Expert review of clinical immunology
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Egg allergy is the second most frequent food allergy in children of the Western Countries, with an overall prevalence of 1-3%. Today strict avoidance diet is the only treatment, but its feasibility is difficult to obtain in childhood because of the large amount of egg proteins present in different foods. From 1998, a growing number of protocols on immunotherapy for egg allergy have been published, but all of them differ for patients' age, inclusion of high-risk patients, amount of allergen administered, duration of the protocols and presence of a control group. We reviewed the protocols performed in the last 15 years, to underline the most important issues in this kind of food immunotherapy, and the rates of tolerance or desensitization induction.
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Expert Rev Clin Immunol · Mar 2014
EditorialThe practical role of serum allergen-specific IgE as potential biomarker for predicting responder to allergen immunotherapy.
Allergic asthma and rhinitis are characterized by IgE-mediated inflammation consequent to the exposure to a specific allergen. Therefore, IgE production may be considered the hallmark of allergy. Actually, allergen immunotherapy (AIT) is the unique causal treatment for respiratory allergy. ⋯ This issue has been the topic of several studies. Very recently, it has been preliminarly reported that a cut-off of serum specific IgE levels could define AIT-responder. However, further rigorous studies will confirm this view.
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The axial spondyloarthritis (SpA) classification criteria cover both patients with ankylosing spondylitis and non-radiographic axial SpA. After failure of NSAIDs TNF-α-inhibitors (TNF-blockers) can be given to patients with active axial SpA. ⋯ An elevated C-reactive protein and/ or evidence of bone marrow edema on MRI of the sacroiliac joints were required for inclusion in RAPID-axSpA, and patients could have been preexposed to TNF-blockers. The interesting data of this important trial in the context of the emerging therapeutic field of non-radiographic axial SpA therapy is discussed in this review.
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Expert Rev Clin Immunol · Nov 2013
ReviewA case for antibiotic perturbation of the microbiota leading to allergy development.
The use of antibiotics to treat pathogenic bacterial infections has been one of the greatest contributions to human health, yet antibiotic use also perturbs the communities of commensal and symbiotic bacteria that reside in the intestine of mammals. The microbiota are critical for normal immune development and for maintaining intestinal homeostasis, and disruption of the microbiota has been linked to the emergence of allergic disease both in humans and in animal models. The evidence and mechanisms for antibiotic-mediated disruptions leading to the onset of allergic disease at mucosal surfaces is discussed, as well as the future challenges for the field. A more complete understanding of the mechanisms by which the intestinal microbiota modulate allergic disease development will allow for interventions to counter the potentially adverse effects of antibiotic treatment on the microbiota.
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Expert Rev Clin Immunol · Aug 2013
ReviewThe alarmin functions of high-mobility group box-1 and IL-33 in the pathogenesis of systemic lupus erythematosus.
'Alarmins' are a group of endogenous proteins or molecules that are released from cells during cellular demise to alert the host innate immune system. Two of them, high-mobility group box-1 (HMGB1) and IL-33 shared many similarities of cellular localization, functions and involvement in various inflammatory diseases including systemic lupus erythematosus (SLE). The expressions of HMGB1 and IL-33, and their corresponding receptors RAGE (receptor for advanced glycation end products) and ST2, respectively, are substantially upregulated in patients with lupus nephritis (LN). This review highlights the emerging roles of alarmin proteins in various pathologies of LN, by focusing on classical HMGB1 and a newly discovered alarmin IL-33.