ALERGOLOGÍA PARA MÉDICOS Y PACIENTES 2021

Prostaglandin D2 receptor antagonists in allergic disorders: safety, efficacy, and future perspectives. Authors: Marone G1,2, Galdiero MR3,4, Pecoraro A3,4, Pucino V5, Criscuolo G3,4, Triassi M1, Varricchi G3,4. 1 a Department of Public Health , University of Naples Federico II , Naples , Italy. 2 b Monaldi Hospital Pharmacy , Naples , Italy. 3 c Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI) , University of Naples Federico II , Naples , Italy. 4 d WAO Center of Excellence , Naples , Italy. 5 e William Harvey Research Institute, Barts and The London School of Medicine &Dentistry , Queen Mary University of London , London , UK. Abstract: Prostaglandin D2 (PGD2) is a major cyclooxygenase mediator that is synthesized by activated human mast cells and other immune cells. The biological effects of PGD2 are mediated by D-prostanoid (DP1), DP2 (CRTH2) and thromboxane prostanoid (TP) receptors that are expressed on s...

Reacciones adversas a aditivos Dr. Luis Carlos Santamaría (Diciembre de 2018)

Thyroid Autoimmunity and Autoimmunity in Chronic Spontaneous Urticaria Linked to Disease Severity, Therapeutic Response, and Time to Remission in Patients with Chronic Spontaneous Urticaria. Authors:  Chanprapaph K, Iamsumang W, Wattanakrai P, Vachiramon V .  Division of Dermatology, Department of Internal Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. Abstract:  BACKGROUND: Chronic spontaneous urticaria (CSU) is autoimmune in nature and associated with thyroid autoimmunity (TA), but evidence on autoimmunity in relation to CSU progression and prognosis is limited. We evaluated whether TA and autoimmunity in CSU are correlated with disease severity, therapeutic response, and time to remission and establish an association between CSU characteristics linked to thyroid autoantibody. METHODS: Medical records of patients diagnosed with urticaria attending outpatient dermatology clinic at a university-based hospital from 2013 to 2017 were ...

Unproven Diagnostic Tests for Adverse Reactions to Foods Authors: John M. Kelso , Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, Calif. Abstract: Patients often seek opinions from allergists regarding unconventional testing for adverse reactions to foods. These tests include flow cytometry to measure the change in white blood cell volumes after incubation with foods, measurement of serum IgG or IgG4 antibodies directed against foods, intradermal provocation-neutralization with food allergens, hair analysis, electrodermal testing, and applied kinesiology. In some cases, although the laboratory methods may be valid, there are no studies showing correlation with disease. In other cases, blinded, controlled studies have shown a lack of reproducibility and a lack of correlation with disease. Most of the tests lack biologic plausibility. By understanding the methodology of these tests and the lack of evidence supporting their utility, allergists can ...

"Doctor, I have a Sulfa Allergy": Clarifying the Myths of Cross-Reactivity. Authors: Shah TJ1, Moshirfar M2,3,4, Hoopes PC Sr5. 1 University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA. 2 John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA. cornea2020@me.com. 3 HDR Research Center, Hoopes Vision, Draper, UT, USA. cornea2020@me.com. 4 Utah Lions Eye Bank, Murray, UT, USA. cornea2020@me.com. 5 HDR Research Center, Hoopes Vision, Draper, UT, USA. Abstract: Our purpose is to present an evidence-based approach, directed primarily towards eye-care specialists, clarifying whether certain drugs should or should not be used in patients with sulfonamide allergy. We conducted a literature search using PubMed to identify the risk of ophthalmic-specific drugs in patients with a self-reported sulfonamide allergy. MeSH key words included "sulfonamide" and "hyperse...

Fisiopatología del asma Dra. Catalina López (Diciembre de 2018)

Long-term prophylaxis therapy in patients with hereditary angioedema with C1 inhibitor deficiency. Authors: Craig T1, Busse P2, Gower RG3, Johnston DT4, Kashkin JM5, Li HH6, Lumry WR7, Riedl MA8, Soteres D9. 1 Department of Medicine and Pediatrics, Penn State Hershey Allergy, Asthma, and Immunology, Hershey, Pennsylvania. Electronic address: tcraig@pennstatehealth.psu.edu. 2 Icahn School of Medicine at Mount Sinai, New York, New York. 3 Marycliff Clinical Research, Spokane, Washington. 4 Asthma & Allergy Specialists, Charlotte, North Carolina. 5 Jay M Kashkin, MD Allergy, Asthma and Immunology, Fair Lawn, New Jersey. 6 Institute for Asthma and Allergy, Chevy Chase, Maryland. 7 Allergy and Asthma Research Associates, Dallas, Texas. 8 University of California, San Diego, La Jolla, California. 9 Asthma and Allergy Associates PC, Colorado Springs, Colorado. Abstract: OBJECTIVE: To review the criteria for long-term prophylaxis therapy in patients with hereditary angi...

Landscape Plant Selection Criteria for the Allergic Patient. Authors: Green BJ1, Levetin E2, Horner WE3, Codina R4, Barnes CS5, Filley WV6. 1 Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WVa. Electronic address: dox6@cdc.gov. 2 Department of Biological Science, University of Tulsa, Tulsa, Okla. 3 UL Environment, Marietta, Ga. 4 Allergen Science and Consulting, Lenoir, NC. 5 Division of Allergy/Immunology, Children's Mercy Hospital, Kansas City, Mo. 6 Oklahoma Allergy & Asthma Clinic, University of Oklahoma Health Science Center, Oklahoma City, Okla. Abstract: Patients with pollen-related allergies are concerned about the species within their landscape that provoke their symptoms. Allergists are often asked for guidance but few information sources are available to aid patients in the recognition of allergenic plants and str...

Cross-Reactive Aeroallergens: Which Need to Cross Our Mind in Food Allergy Diagnosis? Authors:  Faber MA1, Van Gasse AL2, Decuyper II2, Sabato V1, Hagendorens MM2, Mertens C1, Bridts CH1, De Clerck LS1, Ebo DG3. 1 Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium. 2 Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Science, Department of Pediatrics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium. 3 Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium. Electronic address: immuno@uantwerpen.be. Abstract: Secondary food allergies due to cross-reactivity between inhalant and food a...

Hypersensitivity reactions to beta-lactams in children Authors:  Francois Graham (a), Sophia Tsabouri (b), and Jean-Christoph Caubet (a) a Division of Pediatric Allergy, Department of Pediatrics, Pediatric Allergy Unit, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland and b Department of Paediatrics, Child Health Department, University of Ioannina, School of Medicine, Ioannina, Greece Abstract: Purpose of review To present the most recent evidence on beta-lactam hypersensitivity reactions in children. Recent findings Drug provocation tests (DPTs) are the gold standard when investigating beta-lactam allergy in children and evidence is increasingly supporting DPTs without skin tests as a safe approach when evaluating children with nonimmediate mild reactions to beta-lactams. Of note, data are limited in the adolescent population, and this attitude may not apply to this age group. Standardization of DPT protocols is required in nonimmediate r...

Fisiopatología de la rinitis (Dra. Gloria Gil) Diciembre de 2018

Systemic Treatment for Severe Atopic Dermatitis Authors: Mara Giavina‑Bianchi, Pedro Giavina‑Bianchi Division of Clinical Immunology and Allergy, University of São Paulo School of Medicine, Artur Ramos 178 ap.211A, Jd. América, São Paulo, SP CEP: 01454-904, Brazil Abstract: Atopic dermatitis (AD) is a chronic inflammatory, relapsing disease of the skin, characterized by intense pruritus, maculopapular or vesicular erythematous lesions and scaling, sometimes accompanied by oozing, crusts and/or lichenification that has a negative impact on patients’ quality of life. Prevalence is higher in children, around 15%, and approximately 5% in adults. Before introducing systemic therapy, it is mandatory to review patients’ adherence to the correct use of topical treatments (corticosteroids, calcineurin inhibitors or cresoborole) and/or phototherapy. Ensure that environmental measures are being taken care of, irritant or proven allergic substances are not in use and even if the diagnost...

Role of group 2 innate lymphocytes in aspirin-exacerbated respiratory disease pathogenesis Authors: Andrew A. White, M.D.,1 and Taylor A. Doherty, M.D.2 1 Divison of Allergy, Asthma and Immunology, Scripps Clinic, La Jolla, California, and 2 Department of Medicine, University of California, San Diego, La Jolla, California Abstract: Aspirin-exacerbated respiratory disease (AERD) is characterized by chronic eosinophilic nasal polyps, asthma, and airway reactions upon cyclooxygenase (COX) 1 inhibition. AERD is present in up to 7% of adult patients with asthma and the underlying pathogenesis remains largely elusive but prostaglandin D2, cysteinyl leukotrienes, mast cells, and type 2 cytokines are thought to contribute. A wealth of studies have recently implicated group 2 innate lymphoid cells (ILC2), a novel lineage negative lymphocyte population that produces type 2 cytokines, in human allergic disease pathogenesis. Importantly, our recent work identified that ILC2s are recru...

Non-IgE-mediated food hypersensitivity Authors:  Lori Connors1, Andrew O’Keefe2, Lana Rosenfeld3,5 and Harold Kim4,5 1 Dalhousie University, Halifax, NS, Canada. 2 Memorial University, St. John’s, NL, Canada. 3 University of Manitoba, Winnipeg, MB, Canada. 4 Western University, London, ON, Canada. 5 McMaster University, Hamilton, ON, Canada. Abstract: Non-immunoglobulin E (IgE)-mediated food hypersensitivity includes a spectrum of disorders that predominantly afect the gastrointestinal tract. This review will focus on the following more common non-IgE-mediated food hypersensitivity syndromes: food protein-induced enterocolitis syndrome (FPIES), allergic proctocolitis (AP), food protein-induced enteropathy (FPE) and celiac disease. FPIES, AP and FPE typically present in infancy and are most commonly triggered by cow’s milk protein or soy. The usual presenting features are profuse emesis and dehydration in FPIES; blood-streaked and mucousy stools in AP; and protracted dia...

Generalidades sobre enfermedad respiratoria exacerbada por AINEs Dra. Yurlany Gutiérrez (Diciembre de 2018)

How the Smartphone Is Changing Allergy Diagnostics Authors:  Ana Margarida Pereira1,2 & Cristina Jácome2 & Rute Almeida2 & João Almeida Fonseca1,2,3,4 1 Allergy Unit, Instituto and Hospital CUF, Porto, Portugal 2 CINTESIS- Center for Health Technologies and Information Systems Research, Faculty of Medicine, University of Porto, Porto, Portugal 3 MEDCIDS - Department of Community Medicine, Health Information and Decision, Faculty of Medicine, University of Porto, Porto, Portugal 4 MEDIDA – Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal Abstract: Purpose of Review Evidence-based clinical diagnosis of allergic disorders is increasingly challenging. Clinical decision support systems implemented in mobile applications (apps) are being developed to assist clinicians in diagnostic decisions at the point of care. We reviewed apps for allergic diseases general diagnosis, diagnostic refinement and diagnostic personalisation. Apps de...

Causal Relationship Between Anti-TPO IgE and Chronic Urticaria by In Vitro and In Vivo Tests Authors:  Jorge Sánchez,1,2* Andres Sánchez,1,2,3 Ricardo Cardona1 1 Group of Experimental and Clinical Allergy, IPS Universitaria, University of Antioquia, Medellín, Colombia 2 Foundation for the Development of Medical and Biological Sciences, Cartagena, Colombia 3 Immunology Department, University Corporation Rafael Núñez, Cartagena, Colombia Abstract:  Purpose: Immunoglobulin (Ig) E autoantibodies against thyroid antigens such as thyroid peroxidase (TPO) have been demonstrated in chronic spontaneous urticaria (CSU) patients in higher frequency than healthy subjects. However, if these IgE autoantibodies can trigger urticaria is still a matter of study. The aim of this study was to investigate the relationship between concomitant IgE autoantibodies against thyroid antigens in CSU. Methods: Patients with CSU, healthy subjects and patients with autoimmune thyroid d...

Managing Severe Asthma: A Role for the Long-Acting Muscarinic Antagonist Tiotropium Authors: Eckard Hamelmann, Children’s Center Bethel, Ev. Klinikum Bielefeld gGmbH, Grenzweg 10, 33617 Bielefeld, Germany Abstract: Severe asthma is associated with substantial morbidity and mortality. Terapies must be maximized to gain control of a patient’s severe asthma; however, avoiding overtreatment is also important. Te mainstays of asthma maintenance treatment are inhaled corticosteroids (ICS) and long-acting �2-agonsits (LABAs), with the option of supplementary add-on treatments. New add-on treatments for severe asthma have emerged over the past two decades, including personalized biological therapies that are guided by a patient’s asthma phenotype. In addition, the long-acting muscarinic antagonist tiotropium has been recommended as an addon treatment for severe asthma. Phase III clinical trials have shown tiotropium in combination with ICS/LABA to be efcacious in patients wit...

Cow’s Milk Protein Allergy in Infancy: A Risk Factor for Functional Gastrointestinal Disorders in Children? Authors Licia Pensabene 1,* ,†, Silvia Salvatore 2,†, Enza D’Auria 3,†, Francesca Parisi 1 ,  Daniela Concolino 1 , Osvaldo Borrelli 4 , Nikhil Thapar 4 , Annamaria Staiano 5 ,  Yvan Vandenplas 6 and Miguel Saps 7 1 Department of Medical and Surgical Sciences, Pediatric Unit, University “Magna Graecia” of Catanzaro 88100 Catanzaro, Italy; parisifrancesca01983@gmail.com (F.P.); dconcolino@unicz.it (D.C.) 2 Department of Medicine and Surgery, Section of Pediatrics, University of Insubria,21100 Varese, Italy; silvias.varese@gmail.com 3 Department of Pediatrics, Vittore Buzzi Children’s Hospital-University of Milan, 20154 Milan, Italy; enza.dauria@unimi.it 4 Neurogastroenterology and Motility Unit, Department of Gastroenterology, Great Ormond Street Hospital for Children, London WC1N 3JH, UK; Osvaldo.Borrelli@gosh.nhs.uk (O.B.); Nikhil.Thapar@gosh.nhs.uk (N.T.)...