Transepidermal water loss rises before food anaphylaxis and predicts food challenge outcomes

Charles F Schuler, Kelly M O'Shea, Jonathan P Troost, Bridgette Kaul, Christopher M Launius, Jayme Cannon, David M Manthei, George E Freigeh, Georgiana Sanders, Simon P Hogan, Nicholas W Lukacs, James R Baker
Journal of Clinical Investigation 2023 July 5

RATIONALE: Food allergy (FA) is a growing health problem requiring physiologic confirmation via the oral food challenge (OFC). Many OFCs result in clinical anaphylaxis, causing discomfort and risk while limiting OFC utility. Transepidermal water loss (TEWL) measurement provides a potential solution to detect food anaphylaxis in real time prior to clinical symptoms. We evaluated whether TEWL changes during an OFC could predict anaphylaxis onset.

METHODS: Physicians and nurses blind to TEWL results conducted and adjudicated the results of all 209 OFCs in this study. A study coordinator measured TEWL throughout the OFC and had no input on OFC conduct.

Eosinophil-independent IL-5 levels are increased in critically ill COVID-19 patients who survive

• Letter to the editor
• Open Access
• 
  

• Xiaotian Ju, 
• Kiho Son, 
• Rameen Jamil, 
• Sarah Culgin, 
• Brittany Salter, 
• Kate Miyasaki, 
• Nahal Emami Fard, 
• Maria Xiao, 
• Zil Patel, 
• Kayla Zhang, 
• Braeden Cowbrough, 
• Melanie Kjarsgaard, 
• Katherine Radford, 
• Anna Dvorkin-Gheva, 
• Carl D. Richards, 
• Gerard Cox, 
• Zain Chagla, 
• Marek Smieja, 
• Marcel Tunks, 
• Waleed Alhazzani, 
• Dawn M.E. Bowdish, 
• Dan Perri, 
• Parameswaran K. Nair, 
• Roma Sehmi & 
• Manali Mukherjee 

Allergy, Asthma & Clinical Immunology volume 19, Article number: 58 (2023)

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Dear Editor,

Eosinopenia is predictive of disease severity in COVID-19, and baseline eosinophilia (in asthmatics or non-asthmatics) is associated with a lower risk of severe COVID-19 infection, usually with favourable outcomes.

EPOS/EUFOREA update on indication and evaluation of Biologics in Chronic Rhinosinusitis with Nasal Polyps 2023

Rhinology 61-3: 194-202, 2023

W.J. Fokkens - A-S. Viskens - V. Backer - D. Conti - E. De Corso - P. Gevaert - G.K. Scadding - M. Wagemann - M. Bernal-Sprekelsen - A. Chaker - E. Heffler - J.K. Han - E. Van Staeyen - C. Hopkins - J. Mullol - A. Peters - S. Reitsma - B.A. Senior - P.W. Hellings

Severe chronic rhinosinusitis with nasal polyps (CRSwNP) is a debilitating disease with a significant impact on the quality of life (QoL). It is typically characterized by a type 2 inflammatory reaction and by comorbidities such as asthma, allergies and NSAID-Exacerbated Respiratory Disease (N-ERD). Here, the European Forum for Research and Education in Allergy and Airway diseases discusses practical guidelines for patients on biologic treatment.

Is there a rationale for supplementing with vitamin D patients under treatment with allergen immunotherapy?

Di Gioacchino M, Petrarca C, Della Valle L, Mangifesta R, Santilli F.  Ann Med. 2023 Dec;55(1):2230864. doi: 10.1080/07853890.2023.2230864. 

Abstract

Vitamin D (VD) has been shown to exert immunomodulatory activities, especially in promoting immune tolerance. For these properties VD has been proposed in the therapy of immunological conditions in which the loss of tolerance is the key pathogenetic aspect of the disease, such as allergies. Despite these properties available literature suggests VD is not useful in treating or preventing allergic diseases and whether low serum VD levels favor allergic sensitization and severity is debated.

The level of VD is one of the many conditions that can influence allergic sensitization and therefore only a multivariate analysis on a numerically adequate cohort of patients, that considers all the factors that can favor allergy, would be able to assign the weight of each variable and determine the extent to which VD inhibits allergic sensitization and march. On the contrary, VD is able to potentiate the antigen-specific tolerogenic response induced by Allergen Immunotherapy (AIT) as demonstrated by the large majority of studies.

Eosinophil granule proteins as a biomarker in managing asthma and allergies

Kim CK, Callaway Z, Pawankar R. Asia Pac Allergy. 2023 Jun;13(2):66-71. doi: 10.5415/apallergy.0000000000000104. 

Abstract

In the past few decades, biomarkers have been successfully used for the diagnosis, treatment, and monitoring of disease. Taking together clinical, genetic, lifestyle, and information on relevant biomarkers, the therapy of diseases can be personalized to an individual. Several novel biomarkers have been recently reported for allergic diseases. However, to interpret the validity of biomarker data, the validation of their reliability, precision, and reproducibility is imperative. Once validated, they can be used in therapeutic product development and in clinical practice. Eosinophils are multifunctional leukocytes and major effector cells that play a crucial role in the immunological mechanisms of allergic disease.

PATH-2 TASK FORCE. A Multidisciplinary Approach for Type 2 Allergic Diseases: What Do Biologics Teach Us?

Maniscalco M, Detoraki A, Sarnelli G, Nolano M, De Paulis A, Spadaro G, Cantone E;  J Pers Med. 2023 Jun 1;13(6):941. doi: 10.3390/jpm13060941.

Open AccessEditorial

Patients with atopic/allergic disorders, including atopic dermatitis (AD), allergic rhino-conjunctivitis (AR), chronic rhinosinusitis with/without nasal polyps (CRSwNP/CRSsNP), bronchial asthma, food allergy, and eosinophilic esophagitis (EoE), often share a common genetic background, a type Th2 polarized immune response, and several environmental factors.

Th2 immunity has evolved to ensure the integrity of the epithelial barrier and to protect against helminths.

A EUFOREA comment on a lost comorbidity of asthma

• Letter to the editor
• Open Access

• Diego M. Conti, 
• Peter W. Hellings, 
• Zuzana Diamant, 
• Leif Bjermer, 
• Milos Jesenak, 
• Vibeke Backer, 
• Wytske Fokkens, 
• Susanne Lau, 
• Elizabeth Van Staeyen & 
• Glenis K. Scadding 

Allergy, Asthma & Clinical Immunology volume 19, Article number: 56 (2023) 

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Abstract

“Epidemiology of comorbidities and their association with asthma control” (Tomisa, G., Horváth, A., Sánta, B. et al. Epidemiology of comorbidities and their association with asthma control. Allergy Asthma Clin Immunol 17, 95 (2021). https://doi.org/10.1186/s13223-021-00598-3) is an interesting paper reflecting data collection from more than 12,000 asthmatic patients in Hungary regarding their condition and associated comorbidities.

The Relationship of Parasite Allergens to Allergic Diseases

• Open Access

• Luis Caraballo & 
• Kevin Llinás-Caballero 

Current Allergy and Asthma Reports (2023)

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Abstract

Purpose of Review

Helminth infections modify the natural history of allergic diseases, by either decreasing or increasing their symptoms. Several helminth components are involved in the increasing of the allergic response and symptoms, overcoming the concomitant immunosuppression of helminthiases. However, the role of individual IgE-binding molecules in this process remains to be defined.

Recent Findings

An example of allergic sensitization in a child living in the tropics.
Specific IgE against D. pteronyssinus (Dp), B. tropicalis (Bt), and Ascaris 
extractswere measured using ImmunoCAP™ 100. Specific IgE to A. l
umbricoides GST (AsGST), tropomyosin (Asc l 3), and ABA-1 were
measured by ELISA. 

We updated the list of helminth allergens and IgE-binding molecules, their effects on asthma presentation, and their impact on allergy diagnosis.