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Longo, Giorgio. "Domande e risposte." Medico e Bambino 40, no. 1 (January 28, 2021): 59. http://dx.doi.org/10.53126/meb40059.
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Gastaldi, Roberto, Paola Borgia, and Mohamad Maghnie. "Lo iodio nell’alimentazione dell’età evolutiva." L'Endocrinologo 22, no. 4 (August 2021): 293–97. http://dx.doi.org/10.1007/s40619-021-00924-2.
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SommarioLo iodio viene assunto esclusivamente attraverso gli alimenti e rappresenta un componente essenziale per la sintesi degli ormoni tiroidei. Una carenza iodica misconosciuta da inadeguato apporto dietetico che si instaura nei primi anni di vita può essere responsabile di scarsa crescita e disordini dello sviluppo neuro-cognitivo. Negli ultimi anni è aumentata la prevalenza delle allergie alimentari e dei cultori di diete vegane nei paesi occidentali. Entrambe le situazioni impongono restrizioni dietetiche, limitando le fonti di importanti nutrienti come iodio, ferro, zinco, vitamina D, calcio e vitamina B12. Nelle allergie alimentari e in regime dietetico vegano, infatti, i primi alimenti ad essere esclusi sono proprio quelli a maggior contenuto di iodio, come pesce, latte, uova e derivati. L’apporto di iodio può dunque divenire insufficiente qualora non ci sia adeguato utilizzo di fonti di iodio alternative, come il sale iodato. Pertanto, risulta fondamentale che gli operatori sanitari siano a conoscenza dei possibili rischi di carenze nutrizionali in bambini con allergia alimentare, vegani o entrambi, al fine di garantire un attento monitoraggio auxologico e nutrizionale e soddisfare il fabbisogno energetico e nutritivo. In questo articolo riassumiamo i principali aspetti riguardanti l’apporto iodico in dieta vegana e nelle diete di esclusione dei bambini con allergie alimentari, revisionando la letteratura su questi argomenti e fornendo alcuni suggerimenti per i pediatri.
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Lariou, Maria Stella, Stavroula Dikalioti, Nick Dessypris, Apostolos Pourtsidis, Margarita Baka, Sophia Polychronopoulou, Fani Athanasiadou Piperopoulou, et al. "Country specific serum IgE reactivity profile and concordance with allergic history among acute lymphoblastic leukemia children and controls." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e20002-e20002. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e20002.
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e20002 Background: Allergy has been studied as a risk factor for several malignancies, including childhood leukemia; yet, the tentative etiological nature of this association needs to be further explored. Published studies suffer inappropriate study design and accuracy of exposure variables. In response to the latter need, this study aims to use country specific biological markers, namely levels of the most prevalent allergen-specific immunoglobulin E (IgE) antibodies in Greece as an alternative exposure measurement to history of allergy and compare their concordance with allergic history. Methods: Allergen-specific-IgEs against 24 most prevalent inhalant and food allergens were determined for 199 incident childhood acute lymphoblastic leukemia (ALL), newly diagnosed cases across Greece and registered in the Nationwide Registry for Childhood Hematological Malignancies (NARECHEM) and 113 hospital controls. K statistic was used to check the concordance between serum IgE specific allergens and allergic history overall, as well as among cases and controls. Results: Concordance between self-reported food allergy and food IgE levels in the same individual among both cases and controls was 87% and 83% for respiratory allergens. Among cases, concordance between self reported food allergies and food IgEs was 92% and 80% for controls (p-value 0.003) and the respective κ statistics were 0.28 for cases and 0.10 for controls. Concordance between self reported respiratory allergies and respiratory IgEs was 84% for cases and 81% for controls (p-value 0.57); κ statistics 0.09 for cases and 0.07 for controls. Conclusions: Much of the discordance among cases and controls (self-report false positives) might probably be a reflection of non allergic food hypersensitivity, an allergy that was surpassed or extended allergen avoidance. Other discordance (self-report false negatives) seems to be the result of food sensitization, either hypoclinical or not acknowledged as a type of allergy by mothers of the children. Nevertheless, these measurements jointly analyzed are valuable in exploring the stated hypothesis, especially in well designed prospective studies.
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KOROGLU, Mustafa, Ibrahim Halil KILIC, Isik Didem KARAGOZ, and Mehmet OZASLAN. "Extraction and Purification of the Potential Allergen Proteins from Botryotinia Fuckeliana." Eurasia Proceedings of Science Technology Engineering and Mathematics 12 (December 31, 2021): 28–31. http://dx.doi.org/10.55549/epstem.99247600000.
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An allergy is a disease in which the immune system makes an inflammatory response to a harmless antigen. Any antigen that causes an allergy is called an allergen. Allergens may be inhaled or ingested, or they may come into contact with the skin. According to the data of the World Allergy Organization (WAO), the prevalence of allergies in different countries varies between 10-40%. Pollen, mold, animal hair, house dust mite, medicines, and foods are the most common allergen agents. Common mushrooms in nature have the potential to produce allergenic proteins. Penicillium,Botryotinia, Aspergillus, Rhizopus, and Mucor species, which are allergic fungi, are widely found in nature. In recent years, the cases of allergies caused by molds have increased significantly and studies to determine the causing allergens have accelerated. Botryotinia fuckeliana Pers. is a cosmopolitan necrotrophic pathogen infecting more than 200 plant species in temperate and subtropical climates, some of which are of high economic importance (e.g., grapes, strawberries, solanaceous vegetable). In Europe, maximal spore counts occur during late summer. Prevalence of skin test reactivity, i.e., immediate wheal and flare, to B. cinerea in Europe is comparable to that of Aspergillus spp. and greater than that of Cladosporium and Penicillium spp. Since the prevalence of B. fuckeliana spores and skin test reactivity is significant, further characterization of these allergens is warranted. Botryotinia fuckeliana was used in our study. Botryotinia fuckeliana produced in our laboratory was collected and allergen fungus protein was extracted by 2 different extraction methods. By preparing protein samples from prepared mushroom extracts, the total concentration of potential allergen proteins was determined by the BCA method. According to the data obtained, it was determined that the protein concentration of the mushroom samples dried by that were subjected to dialysis was higher than ethanol.
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KOROGLU, Mustafa, Ibrahim Halil KILIC, Isik Didem KARAGOZ, and Mehmet OZASLAN. "Extraction and Purification of the Potential Allergen Proteins from Botryotinia Fuckeliana." Eurasia Proceedings of Science Technology Engineering and Mathematics 12 (December 31, 2021): 28–31. http://dx.doi.org/10.55549/epstem.992476.
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An allergy is a disease in which the immune system makes an inflammatory response to a harmless antigen. Any antigen that causes an allergy is called an allergen. Allergens may be inhaled or ingested, or they may come into contact with the skin. According to the data of the World Allergy Organization (WAO), the prevalence of allergies in different countries varies between 10-40%. Pollen, mold, animal hair, house dust mite, medicines, and foods are the most common allergen agents. Common mushrooms in nature have the potential to produce allergenic proteins. Penicillium,Botryotinia, Aspergillus, Rhizopus, and Mucor species, which are allergic fungi, are widely found in nature. In recent years, the cases of allergies caused by molds have increased significantly and studies to determine the causing allergens have accelerated. Botryotinia fuckeliana Pers. is a cosmopolitan necrotrophic pathogen infecting more than 200 plant species in temperate and subtropical climates, some of which are of high economic importance (e.g., grapes, strawberries, solanaceous vegetable). In Europe, maximal spore counts occur during late summer. Prevalence of skin test reactivity, i.e., immediate wheal and flare, to B. cinerea in Europe is comparable to that of Aspergillus spp. and greater than that of Cladosporium and Penicillium spp. Since the prevalence of B. fuckeliana spores and skin test reactivity is significant, further characterization of these allergens is warranted. Botryotinia fuckeliana was used in our study. Botryotinia fuckeliana produced in our laboratory was collected and allergen fungus protein was extracted by 2 different extraction methods. By preparing protein samples from prepared mushroom extracts, the total concentration of potential allergen proteins was determined by the BCA method. According to the data obtained, it was determined that the protein concentration of the mushroom samples dried by that were subjected to dialysis was higher than ethanol.
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Kotowska, Agnieszka. "Assessing of patients’ knowledge of anaphylactic shock and allergies." Medical Science Pulse 14, SUPPLEMENT 1 (December 31, 2020): 1–10. http://dx.doi.org/10.5604/01.3001.0014.6894.
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Background: The World Health Organization (WHO) identified allergy as one of the major problems of the 21st century. It was also stated to be a key issue for health protection and public health care activity in the White Book on Allergy published in 2011. An allergy or atopy is called type I hypersensitivity. It may take the form of immediate (anaphylaxis) or late symptoms including allergic rhinitis and eye diseases, atopic dermatitis, food allergies, anaphylactic shock, allergic asthma and hives. Anaphylaxis and anaphylactic shock can occur at any age. Aim of the study: The goal of the study was to assess patient knowledge about allergies and appropriate actions to take in situations of severe allergic symptoms including anaphylactic shock. Material and methods: The study was conducted in 2018 among 150 adult patients in a clinic of Allergy at Optima Medycyna SA in Opole. The author’s survey questionnaire contained 27 closed single or multiple-choice questions. Results: A satisfactory level of knowledge of the most life-threatening allergy exacerbations was found in 79.3% (119) of the examinees. 53.3% (80) had correct knowledge of how to act in the case of a severe allergic shortness of breath and symptoms that do not subside despite administering medications. In such instances, 46.7% did not know what to do. Only 84.7% (127) of respondents knew the definition of anaphylactic shock while 10% (15) did not know the concept at all. Conclusions: Patients showed a significantly higher level of knowledge about allergy complications than about their causes and prevention. Knowledge about the diagnosis of allergy exacerbations, as well as steps to take in life-threatening situations associated with acute allergic disease and anaphylactic shock in home situations was insufficient. In addition, it was found that nursing staff insufficiently educate patients on allergies and associated complications.
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Rueter, Kristina, Anderson P. Jones, Aris Siafarikas, Ee-Mun Lim, Susan L. Prescott, and Debra J. Palmer. "In “High-Risk” Infants with Sufficient Vitamin D Status at Birth, Infant Vitamin D Supplementation Had No Effect on Allergy Outcomes: A Randomized Controlled Trial." Nutrients 12, no. 6 (June 11, 2020): 1747. http://dx.doi.org/10.3390/nu12061747.
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Lower vitamin D status at birth and during infancy has been associated with increased incidence of eczema and food allergies. The aim of this study was to investigate the effect of early infancy vitamin D supplementation on allergic disease outcomes in infants at “hereditary risk” of allergic disease, but who had sufficient vitamin D levels at birth. Here, we report the early childhood follow-up to 2.5 years of age of “high-risk” infants who participated in a double-blinded, randomized controlled trial. For inclusion in this trial, late gestation (36–40 weeks) maternal 25-hydroxyvitamin D levels needed to be ≥50 nmol/L. Infants were randomized to either oral vitamin D supplementation of 400 IU/day (n = 97) or a placebo (n = 98) for the first six months of life. Vitamin D levels and allergic disease outcomes were followed up. There were no statistically significant differences in incidence of any medically diagnosed allergic disease outcomes or allergen sensitization rates between the vitamin D-supplemented and placebo groups at either 1 year or at 2.5 years of age. In conclusion, for “allergy high-risk” infants who had sufficient vitamin D status at birth, early infancy oral vitamin D supplementation does not appear to reduce the development of early childhood allergic disease.
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Best, Karen P., Tim J. Green, Dian C. Sulistyoningrum, Thomas R. Sullivan, Susanne Aufreiter, Susan L. Prescott, Maria Makrides, Monika Skubisz, Deborah L. O'Connor, and Debra J. Palmer. "Maternal Late-Pregnancy Serum Unmetabolized Folic Acid Concentrations Are Not Associated with Infant Allergic Disease: A Prospective Cohort Study." Journal of Nutrition 151, no. 6 (April 13, 2021): 1553–60. http://dx.doi.org/10.1093/jn/nxab040.
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ABSTRACT Background The increase in childhood allergic disease in recent decades has coincided with increased folic acid intakes during pregnancy. Circulating unmetabolized folic acid (UMFA) has been proposed as a biomarker of excessive folic acid intake. Objective We aimed to determine if late-pregnancy serum UMFA and total folate concentrations were associated with allergic disease risk in the offspring at 1 y of age in a population at high risk of allergy. Methods The cohort consisted of 561 mother–infant pairs from Western Australia. To be eligible the infant had to have a first-degree relative (mother, father, or sibling) with a history of medically diagnosed allergic disease. Maternal venous blood was collected between 36 and 40 wk of gestation. Serum UMFA was measured by LC–tandem MS. Serum total folate was determined using a microbiological method with chloramphenicol-resistant Lactobacillus rhamnosus as the test organism, and was collected between 36 and 40 wk of gestation. UMFA concentrations were measured by tandem MS using stable isotope dilution; folate concentrations were determined using the microbiological method with standardized kits. Infant allergic disease outcomes of medically diagnosed eczema, steroid-treated eczema, atopic eczema, IgE-mediated food allergy, allergen sensitization, and medically diagnosed wheeze were assessed at 1 y of age. Results Median (IQR) concentrations for UMFA and serum folate were 1.6 (0.6–4.7) and 53.2 (32.6–74.5) nmol/L, respectively. Of the infants, 34.6% had medically diagnosed eczema, 26.4% allergen sensitization, and 14.9% had an IgE-mediated food allergy. In both adjusted and unadjusted models there was little evidence of association between UMFA or serum folate and any of the infant allergy outcomes. Conclusions In this cohort of children at high risk of allergic disease there was no association between maternal UMFA or serum folate concentrations measured in late pregnancy and allergic disease outcomes at 1 y of age.
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Moroni, L., A. Cariddi, S. Sartorelli, E. Della Torre, T. Germanò, G. A. Ramirez, E. Bozzolo, M. R. Yacoub, and L. Dagna. "AB0512 ALLERGIC PROFILE AND ALLERGEN-SPECIFIC IMMUNOTHERAPY IN EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS (EGPA): A SINGLE CENTER OBSERVATIONAL STUDY." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1553.1–1554. http://dx.doi.org/10.1136/annrheumdis-2020-eular.1766.
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Background:Eosinophilic granulomatosis with polyangiitis (EGPA), previously known as Churg-Strauss syndrome, is a systemic disease characterized by late onset asthma associated with small- and/or medium-size vessel vasculitis, besides eosinophil-mediated cytotoxic organ damage. About 20-30% of patients with EGPA displays allergic manifestations related with inhalant sensitization, while prevalence of food and drug allergy is unknown in this context. Moreover, some authors in the past hypothesized in favor of a possible role of allergen-specific immunotherapy (ASIT) as a trigger of disease.Objectives:Aim of the present study is to establish the prevalence of each category allergen sensitization and to determine whether atopy or specific immunotherapy could influence clinical expression of the disease.Methods:Our study consisted in a retrospective demographic and clinical data collection regarding EGPA history (including age at diagnosis, organ and tissue involvement, autoantibody profile) and the presence of allergic comorbidities or previous drug hypersensitivity reactions. Patients without either proven allergic reactions or positive tests have been excluded.Results:Fifty-three (53) patients with definitive diagnosis of EGPA have been included in the analysis among which 25 (47.2%) with chronic respiratory allergy or previous acute allergic reaction. Among allergic patients 15 (60%) resulted sensitized towards inhalants and among them 13 (86.7%) displayed multiple sensitization. Drug allergy affected 13 patients (52%), food 4 (16%). Among 15 patients with respiratory allergy, 13 were eligible to allergen-specific immunotherapy (ASIT). Seven (7) subjects underwent ASIT prior EGPA diagnosis with an average time-to-EGPA of 16.2 years. No statistically significant difference was found in terms of sex, age at diagnosis, positivity for or specificity of anti-neutrophil cytoplasm antibodies (ANCA), eosinophil count at onset, pattern of clinical manifestations comparing allergic vs. non-allergic, ASIT vs. non-ASIT, ASIT vs. allergic, ASIT vs. eligible.Conclusion:Among patients with EGPA allergies are highly prevalent, particularly towards inhalants and drugs. In the great majority of patients multiple sensitization profile is found. Atopy doesn’t seem to be associated with specific patterns of disease presentation. The absence of correlation between inhalant ASIT exposure and variation in mode and time of EGPA onset doesn’t support the hypothesis of a its potential role in triggering the disease.References:[1]Berti A et al. Severe/uncontrolled asthma and overall survival in atopic patients with eosinophilic granulomatosis with polyangiitis. Respiratory Medicine 2018; DOI: 10.1016/j.rmed.2018.07.017[2]Cottin V et al. Respiratory manifestations of eosinophilic granulomatosis with polyangiitis (Churg–Strauss). European Respiratory Journal 2016; DOI: 10.1183/13993003.00097-2016Disclosure of Interests:Luca Moroni: None declared, adriana cariddi: None declared, Silvia Sartorelli: None declared, Emanuel Della Torre: None declared, Tommaso Germanò: None declared, Giuseppe Alvise Ramirez: None declared, Enrica Bozzolo: None declared, Mona-Rita Yacoub: None declared, Lorenzo Dagna Grant/research support from: The Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR) received unresctricted research/educational grants from Abbvie, Bristol-Myers Squibb, Celgene, Janssen, Merk Sharp & Dohme, Mundipharma Pharmaceuticals, Novartis, Pfizer, Roche, Sanofi-Genzyme, and SOBI., Consultant of: Prof Lorenzo Dagna received consultation honoraria from Abbvie, Amgen, Biogen, Bristol-Myers Squibb, Celltrion, Novartis, Pfizer, Roche, Sanofi-Genzyme, and SOBI.
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Arcimowicz, Magdalena, and Edyta Krzych-Fałta. "Nasal allergen challenge - an important tool in diagnosis of rhinologic disease." Polski Przegląd Otorynolaryngologiczny 9, no. 4 (December 19, 2020): 1–5. http://dx.doi.org/10.5604/01.3001.0014.6068.
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The nasal allergen challenge (NAC) is used in the diagnosis of rhinitis. The primary use of NAC is to confirm allergy to a specific inhaled allergen. NAC reproduces the allergic reaction of the nasal mucosa under standardized and controlled conditions that occurs after direct intranasal administration of allergens. As the only used method for assessing the degree of allergy, it mimics the body’s natural response to the sensitizing factor in the early and late stages of an allergic reaction. NAC is used in the diagnosis of chronic, occupational and local rhinitis, as well as in the differential diagnosis of rhinitis and ophthalmic symptoms. Under conditions similar to natural exposure, it determines the relationship between the allergen and symptoms of allergic rhinitis, especially in the case of difficulties in interpreting the results of skin tests and the serum concentration of specific IgE. It is a truly valuable tool in determining the indications for immunotherapy and the selection of allergens for desensitization therapy. It also serves as a method of monitoring the effectiveness of immunotherapy and pharmacotherapy. For scientific purposes, NAC is used to study the mechanisms of an allergic reaction and the influence of various factors on its course. It is considered safe, but requires appropriate instruments and qualified personnel.
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Bayram, Ali, Nuray Bayar Muluk, and Cemal Cingi. "Allergic diseases in adolescents." Romanian Journal of Rhinology 12, no. 46 (April 1, 2022): 53–61. http://dx.doi.org/10.2478/rjr-2022-0009.
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Abstract OBJECTIVES. We reviewed the literature on allergic disorders during adolescence. MATERIAL AND METHODS. The Pubmed, Google, Google Scholar and Proquest Central databases were used with search terms: adolescent, teenager, allergic rhinitis, asthma, atopic dermatitis and food allergy. RESULTS. Children with a proven allergy have a risk for developing another allergic disorder that is 8-fold higher compared to normal and approaching 7-fold for asthma. The age at which allergy is diagnosed in childhood has a powerful bearing on whether allergic disorders or asthma develop in adolescence. Atopic response severity in a patient during childhood predicts the severity of allergic asthma as an adult. Patients may become asthmatic as adolescents, probably due to a late presentation of allergic disease, or as the presenting complaint for the triad of intrinsic asthma, nasal polyp formation and aspirin intolerance (so-called Samter triad). Allergic eczema (Atopic dermatitis) carries on into their adolescent years in between 10 and 20% of children. Food allergy (FA) is more frequently noted in childhood and adolescence than in adulthood. For the most part, symptoms were attributable to pollen-associated FA and of mild severity. Being hypersensitive to food for non-allergic reasons was rarer. CONCLUSION. Allergic rhinitis represents a significant risk factor for becoming asthmatic, whether in childhood, adolescence or adulthood. Atopic dermatitis and food allergy are also frequent conditions during adolescence. Pollen-associated FA constitutes an important part of the food allergy. Furthermore, food allergy may be the leading trigger for anaphylaxis. Common associations/comorbidities of atopic dermatitis reported are other atopic conditions such as food allergies, asthma and allergic rhinitis/rhinoconjunctivitis.
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Woon, Fui Chee, Yit Siew Chin, Intan Hakimah Ismail, Amir Hamzah Abdul Latiff, Marijka Batterham, and Yoke Mun Chan. "Maternal Vitamin D Levels during Late Pregnancy and Risk of Allergic Diseases and Sensitization during the First Year of Life—A Birth Cohort Study." Nutrients 12, no. 8 (August 12, 2020): 2418. http://dx.doi.org/10.3390/nu12082418.
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Allergic diseases are the most common chronic illness in childhood. Findings from developed countries have reported associations between Vitamin D levels during pregnancy and offspring allergy risk. This prospective cohort study aimed to determine the associations between maternal Vitamin D levels during late pregnancy and allergic diseases in Malaysian infants during the first year of life. Serum 25(OH)D concentrations of 380 pregnant women in the third trimester were measured using a chemiluminescent immunoassay. Children’s allergic outcomes were assessed at 3, 6, and 12 months based on parental reports. Specific IgE antibodies against food and inhalant allergens were measured in infants at 12 months of age. A total of 43.2% pregnant women were Vitamin D deficient (<30 nmol/L) and 56.8% were nondeficient (≥30 nmol/L). A total of 27.6% of the infants had eczema, 6.1% had wheeze, 27.4% had food sensitization, 10.8% had inhalant allergen sensitization, and 3.8% had IgE-mediated food allergy during the first year of life. Compared with the nondeficient group, maternal Vitamin D deficiency in late pregnancy was not associated with any allergic outcomes after adjustment for potential confounding factors. In conclusion, the present study does not support an association between maternal Vitamin D levels in late pregnancy and allergic outcomes during the first year of life.
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Vukičević Lazarević, Vesna, Ana Marija Šola, and Ivan Marković. "Allergen immunotherapy in the polyallergic adolescent." Medica Jadertina 52, no. 3 (December 21, 2022): 201–6. http://dx.doi.org/10.57140/mj.52.3.4.
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Allergen immunotherapy is the only disease-modifying treatment option for allergic rhinitis, with adherence being its major limitation. We report a case of an adolescent with rhinitis, proven allergy to multiple non-homologous pollens, and troublesome symptoms despite maximal symptomatic therapy during the late spring and early summer months. Allergen immunotherapy to the most clinically relevant allergen was initiated under the supervision of a pediatrician. Shortly before her second year of treatment, she transferred to adult care and maintained a high degree of adherence and a favourable response to immunotherapy. In conclusion, allergen immunotherapy is effective in polyallergic adolescents with good adherence.
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Mathews, Kenneth P. "Mediators of Anaphylaxis, Anaphylactoid Reactions, and Rhinitis." American Journal of Rhinology 1, no. 1 (March 1987): 17–26. http://dx.doi.org/10.2500/105065887781390426.
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Besides histamine, a large and increasing number of mediators of allergic reactions are being found to be released by mast cells or basophils during anaphylactic reactions. Many of these same substances are released by stimuli other than allergen-IgE interactions, and this type of phenomenon (anaphylactoid or pseudo-allergic reaction) may account for some nasal symptoms that simulate allergy. In addition to rapidly developing reactions of these types, numerous recent investigations have emphasized the importance of late-phase reactions that occur as a consequence of the immediate reactivity. Besides mast cells and/or basophils, these late effects seem to involve a complex network of cellular interactions, which may include neutrophils, eosinophils, lymphocytes, macrophages, and platelets. Studies of nasal washings following allergen challenges in humans have provided cogent in vivo support of earlier hypotheses about mediator release based on in vitro experimentation.
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Hoyte, Flavia C. L., and Harold S. Nelson. "Recent advances in allergic rhinitis." F1000Research 7 (August 23, 2018): 1333. http://dx.doi.org/10.12688/f1000research.15367.1.
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Allergic rhinitis affects 20 to 30% of adults in both the United States and Europe and perhaps a somewhat higher percentage of children. In addition to nasal and ocular symptoms directly related to the allergic process, interference of these symptoms with sleep leads to daytime sleepiness and impaired quality of life. Patients miss work because of symptoms but an even greater problem is interference with work productivity, or presenteeism, which has been reported to be the biggest contributor to the total economic cost of allergic rhinitis. There has been increasing awareness that many patients with either seasonal or perennial symptoms but negative skin and in vitro tests for allergen sensitivity have local nasal allergy, diagnosable by the presence of allergen-specific IgE in their nasal secretions or a positive nasal allergen challenge or both. The pharmaceutical management of allergic rhinitis rests on symptomatic treatment with antihistamines that perhaps are more effectively administered intranasally than orally and intranasal corticosteroids. Allergen immunotherapy is very effective, even for local allergic rhinitis, and the shortcomings of subcutaneous immunotherapy of inconvenience and safety are reduced by the introduction of sublingual immunotherapy (SLIT). Use of the latter is currently somewhat limited by the lack of appropriate dosing information for SLIT liquids and the limited number of allergens for which SLIT tablets are available.
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Ryoji, Hirota. "Relationship between gut microbiome and allergic asthma." Global Journal of Allergy 8, no. 1 (December 27, 2022): 001–6. http://dx.doi.org/10.17352/2455-8141.000025.
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Since the late 20th century, environmental exposure to endotoxins has been very low and type I allergic disease has increased. In addition, we have increased exposure to PM2.5 and other chemicals. Recently, there is concern that the daily use of hygiene products containing antimicrobial substances is associated with an increased prevalence of allergies. It has been noted that these antimicrobial substances may exacerbate allergies. In our study, we confirmed that intratracheal administration of aqueous mite solution as an inhaled antigen and antimicrobial substance as an aggravating chemical induced much stronger allergic bronchial asthma in mice than in mice that received intratracheal mite solution alone. Thus, allergies have been found to be exacerbated by simultaneous exposure to both environmental antigens and man-made chemicals (adjuvants). Next, we analyzed 16S rRNA of the gut microbiota of triclosan-treated mice that developed an allergy. The bacterial gene abundance of 16S rRNA of Deltaproteobacteria, Erysipelotrichi and Clostridia was increased in a dose-dependent manner in triclosan-treated mice, while Bacteroides were decreased in these mice. The composition of the gut microbiota was altered after triclosan treatment and correlated with the exacerbation of asthmatic disease in these mice. In conclusion, because triclosan exacerbated the condition of allergic asthma in mice that inhaled mite antigens and were given triclosan to drink, and this condition was associated with an increase or decrease in certain bacteria in the gut, we suspect that if allergy sufferers continue to use triclosan, they will inhale dust mites and house dust on a daily basis, which may aggravate their allergy symptoms. Overall, the overuse of antimicrobials and preservatives in current daily life risks further increasing the number of allergic patients. The authors believe that it is time to rethink this lifestyle.
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Velickovic, Jelena, Nebojsa Ladjevic, Branko Milakovic, Ivana Likic-Ladjevic, Djordje Ugrinovic, and Nevena Kalezic. "Preoperative evaluation of patients with history of allergy." Acta chirurgica Iugoslavica 58, no. 2 (2011): 177–83. http://dx.doi.org/10.2298/aci1102177v.
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The prevalence of allergic reactions in general population shows a constant rise. It has been estimated that up to 40% of surgical patients have a positive history of some kind of allergy. These patients represent a challenge during perioperative evaluation, since they can be exposed to a large variety of drugs and substances during surgery and anesthesia. A lot of adverse drug reactions show similar clinical presentation with allergic reactions. The latter are usually poorly explored since preoperative allergology testing is performed in a limited number of patients. Management of patients with history of allergy is impeded by the fact that most of allergens cross-react in a manner that is not always easy to predict. Allergies can manifest themselves with a broad spectrum of clinical symptoms, ranging from mild skin symptoms such as itch and urticaria, to a life-threatening anaphylactic reactions followed by hypotension, bronchospasm and cardiovascular collapse. Prevention of allergic reactions during perioperative period requires detailed history taking in order to identify patients at risk, optimization of anesthesia strategy, pharmacological premedication and further allergology diagnostic work-up in selected cases.
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Bychkova, N. V. "Basophil activation: theoretical aspects and use in the diagnosis of allergic diseases." Medical Immunology (Russia) 23, no. 3 (June 22, 2021): 469–82. http://dx.doi.org/10.15789/1563-0625-bat-2174.
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Diagnostics of allergic diseases is a difficult issue, which requires distinct solutions, since this disorder is very common among the population. The overview focuses on complex diagnostics, including various methods that are most in demand at the present stage. The allergy diagnostics primarily include taking anamnesis, physical examination, instrumental and functional tests. Less often, the provocative tests are used, due to risk of severe adverse reactions. At the present stage, the role of laboratory diagnostics of allergies is growing, since, firstly, there is an increase in difficult-to-diagnose cases that require involvement of the entire medical armamentarium, and, secondly, the sensitivity and specificity of laboratory tests are improving. Among laboratory methods, the most significant are the assessment of the level of specific IgE, and the relatively new basophile activation test. The latter test is the main focus of the present review. It is functional and combines the advantages of provocative tests, during which conditions are created for the interaction of a potential allergen and effector cells of allergic inflammation, keeping safety for the patient. The data on the life cycle of basophils, their expression of membrane receptors, the content of granules, and ability to produce additional inflammatory mediators by the cells are presented. Participation of these cells in pathogenesis of allergic inflammation is being considered. Various mechanisms of basophil activation are discussed, both IgE-mediated and IgE-independent, which are similar in vivo and in vitro. Theoretical aspects of using the in vitro basophil activation test to estimate the hypersensitivity to a wide range of allergens are discussed. High sensitivity and specificity of the test for diagnosing allergies to food, household, pollen, insect and drug allergens are presented. Specific features of the basophil activation test related to the preanalytical, analytical and postanalytical stages of the study are highlighted. The factors influencing evaluation of this method are known. For example, difficulties in interpreting the test may arise while taking glucocorticosteroid hormones, in acute period of inflammation, with severe edema. The possibility of using this test to assess effectiveness of allergen-specific and anti-IgE therapy is being considered. A comparison of the basophil activation test, measurement of specific IgE and skin tests by various parameters related to performance and interpretation of results is carried out. Comprehensive diagnostics of allergic diseases, including usage of pathogenetically determined laboratory methods, will contribute to adequate treatment and, as a result, improve the health of the population.
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Eckl-Dorna, Julia, Sergio Villazala-Merino, Nicholas James Campion, Maria Byazrova, Alexander Filatov, Dmitry Kudlay, Antonina Karsonova, et al. "Tracing IgE-Producing Cells in Allergic Patients." Cells 8, no. 9 (August 28, 2019): 994. http://dx.doi.org/10.3390/cells8090994.
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Immunoglobulin E (IgE) is the key immunoglobulin in the pathogenesis of IgE associated allergic diseases affecting 30% of the world population. Recent data suggest that allergen-specific IgE levels in serum of allergic patients are sustained by two different mechanisms: inducible IgE production through allergen exposure, and continuous IgE production occurring even in the absence of allergen stimulus that maintains IgE levels. This assumption is supported by two observations. First, allergen exposure induces transient increases of systemic IgE production. Second, reduction in IgE levels upon depletion of IgE from the blood of allergic patients using immunoapheresis is only temporary and IgE levels quickly return to pre-treatment levels even in the absence of allergen exposure. Though IgE production has been observed in the peripheral blood and locally in various human tissues (e.g., nose, lung, spleen, bone marrow), the origin and main sites of IgE production in humans remain unknown. Furthermore, IgE-producing cells in humans have yet to be fully characterized. Capturing IgE-producing cells is challenging not only because current staining technologies are inadequate, but also because the cells are rare, they are difficult to discriminate from cells bearing IgE bound to IgE-receptors, and plasma cells express little IgE on their surface. However, due to the central role in mediating both the early and late phases of allergy, free IgE, IgE-bearing effector cells and IgE-producing cells are important therapeutic targets. Here, we discuss current knowledge and unanswered questions regarding IgE production in allergic patients as well as possible therapeutic approaches targeting IgE.
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Skoner, David P., William J. Doyle, Sharon Boehm, and Philip Fireman. "Late Phase Eustachian Tube and Nasal Allergic Responses Associated with Inflammatory Mediator Elaboration." American Journal of Rhinology 2, no. 4 (September 1988): 155–61. http://dx.doi.org/10.2500/105065888781692998.
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Previous work in our laboratories has documented an IgE-mediated functional obstruction of the nose and eustachian tube (ET) immediately after nasal allergen challenge. The goals of this study were to monitor changes in nasal, ET, and bronchial physiology during the 12 hours following nasal allergen challenge and to correlate these changes with the elaboration of inflammatory mediators (IM). Subjects with ragweed allergic rhinitis were challenged intranasally with 2.5 mg of ragweed/nostril, and responses were assessed by posterior rhinomanometry for the nasal airway, sonotubometry for the eustachian tube, and spirometry for the bronchial airway. Blood was obtained simultaneously for quantitating the elaboration of three functionally and metabolically distinct IM. Late nasal responses (3–12 hours postchallenge) were observed in 7 of 10 subjects, with an average decrease of 67 ± 5% in nasal conductance at an average onset time of 6.6 ± 0.8 hours postchallenge. Dual late nasal responses were observed in five subjects. Late ET responses were observed in 10 ears (50%). Two sequential late ET responses were observed in three subjects. Late bronchial responses were detected in three subjects, one of whom did not have an early response. Plasma elevations of one or more IM were detected in all late nasal responders during the late phase response period. Late nasal and ET responses in association with an allergic nasopharyngeal inflammatory process could provide an important insight into the relationship between nasal allergy and middle ear disease.
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Tabachnik, E., A. Schuster, W. M. Gold, and J. A. Nadel. "Role of neutrophil elastase in allergen-induced lysozyme secretion in the dog trachea." Journal of Applied Physiology 73, no. 2 (August 1, 1992): 695–700. http://dx.doi.org/10.1152/jappl.1992.73.2.695.
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To test our hypothesis that neutrophil elastase plays a role in airway hypersecretion associated with the allergic late-phase response, using an isolated tracheal segment system in vivo and measuring lysozyme activity in the perfusate of the lumen as a marker of submucosal gland secretion over 8 h, we studied the response of five allergic dogs to ragweed. The dogs were exposed on separate occasions to specific allergen, to allergen vehicle, and to allergen in the presence of a selective neutrophil elastase inhibitor, ICI 200,355. Allergen exposure caused a marked increase in lysozyme secretion that was significantly increased at 4, 6, and 8 h compared with controls and ICI 200,355-treated dogs. Neutrophil elastase appeared in the perfusate after allergen exposure and was positively correlated with lysozyme secretion at 8 h. These findings suggest that neutrophil elastase plays an important role as a secretagogue in the allergic late-phase response.
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Campbell, Emma M., Steven L. Kunkel, Robert M. Strieter, and Nicholas W. Lukacs. "Temporal Role of Chemokines in a Murine Model of Cockroach Allergen-Induced Airway Hyperreactivity and Eosinophilia." Journal of Immunology 161, no. 12 (December 15, 1998): 7047–53. http://dx.doi.org/10.4049/jimmunol.161.12.7047.
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Abstract The increase in inner-city asthma among children appears to be due to allergic responses to several allergens. Recent studies have demonstrated that Ags derived from cockroaches are especially prominent in these settings and a significant health concern for the induction of asthma in children. In the present study, we have outlined the development of a murine model of cockroach allergen-induced airway disease and assessed specific mechanisms of the response, which resembles atopic human asthma. The allergic responses in this model include allergen-specific airway eosinophilia and significantly altered airway physiology, which directly correlates with inflammation. We have further utilized this allergen to establish primary and secondary rechallenge stages of late phase hyperreactivity exacerbation. This latter stage is characterized by greater changes in airway physiology than the primary stage, and it is likely due to the preexisting peribronchial inflammation present at the time of the second allergen rechallenge. We have identified specific roles for CC chemokines during these stages, with MIP-1α being an important eosinophil attractant during the primary stage and eotaxin during the secondary rechallenge stage. The development of these models allows the evaluation of mediators involved in both stages of cockroach allergen challenge, as well as the testing of specific therapeutic modalities.
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Olsson Mägi, Caroline-Aleksi, Anders Bjerg Bäcklund, Karin Lødrup Carlsen, Catarina Almqvist, Kai-Håkon Carlsen, Berit Granum, Guttorm Haugen, et al. "Allergic disease and risk of stress in pregnant women: a PreventADALL study." ERJ Open Research 6, no. 4 (October 2020): 00175–2020. http://dx.doi.org/10.1183/23120541.00175-2020.
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BackgroundMaternal stress during pregnancy may negatively affect the health of mother and child. We therefore aimed to identify the proportion of women reporting high maternal stress in mid and late pregnancy and explore whether symptoms of maternal allergic disease are associated with perceived maternal stress in late pregnancy.MethodThe population-based Preventing Atopic Dermatitis and Allergy in Children (PreventADALL) study enrolled 2697 pregnant women at their 18-week routine ultrasound examination in Norway and Sweden. Information about sociodemographic factors, symptoms and doctor-diagnosed asthma, allergic rhinitis, atopic dermatitis, food allergy, and anaphylaxis and stress using the 14-item perceived stress scale (PSS) was collected at 18 weeks (mid) and 34 weeks (late) pregnancy. High stress was defined as a PSS score ≥29. Scores were analysed using multivariate logistic and linear regression.ResultsAmong the 2164 women with complete PSS data, 17% reported asthma, 20% atopic dermatitis, 23% allergic rhinitis, 12% food allergy and 2% anaphylaxis. The proportion of women reporting high stress decreased from 15% at mid to 13% at late pregnancy (p<0.01). The adjusted odds ratio for high stress in late pregnancy was 2.25 (95% CI 1.41–3.58) for self-reported symptoms of asthma, 1.46 (95% CI 1.02–2.10) for allergic rhinitis and 2.25 (95% CI 1.32–3.82) for food allergy. A multivariate linear regression model confirmed that symptoms of asthma (β coefficient 2.11; 0.71–3.51), atopic dermatitis (β coefficient 1.76; 0.62–2.89) and food allergy (β coefficient 2.24; 0.63–3.84) were independently associated with increased PSS score.ConclusionAllergic disease symptoms in pregnancy were associated with increased stress, highlighting the importance of optimal disease control in pregnancy.
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West, Christina. "Introduction of Complementary Foods to Infants." Annals of Nutrition and Metabolism 70, Suppl. 2 (2017): 47–54. http://dx.doi.org/10.1159/000457928.
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While earlier food allergy prevention strategies implemented avoidance of allergenic foods in infancy, the current paradigm is shifting from avoidance to controlled exposure. This review focuses on the outcome of recent randomized controlled trials, which have examined the early introduction of allergenic foods for allergy prevention, and discusses the implementation of results in clinical practice. In infants at high risk of allergic disease, there is now direct evidence that regular early peanut consumption will reduce the prevalence of peanut allergy, compared to avoidance. Many international infant feeding guidelines already recommend complementary foods, including allergenic foods, to be introduced from 4 to 6 months of age irrespective of family history risk. Interim guidelines from 10 International Pediatric Allergy Associations state that healthcare providers should recommend the introduction of peanut-containing products into the diets of infants at high risk of allergic disease in countries where peanut allergy is prevalent. Direct translation of the results obtained from a cohort of high-risk infants to the general population has proved difficult, and issues regarding feasibility, safety, and cost-effectiveness have been raised. Five randomized placebo-controlled trials have assessed the effects of early egg exposure in infancy with varying results. In a recent comprehensive meta-analysis, there was moderate-certainty evidence that early versus late introduction of egg was associated with a reduced egg allergy risk. Although promising, optimal timing, doses, and if the feeding regimen should be stratified according to infant allergy risk remain to be determined. The single study that assessed introduction of multiple foods from 3 months whilst breastfeeding compared with exclusive breastfeeding until 6 months of age showed no reduction in food allergy prevalence. Future research should aim at optimizing infant feeding regimens and support a tolerogenic gastrointestinal microenvironment during the period of food allergen introduction.
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Siddall, Hilary, Diana Quint, Hitesh Pandya, Will Powley, Shaila Shabbir, Jens M. Hohlfeld, Dave Singh, and Laurie Lee. "Intranasal GSK2245035, a Toll-like receptor 7 agonist, does not attenuate the allergen-induced asthmatic response in a randomized, double-blind, placebo-controlled experimental medicine study." PLOS ONE 15, no. 11 (November 9, 2020): e0240964. http://dx.doi.org/10.1371/journal.pone.0240964.
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Background Allergic asthma is a heterogenous disorder predominantly driven by a type 2 inflammatory response to aeroallergens. Therapeutic modulation to rebalance these type 2 responses may offer clinical benefit for allergic respiratory inflammatory diseases, with the potential for disease modification. GSK2245035, a selective toll-like receptor-7 agonist, preferentially stimulates the induction of type 1 interferon alpha, reducing type 2 responses. Objective This study investigated whether intranasal GSK2245035 reduced allergen-induced bronchial reactivity in mild allergic asthma. Methods This double-blind, placebo-controlled, parallel-group Phase IIa trial randomized (1:1) participants with mild allergic asthma to intranasal GSK2245035 20 ng or placebo once weekly for 8 weeks; follow-up was conducted 1, 4, and 12 weeks after treatment. Allergen-induced late asthmatic response 1 week after treatment was measured as minimum and weighted mean forced expiratory volume in 1 second (FEV1) 4–10 hours following bronchial allergen challenge (primary endpoint). Pharmacodynamic and allergic biomarkers, and adverse events, were assessed. A Bayesian analysis framework was used; a posterior probability >0.7 denoted primary endpoint success. Results Thirty-six participants were randomized (GSK2245035, n = 22; placebo, n = 14). The percentage attenuation in late asthmatic response was –4.6% (posterior probability: 0.385) and –10.5% (posterior probability: 0.303) for minimum and weighted mean FEV1, respectively. Type 2 responses were confirmed by changes in lung function, eosinophils (blood and sputum), interleukin-5 (sputum) and fractional exhaled nitric oxide biomarkers pre- and post-bronchial allergen challenge. However, no treatment effect was observed. Adverse events were reported by 10/14 (71%) and 21/22 (95%) participants in the placebo and GSK2245035 groups, respectively; headache was the most common. Conclusions and clinical relevance Although target engagement was observed, weekly intranasal GSK2245035 20 ng for 8 weeks did not substantially attenuate the late asthmatic response in participants with mild allergic asthma. Overall, treatment was well tolerated.
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Warner, John O. "Asthma/Rhinitis (The United Airway) and Allergy: Chicken or Egg; Which Comes First?" Journal of Clinical Medicine 9, no. 5 (May 14, 2020): 1483. http://dx.doi.org/10.3390/jcm9051483.
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While allergy, asthma and rhinitis do not inevitably co-exist, there are strong associations. Not all those with asthma are allergic, rhinitis may exist without asthma, and allergy commonly exists in the absence of asthma and/or rhinitis. This is likely due to the separate gene/environment interactions which influence susceptibility to allergic sensitization and allergic airway diseases. Allergic sensitization, particularly to foods, and eczema commonly manifest early in infancy, and not infrequently are followed by the development of allergic rhinitis and ultimately asthma. This has become known as the “allergic march”. However, many infants with eczema never develop asthma or rhinitis, and both the latter conditions can evolve without prior eczema or food allergy. Understanding the mechanisms underlying the ontogeny of allergic sensitization and allergic disease will facilitate rational approaches to the prevention and management of asthma and allergic rhinitis. Furthermore, a range of new, so-called biological, therapeutic approaches, targeting specific allergy-promoting and pro-inflammatory molecules, are now in clinical trials or have been recently approved for use by regulatory authorities and could have a major impact on disease prevention and control in the future. Understanding basic mechanisms will be essential to the employment of such medications. This review will explain the concept of the united airway (rhinitis/asthma) and associations with allergy. It will incorporate understanding of the role of genes and environment in relation to the distinct but interacting origins of allergy and rhinitis/asthma. Understanding the patho-physiological differences and varying therapeutic requirements in patients with asthma, with or without rhinitis, and with or without associated allergy, will aid the planning of a personalized evidence-based management strategy.
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Mullarkey, M. F., K. M. Leiferman, M. S. Peters, I. Caro, E. R. Roux, R. K. Hanna, A. S. Rubin, and C. A. Jacobs. "Human cutaneous allergic late-phase response is inhibited by soluble IL-1 receptor." Journal of Immunology 152, no. 4 (February 15, 1994): 2033–41. http://dx.doi.org/10.4049/jimmunol.152.4.2033.
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Abstract The late-phase allergic reaction (LPR) occurs 4 to 8 h after allergen exposure and probably causes the symptoms of chronic allergic disease. To determine the effects of soluble IL-1 receptor on the cutaneous LPR, we performed a prospective, randomized, double-blind, placebo-controlled study on 15 allergic subjects. Intradermal injections of allergen were placed on subjects' forearms, followed by immediate subcutaneous injections at the same site of either 1, 10, 25, 50, or 100 micrograms of rhu IL-1R to three subjects in each dosage group. Placebo was given to matched allergen-injected sites on the contralateral arm. Erythema, induration, and itching were recorded for each site. Sites were biopsied at 8 h for immunohistologic evaluations. Rhu IL-1R significantly reduced the clinical reaction at all concentrations. At 1 and 10 micrograms, measurements of LPR were significantly less (p < 0.05) than at placebo sites at several time points from 2 to 8 h. At higher concentrations, LPR was suppressed at rhu IL-1R and placebo sites, suggesting a systemic effect of rhu IL-1R. Histologic evaluation and indirect immunofluorescence for eosinophil granule major basic protein, neutrophil elastase, and mast cell tryptase showed no statistical differences between rhu IL-1R and placebo sites or among doses. IL-1 plays an important role in the generation of allergic LPR. While microgram quantities of rhu IL-1R inhibited the clinical signs and symptoms of LPR, its effects on the allergic inflammatory infiltrate are yet to be defined. In this short term trial, rhu IL-1R was neither immunogenic nor toxic.
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Sur, S., J. Lam, P. Bouchard, A. Sigounas, D. Holbert, and W. J. Metzger. "Immunomodulatory effects of IL-12 on allergic lung inflammation depend on timing of doses." Journal of Immunology 157, no. 9 (November 1, 1996): 4173–80. http://dx.doi.org/10.4049/jimmunol.157.9.4173.
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Abstract We investigated the effects of IL-12 on a murine model of allergic lung inflammation. Administration of IL-12 was timed to interfere with either allergic sensitization (early dosage) or the hypersensitivity inflammatory response in the lung (late dosage), or both (early and late dosages). Comparisons of IL-12- and PBS-treated animals within each treatment group revealed several noticeable effects of IL-12. Early dosage, and the combination of early and late dosages, strikingly decreased ragweed-specific serum IgE, tracheal ring reactivity to acetylcholine, and BAL eosinophilia following allergen challenge. In contrast, late dosage had no effect on IgE levels and only a minimal effect on tracheal ring reactivity, but had a modest effect on recruitment of eosinophils. Early dosage down-regulated IL-5 and IL-10, but did not alter IL-4 or IFN-gamma expression. Late dosage down-regulated IL-5, up-regulated IL-10 and IFN-gamma, but did not change IL-4 expression. The combination of early and late dosage down-regulated IL-4, IL-5, and IL-10 expression, but increased IFN-gamma expression and production in the BAL cells and fluids. Taken together, these results indicate that IL-12 has potent immunomodulatory effects on allergic lung inflammation that depend on the timing of IL-12 administration relative to allergic sensitization and allergen challenge.
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GREENBERG, M., C. KAUFMAN, G. GONZALEZ, Z. TRUSEWYCH, C. ROSENBLATT, and R. SUMMERS. "Late systemic-allergic reactions to inhalant allergen immunotherapy." Journal of Allergy and Clinical Immunology 82, no. 2 (August 1988): 287–90. http://dx.doi.org/10.1016/0091-6749(88)91013-5.
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Gushchin, I. S. "Poly-functional anti-allergic activities of anti-histamine drug - rupatadine." Russian Journal of Allergy 9, no. 4 (December 15, 2012): 3–12. http://dx.doi.org/10.36691/rja673.
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Rupatadine is a new agent for the management of diseases with allergic inflammatory conditions. Rupatadine is a dual inhibitor of H 1- and platelet-activating factor (PAF)-receptors and possesses a broader profile of antiallergic properties inhibiting allergy target cells and secretion of different mediators involved in the early- and late-phase of allergic response. Rupatadine is a real example of poly-functional anti-allergic remedy.
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van Neerven, R. J. J., T. Wikborg, G. Lund, B. Jacobsen, Å Brinch-Nielsen, J. Arnved, and H. Ipsen. "Blocking Antibodies Induced by Specific Allergy Vaccination Prevent the Activation of CD4+ T Cells by Inhibiting Serum-IgE-Facilitated Allergen Presentation." Journal of Immunology 163, no. 5 (September 1, 1999): 2944–52. http://dx.doi.org/10.4049/jimmunol.163.5.2944.
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Abstract Allergen-specific CD4+ T lymphocytes are activated at extremely low allergen concentrations in vivo as a result of serum-facilitated allergen presentation (S-FAP). It is not clear at present if specific allergy vaccination (SAV) has an effect on this mechanism. Here we show that birch allergen-specific serum-IgE facilitates the presentation of Bet v 1, the major birch pollen allergen, to Bet v 1-specific CD4+ T lymphocytes by a factor of >100. This process is CD23 mediated, could be detected in sera from the majority of birch-allergic patients, and was clearly dose dependent. S-FAP of Bet v 1 was inhibited in patients undergoing long-term birch SAV, but not by sera from patients undergoing grass SAV, indicating that birch-specific Abs are involved. This resulted in decreased proliferation and IL-4, IL-5, IL-10, and IFN-γ production of Bet v 1-specific T cells. The inhibition was already noted after 3–9 mo of SAV and could not be solely explained by increased serum levels of birch-specific IgG4. When IgG- and IgA/IgM-containing fractions of long-term SAV sera were used to inhibit S-FAP, only IgG-containing fractions were shown to inhibit S-FAP. These results indicate that blocking IgG Abs induced by SAV inhibits the occurrence of S-FAP at very low allergen concentrations, resulting in significantly higher allergen threshold levels to obtain T cell proliferation and cytokine production and thus allergen-induced late-phase responses.
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Petalas, K., and S. R. Durham. "Allergen immunotherapy for allergic rhinitis." Rhinology journal 51, no. 2 (June 1, 2013): 99–110. http://dx.doi.org/10.4193/rhino12.086.
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Allergic rhinitis, a risk factor for bronchial asthma, is a global health problem that impairs patients` physical and social activity and consequently their quality of life. Specific Immunotherapy (SIT) involves the administration, subcutaneously or sublingually, of increasing doses of the causative allergen, in order to induce clinical and immunologic tolerance. SIT has been shown to be effective in those with a poor response to conventional drug therapy. Immunotherapy has been shown to have disease-modifying effects and result in long term remission of allergic symptoms and reduces the risk of progression from rhinitis to asthma, as well as the chances of developing new sensitizations to allergens. Injection immunotherapy is a safe treatment for allergic rhinitis with/without mild controlled asthma, provided that it is performed in the context of a harmonious interaction between trained medical personnel and appropriately selected patients. Immunotherapy suppresses early and late responses to allergen exposure by modifying both T-cell and B-cell responses to inhaled allergens. Immune deviation of allergen-specific T cell responses in favour of Th1 and/or the induction of regulatory T cells is crucial in achieving immune tolerance. Increased understanding of the mechanisms of immunotherapy has identified potential biomarkers of the response to treatment and highlighted new therapeutic pathways with potential for even more effective future standardized vaccines.
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Rustecka, Agnieszka, Maria Węgrzynek, Agata Tomaszewska, and Bolesław Kalicki. "The role of glucocorticoids in the treatment of acute anaphylactic reaction." Pediatria i Medycyna Rodzinna 17, no. 3 (September 30, 2021): 256–60. http://dx.doi.org/10.15557/pimr.2021.0040.
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Food allergy is a growing health problem, which is particularly common among the youngest children. Anaphylaxis, which is defined as a sudden-onset and potentially fatal response to an allergen, is an indication for urgent treatment. Although intramuscular epinephrine is the treatment of choice, all therapeutic algorithms also recommend glucocorticoids. They play an important role in reducing the risk of late allergic reaction, and, due to their non-genomic effects, are also increasingly often mentioned in the context of early response to shock. This effect is directly proportional to the dose of the drug, and a reduced duration of the symptoms of anaphylactic shock is achieved with the use of high doses of glucocorticoids. The paper presents a case of a 3-month-old girl with an anaphylactic reaction after consuming a modified milk preparation. After systemic administration of glucocorticoids, a satisfactory therapeutic effect was observed in the child.
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Omusheva, S. "Modern Diagnostics and Treatment of Allergic Rhinitis in Children in the Kyrgyz Republic." Bulletin of Science and Practice 6, no. 1 (January 15, 2020): 129–37. http://dx.doi.org/10.33619/2414-2948/50/14.
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The aim of the study was to study the detection and treatment of allergic rhinitis in children in the Kyrgyz Republic. A prospective study included 79 children with suspected allergic rhinitis. It was found that 79 patients were diagnosed with allergic rhinitis using an adapted questionnaire. Late reversibility, the duration of the disease on average 3 years from the onset of the first symptoms, and a severe course, indicate a diagnosis of the disease. In allergic rhinitis intermittent flow, sensitization to pollen of cereals and trees predominates, and in persistent, weed, domestic, and epidermal allergens are noted. The effectiveness of subcutaneous and sublingual allergen-specific immunotherapy methods in children was evaluated.
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Welch, Laura. "Evaluating Impairment from Allergic Disorders." Guides Newsletter 4, no. 2 (March 1, 1999): 1–3. http://dx.doi.org/10.1001/amaguidesnewsletters.1999.marapr01.
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Abstract More than 15 million Americans have allergic rhinitis alone, and approximately 12 million have other allergic manifestations such as urticaria, angioedema, eczema, or sensitivity to food, drugs, or insect bites. Almost 10% of patients who seek care at a physician's office do so for one of the common allergic diseases, but rating impairment for allergic disorders is uncommon because typically they do not produce “permanent” impairment and are not work- or liability-related. Section 9.3a, Respiration in Chapter 9, Ear, Nose, Throat, and Related Structures, of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) addresses the process of assessing impairment due to allergic rhinitis, the first type of allergy. Because allergic rhinitis is seasonal, the examiner must determine if permanent impairment is present and if the patient is at maximum medical improvement. The second major manifestation of allergy is allergic skin disease, including urticaria-angioedema and is discussed in Chapter 13, The Skin, where a table classifies skin disorder impairments. The third primary manifestation of allergic disease is eczema, also called atopic dermatitis, which also is discussed in Chapter 13. Allergic diseases are common but generally are quite treatable. Evaluators should ensure that the patient has had an appropriate trial of therapeutic agents before assigning a permanent partial impairment; because of treatment options, the latter should be rare.
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Henry, Peter J., Tracy S. Mann, Angela C. D'Aprile, Glenn J. Self, and Roy G. Goldie. "An endothelin receptor antagonist, SB-217242, inhibits airway hyperresponsiveness in allergic mice." American Journal of Physiology-Lung Cellular and Molecular Physiology 283, no. 5 (November 1, 2002): L1072—L1078. http://dx.doi.org/10.1152/ajplung.00076.2002.
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Within the airways, endothelin-1 (ET-1) can exert a range of prominent effects, including airway smooth muscle contraction, bronchial obstruction, airway wall edema, and airway remodeling. ET-1 also possesses proinflammatory properties and contributes to the late-phase response in allergic airways. However, there is no direct evidence for the contribution of endogenous ET-1 to airway hyperresponsiveness in allergic airways. Allergic inflammation induced in mice by sensitization and challenge with the house dust mite allergen Der P1 was associated with elevated levels of ET-1 within the lung, increased numbers of eosinophils within bronchoalveolar lavage fluid and tissue sections, and development of airway hyperresponsiveness to methacholine ( P < 0.05, n = 6 mice per group). Treatment of allergic mice with an endothelin receptor antagonist, SB-217242 (30 mg · kg−1· day−1), during allergen challenge markedly inhibited airway eosinophilia (bronchoalveolar lavage fluid and tissue) and development of airway hyperresponsiveness. These findings provide direct evidence for a mediator role for ET-1 in development of airway hyperresponsiveness and airway eosinophilia in Der P1-sensitized mice after antigen challenge.
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Álvarez-López, Sabela, María Fernández-González, Kenia Caridad Sánchez Espinosa, Rubén Amigo, and Francisco Javier Rodríguez-Rajo. "London Plane Tree Pollen and Pla A 1 Allergen Concentrations Assessment in Urban Environments." Forests 13, no. 12 (December 8, 2022): 2089. http://dx.doi.org/10.3390/f13122089.
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The London plane tree is frequently used in gardens, parks, and avenues in European urban areas for ornamental purposes with the aim to provide shade, and given its tolerance to atmospheric pollution. Nevertheless, unfortunately, over recent decades, bioaerosols such as Platanus pollen grains cause increasing human health problems such as allergies or respiratory tract infections. An aerobiological sampling of airborne Platanus pollen and Pla a 1 allergen was performed using two volumetric traps placed on the roof of the Science Faculty building of the city of Ourense from 2009 to 2020. A volumetric sampler Hirst–type Lanzoni VPPS 2000 (Lanzoni s.r.l. Bologna, Italy) was used for pollen sampling. Pla a 1 aeroallergen was sampled by using a Burkard Multi-Vial Cyclone Sampler (Burkard Manufacturing Co., Ltd., Hertfordshire, UK) and by means of the enzyme-linked immunosorbent assay (ELISA) technique. Data mining algorithms, C5.0 decision trees, and rule-based models were assessed to evaluate the effects of the main meteorological factors in the pollen or allergen concentrations. Plane trees bloom in late winter and spring months in the Northwestern Spain area. Regarding the trends of the parameters that define the Platanus pollen season, the allergen values fitted the concentrations of pollen in the air in most cases. In addition, it was observed that a decrease in maximum temperatures causes a descent in both pollen and allergen concentrations. However, the presence of precipitations only increases the level of allergens. When the risk of allergy symptomatology was jointly assessed for both the concentration of pollen and allergens in the study area, the number of days with moderate and high risk for pollen allergy in sensitive people increased with respect to traditional alerts considering only the pollen values.
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JANIA, BARTOSZ, MARTA DOPIERAŁA, EWA WÓJCIK, KATARZYNA RYMUZA, and KATARZYNA ANDRASZEK. "IgE-dependent reactivity of canine sera from three regions of Poland." Medycyna Weterynaryjna 76, no. 06 (2020): 6410–2020. http://dx.doi.org/10.21521/mw.6410.
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Allergies in dogs have become a relatively frequent topic of discussion in veterinary surgeries. Many dogs, both purebred and of mixed breeds, are diagnosed for allergies. Allergies have many causes, from genetic predisposition to the environmental conditions in which the animal lives. Allergies in dogs are troublesome because they can lead to serious health complications when diagnosed late or left untreated. The results of the study support the hypothesis that the percentage of allergies to individual allergens varied by region (Tab. 4). Differences were observed in the case of Dermatophagoides pteronyssinus and Dermatophagoides farinae house dust mites, Acarus siro, and Tyrophagus. The remaining allergens caused allergic reactions in similar percentages of dogs from northern, central and southern Poland.
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Kaplan, Michael, and Marion Johnson. "BREASTFEEDING AS PROPHYLAXIS AGAINST ATOPIC DISEASE: PROSPECTIVE FOLLOW-UP STUDY UNTIL 17 YEARS OLD." Pediatrics 98, no. 2 (August 1, 1996): 321. http://dx.doi.org/10.1542/peds.98.2.321.
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Cockcroft, Donald W., Fredrick E. Hargreave, Paul M. O’Byrne, and Louis-Philippe Boulet. "Understanding Allergic Asthma from Allergen Inhalation Tests." Canadian Respiratory Journal 14, no. 7 (2007): 414–18. http://dx.doi.org/10.1155/2007/753450.
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The allergen challenge has evolved, in less than 150 years, from a crude tool used to document the etiology of allergen-induced disease to a well-controlled tool used today to investigate the pathophysiology and pharmacotherapy of asthma. Highlights of the authors’ involvement with the allergen challenge include confirmation of the immunoglobulin E-dependence of the late asthmatic response, importance of (nonallergic) airway hyper-responsiveness as a determinant of the airway response to allergen, identification of allergen-induced increase in airway hyper-responsiveness, documentation of beta2-agonist-induced increase in airway response to allergen (including eosinophilic inflammation), advances in understanding the pathophysiology and kinetics of allergen-induced airway responses, and development of a muticentre clinical trial group devoted to using the allergen challenge for investigating promising new therapeutic strategies for asthma.
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GREENBERG, M., C. KAUFMAN, G. GONZALEZ, C. ROSENBLATT, L. SMITH, and R. SUMMERS. "Late and immediate systemic-allergic reactions to inhalant allergen immunotherapy." Journal of Allergy and Clinical Immunology 77, no. 6 (June 1986): 865–70. http://dx.doi.org/10.1016/0091-6749(86)90385-4.
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Sun, Wai Y., and Claudine S. Bonder. "Sphingolipids: A Potential Molecular Approach to Treat Allergic Inflammation." Journal of Allergy 2012 (December 18, 2012): 1–14. http://dx.doi.org/10.1155/2012/154174.
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Allergic inflammation is an immune response to foreign antigens, which begins within minutes of exposure to the allergen followed by a late phase leading to chronic inflammation. Prolonged allergic inflammation manifests in diseases such as urticaria and rhino-conjunctivitis, as well as chronic asthma and life-threatening anaphylaxis. The prevalence of allergic diseases is profound with 25% of the worldwide population affected and a rising trend across all ages, gender, and racial groups. The identification and avoidance of allergens can manage this disease, but this is not always possible with triggers being common foods, prevalent air-borne particles and only extremely low levels of allergen exposure required for sensitization. Patients who are sensitive to multiple allergens require prophylactic and symptomatic treatments. Current treatments are often suboptimal and associated with adverse effects, such as the interruption of cognition, sleep cycles, and endocrine homeostasis, all of which affect quality of life and are a financial burden to society. Clearly, a better therapeutic approach for allergic diseases is required. Herein, we review the current knowledge of allergic inflammation and discuss the role of sphingolipids as potential targets to regulate inflammatory development in vivo and in humans. We also discuss the benefits and risks of using sphingolipid inhibitors.
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Manavi, Kasra, Bruna Jacobson, Brittany Hoard, and Lydia Tapia. "Influence of model resolution on geometric simulations of antibody aggregation." Robotica 34, no. 8 (May 13, 2016): 1754–76. http://dx.doi.org/10.1017/s0263574716000199.
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SUMMARYIt is estimated that allergies afflict up to 40% of the world's population. A primary mediator for allergies is the aggregation of antigens and IgE antibodies bound to cell-surface receptors, FcεRI. Antibody/antigen aggregate formation causes stimulation of mast cells and basophils, initiating cellular degranulation and releasing immune mediators which produce an allergic or anaphylactic response. Understanding the shape and structure of these aggregates can provide critical insights into the allergic response. We have previously developed methods to geometrically model, simulate and analyze antibody aggregation inspired by rigid body robotic motion simulations. Our technique handles the large size and number of molecules involved in aggregation, providing an advantage over traditional simulations such as molecular dynamics (MD) and coarse-grained energetic models. In this paper, we study the impact of model resolution on simulations of geometric structures using both our previously developed Monte Carlo simulation and a novel application of rule-based modeling. These methods complement each other, the former providing explicit geometric detail and the latter providing a generic representation where multiple resolutions can be captured. Our exploration is focused on two antigens, a man-made antigen with three binding sites, DF3, and a common shrimp allergen (antigen), Pen a 1. We find that impact of resolution is minimal for DF3, a small globular antigen, but has a larger impact on Pen a 1, a rod-shaped molecule. The volume reduction caused by the loss in resolution allows more binding site accessibility, which can be quantified using a rule-based model with implicit geometric input. Clustering analysis of our simulation shows good correlation when compared with available experimental results. Moreover, collisions in all-atom reconstructions are negligible, at around 0.2% at 90% reduction.
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Wooldridge, Amy L., Robert J. Bischof, Hong Liu, Gary K. Heinemann, Damien S. Hunter, Lynne C. Giles, Rebecca A. Simmons, et al. "Late-gestation maternal dietary methyl donor and cofactor supplementation in sheep partially reverses protection against allergic sensitization by IUGR." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 314, no. 1 (January 1, 2018): R22—R33. http://dx.doi.org/10.1152/ajpregu.00549.2016.
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Perinatal exposures are associated with altered risks of childhood allergy. Human studies and our previous work suggest that restricted growth in utero (IUGR) is protective against allergic disease. The mechanisms are not clearly defined, but reduced fetal abundance and altered metabolism of methyl donors are hypothesized as possible underlying mechanisms. Therefore, we examined whether late-gestation maternal dietary methyl donor and cofactor supplementation of the placentally restricted (PR) sheep pregnancy would reverse allergic protection in progeny. Allergic outcomes were compared between progeny from control pregnancies (CON; n = 49), from PR pregnancies without intervention (PR; n = 28), and from PR pregnancies where the dam was fed a methyl donor plus cofactor supplement from day 120 of pregnancy until delivery (PR + Methyl; n = 25). Both PR and PR + Methyl progeny were smaller than CON; supplementation did not alter birth size. PR was protective against cutaneous hypersensitivity responses to ovalbumin (OVA; P < 0.01 in singletons). Cutaneous hypersensitivity responses to OVA in PR + Methyl progeny were intermediate to and not different from the responses of CON and PR sheep. Cutaneous hypersensitivity responses to house dust mites did not differ between treatments. In singleton progeny, upper dermal mast cell density was greater in PR + Methyl than in PR or CON (each P < 0.05). The differences in the cutaneous allergic response were not explained by treatment effects on circulating immune cells or antibodies. Our results suggest that mechanisms underlying in utero programming of allergic susceptibility by IUGR and methyl donor availability may differ and imply that late-gestation methyl donor supplementation may increase allergy risk.
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Sur, Lucia M., Ionel Armat, Emanuela Duca, Genel Sur, Iulia Lupan, Daniel Sur, Gabriel Samasca, Cecilia Lazea, and Calin Lazar. "Food Allergy a Constant Concern to the Medical World and Healthcare Providers: Practical Aspects." Life 11, no. 11 (November 8, 2021): 1204. http://dx.doi.org/10.3390/life11111204.
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Food allergy (FA) is a condition with a growing incidence and is a constant concern for the medical world and healthcare providers. With potential symptoms including anaphylaxis, in the event of an allergic reaction the patient’s life may well be endangered. The diagnosis of FA is a continuous challenge because mild cases tend to be ignored or diagnosed late and young children with allergies are cared for by parents, who are not always able to accurately interpret symptoms. It is very important to be able to differentiate FAs from food intolerance and toxic reactions to food. An accurate diagnosis is required to provide personalized management of an FA. More sophisticated and accurate diagnostic tests, including component diagnosis and epitope reactivity, allow the provision of a directed diagnosis, a more accurate therapeutic approach, and a useful prognostic evaluation. Tests used in current practice include the specific search for serum IgE, elimination diets, oral food challenges, single, blind, and double-blind (DBPCFC) tests, as well as skin tests. The risk of anaphylaxis can be assessed by molecular diagnostics/component-resolved diagnosis (CRD) and by conducting a basophilic activation test (BAT). These tests allow a planned, personalized treatment based on molecular and clinical profiles. CRD can determine the individual profile of allergic molecular reactivity and enable the formulation of a prognostic judgment. Our article highlights the importance of knowing the immune mechanisms, diagnostics, and immunotherapies in FAs. Starting from observing exposure to food allergens, to identifying allergic reactions, analysing the severity of clinical manifestations, noting the possibilities of diagnosis, and illustrating adequate management strategies.
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Starostina, S. V., and A. V. Toldanov. "Significance of modern antihistamines in the treatment of patients with allergic rhinitis." Meditsinskiy sovet = Medical Council, no. 20 (November 18, 2022): 140–48. http://dx.doi.org/10.21518/2079-701x-2022-16-20-140-148.
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Allergic rhinitis (AR) is one of the most common diseases in the world, which is based on immunoglobulin E (IgE) – mediated inflammation that develops after contact with various allergens. About 40 % of people suffer from various allergic diseases, every 3 rd inhabitant of the Earth has symptoms of allergic rhinitis and every 10 th has bronchial asthma. The early phase of allergen binding to IgE antibodies occurs within a few minutes after contact, the late phase develops after 4–6 hours. In addition to the airborne pathway of penetration, contact with the allergen is possible through the skin and mucous membranes, gastrointestinal tract, with parenteral administration of drugs. Taking into account the etiotropic factor, there are year-round allergic rhinitis (CAR) and seasonal (SAR). By the nature of the course, intermittent and persistent allergic rhinitis are distinguished. The most basic symptoms of allergic rhinitis include: sneezing, rhinorrhea, nasal congestion, itching, decreased sense of smell. Treatment includes antihistamines, intranasal steroids, leukotriene receptor antagonists and immunotherapy. To date, antihistamines of the second generation are recommended and widely used for the treatment of patients with allergic rhinitis, the main representative of which is levocetirizine (levocetirizine dihydrochloride). The purpose of the work is an analytical review of the results of clinical trials of levocetirizine for allergic rhinitis. The article discusses in detail the prevalence, etiology and pathogenesis, classification of the disease, treatment regimens for patients with allergic rhinitis, and provides two own clinical observations. Based on the data of a number of studies, the advantages of using antihistamines of the second generation in allergic rhinitis have been demonstrated, expanding not only the possibilities of treating patients, but also preventing the transition of the disease into a chronic process.
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Neves, José, A. Brasileiro, and P. Mendes-Bastos. "Recalcitrant Palmoplantar Pustulosis: Have You Considered Allergic Contact Dermatitis?" Journal of the Portuguese Society of Dermatology and Venereology 79, no. 2 (June 26, 2021): 173–77. http://dx.doi.org/10.29021/spdv.79.2.1313.
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Palmoplantar pustulosis (PPP) is a chronic and relapsing disease of the palms and soles, which tends to be difficult to treat. Classically it was described as a subtype of psoriasis. Nowadays it is regarded as a separate entity, although plaque-type psoriasis affects concomitantly many patients with PPP. A link between allergic contact dermatitis (ACD) and PPP has been described, and the former may encompass a potential to perpetuate the latter. Hereby we report two cases of difficult to treat plantar pustulosis. Underneath the dermatosis’s refractive nature was an allergic sensitization to potassium dichromate and cobalt chloride. Leather shoes and leather insoles were commonly worn, and both allergens are employed by the leather industry. Clinical remission was achieved in both cases with allergen eviction. Patch testing must be considered in cases of PPP without response to treatment. If relevant sensitization is found, allergen eviction measures are mandatory.
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Traidl-Hoffmann, Claudia. "Pollenallergie gegen Ambrosia: Belastungen, Merkmale und Umgang mit einem importierten Allergieverursacher in Europa." Kompass Pneumologie 7, no. 2 (2019): 86–87. http://dx.doi.org/10.1159/000497001.
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Ambrosia artemisiifolia, also known as common or short ragweed, is an invasive annual flowering herbaceous plant that has its origin in North America. Nowadays, ragweed can be found in many areas worldwide. Ragweed pollen is known for its high potential to cause type I allergic reactions in late summer and autumn and represents a major health problem in America and several countries in Europe. Climate change and urbanization, as well as long distance transport capacity, enhance the spread of ragweed pollen. Therefore ragweed is becoming domestic in non-invaded areas which in turn will increase the sensitization rate. So far 11 ragweed allergens have been described and, according to IgE reactivity, Amb a 1 and Amb a 11 seem to be major allergens. Sensitization rates of the other allergens vary between 10 and 50%. Most of the allergens have already been recombinantly produced, but most of them have not been characterized regarding their allergenic activity, therefore no conclusion on the clinical relevance of all the allergens can be made, which is important and necessary for an accurate diagnosis. Pharmacotherapy is the most common treatment for ragweed pollen allergy but fails to impact on the course of allergy. Allergen-specific immunotherapy (AIT) is the only causative and disease-modifying treatment of allergy with long-lasting effects, but currently it is based on the administration of ragweed pollen extract or Amb a 1 only. In order to improve ragweed pollen AIT, new strategies are required with higher efficacy and safety.
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Traidl-Hoffmann, Claudia. "Pollenallergie gegen Ambrosia: Belastungen, Merkmale und Umgang mit einem importierten Allergieverursacher in Europa." Kompass Dermatologie 6, no. 4 (2018): 206–7. http://dx.doi.org/10.1159/000492639.
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Ambrosia artemisiifolia, also known as common or short ragweed, is an invasive annual flowering herbaceous plant that has its origin in North America. Nowadays, ragweed can be found in many areas worldwide. Ragweed pollen is known for its high potential to cause type I allergic reactions in late summer and autumn and represents a major health problem in America and several countries in Europe. Climate change and urbanization, as well as long distance transport capacity, enhance the spread of ragweed pollen. Therefore ragweed is becoming domestic in non-invaded areas which in turn will increase the sensitization rate. So far 11 ragweed allergens have been described and, according to IgE reactivity, Amb a 1 and Amb a 11 seem to be major allergens. Sensitization rates of the other allergens vary between 10 and 50%. Most of the allergens have already been recombinantly produced, but most of them have not been characterized regarding their allergenic activity, therefore no conclusion on the clinical relevance of all the allergens can be made, which is important and necessary for an accurate diagnosis. Pharmacotherapy is the most common treatment for ragweed pollen allergy but fails to impact on the course of allergy. Allergen-specific immunotherapy (AIT) is the only causative and disease-modifying treatment of allergy with long-lasting effects, but currently it is based on the administration of ragweed pollen extract or Amb a 1 only. In order to improve ragweed pollen AIT, new strategies are required with higher efficacy and safety.
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Hernandez-Ramirez, Guadalupe, Domingo Barber, Jaime Tome-Amat, Maria Garrido-Arandia, and Araceli Diaz-Perales. "Alternaria as an Inducer of Allergic Sensitization." Journal of Fungi 7, no. 10 (October 7, 2021): 838. http://dx.doi.org/10.3390/jof7100838.
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Alternaria alternata is a saprophytic mold whose spores are disseminated in warm dry air, the typical weather of the Mediterranean climate region (from 30° to 45°), with a peak during the late summer and early autumn. Alternaria spores are known to be biological contaminants and a potent source of aeroallergens. One consequence of human exposure to Alternaria is an increased risk of developing asthma, with Alt a 1 as its main elicitor and a marker of primary sensitization. Although the action mechanism needs further investigation, a key role of the epithelium in cytokine production, TLR-activated alveolar macrophages and innate lymphoid cells in the adaptive response was demonstrated. Furthermore, sensitization to A. alternata seems to be a trigger for the development of co-sensitization to other allergen sources and may act as an exacerbator of symptoms and an elicitor of food allergies. The prevalence of A. alternata allergy is increasing and has led to expanding research on the role of this fungal species in the induction of IgE-mediated respiratory diseases. Indeed, recent research has allowed new perspectives to be considered in the assessment of exposure and diagnosis of fungi-induced allergies, although more studies are needed for the standardization of immunotherapy formulations.