Introduction from the Editors

2021

Annals of Allergy, Asthma & Immunology, 2017

Background: Eosinophilic esophagitis (EoE) has repeatedly been associated with atopic manifestations, which are reported more frequently in these patients than in the general population. Objective: To systematically assess the evidence and strength of the associations between EoE and atopy. Methods: We performed a systematic search of the MEDLINE, EMBASE, and SCOPUS databases for case-control studies comparing the frequency of atopic diatheses among patients with EoE and control subjects representing the general population without EoE. Using random-effects meta-analyses, we calculated summary estimates, including 95% confidence intervals (CIs), for bronchial asthma, atopic rhinitis, and eczema. Publication bias risks were assessed by means of funnel plot analysis and specific statistical tests. Results: Of the 2,954 references identified, data were collected from 21 studies, including a total of 53,542 patients with EoE and 54,759 controls. The criteria for defining a diagnosis of atopy in patients with EoE or controls was not structurally considered in most of the studies. Overall, allergic rhinitis was significantly more common among patients with EoE compared with control subjects (odds ratio [OR], 5.09; 95% CI, 2.91e8.90; I 2 ¼ 86.7%) as were bronchial asthma (OR, 3.01; 95% CI, 1.96e4.62; I 2 ¼ 84.5%) and eczema (OR, 2.85; 95% CI, 1.87e4.34; I 2 ¼ 57.1%). Food allergies and other atopic conditions were also assessed. No significant publication bias was found for studies dealing with allergic rhinitis and eczema in EoE. Conclusions: Despite pointing to a significant association between atopy and EoE, most of the studies provided no normalized diagnostic criteria for atopy. Further research should provide clear and standardized definitions of such conditions. Trial Registration: www.crd.york.ac.uk/PROSPERO Trial Identifier: CRD42016036161.

Anais Brasileiros de Dermatologia, 2008

Atopic dermatitis is a chronic inflammatory skin disease with a steadily increasing prevalence affecting 10-20 % of infants and 1-3% of adults globally. It is often the first clinical manifestation of atopic disease preceding asthma and allergic rhinitis. Probably half of the children with atopic dermatitis develop some other form of atopic disease later in life. The pathogenesis involves a complex interplay of factors including genetic predisposition due to altered immune or skin barrier function, interactions with the environment such as food and allergen exposures, and infectious triggers of inflammation. In this review, we summarize the recent advances in understanding the contribution of different factors in the pathophysiology of atopic dermatitis and how insights provide new therapeutic potential for its treatment.

Internal Medicine Journal, 2009

To determine whether the ImmunoCAP ISAC platform could be of interest to Allergy specialists in Australasia, clinicians were invited to refer a small number of patients with serious food allergy, unexplained anaphylaxis or apparently discordant skin test, conventional laboratory specific IgE tests and clinical events. We describe the spectrum of specific IgE results from the first forty patients referred in this clinical familiarization protocol. Method: Clinicians were invited to participate by email through the Clinical Immunology and Clinical Immunology Laboratory email discussion groups. Four clinicians referred a total of forty patients in the initial three month period. Patient sera were evaluated using the Phadia ImmunoCAP ISAC platform, a microarray system that allows the simultaneous semiquantitative detection of specific IgE antibodies to 110 clinically important individual recombinant or native allergen molecules from 40 different allergens. Results: Of the forty patients referred, five had unexplained anaphylaxis and two had negative ISAC profiles while two were found to be reactive to Omega-5-gliadin and one was reactive to the Kiwi molecule, nAct d 2, a Thaumatin-like protein and nAct d5, Kiwellin. Of five patients with inhalant allergies and a past history of either large local reactions or anaphylaxis to bee stings, significant specific IgE levels were detected to multiple inhalant allergens on the panel as well as to bee venom Phospholipase A2. Of ten young children with difficult eczema and either past failed challenges or serious reactions to egg or milk, all were found to be reactive to the heatstable egg ovomucoid as well as milk alpha-lactalbumin and beta-lactoglobulin. Of twenty polysensitized (inhalant and food allergic) subjects, clinically unanticipated results with potential clinical significance were found in 16, including to tropomyosin, kiwi fruit, peach, apple, sesame and latex molecules. This cohort included 23 peanut allergic subjects of whom 17 were reactive to ara h 2, which is thought to have strong predictive value for a positive peanut challenge. Summary: The ISAC profile generated useful positive and negative information on the majority of these patients, not otherwise available to them or their clinicians. Although the allergen profile has a European focus, the Australasian patients exhibited reactivity across all the allergen groups. Conclusion: The ISAC profile can contribute clinically useful data on wellselected Australasian patients.

The current growing enthusiasm for atopic dermatitis is clearly reflected in the range of current attitudes on the subject. What are considered to be its protean manifestations are frequent challenges to the pediatrician and other specialists working with children. AD may occur not only in man, but also in other vertebrates. However, it must be assumed that AD has always been an affection of our species. Hippocrates (460-370 BC) reported urticaria and gastrointestinal upset following cow's milk ingestion. Lucretius (98-55 BC) wrote that one man's meat is another man's poison. Galen (131-219) described allergy to goat's milk. At the turn of this century the first description of acute shock due to CM allergy (CMA) and fatal CMA were published. In his pioneer studies of food allergy (FA), Schloss was the first to evaluate skin tests for the diagnosis of FA. Since then, a vast array of symptoms and disorders has been attributed to FA, many of which occur with other conditions. In addition to this, the lack of a single, practical diagnostic test has contributed to the polarization of the scientific controversy between those who believe in and those who deny FA existence. Terminology has also been confusing. A correct use of definitions is necessary for a proper epidemiologic evaluation of the conditions and an accurate diagnostic and therapeutic approach. While this concept was fundamentally correct, it was also too easily weakened by ignoring this prerequisite to be fully acceptable, and this led to an equally disordered use of the term hypersensitivity, since allergy had become a word used to embrace all possible forms of adverse reactions. AD is associated with patchy, characteristically distributed areas of cutaneous eczema, with intense itching and subsequent lichenification of the skin. Cutaneous automic dysfunction (increased vasoconstriction) and xerosis (dryness of the skin) commonly occur in the affected children. In addition, profound immunological dysregulation with various immune alterations has been described in affected children. Most children produce IgE antibodies to a number of food and inhalants allergens, at the point that a minuscule offending quantity can trigger a reaction by skin contact or by inhalation.

2010

When our first consensus meeting took place in Toronto, Canada in October 2003, there were no licensed drugs in North America for the treatment of HAE attacks and only two randomized clinical trials with plasma-derived C1 inhibitor replacement therapy (pdC1INH;[1, 2]) and a few clinical trials using androgens and antifibrinolytics [3-5]. C1-esterase inhibitor concentrates (Berinert P�� and Cetor��) were available mostly in Europe at the time [Henkel G.

Clinical <html_ent glyph="@amp;" ascii="&amp;"/> Experimental Allergy, 2006

Background Patients with atopic dermatitis (AD) often have symptoms suggestive of asthma or rhinitis. The prevalence and signs of respiratory disease in AD patients have been studied to a limited extent. Objectives To assess the prevalence and clustering of respiratory symptoms, bronchial hyperresponsiveness (BHR), and eosinophilic airway inflammation in patients with moderate-tosevere AD. Methods Eighty-six consecutive patients with moderate-to-severe AD and 49 randomly selected control subjects without AD were studied by questionnaire, flow volume spirometry, histamine challenge to detect BHR, induced sputum test to detect eosinophilic airway inflammation, and skin prick tests (SPTs) and total serum immunoglobulin (Ig)E measurements to detect atopy. Results The patients with AD showed increased risk of physician-diagnosed asthma (36% vs. 2%, odds ratio (OR) 10.1, confidence interval (CI) 1.3-79.7, P = 0.03), physician-diagnosed allergic rhinitis (AR) (45% vs. 6%, OR 4.5, CI 1.2-16.7, P = 0.02), BHR (51% vs. 10%, OR 5.5, CI 1.5-20.1, P = 0.01), and sputum eosinophilia (81% vs. 11%, OR 76.1, CI 9.3-623.5, P o 0.0001) compared with the control subjects. In AD patients, elevated s-IgE and positive SPTs were associated with the occurrence of physician-diagnosed asthma and AR, BHR, and the presence of sputum eosinophilia. Conclusions BHR and eosinophilic airway inflammation are more common in patients with AD than in control subjects. The highest prevalences were seen in patients with AD who were SPT positive and had high IgE levels. Longitudinal studies are needed to assess the outcome of patients with signs of airway disease, in order to identify those who need early initiation of asthma treatment.

Allergologie, 2009

Immunology. J. Correia de Sousa has board memberships with Boehringer Ingelheim and Novartis, has received payment for lectures from Boehringer Ingelheim, and has received payment for development of educational presentations from Boehringer Ingelheim. A. A. Cruz has board memberships with Novartis, Boehringer Ingelheim, AstraZeneca, MEDA Pharma, and GlaxoSmithKline; has consultant arrangements with Boehringer Ingelheim; has provided expert testimony for Boehringer Ingelheim; has received grants from GlaxoSmithKline; and has received payment for lectures from Eurofarma, Chiesi, MEDA Pharma, and Hypermarcas-Ache. C. A. Cuello-Garcia has consultant arrangements with and has received payment for manuscript preparation and travel support from the World Allergy Organization. P. Demoly has received consulting fees from ALK-Abell o, Stallergenes Greer, Thermo Fisher Scientific, MEDA, Chiesi, and Ysslab and has received grants from AstraZeneca. M.

Primary Care, 2002

Advances in Dermatology and Allergology, 2012

Allergic diseases are very common in developed countries, particularly among children, adolescents and young adults. Currently, allergies are being considered as an epidemic of the 21 st century. According to the Polish Society of Allergology, the percentage of adults suffering from asthma in our country is 5.4%, and in children 10%. The authors describe current knowledge regarding the pathomechanism, incidence, epidemiology and diagnostics of the most common significant allergic diseases, including allergic rhinitis, asthma, allergic conjunctivitis, atopic dermatitis and urticaria. One of the most common allergic diseases is allergic rhinitis, which is the result of an allergic inflammation of the nasal mucosa mediated by immunoglobulin E. Asthma is a lifelong chronic inflammatory disorder of the airways associated with a variety of structural changes occurring in children and adults of all ages. This disease is characterized by bronchial hyperreactivity and obstruction which often disappear either spontaneously or with treatment. Atopic dermatitis is a chronic and relapsing inflammatory skin disease with a varying clinical spectrum, and may often play the role of the first stage of the atopic march. Urticaria is a heterogeneous group of diseases, characterized by the presence of wheals and/or angioedema. The mainstay of allergy diagnosis is in vivo and in vitro testing. In vivo testing includes skin prick tests, prick-by-prick tests, atopy patch tests and also skin application skin test. In vitro testing includes measurement of serum total and antigen-specific IgE using various methods. During the last years, also component-resolved diagnostics have gained growing importance as a useful tool in clinical investigation of IgE-mediated allergies.