1,721,108 research outputs found
Allergic rhinitis: Current options and future perspectives
No full textPURPOSE OF REVIEW: Allergic rhinitis due its high prevalence and burden needs to be properly treated. The disease's clinical features impose well tolerated drugs usable for long-term treatment. Nowadays, second-generation antihistamines and inhaled steroids represent the milestone of rhinitis therapy. The aim of the present review is to provide an update on allergic rhinitis treatment. A particular attention has been deserved to clinical trials, published in the last year that assess the efficacy and safety of new formulation of available drugs or new molecules. RECENT FINDINGS: Available and new drugs under investigation seem able to control rhinitis symptoms without a significant patient's burden. The challenge for the next years will be to improve treatment adherence rather than to introduce new drugs. SUMMARY: Allergic Rhinitis and its Impact on Asthma guidelines have brought attention to allergic rhinitis and its impact on asthma, but have also proposed a new classification in terms of symptoms severity and persistence useful for tailoring treatment on patients' phenotypes. Their further dissemination is needed; furthermore, they represent a cornerstone for the scientific community through a continuous update on relevant issues such as rhinitis phenotypes, disease management on the basis of new treatments, clinical trials transferability in real life, and allergic rhinitis management in public health programs. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Allergic rhinitis and conjunctivitis: update on pathophysiology
No full textOur understanding of the development and mechanism(s) of allergic diseases has changed dramatically over the last 20 years. With the advent of genetic studies it has now become clear that the linear model, as defined by the allergic march, is no longer tenable. Instead, we must consider all allergies as complex multi-compartment models in which genes which control IgE production and also genes which govern other aspects of allergic disease, such as epithelium integrity, both play an important role. To explore such possibilities, this chapter asks four questions: 1. Is there any evidence of an abnormality in the conjunctival or nasal mucosa which would allow increased allergen penetration? Epithelial changes which are likely to facilitate allergen penetration are present in both allergic conjunctivitis and rhinitis, but they appear different. For example, epithelial PAR-2 expression is elevated in allergic rhinitis whereas in seasonal allergic conjunctivitis, many structural proteins, including E-cadherin, CD44, desmosomes, keratins K5/6, K7, K8, K13, K14, K18 and PAR-2 are all reduced. 2. What is known about the immunology of sensitization in allergic conjunctivitis and allergic rhinitis? Clearly, great strides are being made with respect to the biology of dendritic cells and T regulatory cells and to the possibility of local IgE production, but there is little evidence to suggest differences between the mechanisms of sensitization in the eye and nose. 3. What is the pattern of mediator release in the immediate allergic response and the development of allergic inflammation in allergic conjunctivitis and allergic rhinitis? The pattern of the early phase allergic response in the eye and nose seem similar. While an eosinophil dominated late phase response and allergic inflammation are present in allergic rhinitis, they are only present in the more severe forms of allergic conjunctivitis such as AKC and VKC. 4. Is there any evidence for clinically relevant persistent inflammation or organ remodelling in allergic conjunctivitis and allergic rhinitis? A sustained inflammation and tissue remodelling are well established in the lower airways in asthma where they contribute significantly to the symptoms. However, in upper airways, although there do appear to be functional changes in sensory neurone structure and function in the nose during prolonged allergen exposure, tissue damage seems to be more limited and overt remodelling does not appear to occur in allergic conjunctivitis and is questionable in allergic rhinitis
Current status of allergen immunotherapy around the globe: four commentaries
No full textFil: Canonica, Giorgio Walter. Allergy and Respiratory Diseases, University of Genova DIMI, University of Genova Pad., 16132 Genova, Maragliano Largo Rosanna Benzi 10, ItalyFil: Passalacqua, Giovanni. Allergy and Respiratory Diseases Clinic, Department of Internal Medicine, University of Genoa, 16132 Genoa, Largo Rosanna Benzi 10, ItalyFil: Lockey, Richard F. Division of Allergy and Immunology, University of South Florida College of Medicine, Tampa, FL 33612, 13000 Bruce B. Downs Blvd. (111D), United StatesFil: Baena Cagnani, Carlos E. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Pawankar, Ruby. Division of Rhinology and Allergy, Deptartment of Otolaryngology, Nippon Medical School, Bunkyo-ku, Tokyo 113-8603, 1-1-5, Sendagi, JapanFil: Potter, Paul. Allergy Diagnostic and Clinical Research Unit, University of Cape Town Lung Institute, Mowbray, Cape Town, George Street, South Afric
Expression and Function of Siglec-8 in Human Eosinophils, Basophils, and Mast Cells
No full textSiglec-8, the eighth member of the sialic acid-binding, immunoglobulin [Ig]-like lectin family, was initially discovered as a cell surface protein selectively expressed on human eosinophils. It is now know to also be expressed by mast cells and basophils. Siglec-8 engagement with specific antibodies causes apoptosis via caspase and mitochondrial-dependent pathways. For mast cells, inhibition of mediator release, but no apoptosis, is observed. Siglec-F is the closest mouse paralog to Siglec-8, and both selectively bind the sulfated glycan 6’-sulfo-sialyl Lewis X. Antibodies to Siglec-F reduce blood and tissue eosinophil numbers in vivo. This suggests that Siglec-8 may be a useful future therapeutic target for allergic and other eosinophilic disorders
Rhinitis: adherence to treatment and new technologies
No full textPurpose of review Nonadherence to treatment is a major issue in approximately 50% of patients suffering from chronic diseases. The availability of new technologies could represent a possible way to improve patients' engagement and adherence in a real-life setting. Research and technology tools made available or in process of being made available to patients with allergic diseases and their physicians could potentially improve the management of these disease in daily life by improving adherence. In this review, we sought to outline many of the recent advances in these technological approaches. Recent findings Short Message Service (SMS) reminder, social networks, wearable devices, mobile applications (Apps), monitoring systems of inhaled device use, often presented as 'serious game' are changing the way of approaching to chronic disease, such as rhinitis, management. Summary Studies of the role played by various technologies in improving adherence to treatment in rhinitis are still limited as compared with other diseases such as asthma, but the results are encouraging. Further studies in this area may lead to the discovery of novel management approaches that is easy to be integrated in patients' daily life
Adherence to asthma treatments: we know, we intend, we advocate
No full textPURPOSE OF THE REVIEW: To highlight the state of the art and the current outlook on the adherence to treatment in asthma, starting from the ‘Manifesto on Adherence to asthma treatment in respiratory allergy’ endorsed by the World Allergy Organization, Allergic Rhinitis and Its Impact on Asthma and Global Allergy, Asthma European Network, and Interasma.RECENT FINDINGS: Adherence to the pharmacological treatments of asthma is known to be low: about 50% of those who had been prescribed long-term treatment are nonadherent, at least part of the time. Nonadherence is associated with lack of asthma control, poor health outcomes, and increased costs. The reasons for suboptimal adherence are multifaceted and may be related to the patients, the treatment and asthma features, the physician–patient relationship, and the healthcare resources and facilities.SUMMARY: Taking into account the multidimensional nature of adherence, no single intervention or strategy is per se able to enhance it, but all players involved in the process (government authorities, patient organizations, scientific societies, stakeholders, and others) are called to work together to develop a combined action plan based on the patientʼs complexity
Mast cell function modulating IgE-mediated allergy
No full textABSTRACTAllergic diseases, such as atopic rhinitis, bronchial asthma and urticaria, are prevalent and increasing in frequency. Mast cells are known to play a central role in the immediate phase reaction of allergic diseases through the IgE-mediated release of a variety of chemical mediators, such as histamine, leukotrienes and prostaglandins. In contrast, T lymphocytes, basophils and eosinophils are thought to be responsible for inducing the late phase response. However, whether the mast cell can be simplistically assigned a role in the immediate phase allergic response and whether mast cells are necessary for the ongoing allergic response, including the development of hyperresponsiveness, remains to be completely studied. In the present article, the author will discuss the integrated roles of mast cells in IgE-mediated allergic inflammation, with specific emphasis on the roles of mast cell-derived cytokines in the late phase allergic response and chronic allergic inflammation
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