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Nutrients Apr 2022The role of intestinal permeability (IP) markers among children and adults with food allergies is not fully understood, and the identification of biological... (Review)
Review
The role of intestinal permeability (IP) markers among children and adults with food allergies is not fully understood, and the identification of biological indicators/markers that predict growth retardation in children with allergic diseases and atopy has not been well explained. Studies have shown that patients with atopic diseases respond abnormally to food allergens. Accordingly, differences in the types of immune complexes formed in response to antigen challenges are significant, which seems to underlie the systemic signs of the food allergy. Increased intestinal permeability over the course of a food allergy allows allergens to penetrate through the intestinal barrier and stimulate the submucosal immune system. Additionally, the release of cytokines and inflammatory mediators enhances the degradation of the epithelial barrier and leads to an improper cycle, resulting in increased intestinal permeability. Several studies have also demonstrated increased permeability of the epithelial cells in those afflicted with atopic eczema and bronchial asthma. Ongoing research is aimed at finding various indicators to assess IP in patients with atopic diseases.
Topics: Allergens; Child; Dermatitis, Atopic; Food Hypersensitivity; Humans; Intestines; Permeability
PubMed: 35565858
DOI: 10.3390/nu14091893 -
Biomedicines Jul 2020Asthma and obesity are two major chronic diseases in children and adolescents. Recent scientific evidence points out a causative role of obesity in asthma... (Review)
Review
Asthma and obesity are two major chronic diseases in children and adolescents. Recent scientific evidence points out a causative role of obesity in asthma predisposition. However, studies assessing the real impact of excessive weight gain on lung function in children have shown heterogeneous results. In this review, the pathological mechanisms linking obesity and development of asthma in children are summarized and factors influencing this relationship are evaluated. Common disease modifying factors including age, sex, ethnicity, development of atopic conditions, and metabolic alterations significantly affect the onset and phenotypic characteristics of asthma. Given this, the impact of these several factors on the obesity-asthma link were considered, and from revision of the literature we suggest the possibility to define three main clinical subtypes on the basis of epidemiological data and physiological-molecular pathways: obese-asthmatic and atopy, obese-asthmatic and insulin-resistance, and obese-asthmatic and dyslipidemia. The hypothesis of the different clinical subtypes characterizing a unique phenotype might have an important impact for both future clinical management and research priorities. This might imply the necessity to study the obese asthmatic child with a "multidisciplinary approach", evaluating the endocrinological and pneumological aspects simultaneously. This different approach might also make it possible to intervene earlier in a specific manner, possibly with a personalized and tailored treatment. Surely this hypothesis needs longitudinal and well-conducted future studies to be validated.
PubMed: 32708186
DOI: 10.3390/biomedicines8070231 -
La Tunisie Medicale Dec 2023The detection of a high serum immunoglobulin E (IgE) level is first suggestive of allergy, atopy or parasitosis. However, some very high values can be a sign of more...
The detection of a high serum immunoglobulin E (IgE) level is first suggestive of allergy, atopy or parasitosis. However, some very high values can be a sign of more severe diseases. We propose a diagnostic strategy based on clinical and biological data to identify the various hereditary immune diseases that also present with abnormally high serum IgE levels.
Topics: Humans; Immunoglobulin E; Hypergammaglobulinemia; Hypersensitivity; Immunologic Deficiency Syndromes
PubMed: 38477192
DOI: No ID Found -
Allergology International : Official... Jul 2021
Topics: Allergens; Animals; Humans; Hypersensitivity
PubMed: 34176582
DOI: 10.1016/j.alit.2021.06.003 -
Current Opinion in Allergy and Clinical... Dec 2023Allergy and atopic features are now well recognized manifestations of many inborn errors of immunity (IEI), and indeed may be the hallmark in some, such as DOCK8... (Review)
Review
PURPOSE OF REVIEW
Allergy and atopic features are now well recognized manifestations of many inborn errors of immunity (IEI), and indeed may be the hallmark in some, such as DOCK8 deficiency. In this review, we describe the current IEI associated with atopy, using a comprehensive literature search and updates from the IUIS highlighting clinical clues for underlying IEI such as very early onset of atopic disease or treatment resistance to enable early and accurate genetic diagnosis.
RECENT FINDINGS
We focus on recently described genes, their categories of pathogenic mechanisms and the expanding range of potential therapies.
SUMMARY
We highlight in this review that patients with very early onset or treatment resistant atopic disorders should be investigated for an IEI, as targeted and effective therapies exist. Early and accurate genetic diagnosis is crucial in this cohort to reduce the burden of disease and mortality.
Topics: Humans; Hypersensitivity, Immediate; Hypersensitivity; Job Syndrome; Guanine Nucleotide Exchange Factors
PubMed: 37755421
DOI: 10.1097/ACI.0000000000000943 -
Frontiers in Allergy 2021Allergic mechanisms account for most cases of chronic rhinitis. This condition is associated with significant impairment of quality of life and high indirect costs. The... (Review)
Review
Allergic mechanisms account for most cases of chronic rhinitis. This condition is associated with significant impairment of quality of life and high indirect costs. The identification of the allergic triggers of rhinitis has been historically based on the performance of atopy test [skin prick test (SPT) and serum allergen-specific (s)IgE]. Nevertheless, these tests only denote sensitization, and atopy and allergy represent two different phenomena. It is now clear that allergic phenotypes of rhinitis can exist in both atopic (allergic rhinitis, AR) and non-atopic (local allergic rhinitis, LAR) individuals. Moreover, both allergic phenotypes can coexist in the same rhinitis patient (dual allergic rhinitis, DAR). Therefore, a diagnostic approach merely based on atopy tests is associated with a significant rate of misdiagnosis. The confirmation of the allergic etiology of rhinitis requires the performance of test like the nasal allergen challenge (NAC). NAC is mandatory for the diagnosis of LAR and DAR, and helps decide the best management approach in difficult cases of AR. Nevertheless, NAC is a laborious technique requiring human and technical resources. The basophil activation test (BAT) is a patient-friendly technique that has shown promising results for LAR and DAR diagnosis. In this review, the diagnostic usefulness for chronic rhinitis of SPT, NAC, olfactory tests, serum sIgE, BAT and the quantification of inflammatory mediators in nasal samples will be discussed. The accurate performance of an etiologic diagnosis of rhinitis patients will favor the prescription of specific therapies with disease-modifying potential like allergen immunotherapy.
PubMed: 35386974
DOI: 10.3389/falgy.2021.721851 -
Frontiers in Medicine 2021Exercise-induced bronchoconstriction (EIB) is a transient airflow obstruction, typically 5-15 min after physical activity. The pathophysiology of EIB is related to the... (Review)
Review
Exercise-induced bronchoconstriction (EIB) is a transient airflow obstruction, typically 5-15 min after physical activity. The pathophysiology of EIB is related to the thermal and osmotic changes of the bronchial mucosa, which cause the release of mediators and the development of bronchoconstriction in the airways. EIB in children often causes an important limitation to physical activities and sports. However, by taking appropriate precautions and through adequate pharmacological control of the condition, routine exercise is extremely safe in children. This review aims to raise awareness of EIB by proposing an update, based on the latest studies, on pathological mechanisms, diagnosis, and therapeutic approaches in children.
PubMed: 35047536
DOI: 10.3389/fmed.2021.814976 -
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 -
Revue Francaise D'allergologie (2009) 2020The cumulative incidence of urticaria in children is close to 10%. Two forms are described: the superficial form and the deep form, or angioedema. In young children aged... (Review)
Review
The cumulative incidence of urticaria in children is close to 10%. Two forms are described: the superficial form and the deep form, or angioedema. In young children aged under 3 years, urticaria is commonly annular and ecchymotic, and is mistaken for erythema multiforme or acute hemorrhagic edema. Serum sickness-like reaction is a particular form of urticaria characterized by angioedema of the extremities, fever and arthralgia, and it is chiefly drug-induced (cephalosporins). With children, questioning and clinical examination are essential and, in most cases, reveal an etiology. The main causes of acute or recurrent urticaria are viral infections and/or drugs (non-specific histamine release), whereas chronic urticaria is mostly due to physical causes. In developed countries, parasitic infections are rarely the cause. Arguments in favor of a food allergy are as follows: a setting of atopy, onset within one hour of taking the suspect food, absence of fever or infection, a duration of less than 24 hours, possible association with other signs of anaphylaxis, and further recurrence with each new intake of the suspect food. First-line treatment of urticaria without signs of severity consists solely of non-sedating antihistamine (associated with removal of the cause where the latter has been determined). Nearly one-third of cases of urticaria in children progress over a prolonged period of more than 6 weeks, thus constituting chronic urticaria (most often a form of mild recurrent urticaria during episodes of infection and/or medication). Chronic urticaria is very rarely due to an underlying inflammatory disease or a genetic disease such as cryopyrinopathy, and first-line etiological assessment is usually limited to the following tests: CBC, sedimentation speed and/or CRP, and transaminases.
PubMed: 32346454
DOI: 10.1016/j.reval.2020.02.239 -
The Journal of Allergy and Clinical... Nov 2023Human epigenetic variation is associated with both environmental exposures and allergic diseases and can potentially serve as a biomarker connecting climate change with... (Review)
Review
Human epigenetic variation is associated with both environmental exposures and allergic diseases and can potentially serve as a biomarker connecting climate change with allergy and airway diseases. In this narrative review, we summarize recent human epigenetic studies examining exposure to temperature, precipitation, extreme weather events, and malnutrition to discuss findings as they relate to allergic and airway diseases. Temperature has been the most widely studied exposure, with the studies implicating both short-term and long-term exposures with epigenetic alterations and epigenetic aging. Few studies have examined natural disasters or extreme weather events. The studies available have reported differential DNA methylation of multiple genes and pathways, some of which were previously associated with asthma or allergy. Few studies have integrated climate-related events, epigenetic biomarkers, and allergic disease together. Prospective longitudinal studies are needed along with the collection of target tissues beyond blood samples, such as nasal and skin cells. Finally, global collaboration to increase diverse representation of study participants, particularly those most affected by climate injustice, as well as strengthen replication, validation, and harmonization of measurements will be needed to elucidate the impacts of climate change on the human epigenome.
Topics: Humans; Climate Change; Prospective Studies; Hypersensitivity; Biomarkers; DNA Methylation; Respiration Disorders; Epigenesis, Genetic
PubMed: 37741554
DOI: 10.1016/j.jaci.2023.09.011