Current Allergy and Asthma Reports最新文献

{"title":"Predictors of Clonality and Underlying Mastocytosis in Mast Cell Activation Syndromes.","authors":"David Gonzalez-de-Olano, Iván Álvarez-Twose","doi":"10.1007/s11882-023-01122-w","DOIUrl":"10.1007/s11882-023-01122-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Mast cell (MC) activation can present with a wide range of symptoms. The mechanisms that cause such activation are varied. One of them is the presence of clonal MCs which is defined, within other possible changes, by the presence of a somatic, activating mutation in the KIT gene. The clinical course and prognosis of patients with this underlying disease may be different from other causes of MC activation (MCA). For this reason, it is important to early diagnose, or at least suspect, which patients with MCA are due to clonal MCs.</p><p><strong>Recent findings: </strong>The diagnosis of clonality must be made in a comprehensive manner. However, this paper reviews chronologically each of the stages from the patient's first visit to the doctor's office which can be indicative of clonality: clinical presentation of MCA, physical examination, analytical determinations of tryptase, and/or KIT mutational analysis and bone involvement, among others. The different clonality predictive scores proposed are also reviewed and compared. Although the gold standard for the diagnosis of certainty of MC clonality is the performance of a bone marrow (BM) biopsy, there are clinical symptoms, signs, and biological parameters suggestive of clonality, as well as predictive scores, which can guide (or rule out) an early diagnosis and avoid unnecessary BM biopsies.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":" ","pages":"25-32"},"PeriodicalIF":5.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547362","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":"Urine Mast Cell Mediators in the Evaluation and Diagnosis of Mast Cell Activation Syndrome.","authors":"Dayne Voelker, Thanai Pongdee","doi":"10.1007/s11882-024-01128-y","DOIUrl":"10.1007/s11882-024-01128-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Mast cell activation syndrome is defined by severe, episodic, and recurrent symptoms induced by mast cell mediators with objective measurement of increase in biomarkers of mast cell activation and treatment response with mast cell therapies. Increase in serum tryptase from baseline during a mast cell activation episode is currently the most accepted biomarker measurement of mast cell release. However, during symptomatic episodes, serum tryptase can be difficult to obtain as it is a venipuncture procedure. Other objective measures of mast cell activation are needed to complement serum tryptase.</p><p><strong>Recent findings: </strong>Urine mast cell mediators can be collected at home and are non-invasive tests. There is emerging evidence for the utility of urine mast cell mediators including histamine, cysteinyl leukotrienes, and prostaglandins in the diagnosis of mast cell activation syndrome. In this review, clinically available urine mast cell mediators will be discussed including N-methylhistamine, leukotriene E4, and 2,3-dinor-11beta-prostaglandin F2 alpha. We discuss the rationale for the use of these urine mast cell mediators and examine the studies analyzing their performance for identifying mast cell activation.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":" ","pages":"33-38"},"PeriodicalIF":5.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486839","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":"Cognitive Impairment and Depression in Mastocytosis: A Synthesis of the Literature.","authors":"Jennifer Nicoloro-SantaBarbara, Marzieh Majd, Katherine E Burdick, Victoria Dixon, Matthew P Giannetti","doi":"10.1007/s11882-024-01127-z","DOIUrl":"10.1007/s11882-024-01127-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Symptoms of depression and cognitive dysfunction are commonly reported in mastocytosis. The aims of this review paper are to summarize the current literature on cognitive dysfunction and depressive symptoms, elucidate some of the mechanistic pathways underlying depressive symptoms in mastocytosis, identify gaps in the literature, and offer guidance for future research in this area.</p><p><strong>Recent findings: </strong>The study of cognition and depression in mastocytosis is in its infancy and the methodological flaws of the current literature limit interpretability. There is preliminary evidence that some individuals with mastocytosis might experience mild deficits in memory. On average, depression symptom scores fell within the mild to moderate or sub-syndromal range. Regrettably, only one study utilized a standardized diagnostic instrument to assess major depressive disorder. The authors' tendency to inaccurately equate depressive symptoms with a diagnosis of major depressive disorder presents a notable issue. The prevalence of cognitive deficits and depression appears to be similar to other chronic illnesses. Future work needs to better characterize cognition and characterize \"depression\" in this population.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":" ","pages":"53-62"},"PeriodicalIF":5.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643453","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":"Using the Right Criteria for MCAS.","authors":"Theo Gulen","doi":"10.1007/s11882-024-01126-0","DOIUrl":"10.1007/s11882-024-01126-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>The current article aims to provide a comprehensive update on diagnostic criteria for mast cell activation syndrome (MCAS), addressing challenges in diagnosing and classifying MCAS and its variants.</p><p><strong>Recent findings: </strong>In recent years, there has been a significant increase in our knowledge regarding the underlying mechanisms responsible for the activation of mast cells (MCs) in various pathological conditions. Furthermore, a set of criteria and a classification for MCASs have been established. MCAS is characterized by the presence of typical clinical symptoms, a substantial elevation in serum tryptase levels during an attack compared to the patient's baseline tryptase levels, and a response to MC mediator-targeting therapy. In this report, a thorough examination was conducted on the contemporary literature relating to MCAS, with a focus on comparing the specificity, sensitivity, and robustness of MCAS-related parameters within proposals for diagnosing and classifying MCAS and its variants. Moreover, the significance of employing specific consensus criteria in the assessment and categorization of MCAS in individual patients was underscored, due to the escalating occurrence of patients receiving a misdiagnosis of MCAS based on nonspecific criteria.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":" ","pages":"39-51"},"PeriodicalIF":5.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10866766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139503072","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":"Mast Cells in Aspirin-Exacerbated Respiratory Disease","authors":"E. Abud, Andrew A. White","doi":"10.1007/s11882-024-01125-1","DOIUrl":"https://doi.org/10.1007/s11882-024-01125-1","url":null,"abstract":"","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":"16 2","pages":"1-8"},"PeriodicalIF":5.5,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139437299","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":"Mast Cell–Targeting Therapies in Mast Cell Activation Syndromes","authors":"V. Sabato, M. Beyens, A. Toscano, A. Gasse, Didier G Ebo","doi":"10.1007/s11882-023-01123-9","DOIUrl":"https://doi.org/10.1007/s11882-023-01123-9","url":null,"abstract":"","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":"30 2","pages":"1-9"},"PeriodicalIF":5.5,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139437460","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":"A Review of Pollen Counting Networks: From the Nineteenth Century into the Twenty-first Century.","authors":"Richard W Lucas, Landon Bunderson","doi":"10.1007/s11882-023-01119-5","DOIUrl":"10.1007/s11882-023-01119-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Pollen is enormously important to the human experience. As pollen became germane to human health in the late nineteenth century, methods for pollen collection and measurement were developed. Techniques were standardized and pollen counting networks were established in many parts of the world during the middle to late part of the twentieth century. With some notable exceptions, the technology of the 1950s and 1960s is presently employed to create the current pollen counting networks. Pollen counting networks in the past faced substantial challenges. Pollen counting networks using the same technology as the past face the same challenges.</p><p><strong>Recent findings: </strong>As we move into the twenty-first century, automated pollen counting technology enables pollen counting networks to be robust, available, scalable, self-perpetuating, and able to meet modern demands. Automated pollen measurement networks present a promising path towards a more informed, data-driven, and effective approach to managing allergens, improving crop yields, and minimizing human suffering caused by pollen. By empowering individuals with comprehensive pollen data, a feat not possible with manual counting, we can help people make informed decisions and take proactive measures to minimize exposure to allergens and improve their well-being.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":" ","pages":"1-9"},"PeriodicalIF":5.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049743","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":"Remission in Type 2 Inflammatory Diseases: Current Evidence, Unmet Needs, and Suggestions for Defining Remission in Chronic Rhinosinusitis with Nasal Polyps","authors":"Marco Caminati, Eugenio De Corso, Giancarlo Ottaviano, Carlotta Pipolo, Michele Schiappoli, Veronica Seccia, Francesca Romana Spinelli, Edoardo Vincenzo Savarino, Paolo Gisondi, Gianenrico Senna","doi":"10.1007/s11882-023-01118-6","DOIUrl":"https://doi.org/10.1007/s11882-023-01118-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose of Review</h3><p>The development of biological therapies for type 2 inflammatory diseases raises the possibility of addressing remission in those dis-immune conditions. No consensus exists for a definition of remission in chronic rhinosinusitis with nasal polyps (CRSwNP). This review aims to critically evaluate the published data to provide the basis for defining remission in CRSwNP.</p><h3 data-test=\"abstract-sub-heading\">Recent Findings</h3><p>The published evidence has yet to provide an unequivocal definition on remission in type 2 inflammatory diseases, in part reflecting differences in approaches to diagnosis and follow-up. A multidimensional evaluation is necessary when considering complete remission, including clinical, inflammatory, and histologic criteria, but how to combine or tailor the three perspectives according to disease severity at baseline or timing of assessment of treatment category is yet to reach consensus. We suggest defining remission starting from the approach taken in asthma and eosinophilic esophagitis, that is, including the resolution of symptoms and improvements in objective parameters of disease severity and/or inflammatory activity. Future studies and consensuses should provide validated criteria with cutoffs for the day-to-day definition of remission.</p><h3 data-test=\"abstract-sub-heading\">Summary</h3><p>The definition of remission in CRSwNP should include the following criteria, to be verified and maintained for a period of ≥ 12 months: absence of symptoms (nasal obstruction, loss of smell, rhinorrhea as the main ones); no impact of symptoms on quality of life; no need of surgery; no chronic or rescue medications (systemic corticosteroids or antibiotics); and recovery of smell function, possibly evaluated by objective test. Assessment of underlying inflammation should also be considered once accurate and feasible biomarkers are available in clinical practice.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":"11 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138576693","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":"Biomarkers of Autoimmune Chronic Spontaneous Urticaria","authors":"Désirée Larenas-Linnemann","doi":"10.1007/s11882-023-01117-7","DOIUrl":"https://doi.org/10.1007/s11882-023-01117-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purposeof Review</h3><p>Chronic spontaneous urticaria and chronic inducible urticaria (CSU/CindU) are caused by mast cell and basophil activation leading to degranulation and the release of histamine and several other mediators. Three kinds of factors can trigger mast cells in CSU: (1) activation of stimulating receptor(s) on the mast cell membrane, (2) upregulation of certain receptor(s), and (3) intracellular dysregulation in signaling with overexpression of the spleen tyrosine kinase (SYK) or reduced activation of the inhibitory Src homology 2 (SH2)-containing inositol phosphatases (SHIP)-related pathways. In CSU, two major endotypes exist based on the primary receptor activating mechanism: type I hypersensitivity (IgE-mediated, directed against auto-allergens) and type IIb (autoimmune, via IgG autoantibodies directed against IgE or the IgE-receptor). Their treatment responses vary. We discuss in vitro and in vivo biomarkers.</p><h3 data-test=\"abstract-sub-heading\">Recent Findings</h3><p>Patients with auto-allergic CSU have clinical characteristics that can distinguish them partly from those with autoimmune CSU. Most importantly, their disease generally presents a less aggressive course, a better response to second generation (up-dosed) antihistamines and a good response to omalizumab, if necessary. Meanwhile, autoimmune CSU/CindU patients fare less well and often need immunosuppressive drugs. Biomarkers that might help endotype CSU/CindU patients and select the most appropriate treatment, dose, and duration, e.g., for autoallergic CSU, high total IgE and IgE against auto-allergens; for autoimmune CSU, low IgE, basopenia, and IgG against autoantigens like thyroid peroxidase and a positive autologous serum skin test (but sometimes also positive in autoallergy).</p><h3 data-test=\"abstract-sub-heading\">Summary</h3><p>Some biomarkers are easily accessible but of low specificity; others are highly specific but more futuristic.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":"34 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138560652","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":"Endoscopic Extended Sinus Surgery for Patients with Severe Chronic Rhinosinusitis with Nasal Polyps, the Choice of Mucoplasty: A Systematic Review.","authors":"Daniel Martin-Jimenez, Ramon Moreno-Luna, Alfonso Cuvillo, Jaime Gonzalez-Garcia, Juan Maza-Solano, Serafin Sanchez-Gomez","doi":"10.1007/s11882-023-01113-x","DOIUrl":"10.1007/s11882-023-01113-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>The advances in the knowledge of the molecular basis of the inflammatory response in chronic rhinosinusitis with nasal polyps (CRSwNP) have led the management of these patients towards personalized and precision medicine. Surgery has been positioned as a suitable alternative in patients who do not achieve control with appropriate medical treatment, but polypoid recurrences remain a constraint. The emergence of new surgical approaches based on patient phenotyping and the poor disease control associated with type 2 inflammatory phenotype makes it necessary to review the role of personalized and precision surgery in managing the disease.</p><p><strong>Recent findings: </strong>Surgical approaches based on wide resection of bony sinus structures and the treatment of mucosa lining the sinonasal cavity have been analyzed and compared with other techniques and seem to offer more favorable surgical outcomes and improved quality of life (QoL), in addition to lower relapse rates. The innovations with new complementary surgical techniques, such as reboot surgery adding an extended autologous mucosal graft from the nasal floor (mucoplasty), may benefit endoscopic and QoL outcomes in the most severe CRSwNP patients with type 2 phenotype. Using bilateral endonasal mucoplasty as a complementary technique to reboot surgery is a suitable technical choice that has improved short- and medium-term QoL and endoscopic outcomes for patients with severe CRSwNP. These results are likely due to a combination of the extension of reboot and the inherent inflammatory and healing properties of mucoplasty. We propose this technique as a valuable surgical resource, although more robust clinical studies are needed to evaluate its long-term benefits comprehensively.</p>","PeriodicalId":55198,"journal":{"name":"Current Allergy and Asthma Reports","volume":" ","pages":"733-746"},"PeriodicalIF":5.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10739272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138292393","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}