Current Opinion in Allergy and Clinical Immunology最新文献_第8页

eHealth in pediatric respiratory allergy. 儿科呼吸道过敏症的电子保健。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2024-12-01 Epub Date: 2024-09-13 DOI: 10.1097/ACI.0000000000001027

Inês Pais-Cunha, Cristina Jácome, Rafael Vieira, Bernardo Sousa Pinto, João Almeida Fonseca

{"title":"eHealth in pediatric respiratory allergy.","authors":"Inês Pais-Cunha, Cristina Jácome, Rafael Vieira, Bernardo Sousa Pinto, João Almeida Fonseca","doi":"10.1097/ACI.0000000000001027","DOIUrl":"10.1097/ACI.0000000000001027","url":null,"abstract":"Purpose of review: This review explores the relevance of eHealth technologies to address unmet needs in pediatric respiratory allergies, particularly allergic rhinitis (AR) and asthma. Given the increasing burden of these conditions, there is a pressing need for effective solutions to enhance disease surveillance, diagnosis, and management.Recent findings: Recent literature highlights the potential of eHealth tools to transform pediatric respiratory allergy care. The use of digital data for infodemiology, application of machine learning models to improve diagnostic sensitivity, smartphone apps with digital patient reported outcome measure (PROMs) and embedded sensors to monitor disease, healthcare professional dashboards with real-time data monitoring and clinical decision support systems (CDSS) are advances emerging to optimize pediatric respiratory allergy care.Summary: Integrating eHealth technologies into the pediatric respiratory allergy care pathway is a potential solution for current healthcare challenges to better meet the needs of children with AR and asthma. However, while the potential of eHealth is evident, its widespread implementation in real-world practice requires continued research, collaboration, and efforts to overcome existing barriers.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"536-542"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281708","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

Cost-effectiveness of allergen immunotherapy. 过敏原免疫疗法的成本效益。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2024-12-01 Epub Date: 2024-10-04 DOI: 10.1097/ACI.0000000000001028

Natalia Rodríguez-Otero, Elena Ramírez-Mateo, Maria Nieves Plana, Enrico Heffler, Darío Antolín-Amérigo

{"title":"Cost-effectiveness of allergen immunotherapy.","authors":"Natalia Rodríguez-Otero, Elena Ramírez-Mateo, Maria Nieves Plana, Enrico Heffler, Darío Antolín-Amérigo","doi":"10.1097/ACI.0000000000001028","DOIUrl":"10.1097/ACI.0000000000001028","url":null,"abstract":"Purpose of review: Allergic rhinitis is a relevant and global health problem affecting up to 5-50% of the general population and its prevalence is increasing due to climate change and pollution among other factors and counts among the 10 most frequent reasons for medical consultation, generating an important economic impact. Allergen immunotherapy (AIT) is the only allergy-disease-modifying treatment and there is plenty of evidence of its effectiveness with regards subcutaneous and oral routes of AIT.This narrative review article examines published literature in the last 24 months regarding the pharmacoeconomics of AIT versus standard of care treatment (SOC) for the treatment of allergic rhinitis and asthma.Recent findings: Farraia et al. assessed in 2022 subcutaneous immunotherapy (SCIT, _438/$500.28) and sublingual immunotherapy (SLIT) (_1021/$1116.19) plus symptomatic treatment versus SOC treatment in children with HDM-driven allergic asthma, measuring QALYs, decrease of medication, decrease of exacerbations and symptoms. They used the cost-effective threshold: _18 482.80 ($21 110.14), finding that AIT is cost-effective.Also, SCIT and SLIT plus symptomatic treatment was assessed versus SOC treatment in children with grass pollen allergic rhinitis. The authors concluded that SCIT (_933/$1065.67) and SLIT (_1408/ $1608.22) seem cost-effective, particularly SCIT.Summary: Allergen immunotherapy is cost-effective in the management of allergic rhinitis and asthma as compared with SOC alone. As most studies consider only during-treatment costs and no long-term benefits or preventive effects are being assessed, the real cost-effectiveness of allergen immunotherapy could be even higher.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"496-503"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371232","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

Paucity of gastrointestinal plasma cells in common variable immunodeficiency. 常见变异性免疫缺陷症患者胃肠道浆细胞缺乏。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2024-12-01 Epub Date: 2024-10-07 DOI: 10.1097/ACI.0000000000001040

Jan Willem N Marsden, Miangela M Laclé, Mirjam Severs, Helen Louisa Leavis

{"title":"Paucity of gastrointestinal plasma cells in common variable immunodeficiency.","authors":"Jan Willem N Marsden, Miangela M Laclé, Mirjam Severs, Helen Louisa Leavis","doi":"10.1097/ACI.0000000000001040","DOIUrl":"10.1097/ACI.0000000000001040","url":null,"abstract":"Purpose of review: Common variable immunodeficiency enteropathy (CVID-E) is a noninfectious complication of CVID caused by chronic inflammation of the gastrointestinal (GI) tract. Based on literature, a paucity or lack of plasma cells, although not obligatory for diagnosis, is a pathognomonic feature of CVID and more frequent in CVID-E. However, there is no consensus on standardized histopathological analysis of this feature in biopsies. In this systematic review, we highlight methods of reproducible plasma cell quantification of biopsies in CVID and describe the plasma cell counts and classes as presented in the literature.Recent findings: Reduced plasma cell counts are commonly found over the entire GI tract, except for in the oesophagus. Immunoglobulin A+ (IgA+) plasma cells appear to be the most commonly reduced plasma cell class in CVID, yet there is scarce literature on the predictive value of low IgA+ plasma cell counts in CVID-E.Summary: We propose two optimized methodologies of quantification using a cut-of value of <10 plasma cells per HPF at 40× magnification, or a proportion of ≥1-5% of total mononuclear cells, recorded over ≥3 sections, and in ≥2 biopsies, as the most conservative agreeable definitions for a paucity of plasma cells to be used in diagnostics and further research.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":"24 6","pages":"464-471"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544285","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

Update on hereditary C1q deficiency: pathophysiology, clinical presentation, genotype and management. 遗传性 C1q 缺乏症的最新进展：病理生理学、临床表现、基因型和管理。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2024-12-01 Epub Date: 2024-10-03 DOI: 10.1097/ACI.0000000000001034

Helena Buso, Clément Triaille, Aisling M Flinn, Andrew R Gennery

{"title":"Update on hereditary C1q deficiency: pathophysiology, clinical presentation, genotype and management.","authors":"Helena Buso, Clément Triaille, Aisling M Flinn, Andrew R Gennery","doi":"10.1097/ACI.0000000000001034","DOIUrl":"10.1097/ACI.0000000000001034","url":null,"abstract":"Purpose of review: C1q deficiency is a rare inborn error of immunity characterized by susceptibility to severe infections and profound immune dysregulation, with a systemic lupus erythematosus-like phenotype. The management of patients with C1q deficiency is challenged by the rarity of this condition and the wide clinical variability. This review aims to emphasize the importance of a thorough immunological and clinical characterization to help guide a personalized and comprehensive approach to patients.Recent findings: We focus on the concept of C1q deficiency as a bridge between the monogenic form of systemic lupus erythematosus and the Mendelian type I interferonopathies. Moreover, we explore the role of new treatment strategies such as Janus-associated kinase (JAK) inhibitors and allogeneic stem cell transplantation.Summary: In this narrative review, we provide a systematic overview of C1q deficiency, starting with the description of the pathophysiological background and the variable clinical phenotype, and then exploring the different prognoses, the consequent treatment strategies and future directions.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":"24 6","pages":"427-433"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544287","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

Allergen-specific immunotherapy at the extremes of age: below 5 years and elderly: evidence beyond indications? 极端年龄段的过敏原特异性免疫疗法：5 岁以下和老年人：适应症之外的证据？

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2024-12-01 Epub Date: 2024-09-19 DOI: 10.1097/ACI.0000000000001030

Cansu Özdemiral, Deniz Ilgun Gurel, Umit Sahiner

{"title":"Allergen-specific immunotherapy at the extremes of age: below 5 years and elderly: evidence beyond indications?","authors":"Cansu Özdemiral, Deniz Ilgun Gurel, Umit Sahiner","doi":"10.1097/ACI.0000000000001030","DOIUrl":"10.1097/ACI.0000000000001030","url":null,"abstract":"Purpose of review: Allergen-specific immunotherapy (AIT) has been used in clinical practice to treat allergic diseases for over 100 years. The effectiveness and safety of AIT have been substantiated in numerous studies; however, children before 5 years of age and elderly are not encompassed generally. This review aims to present the current understanding of AIT in the extremes of age.Recent findings: Early allergen immunotherapy during infancy or early childhood may prevent the development of allergic sensitization to common allergens, thereby reducing the risk of developing allergic diseases later in life. In the elderly, improved symptoms and quality of life and reduced dependence on medication are indicated the importance on the implementation of AIT. Both clinical and immunological parameters demonstrated that the treatment was effective at the time of cessation and trend to sustained tolerance.Summary: There is no specific lower or upper age limit for initiating immunotherapy; however, it is important to thoroughly evaluate the severity of disease and the risks and benefits in each case.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"510-519"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343324","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 : 2024-12-01 Epub Date: 2024-10-31 DOI: 10.1097/ACI.0000000000001038

引用次数: 0

The biological basis for current treatment strategies for granulomatous disease in common variable immunodeficiency. 常见可变免疫缺陷病肉芽肿病现行治疗策略的生物学基础。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2024-12-01 Epub Date: 2024-10-21 DOI: 10.1097/ACI.0000000000001032

Astrid C van Stigt, Giulia Gualtiero, Francesco Cinetto, Virgil A S H Dalm, Hanna IJspeert, Francesco Muscianisi

{"title":"The biological basis for current treatment strategies for granulomatous disease in common variable immunodeficiency.","authors":"Astrid C van Stigt, Giulia Gualtiero, Francesco Cinetto, Virgil A S H Dalm, Hanna IJspeert, Francesco Muscianisi","doi":"10.1097/ACI.0000000000001032","DOIUrl":"10.1097/ACI.0000000000001032","url":null,"abstract":"Purpose of review: The pathogenesis of granulomatous disease in common variable immunodeficiency (CVID) is still largely unknown, which hampers effective treatment. This review describes the current knowledge on the pathogenesis of granuloma formation in CVID and the biological basis of the current treatment options.Recent findings: Histological analysis shows that T and B cells are abundantly present in the granulomas that are less well organized and are frequently associated with lymphoid hyperplasia. Increased presence of activation markers such as soluble IL-2 receptor (sIL-2R) and IFN-ɣ, suggest increased Th1-cell activity. Moreover, B-cell abnormalities are prominent in CVID, with elevated IgM, BAFF, and CD21low B cells correlating with granulomatous disease progression. Innate immune alterations, as M2 macrophages and neutrophil dysregulation, indicate chronic inflammation. Therapeutic regimens include glucocorticoids, DMARDs, and biologicals like rituximab.Summary: Our review links the biological context of CVID with granulomatous disease or GLILD to currently prescribed therapies and potential targeted treatments.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"479-487"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460047","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

Bridging the gap: neurodevelopmental disorder risks in inborn errors of immunity. 缩小差距：先天性免疫错误的神经发育障碍风险。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2024-12-01 Epub Date: 2024-10-03 DOI: 10.1097/ACI.0000000000001036

Devika Kurup, Amy M FitzPatrick, Aleksandra Badura, Ines Serra

{"title":"Bridging the gap: neurodevelopmental disorder risks in inborn errors of immunity.","authors":"Devika Kurup, Amy M FitzPatrick, Aleksandra Badura, Ines Serra","doi":"10.1097/ACI.0000000000001036","DOIUrl":"10.1097/ACI.0000000000001036","url":null,"abstract":"Purpose of review: The aim of this review is to examine published reports of neurodevelopmental phenotypes in patients with inborn errors of immunity (IEI). We briefly discuss potential interactions between the immune and the central nervous system and the implications of this crosstalk for current clinical management guidelines.Recent findings: An increasing number of reports have described neurodevelopmental disorders (NDDs) comorbid with immune-mediated signs. However, the prevalence of this association in IEIs remains unknown.Summary: IEIs comprise a group of clinically heterogeneous disorders associated with a number of nonimmune comorbidities. Although certain neurological conditions such as microcephaly are recognized as associated features of some IEIs, NDDs are less well described. We reviewed published clinical descriptions of IEIs and found a number of comorbid NDDs in these patients, including autism spectrum disorder (ASD), behavioral deficits, and intellectual disability. Given the lack of uniform assessments for NDDs, we suspect they may be underdiagnosed in IEIs. As NDDs manifest early and can result in life-long cognitive and emotional deficits, which diminish quality of life and increase healthcare utilization, we hope to elucidate relevant pathomechanisms and raise clinician awareness of these comorbidities so appropriate and timely interventions are sought.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"472-478"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380253","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

Immunotherapy and new treatments. 免疫疗法和新疗法

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2024-12-01 Epub Date: 2024-10-04 DOI: 10.1097/ACI.0000000000001031

Yaroslav Andrew Jakymec, Justin Greiwe, Jonathan A Bernstein

{"title":"Immunotherapy and new treatments.","authors":"Yaroslav Andrew Jakymec, Justin Greiwe, Jonathan A Bernstein","doi":"10.1097/ACI.0000000000001031","DOIUrl":"10.1097/ACI.0000000000001031","url":null,"abstract":"Purpose of review: This review comes at a time where new techniques in immunotherapy administration are being developed, new innovations are being incorporated to standard techniques, and new regulations are being adopted regarding the creation and storage of allergen extracts. Prior to the release of updated practice parameters regarding allergic rhinitis and immunotherapies, this review article provides a synopsis of current recommendations, a comparison of the practices in the United States and those of Europe, and an examination of experimental methods that are being studied.Recent findings: This article seeks to review and discuss the various methods of administration, build up schedules, efficacy, effect on other atopic symptoms, and safety associated with allergen immunotherapy.Summary: Innovations in standard techniques, such as new allergoids for SCIT, appear to be effective in improving symptoms and increasing IgG levels for grass allergens. Data for newer techniques is less clear. There appears to be increased treatment-related adverse events for ILIT, worse symptom scores compared with placebo for IDIT, and insufficient studies regarding the effectiveness of EPIT for aeroallergens. New regulations seek to standardize the documentation, storage, and creation of allergen extracts.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"520-528"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371233","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

Expanding the spectrum of IPEX: from new clinical findings to novel treatments. 扩大 IPEX 的范围：从新的临床发现到新的治疗方法。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2024-12-01 Epub Date: 2024-10-11 DOI: 10.1097/ACI.0000000000001033

Marta Voarino, Filippo Consonni, Eleonora Gambineri

{"title":"Expanding the spectrum of IPEX: from new clinical findings to novel treatments.","authors":"Marta Voarino, Filippo Consonni, Eleonora Gambineri","doi":"10.1097/ACI.0000000000001033","DOIUrl":"10.1097/ACI.0000000000001033","url":null,"abstract":"Purpose of review: This review aims to provide an overview of recent research findings regarding immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome, focusing on clinical and immunological novelties, as well as emerging treatment strategies, based on the published literature of the last few years.Recent findings: While it is well known that IPEX can present with a wide range of atypical clinical manifestations, new and unique phenotypes continue to emerge, making it essential to maintain a high level of clinical suspicion both at the time of diagnosis and during follow-up. This unpredictability in clinical presentation is further compounded by the lack of a clear genotype-phenotype correlation. A valuable tool for monitoring comes from recent discoveries regarding the epigenetic signature of Tregs, which, by correlating with disease severity, could prove to be a useful biomarker for diagnosis and ongoing management. The use of biological agents is emerging as an alternative to traditional immunosuppression. Additionally, ongoing studies are exploring the feasibility of gene therapy through the introduction of the wild-type FOXP3 into peripheral CD4 + T cells.Summary: Further research is needed to fully understand the variable clinical presentations of IPEX and optimize tailored therapies, ensuring better management and outcomes for affected individuals.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":"24 6","pages":"457-463"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544284","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