Current opinion in allergy and clinical immunology
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Curr Opin Allergy Clin Immunol · Feb 2011
ReviewBacterial biofilms and the pathophysiology of chronic rhinosinusitis.
To review the evidence for the presence of bacterial biofilms in chronic rhinosinusitis (CRS) and mechanisms by which they may contribute to the chronic inflammation characteristic of this disease. Lastly, to provide an overview of the current and potential future treatments for bacterial biofilms in CRS. ⋯ Biofilms represent an important influence on the pathophysiology of CRS. Further understanding of biofilm interactions and microbial organism behavior will provide us with future treatment modalities for this disease.
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To analyse the association of systemic allergic hymenoptera sting reactions with mastocytosis and elevated baseline serum tryptase and to discuss diagnosis and treatment in patients with both diseases. ⋯ In all patients with anaphylaxis following hymenoptera stings, baseline serum tryptase should be determined. A value above 11.4 microg/l is often due to mastocytosis and indicates a high risk of very severe anaphylaxis following re-stings. Venom immunotherapy is safe and effective in this situation.
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The review summarizes knowledge about ants that are known to sting humans and their venoms. ⋯ Ants share some common proteins in venoms, but each group appears to have a number of possibly unique components. Further proteomic studies should expand and clarify our knowledge of these fascinating animals.
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Anaphylaxis is an acute-onset and potentially life-threatening allergic reaction that can be caused by numerous allergic triggers including stinging insects. This review focuses on recent advances, natural history, risk factors and therapeutic considerations. ⋯ The incidence of anaphylaxis continues to rise across all demographic groups, especially those less than 20 years of age. Fortunately, the fatalities related to anaphylaxis appear to have decreased over the past decades. Our understanding of various triggers, associated risk factors, as well as an improved understanding and utilization of biological markers such as serum tryptase have improved. Our ability to treat insect anaphylaxis by venom immunotherapy is highly effective. Unfortunately, anaphylaxis continues to be underappreciated and undertreated especially in regard to insect sting anaphylaxis. This includes the appropriate use of injectable epinephrine as the primary acute management tool. These findings suggest that continued education of the general population, primary care healthcare providers and emergency departments is required.
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Curr Opin Allergy Clin Immunol · Apr 2010
ReviewThe role of rhinovirus infections in the development of early childhood asthma.
To discuss the role of human rhinoviruses (HRVs) in early childhood wheezing illnesses and how HRVs contribute to the development of childhood asthma. ⋯ HRV is a significant source of morbidity in infants and young children. The present review identifies mechanisms by which HRV lower respiratory tract infection, particularly in a susceptible host, could promote the development of childhood asthma. Further studies are needed to elucidate the mechanisms underlying the link between HRV wheezing in early childhood and subsequent asthma development, with the critical goal of identifying novel therapeutic and prevention strategies for both early childhood wheezing and asthma.