The Journal of allergy and clinical immunology
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J. Allergy Clin. Immunol. · Oct 2017
ReviewRole of viral infections in the development and exacerbation of asthma in children.
Viral infections are closely linked to wheezing illnesses in children of all ages. Respiratory syncytial virus (RSV) is the main causative agent of bronchiolitis, whereas rhinovirus (RV) is most commonly detected in wheezing children thereafter. Severe respiratory illness induced by either of these viruses is associated with subsequent development of asthma, and the risk is greatest for young children who wheeze with RV infections. ⋯ In addition, allergy and asthma are major risk factors for more frequent and severe RV-related illnesses. Treatments that inhibit inflammation have efficacy for RV-induced wheezing, whereas the anti-RSV mAb palivizumab decreases the risk of severe RSV-induced illness and subsequent recurrent wheeze. Developing a greater understanding of personal and environmental factors that promote more severe viral illnesses might lead to new strategies for the prevention of viral wheezing illnesses and perhaps reduce the subsequent risk for asthma.
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J. Allergy Clin. Immunol. · Oct 2017
Rhinovirus-induced first wheezing episode predicts atopic but not nonatopic asthma at school age.
Persistent childhood asthma is mainly atopy driven. However, limited data exist on the risk factors for childhood asthma phenotypes. ⋯ The data suggest diverse asthma phenotypes and mechanisms that can be predicted by using simple clinical markers at the time of the first severe wheezing episode. These findings are important for designing early intervention strategies for secondary prevention of asthma.
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J. Allergy Clin. Immunol. · Sep 2017
Observational StudyPatterns of immune development in urban preschoolers with recurrent wheeze and/or atopy.
Disadvantaged urban children have high rates of allergic diseases and wheezing, which are diseases associated with type 2-biased immunity. ⋯ These findings suggest that diverse biologic exposures, including allergens and endotoxin, in urban homes stimulate the development of cytokine responses in early life, and that cytokine responses to specific microbial and viral stimuli are associated with the development of allergic sensitization and recurrent wheeze.
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J. Allergy Clin. Immunol. · Sep 2017
Urban residence, neighborhood poverty, race/ethnicity, and asthma morbidity among children on Medicaid.
Although poor-urban (inner-city) areas are thought to have high asthma prevalence and morbidity, we recently found that inner cities do not have higher prevalent pediatric asthma. Whether asthma morbidity is higher in inner-city areas across the United States is not known. ⋯ Residence in poor and urban areas is an important risk factor for asthma morbidity, but not for prevalence, among low-income US children.
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J. Allergy Clin. Immunol. · Aug 2017
Case ReportsDisease-associated mutations identify a novel region in human STING necessary for the control of type I interferon signaling.
Gain-of-function mutations in transmembrane protein 173 (TMEM173) encoding stimulator of interferon genes (STING) underlie a recently described type I interferonopathy called STING-associated vasculopathy with onset in infancy (SAVI). ⋯ Structural analysis indicates that the 3 disease-associated mutations at positions 206, 281, and 284 of the STING protein define a novel cluster of amino acids with functional importance in the regulation of type I interferon signaling.