Abstract
Purpose of Review
This review examines whether allergen immunotherapy (AIT) for grass pollen allergy should expand beyond the recent trend towards a mono-species approach based on Phleum pratense. It explores whether multi-species formulations better reflect natural exposure and could improve clinical outcomes.
Recent Findings
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| Group 5 homologues identified in individual extracts and a mixed extract of 13 species of Poaceae family grasses, using a monoclonal antibody |
Abstract
Purpose of review
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| This figure demonstrateds the concept of disease modification in pediatric atopic dermatitis showing the window of opportunity for early systemic intervention to modify/attenuate the atopic march. |
Recent findings
Among currently available therapies, dupilumab, targeting interleukin (IL)-4 and IL-13 signaling, provides the most compelling evidence for potential disease modification.
Abstract
Extracellular vesicles (EVs) are lipid bilayer-enclosed particles released by both eukaryotic and prokaryotic cells and represent an evolutionarily conserved system of intercellular communication. By transporting bioactive cargo, including proteins, lipids, microRNAs, EVs enable the transfer of molecular signals between cells, thereby regulating immune homeostasis and inflammatory responses. In allergic diseases, EVs have emerged as key mediators linking epithelial barriers, immune cells, and the microbiome. EVs derived from epithelial, immune, and microbiota-associated cells may contribute to the initiation, amplification, and persistence of allergic inflammation by modulating barrier integrity, immune cell polarization, and cytokine signaling pathways.
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| EVs derived from asthmatic patients contribute to the progression of the disease. |
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Conceptual overview of major mechanistic pathways |
Reduced intensity and diversity of microbial stimulation and decreased intake of anti-inflammatory ω-3 polyunsaturated fatty acids (PUFAs) in Western diets may contribute to impaired postnatal immune development and increased allergy risk. Here, we hypothesize that early supplementation with probiotics and ω-3 PUFAs, starting during pregnancy and continuing during infancy, may promote appropriate immune maturation and thereby potentially prevent allergy development.
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| Schematic overview of the PROOM-3 study (PRObiotics and OMega-3, ClinicalTrials.gov-ID: NCT01542970) |
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| Multivariate analysis of the main knowledge about ARIA guidelines/mask-air according to the study groups |
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ABSTRACT
Background
To achieve adequate symptom control, patients with allergic rhinitis (AR) often need to increase their medication dose or add other treatments (co-medication). We aimed to perform a systematic review to compare the efficacy and safety of AR medications for increased dose versus co-medication.
Methods
We searched four bibliographic databases and three trial databases for randomised controlled trials assessing the effect of intranasal and/or oral medications in patients of all ages with seasonal or perennial AR. We performed pairwise meta-analysis based on direct evidence to compare (i) non-standard versus standard treatment doses, and (ii) co-medication strategies versus monotherapy using standard doses. Furthermore, we fitted dose–response network meta-analysis (NMA) to obtain projected estimates for comparisons involving two times the standard dose of AR medications in monotherapy versus co-medication with the standard dose of the same medications. We assessed the certainty of evidence using GRADE for NMA.
Results
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| Comparison between doubling the dose of the medication on each row versus adding the medication of each column |
