Cold Anaphylaxis in Children: Italian Case Series and Review of the Literature

Tomei L, Saretta F, Arasi S, Sarti L, Licari A, Giovannini M, Barni S, Liccioli G, Tallarico V, Piccorossi A, Caffarelli C, Novembre E, Mori F. Diseases. 2023 Oct 18;11(4):143. doi: 10.3390/diseases11040143.

Free article

Abstract

Chronic urticaria (CU) is one of the most common skin disorders worldwide. Among the inducible subgroup of CU, cold urticaria (ColdU) can affect both children and adults and is the only type associated with the risk of anaphylaxis without cofactors. In the scientific literature, data about cold anaphylaxis (ColdA) are poor, especially at pediatric age, and little is known about risk factors associated with the onset of systemic reactions and about the criteria for prescribing adrenaline auto-injectors (AAIs) in these patients.

The mycobiome in atopic diseases: inducers and triggers

Open Access

Glatthardt T, van Tilburg Bernardes E, Arrieta MC. J Allergy Clin Immunol. 2023 Oct 19:S0091-6749(23)01288-5. doi: 10.1016/j.jaci.2023.10.006.

Abstract:

Atopic diseases are characterized by type 2 inflammation, with high allergen-specific T helper type 2 (Th2) immune responses and elevated immunoglobulin E (IgE) production. These common disorders have increased in incidence around the world, partly explained by detrimental disturbances to the early-life intestinal microbiome. While most studies have focused exclusively on bacterial members of the microbiome, intestinal fungi have started to gain an appreciation for their impact on host immune development and atopy pathogenesis. In this perspective, we review recent findings demonstrating the strong interactions between members of the mycobiome and the host immune system early in life, leading to immune tolerance during eubiosis,

EAACI guidelines on the diagnosis of IgE-mediated food allergy.

Santos AF, Riggioni C, Agache I et al.  Allergy 2023 Oct 10. doi: 10.1111/all.15902. 

Abstract

This European Academy of Allergy and Clinical Immunology guideline provides recommendations for diagnosing IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.

Integration of pre-test probability estimated from the clinical history
(left column) and the post-test probability (in italics) that will be used
to support or refute the diagnosis ofIgE-mediated food allergy
 (adapted from69).

Food allergy diagnosis starts with an allergy-focused clinical history followed by tests to determine IgE sensitization, such as serum allergen-specific IgE (sIgE) and skin prick test (SPT), and the basophil activation test (BAT), if available. Evidence for IgE sensitization should be sought for any suspected foods. The diagnosis of allergy to some foods, such as peanut and cashew nut, is well supported by SPT and serum sIgE, whereas there are less data and the performance of these tests is poorer for other foods, such as wheat and soya.

Why drug exposure is frequently associated with T-cell mediated cutaneous hypersensitivity reactions.

Line J, Saville E, Meng X, Naisbitt D. Front Toxicol. 2023 Sep 19;5:1268107. doi: 10.3389/ftox.2023.1268107.

Abstract

Cutaneous hypersensitivity reactions represent the most common manifestation of drug allergy seen in the clinic, with 25% of all adverse drug reactions appearing in the skin.

Pathways of drug-induced T-cell activation.

The severity of cutaneous eruptions can vastly differ depending on the cellular mechanisms involved from a minor, self-resolving maculopapular rash to major, life-threatening pathologies such as the T-cell mediated bullous eruptions, i.e., Stevens Johnson syndrome/toxic epidermal necrolysis. It remains a significant question as to why these reactions are so frequently associated with the skin and what factors polarise these reactions towards more serious disease states. The barrier function which the skin performs means it is constantly subject to a barrage of danger signals, creating an environment that favors elicitation. Therefore, a critical question is what drives the expansion of cutaneous lymphocyte antigen positive, skin homing, T-cell sub-populations in draining lymph nodes.

A risk of serious anaphylatic reactions to asthma biologics: a pharmacovigilance study based on a global real-world database

Article - Open access

Sunny Park, Yeju Kim, Geon Ho Lee & Soo An Choi 

Scientific Reports volume 13, Article number: 17607 (2023) 

Abstract

Asthma is a chronic inflammatory condition that affects the lung airways. Chronic use of oral glucocorticoids in patients with severe asthma is associated with several adverse events (AEs). Biologics (omalizumab, benralizumab, mepolizumab, reslizumab, and dupilumab) have been developed as alternative therapies for the treatment of asthma. In this study, we aimed to evaluate the risk of anaphylactic reactions associated with these five biologics based on a large global database. We utilized individual case reports from the Uppsala Monitoring Center from January 1968 to December 29, 2019. A disproportionality analysis was performed over all drugs and monoclonal antibodies.

Long-term effects of air pollutants on respiratory and cardiovascular mortality in a port city along the Adriatic sea

Research - Open access

Federico Mei, Matteo Renzi, Martina Bonifazi, Floriano Bonifazi, Nicola Pepe, Alessio D’Allura, Giuseppe Brusasca, Giovanni Viegi & Francesco Forastiere 

BMC Pulmonary Medicine volume 23, Article number: 395 (2023) 

Abstract

Background

City map with 800 × 800 m buffer centered
 in the harbour area

Shipping and port-related air pollution has a significant health impact on a global scale. The present study aimed to assess the mortality burden attributable to long-term exposure to ambient particulate matter (PM2.5, PM10) and nitrogen dioxide (NO2) in the city of Ancona (Italy), with one of the leading national commercial harbours.

Methods

Exposure to air pollutants was derived by dispersion models. The relationship between the long-term exposure of air pollution exposure and cause-specific mortality was evaluated by Poisson regression models, after adjustment for gender, age and socioeconomic status. Results are expressed as percent change of risk (and relative 95% confidence intervals) per 5 unit increases in the exposures. The health impact on the annual number of premature cause-specific deaths was also assessed.

Urticaria and mimickers of urticaria.

Fok JS, Katelaris CH. Front Allergy. 2023 Sep 28;4:1274031. doi: 10.3389/falgy.2023.1274031. 

Abstract

An urticarial wheal

Urticaria is a common skin condition encountered across various specialties in medicine, especially in dermatology and allergy/immunology practice. It has a heterogeneous presentation hence it is unsurprising that many skin conditions may be confused with urticaria.

A nerve-goblet cell association promotes allergic conjunctivitis through the rapid antigen passage.

Kimura M, Ando T, Kume Y, Fukase S, Matsuzawa M, Kashiwagi K, Izawa K, Kaitani A, Nakano N, Maeda K, Ogawa H, Okumura K, Nakao S, Murakami A, Ebihara N, Kitaura J. JCI Insight. 2023 Oct 11:e168596. doi: 10.1172/jci.insight.168596. 

Abstract

The penetration of allergens through the epithelial layer is the initial step in the development of allergic conjunctivitis. Although the pollinosis patients manifest symptoms in minutes after pollen exposure, the mechanisms of the rapid allergen transport remain unclear.

Graphical Abstract

In the present study, we found that the instillation of pollen shells rapidly induces a large number of goblet cell-associated antigen passages (GAPs) in the conjunctiva. Antigen acquisition by the stromal cells including macrophages and CD11b+ dendritic cells correlated with the surface GAP formation.