September 8, 2014

Component resolved diagnosis: when should it be used?

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Open AccessReview

Component resolved diagnosis: when should it be used?

Olga Luengo and Victòria Cardona

Citation

Abstract (provisional)

The knowledge on molecular allergy diagnosis is continuously evolving. It is now time for the clinician to integrate this knowledge and use it when needed to improve the accuracy of diagnosis and thus provide more precise therapeutic and avoidance measures. This review does not intend to comprehensively analyze all the available allergen molecules, but to provide some practical clues on use and interpretation of molecular allergy diagnosis. The potential role of component resolved diagnosis in circumstances such as the indication of allergen immunotherapy, pollen polysensitization, food allergy, latex allergy or anaphylaxis, is assessed. Interpreting the information provided by molecular allergy diagnosis needs a structured approach. It is necessary to evaluate single positivities and negativities, but also to appraise "the big picture" with perspective.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.


September 6, 2014

Anti-Inflammatory Effect of IL-37b in Children with Allergic Rhinitis

Mediators of Inflammation
Volume 2014 (2014), Article ID 746846, 13 pages
http://dx.doi.org/10.1155/2014/746846
Research Article
1Department of Otolaryngology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical College, No. 9 Jinsui Road, Guangzhou 510623, China
2Department of Otolaryngology, Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, No. 1665 Kongjiang Road, Shanghai 200092, China
Received 9 December 2013; Revised 4 July 2014; Accepted 14 July 2014; Published 11 August 2014
Academic Editor: Arkadiusz Orzechowski
Copyright © 2014 Wenlong Liu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Interleukin-37 (IL-37), a newly described member of IL-1family, functioned as a fundamental inhibitor of innate inflammatory and immune responses, especially its isoform IL-37b. Objective. This study was undertaken to evaluate the expression and regulation of IL-37b in children with allergic rhinitis (AR).Methods. Forty children with AR and twenty-five normal controls were included. The relationship between IL-37b and Th1/2 cytokines production in serum and nasal lavage was examined by enzyme-linked immunosorbent assay (ELISA). Peripheral blood mononuclear cells (PBMCs) were purified for in vitro regulation experiment of IL-37b. Intranasal mometasone furoate was given in AR children and IL-37b change after one-month treatment was detected using ELISA. Results. We observed significantly decreased IL-37b expression levels in both serum and nasal lavage compared to controls. IL-37b was negatively correlated with Th2 cytokines. Our results also showed that IL-37b downregulated Th2 cytokine expressed by PBMCs and this modulation was through mitogen-activated protein kinase (MAPK) and phosphatidylinositol 3-kinase (PI3K) pathway. We also found that intranasal mometasone furoate therapy can promote nasal IL-37b expression.Conclusion. IL-37b may be involved in Th2 cytokine regulation in AR and its expression was related to the efficacy of intranasal steroid therapy.

Asthma in the elderly: a study of the role of vitamin D

Short report


Michele ColumboReynold A Panettieri and Albert S Rohr
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Allergy, Asthma & Clinical Immunology 2014, 10:48  doi:10.1186/1710-1492-10-48
Published: 5 September 2014

Abstract (provisional)

Background

Asthma in the elderly is poorly understood and vitamin D deficiency and insufficiency are very common in older individuals. We studied the role of vitamin D in elderly asthmatics.
Findings: Asthmatics subjects, age 65 and older, were followed every 4 weeks for 12 weeks in the late fall and winter. During the study period they took 2,000 I.U. vitamin D3 daily. Serum 25-Hydroxyvitamin D and calcium were measured at baseline and study end. Twenty nine percent of subjects were deficient and 50% insufficient in serum vitamin D at baseline. Serum vitamin D increased from 24.3 +/- 9.2 ng/ml (60.7 +/- 23 nmol/L) to 34 +/- 7.1 ng/ml (84.9 +/- 17.7 nmol/L) at the end of the study (p < 0.001), whereas calcium was unchanged. We found no significant association between vitamin D and subjects' demographics. Vitamin D was similar in men and women. There was no association between serum vitamin D and inhaled steroid dose. Vitamin D was significantly lower in subjects with uncontrolled asthma (Asthma Control Test, ACT -= 19) compared to the ones with well controlled symptoms (p - 0.05). In subjects with uncontrolled asthma at baseline, ACT scores increased significantly at the end of the study (p - 0.04), but not at 4 and 8 weeks. Spirometric values remained unchanged throughout the study.

Conclusions

Elderly asthmatics very commonly have vitamin D deficiency or insufficiency. Serum vitamin D levels were lower in subjects with uncontrolled asthma. In these subjects, vitamin D supplementation for 12 weeks led to improved ACT scores. Larger, randomized, placebo controlled studies are required to further evaluate whether vitamin D supplementation may improve asthma symptoms in this population.
Trial registration: ClinicalTrials.gov NCT01730976.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

The intestinal microbiome in early life: health and disease


  • 1Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada
  • 2Child and Family Research Institute, University of British Columbia, Vancouver, BC, Canada
  • 3Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
  • 4Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC, Canada
Human microbial colonization begins at birth and continues to develop and modulate in species abundance for about 3 years, until the microbiota becomes adult-like. During the same time period, children experience significant developmental changes that influence their health status as well as their immune system. An ever-expanding number of articles associate several diseases with early-life imbalances of the gut microbiota, also referred to as gut microbial dysbiosis. Whether early-life dysbiosis precedes and plays a role in disease pathogenesis, or simply originates from the disease process itself is a question that is beginning to be answered in a few diseases, including IBD, obesity, and asthma. This review describes the gut microbiome structure and function during the formative first years of life, as well as the environmental factors that determine its composition. It also aims to discuss the recent advances in understanding the role of the early-life gut microbiota in the development of immune-mediated, metabolic, and neurological diseases. A greater understanding of how the early-life gut microbiota impacts our immune development could potentially lead to novel microbial-derived therapies that target disease prevention at an early age.

Regulation of intestinal health and disease by innate lymphoid cells



Gregory F. Sonnenberg

Abstract

Innate lymphoid cells (ILCs) are a recently appreciated immune cell population that is constitutively found in the healthy mammalian gastrointestinal (GI) tract and associated lymphoid tissues. Translational studies have revealed that alterations in ILC populations are associated with GI disease in patients, such as inflammatory bowel disease, HIV infection and colon cancer, suggesting a potential role for ILCs in either maintaining intestinal health or promoting intestinal disease. Mouse models identified that ILCs have context-dependent protective and pathologic functions either during the steady state, or following infection, inflammation or tissue damage. This review will discuss the associations of altered intestinal ILCs with human GI diseases, and the functional consequences of targeting ILCs in mouse models. Collectively, our current understanding of ILCs suggests that the development of novel therapeutic strategies to modulate ILC responses will be of significant clinical value to prevent or treat human GI diseases.


© The Japanese Society for Immunology. 2014. All rights reserved.


Japanese Guideline for Allergic Rhinitis 2014

REVIEW ARTICLE


Kimihiro Okubo, Yuichi Kurono, Shigeharu Fujieda, Satoshi Ogino, Eiichi Uchio, Hiroshi Odajima, Hiroshi Takenaka and Japanese Society of Allergology 

ABSTRACT
Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes pollinosis, which is intractable and reduces quality of life (QOL) when it becomes severe. A guideline is needed to understand allergic rhinitis and to use this knowledge to develop a treatment plan. In Japan, the first guideline was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 7th edition was published in 2013, and is widely used today.
To incorporate evidence based medicine (EBM) introduced from abroad, the most recent collection of evidence/literature was supplemented to the Practical Guideline for the Management of Allergic Rhinitis in Japan 2013. The revised guideline includes assessment of diagnosis/treatment and prescriptions for children and pregnant women, for broad clinical applications. An evidence-based step-by-step strategy for treatment is also described. In addition, the QOL concept and cost benefit analyses are also addressed. Along with Allergic Rhinitis and its Impact of Asthma (ARIA), this guideline is widely used for various clinical purposes, such as measures for patients with sinusitis, childhood allergic rhinitis, oral allergy syndrome, and anaphylaxis and for pregnant women. A Q&A section regarding allergic rhinitis in Japan was added to the end of this guideline.


KEY WORDS:
allergen immunotherapy, mechanism, pharmacotherapy, pollinosis, surgery

Received: 28 April 2014.



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