Allergy
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Anaphylaxis in an emergency setting - elicitors, therapy and incidence of severe allergic reactions.
Anaphylaxis is a severe potentially life-threatening hypersensitivity reaction with an estimated lifetime prevalence of 0.5-2.0%. The prevalence and incidence of anaphylactic reactions in Germany are unknown. We therefore assessed anaphylactic patients seen by emergency physicians in the Berlin area covering 4 million people. ⋯ Our data show that food products are frequent elicitors of severe allergic reactions in the general population including children and adults. It unravels a strong underuse of adrenaline by emergency physicians, not reflecting treatment protocols according to the current guidelines. As data obtained from allergists reveal a different rank order of elicitors, this study suggests that food-allergic adult patients may present a risk population and should receive more attention by allergists.
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Specific immunotherapy via the subcutaneous or oral route is associated with local and, in some cases, systemic side effects and suffers from low patient compliance. Due to its unique immunological features, the skin represents a promising target tissue for effective and painless treatment of type I allergy. The current study was performed to compare the efficacy of transcutaneous immunotherapy via laser-generated micropores to subcutaneous injection. ⋯ Transcutaneous immunotherapy via laser microporation is equally efficient compared with conventional subcutaneous treatment but avoids therapy-associated boosting of systemic Th2 immunity. Immunotherapy via laser-microporated skin combines a painless application route with the high efficacy known from subcutaneous injections and therefore represents a promising alternative to established forms of immunotherapy.