ALERGOLOGÍA PARA MÉDICOS Y PACIENTES 2021

A cohort study on the risk of lymphoma and skin cancer in users of topical tacrolimus, pimecrolimus, and corticosteroids (Joint European Longitudinal Lymphoma and Skin Cancer Evaluation – JOELLE study) Authors: Castellsague J1, Kuiper JG2, Pottegård A3, Anveden Berglind I4, Dedman D5, Gutierrez L1, Calingaert B6, van Herk-Sukel MP2, Hallas J3, Sundström A4, Gallagher AM5, Kaye JA7, Pardo C8, Rothman KJ7, Perez-Gutthann S1. 1 Department of Epidemiology, RTI Health Solutions, Barcelona, Spain. 2 Department Research, PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands. 3 Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark. 4 Centre for Pharmacoepidemiology, Unit of Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. 5 Clinical Practice Research Datalink, Medicines and Healthcare products Regulatory Agency, London, UK. 6 Department Epidemiology, RTI Health Solu...

Diagnostic spirometry in primary care: Proposed standards for general practice compliant with American Thoracic Society and European Respiratory Society recommendations: a General Practice Airways Group (GPIAG)1 document, in association with the Association for Respiratory Technology & Physiology (ARTP)2 and Education for Health3 1 www.gpiag.org 2 www.artp.org 3 www.educationforhealth.org.uk. Authors: Levy ML1, Quanjer PH, Booker R, Cooper BG, Holmes S, Small I; General Practice Airways Group. Allergy & Respiratory Research Group, Division of Community Health Sciences:GP section, University of Edinburgh, Scotland, UK. marklevy@animalswild.com Abstract: Primary care spirometry services can be provided by trained primary care staff, peripatetic specialist services, or through referral to hospital-based or laboratory spirometry. The first of these options is the focus of this Standards Document. It aims to provide detailed information for clinicians, managers and hea...

Eosinophilic gastrointestinal diseases beyond eosinophilic esophagitis Authors:  Egan M ,  Section of Pediatric Allergy and Immunology, Department of Pediatrics, Children's Hospital of Colorado, Aurora, Colorado; Gastrointestinal Eosinophilic Disease Program, University of Colorado School of Medicine, Aurora, Colorado. Electronic address: maureen.egan@childrenscolorado.org. Furuta GT , Gastrointestinal Eosinophilic Disease Program, University of Colorado School of Medicine, Aurora, Colorado; Digestive Health Institute, Department of Pediatrics, Children's Hospital of Colorado, Aurora, Colorado. Abstract:  OBJECTIVE: Eosinophilic gastrointestinal diseases (EGIDs) are a rare group of disorders that can have varied clinical presentations dependent on the involved segment within the gastrointestinal tract. Eosinophilic gastritis presents with abdominal pain or vomiting, eosinophilic gastroenteritis presents with diarrhea and anemia or hypoalbuminemia, an...

Fisiopatología de las reacciones de hipersensibilidad Dra. Gloria Gil (Octubre de 2018).

Who needs penicillin allergy testing? Authors: Macy E , Department of Allergy, Southern California Permanente Medical Group, San Diego Medical Center, San Diego, California. Electronic address: eric.m.macy@kp.org. Vyles D , Pediatric Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. Abstract: All individuals with an unconfirmed penicillin allergy should have their penicillin allergy evaluated, and if appropriate, tested to confirm current hypersensitivity or tolerance. DOI:  https://doi.org/10.1016/j.anai.2018.07.041

Early IL-10 producing B-cells and coinciding Th/Tr17 shifts during three year grass-pollen AIT Authors:  Ulrich M. Zissler a,1, Constanze A. Jakwerth a,1, FerdinandM. Guertha, Lisa Pechtold a,b, Juan Antonio Aguilar-Pimentel a, Katharina Dietz a, Kathrin Suttner a, Guido Piontek b, Bernhard Haller c, Zuzana Hajdu b, Matthias Schiemann d, Carsten B. Schmidt-Weber a, Adam M. Chaker a,b a Center of Allergy & Environment (ZAUM), German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), Helmholtz Center Munich, Technical University of Munich (TUM), Biedersteiner Str. 29, Munich 80802, Germany b Department of Otorhinolaryngology and Head and Neck Surgery, Medical School, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany c Institute of Medical Informatics, Statistics and Epidemiology, Medical School, Technical University of Munich, Grillparzerstr. 18, Munich 81675, Germany d Department of Microbiology and...

Position statement: topical calcineurin inhibitors in atopic dermatitis. Authors: Remitz A1, De Pità O2, Mota A3, Serra-Baldrich E4, Vakirlis E5, Kapp A6. 1 Department of Skin and Allergic diseases, Helsinki University Central Hospital, Helsinki, Finland. 2 Department of Dermatology and Allergy, Cristo Re Hospital, Rome, Italy. 3 Department of Dermatology, Faculty of Medicine, University of Porto, i3S Research Institute, Porto, Portugal. 4 Department of Dermatology, Sant Pau Hospital, Autonomous University, Barcelona, Spain. 5 Department of Dermatology and Venereology, Aristotle University Medical School, Thessaloniki, Greece. 6 Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany. Abstract: BACKGROUND: Atopic dermatitis (AD) is a common inflammatory skin disease in both adults and children. Whilst topical calcineurin inhibitors (TCIs), tacrolimus ointment and pimecrolimus cream, have proven efficacy for the treatment of AD, it is important...

Nasal and ocular challenges Authors: Pepper AN,  Ledford DK , Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine and James A. Haley Veterans' Affairs Hospital, Tampa, Fla. Abstract: Nasal and ocular challenges facilitate the evaluation of subjective and objective responses to defined allergen or irritant exposure. Nasal and ocular allergen challenges are the gold standard to diagnose allergic rhinitis and conjunctivitis, respectively, and aid in the evaluation of novel therapies in clinical trials. Additionally, nasal and ocular allergen challenges might help identify medically relevant allergens in clinical practice. Nonspecific or irritant challenges evaluate mucosal hyperreactivity. Direct mucosal challenges, which can be performed in an office or research setting, expose the participant to higher allergen doses than common in the natural environment. Park studies and environmental chambe...

Diagnosis of fish and shellfish allergies Authors: Tong WS1, Yuen AW1, Wai CY2, Leung NY2, Chu KH1, Leung PS3.   1 School of Life Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China. 2 Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China, christineyywai@cuhk.edu.hk. 3 Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, University of California Davis, Davis, CA, USA, psleung@ucdavis.edu. Abstract: Seafood allergy is a hypersensitive disorder with increasing prevalence worldwide. Effective and accurate diagnostic workup for seafood allergy is essential for clinicians and patients. Parvalbumin and tropomyosin are the most common fish and shellfish allergens, respectively. The diagnosis of seafood allergies is complicated by cross-reactivity among fish allergens and between shellfish allergens and other arthropods. Current clinical diagnosis of seafood allergy is a com...

Ascariasis as a model to study the helminth/allergy relationships. Authors:  Caraballo L, Acevedo N, Zakzuk J .  Institute for Immunological Research, University of Cartagena, Cartagena, Colombia. Abstract: Ascariasis is the most frequent soil transmitted helminthiasis and, as well as other helminth infections, is expected to influence the clinical presentation of allergic diseases such as asthma. Indeed, several clinical and experimental works have shown an important impact either increasing or suppressing symptoms, and the same effects have been detected on the underlying immune responses. In this review we analyze the work on this field performed in Colombia, a Latin American tropical country, including aspects such as the molecular genetics of the IgE response to Ascaris; the allergenic activity of Ascaris IgE-binding molecular components and the immunological and clinical influences of ascariasis on asthma. The analysis allows us to conclude that the impact o...

Outcome of 490 Desensitizations to Chemotherapy Drugs with a Rapid One-Solution Protocol. Authors:  Pérez-Rodríguez E, Martínez-Tadeo JA, Pérez-Rodríguez N, Hernández-Santana G, Callero-Viera A, Rodríguez-Plata E, García-Robaina JC. Abstract: BACKGROUND: Hypersensitivity reactions to chemotherapy drugs are quite frequent. Desensitization for chemotherapy drugs has become an option to maintain first-line therapy in patients who have suffered such reactions. OBJECTIVE: The objective of this study was to describe our experience in desensitization with antineoplastic agents using a rapid 1-solution protocol. METHODS: We performed a 3-year prospective observational study recording all patients who were desensitized with this protocol. All patients signed an informed consent. Skin test was performed at concentrations previously described as nonirritant. Desensitization was performed using only 1 solution of the drug prepared following the manufacturer instructions. Mos...

Anxiety and Depression Effects During Drug Provocation Test. Authors: Losappio LM, Cappai A, Arcolaci A, Badiu I, Bonadonna P, Boni E, Bussolino C, Caminati M, Galati P, Heffler E, Intravaia R, Mauro M, Massaro I, Romano A, Rumi G, Parolo A, Pizzimenti S, Nichelatti M, Pastorello EA. Abstract: BACKGROUND: Drug provocation test (DPT) represents the gold standard for the diagnosis of drug allergy. A DPT can be performed in a single-blind placebo-controlled manner. In anxiety and depressive disorders, patients need to be evaluated to understand the nature of placebo reactions. OBJECTIVE: The aim of this study was to evaluate the psychological profile of patients with reactions to placebo during a DPT. METHODS: We consecutively enrolled patients with suspected drug allergy undergoing a DPT preceded by the administration of the placebo. All patients underwent the Hospital Anxiety and Depression Scale (HADS), a questionnaire aimed to identify anxiety and depression, before ...

Sleep disorders and atopic dermatitis: A 2-way street? Authors:  Chang YS ,  Department of Pediatrics, Taipei City Hospital Renai Branch, Taipei, Taiwan; Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. Chiang BL,  Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: gicmbor@ntu.edu.tw. Abstract: Sleep disturbance is very common in patients with atopic dermatitis (AD) and is a major factor leading to impaired quality of life. Sleep disturbance is often viewed as one of the symptoms of AD and one of the measures of disease severity. In this review we describe a variety of sleep disorders associated with AD and a wide range of effect that sleep disorders have on patients with AD. We also discuss our current understa...

Pediatric asthma: an unmet need for more effective, focused treatments. Authors:   Papadopoulos NG, Čustović A, Cabana MD, Lee PR, Dell SD, Deschildre A, Hedlin G, Hossny E, Le Souëf P, Matricardi PM, Nieto A, Phipatanakul W, Pitrez PM, Pohunek P, Gavornikova M, Jaumont X, Price DB. Abstract: BACKGROUND: Despite remarkable advances in our understanding of asthma, there are still several unmet needs associated with the management of pediatric asthma. METHODS: A two-day, face-to-face, meeting was held in London, United Kingdom, on 28th and 29th October 2017 involving a group of international expert clinicians and scientists in asthma management to discuss the challenges and unmet needs that remain to be addressed in pediatric asthma. RESULTS: These unmet needs include a lack of clinical efficacy and safety evidence, and limited availability of non-steroid-based alternative therapies in patients <6 years of age. An increased focus on children is needed in the con...

Eosinophilic Esophagitis and the Eosinophilic Gastrointestinal Diseases: Approach to Diagnosis and Management. Authors: Steinbach EC , Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC. Hernandez M ,  Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC. Dellon ES , Center for Esophageal Diseases and Swallowing, Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC. Electronic address: edellon@med.unc.edu. Abstract: The eosinophilic gastrointestinal diseases (EGIDs) represent disorders of the gastrointestinal (GI) tract that result from the local infiltration and aberrant activity of eosinophils and other immune cells. Eosinophilic esophagitis (EoE) is the mo...

Allergen Extracts for In Vivo Diagnosis and Treatment of Allergy: Is There a Future? Authors:  Rudolf Valenta, MDa,b,c, Alexander Karaulov, MDc, Verena Niederberger, MDd, Yury Zhernov, PhDb, Olga Elisyutina, MDb, Raffaela Campana, PhDa, Margarete Focke-Tejkl, PhDa, Mirela Curin, PhDa, Leyla Namazova-Baranova, MDe, Jiu-Yao Wang, MD, PhDf, Ruby Pawankar, MD, PhDg, and Musa Khaitov, MDb V. aDepartment of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria bNRC Institute of Immunology FMBA of Russia, Moscow, Russia cLaboratory for Immunopathology, Department of Clinical Immunology and Alergy, Sechenov First Moscow State Medical University, Moscow, Russia dDepartment of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria eDepartment of Pediatrics, Pirogov Russian National Research Medical University, Moscow, Russia fCenter for Allergy and Immunology Research (ACIR), College ...

Molecular Aspects of Allergensand Allergy  Abstract Immunoglobulin E (IgE)-associated allergy is the most common immune disorder. More than 30% of the population suffer from symptoms of allergy which are often severe, disabling, and life threatening such as asthma and anaphylaxis. Population-based birth cohort studies show that up to 60% of the world population exhibit IgE sensitization to allergens, of which most are protein antigens. Thirty years ago the first allergenencoding cDNAs have been isolated. In the meantime, the structures of most of the allergens relevant for disease in humans have been solved. Here we provide an update regarding what has been learned through the use of defined allergen molecules (i.e., molecular allergology) and about mechanisms of allergic disease in humans. We focus on new insights gained regarding the process of sensitization to allergens, allergen-specific secondary immune responses, and mechanisms underlying allergic inflammation and discuss ...

Hipersensiblidad a glucocorticoides Dra. July Ospina (11 de Octubre de 2018)

Hypersensitivity reactions to therapeutic monoclonal antibodies: Phenotypes and endotypes Authors: Isabwe GAC, Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Department of Pediatrics, Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Garcia Neuer M, Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass. de Las Vecillas Sanchez L, Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass; Department of Allergy, Marqués de Valdecilla University Hospital-Instituto de Investigacion Marques de Valdecilla, Santander, Spain. Lynch DM, Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham ...

Next generation anti-S. aureus vaccines: a potential new therapeutic option for atopic dermatitis? Authors:  Clowry J , Pediatric Dermatology, Our Lady's Children's Hospital Crumlin, Dublin 12, Ireland; National Children's Research Centre, Our Lady's Children's Hospital Crumlin, Dublin 12, Ireland; Clinical Medicine, Trinity College Dublin, Dublin 2, Ireland. Irvine AD , Pediatric Dermatology, Our Lady's Children's Hospital Crumlin, Dublin 12, Ireland; National Children's Research Centre, Our Lady's Children's Hospital Crumlin, Dublin 12, Ireland; Clinical Medicine, Trinity College Dublin, Dublin 2, Ireland. McLoughlin RM , Host-Pathogen Interactions Group, School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland. Abstract:  Disease severity in patients with atopic dermatitis (AD) is directly correlated with colonization by Staphylococcus aureus.1 An increasing body of evidence now also supp...

Association of atopic dermatitis with depression, anxiety, and suicidal ideation in children and adults: A systematic review and meta-analysis. Authors: Rønnstad ATM, Halling-Overgaard AS, Hamann CR, Skov L, Egeberg A ; Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark. Thyssen JP ;  Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark; National Allergy Research Centre, Herlev and Gentofte Hospital, Hellerup, Denmark. Electronic address: jacob.p.thyssen@regionh.dk. Abstract:  BACKGROUND: Atopic dermatitis (AD) has been associated with anxiety and depression, but the magnitude of the alleged association is unknown. OBJECTIVE: To perform a systematic review and meta-analysis of the associatio...

Un cordial saludo. Para mí fue un honor que el Concejo de la Facultad de Medicina me postulara a la distinción “medalla Francisco José de Caldas a la excelencia Universitaria” 2018, Categoría plata. Solicitud que me dejó varias sensaciones encontradas. Si bien, tenía confianza en mi trayectoria académica y a lo largo de los años he dejado el alma en la Universidad de Antioquia como un buen hijo de esta madre que nutre a nativos y foráneos, tenía claro que ya era dueño de un enorme placer académico: ¡ser tenido en cuenta para este reconocimiento! ¿Quién era el sabio Caldas y por qué se cruzaban nuestros caminos, si somos dos seres tan distantes en el tiempo y tan distintos como personas? Investigando su muy productiva vida, interrumpida por un certero fogonazo, pensaba que mis mulas cargadas de conocimiento no se perdieron en un abismo de las vastas montañas andinas colombianas, y que, si bien eran muchas las diferencias entre ambos, teníamos “una mujer inspiradora” a qu...

Skin diseases associated with atopic dermatitis Authors:  Fenner J, Silverberg NB . Department of Dermatology, Mt Sinai West, Icahn School of Medicine at Mt Sinai, New York, NY. Abstract:  Atopic dermatitis is a common chronic pruritic inflammatory skin disorder, characterized by an abnormal skin barrier, immune dysfunction, and an altered skin microbiome. Atopic dermatitis may be seen in conjunction with a variety of other skin disorders due to the complex pathogenesis of atopic dermatitis, involving genetic and environmental factors that are associated with immune dysfunction, barrier defects, and altered skin microbiomes. Skin disorders associated with atopic dermatitis include diseases sharing similar genetic origins like ichthyosis vulgaris, infectious diseases such as impetigo, and eczema herpeticum, in addition to the cutaneous autoimmune diseases, alopecia areata, and vitiligo. Atopic dermatitis is also often linked to such benign conditions as pityri...

The microbial environment and its influence on asthma prevention in early life Authors: Von Mutius E , Department of Pediatrics, Dr von Hauner Children's Hospital of Ludwig Maximilian University of Munich, Munich, Germany. Electronic address: erika.von.mutius@med.lmu.de. Abstract:  There is accumulating evidence to suggest that the environmental microbiome plays a significant role in asthma development. The very low prevalence of asthma in populations highly exposed to microbial environments (farm children and Amish populations) highlights its preventive potential. This microbial diversity might be necessary to instruct a well-adapted immune response and regulated inflammatory responses to other inhaled and ingested environmental elements, such as allergens, particles, and viruses. Like the internal gut microbiome, which is increasingly recognized as an important instructor of immune maturation, the external environmental microbiome might shape immune responses on the s...

El día 9 de octubre de 2018 tendrá lugar en la Universidad de Antioquia la celebración del “día clásico”, en ella se entregará la distinción “Medalla Francisco José de Caldas a la Excelencia Universitaria”.  Esta medalla se otorga a profesores asociados o titulares de la Universidad de Antioquia, quienes hayan sobresalido por sus aportes a las ciencias, a las humanidades, artes o técnicas tanto a nivel nacional como internacional. Francisco José de Caldas nació en Popayán en Octubre de 1768 y muere fusilado en Santa fé de Bogotá, 29 de octubre de 1816  Era hijo de un español, Josef de Caldas y una criolla, Vicenta Thenorio Arboleda, nieta de español. Realizó sus primeros estudios en el Real Colegio Seminario de San Francisco de Asís, donde era maestro José Félix de Restrepo, quien llegó en 1782 y cumplió una meritoria labor tanto en la renovación de los métodos de enseñanza, como de los contenidos de los cursos. En 1788 se fue a Santa fé de Bogotá y, en el Colegio Mayor ...