The Journal of allergy and clinical immunology
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J. Allergy Clin. Immunol. · Feb 2018
Multicenter Study Clinical TrialSputum transcriptomics reveal upregulation of IL-1 receptor family members in patients with severe asthma.
Sputum analysis in asthmatic patients is used to define airway inflammatory processes and might guide therapy. ⋯ IL1RL1 gene expression is associated with eosinophilic SA, whereas NLRP3 inflammasome expression is highest in patients with neutrophilic SA. TH2-driven eosinophilic inflammation and neutrophil-associated inflammasome activation might represent interacting pathways in patients with SA.
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J. Allergy Clin. Immunol. · Oct 2017
Multicenter StudyCan we predict fall asthma exacerbations? Validation of the seasonal asthma exacerbation index.
A Seasonal Asthma Exacerbation Predictive Index (saEPI) was previously reported based on 2 prior National Institute of Allergy and Infectious Diseases Inner City Asthma Consortium trials. ⋯ An exacerbation in children treated with GBT with or without omalizumab was associated with a higher saEPI along with higher markers of allergic inflammation, treatment step, and a recent exacerbation. Those that exacerbated on omalizumab had similar features with the exception of some markers of allergic sensitization, indicating a need to develop better markers to predict poor response to omalizumab therapy and alternative treatment strategies for children with these risk factors. The saEPI was able to reliably predict those children unlikely to have an asthma exacerbation in both groups.
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J. Allergy Clin. Immunol. · Jul 2017
Randomized Controlled Trial Multicenter StudyA randomized multicenter study evaluating Xolair persistence of response after long-term therapy.
Few data are available to assist clinicians with decisions regarding long-term use of asthma therapies, including omalizumab. ⋯ Continuation of omalizumab after long-term treatment results in continued benefit, as evidenced by improved symptom control and reduced exacerbation risk.
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J. Allergy Clin. Immunol. · May 2017
Multicenter StudyPeanut Allergen Threshold Study (PATS): Novel single-dose oral food challenge study to validate eliciting doses in children with peanut allergy.
Eliciting doses (EDs) of allergenic foods can be defined by the distribution of threshold doses for subjects within a specific population. The ED05 is the dose that elicits a reaction in 5% of allergic subjects. The predicted ED05 for peanut is 1.5 mg of peanut protein (6 mg of whole peanut). ⋯ A single administration of 1.5 mg of peanut protein elicited objective reactions in fewer than the predicted 5% of patients with peanut allergy. The novel single-dose oral food challenge appears clinically safe and patient acceptable, regardless of the outcome. It identifies the most highly dose-sensitive population with food allergy not otherwise identifiable by using routinely available peanut skin prick test responses or specific IgE levels, but this single-dose approach has not yet been validated for risk assessment of individual patients.
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J. Allergy Clin. Immunol. · Dec 2015
Randomized Controlled Trial Multicenter StudyPreseasonal treatment with either omalizumab or an inhaled corticosteroid boost to prevent fall asthma exacerbations.
Short-term targeted treatment can potentially prevent fall asthma exacerbations while limiting therapy exposure. ⋯ Adding omalizumab before return to school to ongoing guidelines-based care among inner-city youth reduces fall asthma exacerbations, particularly among those with a recent exacerbation.