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Acta Bio-medica : Atenei Parmensis Nov 2021Prevalence of food allergy has been increasing over the last decades. It may appear as an immediate or a delayed reaction. The disease has a major impact on the quality... (Review)
Review
Prevalence of food allergy has been increasing over the last decades. It may appear as an immediate or a delayed reaction. The disease has a major impact on the quality of life of patients and their families, and it is associated to elevated costs. Primary care physicians are the first healthcare providers who assist children with food allergy, especially in mild to moderate forms. Through the present review, we examine the steps that should be followed in primary care to manage food allergy, and to promptly prescribe an elimination diet and an emergency kit in case of accidental exposure to the allergen. We also focus on the special management of IgE and non-IgE mediated cow's milk allergy, and on management and prevention of egg and peanuts allergy.
Topics: Animals; Cattle; Female; Food Hypersensitivity; Humans; Immunoglobulin E; Infant; Milk Hypersensitivity; Primary Health Care; Quality of Life
PubMed: 34842586
DOI: 10.23750/abm.v92iS7.12416 -
Italian Journal of Pediatrics Mar 2024Exercise-induced bronchoconstriction (EIB) is characterized by the narrowing of airways during or after physical activity, leading to symptoms such as wheezing,... (Review)
Review
Exercise-induced bronchoconstriction (EIB) is characterized by the narrowing of airways during or after physical activity, leading to symptoms such as wheezing, coughing, and shortness of breath. Distinguishing between EIB and exercise-induced asthma (EIA) is essential, given their divergent therapeutic and prognostic considerations. EIB has been increasingly recognized as a significant concern in pediatric athletes. Moreover, studies indicate a noteworthy prevalence of EIB in children with atopic predispositions, unveiling a potential link between allergic sensitivities and exercise-induced respiratory symptoms, underpinned by an inflammatory reaction caused by mechanical, environmental, and genetic factors. Holistic management of EIB in children necessitates a correct diagnosis and a combination of pharmacological and non-pharmacological interventions. This review delves into the latest evidence concerning EIB in the pediatric population, exploring its associations with atopy and sports, and emphasizing the appropriate diagnostic and therapeutic approaches by highlighting various clinical scenarios.
Topics: Humans; Child; Bronchoconstriction; Hypersensitivity; Sports; Asthma, Exercise-Induced; Exercise; Hypersensitivity, Immediate
PubMed: 38475842
DOI: 10.1186/s13052-024-01594-0 -
Current Opinion in Allergy and Clinical... Apr 2024Healthcare disparities impact prevalence, diagnosis, and management of allergic disease. The purpose of this review is to highlight the most recent evidence of... (Review)
Review
PURPOSE OF REVIEW
Healthcare disparities impact prevalence, diagnosis, and management of allergic disease. The purpose of this review is to highlight the most recent evidence of healthcare disparities in allergic conditions to provide healthcare providers with better understanding of the factors contributing to disparities and to provide potential management approaches to address them. This review comes at a time in medicine where it is well documented that disparities exist, but we seek to answer the Why , How and What to do next?
RECENT FINDINGS
The literature highlights the socioeconomic factors at play including race/ ethnicity, neighborhood, insurance status and income. Management strategies have been implemented with the hopes of mitigating the disparate health outcomes including utilization of school-based health, distribution of educational tools and more inclusive research recruitment.
SUMMARY
The studies included describe the associations between upstream structural and social factors with downstream outcomes and provide ideas that can be recreated at other institutions of how to address them. Focus on research and strategies to mitigate healthcare disparities and improve diverse research participant pools are necessary to improve patient outcomes in the future.
Topics: Humans; Ethnicity; Socioeconomic Factors; Healthcare Disparities; Hypersensitivity
PubMed: 38295102
DOI: 10.1097/ACI.0000000000000972 -
Pediatric Annals May 2021
Topics: Child; Food Hypersensitivity; Humans; Hypersensitivity
PubMed: 34044709
DOI: 10.3928/19382359-20210421-03 -
Allergy and Asthma Proceedings Sep 2019
Topics: Food Hypersensitivity; Humans; Hypersensitivity; Peanut Hypersensitivity
PubMed: 31514786
DOI: 10.2500/aap.2019.40.4245 -
Tidsskrift For Den Norske Laegeforening... Oct 2021Glove-related hand urticaria is probably underdiagnosed and is an important differential diagnosis in suspected cases of contact allergy.
BACKGROUND
Glove-related hand urticaria is probably underdiagnosed and is an important differential diagnosis in suspected cases of contact allergy.
CASE PRESENTATION
A nurse in her twenties presented with recurrent immediate-onset erythematous eruption with burning sensation on the dorsal hands after wearing disposable gloves. This occurred irrespective of the type of disposable gloves used. Patch testing, serological analysis for latex IgE and prick tests with latex and different glove materials all gave negative results. Dermographism was demonstrated on her back, and symptoms were reproduced after wearing disposable gloves. Symptoms were less severe when a looser-fitting glove was worn. She was treated with antihistamines and intensified barrier cream, and was recommended to wear loose-fitting gloves at work. She experienced no effect from antihistamines but some improvement from barrier protection.
INTERPRETATION
Glove-related hand urticaria should be suspected in healthcare workers with immediate-onset urticarial reaction to multiple glove types, negative allergy tests and the presence of dermographism. Symptoms may be reproduced when wearing a tight-fitting glove.
Topics: Dermatitis, Allergic Contact; Female; Health Personnel; Humans; Skin Tests; Urticaria
PubMed: 34641653
DOI: 10.4045/tidsskr.21.0050 -
BMJ Case Reports Dec 2019Hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis, is a granulomatous, non-IgE-mediated hypersensitivity reaction of the alveoli and distal...
Hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis, is a granulomatous, non-IgE-mediated hypersensitivity reaction of the alveoli and distal bronchioles presenting as an acute, subacute or chronic condition. It is most commonly associated with exposure to extrinsic allergens (eg, avian dust, mould and tobacco) and medications including antiarrhythmics (eg, amiodarone), cytotoxics (eg, methotrexate) and antiepileptics (eg, carbamazepine). Individuals diagnosed with this condition can present with severe hypoxia and respiratory failure. The fundamental principle of management is to remove the causative allergen. Evidence implicating selective serotonin reuptake inhibitors as a causative agent is limited, and this case report describes a rare clinical presentation of HP associated with sertraline, how it was diagnosed and subsequently treated. It is anticipated that raising awareness of this interaction will assist multidisciplinary teams, managing patients diagnosed with HP, to be more cognisant of sertraline as being an aetiological factor for this condition.
Topics: Alveolitis, Extrinsic Allergic; Chest Pain; Cough; Diagnosis, Differential; Dyspnea; Female; Humans; Middle Aged; Selective Serotonin Reuptake Inhibitors; Sertraline
PubMed: 31862812
DOI: 10.1136/bcr-2019-230724 -
Asian Pacific Journal of Allergy and... Jun 2023The significance of periostin as a biomarker of Th2-induced airway inflammation has recently been highlighted in adult patients with allergic diseases. It may help... (Observational Study)
Observational Study
BACKGROUND
The significance of periostin as a biomarker of Th2-induced airway inflammation has recently been highlighted in adult patients with allergic diseases. It may help identify drug-responsive inflammatory phenotypes, particularly in children. However, little is known about the usefulness of this parameter as a biomarker for allergic diseases in children. Furthermore, it is not known how much adolescent bone metabolism affects allergic inflammation.
OBJECTIVE
To evaluate the relationship between serum periostin levels and allergic diseases in adolescents, we investigated periostin levels and the prevalence of allergic diseases.
METHODS
We conducted a cross-sectional observational study of 100 males and females in two age groups: age 9-12 years (pre-early adolescence) and 13-15 years (post-early adolescence). Serum periostin levels were determined using Enzyme-Linked Immuno Sorbent Assay (ELISA). Presence of allergic diseases and allergy sensitization were obtained via a self-reported survey and the Multiple Antigen Simultaneous Test (MAST). The protocol was registered in a clinical trial registry as UMIN 000036051.
RESULTS
There were no significant differences in serum periostin levels between pre-early and post-early adolescents. There were no differences by gender. Age and Body Mass Index were not significantly associated with serum periostin levels. Periostin levels were elevated in adolescents with allergic diseases overall compared to healthy adolescents [mean (95%CI): 41.6 (33.4, 49.7) vs. 28.6 (21.9, 35.3) ng/ml; P < 0.05].
CONCLUSIONS
The effects of bone metabolism on serum periostin levels may be limited at 9-15 years of age. Further studies are required to determine reference values in adolescents.
Topics: Male; Female; Humans; Cross-Sectional Studies; Hypersensitivity; Inflammation; Biomarkers; Phenotype
PubMed: 33274950
DOI: 10.12932/AP-010620-0868 -
Frontiers in Immunology 2021Allergy is an inflammatory process determined by a cascade of immune events characterized by T-helper 2 lymphocytes polarization leading to interleukin-4 upregulation,... (Review)
Review
Allergy is an inflammatory process determined by a cascade of immune events characterized by T-helper 2 lymphocytes polarization leading to interleukin-4 upregulation, IgE secretion, and mast cell and eosinophil activation. HLA-G molecules, both in membrane-bound and in soluble forms, are known to play a key immunoregulatory role and their involvement in allergic diseases is supported by increasing literature data. HLA-G expression and secretion is specifically induced in peripheral blood mononuclear cells of allergic patients after incubation with the causal allergen. Elevated levels of soluble HLA-G molecules are detected in serum of patients with allergic rhinitis correlating with allergen-specific IgE levels, clinical severity, drug consumption and response to allergen-specific immunotherapy. HLA-G genetic polymorphisms confer susceptibility to allergic asthma development and high levels of soluble HLA-G molecules are found in plasma and bronchoalveolar lavage fluid of patients with allergic asthma correlating with allergen-specific IgE levels. Interestingly, allergic pregnant women have lower plasma sHLA-G levels than non-allergic women during the 3 trimester of pregnancy and at delivery. Finally, in allergic patients with atopic dermatitis HLA-G molecules are expressed by T cells, monocytes-macrophages and Langerhans cells infiltrating the dermis. Although at present is difficult to completely define the role of HLA-G molecules in allergic diseases, it may be suggested that they are specifically expressed and secreted by immune cells during the allergic reaction in an attempt to suppress allergic inflammation.
Topics: Animals; HLA-G Antigens; Humans; Hypersensitivity
PubMed: 35082780
DOI: 10.3389/fimmu.2021.789684 -
Journal of Pharmacological Sciences Sep 2021Type I hypersensitivity is an immediate immune reaction that involves IgE-mediated activation of mast cells. Activated mast cells release chemical mediators, such as... (Review)
Review
Type I hypersensitivity is an immediate immune reaction that involves IgE-mediated activation of mast cells. Activated mast cells release chemical mediators, such as histamine and lipid mediators, which cause allergic reactions. Recent developments in detection devices have revealed that mast cells simultaneously release a wide variety of lipid mediators. Mounting evidence has revealed that mast cell-derived mediators exert both pro- and anti-inflammatory functions and positively and negatively regulate the development of allergic inflammation. This review presents the roles of major lipid mediators released from mast cells. Author believes this review will be helpful for a better understanding of the pathogenesis of allergic diseases and provide a new strategy for the diagnosis and treatment of allergic reactions.
Topics: Fatty Acids, Unsaturated; Histamine Release; Humans; Hydroxyeicosatetraenoic Acids; Hypersensitivity, Immediate; Immunoglobulin E; Inflammation; Leukotriene B4; Leukotriene C4; Lipid Metabolism; Mast Cells; Prostaglandin D2
PubMed: 34294363
DOI: 10.1016/j.jphs.2021.06.001