Current Opinion in Allergy and Clinical Immunology最新文献_第2页

Nasal allergen provocation test: updated indications and diagnostic accuracy.

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-03-07 DOI: 10.1097/ACI.0000000000001066

Dichapong Kanjanawasee, Apinat Wattanaphichet, Pongsakorn Tantilipikorn, Bannawat Tantikun

{"title":"Nasal allergen provocation test: updated indications and diagnostic accuracy.","authors":"Dichapong Kanjanawasee, Apinat Wattanaphichet, Pongsakorn Tantilipikorn, Bannawat Tantikun","doi":"10.1097/ACI.0000000000001066","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001066","url":null,"abstract":"Purpose of review: The Nasal Allergen Provocation Test (NAPT) is a valuable diagnostic tool for allergic rhinitis, particularly in cases where conventional tests, such as the skin prick test (SPT) and serum-specific IgE (sIgE), yield inconclusive results. By replicating real-life allergen exposure in a controlled setting, NAPT enables the assessment of allergen-specific nasal reactivity. This article aims to review the current knowledge of NAPT.Recent findings: Recent studies have reinforced NAPT as the gold standard for confirming nasal allergic responses. In the past, test protocols, allergen dosages, and outcome measurements varied widely. However, advancements in allergen standardization, the combination of objective and subjective measurements, and metered nasal allergen application have led to an improved and more reliable test method, with ongoing efforts to establish a universal protocol for clinical testing.Summary: This review summarizes current knowledge on NAPT, including its clinical applications, indications, methodology, and recent advancements. Additionally, we compare NAPT with SPT and sIgE in terms of diagnostic accuracy. The protocols, allergen types and doses, test methodologies, and outcome measures of these studies were analyzed and compared.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From one biologic to another: the rationale and evidence behind switching therapies in chronic rhinosinusitis.

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-02-28 DOI: 10.1097/ACI.0000000000001067

Baharudin Abdullah, Farah Dayana Zahedi, Pongsakorn Tantilipikorn

{"title":"From one biologic to another: the rationale and evidence behind switching therapies in chronic rhinosinusitis.","authors":"Baharudin Abdullah, Farah Dayana Zahedi, Pongsakorn Tantilipikorn","doi":"10.1097/ACI.0000000000001067","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001067","url":null,"abstract":"Purpose of review: Although biologics had been used to treat CRSwNP, not all patients respond favourably, necessitating the use of other biologics. As there are currently no guidelines available, the process and rationale for switching biologic therapy in the treatment of CRSwNP are examined in this review.Recent findings: Due to the heterogeneity of diseases, biologic therapies may efficiently control CRSwNP but give inadequate control for asthma, or vice versa. Changing an ineffective first-line biologic to a second-line treatment or others is generally referred to as switching. The most common reasons for switching biologics are poor symptom management or ineffectiveness, and undesirable adverse effects. The ineffectiveness was largely due to the use of omalizumab or mepolizumab, whereas the adverse effects were due to dupilumab.Summary: Switching biologics is a nuanced process influenced by a variety of patient-specific and clinical factors. Biologics that effectively treat upper and lower airway diseases are recommended for optimal control in CRSwNP patients with concurrent asthma. There was no difference in outcomes between switching biologics with and without a washout period. Switching between biologics in the same class is generally not recommended. Dupilumab serves as an effective treatment option for refractory cases particularly aspirin-exacerbated respiratory disease.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Doxycycline: lights and shadows of a mysterious treatment for chronic rhinosinusitis. 强力霉素：慢性鼻炎神秘疗法的光与影。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-02-13 DOI: 10.1097/ACI.0000000000001065

Minh P Hoang, Kachorn Seresirikachorn, Kornkiat Snidvongs

{"title":"Doxycycline: lights and shadows of a mysterious treatment for chronic rhinosinusitis.","authors":"Minh P Hoang, Kachorn Seresirikachorn, Kornkiat Snidvongs","doi":"10.1097/ACI.0000000000001065","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001065","url":null,"abstract":"Purpose of review: Chronic rhinosinusitis (CRS) is a diverse condition, including different underlying pathophysiologies. Tailoring the treatment for CRS depends on the individual's specific endotype and phenotype rather than using a universal approach. The emergence of biologics in recent years has raised questions about the role of antibiotics, particularly doxycycline, in CRS management. Insights from existing research on the mechanisms and appropriate use of doxycycline therapy may guide physicians in selecting the right treatment target.Recent findings: CRS with nasal polyps (CRSwNP) is frequently associated with type 2 inflammation and characterized by tissue remodeling process that can result in recalcitrant condition. Doxycycline therapy (100 mg daily) improves CRSwNP by exerting antitissue remodeling effects through matrix metalloproteinase inhibition. Doxycycline seems to provide benefits when used alongside adequate medicine treatment.Summary: Current evidence on the use of doxycycline therapy is limited to a small number of high-quality studies. Further research is needed to explore the duration and factors of success of doxycycline in treating CRS. Like other antibiotics, doxycycline has limitations related to side effects and the potential for antibiotic resistance. Therefore, treatment decisions should be made with caution, especially when doxycycline is used in combination with other pharmacologic therapies.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Update on aspirin exacerbated respiratory disease with chronic rhinosinusitis. 阿司匹林加重慢性鼻窦炎呼吸道疾病的最新进展

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-02-01 Epub Date: 2024-12-06 DOI: 10.1097/ACI.0000000000001054

Jason R Gandre, Dennis K Ledford

{"title":"Update on aspirin exacerbated respiratory disease with chronic rhinosinusitis.","authors":"Jason R Gandre, Dennis K Ledford","doi":"10.1097/ACI.0000000000001054","DOIUrl":"10.1097/ACI.0000000000001054","url":null,"abstract":"Purpose of review: This review provides the current understanding on the mechanism, diagnosis, and treatment of aspirin exacerbated respiratory disease (AERD) with chronic rhinosinusitis (CRS).Recent findings: Updates focus on the current understanding of type 2 inflammation as a disease driver, alterations in gene expression in nasal polyps, and use of biologics in treating aspirin exacerbated respiratory disease. Recent findings include altered expression of GATA binding protein 3 (GATA3), interleukin (IL)-4, IL-5, and IL-17 in nasal polyps supports the current understanding that type 2 inflammation predominantly drives the pathophysiology of AERD with CRS. From a clinical standpoint, biologics offer an effective treatment option to address type 2 inflammation. Biologics should not be favored over endoscopic sinus surgery and aspirin desensitization with daily aspirin therapy (unless contraindication are present) due to high associated cost and failure to achieve remission.Summary: This review outlines the current approach for diagnosis and treatment of aspirin exacerbated respiratory disease with a focus on desensitization protocols, the importance of endoscopic sinus surgery, the role of biologics, and the use of leukotriene modulators.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"10-18"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of macrolides in chronic rhinosinusitis and nasal polyps. 大环内酯类药物在慢性鼻炎和鼻息肉中的作用。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-02-01 Epub Date: 2024-11-25 DOI: 10.1097/ACI.0000000000001050

Isao Suzaki

{"title":"The role of macrolides in chronic rhinosinusitis and nasal polyps.","authors":"Isao Suzaki","doi":"10.1097/ACI.0000000000001050","DOIUrl":"10.1097/ACI.0000000000001050","url":null,"abstract":"Purpose of review: Chronic rhinosinusitis (CRS) is a heterogeneous condition, so personalized treatment based on each patient's pathophysiology is essential, rather than a one-size-fits-all approach. Drug therapy for CRS has evolved significantly in recent years with the introduction of biologics, necessitating a reconsideration of the role of low-dose and long-term administration of a 14-membered ring macrolide (macrolide therapy) in the treatment of CRS. Recent research on the mechanisms of macrolide therapy and its proper use may assist physicians in improving patients' quality of life and reducing disease burden.Recent findings: A classification of the pathogenesis of CRS based on endotype has been proposed, with type 2 inflammation playing a particularly important role as a refractory factor. Macrolide therapy improves CRS via immunomodulatory and anti-inflammatory effects rather than antimicrobial action, and it is expected to be effective in patients with neutrophil-dominant inflammation.Summary: Understanding the effectiveness and limitations of macrolide therapy is critical for making the best treatment decisions, especially when combined with surgery and other pharmacologic therapies. Therefore, selecting appropriate patients for macrolide therapy is critical for achieving adequate therapeutic efficacy.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"19-26"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New insights into the mechanisms of aspirin-exacerbated respiratory disease. 阿斯匹林加重呼吸道疾病机制的新见解。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-02-01 Epub Date: 2024-12-06 DOI: 10.1097/ACI.0000000000001051

Tanya M Laidlaw

{"title":"New insights into the mechanisms of aspirin-exacerbated respiratory disease.","authors":"Tanya M Laidlaw","doi":"10.1097/ACI.0000000000001051","DOIUrl":"10.1097/ACI.0000000000001051","url":null,"abstract":"Purpose of review: Aspirin-exacerbated respiratory disease (AERD), a syndrome characterized clinically by asthma, chronic rhinosinusitis with nasal polyposis, and respiratory reactions to aspirin and other cyclooxygenase-1 inhibitors, is an inflammatory condition of the respiratory tract that is often severe and challenging to treat. There have been several recent advances in our understanding of the underlying pathology of the disease. These have been paralleled by welcome advances in the availability of targeted treatment options for patients with AERD.Recent findings: Spurred in part by results from trials of targeted biologic therapies, along with single cell genomics, there is now clear evidence that the chronic respiratory inflammation in AERD is driven by combination of local tissue factors. These include abnormalities in effector cell populations, with increased accumulation and activation of mast cells and plasma cells in the nasal polyp, along with notable epithelial barrier dysregulation. The key mediators now identified include high levels of both type 2 inflammatory cytokines (IL-4, IL-5, IL-13) and cytokines involved in broader inflammatory pathways (IL-33, TSLP, IL-6, oncostatin M), as well as the overproduction of cysteinyl leukotrienes, and the underproduction of prostaglandin E 2 .Summary: This review covers the latest insights into the immunopathogenesis of and targeted treatment of AERD, including the roles of lipids, effector cells, and inflammatory cytokines, and discusses unanswered questions regarding its pathogenesis and potential future therapies.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"41-46"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Precision medicine and choosing a biologic in asthma: understanding the current state of knowledge for predictors of response and clinical remission. 精准医学和选择哮喘生物制剂：了解反应和临床缓解预测因子的知识现状。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-02-01 Epub Date: 2024-11-29 DOI: 10.1097/ACI.0000000000001044

Sadhana Balasubramanyam, Elizabeth K George, Eileen Wang

{"title":"Precision medicine and choosing a biologic in asthma: understanding the current state of knowledge for predictors of response and clinical remission.","authors":"Sadhana Balasubramanyam, Elizabeth K George, Eileen Wang","doi":"10.1097/ACI.0000000000001044","DOIUrl":"10.1097/ACI.0000000000001044","url":null,"abstract":"Purpose of review: We review updated key literature on comparative meta-analyses and real-world effectiveness of asthma biologics, with a focus on predictors of response and clinical remission while highlighting ongoing knowledge gaps. We aim to provide insight into the many factors to consider when choosing a biologic to treat uncontrolled moderate to severe asthma.Recent findings: Predictors of response included higher type 2 (T2) biomarkers, shorter duration of asthma, and presence of key T2-related comorbidities. There were outcome-related variations in predictors. Predictors of clinical remission included better controlled asthma, better lung function, and higher T2 biomarkers. Few real-world studies included those treated with tezepelumab, a clear knowledge gap.Summary: Asthma biologics demonstrate clear real-world effectiveness. There have been significant strides in better understanding predictors of response or clinical remission to guide management, yet ongoing knowledge gaps and the heterogeneity of asthma preclude a simple algorithmic approach. Our tools for precision medicine include consideration of clinical phenotypes and shared decision making while striving to achieve clinical remission in all our patients with asthma.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"66-74"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial introductions. 编辑介绍。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-02-01 Epub Date: 2025-01-03 DOI: 10.1097/ACI.0000000000001049

引用次数: 0

Biomarkers in the diagnosis of mast cell activation. 肥大细胞活化诊断中的生物标志物。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-02-01 Epub Date: 2024-11-18 DOI: 10.1097/ACI.0000000000001046

Dayne Voelker, Thanai Pongdee

{"title":"Biomarkers in the diagnosis of mast cell activation.","authors":"Dayne Voelker, Thanai Pongdee","doi":"10.1097/ACI.0000000000001046","DOIUrl":"10.1097/ACI.0000000000001046","url":null,"abstract":"Purpose of review: Mast cell activation is defined by activation of mast cells by varying stimuli with release of chemical mediators either through degranulation or release of de novo synthesized proteins or lipid mediators. Currently, tryptase measurement increase during symptomatic episodes is the most accepted biomarker measurement for mast cell activation. However, newer diagnostic tools including clinically available urinary mast cell mediators are noninvasive and can be more readily obtained compared to serum tryptase levels. This review will highlight biomarker measurement in the diagnosis of mast cell activation.Recent findings: This review will highlight biomarker measurement in mast cell activation including serum tryptase and urinary mast cell mediators including N-methylhistamine, leukotriene E4, and 2,3-dinor-11beta-prostaglandin F2 alpha.Summary: Urine mast cell mediators obtained at baseline and during symptom exacerbation are emerging biomarkers in the diagnosis of mast cell activation. Tryptase measurement and urinary mast cell mediator measurement are currently the most accepted biomarkers for mast cell activation. Further research is needed to establish new biomarkers for mast cell activation.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":"25 1","pages":"27-33"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11676608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neuroimmune signalling pathways in chronic rhinosinusitis with nasal polyps. 慢性鼻窦炎伴鼻息肉的神经免疫信号通路。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-02-01 Epub Date: 2024-11-18 DOI: 10.1097/ACI.0000000000001048

Guled M Jama, Harsha H Kariyawasam

{"title":"Neuroimmune signalling pathways in chronic rhinosinusitis with nasal polyps.","authors":"Guled M Jama, Harsha H Kariyawasam","doi":"10.1097/ACI.0000000000001048","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001048","url":null,"abstract":"Purpose of review: To evaluate the role of neuroimmune signalling pathways in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP).Recent findings: The sinonasal mucosa is densely infiltrated by immune cells and neuronal structures that share an intimate spatial relationship within tissue compartments. Together, such neuroimmune units play a critical role in airway defence and homeostatic function. CRSwNP is primarily driven by a type 2 immune endotype in the majority of patients. So far, central and peripheral neuronal mechanisms that promote, regulate and enhance immune responses have not been investigated to any detail within this disease group. Neurogenic inflammation, mediated by neuropeptides such as substance P and calcitonin gene-related peptide (CGRP), has been shown to modulate immune responses. Emerging evidence now suggests a bidirectional communication between immune cells and neurons, with inflammatory cytokines directly activating sensory neurons and influencing their function alongside the nervous system directly modulating immune cells.Summary: The complex interplay between epithelial cells, immune cells and neurons in CRSwNP presents both challenges and opportunities for therapeutic intervention. Understanding these neuroimmune interactions not only provides valuable insights into the pathogenesis of CRSwNP but also may open up new avenues for therapeutic strategies targeting both the inflammatory and neuronal components of the disease.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":"25 1","pages":"1-9"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0