CD4+ T cell memory. Open Access Review.

Künzli, M., Masopust, D. Nat Immunol (2023). https://doi.org/10.1038/s41590-023-01510-4

Abstract

Specialized subpopulations of CD4+ T cells survey major histocompatibility complex class II–peptide complexes to control phagosomal infections, help B cells, regulate tissue homeostasis and repair or perform immune regulation. Memory CD4+ T cells are positioned throughout the body and not only protect the tissues from reinfection and cancer, but also participate in allergy, autoimmunity, graft rejection and chronic inflammation. 

Food anaphylaxis in older people. Open Access

Boyle RJ, Shamji MH. Food anaphylaxis in older people. Clin Exp Allergy. 2023 May;53(5):488-490. doi: 10.1111/cea.14330.

Food anaphylaxis has received increasing scientific and media attention in recent decades. While anaphylaxis and food allergy are not new conditions, numbers of hospital admissions, diagnoses and related prescriptions have been rising fast in high-income countries. There is a controversy about how much of this rise is increased pathology and how much is due to changing patterns of behaviour in people with food allergy and their caregivers. However, food anaphylaxis certainly presents a significant burden to those affected, largely due to the dietary and social restrictions which accompany food allergen avoidance, and to anxiety associated with the remote possibility of fatal food anaphylaxis. 

EAACI POSITION PAPER: Allergy to stings and bites from rare or locally important arthropods: worldwide distribution, available diagnostics, and treatment. Open Access.

Sturm GJ, Boni E, Antolín-Amérigo D, et al. Allergy. 2023 May 16. doi: 10.1111/all.15769. Epub ahead of print.

Abstract

Insect venom allergy is the most frequent cause of anaphylaxis in Europe and possibly worldwide. The majority of systemic allergic reactions after insect stings are caused by Hymenoptera and among these, vespid genera induce most of the systemic sting reactions (SSR). Honey bees are the second leading cause of SSR.

Evaluation of Plasmapheresis vs Immunoglobulin as First Treatment After Ineffective Systemic Corticosteroid Therapy for Patients With Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Miyamoto Y, Ohbe H, Kumazawa R et al. JAMA Dermatol. 2023 May 1;159(5):481-487. doi: 10.1001/jamadermatol.2023.0035.

Key Points

Question  Are the clinical outcomes of administering plasmapheresis therapy first better than those of administering intravenous immunoglobulin (IVIG) therapy first after ineffective systemic corticosteroid therapy in patients with Stevens-Johnson syndrome or toxic epidermal necrolysis (SJS/TEN)?

Findings  This retrospective cohort study of 266 inpatients with SJS/TEN found no significant difference in mortality rates between the plasmapheresis-first and the IVIG-first groups. Patients who received plasmapheresis therapy first had longer hospitalization stays and incurred higher expenses.

Obstructive Sleep Apnea May Lead to Early Cognitive Decline in Men

Distinct cognitive changes in male patients with obstructive sleep apnoea without co-morbidities

Valentina Gnoni1, Michel Mesquita2, David O'Regan1,3,4, Alessio Delogu5, Ivan Chakalov6,7, Andrea Antal7, Allan H. Young8,9, Romola S. Bucks10,11, Melinda L. Jackson12 and Ivana Rosenzweig1,3,4*

• 1Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
• 2L&M Data Science Ltd., London, United Kingdom
• 3Sleep Disorder Centre, Nuffield House, Guy's Hospital, London, United Kingdom
• 4Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
• 5Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
• 6Department of Anesthesiology, University Medical Center Göttingen, Göttingen, Germany
• 7Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
• 8Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
• 9South London and Maudsley National Health Service (NHS) Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
• 10School of Psychological Science, University of Western Australia, Perth, WA, Australia
• 11The Raine Study, School of Population and Global Health, University of Western Australia, Perth, WA, Australia
• 12Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia

Introduction: Obstructive sleep apnoea (OSA) is a multisystem, debilitating, chronic disorder of breathing during sleep, resulting in a relatively consistent pattern of cognitive deficits. More recently, it has been argued that those cognitive deficits, especially in middle-aged patients, may be driven by cardiovascular and metabolic comorbidities, rather than by distinct OSA-processes, such as are for example ensuing nocturnal intermittent hypoxaemia, oxidative stress, neuroinflammation, and sleep fragmentation.

Upregulated expression of Notch1/4 - JAG-1/DLL-1 detected in allergic rhinitis

Hjalmarsson, E., Petro, M., Georén, S.K. et al. Allergy Asthma Clin Immunol 19, 41 (2023). https://doi.org/10.1186/s13223-023-00793-4

Abstract

Background

Allergic rhinitis (AR) is a chronic disease with high prevalence. There are currently many treatments available. However, despite an often good therapeutic response, many patients still report impairment in quality of life (QoL) during the pollen season. A skewed T helper (Th)2 polarization is a well-acknowledged pathologic feature of AR. In animal models, local notch signaling in peripheral tissue seems crucial for Th2 cell differentiation and the development of AR. However, the involvement of Notch signaling in Th2 cell differentiation and the development of AR in humans remains unknown. Hence, the present study investigated the human expression of Notch receptors on CD4+ T-cells in nasal mucosa and blood. Correspondingly Notch ligand expression was assessed on nasal epithelial cells and neutrophils.

Evaluation of pediatric patients with suspected polyethylene glycol and polysorbate allergy before mRNA SARS-CoV2 vaccination

Karaaslan BG, Burtecene N, Mustu U, Ocak S, Kasapcopur O, Kıykım A, Cokugras H. Allergol Immunopathol (Madr). 2023 May 1;51(3):174-180. doi: 10.15586/aei.v51i3.800.

Abstract

mRNA vaccines, particularly, have been associated with an increased risk of allergic reactions and rarely anaphylaxis. Although rare, vaccine reactions can cause significant anxiety and fear in the population, leading to indecision and vaccine refusal. This study aimed to retrospectively evaluate the role of polyethylene glycol (PEG) sensitivity in vaccination decision-making in pediatric patients at high risk of allergy or with suspected allergic reactions to the first dose of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) vaccine. Seventeen enrolled patients were found to have decreased readiness to receive the Coronavirus Disease 2019 (COVID-19) vaccine after developing hypersensitivity to multiple and/or injectable drugs.

The Evolving Landscape of Immunotherapy for the Treatment of Allergic Conditions

Pandya A, Adah E, Jones B, Chevalier R. Clin Transl Sci. 2023 May 11. doi: 10.1111/cts.13546.

Abstract

Allergic conditions such as asthma, chronic urticaria, atopic dermatitis, and eosinophilic esophagitis have long been treated with oral and topical steroids which resulted in negative off target effects. However, newer biologic medications are increasingly being developed and approved for treatment of these conditions. These medications have a variety of mechanisms of action to target pathophysiology specific to these diseases. As biologics become more targeted, fewer off-target effects are seen improving tolerability for patients as well as expanded options for treatment of these conditions.