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Schwarze, J.; Openshaw, P.; Jha, A.; Giacco, S. R.; Firinu, D.; Tsilochristou, O.; Roberts, G.; Selby, A.; Akdis, C.; Agache, I.; Custovic, A.; Heffler, E.; Pinna, G.; Khaitov, M.; Nikonova, A.; Papadopoulos, N.; Akhlaq, A.; Nurmatov, U.; Renz, H.; Sheikh, A.; Skevaki, C.
2018 Allergy
doi: 10.1111/all.13333pmid: 29105786
To address uncertainties in the prevention and management of influenza in people with asthma, we performed a scoping review of the published literature on influenza burden; current vaccine recommendations; vaccination coverage; immunogenicity, efficacy, effectiveness, and safety of influenza vaccines; and the benefits of antiviral drugs in people with asthma. We found significant variation in the reported rates of influenza detection in individuals with acute asthma exacerbations making it unclear to what degree influenza causes exacerbations of underlying asthma. The strongest evidence of an association was seen in studies of children. Countries in the European Union currently recommend influenza vaccination of adults with asthma; however, coverage varied between regions. Coverage was lower among children with asthma. Limited data suggest that good seroprotection and seroconversion can be achieved in both children and adults with asthma and that vaccination confers a degree of protection against influenza illness and asthma‐related morbidity to children with asthma. There were insufficient data to determine efficacy in adults. Overall, influenza vaccines appeared to be safe for people with asthma. We identify knowledge gaps and make recommendations on future research needs in relation to influenza in patients with asthma.
Crossman‐Barnes, C‐J.; Peel, A.; Fong‐Soe‐Khioe, R.; Sach, T.; Wilson, A.; Barton, G.
2018 Allergy
doi: 10.1111/all.13337pmid: 29105788
Asthma management, education and environmental interventions have been reported as cost‐effective in a previous review (Pharm Pract (Granada), 2014;12:493), but methods used to estimate costs and outcomes were not discussed in detail. This review updates the previous review by providing economic evidence on the cost‐effectiveness of studies identified after 2012, and a detailed assessment of the methods used in all identified studies. Twelve databases were searched from 1990 to January 2016, and studies included economic evaluations, asthma subjects and nonpharmacological interventions written in English. Sixty‐four studies were included. Of these, 15 were found in addition to the earlier review; 53% were rated fair in quality and 47% high. Education and self‐management interventions were the most cost‐effective, in line with the earlier review. Self‐reporting was the most common method used to gather resource‐use data, accompanied by bottom‐up approaches to estimate costs. Main outcome measures were asthma‐related hospitalizations (69%), quality of life (41%) and utility (38%), with AQLQ and the EQ‐5D being the most common questionnaires measured prospectively at fixed time points. More rigorous costing methods are needed with a more common quality of life tool to aid greater replicability and comparability amongst asthma studies.
Sharma, N.; Akkoyunlu, M.; Rabin, R. L.
2018 Allergy
doi: 10.1111/all.13369pmid: 29178573
Macrophages are essential innate immune cells that also regulate local metabolism. Endogenous or exogenous stimuli may polarize macrophages toward phenotypes that serve distinct innate immunological metabolic functions. IFN‐γ or lipopolysaccharide (LPS) polarizes macrophages toward the M1, or “classically activated” phenotype that participates in defense against intracellular pathogens. IL‐4, IL‐13, or chitin polarizes macrophages toward the M2, or “alternatively activated” phenotype, which defends against multicellular nematodes and fungi. As macrophages polarize in local environments, M1 and M2 macrophages may coexist in different organs and may differentially affect asthma and obesity, two comorbid diseases where polarized macrophages contribute to their pathogenesis. While M1 macrophages are considered beneficial in asthma and contribute to the pathology of obesity, M2 macrophages contribute to the pathology of asthma, but limit metabolic syndrome associated with obesity. Here, we discuss the roles for M1 and M2 macrophages in asthma and obesity, and propose a model by which M1‐mediated inflammation in adipose tissue enhances M2‐mediated inflammation in the asthmatic lung.
Dávila, I.; Domínguez‐Ortega, J.; Navarro‐Pulido, A.; Alonso, A.; Antolín‐Amerigo, D.; González‐Mancebo, E.; Martín‐García, C.; Núñez‐Acevedo, B.; Prior, N.; Reche, M.; Rosado, A.; Ruiz‐Hornillos, J.; Sánchez, M. C.; Torrecillas, M.
2018 Allergy
doi: 10.1111/all.13391pmid: 29318625
The prevalence of sensitization to dogs and cats varies by country, exposure time and predisposition to atopy. It is estimated that 26% of European adults coming to the clinic for suspected allergy to inhalant allergens are sensitized to cats and 27% to dogs. This document is intended to be a useful tool for clinicians involved in the management of people with dog or cat allergy. It was prepared from a consensus process based on the RAND/UCLA method. Following a literature review, it proposes various recommendations concerning the diagnosis and treatment of these patients, grounded in evidence and clinical experience. The diagnosis of dog and cat allergy is based on a medical history and physical examination that are consistent with each other and is confirmed with positive results on specific IgE skin tests. Sometimes, especially in polysensitized patients, molecular diagnosis is strongly recommended. Although the most advisable measure would be to avoid the animal, this is often impossible and associated with a major emotional impact. Furthermore, indirect exposure to allergens occurs in environments in which animals are not present. Immunotherapy is emerging as a potential solution to this problem, although further supporting studies are needed.
Arzt, L.; Bokanovic, D.; Schrautzer, C.; Laipold, K.; Möbs, C.; Pfützner, W.; Herzog, S. A.; Vollmann, J.; Reider, N.; Bohle, B.; Aberer, W.; Sturm, G. J.
2018 Allergy
doi: 10.1111/all.13368pmid: 29171032
Wang, X.‐Y.; Ma, T.‐T.; Wang, X.‐Y.; Zhuang, Y.; Wang, X.‐D.; Ning, H.‐Y.; Shi, H.‐Y.; Yu, R.‐L.; Yan, D.; Huang, H.‐D.; Bai, Y.‐F.; Shan, G.‐L.; Zhang, B.; Song, Q.‐K.; Zhang, Y.‐F.; Zhang, T.‐J.; Jia, D.‐Z.; Liu, X.‐L.; Kang, Z.‐X.; Yan, W.‐J.; Yang, B.‐T.; Bao, X.‐Z.; Sun, S.‐H.; Zhang, F.‐F.; Yu, W.‐H.; Bai, C.‐L.; Wei, T.; Yang, T.; Ma, T.‐Q.; Wu, X.‐B.; Liu, J.‐G.; Du, H.; Zhang, L.; Yan, Y.; Wang, D.‐Y.
2018 Allergy
doi: 10.1111/all.13388pmid: 29322523
Kuiper, J. R.; Hirsch, A. G.; Bandeen‐Roche, K.; Sundaresan, A. S.; Tan, B. K.; Schleimer, R. P.; Kern, R. C.; Stewart, W. F.; Schwartz, B. S.
2018 Allergy
doi: 10.1111/all.13409pmid: 29331046
Mösges, R.; Koch, A. F.; Raskopf, E.; Singh, J.; Shah‐Hosseini, K.; Astvatsatourov, A.; Hauswald, B.; Yarin, Y.; Corazza, F.; Haazen, L.; Pirotton, S.; Allekotte, S.; Zadoyan, G.; Legon, T.; Durham, S. R.; Shamji, M. H.
2018 Allergy
doi: 10.1111/all.13392pmid: 29322510
Mayado, A.; Teodosio, C.; Dasilva‐Freire, N.; Jara‐Acevedo, M.; Garcia‐Montero, A. C.; Álvarez‐Twose, I.; Sánchez‐Muñoz, L.; Matito, A.; Caldas, C.; Muñoz‐González, J. I.; Henriques, A.; Sánchez‐Gallego, J. I.; Escribano, L.; Orfao, A.
2018 Allergy
doi: 10.1111/all.13413pmid: 29331029
Worm, M.; Francuzik, W.; Renaudin, J.‐M.; Bilo, M. B.; Cardona, V.; Scherer Hofmeier, K.; Köhli, A.; Bauer, A.; Christoff, G.; Cichocka‐Jarosz, E.; Hawranek, T.; Hourihane, J. O.’B.; Lange, L.; Mahler, V.; Muraro, A.; Papadopoulos, N. G.; Pföhler, C.; Poziomkowska‐Gęsicka, I.; Ruëff, F.; Spindler, T.; Treudler, R.; Fernandez‐Rivas, M.; Dölle, S.
2018 Allergy
doi: 10.1111/all.13380pmid: 29318637
Heeringa, J. J.; Rijvers, L.; Arends, N. J.; Driessen, G. J.; Pasmans, S. G.; Dongen, J. J. M.; Jongste, J. C.; Zelm, M. C.
2018 Allergy
doi: 10.1111/all.13421pmid: 29380876
Despite the critical role of soluble IgE in the pathology of IgE‐mediated allergic disease, little is known about abnormalities in the memory B cells and plasma cells that produce IgE in allergic patients. We here applied a flow cytometric approach to cross‐sectionally study blood IgE+ memory B cells and plasmablasts in 149 children with atopic dermatitis, food allergy, and/or asthma and correlated these to helper T(h)2 cells and eosinophils. Children with allergic disease had increased numbers of IgE+CD27‐ and IgE+CD27+ memory B cells and IgE+ plasmablasts, as well as increased numbers of eosinophils and Th2 cells. IgE+ plasmablast numbers correlated positively with Th2 cell numbers. These findings open new possibilities for diagnosis and monitoring of treatment in patients with allergic diseases.
Ginkel, C. D.; Pettersson, M. E.; Dubois, A. E. J.; Koppelman, G. H.
2018 Allergy
doi: 10.1111/all.13432pmid: 29457221
This study describes the role of two STAT6 gene variants in food allergy using data of patients and their parents who underwent double‐blind placebo‐controlled food challenges (DBPCFCs). After quality control, 369 trios were analysed including 262 children (71.0%) with food allergy. Associations were tested by the Family based association test. The A alleles of both SNPs were associated with food allergy (P = .036 and P = .013 for rs324015 and rs1059513, respectively). Furthermore, these A alleles were associated with peanut allergy, higher sIgE levels to both peanut and cow's milk, more severe symptoms and higher eliciting doses during peanut and cow's milk DBPCFCs (all P < .05). In silico analysis indicates that the identified risk variants increase STAT6 expression which stimulates the differentiation of CD4 + T cells to the Th2 subset. In conclusion, STAT6 variants may be involved in the pathophysiology of food allergy and their role seems to be independent of the allergenic food.