July 23, 2014

0 Fighting respiratory diseases: divided efforts lead to weakness

J. bras. pneumol. vol.40 no.3 São Paulo May/June 2014

http://dx.doi.org/10.1590/S1806-37132014000300001 

EDITORIAL
Rogelio Pérez-Padilla I , Rafael Stelmach II , Manuel Soto-Quiroz III , Álvaro Augusto Cruz IV
IInvestigator, National Institute of Respiratory Diseases, Mexico City, Mexico
IIAssociate Professor, Pulmonary Division, Heart Institute, University of São Paulo Hospital das Clínicas, São Paulo, Brazil
IIIChief of Pulmonary Medicine, Hospital Nacional de Niños, San José, Costa Rica
IVHead, Center of Excellence in Asthma, Federal University of Bahia, Salvador, Brazil

Various respiratory diseases have been leading causes of death and morbidity over time, and that could be expected considering the huge interface between the respiratory system and the often hostile environment. The respiratory system filters almost 100,000 liters of air in an adult every day. The relevance of the burden of respiratory diseases has been recently emphasized by publications of the major respiratory societies in the world...

Article

0 Meeting abstracts 6th Drug Hypersensitivity Meeting (DHM 6) Bern, Switzerland 9-12 April 2014

Clinical and Translational Allergy publishes selected collections of research articles, conference proceedings, reviews and reports as supplements, which are free to access online. All articles published in supplements are subject to peer review; meeting abstracts undergo review and selection by the conference. Find out more about publishing a supplement with BioMed Central.

Volume 4 Supplement 3

6th Drug Hypersensitivity Meeting (DHM 6)

Meeting abstracts
6th Drug Hypersensitivity Meeting (DHM 6)
Bern, Switzerland
9-12 April 201
Publication of this supplement was funded by the European Academy of Allergy and Clinical Immunology (EAACI).


July 21, 2014

0 Allergic diseases in subjects under 18 years living with HIV

Research

Open Access

Leandro S LinharJefferson TraebertDayani GalatoRosemeri M da SilvaFabiana Schuelter-TrevisolNatália S Rovaris and Jane da Silva
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Allergy, Asthma & Clinical Immunology 2014, 10:35  doi:10.1186/1710-1492-10-35
Published: 7 July 2014

Abstract (provisional)

Background

In recent decades there has been an increase in the prevalence of allergic disease. Manifestations of these diseases have allegedly been observed in people living with Human Immunodeficiency Virus (HIV), however, few studies have been directed at patients under 18 years old. In this context, the aim of this study is to estimate the prevalence of allergic disease in patients under 18 years old, living with HIV, and to investigate the relationship between clinico-immunological characteristics of the HIV infection and atopy.

Methods

This is a cross-sectional epidemiological study involving patients under 18 years of age who were followed up by specialized HIV services in the Southern Region of the State of Santa Catarina, Brazil, from February to October 2012. Data collection tools included a questionnaire established by the International Study of Asthma and Allergy in Childhood (ISAAC), socio-demographic data, as well as laboratory test results obtained from the medical records. Blood samples were taken to measure total serum Immunoglobulin E (IgE) levels and a Radioallergosorbent Test (RAST) for the main aeroallergens. Analysis was performed using Student's t test, chi-squared, Fisher's exact and Mann-Whitney tests, wherever indicated, with p - 0.05.

Results

29 individuals were evaluated. The prevalence of symptoms of allergic disease was 65.5% (95%CI 56.1-74.8), the most frequent being rhinitis 44.8% (95%CI 35.0-54.5), followed by asthma 37.9% (95%CI 28.3-47.4) and eczema 27.6%% (95%CI 18.8-36.3). RAST was positive in 20.7% of the individuals. There was no significant difference in terms of total serum IgE between individuals with and without symptoms of allergic disease. Nevertheless, a high frequency of raised levels of total serum IgE (40.7%) and an association between raised IgE and clinical staging of disease were observed. A further association between CD8+ cell count and prevalence of symptomatic allergic disease (p = 0.014) was observed.

Conclusion

There was a high prevalence of reported allergic disease, as well as a high frequency of raised levels of total serum IgE. The association between CD8+ cell count and the prevalence of symptomatic allergic disease corroborates studies that demonstrated the role of such cells in the development of allergic disease.

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0 Trends in Specific Immunotherapy for Allergic Rhinitis: A Survey of Chinese ENT Specialists

Full Text
Original Article  Open Access


      

Allergy Asthma Immunol Res. 2014 Jul;6(4):296-303. English.
Published online 2014 February 13.  http://dx.doi.org/10.4168/aair.2014.6.4.296 
Copyright © 2014 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease
Han Zhou,1 Qi-Lei Tao,1,2 Jun-Min Wei,3 Geng Xu,4 and Lei Cheng1,5
1Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
2Department of Otorhinolaryngology, Changzheng Hospital, The Second Military Medical University, Shanghai, China.
3Editorial Office, Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association, Beijing, China.
4Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China.
5International Centre for Allergy Research, Nanjing Medical University, Nanjing, China.

 Correspondence to: Lei Cheng, MD, PhD, Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China. Tel: +86-(0)25-6813-6031; Fax: +86-(0)25-8378-0934; Email: jspent@126.com 
Received June 24, 2013; Revised August 13, 2013; Accepted September 24, 2013.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose
Specific immunotherapy (SIT) is a suitable but uncommon treatment option for allergic rhinitis (AR) in China. The current understanding and attitude of Chinese ENT (ear, nose, and throat) specialists in regards to SIT is unclear. This study investigates current trends in the awareness and application status of SIT among Chinese ENT specialists.
Methods
We performed a nationwide, cross-sectional survey with a specially designed questionnaire given to 800 ENT specialists in China. A member of the trained research group conducted face-to-face interviews with each respondent.
Results
Most of the respondents considered AR (96.0%) and allergic asthma (96.0%) the most suitable indications for SIT. Of all respondents, 77.0% recommended the application of SIT as early as possible; in addition, SIT was considered 'relatively controllable and safe' by most respondents (80.6%). The highest allergen-positive rate in AR was associated with house dust mite (47.7%) and obvious differences existed among geographical regions. Conventional subcutaneous immunotherapy was the most highly recommended treatment option (96.2%). 'The high cost of SIT' (86.6%) and 'lack of patient knowledge of SIT' (85.2%) were probably the main reasons for the lower clinical use of SIT in China.
Conclusions
Most cases showed that the opinions of Chinese ENT specialists appeared to be in agreement with recent SIT progress and international guidelines; however, many areas still need to enhance the standardization and use of SIT in China. Clinical guidelines for SIT require improvement; in addition, Chinese ENT specialists need continuing medical education on SIT.
Keywords: Allergic rhinitisspecific immunotherapydata collectionChinese otolaryngologists.

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0 Epidemiology of allergic rhinitis in Quebec: from a 2008 population-based survey


M. Canuel, MSc; G. Lebel, MSc
Author references:
Institut national de santé publique du Québec (INSPQ), Québec, Quebec, Canada
Correspondence: Magalie Canuel, INSPQ, 945, avenue Wolfe, 4eétage, Québec, QC G1V 5B3; Tel.: 418-650-5115, ext. 5224; Fax: 418-654-3144; Email: magalie.canuel@inspq.qc.ca

Abstract

Introduction: Our objective was to estimate the prevalence of symptoms and the proportion of a lifetime physician-based diagnosis of allergic rhinitis (AR) in the province of Quebec among people aged 15 years and older.
Methods: The 2008 Quebec Population Health Survey provided data on the prevalence of symptoms and proportion of lifetime physician-based diagnoses of AR. The prevalence of symptoms was defined as the proportion of individuals who, in the absence of a cold or the flu, had nasal and ocular symptoms in the 12 months before the survey.
Results: The reported prevalence of AR symptoms was 17%, although 9% did not have a diagnosed condition. Reported prevalence was lowest in those aged 65 years and older (12%) and was more common among women (19%) than men (15%). The estimated prevalence of lifetime physician-based diagnosis was 17%.
Conclusion: AR prevalence is high in Quebec with about 1 in 6 people experiencing symptoms. The condition is underdiagnosed and might also be undertreated.
Keywords: adult, allergic rhinitis, allergy, diagnosis, prevalence, rhinoconjunctivitis, symptoms

0 Efficacy and safety of fluticasone furoate 100 mug and 200 mug once daily in the treatment of moderate-severe #asthma in adults and adolescents: a 24-week randomised study

Research article

Ashley WoodcockJan LötvallWilliam W BusseEric D BatemanSally StoneAnna Ellsworth and Loretta Jacques

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BMC Pulmonary Medicine 2014, 14:113  doi:10.1186/1471-2466-14-113
Published: 9 July 2014

Abstract (provisional)

Background

Inhaled corticosteroids are a mainstay of therapy for persistent asthma, but suboptimal adherence with twice-daily use is widespread. Fluticasone furoate (FF) is a new inhaled corticosteroid (ICS) suitable for once-daily dosing in asthma. This study was performed to descriptively assess the efficacy and safety of two doses of FF, with no planned formal statistical hypothesis testing.

Methods

This was a 24-week double-blind, multicentre, parallel-group study (NCT01431950). Patients aged >=12 years with moderate-severe persistent asthma and uncontrolled on mid-high dose ICS were stratified by baseline FEV1 and randomised (1:1) to treatment with FF 100mug or 200mug once daily in the evening. The primary endpoint was change from baseline trough FEV1 after 24 weeks; secondary and other endpoints included peak expiratory flow (PEF) and rescue- and symptom-free 24-hour periods over Weeks 1-24, and Asthma Control TestTM (ACT) score at Week 24. A pre-specified subgroup analysis of patients by randomisation strata was performed for the primary and selected secondary and other endpoints. Safety assessments included adverse events, laboratory and vital sign measurements, and change from baseline in 24-hour urinary cortisol at Week 24.

Results

With FF 100mug and 200mug, least squares mean trough FEV1 improved from baseline by 208mL and 284mL respectively at Week 24; treatment difference: 77mL (95% CI: -39, 192). Similar improvements from baseline in rescue- and symptom-free periods, and morning and evening PEF were observed in both groups. Patients were 42% more likely to be well-controlled (ACT score >=20) with FF 200mug than with FF 100mug. Slightly more patients receiving FF 200mug vs. FF 100mug reported adverse events (63% vs. 59%) and events deemed treatment related (5% vs. -1%). Seven serious adverse events (FF 200mug 4; FF 100mug 3) were reported, none of which were deemed treatment related. No clinically relevant effects of either dose on 24-hour urinary cortisol were observed.

Conclusion

Improvements from baseline in trough FEV1 were observed after 24 weeks of treatment with both doses of FF, with a numerically greater improvement in FEV1 observed in patients receiving FF 200mug. Secondary endpoint findings were similar between groups. No safety concerns were identified during the study.

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0 Anaphylaxis avoidance and management: educating patients and their caregivers

Review

Authors: Järvinen KM, Celestin J

Published Date July 2014 Volume 2014:7 Pages 95 - 104
DOI: http://dx.doi.org/10.2147/JAA.S48611

Kirsi M Järvinen, Jocelyn Celestin

Division of Allergy and Immunology, Department of Medicine, Albany Medical College, Albany, NY, USA

Abstract: Anaphylaxis is an increasingly prevalent problem in westernized countries. Therefore, it is of utmost importance that the increasing numbers of patients at risk for anaphylaxis receive proper education on the etiology and risk factors as well as appropriate treatment of anaphylaxis with epinephrine. The physician's role is crucial in order to educate the patients and care takers on effective measures to prevent anaphylaxis and empower them to take charge of early recognition and proper management of an anaphylactic reaction to prevent poor outcomes. This review summarizes the clinical presentation, triggers, avoidance, and management of anaphylaxis.

Keywords: food allergy, drug allergy, Hymenoptera, latex


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Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

July 17, 2014

0 Transcription factor IRF4 drives dendritic cells to promote Th2 differentiation

Logo of nihpa
Nat Commun. Author manuscript; available in PMC Apr 29, 2014.
Published in final edited form as:
PMCID: PMC4003872
NIHMSID: NIHMS565877

Abstract

Atopic asthma is an inflammatory pulmonary disease associated with Th2 adaptive immune responses triggered by innocuous antigens. While dendritic cells (DCs) are known to shape the adaptive immune response, the mechanisms by which DCs promote Th2 differentiation remain elusive. Herein we demonstrate that Th2-promoting stimuli induce DC expression of IRF4. Mice with conditional deletion of Irf4 in DCs show a dramatic defect in Th2-type lung inflammation, yet retain the ability to elicit pulmonary Th1 anti-viral responses. Using loss- and gain-of-function analysis, we demonstrate that Th2 differentiation is dependent on IRF4 expression in DCs. Finally, IRF4 directly targets and activates the Il10 and Il33 genes in DCs. Reconstitution with exogenous IL-10 and IL-33 recovers the ability of Irf4 deficient DCs to promote Th2 differentiation. These findings reveal a regulatory module in DCs by which IRF4 modulates IL-10 and IL-33 cytokine production to specifically promote Th2 differentiation and inflammation.
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0 An Overview of Parabens and Allergic Contact Dermatitis


Farhaan Hafeez, BA, MS and Howard Maibach, MD 
Dermatology of Department, University of California San Francisco, San Francisco, CA, USA


ABSTRACT

Esters of p-hydroxybenzoic acid (parabens) are the most widely used preservatives in cosmetic, pharmaceutical, and industrial products. However, since the 1960s, controversy has surrounded its use and safety as a potential cause of allergic contact dermatitis. Despite the cloud of suspicion that has hovered over parabens ever since, these ubiquitous compounds have withstood four decades of extensive skin testing conducted by a variety of organizations, both North American and European, and now, it seems parabens have shown to be one of the least sensitizing preservatives in commercial use. Of the very limited reports of paraben-induced allergic contact dermatitis, these cases are often attributable to the application of parabens on damaged skin. 

Key Words: parabens, allergic contact dermatitis, sensitization, allergen, patch test


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