Stress, pseudoallergens, autoimmunity, infection and inflammation in chronic spontaneous urticaria

• Review
• Open Access

Ciara Jade Bansal & 

Amolak Singh Bansal 

Allergy, Asthma & Clinical Immunologyvolume 15, Article number: 56 (2019) 

Abstract

Mast cell activation in acute and chronic spontaneous Urticaria

Chronic spontaneous urticaria (CSU) is often associated with organ specific autoimmunity but is rarely caused by food allergy. Colourings and preservatives in pre-packaged foods, so called pseudoallergens, have also been implicated. Factors that promote inflammation or reduce anti-inflammatory mechanisms may however, predispose susceptible individuals to CSU. Chronic underlying infection and mental and emotional stress can sometimes precede the onset of CSU and once established can exacerbate the symptoms.

Contraindications to immunotherapy: a global approach

• Review
• Open Access

• C. Pitsios, 
• M. Tsoumani, 
• M. B. Bilò, 
• G. J. Sturm, 
• P. Rodríguez del Río, 
• R. Gawlik, 
• F. Ruëff, 
• G. Paraskevopoulos, 
• E. Valovirta, 
• O. Pfaar, 
• M. A. Calderón & 
• P. Demoly 

Clinical and Translational Allergyvolume 9, Article number: 45 (2019) | 

Abstract

Conflicting guidelines on whether a condition/comorbidity
consists absolute, relative or no contraindication to SCIT

Background

Recommendations on contraindications to allergen immunotherapy (AIT) have been independently developed by National and International Societies/Academies. AIT contraindications are mainly based on case reports, case-series, or experts’ opinion, while evidence-based information is limited. The aim of the present review was to describe existing guidelines on contraindications to AIT and to highlight differences between them.

Main body

A randomized, placebo-controlled, double-blinded, single-centre, phase IV trial to assess the efficacy and safety of OM-85 in children suffering from recurrent respiratory tract infections

Journal of Translational Medicine — Esposito S, Bianchini S, Bosis S, et al. | August 29, 2019

Via a randomized, placebo-controlled, double-blind, single-centre, phase IV trial conducted in Italy, researchers further added to the assessment of the role played by OM-85, a lysate of 21 common bacterial respiratory pathogens, in the prevention of recurrent respiratory tract infections (RTIs) in children. Among patients receiving OM-85 for 3 months vs those given placeboes, the number of RTIs and of children who experienced at least one RTI were significantly lower. For upper RTIs, variations were statistically important. In the group with children treated with OM-85 for 3 months vs the placebo group, days of absence from daycare for children and working days lost by parents were significantly lower.

The Explosion of OTC Management of Allergic Rhinitis: Costs and Risks

• Authors

• Juan Carlos Ivancevich
• Hugo Neffen 
• Jorge Fernando Máspero

Abstract

Purpose of the Review

To review self-medication and the increasing use of over-the-counter (OTC) medications in the treatment of allergic rhinitis in the last years.

Recent Findings

Thanks to recent research and the use of mHealth tools, the preferences of patients, the role of primary care physicians, pharmacists, and specialists in the management of this prevalent condition have been known.

Summary

Successful self-management of AR requires that patients be fully informed about the available treatment options, the proper use of nasal spray devices, the need for therapy based on prevention, and avoidance of allergens. The use of OTC medications facilitates access to treatment and lowers health costs, but requires education of patients, and advice from the pharmacist, the primary care physician and, occasionally, the specialist to ensure its effectiveness and avoid under-diagnosis, multimorbidities, sub-treatment, and adverse events.

Full-text view-only version

Lung ultrasound in infants with bronchiolitis

BMC Pulmonary Medicine

Danilo Buonsenso, 

Anna Maria Musolino, 

Antonio Gatto, 

Ilaria Lazzareschi, 

Antonietta Curatola & 

Piero Valentini 

BMC Pulmonary Medicinevolume 19, Article number: 159 (2019) | 

Abstract

Lung ultrasound (LUS) is nowadays a fast-growing field of study since the technique has been widely acknowledged as a cost-effective, radiation free, and ready available alternative to standard X-ray imaging. However, despite extensive acoustic characterization studies and documented medical evidences, a lot is still unknown about how ultrasounds interact with lung tissue. One of the most discussed lung artifacts are the B-lines [in all ages] and the subpleural consolidations (in young infants). Recently, LUS has been claimed to be able to detect pneumonia in infants with bronchiolitis, although this can be an overestimation due to the peculiar physiology of small peripheral airways of the pediatric lung (particularly in neonate/infants).

Consensus on the therapeutic management of atopic dermatitis - Brazilian Society of Dermatology*

• An Bras Dermatol
• v.94(2 Suppl 1); Mar-Apr 2019
• PMC6544038

An Bras Dermatol. 2019 Mar-Apr; 94(2 Suppl 1): 67–75.

doi: 10.1590/abd1806-4841.2019940210

Valeria Aoki,1 Daniel Lorenzini,2 Raquel Leão Orfali,1 Mariana Colombini Zaniboni,1Zilda Najjar Prado de Oliveira,1 Maria Cecília Rivitti-Machado,1 Roberto Takaoka,1 Magda Blessmann Weber,3Tania Cestari,4 Bernardo Gontijo,5 Andrea Machado Coelho Ramos,5 Claudia Marcia de Resende Silva,5Silmara da Costa Pereira Cestari,6 Silvia Souto-Mayor,7 Francisca Regina Carneiro,8Ana Maria Mosca de Cerqueira,9 Cristina Laczynski,10 and Mario Cezar Pires11,12

ABSTRACT

BACKGROUND

Consensus-based recommendations of topical and systemic
treatments for patients with atopic dermatitis (AD)

Atopic dermatitis is a highly prevalent inflammatory and pruritic dermatosis with a multifactorial etiology, which includes skin barrier defects, immune dysfunction, and microbiome alterations. Atopic dermatitis is mediated by genetic, environmental, and psychological factors and requires therapeutic management that covers all the aspects of its complex pathogenesis.

OBJECTIVES

The aim of this article is to present the experience, opinions, and recommendations of Brazilian dermatology experts regarding the therapeutic management of atopic dermatitis.

Psychiatric comorbidity in chronic urticaria patients: a systematic review and meta-analysis

Review - Open Access

Gerasimos N. Konstantinou & George N. Konstantinou

Clinical and Translational Allergy volume 9, Article number: 42 (2019) 

Abstract
Background
Dermatological illness can affect the quality of life and may coexist with psychiatric disorders.
Objective
The aim of this review was to systematically evaluate the published evidence of any psychiatric disorders that may coexist with chronic urticaria (CU) and any effect psychiatric interventions may have on CU.
Methods
Following the Cochrane guidance, we conducted a systematic literature search using web-based search engines provided by PubMed (for Medline database), Google Scholar and Scopus for studies that have investigated the existence of psychiatric comorbidity in patients with CU.

Consensus on the diagnostic and therapeutic management of chronic spontaneous urticaria in adults - Brazilian Society of Dermatology

• An Bras Dermatol
• v.94(2 Suppl 1); Mar-Apr 2019
• PMC6544033

An Bras Dermatol. 2019 Mar-Apr; 94(2 Suppl 1): 56–66.

doi: 10.1590/abd1806-4841.2019940209

PMCID: PMC6544033

PMID: 31166404

Paulo Ricardo Criado,1,2 Celina Wakisaka Maruta,3 Alice de Oliveira de Avelar Alchorne,4,5Andréa Machado Coelho Ramos,6 Bernardo Gontijo,7 Josemir Belo dos Santos,8Luis Eduardo Agner Machado Martins,9 Maria Cecília Rivitti-Machado,10 Maria Regina Cavariani Silvares,11Mario Cezar Pires,12,13 Patricia Karla de Souza,14 Raquel Leão Orfali,10 Renan Rangel Bonamigo,15,16,17Roberta Buense Bedrikow,18,19 Roberta Fachini Jardim Criado,20 and Zilda Najjar Prado de Oliveira10

Abstract

Background

Urticarias are frequent diseases, with 15% to 20% of the population presenting at least one acute episode in their lifetime. Urticaria are classified in acute ( ≤ 6 weeks) or chronic (> 6 weeks). They may be induced or spontaneous.

Pneumococcal vaccination responses in adults with subnormal IgG subclass concentrations

• Research article
• OPEN ACCESS

BMC Immunology

• Antony R. Parker, 
• Markus Skold, 
• Stephen Harding, 
• J. Clayborn Barton, 
• Luigi F. Bertoli & 
• James C. Barton 

BMC Immunologyvolume 20, Article number: 29 (2019) | 

Abstract

Background

We sought to compare Pneumovax®23 responses in adults with subnormal IgG subclass concentrations. We studied adults with normal total IgG, frequent/severe respiratory infection, and subnormal IgG1, IgG3, or IgG1 + IgG3 before and after Pneumovax®23. We defined response as serotype-specific IgG > 1.3 μg/mL and aggregate response as IgG > 1.3 μg/mL for ≥70% of all serotypes tested. We compared patients with and without serotype-specific responses and performed logistic regression on aggregate responses using: age; male sex; body mass index; autoimmune condition(s); atopy; other allergies; subnormal IgGSc immunophenotypes; IgA; and IgM.

A case of eosinophilic granulomatosis with polyangiitis complicated with a similar condition to IgG4 related lung disease

• Case report
• OPEN ACCESS
• Open Peer Review
• 
  

BMC Pulmonary Medicine

• Li Zhou, 
• Fen Cao, 
• Songqing Fan, 
• Ping Chen, 
• Shuizi Ding, 
• Guiqian Liu & 
• Ruoyun Ouyang 

BMC Pulmonary Medicinevolume 19, Article number: 154 (2019) | Download Citation

Abstract

Background

Atypical manifestations, such as elevated serum immunoglobulin-G4 (IgG4) and extra-pulmonary IgG4 positive plasmacyte infiltration, have been described in patients with eosinophilic granulomatosis with polyangiitis (EGPA), such complicated situation might not be readily differentiated from IgG4-related disease.

Engaging and Educating Patients to Improve AD Care: A Practical Toolkit for Clinical Teams

Intended Audience: Physicians, Nurse Practitioners, Physician Assistants, and Nurses

• Activity Overview
• CE Details & Instructions
• Faculty Disclosures

Did you know that patients who learn about their own health conditions and partner with their clinical teams to decide on the best treatments are much happier and achieve better outcomes with their care?

This inclusive guide provides clinicians with materials and resources to engage and educate patients, individually or through group education, about atopic dermatitis (AD) and help build a strong foundation for informed decision-making regarding treatment goals, preferences, and plans.

Included in this guide: 

• Patient-friendly slide deck with helpful speaker notes on AD triggers and risk factors, associated comorbidities, and available treatment options
• Brief video with guidance on organizing and delivering the patient education sessions
• Tips for engaging patients in open and collaborative learning so they become active players in their own care
• Resources for implementing shared decision-making and motivational interviewing in your practice

Physicians completing this program will earn AMA PRA Category 1 Credit™ classified as Enduring material.

Monograph access

Early antibiotic exposure and development of asthma and allergic rhinitis in childhood

Abstract

Background

The prevalence of pediatric allergic diseases has increased rapidly in the United States over the past few decades. Recent studies suggest an association between the increase in allergic disease and early disturbances to the gut microbiome. The gut microbiome is a set of intestinal microorganisms that begins to form during birth and is highly susceptible to disturbance during the first year of life. Early antibiotic exposure may negatively impact the gut microbiota by altering the bacterial composition and causing dysbiosis, thus increasing the risk for developing childhood allergic disease.

Methods

We performed a retrospective chart review of data in Loyola University Medical Center’s (LUMC) Epic system from 2007 to 2016. We defined antibiotic exposure as orders in both the outpatient and inpatient settings. Inclusion criteria were being born at LUMC with at least two follow up visits. Asthma and allergic rhinitis diagnoses were obtained using ICD 9 and ICD 10 codes. We controlled for multiple confounding factors. Using Stata, bivariate logistic regression was performed between antibiotics from 0 to 12 months of life and development of disease. This analysis was repeated for total lifetime antibiotics. We defined statistically significant as p < .05.

Results

The administration of antibiotics within the first 12 months of life was significantly associated with lifetime asthma (OR 2.66; C. I 1.11–6.40) but not allergic rhinitis. There was a significant association between lifetime antibiotics and asthma (OR 3.54; C. I 1.99–6.30) and allergic rhinitis (OR 2.43; C. I 1.43–4.11).

Conclusion

Antibiotic administration in the first year of life and throughout lifetime is significantly associated with developing asthma and allergic rhinitis. These results provide support for a conservative approach regarding antibiotic use in early childhood.

Jeffrey Ni, Hannah Friedman, Bridget C. Boyd, Andrew McGurn, Piotr Babinski, Talar Markossian, and Lara R. Dugas

BMC Pediatr. 2019; 19: 225.

Published online 2019 Jul 5. doi: 10.1186/s12887-019-1594-4

Abstract

Background

The prevalence of pediatric allergic diseases has increased rapidly in the United States over the past few decades. Recent studies suggest an association between the increase in allergic disease and early disturbances to the gut microbiome. The gut microbiome is a set of intestinal microorganisms that begins to form during birth and is highly susceptible to disturbance during the first year of life. Early antibiotic exposure may negatively impact the gut microbiota by altering the bacterial composition and causing dysbiosis, thus increasing the risk for developing childhood allergic disease.