Allergologie Select最新文献

{"title":"Biologics for atopic diseases: Indication, side effect management, and new developments.","authors":"Uta Jappe, Hendrik Beckert, Karl-Christian Bergmann, Askin Gülsen, Ludger Klimek, Sandra Philipp, Julia Pickert, Michèle M Rauber-Ellinghaus, Harald Renz, Christian Taube, Regina Treudler, Martin Wagenmann, Thomas Werfel, Margita Worm, Torsten Zuberbier","doi":"10.5414/ALX02197E","DOIUrl":"10.5414/ALX02197E","url":null,"abstract":"<p><p>With the advent of biologicals, more and more therapeutics are available that specifically address specific switch points in the pathomechanism of immunologically dominated diseases. Thus, the focus of diagnostics and therapy (precision medicine) is more on the individual disease characteristics of the individual patient. Regarding the different phenotypes of atopic diseases, severe asthma was the first entity for which biologicals were approved, followed by urticaria, and finally atopic dermatitis and chronic rhinosinusitis with nasal polyps. Experience in the treatment of severe bronchial asthma has shown that the intensity of the response to biological therapy depends on the quality of clinical and immunological phenotyping of the patients. This also applies to different diseases of the atopic form, as patients can suffer from several atopic diseases at the same time, each with different characteristics. Biologics are already emerging that may represent a suitable therapy for allergic bronchial asthma, which often occurs together with severe neurodermatitis, and chronic rhinosinusitis with nasal polyps. In practice, however, the question of possible combinations of biologicals for the therapy of complex clinical pictures of individual patients is increasingly arising. In doing so, the side effect profile must be taken into account, including hypersensitivity reactions, whose diagnostic and logistical management must aim at a safe and efficient therapy of the underlying disease. Increased attention must also be paid to biological therapy in pregnancy and planned (predictable) vaccinations as well as existing infections, such as SARS-CoV-2 infection. Before starting a biological therapy, the immune status should be checked with regard to chronic viral and bacterial infections and, if necessary, the vaccination status should be refreshed or missing vaccinations should be made up for before starting therapy. Currently, reliable data on the effect of biologicals on the immunological situation of SARS-CoV-2 infection and COVID-19 are not available. Therefore, research and development of suitable diagnostic methods for detection of immunologically caused side effects as well as detection of potential therapy responders and non-responders is of great importance.</p>","PeriodicalId":7485,"journal":{"name":"Allergologie Select","volume":"5 ","pages":"1-25"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38806654","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":"Can nasal acetylsalicylic acid challenge predict the severity of non-steroidal anti-inflammatory drugs (NSAIDs)-exacerbated respiratory disease (N-ERD)?\u2029.","authors":"Ulrike Förster-Ruhrmann,&nbsp;Anne-Kristin Tietz,&nbsp;Jonghui Kim,&nbsp;Uta Liebers,&nbsp;Agnieszka J Szczepek,&nbsp;Heidi Olze","doi":"10.5414/ALX01996E","DOIUrl":"https://doi.org/10.5414/ALX01996E","url":null,"abstract":"<p><strong>Background: </strong>Non-steroidal anti-inflammatory drugs (NSAIDs)-exacerbated respiratory disease (N-ERD) complicates the clinical course of chronic rhinosinusitis with nasal polyps (CRSwNP) and severe asthma. We aimed to determine the detection rate of NERD in patients with CRSwNP, asthma, and history of NSAID intolerance using nasal challenge with acetylsalicylic acid (ASA) and the relationship between the severities of response to ASA challenges and the grade of N-ERD.</p><p><strong>Materials and methods: </strong>Three groups of patients were included: CRSwNP with asthma and clinical history of analgesics intolerance (CRSwNP-AAI n = 18), CRSwNP with asthma but without a clinical history of analgesics intolerance (CRSwNP-A n = 20), and CRSwNP without asthma or analgesics intolerance (n = 18). All subjects were challenged nasally with 16 mg ASA and monitored with active anterior rhinomanometry. Rhinological (nasal polyp score), pulmonary (spirometry, Asthma Control Test (ACT), and asthma treatment), and psychometric questionnaire scores were recorded and correlated with rhinomanometric data following nasal challenges (flow depressions and symptom scores).</p><p><strong>Results: </strong>Nasal ASA challenge detected N-ERD in 96.7% of CRSwNP-AAI patients and 45% of CRSwNP-A patients. No N-ERD was seen in the CRSwNP group. The control grade of asthma measured with ACT scores was significantly lower in the groups CRSwNP-AAI (MV 18.22) and CRSwNP-A (MV 19.75) when compared to the CRSwNP group (MV 24.39) (p = 0.000). In the CRSwNP-AAI group, 11 patients had uncontrolled asthma (61%), and in the CRSwNP-A group, 9 patients had uncontrolled asthma (45%). No correlation was found between rhinology and pulmonary parameters, nasal symptoms, and the severity of nasal ASA challenges. Specific reactions were detectable under the therapy of prednisolone and omalizumab.</p><p><strong>Conclusion: </strong>N-ERD might not always be detected by screening a patient's medical history. Nasal ASA challenges are recommended in patients with CRSwNP and asthma. The nasal challenge with ASA positively confirms the N-ERD diagnosis. Moreover, N-ERD is a differential diagnosis in patients with severe asthma with the need for prednisolone or omalizumab therapy. The severity of the reaction to the ASA challenge in controlled and uncontrolled asthma patients is independent of the grade of N-ERD.\u2029.</p>","PeriodicalId":7485,"journal":{"name":"Allergologie Select","volume":"4 ","pages":"135-143"},"PeriodicalIF":0.0,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39125488","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":"Occupational diisocyanate asthma of a female professional driver - the importance of allergological diagnostics.","authors":"Christian Eisenhawer,&nbsp;Monika Raulf,&nbsp;Rolf Merget","doi":"10.5414/ALX02133E","DOIUrl":"https://doi.org/10.5414/ALX02133E","url":null,"abstract":"<p><p>Diisocyanates continue to be one of the most frequent causes of occupational asthma worldwide. They are still indispensable in industrial use as components of coatings, glues, and polyurethane foams. In Germany, respiratory diseases due to diisocyanates can be compensated by the statutory accident insurance (according to BK-Nr. 1315). The present case report shows a rare case of sensitization against diisocyanates verified by skin prick test and serological testing. Due to these findings, a modified inhalation test with an extremely low initial diisocyanate concentration in the laboratory was performed, and a positive reaction could be detected already after an extremely low diisocyanate concentration. In addition, increases of fractional exhaled nitric oxide (FeNO) and eosinophils in induced sputum after inhalation testing were seen. The present case constellation underlines the particular importance of allergological tests for diagnostic clarification of the diagnosis of diisocyanate asthma.</p>","PeriodicalId":7485,"journal":{"name":"Allergologie Select","volume":"4 ","pages":"124-128"},"PeriodicalIF":0.0,"publicationDate":"2020-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38379066","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":"Occupational allergic contact urticaria to tropomyosin from squid.","authors":"Daniel Wilfinger,&nbsp;Annette Kuehn,&nbsp;Szandra Takacs,&nbsp;Evgenia Galli-Novak,&nbsp;Barbara Machan,&nbsp;Werner Aberer","doi":"10.5414/ALX02121E","DOIUrl":"https://doi.org/10.5414/ALX02121E","url":null,"abstract":"<p><p>A cook's mate working in an Austrian restaurant reported acutely occurring urticarial skin lesions after processing and cooking squid. The prick-to-prick test with squid showed a ++ positive urticarial reaction. Elevated specific IgE antibody levels to squid, shrimp, and house dust mites as well as to tropomyosin from shrimp and house dust mite could be detected in the ImmunoCAP. By means of immunoblot and ELISA, a reaction to squid extract as well as increased IgE antibody levels to squid and tropomyosin from squid could be detected. The patient was diagnosed with a clinically and occupationally relevant type I allergy to squid with cross-reaction to tropomyosin of other invertebrates and therefore recognized as an occupational disease.</p>","PeriodicalId":7485,"journal":{"name":"Allergologie Select","volume":"4 ","pages":"129-134"},"PeriodicalIF":0.0,"publicationDate":"2020-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38379065","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":"Severe bronchial reaction to provocation with fish and crustaceans.","authors":"Alexandra M Preisser,&nbsp;Alexander M Kraft,&nbsp;Volker Harth","doi":"10.5414/ALX02129E","DOIUrl":"https://doi.org/10.5414/ALX02129E","url":null,"abstract":"<p><p>The specific inhalation challenge (SIC), a workplace-related inhalation exposure test, is used to identify allergic asthma when symptoms such as coughing, wheezing, or dyspnea occur at the workplace. Its use is risky. A cook (28 years old) has been complaining of rhinoconjunctivitis and contact urticaria while preparing seafood for 3 years. He continues to work, now wears gloves, no longer tastes fish dishes, and receives anti-obstructive therapy (ICS, LABA). Methacholine (MCH) testing for bronchial hyperreactivity (BHR) shows mild BHR (PD_100;sRaw: 0.28 mg MCH), skin and blood tests show type I sensitization to fish and crustacean proteins. In SIC with fried shrimps, rhinoconjunctivitis, coughing and distance wheezing, FEV₁ drop > 20%, sRaw increase to 9.6 kPa*s and angioedema occur. Since routine tests showed only a moderate BHR, the suspicion of an occupational disease was formulated very late in the medical examination process. Only the SIC showed the severity of the cook's bronchial asthma.</p>","PeriodicalId":7485,"journal":{"name":"Allergologie Select","volume":"4 ","pages":"118-123"},"PeriodicalIF":0.0,"publicationDate":"2020-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38729237","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":"Unusual allergen in a butcher with respiratory symptoms.","authors":"Ingrid Sander,&nbsp;Claus Keller,&nbsp;Christina Czibor,&nbsp;Ursula Meurer,&nbsp;Rolf Merget,&nbsp;Monika Raulf","doi":"10.5414/ALX02126E","DOIUrl":"https://doi.org/10.5414/ALX02126E","url":null,"abstract":"<p><p>A 37-year-old butcher developed respiratory symptoms during sausage and chicken production in a large company. In addition to various spices, the enzyme transglutaminase was a possible cause. The lung function test showed mild partial reversible airway obstruction and severe bronchial hyperresponsiveness. The IgE test showed sensitizations to various spice mixtures, coriander (0.74 kU/L), and to the ImmunoCAP-bound transglutaminase preparation from the workplace (7.12 kU/L). The skin prick tests with this transglutaminase were also positive. In the immunoblot of this preparation, a 40-kD protein reacted with the patient's IgE and was identified as transglutaminase from <i>Streptomyces mobaraensis</i> by inhibition experiments. This is the first case of a butcher with an allergy to transglutaminase. After moving to a small enterprise without enzyme use, his symptoms improved. Sensitization and the course of the symptoms indicate a dominant role of transglutaminase in the patient's allergic asthma.</p>","PeriodicalId":7485,"journal":{"name":"Allergologie Select","volume":"4 ","pages":"105-109"},"PeriodicalIF":0.0,"publicationDate":"2020-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38379067","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":"Microbial contamination in water-based metalworking fluid as trigger for occupational hypersensitivity pneumonitis - development of specific IgG tools for a suspected clinical case.","authors":"Sabine Kespohl,&nbsp;Isabell Warfolomeow,&nbsp;Gerd Schneider,&nbsp;Silke Maryska,&nbsp;Ursula Meurer,&nbsp;Monika Raulf","doi":"10.5414/ALX02124E","DOIUrl":"https://doi.org/10.5414/ALX02124E","url":null,"abstract":"<p><p>Microbially contaminated metal-working fluid (MWF) can cause respiratory symptoms in exposed workers in the form of exogenous allergic alveolitis/hypersensitivity pneumonitis (HP). The diagnosis of HP is based, among others, on the identification of the culprit and the detection of corresponding specific IgG antibodies (sIgG) in the patient's serum. Commercial antigen tools for the detection of these HP triggers are rarely available; therefore, antigens from contaminated MWF workplace samples were isolated exemplarily for diagnosis of a suspected HP case. Various MWF-specific bacteria were identified in the workplace samples, including <i>Pseudomonas oleovorans, Pseudomonas alcaliphila, Pseudomonas</i> spec., <i>Paenibacillus glucanolyticus,</i> and <i>Corynebacterium amycolatum.</i> The sIgG antigen binding, detected by ImmunoCAP system against MWF antigens from workplace samples and against the identified bacterial antigens, was much stronger in the patient serum compared to selected reference sera. The highest sIgG concentrations in the patient's serum could be determined against <i>Pseudomonas</i> antigens. Inhibition tests showed cross-reactions of MWF and <i>Pseudomonas</i> antigens, whereby the <i>Pseudomonas</i> antigens cross-reacted less with each other. For in-vitro diagnosis in case of suspected HP caused by contaminated MWF, workplace-related antigens are now available.</p>","PeriodicalId":7485,"journal":{"name":"Allergologie Select","volume":"4 ","pages":"110-117"},"PeriodicalIF":0.0,"publicationDate":"2020-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38379068","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":"Insect hypersensitivity beyond bee and wasp venom allergy.","authors":"Wolfgang Hemmer,&nbsp;Felix Wantke","doi":"10.5414/ALX02123E","DOIUrl":"https://doi.org/10.5414/ALX02123E","url":null,"abstract":"<p><p>The bites of blood-feeding insects regularly induce sensitization to salivary proteins and cause local hypersensitivity reactions in over 90% of the population, representing either an IgE-mediated immediate wheal and flare reaction or a T cell-driven delayed papule. Long-lasting large local reactions and bullous reactions may cause significant discomfort and reduction in quality-of-life. Anaphylaxis is rarely reported though proven for several insects, above all mosquitoes, horse flies, and kissing bugs. Recently, salivary gland proteins have been thoroughly studied in some blood-feeding insect species, and several allergens have been identified. Interestingly, many of them belong to the same protein families as the well-known honeybee and wasp venom allergens (phospholipases, hyaluronidases, antigens 5, serine proteases) though sequence identities are mostly low. There is still insufficient evidence for the proposed cross-reactivity between salivary proteins from blood-feeding insects and Hymenoptera venom allergens.</p>","PeriodicalId":7485,"journal":{"name":"Allergologie Select","volume":"4 ","pages":"97-104"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7709451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38674748","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":"Atopic dermatitis and psychosocial comorbidities - What's new?","authors":"Paula Kage,&nbsp;Julia Zarnowski,&nbsp;Jan-Christoph Simon,&nbsp;Regina Treudler","doi":"10.5414/ALX02174E","DOIUrl":"https://doi.org/10.5414/ALX02174E","url":null,"abstract":"<p><p>Atopic dermatitis (AD) is a chronic inflammatory disease. During the last years, researchers have focused on a variety of associated comorbidities, especially psychosocial disease. This article aims at giving an overview over recent data. A systematic literature research was performed in PubMed including data from the time period January 1, 2018 until March 1, 2020. Patients with AD frequently suffer from cocomitant depression, anxiety, and attention deficit hyperactivity disorder. There is less evidence about the relation between AD and schizophrenia, eating disorder, and obsessive compulsive disorder. There is still great need for research in the connection between AD and psychosocial disease, particularly about the pathogenesis and the influence of new therapies.</p>","PeriodicalId":7485,"journal":{"name":"Allergologie Select","volume":"4 ","pages":"86-96"},"PeriodicalIF":0.0,"publicationDate":"2020-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7659463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38607720","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":"Obesity-associated asthma in childhood.","authors":"Maria Mangova,&nbsp;Tobias Lipek,&nbsp;Maike Vom Hove,&nbsp;Antje Körner,&nbsp;Wieland Kiess,&nbsp;Regina Treudler,&nbsp;Freerk Prenzel","doi":"10.5414/ALX02178E","DOIUrl":"https://doi.org/10.5414/ALX02178E","url":null,"abstract":"<p><p>Obesity and bronchial asthma are very common diseases in children and adolescents, associated with a considerable burden of disease, reduced quality of life and comorbidities. Obesity is a significant risk factor for bronchial asthma. On the one hand, obesity leads to changes in the mechanics and function of the lungs and chest. On the other hand, obesity-associated inflammatory processes with increased production of leptin and cytokines may trigger bronchial inflammation with the appearance of asthmatic symptoms. The diseases are also linked by genetic factors. Physical activity and weight reduction have a significant benefit. Pharmacotherapy must be based on the pattern of inflammation. This article summarizes the current state of the literature on the association of asthma and obesity and presents current and possible future treatment options.</p>","PeriodicalId":7485,"journal":{"name":"Allergologie Select","volume":"4 ","pages":"76-85"},"PeriodicalIF":0.0,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7592418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38555103","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}