The Journal of allergy and clinical immunology
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J. Allergy Clin. Immunol. · Aug 2007
Randomized Controlled Trial Multicenter StudyCritical role of kallikrein in hereditary angioedema pathogenesis: a clinical trial of ecallantide, a novel kallikrein inhibitor.
Hereditary angioedema (HAE) is a rare, autosomal-dominant disorder caused by C1 inhibitor gene mutation. Patients with HAE experience intermittent attacks of edema affecting the oropharynx, abdomen, gastrointestinal tract, and limbs. C1 inhibitor is the primary endogenous inhibitor of the kallikrein-kinin (contact) cascade. Unregulated kallikrein activation generates bradykinin, the likely mediator of the swelling and pain characterizing HAE attacks. Ecallantide, a novel, recombinant protein, potently inhibits kallikrein. This is the first placebo-controlled assessment in human beings of a therapeutic intervention to improve symptoms of HAE attacks under the hypothesis that the contact cascade is the putative pathway responsible for HAE pathology. ⋯ Ecallantide is a promising new therapy for HAE attacks.
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J. Allergy Clin. Immunol. · May 2007
Multicenter StudyNot all farming environments protect against the development of asthma and wheeze in children.
In recent years, studies have shown a protective effect of being raised in a farm environment on the development of hay fever and atopic sensitization. Inconsistent data on the relation of farming to asthma and wheeze have raised some doubt about a true protective effect. ⋯ The development of atopic sensitization and atopic and nonatopic asthma is most likely determined by different environmental factors, possibly reflecting distinct pathomechanisms.
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J. Allergy Clin. Immunol. · Apr 2006
Randomized Controlled Trial Multicenter StudySublingual immunotherapy with once-daily grass allergen tablets: a randomized controlled trial in seasonal allergic rhinoconjunctivitis.
Specific immunotherapy is the only treatment modality that has the potential to alter the natural course of allergic diseases. Sublingual immunotherapy has been developed to facilitate access to this form of treatment and to minimize serious adverse events. ⋯ For patients with grass pollen allergy, sublingual immunotherapy is well tolerated and can reduce symptoms and improve quality of life.
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J. Allergy Clin. Immunol. · Mar 2006
Randomized Controlled Trial Multicenter Study Comparative StudyAsthma control can be maintained when fluticasone propionate/salmeterol in a single inhaler is stepped down.
Asthma control is the goal of treatment, but little data exist to support treatment strategies for stepping down treatment once control has been achieved. ⋯ In patients achieving asthma control with FSC 250/50 microg twice daily, stepping treatment down to a lower dose of FSC 100/50 microg twice daily is more effective than switching to an inhaled corticosteroid alone.
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J. Allergy Clin. Immunol. · Oct 2004
Randomized Controlled Trial Multicenter Study Clinical TrialCoseasonal sublingual immunotherapy reduces the development of asthma in children with allergic rhinoconjunctivitis.
We wondered whether short-term coseasonal sublingual immunotherapy (SLIT) can reduce the development of asthma in children with hay fever in an open randomized study. ⋯ Three years of coseasonal SLIT improves seasonal allergic rhinitis symptoms and reduces the development of seasonal asthma in children with hay fever.