Allergologie select最新文献

{"title":"Regulatory framework for development and marketing authorization of allergen products for diagnosis of rare type I and type IV allergies: The current status.","authors":"Julia Zimmer, Vera Mahler","doi":"10.5414/ALX02505E","DOIUrl":"10.5414/ALX02505E","url":null,"abstract":"<p><p>Development, production, and marketing authorization of allergen products is generally challenging due to several specific characteristics, including the natural source as well as the multitude of allergenic materials. Also, depending on the frequency of sensitization in the population, the number of patients available for inclusion in clinical trials can be a limiting factor for product development. In the development of allergen products for diagnosis of type I and type IV allergies these challenges are particularly demanding because, in contrast to certain products for allergen-specific immunotherapy, no exemptions from marketing authorization are foreseen for this product group in Directive 2001/83/EC. Thus, the regulatory framework is constantly adapted within the legal scope in order to balance necessary regulatory requirements ensuring quality, safety, and efficacy with the clinical need for a comprehensive range of diagnostic allergen products. In this article, we give an overview on the current regulatory framework for development and marketing authorization of allergen products for diagnosis of rare type I and type IV allergies.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"212-219"},"PeriodicalIF":0.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostics of IgE-mediated occupational allergies: Between reality, requirements, and opportunities.","authors":"Monika Raulf, Sabine Kespohl","doi":"10.5414/ALX02500E","DOIUrl":"10.5414/ALX02500E","url":null,"abstract":"<p><p>Occupational skin and respiratory allergies are among the most common occupational diseases in Germany. The identification of the allergy trigger is essential for the recognition of an occupational allergy as well as for effective individual prevention. However, occupational type I allergens are among the \"rare\" allergens and the possibilities of guideline-compliant diagnosis using quality-tested skin test solutions is becoming increasingly difficult due to the reduction in commercially available test allergens. In order to guarantee meaningful diagnostic workup for all affected insured persons with suspected occupational type I allergies and to ensure this in the future, a durable optimization, standardization, and availability of allergy tests for occupational allergic diseases is urgently required. The need for action has been recognized by the German Social Accident Insurance (DGUV), and steps to eliminate the diagnostic gaps have been initiated by a joint research project at the Institute for Prevention and Occupational Medicine of the DGUV (IPA) and the Paul Ehrlich Institut (PEI). The evaluation of alternative methods for the production of standardized test allergen solutions can also be used for newly emerging allergens in the workplace. New allergen sources at workplaces and thus also sensitization and allergies among employees can be expected as a result of changes in work processes and the introduction of new technologies and/or working materials, which are also introduced in connection with climate change and the concept of sustainability.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"220-227"},"PeriodicalIF":0.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Climate-friendly\" diets from an allergy point of view.","authors":"Imke Reese","doi":"10.5414/ALX02471E","DOIUrl":"https://doi.org/10.5414/ALX02471E","url":null,"abstract":"<p><p>Since the EAT-Lancet Commission's call for a change in diet towards more plant-based foods, especially protein sources, this so called \"Planetary Health Diet (PHD)\" has been widely discussed. While for some the reduction in animal foods is not enough and vegan diets are advocated to save the climate, others are sounding the alarm that the reduction is too drastic and that the PHD makes it impossible to provide a diet that meets our needs (of essential nutrients). In addition to climate aspects, health benefits often cited to justify the PHD do not take into account that vegetarians/vegans differ from the general population by far more factors than the reduction or elimination of animal foods. Also not sufficiently discussed is the fact that a diet which excludes or severely restricts animal foods is also associated with health risks if critical nutrients are not adequately covered. Moreover, the challenge of meeting protein requirements is underestimated by many. The food industry has responded to the trend towards more plant-based foods by massively expanding the range of highly processed or ultra-processed vegan foods. These - vegan or not vegan - are suspected of being partly responsible for the development of non-communicable diseases. In addition to general criticism regarding the usefulness of advertising the PHD, the replacement of animal protein sources with plant-based sources notably harbors a number of additional relevant risks for allergy sufferers so that the latter should be classified as an unfavorable target group for the implementation of the PHD recommendations.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"199-205"},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patch testing in occupational dermatology: Practical aspects in relation to the conditions in Germany.","authors":"Richard Brans, Christoph Skudlik","doi":"10.5414/ALX2483E","DOIUrl":"https://doi.org/10.5414/ALX2483E","url":null,"abstract":"<p><p>Allergic contact dermatitis is one of the most frequent occupational skin diseases. Targeted allergen avoidance can only be achieved by identification of the causative allergen. Therefore, patch testing is of utmost importance in occupational dermatology, not only in terms of assessing causal relationships but also regarding the implementation of prevention measures and evaluation of the legal criteria for an occupational skin disease in Germany (statutory occupational disease BK 5101). The lack of commercial patch test preparations poses a great diagnostic challenge. Patch testing of patient's own materials from their workplace is therefore very important to reduce diagnostic gaps. The performance and documentation of the patch test should be in line with current guidelines and recommendations to ensure the necessary test quality and comprehensibility of the test results.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"82-89"},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AWMF mold guideline \"Medical clinical diagnostics for indoor mold exposure\" - Update 2023 AWMF Register No. 161/001.","authors":"Julia Hurraß, Birger Heinzow, Sandra Walser-Reichenbach, Ute Aurbach, Sven Becker, Romuald Bellmann, Karl-Christian Bergmann, Oliver A Cornely, Steffen Engelhart, Guido Fischer, Thomas Gabrio, Caroline E W Herr, Marcus Joest, Christian Karagiannidis, Ludger Klimek, Martin Köberle, Annette Kolk, Herbert Lichtnecker, Thomas Lob-Corzilius, Norbert Mülleneisen, Dennis Nowak, Uta Rabe, Monika Raulf, Jörg Steinmann, Jens-Oliver Steiß, Jannik Stemler, Ulli Umpfenbach, Kerttu Valtanen, Barbora Werchan, Birgit Willinger, Gerhard A Wiesmüller","doi":"10.5414/ALX02444E","DOIUrl":"10.5414/ALX02444E","url":null,"abstract":"<p><p>None.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"90-198"},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid response to dupilumab in an adult patient with eosinophilic esophagitis and allergic asthma.","authors":"Benjamin Klein, Regina Treudler","doi":"10.5414/ALX02485E","DOIUrl":"https://doi.org/10.5414/ALX02485E","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic esophagitis (EoE) is an inflammatory disease of the esophagus that belongs to the spectrum of Th2-mediated diseases. It is often associated with atopic comorbidities such as allergic asthma (AA) and poses a therapeutic challenge.</p><p><strong>Case report: </strong>We report on a 43-year-old patient with EoE and AA who did not show sufficient therapeutic control despite standard therapy. We started treatment with dupilumab, whereupon both EoE and AA rapidly improved and complete symptom resolution could be documented. The response to dupilumab was assessed by laboratory monitoring and gastroscopy, which showed a reduction of markers of type II inflammation and eosinophilic infiltrates in the esophagus.</p><p><strong>Summary: </strong>Our report emphasizes the effective and safe use of dupilumab as a treatment option for EoE with concomitant beneficial effects on AA.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"78-81"},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Animal exposure, sensitization, and allergic symptoms in first-year veterinary medicine students.","authors":"Eva Zahradnik, Christoph Nöllenheidt, Ingrid Sander, Alexandra Beine, Martin Lehnert, Frank Hoffmeyer, Monika Raulf","doi":"10.5414/ALX02449E","DOIUrl":"10.5414/ALX02449E","url":null,"abstract":"<p><p>The AllergoVet study longitudinally examines the influence of animal exposure on the development of sensitization and allergic diseases among veterinary medicine students. In this group, contact to animals usually existed long before the study began. Therefore, the aim of this analysis was to investigate lifelong animal species-specific exposure and the prevalence of sensitizations and allergic symptoms already existing before the start of the study. Questionnaire data, including exposure history, were summarized to determine the duration and intensity of animal-related exposure as well as the prevalence of allergic symptoms to animals. Serologically, specific IgE was determined against ubiquitous inhalant allergens (atopy screen sx1) and against animal allergens using ImmunoCAP. The association between animal-specific sensitization, allergic symptoms, and exposure was analyzed using Fisher's exact test or Cochran-Armitage trend test. All study participants (n = 313) had previous contact with animals, with dogs mentioned most frequently (91.1%) followed by cats (89.5%) and horses (72.2%). Sensitization to ubiquitous allergens (positive sx1 value) was detected in 38.4% of subjects. Approximately 11%, 7%, and 5% were sensitized to cats, dogs, and horses, respectively. Only a small proportion of these sensitizations were associated with self-reported symptoms (41% for cat, 9% for dog, and 13% for horse). While no significant association between animal-specific exposure and sensitization was found for cats and horses, a clear trend emerged for dogs. With increasing duration of exposure to dogs, the number of dog-specific sensitizations decreased significantly (p = 0.0069). Furthermore, a decreasing trend in sx1 sensitization was noted with increasing cat (p = 0.0288) and dog (p = 0.0107) exposure. None of the subjects who grew up on a farm (n = 40) had any sensitization to animals. The sensitization prevalence determined among first-year students in veterinary medicine roughly corresponds to that in the general population. Most animal sensitizations were not clinically relevant. In this collective, a protective effect of increasing exposure to animals in childhood and adolescence was found on sensitization, which was particularly pronounced during contact with dogs.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"51-63"},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10975734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EGPA: Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) as a special presentation of chronic rhinosinusitis with nasal polyps (CRSwNP).","authors":"Jan Hagemann, Martin Laudien, Sven Becker, Mandy Cuevas, Felix Klimek, Roya Kianfar, Ingrid Casper, Ludger Klimek","doi":"10.5414/ALX02475E","DOIUrl":"10.5414/ALX02475E","url":null,"abstract":"<p><strong>Introduction: </strong>Eosinophilic granulomatosis with polyangiitis (EGPA) was formerly known as Churg-Strauss syndrome. The condition is characterized by disseminated necrotizing vasculitis with extravascular granulomas associated with hypereosinophilia. The vasculitides affect small vessels and are associated with antineutrophil cytoplasmic antibodies (ANCAs) detectable in the blood. Distinguishing between type 2-mediated chronic airway inflammation such as chronic rhinosinusitis with nasal polyps (CRSwNP) without vasculitis can be clinically challenging and should be considered.</p><p><strong>Materials and methods: </strong>Immunological background, diagnosis, and therapy of EGPA were identified through literature searches in Medline, PubMed, as well as national and international studies (ClinicalTrials.gov) and the Cochrane Library. Human studies published up to and including 10/2023 on the topic were considered.</p><p><strong>Results: </strong>In cases of deteriorating general health with previously known eosinophilic inflammation of the upper and lower airways, EGPA and its interdisciplinary investigation should be considered. Various types of eosinophilic inflammation and syndromes must be considered differentially.</p><p><strong>Conclusion: </strong>Characterization of mucosal airway inflammation through biomarker determination is meaningful and occasionally makes the difference for targeted therapy.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"18-25"},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10975735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring mepolizumab treatment in chronic rhinosinusitis with nasal polyps (CRSwNP): Discontinue, change, continue therapy?","authors":"Ludger Klimek, Ulrike Förster-Ruhrmann, Heidi Olze, Achim G Beule, Adam M Chaker, Jan Hagemann, Tilman Huppertz, Thomas K Hoffmann, Stefan Dazert, Thomas Deitmer, Sebastian Strieth, Holger Wrede, Wolfgang W Schlenter, Hans-Jürgen Welkoborsky, Barbara Wollenberg, Sven Becker, Fredericke Bärhold, Felix Klimek, Ingrid Casper, Jaron Zuberbier, Claudia Rudack, Mandy Cuevas, Constantin A Hintschich, Orlando Guntinas-Lichius, Timo Stöver, Christoph Bergmann, Pascal Werminghaus, Oliver Pfaar, Jan Gosepath, Moritz Gröger, Caroline Beutner, Martin Laudien, Rainer K Weber, Tanja Hildebrand, Anna S Hoffmann, Claus Bachert","doi":"10.5414/ALX02460E","DOIUrl":"10.5414/ALX02460E","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial inflammatory disease of the mucous membranes of the nose and sinuses. Eosinophilic inflammation is described as a common endotype. The anti-IL-5 antibody mepolizumab was approved in November 2021 as an add-on therapy to intranasal glucocorticosteroids for the treatment of adults with severe chronic rhinosinusitis with nasal polyps when systemic glucocorticosteroids or surgery do not provide adequate disease control. While national and international recommendations exist for the use of mepolizumab in CRSwNP, it has not yet been adequately specified how this therapy should be monitored, what follow-up documentation is necessary, and when it should be discontinued if necessary.</p><p><strong>Materials and methods: </strong>A literature search was performed to analyze previous data on the treatment of CRSwNP with mepolizumab and to determine the available evidence by searching Medline, Pubmed, the national and international trial and guideline registries, and the Cochrane Library. Human studies published in the period up to and including 10/2022 were considered.</p><p><strong>Results: </strong>Based on the international literature and previous experience by an expert panel, recommendations for follow-up, adherence to therapy intervals, and possible therapy breaks as well as discontinuation of therapy when using mepolizumab for the indication CRSwNP in the German healthcare system are given on the basis of a documentation sheet.</p><p><strong>Conclusion: </strong>Understanding the immunological basis of CRSwNP opens up new non-surgical therapeutic approaches with biologics for patients with severe, uncontrolled courses. Here, we provide recommendations for follow-up, adherence to therapy intervals, possible therapy pauses, or discontinuation of therapy when mepolizumab is used as add-on therapy with intranasal glucocorticosteroids to treat adult patients with severe CRSwNP that cannot be adequately controlled with systemic glucocorticosteroids and/or surgical intervention.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"26-39"},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10975744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eosinophil granulocytes in chronic inflammatory respiratory diseases and CRSwNP: Function, immunological basis, and clinical significance.","authors":"Felix Klimek, Christoph Bergmann, Jan Hagemann, Mandy Cuevas, Sven Becker, Oliver Pfaar, Ingrid Casper, Ludger Klimek","doi":"10.5414/ALX02469E","DOIUrl":"10.5414/ALX02469E","url":null,"abstract":"<p><strong>Introduction: </strong>Eosinophils play an important regulatory and immunomodulatory role in airway mucosa and have antiparasitic and antiviral properties as well as pro-inflammatory effects that may also cause persistence of inflammation with tissue remodeling. The number of eosinophils and the detection of specific mediators in biological samples from, e.g., blood, nasal secretions, and bronchial fluid can serve as biomarkers that reflect the underlying pathophysiology of certain diseases, predict treatment success, and detect therapy effects.</p><p><strong>Materials and methods: </strong>A literature search was conducted to determine the immunologic basis, mode of action, clinical significance, and available evidence for therapeutic approaches using eosinophil-targeted monoclonal antibodies by searching Medline, Pubmed, and the national and international trial database (ClinicalTrials.gov) and guideline registries as well as the Cochrane Library. Human studies published on the topic in the period up to and including 10/2023 were considered.</p><p><strong>Results: </strong>Based on the international literature and previous experience, the results are summarized, and recommendations are given.</p><p><strong>Conclusion: </strong>The important role of eosinophils in immunological processes in the airway mucosa is comprehensively analyzed and can serve as a basis for current and future treatment approaches.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"40-50"},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10975747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}