Marcus S Shaker, Aikaterini Anagnostou, Matthew Greenhawt
{"title":"To the ER? Can Patients Treat Their Anaphylaxis at Home?","authors":"Marcus S Shaker, Aikaterini Anagnostou, Matthew Greenhawt","doi":"10.1007/s11882-024-01174-6","DOIUrl":"10.1007/s11882-024-01174-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>To discuss if all patients who use self-injectable epinephrine outside the hospital setting require immediate emergency care.</p><p><strong>Recent findings: </strong>Prior to 2023, anaphylaxis management guidance universally recommended that patients who use self-injectable epinephrine outside of the hospital or clinic setting immediately activate emergency medical services and seek further care. Additional food-induced anaphylaxis management recommendations specified that all patients always carry 2 auto-injector devices and give a second dose of epinephrine if there was not immediate response within 5 min of injection. Patients presenting for emergency care after epinephrine are often observed for up to 4-6 h afterwards, even when completely asymptomatic. These management steps have lacked evidence for improving outcomes, and universal implementation of these approaches is not cost-effective as guidance for food allergic patients. Epinephrine pharmacokinetics and pharmacodynamics suggest that peak physiologic response is more likely to occur closer to 15 min than before 5 min, that few patients require a second dose of epinephrine as most stabilize within 15 min of use, that 60 min of observation after a patient stabilizes after epinephrine use may be adequate as patients infrequently have further sequelae, and that not everyone needs to carry 2 epinephrine auto-injectors on their person at all times. The most recent anaphylaxis practice parameter promotes a contextualized approach to these management questions, outlining the option for watchful waiting to gauge response to epinephrine before seeking emergency care, which has been proven as a more cost-effective management strategy. The recent updated anaphylaxis care guidelines support the evolution of anaphylaxis care, in that universal, immediate activation of emergency services is not required for using self-injectable epinephrine outside the hospital setting.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":" ","pages":"623-629"},"PeriodicalIF":5.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carla S S Teixeira, Bruno Carriço-Sá, Caterina Villa, Isabel Mafra, Joana Costa
{"title":"Can Physicochemical Properties Alter the Potency of Aeroallergens? Part 2 - Impact of Physicochemical Properties.","authors":"Carla S S Teixeira, Bruno Carriço-Sá, Caterina Villa, Isabel Mafra, Joana Costa","doi":"10.1007/s11882-024-01173-7","DOIUrl":"10.1007/s11882-024-01173-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>A holistic perspective on how physicochemical properties modulate the allergenicity of proteins has recently been performed for food allergens, launching the challenge of a similar analysis for aeroallergens. After a first review on aeroallergen classification into protein families (Part 1), this second part (Part 2) will exploit the impact of physicochemical properties (abundance/biological function, protein structure/presence of post-translational modifications, ligand/cofactor/lipid-binding) on inhalant protein allergenicity.</p><p><strong>Recent findings: </strong>The abundance linked to biological function is correlated with increased allergenic risk for most protein families, while the loss of structural integrity with consequent destruction of conformational epitopes is well linked with decreased allergenicity. Ligand-binding effect totally depends on the ligand type being highly variable among aeroallergens. Knowledge about the physicochemical properties of aeroallergens is still scarce, which highlights the need for research using integrated approaches (in silico and experimental) to generate and analyze new data on known/new aeroallergens.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":" ","pages":"609-617"},"PeriodicalIF":5.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sabrina Bischoff, Mathilde Moyaert, Marnick Clijsters, Annabelle Vanderbroek, Laura Van Gerven
{"title":"Treatment of COVID-19 Associated Olfactory Dysfunction: A Systematic Review.","authors":"Sabrina Bischoff, Mathilde Moyaert, Marnick Clijsters, Annabelle Vanderbroek, Laura Van Gerven","doi":"10.1007/s11882-024-01182-6","DOIUrl":"10.1007/s11882-024-01182-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>COVID -19 associated olfactory dysfunction is widespread, yet effective treatment strategies remain unclear. This article aims to provide a comprehensive systematic review of therapeutic approaches and offers evidence-based recommendations for their clinical application.</p><p><strong>Recent findings: </strong>A living Cochrane review, with rigorous inclusion criteria, has so far included 2 studies with a low certainty of evidence. In this systematic review we list clinical data of 36 randomised controlled trials (RCTs) and non-randomised studies published between Jan 1, 2020 and Nov 19, 2023 regarding treatment options for COVID-19 associated olfactory dysfunction. Nine treatment groups were analysed, including olfactory training, local and systemic corticosteroids, platelet-rich plasma (PRP), calcium chelators, vitamin supplements including palmitoylethanolamide with luteolin, insulin, gabapentin and cerebrolysin. Primary objective was the effect of the studied treatments on the delta olfactory function score (OFS) for objective/psychophysical testing. Treatments such as PRP and calcium chelators demonstrated significant improvements on OFS, whereas olfactory training and corticosteroids did not show notable efficacy for COVID-19 associated olfactory dysfunction.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":"25 1","pages":"2"},"PeriodicalIF":5.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11525399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yiqiong Wen, Yuanyuan Zheng, Shu Hua, Tongfen Li, Xiaoqing Bi, Qiongfen Lu, Min Li, Shibo Sun
{"title":"Mechanisms of Bone Morphogenetic Protein 2 in Respiratory Diseases.","authors":"Yiqiong Wen, Yuanyuan Zheng, Shu Hua, Tongfen Li, Xiaoqing Bi, Qiongfen Lu, Min Li, Shibo Sun","doi":"10.1007/s11882-024-01181-7","DOIUrl":"https://doi.org/10.1007/s11882-024-01181-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Bone morphogenetic protein 2 (BMP2) belongs to the transforming growth factor-β (TGF-β) superfamily and plays an important role in regulating embryonic development, angiogenesis, osteogenic differentiation, tissue homeostasis, and cancer invasion. Increasing studies suggest BMP2 is involved in several respiratory diseases. This study aimed to review the role and mechanisms of BMP2 in respiratory diseases.</p><p><strong>Recent findings: </strong>BMP2 signaling pathway includes the canonical and non-canonical signaling pathway. The canonical signaling pathway is the BMP2-SMAD pathway, and the non-canonical signaling pathway includes mitogen-activated protein kinase (MAPK) pathway and phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) pathway. The BMP2 is related to pulmonary hypertension (PH), lung cancer, pulmonary fibrosis (PF), asthma, and chronic obstructive pulmonary disease (COPD). BMP2 inhibits the proliferation of pulmonary artery smooth muscle cells (PASMCs), promotes the apoptosis of PASMCs to reduce pulmonary vascular remodeling in PH, which is closely related to the canonical and non-canonical pathway. In addition, BMP2 stimulates the proliferation and migration of cells to promote the occurrence, colonization, and metastasis of lung cancer through the canonical and the non-canonical pathway. Meanwhile, BMP2 exert anti-fibrotic function in PF through canonical signaling pathway. Moreover, BMP2 inhibits airway inflammation to maintain airway homeostasis in asthma. However, the signaling pathways involved in asthma are poorly understood. BMP2 inhibits the expression of ciliary protein and promotes squamous metaplasia of airway epithelial cells to accelerate the development of COPD. In conclusion, BMP2 may be a therapeutic target for several respiratory diseases.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":"25 1","pages":"1"},"PeriodicalIF":5.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amita Aggarwal, Taciana A P Fernandes, Angela Migowa, Eve M D Smith, Maria Hanif, Kate Webb, Laura B Lewandowski
{"title":"Childhood-Onset Systemic Lupus Erythematosus (cSLE): An International Perspective.","authors":"Amita Aggarwal, Taciana A P Fernandes, Angela Migowa, Eve M D Smith, Maria Hanif, Kate Webb, Laura B Lewandowski","doi":"10.1007/s11882-024-01169-3","DOIUrl":"10.1007/s11882-024-01169-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>Childhood-onset systemic lupus erythematosus (cSLE) is a severe and potentially life-threatening chronic autoimmune disease. cSLE is more aggressive and has poorer outcomes than adult-onset disease. The global burden of cSLE is poorly understood, with most publications on cSLE originating from high-resourced settings. The reports from less resourced settings indicate high morbidity and mortality in these populations.</p><p><strong>Recent findings: </strong>In this article, we review the disparities in global access to rheumatology care and research for patients with cSLE. We highlight recent cSLE advances from all regions of the globe. We describe current obstacles to cSLE clinical care and research in all settings. Finally, we propose a path forward for high quality, equitable and accessible care to individuals with cSLE everywhere. Individuals with cSLE are at risk for morbidity and death, yet patients worldwide face challenges to adequate access to care and research. Sustained, collaborative efforts are needed to create pathways to improve care and outcomes for these patients.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":" ","pages":"559-569"},"PeriodicalIF":5.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Martha Beatriz Morales-Amparano, Maria G Teran, José Ángel Huerta-Ocampo, Luis M Teran
{"title":"Impact of Enolase in Allergic Disease.","authors":"Martha Beatriz Morales-Amparano, Maria G Teran, José Ángel Huerta-Ocampo, Luis M Teran","doi":"10.1007/s11882-024-01170-w","DOIUrl":"10.1007/s11882-024-01170-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>There is growing evidence that enolase is involved in allergy. This manuscript reviews the impact of enolase in allergic disease and describes several sources of this allergen including molds, plants, animals, and pollens, among others. IgE epitopes are carefully analyzed as they may account for cross-reactivity.</p><p><strong>Recent findings: </strong>Enolase has been previously associated to food allergy and contact dermatitis. However, other groups and we have identified recently novel enolases derived from diverse pollens in patients suffering asthma and allergic rhinitis. Exposure to outdoor enolases may cause respiratory disease. Enolase has been identified across various species and its amino acid sequence is highly conserved among different sources of this allergen. The demonstration that enolase is involved in many allergic diseases including respiratory allergies, is of clinic relevance. Thus, the development of novel molecular-based diagnostic and therapeutic strategies may pave the way for improved diagnosis and therapeutics.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":" ","pages":"571-579"},"PeriodicalIF":5.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cephalosporin Allergy: Updates on Diagnostic Testing.","authors":"Timothy G Chow, Elizabeth S Brunner, David A Khan","doi":"10.1007/s11882-024-01171-9","DOIUrl":"10.1007/s11882-024-01171-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cephalosporins are one of the most prescribed antibiotics worldwide and are implicated in a wide range of hypersensitivity reactions (HSR). This review summarizes recent updates in cephalosporin hypersensitivity with a focus on diagnostic testing.</p><p><strong>Recent findings: </strong>Reported testing strategies to evaluate different immediate and delayed cephalosporin HSR have included skin testing, in vitro testing, and diagnostic drug challenges. However, the diagnostic performance of in vivo and in vitro tests remains unclear across different hypersensitivity endotypes; adequately powered studies investigating the true positive and negative predictive value of these diagnostic modalities are needed using the reference standard of drug challenges to define cephalosporin hypersensitivity. Refinement of diagnostic testing should be guided by growth in our understanding of cephalosporin antigenic determinants. This growth will be crucial in driving further clarification of cross-reactivity between cephalosporins, and potentially delineating streamlined evaluation processes resulting in reduced unnecessary antibiotic avoidance.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":" ","pages":"581-590"},"PeriodicalIF":5.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Getting in Shape: Updates in Exercise Anaphylaxis","authors":"Annette Carlisle, Jay Adam Lieberman","doi":"10.1007/s11882-024-01176-4","DOIUrl":"https://doi.org/10.1007/s11882-024-01176-4","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose of Review</h3><p>Exercise induced anaphylaxis (EIA) can be difficult to diagnose due to the interplay of co-factors on clinical presentation and the lack of standardized, confirmatory testing.</p><h3 data-test=\"abstract-sub-heading\">Recent Findings</h3><p>EIA has been historically categorized as either food-independent or food-dependent. However, recent literature has suggested that perhaps EIA is more complex given the relationship between not only food on EIA but other various co-factors such as medications and alcohol ingestion that are either required to elicit symptoms in EIA or make symptoms worse.</p><h3 data-test=\"abstract-sub-heading\">Summary</h3><p>For the practicing clinician, understanding how these co-factors can be implicated in EIA can enable one to take a more personalized approach in treating patients with EIA and thus improve quality of life for patients.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":"25 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Epidemiology, Risk Factors, and Management of Biphasic Anaphylaxis","authors":"Matthew P. Giannetti","doi":"10.1007/s11882-024-01179-1","DOIUrl":"https://doi.org/10.1007/s11882-024-01179-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose of Review</h3><p>Biphasic anaphylaxis is a variant of anaphylaxis characterized by recurrence of symptoms after initial resolution of anaphylaxis. It was first described in the mid 1990s by Popa and Lerner. Our understanding of the pathophysiology and epidemiology of the condition has advanced considerably since then. The purpose of this manuscript is to review the literature surrounding biphasic anaphylaxis while highlighting key works and recent advances.</p><h3 data-test=\"abstract-sub-heading\">Recent Findings</h3><p>Prior studies have estimated biphasic anaphylaxis occurs in 0.4–20% of anaphylaxis episodes. The wide range may be related to differences in anaphylaxis diagnostic criteria which was inconsistent across studies. Recently identified risk factors for occurrence of biphasic anaphylaxis include severe initial symptoms including hypotension or hypoxia, delay in epinephrine use, and greater than one dose of epinephrine required to treat symptoms.</p><h3 data-test=\"abstract-sub-heading\">Summary</h3><p>Despite our progress to better understand biphasic anaphylaxis, there remain gaps in the literature. This article aims to review the recent literature including, epidemiology, risk factors, and management of biphasic anaphylaxis.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":"82 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marjon Wouters, Lisa Ehlers, Mariia Dzhus, Verena Kienapfel, Giorgia Bucciol, Selket Delafontaine, Anneleen Hombrouck, Bethany Pillay, Leen Moens, Isabelle Meyts
{"title":"Human ADA2 Deficiency: Ten Years Later.","authors":"Marjon Wouters, Lisa Ehlers, Mariia Dzhus, Verena Kienapfel, Giorgia Bucciol, Selket Delafontaine, Anneleen Hombrouck, Bethany Pillay, Leen Moens, Isabelle Meyts","doi":"10.1007/s11882-024-01163-9","DOIUrl":"10.1007/s11882-024-01163-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>In this review, an update is provided on the current knowledge and pending questions about human adenosine deaminase type 2 deficiency. Patients have vasculitis, immunodeficiency and some have bone marrow failure. Although the condition was described ten years ago, the pathophysiology is incompletely understood RECENT FINDINGS: Endothelial instability due to increased proinflammatory macrophage development is key to the pathophysiology. However, the physiological role of ADA2 is a topic of debate as it is hypothesized that ADA2 fulfils an intracellular role. Increasing our knowledge is urgently needed to design better treatments for the bone marrow failure. Indeed, TNFi treatment has been successful in treating DADA2, except for the bone marrow failure. Major advances have been made in our understanding of DADA2. More research is needed into the physiological role of ADA2.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":" ","pages":"477-484"},"PeriodicalIF":5.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}