The Journal of allergy and clinical immunology
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J. Allergy Clin. Immunol. · Jun 2019
Observational StudyHLA-C*06:02 genotype is a predictive biomarker of biologic treatment response in psoriasis.
Biologic therapies can be highly effective for the treatment of severe psoriasis, but response for individual patients can vary according to drug. Predictive biomarkers to guide treatment selection could improve patient outcomes and treatment cost-effectiveness. ⋯ This large observational study suggests that reference to HLA-C*06:02 status could offer substantial clinical benefit when selecting treatments for severe psoriasis.
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J. Allergy Clin. Immunol. · May 2019
Randomized Controlled Trial Multicenter StudyAssessment of the long-term safety of mepolizumab and durability of clinical response in patients with severe eosinophilic asthma.
Mepolizumab has demonstrated favorable safety and efficacy profiles in placebo-controlled trials of 12 months' duration or less; however, long-term data are lacking. ⋯ These data support the long-term safety and efficacy of mepolizumab in patients with SEA.
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J. Allergy Clin. Immunol. · Apr 2019
ReviewAirways exudation of plasma macromolecules: Innate defense, epithelial regeneration, and asthma.
This review discusses in vivo airway aspects of plasma exudation in relation to current views on epithelial permeability and epithelial regeneration in health and disease. Microvascular-epithelial exudation of bulk plasma proteins characteristically occurs in asthmatic patients, being especially pronounced in those with severe and exacerbating asthma. Healthy human and guinea pig airways challenged by noninjurious histamine-leukotriene-type autacoids also respond through prompt mucosal exudation of nonsieved plasma macromolecules. ⋯ In conclusion, nonsieved plasma macromolecules can operate on the intact airway mucosa as potent components of first-line innate immunity responses. Exuded plasma also takes center stage in epithelial regeneration. When exaggerated, epithelial regeneration can contribute to the inception and development of asthma.
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J. Allergy Clin. Immunol. · Apr 2019
Epidemiology and risk factors of asthma-chronic obstructive pulmonary disease overlap in low- and middle-income countries.
Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) represents the confluence of bronchial airway hyperreactivity and chronic airflow limitation and has been described as leading to worse lung function and quality of life than found with either singular disease process. ⋯ ACO may be as prevalent and more severe in LMICs than has been reported in high-income settings. Exposure to biomass fuel smoke may be an overlooked risk factor, and we favor diagnostic criteria for ACO that include environmental exposures common to LMICs.
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J. Allergy Clin. Immunol. · Apr 2019
Synergistic convergence of microbiota-specific systemic IgG and secretory IgA.
Commensals induce local IgA responses essential to the induction of tolerance to gut microbiota, but it remains unclear whether antimicrobiota responses remain confined to the gut. ⋯ Secretory IgA and systemic IgG converge to target gut microbiota at the cellular level. SIgAd-associated inflammation is inversely correlated with systemic anticommensal IgG responses, which might serve as a second line of defense. We speculate that patients with SIgAd could benefit from oral IgA supplementation. Our data also suggest that intravenous immunoglobulin preparations can be supplemented with IgG from IgA-deficient patient pools to offer better protection against gut bacterial translocations in patients with CVID.