首页期刊导航|Current opinion in allergy and clinical immunology
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Current opinion in allergy and clinical immunology
Lippincott Williams & Wilkins
Current opinion in allergy and clinical immunology

Lippincott Williams & Wilkins

1528-4050

Current opinion in allergy and clinical immunology/Journal Current opinion in allergy and clinical immunologySCI
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    Atopic dermatitis endotypes: knowledge for personalized medicine

    Jihyun,KimKangmo,Ahn
    7页
    查看更多>>摘要：Endotypes are clinically relevant phenotypes that can be explained by molecular mechanisms, and are defined to predict the development, progression, prognosis and responses to treatment on the individual level. This review summarizes atopic dermatitis phenotypes, endotypes and their potential application for personalized medicine. Atopic dermatitis can be classified into several phenotypes according to disease courses that likely have common pathophysiology. The genotype is important to define endotypes, but the value of genotype alone remains somewhat limited in most atopic dermatitis patients. Recent studies have demonstrated that atopic dermatitis phenotypes according to ethnicity or age can be classified into endotypes based on the dominant immunologic markers, that is TH1/TH2/TH17/TH22 cells. Newly developed biologic agents targeting specific cytokines show therapeutic potential in a personalized medicine approach. Cytokine-based endotypes in different age groups or ethnic groups have contributed to expanding our understanding of atopic dermatitis. Recent biologics or small molecules can be used for more personalized treatment of atopic dermatitis. Further research using integrated multiomic analysis is needed to define a more detailed classification of endotypes and provide endotype-driven targeted therapies for personalized medicine.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Personalized management for unmet needs with food allergy

    Yoko,MiuraNoriyuki,YanagidaSakura,SatoMotohiro,Ebisawa...
    7页
    查看更多>>摘要：Patients with food allergies are at risk of experiencing accidental allergic symptoms in real life. Low thresholds may be a risk factor for accidental allergic reactions. Therefore, the evaluation of this threshold is required for the management of food allergies. We have suggested a management approach to identify the threshold dose and the consumable dose, considering patient age and the severity of food allergies. A younger age is a risk factor for accidental allergic reactions, and school-age children are likely to have a lower quality of life (QOL) than younger children. Additionally, patients with a low threshold may have difficulty in acquiring tolerance. We performed a stepwise oral food challenge (OFC) to evaluate the threshold and consumable doses for patients with food allergies. Performing a low-dose OFC for the first step would identify the dose that could be consumed at home safely and avoid the complete elimination of allergic foods. Identifying the threshold dose would be effective in managing the risk of accidental ingestion. For patients who react to low-dose OFC, low-dose oral immunotherapy (OIT) would be expected to prevent the experience of allergic reactions by accidental ingestion and consume medium doses safely. For food allergy patients and their caregivers, identifying the consumable dose would help manage the diet and eliminate their anxiety. Low-dose OFC and low-dose OIT are effective and well tolerated, which would improve their QOL. Considering the severity of food allergy and age, determining a safe threshold with no reactions would meet the unmet needs of patients with food allergy.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Drug allergy desensitization is not a unique recipe

    Ricardo,Madrigal-BurgaletaMaria Antonieta,Guzman-MelendezEmilio,Alvarez-Cuesta
    8页
    查看更多>>摘要：Drug desensitization is the only therapeutic option for patients with drug allergies who need to receive the drugs they are allergic to, and it is especially critical in patients with an urgent need for chemotherapy, biologics, or antibiotics, where equally effective alternatives might not be available. However, drug desensitization is not a cookbook where anyone with no experience or specific training can find a general recipe. This review article will approach the singularities that make personalized and highly specialized care essential in this field. Drug desensitization needs to be personalized for each individual patient bearing in mind countless factors. Recent articles have tried to define the optimal resources and the most important factors to account for in personalization. However, drug desensitization is only a tool within the wider management pathway, and we will discuss recent findings in allergy delabelling in chemotherapy, biologics, and antibiotics. Risk-assessment, delabelling, and desensitization protocols, as a part of wider management pathways, can be adapted locally along with comprehensive and multifactorial risk-management strategies. These high-complexity and high-risk procedures, such as drug desensitization, need to be managed by expert allergists who can provide personalization, innovation, continuous improvement, research, and teaching in expert centres.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Molecular diagnosis contribution for personalized medicine

    Olga,LuengoPaula,Galvan-BlascoVictoria,Cardona
    6页
    查看更多>>摘要：The purpose of the current review is to highlight the most recent findings in molecular allergy and its applicability in precision medicine for allergic patients. Molecular allergy provides useful information in areas of respiratory allergy (house dust mites, pet dander and pollen allergy), food allergy (tree nuts, peanuts, fruits and vegetables), hymenoptera venom allergy and others, in order to improve management of patients. Regional differences in sensitization profiles, assay characteristics and interpretation of molecular sensitization in relation to whole extracts and total immunoglobulin E need to be taken into account. Studies of the impact of such strategies are needed. Molecular allergy diagnosis represents a major contribution for personalized medicine. It aids in the assesment of risk prediction, disease severity, genuine/cross-reactive sensitization, and finally to apply precise management strategies.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Cow's milk allergy

    Stefania,ArasiArianna,CafarottiAlessandro,Fiocchi
    7页
    查看更多>>摘要：To highlight the most recent insights on cow's milk allergy (CMA), its treatment, and management. CMA is one of the most common food allergies among children. Burdened by the risk for fatal reaction, CMA may imply also a severe impairment of health-related quality of life at individual and family level as well as well as individual and societal costs. The updated Diagnosis and Rationale for Action against Cow's Milk Allergy series is going to provide a series of manuscripts that will offer a comprehensive state-of-the-art specifically on CMA, including international evidence-based recommendations. The current results from randomized clinical trials highlight that oral immunotherapy may be effective by itself in providing desensitization. Preliminary data suggest that biologicals such as omalizumab may be able to increase the threshold of reactivity to milk or several foods (if multiple food allergies) without requiring allergen exposure. Breastfeeding is the first choice for infants with CMA. Extensively hydrolyzed formula and amino-acid formula are valid alternatives and may be particularly helpful when eliminating multiple foods, with severe complex gastrointestinal food allergies, eosinophilic esophagitis, severe eczema, or symptoms while exclusively breastfeeding. Heed is needed to ensure the formula is nutritionally sufficient. Due to a high degree of cross-reactivity with cow's milk proteins and risk for allergic reactions, goats’ milk or other mammals’ milk should not be used. The adoption and implementation of evidence-based recommendations may guide a proper diagnostics and management and awaited advances in knowledge will allow the development of a personalized treatment tailored on the specific CMA patient's profile.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Current insights: a systemic review of therapeutic options for peanut allergy

    Hilary,TangAndrew,ChinAndrew,LongSayantani,Sindher...
    6页
    查看更多>>摘要：With increasing prevalence of peanut allergy (PA) globally and the greater risk of potential reactions occurring due to the leading role of nuts in food products, PA has become a significant public health concern over the past decade, affecting up to 5 million of the US adult population. This review details updates and advances in prevalence, diagnosis, and immunotherapies that have occurred over the past year. Therapeutic and diagnostic advances remain at the forefront of research and have continued to push the food allergy (FA) field forward to provide a promising role in the detection and treatment of PA. The FA field has researched significant advances in peanut immunotherapy, biomarker diagnosis, and quality of life (QoL) improvement. Given the burden and consequences for individuals with PA, these advances delivered in clinical practice can significantly improve the QoL of individuals with PA and their caregivers. Ongoing studies will continue to investigate long-term outcome measures of desensitisation and effective management plans tailored to the families’ needs.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Recent advances in the diagnosis and management of tree nut and seed allergy

    Roxane,LabrosseFran?ois,GrahamJean-Christoph,Caubet
    8页
    查看更多>>摘要：Tree nut (TN) and seed allergies are frequent, and their prevalence appears to be on the rise. Allergic reactions associated with these foods are more frequently severe, and these allergies tend to persist into adulthood, consequently affecting quality of life. In this review, we summarize recent advances in diagnostic modalities and management strategies for TN/seed-allergic patients. Clinical manifestations of TN and seed allergy range from asymptomatic sensitization to severe anaphylactic reactions. The use of emerging diagnostic tools such as component resolved diagnostics (CRD) and the basophil activation test (BAT) can help better predict clinical reactivity, the latter being currently reserved for research settings. Strict avoidance of all TN is generally not required, as most patients can tolerate select TN despite co-sensitization. Oral immunotherapy (OIT) is a promising alternative treatment instead of complete avoidance of culprit allergens, as it can safely increase the allergy threshold. Our recent understanding of co-reactivity between various TN and seeds has shaped management opportunities, including select TN introduction and optimization of OIT, two strategies which may improve quality of life. There is a need for better minimally invasive diagnostic methods for TN and seed allergy, with CRD and BAT being promising tools.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Emerging approaches in the diagnosis and therapy in shellfish allergy

    Christine Y.Y.,WaiPatrick S.C.,Leung
    11页
    查看更多>>摘要：Despite the high prevalence of shellfish allergy, the clinical management of seafood allergy has remained unchanged over decades. Here, we examined the current status in the diagnosis and clinical management of shellfish allergy and highlighted the imminent need for more specific diagnostic methods, as well as effective and safe therapeutic approaches for shellfish allergy. With the advancement in the molecular identifications and definition of reactive epitopes of shellfish allergens, new diagnostic designs such as component-resolved diagnosis, basophil activation test (BAT) and the emerging IgE-crosslinking-induced luciferase expression are emerging. Furthermore, various allergen-specific immunotherapy strategies (such as shellfish extracts and allergens, hypoallergens, hypoallergen DNA vaccines, mimotopes and peptide-based therapies) are being explored at preclinical stages whereas limited nonallergen specific immunotherapy approaches are under clinical trials. With an increasing understanding of the underlying immunological mechanisms and molecular features of shellfish allergy, the future for developing precise diagnostic and therapeutic strategies to better manage shellfish allergy is promising.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Editorial introductions

    2页
      原文链接:
    • NSTL