Advances and recent developments in asthma in 2020

Allergy, Journal Year: 2020, Volume and Issue: 75(12), P. 3124 - 3146

Published: Sept. 30, 2020

In this review, we discuss recent publications on asthma and review the studies that have reported different aspects of prevalence, risk factors prevention, mechanisms, diagnosis, treatment asthma. Many protective molecular mechanisms are involved in development Emerging concepts challenges implementing exposome paradigm its application allergic diseases reviewed, including genetic epigenetic factors, microbial dysbiosis, environmental exposure, particularly to indoor outdoor substances. The most relevant experimental further advancing understanding immune with potential new targets for therapeutics discussed. A reliable diagnosis asthma, disease endotyping, monitoring severity great importance management Correct evaluation comorbidity/multimorbidity, interaction phenotypes value precision medicine approach validation predictive biomarkers, detailed. Novel approaches strategies linked endotypes biologicals, critically appraised. Finally, due pandemics impact patient management, challenges, relationships, between allergies, SARS-CoV-2, COVID-19.

Language: Английский

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Mechanisms of allergen-specific immunotherapy and allergen tolerance

Allergology International, Journal Year: 2020, Volume and Issue: 69(4), P. 549 - 560

Published: Sept. 6, 2020

Allergen-specific immunotherapy (AIT) is the mainstay treatment for cure of allergic disorders, with depicted efficacy and safety by several trials meta-analysis. AIT impressively contributes to management rhinitis, asthma venom allergies. Food allergy a new arena promising results, especially via novel administration routes. Cell subsets regulatory capacities are induced during AIT. IL-10 transforming growth factor (TGF)-β main suppressor cytokines, in addition surface molecules such as cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) programmed cell death protein-1 (PD-1) within micro milieu. Modified T- B-cell responses antibody isotypes, increased activity thresholds eosinophils, basophils mast cells consequent limitation inflammatory cascades altogether induce maintain state sustained allergen-specific unresponsiveness. Established tolerance reflected into clinical perspectives improvement symptoms together reduced medication requirements evolved disease severity. Long durations, costs, patient compliance risk severe, even life-threatening adverse reactions stand major limiting factors By development purified non-allergenic, highly-immunogenic modified allergen extracts, combinational usage them adjuvant routes may shorten durations possibly reduce these drawbacks. best model custom-tailored therapy disorders. Better characterization endotypes, definition specific biomarkers diagnosis follow-up, well precision medicine approaches further contribute success

Language: Английский

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Six Injections of Modified Adjuvanted PQ Grass Is Effective and Well‐Tolerated in a Pivotal Phase III Trial

Allergy, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 4, 2025

ABSTRACT Background PQ Grass 27600 SU (PQ Grass) cumulative dose is a pre‐seasonal, six‐injection, aluminium‐free, modified subcutaneous immunotherapy product under development for the treatment of allergic rhinitis (AR). A pivotal Phase III randomised double‐blind, placebo‐controlled clinical trial was performed to evaluate efficacy and safety in subjects with seasonal AR. Methods An adaptive group sequential PQGrass306 (G306) one pre‐defined interim analysis designed, using 2 parallel groups applying 1:1 active versus placebo randomisation patients aged 18–65. The primary endpoint EAACI (European Academy Allergy Clinical Immunology) Combined Symptom Medication Score (EAACI‐CSMS 0–6 ) averaged over peak grass pollen season (GPS). Results 858 were screened 555 randomised. Based on results analysis, stopped success showing superiority favour Grass. EAACI‐CSMS (peak GPS) demonstrated highly significant clinically meaningful point difference −0.27 points (95% CI: −0.42 −0.12), corresponding relative −20.3% ( p = 0.0005). Highly consistent beneficial obtained all key secondary endpoints. Significant induction blocking IgG4 IgA antibody subclasses occurred. well tolerated, no unexpected signals Conclusions This effect as supportive profile.

Language: Английский

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Food allergy and hypersensitivity reactions in children and adults—A review

Journal of Internal Medicine, Journal Year: 2021, Volume and Issue: 291(3), P. 283 - 302

Published: Dec. 7, 2021

Abstract Adverse reactions after food intake are commonly reported and a cause of concern anxiety that can lead to very strict diet. The severity the reaction vary depending on type mechanism, it is not always easy disentangle different hypersensitivity diagnoses, which sometimes exist simultaneously. After carefully taken medical history, often be ruled out or suspected. most common allergic immunoglobulin E (IgE)–mediated allergy (prevalence 5–10%). Symptoms from mild itching, stomach pain, rash severe anaphylaxis. definition IgE‐mediated symptoms combined with specific IgE‐antibodies, therefore only IgE‐antibodies suspected allergens should analyzed. Nowadays, methods molecular allergology help diagnostic process. milk egg in infants, peanut tree nuts children, fish shellfish adults. In young milk/egg has good chance remit, making important follow up reintroduce when possible. Other diseases triggered by non‐IgE‐mediated allergy, for example, eosinophilic esophagitis, celiac disease, protein‐induced enterocolitis syndrome, biogenic amines. Some hypersensitivities dominate childhood, others more Interesting studies ongoing regarding possibilities treating hypersensitivity, such as through oral immunotherapy. purpose this review was provide an overview types reactions.

Language: Английский

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The Burden of Childhood Asthma by Age Group, 1990–2019: A Systematic Analysis of Global Burden of Disease 2019 Data

Frontiers in Pediatrics, Journal Year: 2022, Volume and Issue: 10

Published: Feb. 16, 2022

Asthma is a common respiratory disease in children. We aimed to update information about the incidence and mortality disability-adjusted life years (DALYs) of childhood asthma provide evidence-based recommendations for prevention.Data were obtained from Global Burden Disease (GBD) study, which was conducted 1990 2019 204 countries. First, we estimated incidence, DALY rates using Bayesian meta-regression model. Second, analyzed relationship between sociodemographic index (SDI) DALYs different age groups. Third, studied changes trends age-standardized rate based on group, SDI, risk factors.Globally, number deaths due 12.9 thousand (95% UI 10.6 15.7), 22 million 15 31), 5.1 3.4 7.5) 2019, decreasing by 65.1% 47.6 72.4), 5.3% 2.6 8.8) 30% 18 41) those 1990, respectively. With exception high-SDI regions, all groups SDI regions declined. In 1- 4-year-old individuals highest low-SDI that 5- 19-year-old regions. contrast had higher asthma, except aged 1 4 years. A high body mass (BMI) stronger factor than occupational asthmagens asthma.Our findings insight into prevention treatment through identification key factors related asthma. Based data available, according group region/country suggest strategies, preventing

Language: Английский

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Mechanisms of Allergen Immunotherapy and Potential Biomarkers for Clinical Evaluation

Journal of Personalized Medicine, Journal Year: 2023, Volume and Issue: 13(5), P. 845 - 845

Published: May 17, 2023

Allergen-immunotherapy (AIT) is an efficacious and disease-modifying treatment option for IgE-mediated diseases. Among these allergic rhinitis, insect venom allergy, food asthma are the most common candidates AIT. AIT gives rise to clinical immunotolerance which may last years after cessation. Mechanisms of include suppression inflammation in target tissues stimulation production blocking antibodies, especially IgG4 IgA. These mechanisms followed by a reduction underlying allergen-specific Th2 cell-driven responses allergens. Tolerance induction takes place through desensitization effector cells regulatory T that show their effects involving cell-cell cross-talk, but also other mechanisms, e.g., immunomodulatory cytokines such as, IL-10 TGF-beta. From personalized medical perspective, there need biomarkers value selecting responders optimizing patient care during Also, deeper understanding mechanistic processes will improve AIT’s future outcomes. In this paper, current knowledge reviewed with special focus on therapy.

Language: Английский

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Desensitization and remission after peanut sublingual immunotherapy in 1- to 4-year-old peanut-allergic children: A randomized, placebo-controlled trial

Journal of Allergy and Clinical Immunology, Journal Year: 2023, Volume and Issue: 153(1), P. 173 - 181.e10

Published: Oct. 10, 2023

BackgroundPrior studies of peanut sublingual immunotherapy (SLIT) have suggested a potential advantage with younger age at treatment initiation.ObjectiveWe studied the safety and efficacy SLIT for allergy in 1- to 4-year-old children.MethodsPeanut-allergic children were randomized receive 4 mg versus placebo. Desensitization was assessed by double-blind, placebo-controlled food challenge (DBPCFC) after 36 months treatment. Participants desensitized least 443 protein discontinued therapy 3 then underwent DBPCFC assess remission. Biomarkers measured baseline longitudinally during treatment.ResultsFifty participants (25 SLIT, 25 placebo) median 2.4 years enrolled across 2 sites. The primary end point desensitization met actively treated placebo having significantly greater cumulative tolerated dose (4443 vs 143 mg), higher likelihood passing month (60% 0), demonstrating remission (48% 0). highest rate seen 2-year-olds, followed 2- 3-year-olds 3- 4-year-olds. Longitudinal changes skin prick testing, peanut-specific IgG4, IgG4/IgE ratio but not participants. Oropharyngeal itching more commonly reported than Skin, gastrointestinal, upper respiratory, lower multisystem adverse events similar between groups.ConclusionPeanut safely induces children, improved outcomes initiation. Prior We children. Peanut-allergic Fifty groups. Peanut

Language: Английский

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Is exposure to pollen a risk factor for moderate and severe asthma exacerbations?

Allergy, Journal Year: 2023, Volume and Issue: 78(8), P. 2121 - 2147

Published: March 24, 2023

Limited number of studies have focused on the impact pollen exposure asthma. As a part EAACI Guidelines Environment Science, this first systematic review relationship to asthma exacerbations aimed bridge knowledge gap in view implementing recommendations prevention. We searched electronic iPubMed, Embase, and Web Science databases using set MeSH terms related synonyms identified 73 eligible that were included for systemic review. When possible, meta-analyses conducted. Overall meta-analysis suggests outdoor may an effect exacerbation, but caution is needed due low their heterogeneity. The strongest associations found between attacks, asthma-related ED admissions or hospitalizations, increase grass concentration previous 2-day overall children aged less than 18 years age. Tree visits lagged up 7-day individuals younger years. Rare data show among subjects under age, 3 days lower lung function. Further research considering modifiers sensitization, hay fever, asthma, air pollution, green spaces, pre-existing medications urgently warranted better evaluate impacts exacerbation. Preventive measures relation should be integrated control as continues climate change.

Language: Английский

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Updated grading system for systemic allergic reactions: Joint Statement of the World Allergy Organization Anaphylaxis Committee and Allergen Immunotherapy Committee

World Allergy Organization Journal, Journal Year: 2024, Volume and Issue: 17(3), P. 100876 - 100876

Published: Feb. 10, 2024

There is a lack of consensus over the description and severity assignment allergic adverse reactions to immunotherapy, although there seems be at least in terms using World Allergy Organization (WAO) grading systems describe local events for Sublingual Immunotherapy (SLIT) Systemic Allergic Reactions (SARs) Subcutaneous (SCIT) amongst major national/regional allergy societies. In this manuscript, we propose modification previous WAO Grading system SARs, which aligns with newly-proposed Consortium Food Research (CoFAR) Scale (version 3.0). We hope can facilitate unified appropriate SARs due allergen independent route administration, across clinical research practice.

Language: Английский

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Efficacy and safety of sublingual immunotherapy using a combination of Dermatophagoides pteronyssinus and Blomia tropicalis extracts in patients with allergic rhinitis: A randomized, double-blind, placebo-controlled trial

World Allergy Organization Journal, Journal Year: 2025, Volume and Issue: 18(2), P. 101020 - 101020

Published: Jan. 28, 2025

Language: Английский

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