MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Immunology and Allergy Clinics of North America' source. Wed, 08 Feb 2012 06:42:53 +0100 http://www.medworm.com/index.php?rid=5596679&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856112000094%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596679 Tue, 17 Jan 2012 11:16:53 +0100 5596679 http://www.medworm.com/index.php?rid=5596675&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111001081%2Fabstract%3Frss%3Dyes One of the most promising therapies for food allergy is oral immunotherapy (OIT), in which small amounts of allergen are administered in increasing amounts, with the immediate goal of desensitization and the long-term goal of tolerance. However, safety and standardization concerns prevent its widespread use, and a subgroup of patients may experience severe allergic reactions. These concerns might be addressed by another promising therapy involving anti-IgE monoclonal antibodies (mAb), which can reduce allergic reactions associated with food administration. A recent pilot study combining anti-IgE mAb with OIT suggests that anti-IgE mAb might improve the safety, rapidity, and efficacy of OIT. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596675 Tue, 17 Jan 2012 11:16:52 +0100 5596675 http://www.medworm.com/index.php?rid=5596674&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111001068%2Fabstract%3Frss%3Dyes This article reviews several promising novel approaches for the diagnosis of food allergy, such as new molecular diagnostic technologies and functional assays, along with their potential clinical applications. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596674 Tue, 17 Jan 2012 11:16:52 +0100 5596674 http://www.medworm.com/index.php?rid=5596669&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111001159%2Fabstract%3Frss%3Dyes Food allergy is an emerging epidemic in the United States and the Western world. The determination of factors that make certain foods allergenic is still not clearly understood. Only a tiny fraction of thousands of proteins and other molecules is responsible for inducing food allergy. In this review, the authors present 3 examples of food allergies with disparate clinical presentations: peanut, soy, and mammalian meat. The potential relationships between allergen structure and function, emphasizing the importance of cross-reactive determinants, immunoglobulin E antibodies to the oligosaccharides, and the immune responses induced in humans are discussed. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596669 Tue, 17 Jan 2012 11:16:52 +0100 5596669 http://www.medworm.com/index.php?rid=5596665&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856112000082%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596665 Tue, 17 Jan 2012 11:16:52 +0100 5596665 http://www.medworm.com/index.php?rid=5596664&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856112000070%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596664 Tue, 17 Jan 2012 11:16:52 +0100 5596664 http://www.medworm.com/index.php?rid=5596663&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856112000069%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596663 Tue, 17 Jan 2012 11:16:52 +0100 5596663 http://www.medworm.com/index.php?rid=5596667&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111001135%2Fabstract%3Frss%3Dyes Allergic reactions to milk were first described by Hippocrates more than two thousand years ago; however, it is only in the past two decades that food allergy has emerged as an important public health problem affecting people of all ages in societies with a western lifestyle, such as US, Canada, UK, Australia, and Western Europe. The overall prevalence of food allergy increased by 18% from 1997 to 2007 in US children. In particular, peanut allergy tripled over the similar period in the US, Canada, UK, and Australia. Eosinophilic esophagitis (EoE) epidemics have been recognized in children and adults in the past decade; diagnosis of food allergy in EoE is especially challenging due to the lack of a noninvasive diagnostic test. Food allergy is the most common cause of the anaphylaxis in the ... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596667 Mon, 26 Dec 2011 05:00:00 +0100 5596667 http://www.medworm.com/index.php?rid=5596666&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111001147%2Fabstract%3Frss%3Dyes There are some who do not bear cheese well, their constitutions are different, they differ in this respect, that what in their body is incompatible with cheese, is roused and put in commotion by such a thing; and those in whose bodies such a humor happens to prevail in greater quantity and intensity, are likely to suffer the more from it.—Hippocrates, ca. 460 BC–ca. 370 BC (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596666 Mon, 26 Dec 2011 05:00:00 +0100 5596666 http://www.medworm.com/index.php?rid=5596677&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS088985611100107X%2Fabstract%3Frss%3Dyes Heat treatment of several foods, including all types of cooking, has been mainly used to minimize the number of viable microbes, reduce pathogenicity, and destroy the undesirable enzymes, maintaining food quality. In addition, food processing improves sensory, nutritional, and physical properties of the foods, due to food protein denaturation. Heat-induced alterations of food proteins can attenuate allergenicity. In this article, the authors review the important role of thermal processing on milk and egg proteins, which comprise the commonest food allergies in infancy and early childhood. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596677 Mon, 19 Dec 2011 05:00:00 +0100 5596677 http://www.medworm.com/index.php?rid=5596676&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111001056%2Fabstract%3Frss%3Dyes This article focuses on recent advances in CAM for food allergy, including acupuncture, herbal medicine, probiotics, and alternative approaches to allergen immunotherapy. The mechanism of action of several novel approaches to treatment of food allergy is reviewed, but FAHF-2 is the only investigational herbal formulation currently validated for use in human clinical trials. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596676 Mon, 19 Dec 2011 05:00:00 +0100 5596676 http://www.medworm.com/index.php?rid=5596672&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS088985611100110X%2Fabstract%3Frss%3Dyes Eosinophilic esophagitis is a clinicopathologic disease that can present with a constellation of upper gastrointestinal symptoms and endoscopic findings in conjunction with significant infiltration of the esophageal tissue with eosinophils. Clinical and histologic resolution of the disease can be seen with dietary restriction therapies and systemic and topical corticosteroids. Because most patients have an atopic background and the disease seems to have an underlying T-helper type 2 pathogenesis, allergists and gastroenterologists need to be familiar with the diagnosis and management of this disease. In this review, clinical characteristics, endoscopic and histologic findings, and available therapy options are discussed. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596672 Mon, 19 Dec 2011 05:00:00 +0100 5596672 http://www.medworm.com/index.php?rid=5596671&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111001111%2Fabstract%3Frss%3Dyes This article provides a careful evaluation of the rationale and existing data on the effect of timing of the introduction of food allergens (during pregnancy, lactation, and early childhood) on the development of specific food allergies. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596671 Mon, 19 Dec 2011 05:00:00 +0100 5596671 http://www.medworm.com/index.php?rid=5596673&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111001093%2Fabstract%3Frss%3Dyes This article discusses the effects on parent and child QoL, as well as distress, while appraising the limitations of knowledge given the methods used. Topics include whether QoL and distress are affected compared with other illnesses, assessment of distress and QoL in parents compared with children, concerns about food allergy-related bullying, and the necessity for evidence-based interventions. Suggestions are offered for how to improve QoL and reduce distress on the way to better coping with food allergy. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596673 Thu, 15 Dec 2011 05:00:00 +0100 5596673 http://www.medworm.com/index.php?rid=5596670&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111001123%2Fabstract%3Frss%3Dyes The rise in food allergy prevalence in developed countries is evident from anecdotal reports but has been difficult to document and until recently good quality prevalence data were lacking. Although most emerging risk factors seem related to the “modern lifestyle” the reasons for the rise in food allergy prevalence remain poorly understood. The incidence of food allergy–related anaphylaxis is rising particularly in children younger than 5 years of age. Emerging studies are better designed to assess the true prevalence of IgE-mediated food allergy using formal population sampling frames, standardized and objective outcome data including use of the gold standard oral food challenge, and the capacity to adjust for potential selection bias. (Source: Immunology and Allergy Clinics of Nort... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596670 Thu, 15 Dec 2011 05:00:00 +0100 5596670 http://www.medworm.com/index.php?rid=5596668&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111001032%2Fabstract%3Frss%3Dyes This article discusses the implications of these approaches for understanding the mechanisms of sensitization to food allergens in human disease. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596668 Fri, 09 Dec 2011 05:00:00 +0100 5596668 http://www.medworm.com/index.php?rid=5596678&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111001044%2Fabstract%3Frss%3Dyes Food-induced anaphylaxis (FIA) is a serious allergic reaction that may cause death rapidly in otherwise healthy individuals. There is no universal agreement on its definition or criteria for diagnosis. Hospital admissions for FIA have more than doubled in the last decade. Food is one of the most common causes of anaphylaxis, with most surveys indicating that food-induced reactions account for 30% to 50% of cases. The most commonly implicated foods are peanut, tree nuts, milk, eggs, sesame seeds, fish, and shellfish. The only life-saving treatment for anaphylaxis is allergen avoidance, and epinephrine injection if an anaphylactic event occurs. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5596678 Mon, 21 Nov 2011 05:00:00 +0100 5596678 http://www.medworm.com/index.php?rid=5296297&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000981%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5296297 Sat, 08 Oct 2011 22:50:06 +0100 5296297 http://www.medworm.com/index.php?rid=5296296&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000865%2Fabstract%3Frss%3Dyes Work-related rhinitis, which includes work-exacerbated rhinitis and occupational rhinoconjunctivitis (OR), is two to three times more common than occupational asthma. High molecular weight proteins and low molecular weight chemicals have been implicated as causes of OR. The diagnosis of work-related rhinitis is established based on occupational history and documentation of immunoglobulin E (IgE) mediated sensitization to the causative agent if possible. Management of work-related rhinitis is similar to that of other causes of rhinitis and includes elimination or reduction of exposure to causative agents combined with pharmacotherapy. If allergens are commercially available, allergen immunotherapy can be considered. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5296296 Sat, 08 Oct 2011 22:50:06 +0100 5296296 http://www.medworm.com/index.php?rid=5296295&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS088985611100083X%2Fabstract%3Frss%3Dyes Hypersensitivity pneumonitis can occur from a wide variety of occupational exposures. Although uncommon and difficult to recognize, through a detailed work exposure history, physical examination, radiography, pulmonary function studies, and selected laboratory studies using sera and bronchoalveolar lavage fluid, workers can be identified early to effect avoidance of the antigen and institute pharmacologic therapy, if necessary. A lung biopsy may be necessary to rule out other interstitial lung diseases. Despite the varied organic antigen triggers, the presentation is similar with acute, subacute, or chronic forms. Systemic corticosteroids are the only reliable pharmacologic treatment but do not alter the long-term outcome. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5296295 Sat, 08 Oct 2011 22:50:06 +0100 5296295 http://www.medworm.com/index.php?rid=5296294&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000816%2Fabstract%3Frss%3Dyes Thousands of persons experience accidental high-level irritant exposures each year but most recover and few die. Irritants function differently than allergens because their actions proceed nonspecifically and by nonimmunologic mechanisms. For some individuals, the consequence of a single massive exposure to an irritant, gas, vapor or fume is persistent airway hyperresponsiveness and the clinical picture of asthma, referred to as reactive airways dysfunction syndrome (RADS). Repeated irritant exposures may lead to chronic cough and continual airway hyperresponsiveness. Cases of asthma attributed to repeated irritant-exposures may be the result of genetic and/or host factors. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5296294 Sat, 08 Oct 2011 22:50:06 +0100 5296294 http://www.medworm.com/index.php?rid=5296293&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000853%2Fabstract%3Frss%3Dyes This article discusses the approaches that may be taken for patients with different forms of work-related asthma. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5296293 Sat, 08 Oct 2011 22:50:06 +0100 5296293 http://www.medworm.com/index.php?rid=5296292&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000841%2Fabstract%3Frss%3Dyes Occupational asthma (OA) is defined as asthma caused by sources and conditions attributable to a particular occupational environment and not to stimuli encountered outside the workplace. Two types of OA are distinguished based on their appearance after a latency period or not. The most frequent type appears after a latency period leading to sensitization; the clinical assessment of this type of OA is the topic of this review. The differential diagnosis of OA is also reviewed, including work-exacerbated asthma, eosinophilic bronchitis, hyperventilation syndrome, vocal cord dysfunction, bronchiolitis, and other causes of dyspnea or cough. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5296292 Sat, 08 Oct 2011 22:50:06 +0100 5296292 http://www.medworm.com/index.php?rid=5296291&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000877%2Fabstract%3Frss%3Dyes This article discusses the various immunologic and nonimmunologic mechanisms and genetic susceptibility factors that drive the inflammatory processes of OA. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5296291 Sat, 08 Oct 2011 22:50:06 +0100 5296291 http://www.medworm.com/index.php?rid=5296290&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000804%2Fabstract%3Frss%3Dyes International reviews suggest that the median proportion of adult cases of asthma attributable to occupational exposure is between 10% and 15%. Therefore, it is essential that clinicians have a broad knowledge of the various causes associated with occupational asthma. Occupational asthmagens are categorized as low-molecular-weight (LMW, ≤1000 kd) and high-molecular-weight (HMW, ≥1000 kd) antigens. The purpose of this article is to review the most common representative LMW and HMW causes of occupational asthma over the past 70 years, with specific emphasis on newer causes reported over the past 5 years. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5296290 Sat, 08 Oct 2011 22:50:06 +0100 5296290 http://www.medworm.com/index.php?rid=5296289&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000889%2Fabstract%3Frss%3Dyes Much has been learned from epidemiologic studies conducted in the past 4 decades that can be directly applied to the management of workers affected with occupational asthma. Studies have provided information about host factors, environmental exposure, and occupational agents posing the highest risks for development of severe irreversible airway obstruction and asthma disability. Investigators have developed methods for screening workers at risk and novel interventions that may prevent new cases among exposed worker populations. Less is known about the natural history and chronic morbidity associated with work-aggravated asthma and irritant-induced asthma syndromes; more studies are needed in at-risk worker populations. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5296289 Sat, 08 Oct 2011 22:50:06 +0100 5296289 http://www.medworm.com/index.php?rid=5296288&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000828%2Fabstract%3Frss%3Dyes The workplace can trigger or induce asthma and cause the onset of different types of work-related asthma (WRA). Based on current knowledge of clinical features, pathophysiologic mechanisms, and evidence supporting a causal relationship, the following conditions should be distinguished in the spectrum of WRA: (1) immunologic occupational asthma (OA), (2) nonimmunologic OA, (3) work-exacerbated asthma, and (4) variant syndromes, including eosinophilic bronchitis, potroom asthma, and asthmalike disorders caused by organic dusts. The rationale, issues, and controversies relating to this approach are critically reviewed to stimulate the development of a consensus on operational definitions of the various phenotypes of WRA. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5296288 Sat, 08 Oct 2011 22:50:06 +0100 5296288 http://www.medworm.com/index.php?rid=5296287&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000890%2Fabstract%3Frss%3Dyes Work-related asthma is the most common form of occupational lung disease, affecting 10–25% of the adult population. These conditions take on greater importance in industrialized countries but are even more significant in the developing world, which has seen tremendous growth in manufacturing of all kinds. Patients and workers with increased asthma symptoms at work may present to occupational physicians, allergists, or pulmonologists. This monograph, authored by a renowned group of experts, has been written for all physicians with special interests in occupational lung disease, although it is not intended as a comprehensive review. Rather the aim of this issue of Immunology and Allergy Clinics of North America is to update selected and timely topics in this field. (Source: Immunology and ... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5296287 Sat, 08 Oct 2011 22:50:06 +0100 5296287 http://www.medworm.com/index.php?rid=5296286&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000907%2Fabstract%3Frss%3Dyes First recognized by Hippocrates, fully described by Bernardino Ramazzini, and scientifically researched by Jack Pepys, occupational asthma remains the most prevalent occupational lung disease despite the implementation of governmental regulatory processes at the workplace. Its incidence remains largely unchanged. This is likely due to the introduction of an increasing number of novel chemicals into the workplace. Occupational asthma distinguishes itself from other forms of asthma in a number of important aspects. There is a well-defined exposure to an offending agent and duration of the exposure. The chemical nature of the offending agent is usually known. Further, the time of onset of asthma is known. These attributes make occupational asthma a highly desirable subject for research. (Sour... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5296286 Sat, 08 Oct 2011 22:50:06 +0100 5296286 http://www.medworm.com/index.php?rid=5296285&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS088985611100097X%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5296285 Sat, 08 Oct 2011 22:50:06 +0100 5296285 http://www.medworm.com/index.php?rid=5296284&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000968%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5296284 Sat, 08 Oct 2011 22:50:06 +0100 5296284 http://www.medworm.com/index.php?rid=5296283&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000956%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5296283 Sat, 08 Oct 2011 22:50:06 +0100 5296283 http://www.medworm.com/index.php?rid=5009255&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000750%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009255 Sat, 09 Jul 2011 13:57:28 +0100 5009255 http://www.medworm.com/index.php?rid=5009254&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000567%2Fabstract%3Frss%3Dyes This article presents a systematic approach to office care of rhinitis from the perspective of an allergist-immunologist. More emphasis is given to discussion of dilemmas that face the specialist or more involved considerations that have been highlighted in recently published guidelines. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009254 Sat, 09 Jul 2011 13:57:28 +0100 5009254 http://www.medworm.com/index.php?rid=5009253&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000622%2Fabstract%3Frss%3Dyes This article provides an overview of treatment suggestions, benefits, and side effects for available OTC, prescription drug, and alternative choices in addition to the therapies described in other articles. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009253 Sat, 09 Jul 2011 13:57:28 +0100 5009253 http://www.medworm.com/index.php?rid=5009252&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000555%2Fabstract%3Frss%3Dyes Numerous controlled clinical trials have demonstrated the efficacy of specific allergen immunotherapy (SIT) in reducing the clinical symptoms and costs associated with allergic rhinitis. Compared with pharmacotherapy, SIT may provide persistent clinical benefits after treatment discontinuation. Subcutaneous and sublingual immunotherapy are the two most widely prescribed SIT routes worldwide. This review compares the efficacy, safety, preventive effect, immunologic mechanisms, and adherence rates associated with these two forms of SIT. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009252 Sat, 09 Jul 2011 13:57:28 +0100 5009252 http://www.medworm.com/index.php?rid=5009251&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000580%2Fabstract%3Frss%3Dyes Intranasal corticosteroids (INSs) are the first choice for rhinitis pharmacotherapy. This preference is because of their broad range of actions that result in reductions of proinflammatory mediators, cytokines, and cells. Over the past 30 years, INSs have been modified to improve their pharmacodynamic, pharmacokinetic, and delivery system properties, with attention to improving characteristics such as receptor binding affinity, lipophilicity, low systemic bioavailability, and patient preference. Clinically, they have been shown to be the most effective class of nasal medications for treating allergic rhinitis and nonallergic rhinopathy, with no clear evidence that any specific INS is superior to others. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009251 Sat, 09 Jul 2011 13:57:27 +0100 5009251 http://www.medworm.com/index.php?rid=5009250&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000579%2Fabstract%3Frss%3Dyes Antihistamines have long been a mainstay in the therapy for allergic rhinitis. Many different oral antihistamines are available for use, and they are classified as first generation or second generation based on their pharmacologic properties and side-effect profiles. The recent introduction of intranasal antihistamines has further expanded the role of antihistamines in the treatment of allergic rhinitis. Certain patient populations, such as children and pregnant or lactating women, require special consideration regarding antihistamine choice and dosing as part of rhinitis therapy. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009250 Sat, 09 Jul 2011 13:57:27 +0100 5009250 http://www.medworm.com/index.php?rid=5009249&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000592%2Fabstract%3Frss%3Dyes Allergic rhinitis affects a large portion of the population. Patients are frequently sensitized to indoor allergens. The most important contributors are house dust mites, pets, and fungi. In very controlled environments where allergen exposure is significantly reduced, individuals have been shown to have clinical improvement in allergic rhinitis and/or asthma symptoms. Achieving sufficient exposure reduction in the home has proven difficult. Nonetheless, evidence exists that demonstrates exposure avoidance can be useful as an adjunct to other therapies, such as pharmacotherapy and immunotherapy, for the treatment of allergic rhinitis. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009249 Sat, 09 Jul 2011 13:57:27 +0100 5009249 http://www.medworm.com/index.php?rid=5009248&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000646%2Fabstract%3Frss%3Dyes Epidemiologic, genetic, immunologic, and clinical studies show a close relationship between allergic rhinitis and asthma, food allergy, and atopic dermatitis. Rhinitis and sinusitis often coexist and are commonly referred to with the term rhinosinusitis. These conditions are also linked in the so-called atopic march, which is the sequential appearance of atopic manifestations starting with atopic dermatitis and later followed by food allergy, allergic rhinitis, and asthma. Allergic rhinitis and asthma are now increasingly being approached diagnostically and therapeutically as the one-airway concept. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009248 Sat, 09 Jul 2011 13:57:27 +0100 5009248 http://www.medworm.com/index.php?rid=5009247&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000609%2Fabstract%3Frss%3Dyes The nose has a limited repertoire of responses regardless of the triggers. These responses primarily serve as a protective mechanism for the lower respiratory tract. Although the nasal reactions to pollens, particles, and pollution may have a beneficial effect for the lower airway, they create symptoms in some individuals that lead to significant morbidity. The symptoms of allergic rhinitis extend far beyond the nose, and the morbidity associated with rhinitis is significant. The nasal symptoms of rhinitis and their causes are the focus of this review. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009247 Sat, 09 Jul 2011 13:57:27 +0100 5009247 http://www.medworm.com/index.php?rid=5009246&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000658%2Fabstract%3Frss%3Dyes This article focuses on some of the most common types of chronic rhinitis, including mixed rhinitis (allergic and nonallergic overlap), rhinitis medicamentosa, hormonal rhinitis, rhinitis of the elderly, and gustatory rhinitis. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009246 Sat, 09 Jul 2011 13:57:26 +0100 5009246 http://www.medworm.com/index.php?rid=5009245&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000610%2Fabstract%3Frss%3Dyes This review focuses on the poorly understood condition of nonallergic rhinopathy (NAR) at a clinical level, with an eye on current optimal treatment. NAR is the new designation for the conditions formerly referred to as vasomotor rhinitis or nonallergic idiopathic rhinitis. The clinical characteristics and differential diagnosis are provided in detail in this review, and the disease should now be characterized sufficiently for clinical studies. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009245 Sat, 09 Jul 2011 13:57:26 +0100 5009245 http://www.medworm.com/index.php?rid=5009242&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000671%2Fabstract%3Frss%3Dyes Nearly 25% of the U.S. population suffers from allergic rhinitis. This is clearly one of the most common human illnesses and is likely to impact the development of other illnesses. Another common pathologic process that affects all aging human beings is atherosclerosis. So, one interesting question is whether allergic rhinitis affects the development of atherosclerosis and, indirectly, cardiovascular illnesses and stroke. There is scientific rationale to take this issue seriously. It is well established that a low-grade inflammation involving macrophages is critical for the development of atherosclerosis. There is growing evidence that leukotrienes are involved in atherosclerosis. Genetic studies with mice have identified 5-lipoxygenase (5-LO) as an important contributor of atherosclerosis... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009242 Sat, 09 Jul 2011 13:57:25 +0100 5009242 http://www.medworm.com/index.php?rid=5009241&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000749%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009241 Sat, 09 Jul 2011 13:57:25 +0100 5009241 http://www.medworm.com/index.php?rid=5009240&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000737%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009240 Sat, 09 Jul 2011 13:57:25 +0100 5009240 http://www.medworm.com/index.php?rid=5009239&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000725%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009239 Sat, 09 Jul 2011 13:57:25 +0100 5009239 http://www.medworm.com/index.php?rid=5009244&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000634%2Fabstract%3Frss%3Dyes This article discusses some of this recent work and reviews the basics behind of all of the stages of the allergic response. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009244 Sun, 12 Jun 2011 23:00:00 +0100 5009244 http://www.medworm.com/index.php?rid=5009243&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS088985611100066X%2Fabstract%3Frss%3Dyes I have always considered each issue of Immunology and Allergy Clinics to be a precious little gem. Thus, when asked to develop an issue on rhinitis, I immediately accepted, pleased to be able to contribute to this important series. It was easy to select both the topics and the authors. We looked at the clinical field of rhinitis and chose the most important epidemiologic, pathophysiologic, clinical, and treatment advances and asked those authors who had contributed the most to each area to write it up. Everyone accepted the offer. Thus, a star-studded group of investigators, clinicians, and academicians was easily assembled. The results are a pleasure to read. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5009243 Sun, 12 Jun 2011 23:00:00 +0100 5009243 http://www.medworm.com/index.php?rid=4767962&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000178%2Fabstract%3Frss%3Dyes Please note that in the May 2010 issue of Immunology and Allergy Clinics of North America (Volume 30, Issue 2), an author’s last name was misspelled. The correct spelling is M. Cavazzana-Calvo. The article appeared on pages 237–248 and is entitled, “Gene Therapy for Primary Immunodeficiencies.” (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767962 Sat, 30 Apr 2011 15:42:46 +0100 4767962 http://www.medworm.com/index.php?rid=4767960&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000300%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767960 Sat, 30 Apr 2011 15:42:46 +0100 4767960 http://www.medworm.com/index.php?rid=4767958&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000142%2Fabstract%3Frss%3Dyes Allergen-specific immunotherapy represents a curative treatment of type I allergies. Subcutaneous immunotherapy is conducted with allergens adsorbed on aluminum hydroxide or calcium phosphate particles, whereas sublingual immunotherapy relies on high doses of soluble allergen without any immunopotentiator. There is a potential benefit of adjuvants enhancing regulatory and Th1 CD4+T cell responses during specific immunotherapy. Molecules affecting dendritic cells favor the induction of T regulatory cell and Th1 responses and represent valid candidate adjuvants for allergy vaccines. Furthermore, the interest in viruslike particles and mucoadhesive particulate vector systems, which may better address the allergen(s) to tolerogenic antigen-presenting cells, is documented. (Source: Immunology a... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767958 Sat, 30 Apr 2011 15:42:46 +0100 4767958 http://www.medworm.com/index.php?rid=4767956&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000130%2Fabstract%3Frss%3Dyes For the past century, subcutaneous allergen-specific immunotherapy has been the state-of-the-art treatment for IgE-mediated allergic disease. Current research on allergen-specific immunotherapy is focused on enhancing its efficacy, safety, and patient convenience with the goal of offering a broadly accepted treatment option. There is a growing interest in intralymphatic allergen-specific immunotherapy because it is a highly efficacious and safe treatment route that requires only 3 injections. Concurrently, epicutaneous allergen-specific immunotherapy is attracting increasing attention because of its capacity to offer a safe, needle-free, and potentially self-administrable treatment option for IgE-mediated allergic diseases. In this article, we discuss the principles and immunologic rationa... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767956 Sat, 30 Apr 2011 15:42:46 +0100 4767956 http://www.medworm.com/index.php?rid=4767954&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS088985611100021X%2Fabstract%3Frss%3Dyes Because of the need to standardize allergen immunotherapy and the desire to reduce allergic adverse events during therapy, a transition to recombinant/synthetic hypoallergenic approaches is inevitable. Evidence supports the notion that effective therapy can be delivered using a limited panel of allergens or even epitopes, weakening the argument that all allergens must be present for optimal efficacy. Moreover, standardized products will allow direct comparisons between studies and, for the first time, immunotherapy studies will be truly blinded, allowing an accurate assessment of the actual treatment effect that can be achieved with this form of intervention. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767954 Sat, 30 Apr 2011 15:42:46 +0100 4767954 http://www.medworm.com/index.php?rid=4767953&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000099%2Fabstract%3Frss%3Dyes This article examines the mechanisms of oral tolerance and the breakdown that leads to food allergy, as well as the history and current state of oral and sublingual immunotherapy development. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767953 Sat, 30 Apr 2011 15:42:46 +0100 4767953 http://www.medworm.com/index.php?rid=4767952&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS088985611100004X%2Fabstract%3Frss%3Dyes Future forms of immunotherapy, particularly toll-like receptor agonists, have shown promising results in animal models of allergic disease although most have failed to translate into successful human clinical trials. These results have helped to elucidate the pleotropic roles of cytokines as well as the diverse phenotypes of allergic diseases, particularly asthma. The goals of these therapies are to improve patient symptoms and quality of life, to prevent and favorably alter disease course, and to maintain a good risk/benefit ratio along with a cost-effective profile. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767952 Sat, 30 Apr 2011 15:42:45 +0100 4767952 http://www.medworm.com/index.php?rid=4767951&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000208%2Fabstract%3Frss%3Dyes In contrast to symptomatic drug treatment, which only temporarily relieves allergy symptoms, allergen-specific immunotherapy (SIT) has the potential to alter the course of allergic disease, thereby reducing the need for long-term treatment, the progression of allergic rhinitis (AR) to asthma, and the development of new allergies. The clinical benefits of SIT have been shown to persist for an additional 3 to 12 years after discontinuation of a 2.5- to 5.0-year treatment. It therefore stands to reason that the clinical benefits of SIT also extend to economic benefits. A growing number of studies have evaluated the economic benefits of SIT in patients with AR and/or asthma. The authors critically examine each of these studies published from 1995 to present. (Source: Immunology and Allergy Cli... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767951 Sat, 30 Apr 2011 15:42:45 +0100 4767951 http://www.medworm.com/index.php?rid=4767950&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS088985611100018X%2Fabstract%3Frss%3Dyes This article explores the possibility that functional assays based on the ability of IgG to compete with IgE and inhibit IgE-allergen complex formation may be surrogate or predictive of the clinical response to immunotherapy. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767950 Sat, 30 Apr 2011 15:42:45 +0100 4767950 http://www.medworm.com/index.php?rid=4767949&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000051%2Fabstract%3Frss%3Dyes This article reviews different methods assessing the clinical outcome of trials on both subcutaneous and sublingual immunotherapy, and highlights potential advantages and drawbacks of each method. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767949 Sat, 30 Apr 2011 15:42:45 +0100 4767949 http://www.medworm.com/index.php?rid=4767948&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000129%2Fabstract%3Frss%3Dyes Sublingual immunotherapy (SLIT) represents a significant advance and it seems particularly suitable in pediatric patients. There are favorable results for food allergy in controlled trials. For latex allergy, the results of several trials are encouraging. For atopic dermatitis, previous experience with subcutaneous immunotherapy and some earlier trials suggest the possible application of SLIT in children with mild to moderate dermatitis and sensitization to dust mite, but this recommendation is considered insufficiently evidence based. In hymenoptera allergy, the only trial available is a proof-of-concept study in large local reactions that needs to be confirmed in well-controlled studies. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767948 Sat, 30 Apr 2011 15:42:45 +0100 4767948 http://www.medworm.com/index.php?rid=4767947&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000154%2Fabstract%3Frss%3Dyes Subcutaneous immunotherapy (SCIT) is effective and safe when properly prescribed and administered. However, a certain risk of severe side effects exists, even when the reaction is managed correctly. These potential adverse effects stimulated the search for new administration routes (nasal, bronchial, oral, sublingual), which were expected to be safer. Not all of these alternative routes provided an improved benefit–safety profile compared with SCIT. The sublingual route (SLIT) seemed to be a good candidate for the clinical practice because of its satisfactory safety profile and is now considered an acceptable alternative to SCIT in adults and children. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767947 Sat, 30 Apr 2011 15:42:45 +0100 4767947 http://www.medworm.com/index.php?rid=4767946&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000026%2Fabstract%3Frss%3Dyes Subcutaneous immunotherapy is divided into a buildup and a maintenance phase. Accelerated immunotherapy has the advantage of a reduced number of office visits. Rush and cluster immunotherapy schedules are the most common accelerated schedules used in the United States. A cluster immunotherapy schedule involves the patient receiving several allergen injections sequentially in a single day of treatment on nonconsecutive days. The maintenance dose is reached in 4 to 8 weeks. In rush immunotherapy protocols, higher doses are administered at intervals of 15 to 60 minutes in a period of 1 to 3 days until the maintenance dose is achieved. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767946 Sat, 30 Apr 2011 15:42:44 +0100 4767946 http://www.medworm.com/index.php?rid=4767945&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000087%2Fabstract%3Frss%3Dyes This article reviews data derived from retrospective surveys conducted to define the incidence, prevalence, and factors contributing to injection-related fatal anaphylactic and near-fatal systemic reactions, as well as recently initiated longitudinal surveillance studies of SCIT reactions. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767945 Sat, 30 Apr 2011 15:42:44 +0100 4767945 http://www.medworm.com/index.php?rid=4767944&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000105%2Fabstract%3Frss%3Dyes Stability studies with a few well-characterized allergen extracts have yielded useful information about the shelf-life of these products stored under various conditions. The development of validated stability-indicating tests and their clinical verification remains a fundamental challenge for extending this information to cover more products. This challenge becomes even greater for evaluations of more complex, multiextract mixtures that are used in clinical practice. Thus, the current approach for developing guidelines for extract expiration dating practices must rely on extrapolations of data obtained from a few well-controlled studies. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767944 Sat, 30 Apr 2011 15:42:44 +0100 4767944 http://www.medworm.com/index.php?rid=4767943&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000117%2Fabstract%3Frss%3Dyes Immunotherapy by the subcutaneous injection of increasing doses and then maintenance doses of extracts of inhalant allergens has been practiced for 100 years. Controlled clinical trials have established its efficacy in treating allergic rhinitis, asthma, and stinging insect sensitivity, and there are preliminary data to suggest a favorable response in some patients with atopic dermatitis. The response to subcutaneous injection immunotherapy is dose dependent. Disease-modifying actions include blocking development of new sensitivities in monosensitized patients, blocking progression to asthma in patients with allergic rhinitis, and persistence of treatment effects for up to 7 to 10 years after an initial course. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767943 Sat, 30 Apr 2011 15:42:44 +0100 4767943 http://www.medworm.com/index.php?rid=4767942&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000063%2Fabstract%3Frss%3Dyes This article considers the role of the local oral mucosa and regional lymphoid tissues in the processing of allergen during SLIT and the subsequent effects on T-cell and B-cell immune compartments and at mucosal sites. The likely time course of events and the evidence for long-lasting tolerance following SLIT are discussed. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767942 Sat, 30 Apr 2011 15:42:44 +0100 4767942 http://www.medworm.com/index.php?rid=4767941&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000075%2Fabstract%3Frss%3Dyes Allergen-specific immunotherapy (SIT) is the only curative approach in the treatment of allergic diseases defined up-to-date. Peripheral T-cell tolerance to allergens, the goal of successful allergen-SIT, is the primary mechanism in healthy immune responses to allergens. By repeated administration of increased doses of the causative allergen, allergen-SIT induces a state of immune tolerance to allergens through the constitution of T regulatory (Treg) cells, including allergen-specific interleukin (IL)-10–secreting Treg type 1 cells and CD4+CD25+Treg cells; induction of suppressive cytokines, such as IL-10 and transforming growth factor β; suppression of allergen-specific IgE and induction of IgG4 and IgA; and suppression of mast cells, basophils, eosinophils, and inflammatory dendritic... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767941 Sat, 30 Apr 2011 15:42:43 +0100 4767941 http://www.medworm.com/index.php?rid=4767940&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000038%2Fabstract%3Frss%3Dyes Meta-analysis is a powerful tool for evaluating the efficacy of a therapeutic intervention, and has clearly demonstrated that specific allergen immunotherapy (SIT) is effective for treating allergic rhinitis and asthma. Future research needs to focus on specifying the most effective forms of SIT for specific populations and allergens, using validated clinical outcomes, studying long-term outcomes (particularly the potential disease-modifying effect of immunotherapy), and assessing outcomes regarding health economics. The safety profile of SIT should be evaluated using international guidelines and terminology, and needs to include high-quality surveillance data. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767940 Sat, 30 Apr 2011 15:42:43 +0100 4767940 http://www.medworm.com/index.php?rid=4767939&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000166%2Fabstract%3Frss%3Dyes Allergen-specific immunotherapy (SIT) defines and distinguishes the modern practice of clinical allergy and immunology as the 100th anniversary of this pioneering technique is celebrated. Despite the tremendous advancements made in therapeutics, pharmacology, and the basic science of allergy, SIT remains the only treatment modality that offers a potential cure for atopic diseases rather than simply an amelioration of symptoms. A historical perspective not only offers an opportunity to tell some of the fascinating stories that led to the conception of SIT but also gives an occasion to recognize, remember, and honor those individuals who have contributed to its development. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767939 Sat, 30 Apr 2011 15:42:43 +0100 4767939 http://www.medworm.com/index.php?rid=4767938&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000191%2Fabstract%3Frss%3Dyes One hundred years have elapsed since specific allergen immunotherapy (SIT) was first employed and found to be effective in the treatment of allergic respiratory diseases and 4 years since an edition of Immunology and Allergy Clinics of North America was dedicated to this topic. This publication offers a comprehensive review of this disease-modifying treatment, exploring its history, current status, and potential future. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767938 Sat, 30 Apr 2011 15:42:43 +0100 4767938 http://www.medworm.com/index.php?rid=4767937&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000221%2Fabstract%3Frss%3Dyes This year is the 100th anniversary of the first scientific publication on allergen immunotherapy. Leonard Noon, the father of allergen immunotherapy, called it “prophylactic inoculation against hay fever.” In his pioneering article, he acknowledged that Dunbar in Hamburg, Germany, through his animal experiments, provided the initial scientific understanding for sensitivity to pollens. Alexandre Besredka in Paris was the first to successfully perform allergen hyposensitization in animals. The foregoing scientific works formed the foundation for “prophylactic inoculation” against hay fever. However, the concept of prophylactic inoculation, ie, vaccination, was introduced to the Western medicine more than 100 years earlier in 1798 by Edward Jenner. Therefore, it is likely that Leonard... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767937 Sat, 30 Apr 2011 15:42:41 +0100 4767937 http://www.medworm.com/index.php?rid=4767936&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000294%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767936 Sat, 30 Apr 2011 15:42:41 +0100 4767936 http://www.medworm.com/index.php?rid=4767935&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000282%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767935 Sat, 30 Apr 2011 15:42:41 +0100 4767935 http://www.medworm.com/index.php?rid=4767934&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856111000270%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4767934 Sat, 30 Apr 2011 15:42:41 +0100 4767934 http://www.medworm.com/index.php?rid=4191166&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110001086%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4191166 Wed, 24 Nov 2010 01:15:48 +0100 4191166 http://www.medworm.com/index.php?rid=4191165&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000846%2Fabstract%3Frss%3Dyes Psychological stress has known effects on the immune system, including impacting effector and regulatory components. This can result in increased susceptibility to various infections, latent virus reactivation, and impact on immunoregulatory circuits. One of the great challenges in translational research is defining the risks associated with stress in specific patient populations and individuals. Future studies must include identification and validation of biomarkers that can categorize patient risk for adverse immune effects from various forms and degrees of psychological stress and how this impacts the course of their inflammatory disease. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4191165 Wed, 24 Nov 2010 01:15:48 +0100 4191165 http://www.medworm.com/index.php?rid=4191164&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS088985611000072X%2Fabstract%3Frss%3Dyes This review focuses on the contributions of stress-related behavioral factors to cancer growth and metastasis and the biobehavioral mechanisms underlying these relationships. Behavioral factors that are important in modulation of the stress response and the pivotal role of neuroendocrine regulation in the downstream alteration of physiologic pathways relevant to cancer control, including the cellular immune response, inflammation, and tumor angiogenesis, invasion, and cell signaling pathways are described. Consequences for cancer progression and metastasis, as well as quality of life, are delineated. Behavioral and pharmacologic interventions with the potential to alter these biobehavioral pathways for patients with cancer are discussed. (Source: Immunology and Allergy Clinics of North Ame... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4191164 Wed, 24 Nov 2010 01:15:48 +0100 4191164 http://www.medworm.com/index.php?rid=4191163&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000767%2Fabstract%3Frss%3Dyes This article highlights evidence for the impact of age and stress on neuroendocrine regulation of inflammatory processes that may substantially increase risk for inflammatory disease at older ages. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4191163 Wed, 24 Nov 2010 01:15:48 +0100 4191163 http://www.medworm.com/index.php?rid=4191162&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000810%2Fabstract%3Frss%3Dyes This article reviews the methods and findings of experimental models of wound healing. Psychological stress can have a substantial and clinically relevant impact on wound repair. Physiologic stress responses can directly influence wound-healing processes. Furthermore, psychological stress can indirectly modulate the repair process by promoting the adoption of health-damaging behaviors. Translational work is needed to develop innovative treatments able to attenuate stress-induced delays in wound healing. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4191162 Wed, 24 Nov 2010 01:15:48 +0100 4191162 http://www.medworm.com/index.php?rid=4191161&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000731%2Fabstract%3Frss%3Dyes The stress response influences the immune system, and studies in laboratory animals indicate that the response to stress significantly reduces resistance to infectious challenge. Only a few studies, however, have determined the impact of the stress response on human susceptibility to infectious challenge due, in part, to the difficulties of using live, replicating pathogens in human research. As a result, many studies have assessed the immune response to vaccination as a surrogate for the immune response to an infectious challenge. Thus, much is known about how the stress response influences adaptive immunity, and memory responses, to vaccination. These studies have yielded data concerning the interactions of the nervous and immune systems and have provided important information for clinic... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4191161 Wed, 24 Nov 2010 01:15:47 +0100 4191161 http://www.medworm.com/index.php?rid=4191160&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000809%2Fabstract%3Frss%3Dyes Allergy describes a constellation of clinical diseases that affect up to 30% of the world's population. It is characterized by production of allergen-specific IgE, which binds to mast cells and initiates a cascade of molecular and cellular events that affect the respiratory tract (rhinitis and asthma), skin (dermatitis, urticaria), and multiple systems (anaphylaxis) in response to a variety of allergens including pollens, mold spores, animal danders, insect stings, foods, and drugs. The underlying pathophysiology involves immunoregulatory dysfunctions similar to those noted in highly stressed populations. The relationships in terms of potential for intervention are discussed. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4191160 Wed, 24 Nov 2010 01:15:47 +0100 4191160 http://www.medworm.com/index.php?rid=4191159&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000743%2Fabstract%3Frss%3Dyes This article reviews literature assessing the effects of psychological stress on asthma outcomes and discusses the benefits and disadvantages of different measures for assessing stress, including subjective questionnaires, event checklists, and interview-based approaches. We discuss the importance of taking into account the timing and chronicity of stress, as well as individuals' subjective appraisals of stress. We suggest that, although questionnaire and checklist approaches are easier to administer, interview-based stress assessments are preferable, where feasible, because they generate richer and more in-depth information regarding the stressors that people experience. In addition, this kind of information seems to be more robustly linked to pediatric asthma outcomes of interest. (Sourc... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4191159 Wed, 24 Nov 2010 01:15:47 +0100 4191159 http://www.medworm.com/index.php?rid=4191158&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000822%2Fabstract%3Frss%3Dyes Several epidemiologic frameworks, exemplified through extant research examples, provide insight into the role of stress in the expression of asthma and other allergic disorders. Biologic, psychological, and social processes interact throughout the life course to influence disease expression. Studies exploiting a child development framework focus on critical periods of exposure, including the in utero environment, to examine the influence of stress on disease onset. Early stress effects that alter the normal course of morphogenesis and maturation that affect both structure and function of key organ systems (eg, immune, respiratory) may persist into adult life underscoring the importance of a life course perspective. Other evidence suggests that maternal stress influences programming of inte... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4191158 Wed, 24 Nov 2010 01:15:46 +0100 4191158 http://www.medworm.com/index.php?rid=4191157&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000755%2Fabstract%3Frss%3Dyes This article evaluates the effects of stress as a trigger and a modulator, and stress reduction as a treatment option in rheumatoid arthritis. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4191157 Wed, 24 Nov 2010 01:15:45 +0100 4191157 http://www.medworm.com/index.php?rid=4191156&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110001001%2Fabstract%3Frss%3Dyes This issue of Immunology and Allergy Clinics of North America is, in some ways, a translational follow-up to a previous issue on psychoneuroimmunology. The principles laid down in that volume are the basis for the description of the effects of psychological stress on several clinical manifestations of inflammation. We have attempted to provide broad clinical examples of the proposed immune effects that are common to all inflammatory diseases as well as specific pathways unique to particular inflammatory diseases. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4191156 Wed, 24 Nov 2010 01:15:45 +0100 4191156 http://www.medworm.com/index.php?rid=4191155&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110001013%2Fabstract%3Frss%3Dyes I want to write this foreword by describing my own state of the mind when approaching to write it. First, there is this deadline to meet, which is a stress for the mind. There is subconscious worry that I may forget it or miss the deadline. When I sit down to write it, I recognize that I have to write about a subject which is not my field of expertise. So, I do not feel sure about what to write. I could read up and then write, but will it make a difference? There is concern about how it will be perceived. You are now beginning to see what we all go through in dealing with matters in our daily life. Once we have dealt with the matter, we feel more relaxed when dealing with it for the second time. This is adaptation, which is the most important factor that determines the outcome of stress. ... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4191155 Wed, 24 Nov 2010 01:15:45 +0100 4191155 http://www.medworm.com/index.php?rid=4191154&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110001074%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4191154 Wed, 24 Nov 2010 01:15:45 +0100 4191154 http://www.medworm.com/index.php?rid=4191153&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110001128%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4191153 Wed, 24 Nov 2010 01:15:45 +0100 4191153 http://www.medworm.com/index.php?rid=4191152&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110001062%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4191152 Wed, 24 Nov 2010 01:15:45 +0100 4191152 http://www.medworm.com/index.php?rid=4109223&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000949%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4109223 Fri, 29 Oct 2010 16:08:20 +0100 4109223 http://www.medworm.com/index.php?rid=4109222&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000676%2Fabstract%3Frss%3Dyes Mycoplasma pneumoniae and Chlamydophila pneumoniae are atypical bacteria that are frequently found in patients with asthma. A definitive diagnosis of infection is often difficult to obtain because of limitations with sampling and detection. Numerous animal studies have outlined mechanisms by which these infections may promote allergic lung inflammation and airway remodeling. In addition, there is mounting evidence from human studies suggesting that atypical bacterial infections contribute to asthma exacerbations, chronic asthma, and disease severity. The role of antimicrobials directed against atypical bacteria in asthma is still under investigation. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4109222 Fri, 29 Oct 2010 16:08:20 +0100 4109222 http://www.medworm.com/index.php?rid=4109221&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000780%2Fabstract%3Frss%3Dyes Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis seem to have no role in asthma in children. Mycoplasma pneumoniae and Chlamydophila pneumoniae can induce wheezing and cause asthma exacerbations in children, and chronic Chlamydophila infections may even participate in asthma pathogenesis. However, studies have failed to show any benefits from antibiotics for incipient or stable pediatric asthma, as well as for asthma exacerbations in children. Exposure to antibiotics in infancy has been an independent risk factor of later asthma in many studies. A recent study applying molecular biology methods to lower airway samples provided preliminary evidence that lower airways are not sterile but have their own protective microbiota, which can be disturbed in lung diseases l... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4109221 Fri, 29 Oct 2010 16:08:20 +0100 4109221 http://www.medworm.com/index.php?rid=4109218&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000706%2Fabstract%3Frss%3Dyes Respiratory syncytial virus (RSV), a single-stranded RNA virus of the Paramyxoviridae family, is a major cause of bronchiolitis in infants and is also conjectured to be an early-life influence on the development of asthma. Although the data supporting a role for RSV in bronchiolitis in children are robust and evidence to support its role in juvenile asthmatics exists, RSV's role in asthma pathogenesis in adults is not as clearly defined. The authors review the literature to further elucidate RSV's impact on adult asthmatics, including its importance as a cause of asthma exacerbations. They examine the morbidity associated with RSV infection and how the immune response may differ between adult asthmatics and nonasthmatics. They review the responses by specific cell types from adults with as... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4109218 Fri, 29 Oct 2010 16:08:20 +0100 4109218 http://www.medworm.com/index.php?rid=4109217&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000688%2Fabstract%3Frss%3Dyes Viral respiratory illnesses associated with wheezing are extremely common during early life and remain a frequent cause of morbidity and hospitalization in young children. Although many children who wheeze with respiratory viruses during infancy outgrow the problem, most children with asthma and reductions in lung function at school age begin wheezing during the first several years of life. Whether symptomatic viral infections of the lower respiratory tract are causal in asthma development or simply identify predisposed children remains a controversial issue. Wheezing illnesses caused by respiratory syncytial virus (RSV), particularly those severe enough to lead to hospitalization, have historically been associated with an increased risk of asthma at school age. However, with the developme... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4109217 Fri, 29 Oct 2010 16:08:20 +0100 4109217 http://www.medworm.com/index.php?rid=4109215&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000652%2Fabstract%3Frss%3Dyes Asthma exacerbations are precipitated primarily by respiratory virus infection and frequently require immediate medical intervention. Studies of childhood and adult asthma have implicated a wide variety of respiratory viruses in exacerbations. By focusing on both RNA and DNA respiratory viruses and some newly identified viruses, this review illustrates the diversity and highlights some of the uncertainties that exist in our understanding of virus-related asthma exacerbations. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4109215 Fri, 29 Oct 2010 16:08:19 +0100 4109215 http://www.medworm.com/index.php?rid=4109214&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000792%2Fabstract%3Frss%3Dyes There has been significant progress in our knowledge about the relationship between infectious disease and the immune system in relation to asthma, but many unanswered questions still remain. Respiratory tract infections such as those caused by respiratory syncytial virus and rhinovirus during the first 2 years of life are still clearly associated with later wheezing and asthma, but the mechanism has not been completely worked out. Is there an “infectious march” triggered by infection in infancy that progresses to disease pathology or are infants who contract respiratory infections predisposed to developing asthma? This review focuses on the common themes in the interaction between microbes and the immune system, and presents a critical appraisal of the evidence to date. The various me... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4109214 Fri, 29 Oct 2010 16:08:19 +0100 4109214 http://www.medworm.com/index.php?rid=4109213&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000858%2Fabstract%3Frss%3Dyes Physicians and patients both have recognized a connection between asthma and respiratory infections since the disease was first described over two thousand years ago. The link has held throughout medical history until today; we recognize that about 80% of all asthma attacks can be associated with respiratory viral infections. We know a great deal more today than clinicians did in Hippocrates' time about the mechanism of asthma pathogenesis and pathology but the picture is still not complete. The sequencing of the human genome ushered in a decade of intense research into the genetics of disease and we have made great advances, but a complex illness like asthma whose etiology involves individual differences in immune responses, as well as an array of environmental factors from microbial infe... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4109213 Fri, 29 Oct 2010 16:08:19 +0100 4109213 http://www.medworm.com/index.php?rid=4109212&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS088985611000086X%2Fabstract%3Frss%3Dyes Infection has always been suspected to play a pivotal role in the pathogenesis and/or clinical course of asthma. Epidemiological studies have demonstrated an increased risk for atopy and asthma in children having recurrent infections or having infection with a specific microbe. Significant progress has been made in understanding the mechanism by which infection could augment an allergic immune response. The progress in the past was in part delayed by the dogma of Th1-Th2 antagonism. Allergic diseases represent a Th2 response, whereas infection typically elicits a Th1 response. Thus, it was conceptually difficult to reconcile a positive effect of infection on allergic inflammation. It should be stated that some publications had indicated a coexistence and even cooperation between Th1 and Th... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4109212 Fri, 29 Oct 2010 16:08:19 +0100 4109212 http://www.medworm.com/index.php?rid=4109211&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000937%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4109211 Fri, 29 Oct 2010 16:08:19 +0100 4109211 http://www.medworm.com/index.php?rid=4109210&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000925%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4109210 Fri, 29 Oct 2010 16:08:19 +0100 4109210 http://www.medworm.com/index.php?rid=4109209&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000913%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4109209 Fri, 29 Oct 2010 16:08:19 +0100 4109209 http://www.medworm.com/index.php?rid=4109220&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000664%2Fabstract%3Frss%3Dyes This article summarizes the current literature linking these 2 risk factors for asthma exacerbation, and reviews experimental data suggesting potential mechanisms for interactions between viral infection and allergy that cause asthma exacerbations. In addition, the authors discuss clinical evidence that treatment of allergic inflammation could help to reduce the frequency and severity of virus-induced exacerbations of asthma. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4109220 Mon, 27 Sep 2010 23:00:00 +0100 4109220 http://www.medworm.com/index.php?rid=4109219&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000718%2Fabstract%3Frss%3Dyes This article describes the different species of this virus and their roles as major triggers of asthma exacerbations. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4109219 Mon, 27 Sep 2010 23:00:00 +0100 4109219 http://www.medworm.com/index.php?rid=4109216&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS088985611000069X%2Fabstract%3Frss%3Dyes There is increasing evidence that experiencing viral wheezing illnesses early in life, especially in conjunction with allergic sensitization, is an important risk factor for the onset of asthma. In this review, the potential advantages and disadvantages of using rodent models of virus-induced chronic airway dysfunction to investigate the mechanisms by which early-life viral respiratory tract infections could initiate a process leading to chronic airway dysfunction and the asthmatic phenotype are discussed. The potential usefulness of rodent models for elucidating the viral, host, environmental, and developmental factors that might influence these processes is emphasized. There is a need for the continued development of rodent models of early-life viral respiratory tract infections that inc... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4109216 Mon, 27 Sep 2010 23:00:00 +0100 4109216 http://www.medworm.com/index.php?rid=3803499&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000615%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803499 Sat, 31 Jul 2010 05:01:52 +0100 3803499 http://www.medworm.com/index.php?rid=3803497&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000500%2Fabstract%3Frss%3Dyes The burden of atopic diseases, including atopic dermatitis (AD), is significant and far-reaching. In addition to cost of care and therapies, it affects the quality of life for those affected as well as their caretakers. Complementary and alternative therapies are commonly used because of concerns about potential adverse effects of conventional therapies and frustration with the lack of response to prescribed medications, be it due to the severity of the AD or the lack of appropriate regular use. Despite the promising results reported with various herbal medicines and biologic products, the clinical efficacy of such alternative therapies remains to be determined. Physicians need to be educated about alternative therapies and discuss benefits and potential adverse effects or limitations with... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803497 Sat, 31 Jul 2010 05:01:52 +0100 3803497 http://www.medworm.com/index.php?rid=3803496&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000433%2Fabstract%3Frss%3Dyes This review examines the scientific evidence behind the hypothesis that vitamin D plays a role in the pathogenesis of allergic diseases, along with a focus on emerging data regarding vitamin D and atopic dermatitis. Elucidated molecular interactions of vitamin D with components of the immune system and clinical data regarding vitamin D deficiency and atopic diseases are discussed. The rationale behind the sunshine hypothesis, laboratory evidence supporting links between vitamin D deficiency and allergic diseases, the clinical evidence for and against vitamin D playing a role in allergic diseases, and the emerging evidence regarding the potential use of vitamin D to augment the innate immune response in atopic dermatitis are reviewed. (Source: Immunology and Allergy Clinics of North America... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803496 Sat, 31 Jul 2010 05:01:52 +0100 3803496 http://www.medworm.com/index.php?rid=3803494&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000512%2Fabstract%3Frss%3Dyes Nursing is making a key contribution to the development and evaluation of atopic dermatitis (AD) education. Educational interventions have long been recommended and used as a critical adjunct at all levels of therapy for patients with AD to enhance therapy effectiveness. These interventions may be directed toward adult patients or the parent/caregiver or child with eczema. Education should be individualized and includes teaching about the chronic or relapsing nature of AD, exacerbating factors, and therapeutic options with benefits, risks, and realistic expectations. This important educational facet of care management is becoming increasingly difficult to accomplish in routine care visits and seems to be equally difficult to measure and evaluate. A limited number of studies to date suggest... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803494 Sat, 31 Jul 2010 05:01:51 +0100 3803494 http://www.medworm.com/index.php?rid=3803493&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000494%2Fabstract%3Frss%3Dyes Conventional therapy for atopic dermatitis has evolved along with better understanding of underlying impaired barrier function, role of microorganisms, and immune abnormalities. Emollients, along with antimicrobial and topical anti-inflammatory therapies, remain the cornerstone of conventional therapy. Recent therapeutic advances include use of nonsteroidal therapy for epidermal barrier repair, along with proactive therapy with topical corticosteroids and calcineurin inhibitors. Minimal anti-inflammatory treatment of the underlying residual disease is the immunobiologic rationale for proactive therapy. Further progress in understanding this increasingly common disease will hopefully lead to more targeted therapies. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803493 Sat, 31 Jul 2010 05:01:51 +0100 3803493 http://www.medworm.com/index.php?rid=3803492&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000457%2Fabstract%3Frss%3Dyes Although allergic contact dermatitis (CD) was previously thought to occur less frequently in patients with atopic dermatitis (AD), more recent studies show that it is at least as common in patients with AD as in the general population, if not more so. Thus, patients with AD should be considered for patch testing (PT). Although conflicting data exist, the severity of the AD may impact the PT results. Furthermore, younger patients may yield more positive PT results. Hand eczema and compositae allergy are more common in atopic patients. Reassuringly, PT is positive for topical antiseptic and corticosteroids in only a small subset of patients. When personal products are patch tested, emollients should be included in the series. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803492 Sat, 31 Jul 2010 05:01:51 +0100 3803492 http://www.medworm.com/index.php?rid=3803491&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000482%2Fabstract%3Frss%3Dyes Atopic dermatitis, a chronic disease seen by allergist-immunologists, has both dermatologic and ocular manifestations. The ocular component is often disproportionately higher than the dermatologic disease. Even if skin abnormalities seem well controlled, these patients require ophthalmic evaluation. Atopic keratoconjunctivitis in atopic dermatitis patients is characterized by acute exacerbations and requires maintenance therapy for long-term control. Future studies will continue to emphasize the use of steroid-sparing, immunomodulating agents that have the potential to provide long-lasting anti-inflammatory control with a more favorable side-effect profile. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803491 Sat, 31 Jul 2010 05:01:51 +0100 3803491 http://www.medworm.com/index.php?rid=3803489&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000469%2Fabstract%3Frss%3Dyes Food or environmental allergens play a significant pathogenic role in a subgroup of patients with atopic dermatitis (AD) and can trigger eczema flares. This review focuses on when and which diagnostic and allergen-avoidance measures are beneficial. Diagnosis of allergic triggers may be aided by skin-prick tests measuring serum-specific IgE and/or atopy patch tests (APT) based on the patient's history, and when necessary, oral food challenges (OFC). In a subset of patients, therapeutic measures, such as elimination of the incriminated allergen(s), can lead to marked improvement of AD; this is especially true for food allergens, but can also apply to inhalant allergens. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803489 Sat, 31 Jul 2010 05:01:50 +0100 3803489 http://www.medworm.com/index.php?rid=3803487&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000470%2Fabstract%3Frss%3Dyes Atopic dermatitis (AD) is one of the most common chronic childhood skin diseases affecting up to 17% of children in the United States. The point prevalence of AD has increased based on validated questionnaires in the most recent update of the International Study of Asthma and Allergies in Childhood. However, the increases are primarily in developing countries, whereas the rates have stabilized in countries with higher incomes. AD starts in early childhood with 65% of children affected by 18 months of age. Furthermore, less than half of the patients with AD have complete resolution by 7 years of age and only 60% have resolution by adulthood, indicating the chronic nature of AD. AD is a major risk factor for the development of asthma, with an increased odds ratio in children with AD in sever... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803487 Sat, 31 Jul 2010 05:01:49 +0100 3803487 http://www.medworm.com/index.php?rid=3803486&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000524%2Fabstract%3Frss%3Dyes Since the last issue of Immunology and Allergy Clinics of North America devoted to atopic dermatitis was published in 2002, a number of important observations have been made regarding our understanding of the underlying pathophysiology of this disease and new approaches, including a change in the treatment paradigm, have emerged based on these insights. I am pleased that the Consulting Editor, Dr Rafeul Alam, has identified atopic dermatitis as an important disease worthy of a timely review devoted to these advances and I am honored to once again serve as Editor for the Atopic Dermatitis issue. I wish to express my sincere gratitude to the distinguished group of authors who generously agreed to share their expertise and valuable time in contributing to these state-of-the-art reviews. These... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803486 Sat, 31 Jul 2010 05:01:49 +0100 3803486 http://www.medworm.com/index.php?rid=3803485&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000536%2Fabstract%3Frss%3Dyes The difference between atopic dermatitis and other atopic illnesses is that the pathologic process in the former can be followed visually from the start to the end. Unlike other organs affected by atopic conditions, skin can be inspected on an ongoing basis, biopsied at various stages, and intervened pharmacologically more easily. This makes atopic dermatitis an excellent model disease to study. Because of this easy accessibility, atopic dermatitis has provided exciting new knowledge to the field of allergy over the years. It is a disease where Th1, Th2, and Th17 cells work in an orderly sequence to produce a complete phenotype. The high prevalence of filagrin mutation in atopic dermatitis suggests that structural abnormalities leading to tissue permeability play an important role in the c... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803485 Sat, 31 Jul 2010 05:01:49 +0100 3803485 http://www.medworm.com/index.php?rid=3803484&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000603%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803484 Sat, 31 Jul 2010 05:01:49 +0100 3803484 http://www.medworm.com/index.php?rid=3803483&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000597%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803483 Sat, 31 Jul 2010 05:01:49 +0100 3803483 http://www.medworm.com/index.php?rid=3803482&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000585%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803482 Sat, 31 Jul 2010 05:01:49 +0100 3803482 http://www.medworm.com/index.php?rid=3803498&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000408%2Fabstract%3Frss%3Dyes Atopic dermatitis can be a challenging disease to treat, often having a chronic or relapsing course. For patients with moderate to severe disease, it can result in significant morbidity and affect quality of life of patients or families. Current treatment can be associated with side effects or patient and caregiver concerns about use. Recent advances in the understanding of barrier defects and innate and adaptive immune systemic abnormalities in atopic dermatitis have provided potential new targets for therapeutic intervention. These advances include antimicrobial peptides, antistaphylococcal toxin strategies, Th2 cytokine inhibitors, and modulation of pruritus at the neuromediator level. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803498 Thu, 08 Jul 2010 23:00:00 +0100 3803498 http://www.medworm.com/index.php?rid=3803495&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS088985611000041X%2Fabstract%3Frss%3Dyes This article reviews the effect of AD on patients and their families and intervention strategies that have some success in improving quality of life. A treatment model for addressing the psychosocial effect of moderate to severe AD within a multidisciplinary setting is suggested herein. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803495 Thu, 08 Jul 2010 23:00:00 +0100 3803495 http://www.medworm.com/index.php?rid=3803488&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000421%2Fabstract%3Frss%3Dyes Atopic dermatitis is a common childhood skin disease of increasing prevalence that greatly affects the quality-of-life of affected children and their families. The complex and multidimensional effects of this disease have been described qualitatively and measured quantitatively with quality-of-life instruments. The burden of atopic dermatitis can likely be improved by identifying parents and their caregivers with impaired quality-of-life and providing appropriate education and psychosocial support. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803488 Thu, 01 Jul 2010 23:00:00 +0100 3803488 http://www.medworm.com/index.php?rid=3803490&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000391%2Fabstract%3Frss%3Dyes Atopic dermatitis is characterized by Staphylococcus aureus colonization and recurrent skin infections. In addition to an increased risk of invasive infections by herpes simplex or vaccinia viruses, there is ample evidence that microbial pathogens, particularly S aureus and fungi, contribute to the cutaneous inflammation of atopic dermatitis. The authors describe recent developments in the pathogenesis of atopic dermatitis in relation to the role of microbial pathogens. Understanding how microbial pathogens interact or evade the cutaneous immunity of atopic dermatitis may be crucial in preventing infections or cutaneous inflammation in this disease. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3803490 Wed, 30 Jun 2010 23:00:00 +0100 3803490 http://www.medworm.com/index.php?rid=3582513&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000342%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3582513 Fri, 30 Apr 2010 23:00:00 +0100 3582513 http://www.medworm.com/index.php?rid=3582512&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000251%2Fabstract%3Frss%3Dyes A complete list of definite, as well as possible, indications for hemopoietic stem cell transplantation in primary immunodeficiency is provided. Included are: severe combined immunodeficiency, profound T cell defects, autoimmune and autoinflammatory syndromes, innate immune defects, hemophagocytic disorders, and other conditions. Some causes and limitations are included. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3582512 Fri, 30 Apr 2010 23:00:00 +0100 3582512 http://www.medworm.com/index.php?rid=3582511&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000214%2Fabstract%3Frss%3Dyes In the last decade, gene therapy for adenosine deaminase deficiency has been developed as a successful alternative strategy to allogeneic bone marrow transplant and enzyme replacement therapy. Infusion of autologous hematopoietic stem cells, corrected ex vivo by retroviral vectors and combined to low-intensity conditioning regimen, has resulted in immunologic improvement, metabolic correction, and long-term clinical benefits. These findings have opened the way to applications of gene therapy in other primary immune deficiencies using novel vector technology. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3582511 Fri, 30 Apr 2010 23:00:00 +0100 3582511 http://www.medworm.com/index.php?rid=3582510&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000202%2Fabstract%3Frss%3Dyes The concept of gene therapy emerged as a way of correcting monogenic inherited diseases by introducing a normal copy of the mutated gene into at least some of the patients' cells. Although this concept has turned out to be quite complicated to implement, it is in the field of primary immunodeficiencies (PIDs) that proof of feasibility has been undoubtedly achieved. There is now a strong rationale in support of gene therapy for at least some PIDs, as discussed in this article. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3582510 Fri, 30 Apr 2010 23:00:00 +0100 3582510 http://www.medworm.com/index.php?rid=3582509&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000172%2Fabstract%3Frss%3Dyes Adenosine deaminase (ADA)-deficient severe combined immunodeficiency (SCID) comprises approximately 10% to 15% of all cases of SCID. The clinical effects of ADA deficiency are manifest most dramatically in the immune system, where it leads to severe lymphopenia. Although hematopoietic stem cell transplantation remains the mainstay of treatment for ADA-deficient SCID, 2 other treatment options are available, namely enzyme replacement therapy with PEG-ADA and autologous hematopoietic stem cell gene therapy. In this article the author reviews the available data on treatment by these different options, and offers an overview on when each of the different treatment options should be used. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3582509 Fri, 30 Apr 2010 23:00:00 +0100 3582509 http://www.medworm.com/index.php?rid=3582508&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000226%2Fabstract%3Frss%3Dyes Typical cases of severe combined immunodeficiency present at infancy (most frequently at 6 months of age) with repeated opportunistic infections; failure to thrive; and scarcity of lymphoid tissues, including undetectable lymph nodes and a small dysplastic thymus. Patients with profound T-cell dysfunction (PTD)/combined immunodeficiency (CID) have moderate to large numbers of circulating autologous lymphocytes with variable residual function. These cells may interfere with proper engraftment and may complicate the procedure of HSCT, hence the need for conditioning. There is no immediate explanation for the excellent outcome of hematopoietic stem cell transplantation (HSCT) for PTD/CID. Historically, protocols for mismatched related donor HSCT did not include conditioning regimens, which co... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3582508 Fri, 30 Apr 2010 23:00:00 +0100 3582508 http://www.medworm.com/index.php?rid=3582507&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000184%2Fabstract%3Frss%3Dyes This article addresses recent progress in HSCT for CGD, delineates present limitations, and points to future developments. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3582507 Fri, 30 Apr 2010 23:00:00 +0100 3582507 http://www.medworm.com/index.php?rid=3582506&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000196%2Fabstract%3Frss%3Dyes The Wiskott-Aldrich syndrome (WAS) is an X-linked disorder characterized by a triad of diagnostic clinical elements: immunodeficiency, eczema, and hemorrhage caused by thrombocytopenia with small-sized platelets. The formal proof that hematopoietic cell transplantation (HCT) could be used to cure WAS revealed a requirement for both immunosuppression and myelosuppression that still underlies the standard approach to curative therapy today. The current short- and long-term toxicities of HCT are the main stumbling block for the ability to cure every patient with WAS and X-linked thrombocytopenia, and much remains to be done. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3582506 Fri, 30 Apr 2010 23:00:00 +0100 3582506 http://www.medworm.com/index.php?rid=3582505&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000160%2Fabstract%3Frss%3Dyes Major histocompatibility complex (MHC) class II expression deficiency is a rare condition with autosomal recessive transmission. The defect of MHC class II leads to combined immunodeficiency with defective CD4+ T-cell development and a lack of T helper cell–dependent antibody production by B cells. The clinical course of disease is characterized by the recurrence of bacterial, viral, fungal, and protozoan infections. The optimal symptomatic care that is available involves the prophylactic use of antibiotics and the administration of immunoglobulin with adequate nutritional support. Hematopoietic stem cell transplantation is the only known treatment available to cure MHC class II expression deficiency. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3582505 Fri, 30 Apr 2010 23:00:00 +0100 3582505 http://www.medworm.com/index.php?rid=3582504&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS088985611000024X%2Fabstract%3Frss%3Dyes This article explores and delineates the potential expansion of this technique to treat a variety of inherited diseases of immune function, the current barriers in HCT and pure HSC transplantation, and the up-and-coming strategies to combat these obstacles. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3582504 Fri, 30 Apr 2010 23:00:00 +0100 3582504 http://www.medworm.com/index.php?rid=3582503&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000238%2Fabstract%3Frss%3Dyes This issue of the Immunology and Allergy Clinics of North America contains contributions from leaders in the field discussing the option of hematopoietic stem cell transplantation (HSCT) for conditions other than severe combined immunodeficiency. Immunologists frequently face the dilemma of “To BMT or not to BMT.” Each condition should be carefully studied, ideally with homogenous patient groups. Often such studies are not available. It is therefore imperative to set interim guidelines for transplantation. These could be based on several basic principles: (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3582503 Fri, 30 Apr 2010 23:00:00 +0100 3582503 http://www.medworm.com/index.php?rid=3582502&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000263%2Fabstract%3Frss%3Dyes A quick review of the literature indicates that among all the areas of medical sciences, immunodeficiency seems to have benefited the most from the advances in the gene sequencing technology and from the human genome project. The speed of the progress is astounding. Within the first 3 months of 2010, I counted more than 25 publications in PubMed directly related to new mutations in immunodeficiency disorders. This accelerated progress is likely due to the fact that many immunodeficiency disorders result from a single gene defect. This is unlike complex diseases, such as asthma or type 2 diabetes mellitus, which are likely polygenic. The single gene mutation in immunodeficiency disorders makes them ideal candidates for gene therapy. The major hurdle to gene therapy has been the selection of... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3582502 Fri, 30 Apr 2010 23:00:00 +0100 3582502 http://www.medworm.com/index.php?rid=3582501&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000330%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3582501 Fri, 30 Apr 2010 23:00:00 +0100 3582501 http://www.medworm.com/index.php?rid=3582500&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000329%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3582500 Fri, 30 Apr 2010 23:00:00 +0100 3582500 http://www.medworm.com/index.php?rid=3582499&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000317%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3582499 Fri, 30 Apr 2010 23:00:00 +0100 3582499 http://www.medworm.com/index.php?rid=3217577&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000093%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3217577 Fri, 29 Jan 2010 13:38:23 +0100 3217577 http://www.medworm.com/index.php?rid=3217576&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856109000782%2Fabstract%3Frss%3Dyes This article reviews the literature regarding long-term neurocognitive function of patients who have received HSCT for SCID, including the effect of disease-specific characteristics, psychosocial factors, being a chronically ill child, and transplant-related factors. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3217576 Fri, 29 Jan 2010 13:38:22 +0100 3217576 http://www.medworm.com/index.php?rid=3217575&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856109000794%2Fabstract%3Frss%3Dyes Inherited defects in components of the nonhomologous end-joining DNA repair mechanism produce a T–B–NK+ severe combined immunodeficiency disease (SCID) characterized by heightened sensitivity to ionizing radiation. Patients with the radiosensitive form of SCID may also have increased short- and long-term sensitivity to the alkylator-based chemotherapy regimens that are traditionally used for conditioning before allogeneic hematopoietic cell transplantation (HCT). Known causes of radiosensitive SCID include deficiencies of Artemis, DNA ligase IV, DNA-dependent protein kinase catalytic subunit, and Cernunnos-XLF, all of which have been treated with HCT. Because of these patients' sensitivity to certain forms of chemotherapy, the approach to donor selection and the type of conditioning re... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3217575 Fri, 29 Jan 2010 13:38:22 +0100 3217575 http://www.medworm.com/index.php?rid=3217574&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856109000824%2Fabstract%3Frss%3Dyes This article addresses modifications in the conditioning regimen that might lead to further improvement in HCT outcomes. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3217574 Fri, 29 Jan 2010 13:38:22 +0100 3217574 http://www.medworm.com/index.php?rid=3217573&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856109000769%2Fabstract%3Frss%3Dyes This article reviews the important elements in the complex immunologic interactions involving cytokine networks, chemokine gradients, and the direct mediators of cellular cytotoxicity that cause clinical GVHD, and discusses the risk factors and strategies for management of GVHD. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3217573 Fri, 29 Jan 2010 13:38:22 +0100 3217573 http://www.medworm.com/index.php?rid=3217572&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856109000800%2Fabstract%3Frss%3Dyes In conclusion, the excellent long-term survival, immune reconstitution, and normal quality of life after MUD BMT suggests that in the absence of RID or PMD, MUD BMT should be offered for patients suffering from SCID. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3217572 Fri, 29 Jan 2010 13:38:22 +0100 3217572 http://www.medworm.com/index.php?rid=3217571&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856109000812%2Fabstract%3Frss%3Dyes Since the early 1980s T-cell depletion has allowed haploidentical bone marrow transplantation to be performed in patients with primary immunodeficiency for whom a matched sibling donor was not available, without causing severe graft versus host disease (GVHD). This review article presents the available data in the literature on survival, GVHD, and immune reconstitution in different categories of patients, with special emphasis on the impact of different T-cell depletion methods. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3217571 Fri, 29 Jan 2010 13:38:22 +0100 3217571 http://www.medworm.com/index.php?rid=3217570&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856109000836%2Fabstract%3Frss%3Dyes Curative treatment of Severe Combined Immunodeficiency (SCID) by Hematopoietic Cell Transplantation (HCT) remains a challenge, in particular in infants presenting with serious, poorly controllable complications. In the absence of a matched family donor, HLA-haploidentical transplantation from parental donors represents a uniformly and readily available treatment option, offering a high chance to be successful. Concerning outcomes of HCT in SCID, other important parameters beside survival need to be taken into consideration, in particular the stability and robustness of the graft and its function, as well as potential late complications, related either to the disease or to the treatment. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3217570 Fri, 29 Jan 2010 13:38:21 +0100 3217570 http://www.medworm.com/index.php?rid=3217568&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856109000770%2Fabstract%3Frss%3Dyes This article reviews the clinical and biologic lessons that have been learned from HSCT for SCID patients, and how the information has impacted the general field of allogeneic HSCT. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3217568 Fri, 29 Jan 2010 13:38:21 +0100 3217568 http://www.medworm.com/index.php?rid=3217567&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856109000848%2Fabstract%3Frss%3Dyes This article represents a historical perspective of the early investigators and their contributions. It also reviews the parallel work that oncologists and immunologists have undertaken to treat both primary immunodeficiencies and hematologic malignancies. (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3217567 Fri, 29 Jan 2010 13:38:19 +0100 3217567 http://www.medworm.com/index.php?rid=3217565&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856109000861%2Fabstract%3Frss%3Dyes Stem cell transplantation has been a life-saving procedure for patients with primary immunodeficiency for more than 4 decades. Using a family-related HLA-identical donor (RID) has been so successful (with 90% survival) that it meets consensus as first choice of therapy when stem cell therapy is recommended for primary immunodeficiency. Unfortunately, RID is available in fewer than 20% of cases. Even when available, it remains an imperfect procedure, being rarely associated with complications, such as graft-versus-host disease (GVHD). Opinions defer whether patients receiving RID should be given GVHD prophylaxis. Another controversy involves the use of conditioning, especially in cases with significant residual T cell numbers and function. Critical assessment of these practices is sorely ne... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3217565 Fri, 29 Jan 2010 13:38:19 +0100 3217565 http://www.medworm.com/index.php?rid=3217564&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS088985610900085X%2Fabstract%3Frss%3Dyes Since the discovery of the blood group in 1901 by Nobel laureate Karl Landsteiner and the first successful bone marrow transplantation in 1956 by another Nobel laureate, Donnall Thomas, we have come a long way to understanding the fundamental principles of transplantation immunology and clinical transplantation. Hematopoietic stem cell transplantation in primary immunodeficiency disorders, especially in severe combined immunodeficiency (SCID), has been a prime example of progress that this discipline has made and the difficulties it faces. The use of haplocompatible related donors has reduced the length of time required to perform transplantation and has improved the outcome. Similarly, the availability of cord blood stem cells has opened new opportunities. The requirement for precondition... Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3217564 Fri, 29 Jan 2010 13:38:19 +0100 3217564 http://www.medworm.com/index.php?rid=3217563&cid=s_33229_3_f&fid=33229&url=http%3A%2F%2Fwww.immunology.theclinics.com%2Farticle%2FPIIS0889856110000081%2Fabstract%3Frss%3Dyes (Source: Immunology and Allergy Clinics of North America) Immunology and Allergy Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3217563 Fri, 29 Jan 2010 13:38:19 +0100 3217563