ALERGOLOGÍA PARA MÉDICOS Y PACIENTES 2021

 Age at introduction to complementary solid food and food allergy and sensitization: A systematic review and meta-analysis Authors: John A Burgess  1 , Shyamali C Dharmage  1   2 , Katrina Allen  2   3 , Jennifer Koplin  2 , Vanessa Garcia-Larsen  4 , Robert Boyle  5 , Nilakshi Waidyatillake  1 , Caroline J Lodge  1 Abstract Background and objective: An infant's age at introduction of complementary solids may contribute to food allergy. We aimed to synthesize the literature on the association between age at introduction of complementary solids, excluding milk products, and food allergy and sensitization. Design: We searched the electronic databases PubMed and EMBASE (January 1946-February 2017) using solid food, allergy and sensitization terms. Methods: Two authors selected papers according to inclusion criteria, identifying 16 cohort studies, 1 case-control study and 8 randomized controlled trials (RCTs). Pooled effects across stu...

 Peptic Ulcer Disease is Associated with Increased Risk of Chronic Urticaria Independent of Helicobacter pylori Infection: A Population-Based Cohort Study Authors: Chun-Ming Chen  1   2 , Wan-Ting Huang  3 , Li-Jen Chang  4 , Chih-Cheng Hsu  5   6 , Yueh-Han Hsu   Abstract Background: Some studies showed patients with chronic urticaria have a higher rate of peptic ulcer disease (PUD). Whether PUD is a risk factor for chronic urticaria is unclear. Objective: The objective of this study was to evaluate the incidence of and risk factors for chronic urticaria in patients with PUD using the Taiwan National Health Insurance Research Database. Methods: We conducted a retrospective nationwide cohort study of the period 2000-2012 and involving 11,901 patients with PUD who underwent Helicobacter pylori (HP) therapy (PUD + HP group) and an equal number of matched patients without HP infection (PUD - HP group). Furthermore, we enrolled 23,802 patients without...

 Paracetamol exposure in pregnancy and early childhood and development of childhood asthma: a systematic review and meta-analysis Authors: M Cheelo  1 , C J Lodge  1 , S C Dharmage  2 , J A Simpson  3 , M Matheson  1 , J Heinrich  4 , A J Lowe  2 Affiliations  expand Abstract Background and objective: While paracetamol exposure in pregnancy and early infancy has been associated with asthma, it remains unclear whether this is confounded by respiratory tract infections, which have been suggested as an alternative explanation. We undertook a systematic review and meta-analysis of longitudinal studies that reported the association between paracetamol exposure during pregnancy or infancy and the subsequent development of childhood asthma (≥5 years). Methods: Two independent researchers searched the databases EMBASE and PUBMED on 12 August 2013 for relevant articles using predefined inclusion and exclusion criteria. Study quality was assessed and r...

 Global Trends in Anaphylaxis Epidemiology and Clinical Implications Authors: Paul J Turner  1 , Dianne E Campbell  2 , Megan S Motosue  3 , Ronna L Campbell  4 Abstract The true global scale of anaphylaxis remains elusive, because many episodes occur in the community without presentation to health care facilities, and most regions have not yet developed reliable systems with which to monitor severe allergic events. The most robust data sets currently available are based largely on hospital admissions, which are limited by inherent issues of misdiagnosis, misclassification, and generalizability. Despite this, there is convincing evidence of a global increase in rates of all-cause anaphylaxis, driven largely by medication- and food-related anaphylaxis. There is no evidence of parallel increases in global all-cause anaphylaxis mortality, with surprisingly similar estimates for case-fatality rates at approximately 0.5% to 1% of fatal outcomes for hospitalizations d...

 Cyclosporine for Chronic Spontaneous Urticaria: A Meta-Analysis and Systematic Review Authors: Kanokvalai Kulthanan  1 , Pichanee Chaweekulrat  1 , Chulaluk Komoltri  2 , Saowalak Hunnangkul  2 , Papapit Tuchinda  3 , Leena Chularojanamontri  1 , Marcus Maurer  4 Abstract Background: Despite widely recommended usage of cyclosporine A (CsA) in chronic spontaneous urticaria (CSU), there is no meta-analysis concerning its efficacy and safety. Objective: To meta-analyze and review the efficacy and safety of CsA in CSU. Methods: Efficacy was assessed by the relative change in urticaria activity score at 4 weeks and response rates at 4, 8, and 12 weeks. Safety was assessed by analyzing the number of patients with 1 or more adverse event. Results: Eighteen studies (909 participants) including 2 randomized controlled trials were included, with 125, 363, and 266 patients with CSU receiving very low (<2 mg/kg/d), low (from 2 to< 4 mg/kg/d), and moder...

 Chronic urticaria and thyroid pathology Authors: Sandra Nora Gonzalez-Diaz,a Mario Sanchez-Borges,b Diana Maria Rangel-Gonzalez,a,∗ Rosa Ivett Guzman-Avilan,a Jose Ignacio Canseco-Villarreal,a and Alfredo Arias-Cruza Abstract Urticaria is defined as the sudden appearance of erythematous, itchy wheals of variable size, with or without angioedema (AE) (swelling of the deeper layers of the skin). Its classification depends on time course of symptoms and the presence of eliciting factors. When it lasts less than 6 weeks it is classified as acute urticaria (AU), and if the symptoms persist for more than 6 weeks, it is classified as chronic urticaria (CU). Current International Guidelines also classify CU as chronic spontaneous urticaria (CSU) and inducible urticarial, according to the absence or presence of environmental triggering factors. CSU is defined as urticaria and/or angioedema in which there is no evidence of a specific eliciting factor. CSU is associated with autoimmunity in ...

 Drug allergy in children and adults: Is it the double X chromosome? Authors: Allison Eaddy Norton  1 , Ana Dioun Broyles  2 Abstract Objective: This article reviews the latest science and epidemiologic studies related to drug allergy in children and adults to explore possible mechanisms related to female propensity for drug allergy. Data sources: PubMed literature review, focusing primarily on the last 5 years. Study selections: Articles reviewing the science behind female predisposition to atopic and asthmatic conditions and epidemiologic studies reviewing drug allergy and drug-induced anaphylaxis. Results: Despite adult female predilection for atopic conditions, few laboratory studies explore sex-specific mechanisms in atopic/allergic diseases, and most are focused on autoimmunity and asthma. Drug allergy is more frequently reported in adult females compared with adult males. Adult females are also more likely to have drug-induced anaphylaxis (DIA), although no clear s...

 Epicutaneous sensitization in the development of food allergy: What is the evidence and how can this be prevented? Authors: Helen A. Brough  Kari C. Nadeau  Sayantani B. Sindher  Shifaa S. Alkotob  Abstract There is increasing evidence regarding the importance of allergic sensitization through the skin. In this review, we provide an overview of the atopic march and immune mechanism underlying the sensitization and effector phase of food allergy. We present experimental models and human data that support the concept of epicutaneous sensitization and how this forms one half of the dual‐allergen exposure hypothesis. We discuss specific important elements in the skin (FLG and other skin barrier gene mutations, Langerhans cells, type 2 innate lymphoid cells, IL‐33, TSLP) that have important roles in the development of allergic responses as well as the body of evidence on environmental allergen exposure and how this can sensitize an individual. Given the link between...

Ligelizumab for Chronic Spontaneous Urticaria Authors:  Marcus Maurer, M.D., Ana M. Giménez-Arnau, M.D., Ph.D., Gordon Sussman, M.D., Martin Metz, M.D., Diane R. Baker, M.D., Andrea Bauer, M.D., Jonathan A. Bernstein, M.D., Randolf Brehler, M.D., Chia-Yu Chu, M.D., Ph.D., Wen-Hung Chung, M.D., Inna Danilycheva, M.D., Clive Grattan, M.D., et al. Abstract BACKGROUND In the majority of patients with chronic spontaneous urticaria, most currently available therapies do not result in complete symptom control. Ligelizumab is a next-generation high-affinity humanized monoclonal anti-IgE antibody. Data are limited regarding the dose–response relationship of ligelizumab and the efficacy and safety of ligelizumab as compared with omalizumab and placebo in patients who have moderate-to-severe chronic spontaneous urticaria that is inadequately controlled with H1-antihistamines at approved or increased doses, alone or in combination with H2-antihistamines or leukotriene-receptor antagonists. MET...

 EAACI position paper on how to classify cutaneous manifestations of drug hypersensitivity Authors: Knut Brockow  1 , Michael R Ardern-Jones  2   3 , Maja Mockenhaupt  4 , Werner Aberer  5 , Annick Barbaud  6 , Jean-Christoph Caubet  7 , Radoslaw Spiewak  8 , María José Torres  9 , Charlotte G Mortz  10 Abstract Drug hypersensitivity reactions (DHRs) are common, and the skin is by far the most frequently involved organ with a broad spectrum of reaction types. The diagnosis of cutaneous DHRs (CDHR) may be difficult because of multiple differential diagnoses. A correct classification is important for the correct diagnosis and management. With these guidelines, we aim to give precise definitions and provide the background needed for doctors to correctly classify CDHR. DOI 10.1111/all.13562