The Journal of allergy and clinical immunology
-
J. Allergy Clin. Immunol. · Apr 2017
ReviewAirway microbial dysbiosis in asthmatic patients: A target for prevention and treatment?
There has been long-standing interest in the role of bacterial communities in the complex and heterogeneous disease of asthma. With the advent of 16s rRNA sequencing replacing traditional culture methods, a strong association between the presence of bacterial communities with asthma has emerged. These microbiota can be modulated by various environmental factors, including diet, antibiotics, and early-life microbial exposures. ⋯ Causality between certain gut microbiota and the development of allergic asthma has been shown in experiments conducted in neonatal mice. Manipulation of the airway microbiome, particularly in early life, might be a strategy to prevent or treat asthma, although the results of studies of probiotics used together with prebiotics have been overall negative. A better understanding of the regulation of both the lung and gut microbiota to derive appropriate targets for prevention or treatment of asthma is needed.
-
J. Allergy Clin. Immunol. · Apr 2017
Practice GuidelineInternational consensus guidelines for the diagnosis and management of food protein-induced enterocolitis syndrome: Executive summary-Workgroup Report of the Adverse Reactions to Foods Committee, American Academy of Allergy, Asthma & Immunology.
Food protein-induced enterocolitis (FPIES) is a non-IgE cell- mediated food allergy that can be severe and lead to shock. Despite the potential seriousness of reactions, awareness of FPIES is low; high-quality studies providing insight into the pathophysiology, diagnosis, and management are lacking; and clinical outcomes are poorly established. ⋯ Research on prevalence, pathophysiology, diagnostic markers, and future treatments is necessary to improve the care of patients with FPIES. These guidelines will be updated periodically as more evidence becomes available.
-
J. Allergy Clin. Immunol. · Apr 2017
Clinical TrialEffectiveness of bronchial thermoplasty in patients with severe refractory asthma: Clinical and histopathologic correlations.
The effectiveness of bronchial thermoplasty (BT) has been reported in patients with severe asthma, yet its effect on different bronchial structures remains unknown. ⋯ BT is a treatment option in patients with severe therapy-refractory asthma that downregulates selectively structural abnormalities involved in airway narrowing and bronchial reactivity, particularly ASM, neuroendocrine epithelial cells, and bronchial nerve endings.
-
J. Allergy Clin. Immunol. · Apr 2017
T-bet inhibits innate lymphoid cell-mediated eosinophilic airway inflammation by suppressing IL-9 production.
Innate lymphoid cells (ILCs) are emerging subsets of immune cells that produce large amounts of cytokines upon cytokine and/or alarmin stimulation. Recent studies have shown that T-bet plays pivotal roles in the development of ILC3s and type 1 ILCs; however, the roles of T-bet in lung type 2 innate lymphoid cells (ILC2s) remain unknown. ⋯ T-bet suppresses IL-9 production from lung ILC2s and thereby inhibits IL-33-induced eosinophilic airway inflammation.