The Journal of allergy and clinical immunology
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Exacerbations of asthma in children are usually triggered by virus infections. Many different respiratory viruses are associated with these exacerbations, but influenza viruses are frequently associated with those requiring hospitalization and are the only ones for which specific treatment and prophylaxis are available. Current studies have shown that influenza vaccines are safe for patients with asthma. ⋯ A direct comparison of the inactivated and live attenuated influenza vaccines in children with asthma demonstrated superior protection by the latter. Live attenuated influenza vaccine, given by nasal spray, is better accepted by children for annual vaccination and is easier to administer. Universal vaccination of all children in school-based clinics will facilitate control of epidemic influenza and provide an infrastructure for control of future influenza pandemics.
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J. Allergy Clin. Immunol. · Dec 2006
Case ReportsInterleukin receptor-associated kinase-4 deficiency impairs Toll-like receptor-dependent innate antiviral immune responses.
Engagement of all known Toll-like receptors (TLRs) causes the production of inflammatory cytokines, including TNF-alpha, whereas in humans, engagement of TLRs 3, 7, 8, and 9 also induces type I IFNs. IRAK-4 is a critical effector in signaling by TLRs and the IL-1 receptor, which share homology in their intracellular domain and recruit IRAK-4 via the adaptor myeloid differentiation factor 88 (MyD88). Patients with IRAK-4 deficiency are susceptible to invasive bacterial infections but have so far not been reported to be susceptible to viral infection. Blood cells from these patients are impaired in their ability to make TNF-alpha in response to activation by TLRs. A recent report has described concomitant impairment of type I IFN production after activation of TLRs 7, 8, and 9, but not TLR3. ⋯ IRAK-4 may play a broader role in human innate antiviral immunity than previously appreciated.
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J. Allergy Clin. Immunol. · Dec 2006
Enhanced allergen-induced airway inflammation in paucity of lymph node T cell (plt) mutant mice.
Dendritic cells and lymphocytes play a central role in allergic asthma. Chemokines for these cells include the CCR7 agonists secondary lymphoid chemokine/CCL21 and EBV-induced lymphoid chemokine/CCL19, but their role in allergic asthma is poorly understood. ⋯ Disruption of chemokines responsible for trafficking of antigen-processing cells and lymphocytes to the draining lymph nodes might lead to enhanced allergic airway responses.