly BALB/c. Animal models of asthma try to mimic the pathophysiology of human disease...
2017: Journal of Asthma and Allergy
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