Developing integrated care pathways for atopic dermatitis-Challenges and unmet needs

Zuberbier T, Beck LA, Bedbrook A, de Bruin-Weller M, Bousquet J, Cork M, Douladiris N, Katoh N, Mortz CG, Werfel T, Wojciech F, Wollenberg A, Siemens K, Stevanovic K, Worm M; AD-ICPs Working Group.  Clin Transl Allergy. 2023 Mar;13(3):e12236. doi: 10.1002/clt2.12236.

Abstract

Background

GA2LEN-ADCARE is a branch of the largest multidisciplinary network of research centres and clinical care in allergy and asthma, GA2LEN, focussing on the field of atopic dermatitis (AD). AD is a chronic inflammatory skin disease with high burden and many comorbidities requiring different levels of treatment. The need for aligned information from all involved healthcare providers led to the discussion of an integrated care pathway (ICP) plan for AD patient care involving all stakeholders and considering the complexity and variability of the disease, with a particular focus placed on the large number of patients with milder forms of AD.

Methods

The GA2LEN ADCARE network and all stakeholders, abbreviated the AD-ICPs working group, were involved in the discussion and preparation of the AD-ICPs during a series of subgroup workshops and meetings in years 2020 and 2021.

A real-world characterization of a cohort with eosinophilic esophagitis: looking for severity biomarkers

Esteves Caldeira L, Limão R, Brás R, Pedro E, Costa C. Eur Ann Allergy Clin Immunol. 2023 Mar 28. doi: 10.23822/EurAnnACI.1764-1489.292.

Abstract

Background. Eosinophilic esophagitis (EoE) is an immune-mediated chronic esophageal disease, with frequent association with atopy. A validated non/minimally invasive biomarker of disease severity has not been identified. We aimed to determine if sensitization to airborne and food allergens correlates with disease severity, and to evaluate the association between clinical and laboratory characteristics with the severity of EoE. 

Modulation of pulmonary immune function by inhaled cannabis products and consequences for lung disease

• Review
• Open Access

• Matthew Preteroti, 
• Emily T. Wilson, 
• David H. Eidelman & 
• Carolyn J. Baglole 

Respiratory Research volume 24, Article number: 95 (2023) 

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Abstract

The lungs, in addition to participating in gas exchange, represent the first line of defense against inhaled pathogens and respiratory toxicants. Cells lining the airways and alveoli include epithelial cells and alveolar macrophages, the latter being resident innate immune cells important in surfactant recycling, protection against bacterial invasion and modulation of lung immune homeostasis. 

Environmental exposure to toxicants found in cigarette smoke, air pollution and cannabis can alter the number and function of immune cells in the lungs. Cannabis (marijuana) is a plant-derived product that is typically inhaled in the form of smoke from a joint. However, alternative delivery methods such as vaping, which heats the plant without combustion, are becoming more common. Cannabis use has increased in recent years, coinciding with more countries legalizing cannabis for both recreational and medicinal purposes. Cannabis may have numerous health benefits owing to the presence of cannabinoids that dampen immune function and therefore tame inflammation that is associated with chronic diseases such as arthritis.

IgE-Dependent Allergy in Patients with Celiac Disease: A Systematic Review.

Majsiak, E.; Choina, M.; Knyziak-Mędrzycka, I.; Bierła, J.B.; Janeczek, K.; Wykrota, J.; Cukrowska, B.  Nutrients 2023, 15, 995. https://doi.org/10.3390/nu15040995

Abstract

In order to answer the question if an IgE-mediated allergy (A-IgE) may occur in subjects with celiac disease (CD), a systematic review was performed of available publications collected in the United States National Institute for Biotechnology Information/National Institutes of Health/National Library of Medicine/PubMed database up to 28 December 2022, with the use of the following keywords “allergy&celiac/coeliac”, “sensitization&celiac/coeliac”, and “anaphylaxis&celiac/coeliac” compared in the form of a conjunction. In total, the search returned 2013 publications from these keywords in any section of the article.

As numerous review articles included the above-mentioned entries in the abstract, we decided to focus on the publications with the entries only in the title (n = 63). After rejecting studies unrelated to the topic, narrative reviews, book chapters, conference abstracts, symposium reports, letters to the editor, or non-English articles, 18 publications (6 observational original studies and 12 case reports describing a total of 15 cases of A-IgE developed after a diagnosis of CD) were included to this review. Our study is the first systematic review on allergy occurrence in CD patients.

Allergen challenge tests in allergen immunotherapy: State of the art

Zieglmayer P, Zieglmayer R, Lemell P. Allergol Select. 2023 Mar 1;7:25-32. doi: 10.5414/ALX02322E. 

Abstract

Introduction: Treatment effects in allergen immunotherapy (AIT) studies are based on symptomatic improvement, and evaluations of naturally exposed patients do often show weak efficacy. Allergen challenge tests, such as conjunctival (CAC), nasal (NAC), or bronchial (BAC) challenge tests, or challenges in allergen exposure chambers (AEC) are accepted by regulators for AIT phase II studies only.

Materials and methods: This review aims to describe different allergen challenge test methods, summarizes safety and limitations for each, and discusses their potential for use in AIT trials. 

Results: Organ-specific allergen challenges provide information about individual reactivity, reaction threshold, and organspecific efficacy of AIT.

Cross-sectional study to describe allergic rhinitis flare-ups and associated airways phenotype in house dust mite sensitization.

de Gabory L, Amet S, Le Maux A, Meunier J-P, Chartier A, Chenivesse C (2023)  PLoS ONE 18(3): e0283246. https://doi.org/10.1371/journal.pone.0283246

Abstract

Objectives

To quantify and describe flare-ups of house dust mite allergic rhinitis (HDM-AR) which had occurred during the last 12 months in a population of adults and children candidate for Allergen ImmunoTherapy (AIT). Next, to identify associated clinical features.

Materials and methods

This was an observational, multicenter, cross-sectional study that included patients aged ≥ 5 years with HDM-AR eligible for AIT and without prior AIT for at least 12 months. Flare-ups were all period with impairment of quality of life (QoL) and requiring a change in their usual treatment. Data were collected using medical records and patient questionnaires.

A Scoping Review of Artificial Intelligence Research in Rhinology.

Osie G, Darbari Kaul R, Alvarado R, Katsoulotos G, Rimmer J, Kalish L, Campbell RG, Sacks R, Harvey RJ.  Am J Rhinol Allergy. 2023 Mar 9:19458924231162437. doi: 10.1177/19458924231162437.

BACKGROUND: A considerable volume of possible applications of artificial intelligence (AI) in the field of rhinology exists, and research in the area is rapidly evolving.

OBJECTIVE: This scoping review aims to provide a brief overview of all current literature on AI in the field of rhinology. Further, it aims to highlight gaps in the literature for future rhinology researchers.

METHODS: OVID MEDLINE (1946-2022) and EMBASE (1974-2022) were searched from January 1, 2017 until May 14, 2022 to identify all relevant articles. The Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews checklist was used to guide the review.

B cells and T cells abnormalities in patients with selective IgA deficiency

• Research
• Open Access
• 
  

• Yasser Bagheri, 
• Tannaz Moeini Shad, 
• Shideh Namazi, 
• Farzaneh Tofighi Zavareh, 
• Gholamreza Azizi, 
• Fereshteh Salami, 
• Somayeh Sadani, 
• Ali Hosseini, 
• Mohsen Saeidi, 
• Salar Pashangzadeh, 
• Samaneh Delavari, 
• Babak Mirminachi, 
• Nima Rezaei, 
• Hassan Abolhassani, 
• Asghar Aghamohammadi & 
• Reza Yazdani 

Allergy, Asthma & Clinical Immunology volume 19, Article number: 23 (2023) 

• details

Abstract

Background

Selective IgA deficiency (SIgAD) is the most prevalent inborn errors of immunity with almost unknown etiology. This study aimed to investigate the clinical diagnostic and prognostic values of lymphocyte subsets and function in symptomatic SIgAD patients.

Methods

A total of 30 available SIgAD patients from the Iranian registry and 30 age-sex-matched healthy controls were included in the present study. We analyzed B and T cell peripheral subsets and T cell proliferation assay by flow cytometry in SIgAD patients with mild and severe clinical phenotypes.