December 15, 2014

Defining adult asthma endotypes by clinical features and patterns of volatile organic compounds in exhaled air

ResearchOpen Access

Norbert Meyer12*Jan W Dallinga3*Sarah Janine Nuss1Edwin JC Moonen3Joep JBN van Berkel3Cezmi Akdis4Frederik Jan van Schooten3 and Günter Menz1
Several classifications of adult asthma patients using cluster analyses based on clinical and demographic information has resulted in clinical phenotypic clusters that do not address molecular mechanisms. Volatile organic compounds (VOC) in exhaled air are released during inflammation in response to oxidative stress as a result of activated leukocytes. VOC profiles in exhaled air could distinguish between asthma patients and healthy subjects. In this study, we aimed to classify new asthma endotypes by combining inflammatory mechanisms investigated by VOC profiles in exhaled air and clinical information of asthma patients.

December 14, 2014

Multiple Drug Intolerance Syndrome: A Large-Scale Retrospective Study

The term multiple drug intolerance syndrome (MDIS) has been used to describe patients who express adverse drug reactions to three or more drugs without a known immunological mechanism.

December 12, 2014

Atopic dermatitis increases the effect of exposure to peanut antigen in dust on peanut sensitization and likely peanut allergy

DOI: http://dx.doi.org/10.1016/j.jaci.2014.10.007Publication stage: In Press Corrected Proof

Food allergy enhances allergic asthma in mice

ResearchOpen Access
Tiphaine Bihouée110235Gregory Bouchaud12356Julie Chesné1235David Lair1235,Camille Rolland-Debord1235Faouzi Braza1235Marie-Aude Cheminant1235Philippe Aubert357Guillaume Mahay1235Christine Sagan129Michel Neunlist357Sophie Brouard8Marie Bodinier6 and Antoine Magnan12345*


Respiratory Research 2014, 15:142  doi:10.1186/s12931-014-0142-x

Applicability of the Environmental Relative Moldiness Index for Quantification of Residential Mold Contamination in an Air Pollution Health Effects Study

December 11, 2014

Initiation of immunoglobulin therapy by subcutaneous administration in immunodeficiency patients naive to replacement therapy

ReviewOpen Access
Published: 6 December 2014
Abstract (provisional)


Alan P Koterba* and Mark R Stein
Allergy, Asthma & Clinical Immunology 2014,:63 doi:10.1186/s13223-014-0063-8
BackgroundPatients with immunodeficiency diseases require lifelong treatment with immunoglobulin (Ig), yet few studies have vetted dosing strategies and effectiveness of Ig in older patient populations. Patients requiring subcutaneous (SC) Ig (SCIG) typically start with intravenous dosing before transitioning to SCIG weekly maintenance. In this retrospective review, we investigated an alternate strategy with higher initial SC doses among an older patient population with antibody deficiency syndromes.FindingsRecords of 13 patients (mean age, 70 years) with antibody deficiencies who were naive to treatment with Ig were assessed. SCIG (Vivaglobin? [Immune Globulin Subcutaneous (Human), 16% Liquid] or Hizentra? [Immune Globulin Subcutaneous (Human), 20% Liquid]) was given twice weekly (100 mg/kg) for 2?weeks, followed by weekly (100?mg/kg) administration The mean pretreatment IgG level was 460 mg/dL; at 1, 3, and 6?months after SCIG initiation, mean IgG serum levels were 852, 907, and 943 mg/dL, respectively. Maintenance doses were unchanged during 6 months of follow-up. All patients remain on SCIG (median, 44 months). One patient developed sepsis/cholangitis unrelated to treatment 3 months after starting SCIG; no other serious bacterial infections were reported.ConclusionsInitiation of SCIG by doubling the maintenance dose over 2 weeks may be a well-tolerated and effective option for patients with antibody deficiencies requiring Ig replacement, especially among older patients.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

Biological and Genetic Markers in Occupational Asthma


Current Allergy and Asthma Reports , 15:488
Abstract: Occupational asthma (OA) is a complex disease that is often hard to diagnose due to difficulties in detecting relevant exposure, along with inherent differences in disease susceptibility. Numerous studies have attempted to identify relevant biological and genetic markers for OA and to devise tools capable of detecting exposure to the causative agent. Immunological markers, including skin prick test reactivity and specific IgE and IgG antibodies can be used to detect high-molecular-weight allergens in cases of baker’s asthma. For OA induced by low-molecular-weight agents, such as isocyanate, potential biomarkers include serum-specific IgE and IgG antibodies to isocyanate-HSA conjugate and IgG to cytokeratin 19 and transglutaminase-2. For protein-based markers, ferritin/transferrin and vitamin D-binding protein levels have been suggested for isocyanate-OA. Genetic markers of susceptibility to isocyanate-OA include human leukocyte antigen and CTNNA3. Further investigations will be needed to identify better biomarkers for OA, which may be used to inform clinical decision.

Update on rupatadine in the management of allergic disorders

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  1. J. Mullol1,*
  2. J. Bousquet2
  3. C. Bachert3
  4. G. W. Canonica4
  5. A. Giménez-Arnau5
  6. M. L. Kowalski6
  7. F. E. R. Simons7
  8. M. Maurer8,
  9. D. Ryan9 and
  10. G. Scadding10
Article first published online: 10 DEC 2014
DOI: 10.1111/all.12531
Allergy

Allergy Special Issue: Update on Rupatadine in the Management of Allergic Disorders

Volume 70Issue Supplement s100pages 1–24January 2015


Abstract

In a review of rupatadine published in 2008, the primary focus was on its role as an antihistamine, with a thorough evaluation of its pharmacology and interaction with histamine H1-receptors. At the time, however, evidence was already emerging of a broader mechanism of action for rupatadine involving other mediators implicated in the inflammatory cascade. Over the past few years, the role of platelet-activating factor (PAF) as a potent mediator involved in the hypersensitivity-type allergic reaction has gained greater recognition. Rupatadine has dual affinity for histamine H1-receptors and PAF receptors. In view of the Allergic Rhinitis and its Impact on Asthma group's call for oral antihistamines to exhibit additive anti-allergic/anti-inflammatory properties, further exploration of rupatadine's anti-PAF effects was a logical step forward. New studies have demonstrated that rupatadine inhibits PAF effects in nasal airways and produces a greater reduction in nasal symptoms than levocetirizine. A meta-analysis involving more than 2500 patients has consolidated the clinical evidence for rupatadine in allergic rhinoconjunctivitis in adults and children (level of evidence Ia, recommendation A). Other recent advances include observational studies of rupatadine in everyday clinical practice situations and approval of a new formulation (1 mg/ml oral solution) for use in children. In this reappraisal, we revisit some key properties and pivotal clinical studies of rupatadine and examine new clinical data in more detail including studies that measured health-related quality of life and studies that investigated the efficacy and safety of rupatadine in other indications such as acquired cold urticaria, mosquito bite allergy and mastocytosis.