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Asthma immunotherapy

Anna Slovick, Abdel Douiri, Rachel Muir, Andrea Guerra, Konstantinos Tsioulos, Evie Hay, Emily P S Lam, Joanna Kelly, Janet L Peacock, Sun Ying, Mohamed H Shamji, David J Cousins, Stephen R Durham, Stephen J Till
BACKGROUND: Repeated low dose grass pollen intradermal allergen injection suppresses allergen-induced cutaneous late phase responses, comparable with conventional subcutaneous and sublingual immunotherapy. OBJECTIVE: To evaluate the efficacy and safety of grass pollen intradermal immunotherapy in the treatment of allergic rhinitis. METHODS: We randomly assigned 93 adults with grass pollen allergic rhinitis to receive 7 pre-seasonal intradermal allergen injections (containing 7 nanograms of Phl p 5 major allergen) or histamine control...
October 20, 2016: Journal of Allergy and Clinical Immunology
L Mascarell, S Airouche, N Berjont, C Gary, C Gueguen, G Fourcade, B Bellier, D Togbe, B Ryffel, D Klatzmann, V Baron-Bodo, P Moingeon
The complement subunit C1q was recently identified as a marker for monocyte-derived regulatory dendritic cells supporting the differentiation of interleukin (IL)-10-secreting CD4(+) T cells with a suppressive activity. Furthermore, C1q expression is upregulated in peripheral blood mononuclear cells of allergic patients in the course of successful allergen immunotherapy. Herein, we investigated a potential direct role of C1q in downregulating allergic inflammation. In mice with ovalbumin (OVA) or birch pollen (BP)-induced allergic asthma, C1q is as efficacious as dexamethasone to reduce both airway hyperresponsiveness (AHR), eosinophil, and ILC2 infiltrates in bronchoalveolar lavages, as well as allergen-specific T helper 2 cells in the lungs...
October 12, 2016: Mucosal Immunology
Moisés A Calderón, Carmen Vidal, Pablo Rodríguez Del Río, Jocelyne Just, Oliver Pfaar, Ana I Tabar, Inmaculada Sánchez-Machín, Petra Bubel, Jesus Borja, Peter Eberle, Rainer Reiber, Michel Bouvier, Alain Lepelliez, Ludger Klimek, Pascal Demoly
BACKGROUND: Outside clinical trials, data on systemic reactions (SRs) due to allergen immunotherapy (AIT) are scarce. METHODS: A prospective, longitudinal, web-based survey of "real-life" respiratory allergen immunotherapy (AIT) clinical practice was conducted in France, Germany and Spain. SRs were recorded and coded according to the Medical Dictionary for Regulatory Activities (MedDRA) and risk factors associated with SRs were identified. RESULTS: A total of 4,316 patients (corresponding to 4,363 ongoing courses of AIT) were included...
October 8, 2016: Allergy
Jasper H Kappen, Stephen R Durham, Hans In 't Veen, Mohamed H Shamji
Clinical and immunologic tolerance are hallmarks of successful allergen immunotherapy (AIT). Clinical benefits such as reduced symptoms, pharmacotherapy intake and improvement of quality of life persist following cessation of treatment. Successful AIT is associated with suppression of allergic inflammatory cells such as mast cells, eosinophils and basophils in target organs. Furthermore, AIT down-regulates type 2 innate lymphoid cells and allergen-specific type 2 T-helper (Th2) cells. The immunologic tolerant state following AIT is associated with the induction of distinct phenotypes of regulatory T-cells (T-regs) including interleukin (IL)-10-, IL-35- and transforming growth factor (TGF)-β- producing T-regs and FoxP3(+) T-regs...
September 27, 2016: Therapeutic Advances in Respiratory Disease
Pablo Rodríguez Del Río, Carmen Vidal, Jocelyne Just, Ana I Tabar, Inmaculada Sanchez-Machin, Peter Eberle, Jesus Borja, Petra Bubel, Oliver Pfaar, Pascal Demoly, Moises A Calderón
BACKGROUND: Safety data on "real-life" allergen immunotherapy (AIT) in children and adolescents is usually extrapolated from studies in adults. METHODS: Patients aged 18 or under initiating aeroallergen AIT were evaluated in a prospective European survey. Patient profiles and systemic reactions (SRs) were recorded. Descriptive, univariate and multivariate analyses were used to identify risk factors for SRs. RESULTS: A total of 1,563 patients (mean±SD age: 11...
September 17, 2016: Pediatric Allergy and Immunology
Nathan P Falk, Scott W Hughes, Blake C Rodgers
Chronic asthma is a major health concern for children and adults worldwide. The goal of treatment is to prevent symptoms by reducing airway inflammation and hyperreactivity. Step-up therapy for symptom control involves initiation with low-dose treatment and increasing intensity at subsequent visits if control is not achieved. Step-down therapy starts with a high-dose regimen, reducing intensity as control is achieved. Multiple randomized controlled trials have shown that inhaled corticosteroids are the most effective monotherapy...
September 15, 2016: American Family Physician
Pascal Demoly, Yoshitaka Okamoto, William H Yang, Philippe Devillier, Karl-Christian Bergmann
INTRODUCTION: The once-daily 300 index of reactivity (IR) house dust mite (HDM) tablet (Actair®; Stallergenes Greer, Antony, France/Shionogi & Co. Ltd., Osaka, Japan) is the first sublingual immunotherapy (SLIT) tablet to be approved for the treatment of HDM-induced allergic rhinitis. AREAS COVERED: This drug profile reviews the current body of evidence on the efficacy, safety and tolerability of the 300 IR HDM tablet, its pharmacodynamics, and its role in clinical practice...
September 15, 2016: Expert Review of Clinical Immunology
Matteo Ferrando, Diego Bagnasco, Giovanni Passalacqua, Gilda Varricchi, Giorgio Walter Canonica
INTRODUCTION: Since its introduction in clinical practice one century ago for the treatment of respiratory allergic diseases, allergen-specific immunotherapy (AIT) has exhibited a relevant clinical efficacy that was subsequently confirmed in controlled trials. Thus, AIT has been accepted worldwide, as testified by guidelines and international documents. AIT is considered pivotal in the management of allergic rhinitis with or without conjunctivitis and with or without asthma. These conditions, in addition to hymenoptera venom allergy, currently are the accepted indications...
September 19, 2016: Expert Opinion on Biological Therapy
Amanda Grippen Goddard, Antoine E Azar
No abstract text is available yet for this article.
September 7, 2016: Annals of Allergy, Asthma & Immunology
Jason T Forbush, Taylor A Banks
No abstract text is available yet for this article.
September 2016: Annals of Allergy, Asthma & Immunology
J Hahn-Pedersen, M Worm, W Green, J Nørgaard Andreasen, M Taylor
BACKGROUND: Asthma affects an estimated 300 million people worldwide with the condition associated with significant healthcare utilisation costs and a large impact on patient quality of life. The SQ(®) HDM SLIT-tablet (ACARIZAX(®), Hørsholm, Denmark) is a sublingually administered allergy immunotherapy tablet for house dust mite allergic asthma and allergic rhinitis and has recently been licensed in Europe. OBJECTIVE: To assess the cost-effectiveness of ACARIZAX plus pharmacotherapy versus placebo plus pharmacotherapy in patients with house dust mite allergic asthma that is uncontrolled by inhaled corticosteroids, in a German setting...
2016: Clinical and Translational Allergy
Yamini V Virkud, A Wesley Burks, Pamela H Steele, Lloyd J Edwards, Jelena P Berglund, Stacie M Jones, Amy M Scurlock, Tamara T Perry, Robert D Pesek, Brian P Vickery
BACKGROUND: Though peanut oral immunotherapy (OIT) is a promising investigational therapy, its potential is limited by substantial adverse events (AEs), which are relatively understudied. OBJECTIVE: To conduct a retrospective analysis pooling three pediatric peanut OIT trials, comprising the largest analysis of peanut OIT safety to date. METHODS: We pooled 104 peanut-allergic children from three peanut OIT studies. We catalogued AEs from parental report, daily symptom diaries, and dose escalations...
September 5, 2016: Journal of Allergy and Clinical Immunology
Miguel Tortajada-Girbés, Miriam Moreno-Prat, David Ainsa-Laguna, Silvia Mas
BACKGROUND: Spontaneous pneumomediastinum (SPM) is an uncommon disorder. It is rarely reported in paediatric patients and may be accompanied by subcutaneous emphysema. It is usually benign and self-limiting, with only supportive therapy being needed, but severe cases may require invasive measures. Asthma exacerbations have classically been described as a cause of SPM. However, detailed descriptions in asthmatic children are scarce. We aimed at improving the current understanding of the features of SPM and subcutaneous emphysema, and outcomes, by means of a case report and a systematic review...
October 2016: Therapeutic Advances in Respiratory Disease
Martin F Bachmann, Thomas M Kündig
IgE-mediated allergies, in particular allergic rhino-conjunctivitis and asthma, have reached epidemic proportions, affecting about one third of the population in developed countries. The most effective treatment for allergies is specific immunotherapy (SIT), which involves the injection of increasing doses of an allergen extract to allergic individuals. The current form of SIT was first introduced 1911 and recently celebrated its 100(th) birthday for the treatment of hay fever. The concept of this therapy at the time was straight-forward, since it was believed that pollen contained toxins against which the patient could be vaccinated...
August 24, 2016: Allergy
Emine Güven Sakalar, Nuray Bayar Muluk, Murat Kar, Cemal Cingi
Aspirin-exacerbated respiratory disease (AERD) refers to the combination of asthma, chronic rhinosinusitis with nasal polyposis, and acute upper and lower respiratory tract reactions to the ingestion of aspirin (acetylsalicylic acid, ASA) and other cyclooxygenase-1 inhibiting non-steroidal anti-inflammatory drugs. AERD affects 0.3-0.9 % of the general population. AERD generally occurs due to abnormalities in mediators and expression of arachidonic acid biosynthesis. Local IgE responses to staphylococcal enterotoxins may also be responsible for eosinophilic activation in the nasal polyp tissues of AERD patients...
August 18, 2016: European Archives of Oto-rhino-laryngology
Hendrik Nolte, David I Bernstein, Harold S Nelson, Jörg Kleine-Tebbe, Gordon L Sussman, Dorthe Seitzberg, Dorte Rehm, Amarjot Kaur, Ziliang Li, Susan Lu
BACKGROUND: The house dust mite (HDM) sublingual immunotherapy (SLIT) tablet (MK-8237; Merck & Co, Kenilworth, NJ/ALK-Abelló, Hørsholm, Denmark) has demonstrated beneficial effects on allergic rhinoconjunctivitis and asthma outcomes in European trials. OBJECTIVE: This is the first trial to assess the efficacy/safety of HDM SLIT-tablets in North American subjects with HDM-induced allergic rhinitis with or without conjunctivitis (AR/C). METHODS: In this double-blind, multicenter trial (NCT01700192) 1482 subjects (aged ≥12 years) with HDM-induced AR/C with or without asthma were randomized to a daily SQ HDM SLIT-tablet (12 SQ-HDM dose) or placebo for up to approximately 52 weeks...
August 10, 2016: Journal of Allergy and Clinical Immunology
Hikmet Tekin Nacaroglu, Rana Isguder, Semiha Erdem Bahceci, Gökhan Ceylan, Huseyin Anil Korkmaz, Sait Karaman, Canan Sule Unsal Karkıner, Demet Can
INTRODUCTION: Platelets play important roles in airway inflammation and are activated in inflammatory lung diseases, including asthma. AIM: We evaluated the mean platelet volume (MPV), used as a marker of platelet activation, in asthmatic patients during asymptomatic periods and exacerbations compared to healthy controls to determine whether MPV can be used as an indicator of inflammation. MATERIAL AND METHODS: Our patient group consisted of 95 children with exacerbation of asthma who were admitted to our allergy clinic...
June 2016: Postȩpy Dermatologii i Alergologii
Ayfer Yukselen
Allergen-specific immunotherapy (AIT) is the only curative way that can change the immunologic response to allergens and thus can modify the natural progression of allergic diseases. There are some important criteria which contributes significantly on efficacy of AIT, such as the allergen extract used for treatment, the dose and protocol, patient selection in addition to the severity and control of asthma. The initiation of AIT in allergic asthma should be considered in intermittent, mild and moderate cases which coexisting with other allergic diseases such as allergic rhinitis, and in case of unacceptable adverse effects of medications...
July 2016: Asia Pacific Allergy
Kathrin Damm, Janina Volk, Andreas Horn, Jean-Pierre Allam, Ninette Troensegaard-Petersen, Niels Serup-Hansen, Thomas Winkler, Ivonne Thiessen, Kathrin Borchert, Eike G Wüstenberg, Thomas Mittendorf
BACKGROUND: Allergic Rhinitis (AR) is a common disorder in Europe with Allergic Asthma (AA) as a frequent comorbidity. Allergy immunotherapy (AIT) is the only causal therapy of AR and AA, and can be administered as subcutaneous injections at the physician or as sublingual drops or tablets at home. The usual treatment duration is 3 years. OBJECTIVE: This study aimed to elicit patient preferences to identify the AIT administration mode preferred by patients. METHODS: A discrete-choice-experiment (DCE) was developed to determine how people weight different treatment options using a paper-based questionnaire from June to September 2014, including 16 study centres...
December 2016: Health Economics Review
Pascal Demoly, Giovanni Passalacqua, Oliver Pfaar, Joaquin Sastre, Ulrich Wahn
Allergy immunotherapy (AIT) is acknowledged to produce beneficial mid- and long-term clinical and immunologic effects and increased quality of life in patients with allergic respiratory diseases (such as allergic rhinoconjunctivitis and allergic asthma). However, poor adherence to AIT (due to intentional and/or non-intentional factors) is still a barrier to achieving these benefits. There is an urgent need for patient support programs (PSPs) that encompass communication, educational and motivational components...
2016: Allergy, Asthma, and Clinical Immunology
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