Allergen Immunotherapy in Children User’s Guide

Pediatric Allergy and Immunology, Год журнала: 2020, Номер 31(S25), С. 1 - 101

Опубликована: Май 1, 2020

Abstract Allergen immunotherapy is a cornerstone in the treatment of allergic children. The clinical efficiency relies on well‐defined immunologic mechanism promoting regulatory T cells and downplaying immune response induced by allergens. Clinical indications have been well documented for respiratory allergy presence rhinitis and/or asthma, to pollens dust mites. Patients who had an anaphylactic reaction hymenoptera venom are also good candidates allergen immunotherapy. Administration currently mostly either subcutaneous injections or sublingual administration. Both methods extensively studied pros cons. Specifically children, choice method administration according patient's profile important. Although widely used, there need improvement. More particularly, biomarkers prediction success treatments needed. strength may be boosted use better adjuvants. Finally, novel formulations might more efficient improve adherence treatment. This user's guide reviews current knowledge aims provide guidance healthcare professionals taking care children undergoing

Язык: Английский

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The role of allergen‐specific IgE, IgG and IgA in allergic disease

Allergy, Год журнала: 2021, Номер 76(12), С. 3627 - 3641

Опубликована: Май 17, 2021

Immunoglobulin E (IgE)-mediated allergy is the most common hypersensitivity disease affecting more than 30% of population. Exposure to even minute quantities allergens can lead production IgE antibodies in atopic individuals. This termed allergic sensitization, which occurs mainly early childhood. Allergen-specific then binds high (FcεRI) and low-affinity receptors (FcεRII, also called CD23) for on effector cells antigen-presenting cells. Subsequent repeated allergen exposure increases allergen-specific levels and, by receptor cross-linking, triggers immediate release inflammatory mediators from mast basophils whereas IgE-facilitated presentation perpetuates T cell-mediated inflammation. Due engagement are highly selective IgE, tiny amounts induce massive Naturally occurring IgG IgA usually recognize different epitopes compared with do not efficiently interfere allergen-induced However, these important be induced immunotherapy or passive immunization. These will competition binding prevent responses. Similarly, anti-IgE treatment does same preventing its basophils. Here, we review complex interplay corresponding cell diseases relevance diagnosis, prevention allergy.

Язык: Английский

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A WAO — ARIA — GA2LEN consensus document on molecular-based allergy diagnosis (PAMD@): Update 2020

World Allergy Organization Journal, Год журнала: 2020, Номер 13(2), С. 100091 - 100091

Опубликована: Фев. 1, 2020

Abstract

Precision allergy molecular diagnostic applications (PAMD@) is increasingly entering routine care. Currently, more than 130 allergenic molecules from 50 sources are commercially available for in vitro specific immunoglobulin E (sIgE) testing. Since the last publication of this consensus document, a great deal new information has become regarding topic, with over 100 publications in year alone. It thus seems quite reasonable to publish an update. imperative that clinicians and immunologists specifically trained allergology keep abreast rapidly evolving evidence PAMD@. PAMD@ may initially appear complex interpret; however, increasing experience, gained provides relevant allergist. This especially true food allergy, Hymenoptera selection allergen immunotherapy. Nevertheless, all sIgE tests, including PAMD@, should be evaluated within framework patient's clinical history, because sensitization does not necessarily imply allergies.

Язык: Английский

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Past, present, and future of allergen immunotherapy vaccines

Allergy, Год журнала: 2020, Номер 76(1), С. 131 - 149

Опубликована: Апрель 6, 2020

Allergen-specific immunotherapy (AIT) is an allergen-specific form of treatment for patients suffering from immunoglobulin E (IgE)-associated allergy; the most common and important immunologically mediated hypersensitivity disease. AIT based on administration disease-causing allergen with goal to induce a protective immunity consisting blocking IgG antibodies alterations cellular immune response so that patient can tolerate contact. Major advantages over all other existing treatments allergy are induces long-lasting protection prevents progression disease severe manifestations. cost effective because it uses patient´s own system potentially be used as preventive treatment. However, broad application limited by mainly technical issues such quality preparations risk inducing side effects which results in extremely cumbersome schedules reducing compliance. In this article we review progress made its beginning provide overview state art, needs further development, possible solutions available through molecular allergology. Finally, consider visions development towards prophylactic application.

Язык: Английский

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Immunological Responses and Biomarkers for Allergen-Specific Immunotherapy Against Inhaled Allergens

The Journal of Allergy and Clinical Immunology In Practice, Год журнала: 2021, Номер 9(5), С. 1769 - 1778

Опубликована: Март 27, 2021

Язык: Английский

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30 years of sublingual immunotherapy

Allergy, Год журнала: 2019, Номер 75(5), С. 1107 - 1120

Опубликована: Ноя. 12, 2019

Allergen Immunotherapy (AIT) was introduced in clinical practice on an empirical basis more than 100 years ago. Since the first attempts, AIT administered subcutaneously. Indeed, other routes of administration were proposed and studied, particular to improve safety, but only sublingual route (SLIT) achieved a credibility based evidence then accepted as viable "alternative" option subcutaneous route. SLIT largely used trials this last 30 years. Thus, large amount data is available, coming from either controlled postmarketing surveillance studies. It clear that overall effective, it also efficacy not "class-related," derived meta-analyses, restricted each specific product. The 30-year lasting use allowed clarify many aspects, such efficacy, asthma, regimens administration, optimal doses. In parallel, mechanisms action elucidated, new indications (eg food allergy, atopic dermatitis). addition, introduction molecular-based diagnosis, better refine prescription SLIT, sensitization profiles. present article will describe origin evolution for respiratory taking into account context suggested form treatment, recently developed future perspectives unmet needs, This not, therefore, systematic review, rather narrative historical description past history, look forward opportunities.

Язык: Английский

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Molecular allergology and its impact in specific allergy diagnosis and therapy

Allergy, Год журнала: 2021, Номер 76(12), С. 3642 - 3658

Опубликована: Май 31, 2021

Abstract Progressive knowledge of allergenic structures resulted in a broad availability molecules for diagnosis. Component‐resolved diagnosis allowed better understanding patient sensitization patterns, facilitating allergen immunotherapy decisions. In parallel to the discovery molecules, there was progressive development regulation framework that affected both vitro diagnostics and Allergen Immunotherapy products. With underlying mechanisms associated an increasing experience application molecular daily life, we focus analyzing evidences value provided by allergology clinical practice, with on

Язык: Английский

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Specific IgE and IgG4 Profiles of House Dust Mite Components in Allergen-Specific Immunotherapy

Frontiers in Immunology, Год журнала: 2022, Номер 12

Опубликована: Фев. 7, 2022

Background Allergen immunotherapy (AIT) can induce immune tolerance to allergens by activating multiple mechanisms, including promoting IgG4 synthesis and blunting IgE production. However, the longitudinal data of sIgE sIgG4 allergen components during AIT are limited. Objective We sought investigate persistence evolution against house dust mite (HDM) explore their correlation with clinical responses. Methods Sixty allergic rhinitis (AR) with/without asthma patients receiving for HDM were enrolled in group. Thirty AR without served as control Blood samples collected sIgE, ( Derp 1, Derf 2, 7, 10, 21 23 ) assay at baseline, Month 6 18 AIT. Combined symptom medication scores (CSMS) obtained accordingly. Results In group, 2 significantly increased compared baseline (36.2 U A /mL vs 158.8 /mL, 46.4 94.6 80.5 152.3 78.3 205.1 42.3 59.3 all p <0.05), didn’t see differences (all >0.05).The numbers positive component from 4.5 5 0 1.5 respectively (both <0.05). changes sIgG4, sIgE/sIgG4 ratio had no correlations improvement CSMS after ρ<0.3). For did not change observational period >0.05). Conclusion production components. levels do correlate corresponding or response. qualify a biomarker evaluate efficacy

Язык: Английский

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Preventive Effect of Allergen Immunotherapy on Asthma and New Sensitizations

The Journal of Allergy and Clinical Immunology In Practice, Год журнала: 2021, Номер 9(5), С. 1813 - 1817

Опубликована: Март 20, 2021

Язык: Английский

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A Clinical Approach of Allergic Rhinitis in Children

Children, Год журнала: 2023, Номер 10(9), С. 1571 - 1571

Опубликована: Сен. 19, 2023

Allergic rhinitis is an important disease with a global footprint and growing prevalence, affecting children adults. Although it commonly under-diagnosed under-treated, causes social economic effects (diminished quality of life, poor academic performance, escalated medical visits, heightened medication usage, in other chronic conditions, e.g., asthma). It characterized by distinctive, easily identifiable symptoms (sneezing, nasal discharge, congestion, nasal–eye–palatal itching) indirect accompanying indicators (fatigue decreased school performance). The classification allergic hinges upon its nature distribution (seasonal or perennial) intensity, which spans from mild to moderate severe. diagnostic process primarily relies recognizing key clinical indicators, evaluating historical records, considering risk factors. supported abnormal laboratory findings, like vitro allergen-specific IgE tests (enzyme immunoassay—EIA, chemiluminense immunoassay—CLIA) vivo skin prick for specific allergens. In the differential diagnosis, diseases manifesting should be excluded (e.g., rhinosinusitis, non-allergic rhinitis, triggered medications). treatment mainly focused on allergen exposure prevention, drug therapy, immunotherapy severe cases. Locally administered intranasal corticosteroids are cornerstone therapy. They safe, effective, have favorable safety profile even during long-term use. Choosing suitable corticosteroid low systemic bioavailability makes safer. Combinations H1 antihistamines available several countries widely used more cases presence year-round symptoms. Adding newer-generation oral H1-antihistamines broadens therapeutic inventory without significant compared using previous-generation, once available, H1-antihistamines. Treatment complex multi-dimensional, requiring effective approach specialized group pediatricians, severely affected concurrent development spectrum (conjunctivitis,

Язык: Английский

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