ALERGOLOGÍA PARA MÉDICOS Y PACIENTES 2021

What's new in GINA 2019 (Dr. Jaime Sosa)

Recombinant allergens for immunotherapy: state of the art. Authors:  Zhernov Y1, Curin M2, Khaitov M1, Karaulov A3, Valenta R1,2,3. Author information 1 NRC Institute of Immunology FMBA of Russia, Moscow, Russia. 2 Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria. 3 Laboratory of Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russia. Abstract: PURPOSE OF REVIEW: More than 30 years ago, the first molecular structures of allergens were elucidated and defined recombinant allergens became available. We review the state of the art regarding molecular AIT with the goal to understand why progress in this field has been slow, although there is huge potential for treatment and allergen-specific prevention. RECENT FINDINGS: On the basis of allergen structures, ...

Association of basophil parameters with disease severity and duration in chronic spontaneous urticaria (CSU). Authors:  Huang AH1, Chichester KL1, Saini SS1. Johns Hopkins University School of Medicine, Department of Medicine, Division of Allergy and Clinical Immunology. Abstract: In this quantitative study, we evaluated the efectiveness and safety of fre needle therapy for nodular prurigo. We systematically searched several databases, including EMBASE, PubMed, the Cochrane Library, the Web of Science, the China Network Knowledge Infrastructure, the Wanfang Data Knowledge Service Platform, and the China Science and Technology Journal Database, and retrieved randomized controlled trials comparing conventional therapies (control group) with fre needle therapy alone or in combination with conventional therapies. Revman 5.2 sofware was used to calculate risk ratios (RR) with 95% confdence intervals (CI). In total, 14 trials with 1176 participants were included. Our ...

Efficacy and Safety of Fire Needle Therapy for Nodular Prurigo: A Quantitative Study Authors:  Yue Luo,1,2 Le Kuai,1,2 Ningjing Song,3 Xiaojie Ding,1 Xiaoying Sun,2 Ying Luo,1 Yi Ru,1 Seokgyeong Hong,1 Meng Xing,1 Mi Zhou,1 Bin Li,1,2,4 and Xin Li1,2 1 Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China 2 Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China 3 Department of Dermatology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200050, China 4 Department of Dermatology, Shaanxi Traditional Chinese Medicine Hospital, Xi’an 710003, China Abstract: In this quantitative study, we evaluated the effectiveness and safety of fire needle therapy for nodular prurigo. We systematically searched several databases, including EMBASE, PubMed, the Cochrane Library, the Web of Sc...

Eczematous reactions to food in atopic eczema: position paper of the EAACI and GA2LEN Authors: T.  Werfel B. Ballmer‐Weber  P. A. Eigenmann  B. Niggemann  F. Rancé K. Turjanmaa  M. Worm Prof Dr T. Werfel Departments of Dermatology and Allergology Hannover Medical School Ricklinger Str 5 D‐30449 Hannover Tel.: 49 511 9246319 fax: 49 511 9246440 Abstract:  Food allergy and atopic eczema (AE) may occur in the same patient. Besides typical immediate types of allergic reactions (i.e. noneczematous reactions) which are observed in patients suffering from AE, it is clear that foods, such as cow’s milk and hen’s eggs, can directly provoke flares of AE, particularly in sensitized infants. In general, inhaled allergens and pollen‐related foods are of greater importance in older children, adolescents and adults. Clinical studies have revealed that more than 50% of affected children with AE that can be exacerbate...

Modified Recombinant Allergens for Safer Immunotherapy Authors:  Fátima Ferreira, Peter Briza, Daniela Inführ, Georg Schmidt, Michael Wallner, Nicole Wopfner, Josef Thalhamer and Gernot Achatz Department of Molecular Biology, University of Salzburg, A-5020 Salzburg, Austria Abstract:  Molecular cloning and recombinant production of allergens offered new perspectives for the increasing problem of allergies. A variety of preparations are being developed aiming to increase safety and improve efficacy of specific immunotherapy. Recombinant-based approaches are mostly focused on genetic modification of allergens to produce molecules with reduced allergenic activity and conserved antigenicity, i.e. hypoallergens. Studies dealing with genetic modifications of allergen genes reported the production of site-directed mutants, deletion mutants, allergen fragments and oligomers, and allergen chimeras. An alternative to genetic engineering is the chemical modification of pure ...

Skin bacterial transplant in atopic dermatitis: Knowns, unknowns and emerging trends. Authors:  Hendricks AJ1, Mills BW2, Shi VY3. 1 University of Arizona College of Medicine, Tucson, AZ USA. 2 Texas Tech Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, TX USA. 3 University of Arizona Department of Medicine, Division of Dermatology, Tucson, AZ USA. Electronic address: vshi@email.arizona.edu. Abstract: Dysbiosis is a key pathogenic factor in the cycle of  skin  barrier impairment and inflammation in  atopic   dermatitis  (AD).  Skin  microbial composition in AD is characterized by increased presence of Staphylococcus aureus (S. aureus) and decrease in microbial diversity and commensal  bacterial  species. Attenuation of S. aureus-driven inflammation aids in breaking the itch-scratch cycle via modulation of the cutaneous immune response.  Skin   bacterial   transplant  (SBT), a f...

Assessment of Opioid Cross-reactivity and Provider Perceptions in Hospitalized Patients With Reported Opioid Allergies. Authors:  Powell MZ1, Mueller SW1, Reynolds PM1. 1 University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA. Abstract: Background: The incidence of opioid allergy cross-reactivity in hospitalized patients with historical opioid allergies remains unknown. Objectives: The purpose of this study was to characterize the incidence of newly suspected IgE-mediated reactions (IMRs) based on clinical criteria among patients with a chart-documented opioid allergy and to assess clinician perceptions of opioid allergies. Methods: This retrospective cohort study was conducted in hospitalized adults with a historically documented opioid allergy who received a subsequent opioid. The primary outcome was the incidence of allergic cross-reactivity between clinical and chemical opioid classes in patients with historical IMRs (H-IM...

Cholinergic urticaria: epidemiology, physiopathology, new categorization, and management. Authors:  Fukunaga A1, Washio K2,3, Hatakeyama M2, Oda Y2, Ogura K2, Horikawa T4, Nishigori C2. 1 Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. atsushi@med.kobe-u.ac.jp. 2 Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. 3 Division of Dermatology, Nishi-Kobe Medical Center, 5-7-1 Koji-Dai, Nishi-ku, Kobe, 651-2273, Japan. 4 Ueda Dermatology Clinic, 1654-5 Harima-cho Nozoe, Nishi-ku, Kako-Gun, 675-0151, Japan. Abstract:  PURPOSE: The aim of this study was to review the evidence on the epidemiology, physiopathology, categorization, and management of cholinergic urticaria. We specifically focused on several subtypes of cholinergic urticaria and inves...

The role of component-resolved diagnosis in Hymenoptera venom allergy. Authors:  Bilò MB1, Ollert M2,3, Blank S4. 1 Allergy Unit, Department of Internal Medicine, University Hospital of Ancona - Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy. 2 Department of Infection and Immunity, Luxembourg Institute of Health (LIH), Esch-sur-Alzette, Luxembourg. 3 Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, University of Southern Denmark, Odense, Denmark. 4 Center of Allergy and Environment (ZAUM), Technical University of Munich, School of Medicine, and Helmholtz Center Munich, German Research Center for Environmental Health, Munich, Germany. Abstract:  PURPOSE OF REVIEW: Component-resolved diagnostics (CRD) is a new tool aiming at detecting IgE-mediated sensitizations against individual, relevant allergens. Here, we discuss recent literature on molecular diagnosis in the field of Hymen...

Transfusion reactions: prevention, diagnosis, and treatment. Authors:  Delaney M1, Wendel S2, Bercovitz RS3, Cid J4, Cohn C5, Dunbar NM6, Apelseth TO7, Popovsky M8, Stanworth SJ9, Tinmouth A10, Van De Watering L11, Waters JH12, Yazer M13, Ziman A14; Biomedical Excellence for Safer Transfusion (BEST) Collaborative. 1 Bloodworks NW, Seattle, WA, USA; University of Washington, Department of Laboratory Medicine, Seattle, WA, USA. Electronic address: meghand@bloodworksnw.org. 2 Hospital Sirio Libanes Blood Bank, Sao Paulo, Brazil. 3 BloodCenter of Wisconsin, Milwaukee, WI, USA. 4 Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital Clínic, UB, Barcelona, Spain. 5 Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA. 6 Department of Pathology and Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA. 7 Laboratory of Clinical Biochemistry and Department of Immunology and Transfu...

The asymptomatic patient with eosinophilic esophagitis To treat or not to treat? Authors: Chehade M1, Nowak-Wegrzyn A2. 1 Mount Sinai Center for Eosinophilic Disorders, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: mirna.chehade@mssm.edu. 2 Jaffe Food Allergy Institute, Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY. doi:   10.1016/j.anai.2019.03.035 Minimally symptomatic patients with eosinophilic esophagitis should still be actively treated-CON. Author: Lieberman JA 1. 1 Division of Allergy and Immunology, The University of Tennessee Health Science Center, LeBonheur Children's Hospital, Memphis, Tennessee. Electronic address: Jlieber1@uthsc.edu. doi:  10.1016/j.anai.2018.11.020 Component resolved diagnostic testing adds clinical utility over existing testing for food allergy-PRO. Author: Anagnostou A1.  1Texas Children's Hospital Division of Immu...

Nonclonal Mast Cell Activation Syndrome: A Growing Body of Evidence Author:  Hamilton MJ 1. 1 Division of Gastroenterology, Hepatology, and Endoscopy, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. Electronic address: mjhamilton@bwh.harvard.edu. Abstract: Patients who present with typical features of mast cell activation with laboratory confirmation and without evidence of a clonal mast cell disorder or other medical condition should be initiated on medical treatment to block mast cells and their mediators. If a major response is achieved, a diagnosis of nonclonal mast cell activation syndrome (NC-MCAS) is likely and treatment should be optimized, including management of any associated conditions. In this review, the latest evidence with regard to the diagnosis and treatment of NC-MCAS is presented. doi:   10.1016/j.iac.2018.04.002

Hypersensitivity reactions to food and drug additives: problem or myth? Authors: Laura Andreozzi1, Arianna Giannetti1, Francesca Cipriani1, Carlo Caffarelli2, Carla Mastrorilli2, Giampaolo Ricci1 1 Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy;  2 Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy Abstract: Background and aim of the work: The possibility of an allergic reaction or an intolerance to additives is frequently suspected by parents, especially for chronic illness with frequent exacerbations such as atopic dermatitis or chronic urticaria. For more than 50 years, potential adverse reactions to additives have been suggested, but to date data are conflicting. The purpose of this article is to provide the clinicians with general information about additives and adverse reactions to them and to suggest a practical approach to childr...

Cow’s Milk Allergy: Immunomodulation by Dietary Intervention Authors: Enza D’Auria 1,*, Silvia Salvatore 2, Elena Pozzi 1, Cecilia Mantegazza 1, Marco Ugo Andrea Sartorio 1, Licia Pensabene 3, Maria Elisabetta Baldassarre 4 , Massimo Agosti 2, Yvan Vandenplas 5 and GianVincenzo Zuccotti 1 1  Department of Pediatrics, Vittore Buzzi Children’s Hospital-University of Milan, 20154 Milan, Italy; elena.pozzi@asst-fbf-sacco.it (E.P.); cecilia.mantegazza@asst-fbf-sacco.it (C.M.); marcoua.sartorio@gmail.com (M.U.A.S.); gianvincenzo.zuccotti@unimi.it (G.V.Z.) 2 Department of Pediatrics, Ospedale “F. Del Ponte”, University of Insubria, 21100 Varese, Italy; silvia.salvatore@uninsubria.it (S.S.); massimo.agosti@uninsubria.it (M.A.) 3 Department of Medical and Surgical Sciences, Pediatric Unit, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; pensabene@unicz.it 4 Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human On...

Characteristics of NSAID‐induced hypersensitivity reactions in childhood Authors: Cavkaytar O1, du Toit G2, Caimmi D3,4. 1 Department of Pediatric Allergy, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey. 2 Department of Pediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK. 3 Allergy Unit, Department of respiratory diseases, University Hospital of Montpellier, Univ Montpellier, Montpellier, France. 4 Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Pierre Louis Institute of Epidemiology and Public Health, Saint-Antoine Medical School, Sorbonne Université, INSERM, Paris, France. Abstract:  Non-steroidal anti-inflammatory drugs (NSAIDs) are available as over-the-counter drugs, and they are commonly used in children for their antipyretic, analgesic, and anti-inflammatory effects. NSAIDs are among the most frequently...