Clinical and Molecular Allergy最新文献

{"title":"A 13-year real-life study on efficacy, safety and biological effects of <i>Vespula</i> venom immunotherapy.","authors":"Marcello Albanesi,&nbsp;Andrea Nico,&nbsp;Alessandro Sinisi,&nbsp;Lucia Giliberti,&nbsp;Maria Pia Rossi,&nbsp;Margherita Rossini,&nbsp;Georgios Kourtis,&nbsp;Anna Simona Rucco,&nbsp;Filomena Loconte,&nbsp;Loredana Muolo,&nbsp;Marco Zurlo,&nbsp;Danilo Di Bona,&nbsp;Maria Filomena Caiaffa,&nbsp;Luigi Macchia","doi":"10.1186/s12948-017-0079-y","DOIUrl":"https://doi.org/10.1186/s12948-017-0079-y","url":null,"abstract":"<p><strong>Background: </strong><i>Hymenoptera</i> venom immunotherapy (VIT) is a clinically effective treatment. However, little is known about its long-term clinical efficacy and biological effects. Several mechanisms have been proposed to account for VIT efficacy, including reduction of specific IgE and induction of allergen-specific IgG₄, but the overall picture remains elusive. We investigated <i>Vespula</i> VIT clinical efficacy up to 8 years after discontinuation and the kinetics of <i>Vespula</i>-specific IgE and IgG₄. Out of 686 consecutive patients we retrospectively selected and analysed a series of 23 patients with <i>Vespula</i> allergy that underwent a 5-year IT course, followed by a prolonged follow-up.</p><p><strong>Methods: </strong>Clinical efficacy of VIT was assessed as number and severity of reactions to <i>Vespula</i> re-stinging events. The presence of <i>Vespula</i>-specific IgE and IgG₄ was also monitored over time.</p><p><strong>Results: </strong>During the VIT treatment, patients were protected, reporting no reactions or mild reactions in occasion of re-stinging events. This protection was entirely maintained during the follow-up, up to 8 years. Skin reactivity (reflecting mast cell-bound <i>Vespula</i>-specific IgE) and circulating <i>Vespula</i>-specific IgE levels declined substantially during VIT. Notably, this reduction was maintained over time during the follow-up. Moreover, all the patients were analysed for IgG₄. A robust induction of <i>Vespula</i>-specific IgG₄ was observed during the VIT course, with a substantial decline during the follow-up.</p><p><strong>Conclusions: </strong>We conclude that <i>Vespula</i> VIT is a clinically effective treatment, which induces long-term protection after discontinuation. The reduction of specific IgE, assessed by skin tests and RAST, closely matches the VIT- induced protection, while the IgG₄ induction seems not to be associated with VIT clinical efficacy in the long term.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"16 ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2018-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-017-0079-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35771675","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":"Biological clocks: their relevance to immune-allergic diseases.","authors":"Roberto Paganelli,&nbsp;Claudia Petrarca,&nbsp;Mario Di Gioacchino","doi":"10.1186/s12948-018-0080-0","DOIUrl":"https://doi.org/10.1186/s12948-018-0080-0","url":null,"abstract":"<p><p>The 2017 Nobel Prize for Physiology or Medicine, awarded for the discoveries made in the past 15 years on the genetic and molecular mechanisms regulating many physiological functions, has renewed the attention to the importance of circadian rhythms. These originate from a central pacemaker in the suprachiasmatic nucleus in the brain, photoentrained via direct connection with melanopsin containing, intrinsically light-sensitive retinal ganglion cells, and it projects to periphery, thus creating an inner circadian rhythm. This regulates several activities, including sleep, feeding times, energy metabolism, endocrine and immune functions. Disturbances of these rhythms, mainly of wake/sleep, hormonal secretion and feeding, cause decrease in quality of life, as well as being involved in development of obesity, metabolic syndrome and neuropsychiatric disorders. Most immunological functions, from leukocyte numbers, activity and cytokine secretion undergo circadian variations, which might affect susceptibility to infections. The intensity of symptoms and disease severity show a 24 h pattern in many immunological and allergic diseases, including rheumatoid arthritis, bronchial asthma, atopic eczema and chronic urticaria. This is accompanied by altered sleep duration and quality, a major determinant of quality of life. Shift work and travel through time zones as well as artificial light pose new health threats by disrupting the circadian rhythms. Finally, the field of chronopharmacology uses these concepts for delivering drugs in synchrony with biological rhythms.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"16 ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2018-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-018-0080-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35745318","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":"Immunosenescence in aging: between immune cells depletion and cytokines up-regulation.","authors":"Maria Teresa Ventura,&nbsp;Marco Casciaro,&nbsp;Sebastiano Gangemi,&nbsp;Rosalba Buquicchio","doi":"10.1186/s12948-017-0077-0","DOIUrl":"https://doi.org/10.1186/s12948-017-0077-0","url":null,"abstract":"<p><strong>Background: </strong>The immunosenescence is a relatively recent chapter, correlated with the linear extension of the average life began in the nineteenth century and still in progress. The most important feature of immunosenescence is the accumulation in the \"immunological space\" of memory and effector cells as a result of the stimulation caused by repeated clinical and subclinical infections and by continuous exposure to antigens (inhalant allergens, food, etc.). This state of chronic inflammation that characterizes senescence has a significant impact on survival and fragility. In fact, the condition of frail elderly occurs less frequently in situations characterized by poor contact with viral infections and parasitic diseases. Furthermore the immunosenescence is characterized by a particular \"remodelling\" of the immune system, induced by oxidative stress. Apoptosis plays a central role in old age, a period in which the ability of apoptosis can change. The remodelling of apoptosis, together with the Inflammaging and the up-regulation of the immune response with the consequent secretion of pro-inflammatory lymphokines represents the major determinant of the rate of aging and longevity, as well as of the most common diseases related with age and with tumors. Other changes occur in the innate immunity, the first line of defence providing rapid, but unspecific and incomplete protection, consisting mostly of monocytes, natural killer cells and dendritic cells, acting up to the establishment of a adaptive immune response, which is slower, but highly specific, which cellular substrate consists of T and B lymphocytes. The markers of \"Inflammaging\" in adaptive immunity in centenarians are characterized by a decrease in T cells \"naive.\" The reduction of CD8 virgins may be related to the risk of morbidity and death, as well as the combination of the increase of CD8+ cells and reduction of CD4+ T cells and the reduction of CD19+ B cells. The immune function of the elderly is weakened to due to the exhaustion of T cell-virgin (CD95-), which are replaced with the clonal expansion of CD28-T cells.</p><p><strong>Conclusions: </strong>The increase of pro-inflammatory cytokines is associated with dementia, Parkinson's disease, atherosclerosis, diabetes type 2, sarcopenia and a high risk of morbidity and mortality. A correct modulation of immune responses and apoptotic phenomena can be useful to reduce age-related degenerative diseases, as well as inflammatory and neoplastic diseases.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"15 ","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2017-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-017-0077-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35673134","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":"Tiotropium in asthma: back to the future of anticholinergic treatment.","authors":"Matteo Bonini,&nbsp;Nicola Scichilone","doi":"10.1186/s12948-017-0076-1","DOIUrl":"https://doi.org/10.1186/s12948-017-0076-1","url":null,"abstract":"<p><p>Asthma is among the most common chronic diseases worldwide; however, despite progresses in the understanding of the patho-physiological mechanisms and advances in the development of new therapeutic options and strategies, the disease remains uncontrolled in a not trivial proportion of subjects. Thus, the need of new molecules to treat the underlying biological and functional abnormalities and to control symptoms is strongly advocated by clinicians. In this scenario, the most recent GINA guidelines have included the use of tiotropium bromide in the most severe and uncontrolled forms of the disease, in addition to treatment with inhaled corticosteroid plus long acting beta adrenergic agents. Indeed, a large body of evidence has accumulated to support the use of tiotropium bromide in asthma. The current review paper provides a state of the art systematic revision of findings on the efficacy and safety of tiotropium in the adult and paediatric asthma population. To this aim, electronic searches were undertaken in the most common scientific databases from the date of inception to March 2017. Robust and high quality evidence showed that tiotropium is effective and safe in both adults and children/adolescents. Predictive markers of response have been also suggested, as well as cost-benefit analyses reported. The tiotropium bronchodilator effect seems to be not solely related to the reduction of the smooth muscle tone. However, the observations on anti-inflammatory properties or reduction in mucus production, despite highly interesting, have been only demonstrated in in vitro studies and animal models, therefore advocating for further specifically designed investigations.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"15 ","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2017-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-017-0076-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35227552","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":"Selecting optimal second-generation antihistamines for allergic rhinitis and urticaria in Asia.","authors":"Marysia Tiongco Recto,&nbsp;Ma Teresita Gabriel,&nbsp;Kanokvalai Kulthanan,&nbsp;Pongsakorn Tantilipikorn,&nbsp;Derrick Chen-Wee Aw,&nbsp;Tak Hong Lee,&nbsp;Ch'ng Chin Chwen,&nbsp;Somasundran Mutusamy,&nbsp;Nguyen Trong Hao,&nbsp;Vo Thanh Quang,&nbsp;Giorgio Walter Canonica","doi":"10.1186/s12948-017-0074-3","DOIUrl":"https://doi.org/10.1186/s12948-017-0074-3","url":null,"abstract":"<p><strong>Background: </strong>Allergic diseases are on the rise in many parts of the world, including the Asia-Pacific (APAC) region. Second-generation antihistamines are the first-line treatment option in the management of allergic rhinitis and urticaria. International guidelines describe the management of these conditions; however, clinicians perceive the additional need to tailor treatment according to patient profiles. This study serves as a consensus of experts from several countries in APAC (Hong Kong, Malaysia, the Philippines, Singapore, Thailand, Vietnam), which aims to describe the unmet needs, practical considerations, challenges, and key decision factors when determining optimal second-generation antihistamines for patients with allergic rhinitis and/or urticaria.</p><p><strong>Methods: </strong>Specialists from allergology, dermatology, and otorhinolaryngology were surveyed on practical considerations and key decision points when treating patients with allergic rhinitis and/or urticaria.</p><p><strong>Results: </strong>Clinicians felt the need for additional tools for diagnosis of these diseases and a single drug with all preferred features of an antihistamine. Challenges in treatment include lack of clinician and patient awareness and compliance, financial constraints, and treatment for special patient populations such as those with concomitant disease. Selection of optimal second-generation antihistamines depends on many factors, particularly drug safety and efficacy, impact on psychomotor abilities, and sedation. Country-specific considerations include drug availability and cost-effectiveness. Survey results reveal bilastine as a preferred choice due to its high efficacy and safety, suitability for special patient populations, and the lack of sedative effects.</p><p><strong>Conclusions: </strong>Compliance to the international guidelines is present among allergists, dermatologists and otorhinolaryngologists; however, this is lower amongst general practitioners (GPs). To increase awareness, allergy education programs targeted at GPs and patients may be beneficial. Updates to the existing international guidelines are suggested in APAC to reflect appropriate management for different patient profiles and varying symptoms of allergic rhinitis and urticaria.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"15 ","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-017-0074-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35238789","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":"High frequency of IgE sensitization towards kiwi seed storage proteins among peanut allergic individuals also reporting allergy to kiwi.","authors":"Jenny van Odijk,&nbsp;Sigrid Sjölander,&nbsp;Peter Brostedt,&nbsp;Magnus P Borres,&nbsp;Hillevi Englund","doi":"10.1186/s12948-017-0073-4","DOIUrl":"https://doi.org/10.1186/s12948-017-0073-4","url":null,"abstract":"<p><strong>Background: </strong>IgE sensitization to storage proteins from nuts and seed is often related to severe allergic symptoms. There is a risk of immunological IgE cross-reactivity between storage proteins from different species. The potential clinical implication of such cross-reactivity is that allergens other than the known sensitizer can cause allergic symptoms. Previous studies have suggested that kiwi seed storage proteins may constitute hidden food allergens causing cross-reactive IgE-binding with peanut and other tree nut homologs, thereby mediating a potential risk of causing allergy symptoms among peanut ant tree nut allergic individuals. The objective of this study was to investigate the degree of sensitization towards kiwi fruit seed storage proteins in a cohort of peanut allergic individuals.</p><p><strong>Methods: </strong>A cohort of 59 adolescents and adults with peanut allergy was studied, and self reported allergies to a number of additional foods were collected. Quantitative IgE measurements to seed storage proteins from kiwi and peanut were performed.</p><p><strong>Results: </strong>In the cohort, 23 out of the 59 individuals were reporting kiwi fruit allergy (39%). The frequency of IgE sensitization to kiwi fruit and to any kiwi seed storage protein was higher among peanut allergic individuals also reporting kiwi fruit allergy (<i>P</i> = 0.0001 and <i>P</i> = 0.01). A positive relationship was found between IgE levels to 11S globulin (r = 0.65) and 7S globulin (r = 0.48) allergens from kiwi and peanut, but IgE levels to 2S albumin homologs did not correlate. Patients reporting kiwi fruit allergy also reported allergy to hazelnut (<i>P</i> = 0.015), soy (<i>P</i> < 0.0001), pea (<i>P</i> = 0.0002) and almond (<i>P</i> = 0.016) to a higher extent than peanut allergic individuals without kiwi allergy.</p><p><strong>Conclusions: </strong>Thirty-nine percent of the peanut allergic patients in this cohort also reported kiwi fruit allergy, they displayed a higher degree of sensitization to kiwi storage proteins from both kiwi and peanut, and they also reported a higher extent of allergy to other nuts and legumes. On the molecular level, there was a correlation between IgE levels to 11S and 7S storage proteins from kiwi and peanut. Taken together, reported symptoms and serological findings to kiwi in this cohort of patients with concurrent allergy to peanut and kiwi fruit, could be explained by a combination of cross-reactivity between the 11S and 7S globulins and co-sensitization to the 2S albumin Act d 13.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"15 ","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-017-0073-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35536407","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":"How to fit allergen immunotherapy in the elderly.","authors":"Erminia Ridolo,&nbsp;Anti Rogkakou,&nbsp;Maria Teresa Ventura,&nbsp;Irene Martignago,&nbsp;Cristoforo Incorvaia,&nbsp;Gabriele Di Lorenzo,&nbsp;Giovanni Passalacqua","doi":"10.1186/s12948-017-0075-2","DOIUrl":"https://doi.org/10.1186/s12948-017-0075-2","url":null,"abstract":"<p><p>Asthma, allergic rhinitis (AR) and atopic dermatitis are very common in young people, but in the latest decades it was increasingly recognized that also individuals of higher ages, including the population over 65 years, are concerned. Actually, it is now acknowledged the aging does not considerably alter the immune response to allergens. Allergen immunotherapy (AIT) is the only treatment that works on the causes of allergy, but elderly people are commonly excluded from AIT, except the cases of insect sting allergy. A number of recent studies showed that aged individuals also successfully respond to AIT for respiratory allergy. Therefore, there is no reason to exclude elder patients from AIT. Anyhow, clinical conditions that are considered absolute or relative contraindications are quite frequent in this aged population, thus the risk/benefit ratio must be carefully evaluated for each patient, taking into account that the more frequent occurrence of co-morbidities and the consequent need of daily-based multidrug regimen can favor adverse effects. An important issue concern the ability of AIT, and particularly of sublingual immunotherapy, to significantly improve the quality of life, that often is particularly impaired in the elderly, reducing symptoms and drugs consumption.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"15 ","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2017-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-017-0075-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36118689","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":"Tolerated drugs in subjects with severe cutaneous adverse reactions (SCARs) induced by anticonvulsants and review of the literature.","authors":"Fabrizio De Luca,&nbsp;Laura Michelina Losappio,&nbsp;Corrado Mirone,&nbsp;Jan Walter Schroeder,&nbsp;Antonella Citterio,&nbsp;Maria Gloria Aversano,&nbsp;Joseph Scibilia,&nbsp;Elide Anna Pastorello","doi":"10.1186/s12948-017-0072-5","DOIUrl":"https://doi.org/10.1186/s12948-017-0072-5","url":null,"abstract":"<p><strong>Background: </strong>Anticonvulsant hypersensitivity syndrome represents a rare but potentially fatal kind of adverse drug reaction. This clinical picture often hampers the flexibility with which alternative anticonvulsants or even other classes of drugs are prescribed in these patients, negatively affecting the efficacy of treatment and the course of the disease. The aim of this study was to analyse a group of six patients with severe cutaneous drug reactions induced by anticonvulsants and to report which alternative antiepileptic drugs and which drugs of other classes were tolerated.</p><p><strong>Case presentation: </strong>A total of six patients (2 males and 4 females, age 11-73 years) are described in this study. In all the patients the onset of the severe cutaneous drug reactions was 2-4 weeks after initiating the anticonvulsant therapy: 2 out of 6 patients presented with a drug reaction with eosinophilia and systemic symptoms under therapy with phenytoin; 2 out of 6 presented with Stevens-Johnson syndrome under therapy with lamotrigine; and 2 out of 6 presented with a toxic epidermal necrolysis, one of them under therapy with valproic acid, and the other one under therapy with lamotrigine. Alternative anticonvulsants tolerated after the reaction were: clonazepam, levetiracetam, diazepam, delorazepam and lormetazepam.</p><p><strong>Conclusions: </strong>In our cases we observed that non aromatic anticonvulsants and benzodiazepines were well tolerated as alternative treatments in six patients with reactions to aromatic anticonvulsivants and that the risk of hypersensitivity reactions to other drug classes was not increased as compared to general population.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"15 ","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2017-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-017-0072-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35504747","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":"A survey on the perception of allergy specialists about the reimbursed grass pollen tablets for seasonal allergic rhinitis in Italy.","authors":"Ilaria Massaro,&nbsp;Oliviero Rossi,&nbsp;Cristoforo Incorvaia,&nbsp;Carlo Lombardi","doi":"10.1186/s12948-017-0071-6","DOIUrl":"https://doi.org/10.1186/s12948-017-0071-6","url":null,"abstract":"<p><strong>Background: </strong>Sublingual immunotherapy (SLIT) is a feasible option to classical subcutaneous immunotherapy to treat respiratory allergy and is increasingly prescribed in Europe. However, the lack of reimbursement may limit its prescription. In 2015, the 5-grass pollen tablets was authorized by the European Medicine Agency to treat grass-pollen induced rhinitis and was approved in Italy for full reimbursement. We evaluated the opinions of allergy specialists after the availability of the reimbursed 5-grass pollen tablets.</p><p><strong>Methods: </strong>A multiple choice questionnaire composed by six questions was used to assess the specialists opinion. The questionnaire was uploaded on the free access online platform SurveyMonkey. The link to access the platform was sent to all members of the Società Italiana di Asma, Allergologia e Immunologia Clinica (SIAAIC). The access to the questionnaire was anonymous. At survey ending, the access was closed and data were downloaded directly from SurveyMonkey website.</p><p><strong>Results: </strong>The questionnaire was filled by 70 allergists. The majority of allergists felt as most important the concept of SLIT as a drug, the content of allergen extract mirroring the natural exposure, the pre-coseasonal schedule as the most patient's oriented, the very good profile of tolerability and safety, the importance of the build-up phase, and the importance of checking the patient after starting immunotherapy.</p><p><strong>Conclusions: </strong>The opinions of the Italian allergy specialists about the reimbursed 5-grass-pollen tablets are very positive and make likely an appropriate prescription of SLIT for grass-pollen induced rhinitis in the next years.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"15 ","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2017-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-017-0071-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35419837","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":"Preventive actions of allergen immunotherapy: the facts and the effects in search of evidence.","authors":"Irene Martignago,&nbsp;Cristoforo Incorvaia,&nbsp;Erminia Ridolo","doi":"10.1186/s12948-017-0070-7","DOIUrl":"https://doi.org/10.1186/s12948-017-0070-7","url":null,"abstract":"<p><p>Allergen immunotherapy (AIT) is the only treatment that works on the causes of allergy. Available AIT nowadays are subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) for allergic rhinitis and asthma, while for allergy to <i>Hymenoptera</i> venom only subcutaneous route is recommended. A bulk of trials and meta-analyses demonstrated that efficacy and safety of AIT in decreasing allergic clinical symptoms and use of rescue medications, while its preventive capacity is yet under investigation. The most important of these effects is the prevention of potentially fatal anaphylactic reactions to <i>Hymenoptera</i> stings by venom immunotherapy (VIT). A certain number of studies thus far available showed that AIT, in both forms, is able to prevent the progress of allergic rhinitis into asthma and the development of new sensitizations. These effects should be related to the mechanisms of action of AIT. In fact, it has been demonstrated that both SCIT and SLIT are able to modify the allergen presentation by dendritic cells, with result in modification of the phenotype of allergen-specific T cells, switching from the typical of allergic inflammation Th2-type response to a Th1-type one. Also allergen-specific T regulatory (Treg) cells play a pivotal role by producing suppressive cytokines, such as IL-10 and TGF-beta. However, the only plain evidence of a preventive effect concerns VIT, while the other outcomes need to be furtherly investigated.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"15 ","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2017-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-017-0070-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35109048","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}