Interleukin-5 as a pleiotropic cytokine orchestrating airway type 2 inflammation: Effects on and beyond eosinophils

Buchheit KM, Shaw D, Chupp G, et al. Allergy. 2024; 79: 2662-2679. doi:10.1111/all.16303

Abstract

IL-5 is a key cytokine for type 2 inflammation and plays a broad
role in pathophysiology beyond eosinophilic inflammation.

Interleukin (IL)-5 is the key cytokine in the maturation, activation, proliferation, migration and survival of eosinophils, which are key effector cells in many upper and lower airway diseases. Through its effects on eosinophils, IL-5 indirectly contributes to various pathophysiological processes including tissue damage, repair and remodelling. Understanding the importance of IL-5 in eosinophil-associated diseases led to the development of anti-IL-5 therapies, which provide clinical benefits across a range of conditions. However, recent evidence suggests that eosinophil-depletion alone may not account for all of the therapeutic effects of anti-IL-5 therapy and that IL-5 may also contribute to disease independently of its effects on eosinophils.

Artificial Intelligence for Diagnosis of Obstructive Sleep Apnea

Jasmine May, Roneil G. Malkani. Current Pulmonology Reports 04-09-2024

Abstract

Purpose of Review
This review focuses on the different methodologies and artificial intelligence (AI) technologies being utilized to improve rapid diagnosis of sleep disordered breathing (SDB).

Recent Findings

Many recent studies have examined the application of AI neural networks on imaging techniques, single lead diagnostics, and multi-lead technologies to improve screening and automated diagnosis of SDB. While several techniques are better at identifying moderate or severe sleep apnea, the ability to detect mild cases of sleep apnea still lags.

Young Adults and Allergic Rhinitis: A Population Often Overlooked but in Need of Targeted Help.

Jones, G.; House, R.; Bosnic-Anticevich, S.; Cheong, L.; Cvetkovski, B.  Allergies 2024, 4, 145-161. https://doi.org/10.3390/allergies4040011

Abstract

The comparison of medications used by participants
versus medications recommended by guidelines appropriate
for the participants’ AR status (n = 167).

Allergic Rhinitis (AR) currently affects 27% of young adults (18–24 years old) in Australia. Although the nature of AR and its management are well-researched in adult and paediatric populations, little is known about young adults. Given the biopsychosocial developmental challenges faced by young adults, this study aims to investigate young adults’ AR management and the source of its influence. A total of 185 young adults with AR in Australia completed an online survey. Seventy-eight percent were female and had a mean age of 21.9 years old.

Allergen Immunotherapy for the Prevention and Treatment of Asthma

Batard, T., Taillé, C., Guilleminault, L., Bozek, A., Floch, V.-L., Pfaar, O., Canonica, W., Akdis, C., Shamji, M. and Mascarell, L. (2024) Clin Exp Allergy. https://doi.org/10.1111/cea.14575

ABSTRACT

Graphical Abstract

Allergic asthma is the predominant phenotype among asthmatics. Although conventional pharmacotherapy is a central component in the management of asthma, it does not enable control of asthma symptoms in all patients. In recent decades, some uncontrolled asthmatic patients, especially those with allergic asthma, have benefited from biological therapies. However, biologics do not address all the unmet needs left by conventional pharmacotherapy. Furthermore, it is noteworthy that neither conventional pharmacotherapy nor biological therapies have disease-modifying properties. In this context, allergen immunotherapy (AIT) represents an indispensable component of the therapeutic arsenal against allergic asthma, due to its disease-modifying immunological effects.

Alleviation of Allergic Rhinoconjunctivitis Symptoms in Participants Treated with a 0.005% Tacrolimus Eye-Drop Solution

Sladek S, Unger-Manhart N, Siegl C et al. Clin Ophthalmol. 2024;18:2797-2811 https://doi.org/10.2147/OPTH.S476163

Abstract:

Purpose: This randomized, placebo-controlled, crossover, double‐blind trial aimed to evaluate the efficacy and safety of Tacrosolv, a novel 0.005% tacrolimus eye-drop solution, in adults with grass pollen–induced allergic conjunctivitis.

Methods: A total of 64 adult participants were randomized to receive 2.5 μg or 5 μg tacrolimus/eye/day or placebo treatment for 8 days, with grass pollen exposure on day 1 and day 8. After a 2-week washout period, placebo participants crossed over to Tacrosolv treatment and vice versa, with repeated treatment and exposure. During exposure, participants recorded ocular, nasal, and respiratory allergy symptoms every 15 minutes. The primary endpoint was the mean total ocular symptom score (TOSS) on day 8. Objective ocular safety parameters were assessed before, during, and after exposure. Adverse events were recorded throughout the study.

Diagnostic Decision Point for IgE-Mediated Wheat Allergy in Children

Hwang Y, Kim J, Ahn K,et al. Allergy Asthma Immunol Res. 2024 Sep;16(5):555-561. https://doi.org/10.4168/aair.2024.16.5.555

Abstract

Comparison of wheat and ω-5 gliadin sIgE
levels between the WA and NWA groups. 

The diagnostic decision point can help diagnose food allergies while reducing the need for oral food challenge (OFC) tests. We performed a multicenter survey of children aged 0–7 years from January 1, 2018 to March 31, 2022. A total of 231 children were recruited from 18 institutions. Wheat allergy (WA) or non-wheat allergy (NWA) was determined on the basis of OFC results and symptoms.

Emerging Biologic Therapies for the Treatment of Atopic Dermatitis

Alvarenga, J.M., Bieber, T. & Torres, T. Drugs (2024). https://doi.org/10.1007/s40265-024-02095-4
Abstract
Atopic dermatitis (AD) is a prevalent inflammatory skin disease having a significant impact on patients’ quality of life. Conventional treatments, including topical therapies and systemic immunosuppressants, often have limited efficacy and long-term safety concerns. Emerging biologic therapies target specific immune pathways implicated in AD pathogenesis, offering new therapeutic options in a disease known for its complex immune pathomechanisms. This review focuses on novel biologics under investigation, particularly those targeting specific immune pathways such as interleukin-4 (IL-4), IL-13, IL-22, IL-31, thymic stromal lymphopoietin (TSLP), and OX40-OX40L axis.

How type-2 dendritic cells induce Th2 differentiation: Instruction, repression, or fostering T cell-T cell communication?

Ronchese F, Webb GR, Ochiai S, Lamiable O, Brewerton M. Allergy. 2024; 00: 1-13. doi:10.1111/all.16337 

Abstract

Allergic disease is caused by the activation of allergen-specific CD4+ type-2 T follicular helper cells (Tfh2) and T helper 2 (Th2) effector cells that secrete the cytokines IL-4, IL-5, IL-9, and IL-13 upon allergen encounter, thereby inducing IgE production by B cells and tissue inflammation. While it is accepted that the priming and differentiation of naïve CD4+ T cells into Th2 requires allergen presentation by type 2 dendritic cells (DC2s), the underlying signals remain unidentified.

Allergen sensing by dendritic cells (DCs).

In this review we focus on the interaction between allergen-presenting DC2s and naïve CD4+ T cells in lymph node (LN), and the potential mechanisms by which DC2s might instruct Th2 differentiation.