Current opinion in allergy and clinical immunology
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Curr Opin Allergy Clin Immunol · Dec 2009
ReviewSpecific immunotherapy with allergen mixes: what is the evidence?
The purpose is to review the published evidence for the use of multiallergen mixes in subcutaneous and sublingual immunotherapy. ⋯ Multiallergen extract mixes are probably effective for subcutaneous immunotherapy provided attention is paid to the concentration of each allergen in the mix and mixing of protease containing extracts with pollen and dander extracts is avoided. Further studies are needed to determine if multiallergen mixes are effective in sublingual immunotherapy.
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Curr Opin Allergy Clin Immunol · Oct 2009
ReviewThe chitinase and chitinase-like proteins: a review of genetic and functional studies in asthma and immune-mediated diseases.
The present review provides an overview of the chitinase and chitinase-like proteins, chitotriosidase (CHIT1), YKL-40, and acid mammalian chitinase, and summarizes the genetic studies of asthma and immune-mediated diseases with polymorphisms in the genes encoding these proteins, CHIT1, CHI3L1, and CHIA, respectively. ⋯ These genes represent novel asthma susceptibility genes. Variations in CHI3L1 and CHIA have been associated with asthma risk. Polymorphisms in CHIT1 have not yet been associated with asthma, but few studies have been reported. Given that chitotriosidase is the major chitinase in the airways and a common nonfunctional allele is present in many populations, additional studies of this gene are warranted. Lastly, studies of all three genes need to be conducted in populations of diverse ancestries.
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This review will consider how recent epidemiological studies have helped reveal the role of respiratory infection in asthma inception early in life. We will also review the importance of respiratory infections and exacerbations of asthma and will discuss genetic factors controlling host immune responses to respiratory infection and the influence these may exert on asthma pathogenesis. ⋯ Early in life, such genetic factors contribute to the risk of severe lower respiratory tract viral infection as well as later development of wheezing illness and asthma. Respiratory viruses are also the most frequent cause of asthma exacerbations at all ages.
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Patients suffering from mastocytosis are at risk for a particularly severe Hymenoptera sting anaphylaxis. The purpose of this review is to evaluate the current knowledge on pathophysiologic events, which might explain the specific risk of patients with mastocytosis. ⋯ The particular anaphylactic risk of patients with mastocytosis results from a variety of mechanisms. However, their individual contribution still needs further clarification.
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To review current knowledge and recent advances in food protein-induced enterocolitis syndrome (FPIES). ⋯ FPIES is a non-IgE-mediated gastrointestinal food hypersensitivity disorder. Food protein-activated intestinal lymphocytes elaborate inflammatory cytokines that result in increased intestinal permeability, malabsorption, dysmotility, emesis, diarrhea, pain, and failure to thrive. Decreased intestinal transforming growth factor beta and increased TNFalpha may be important in FPIES. Cow's milk and soy are the most common causes of FPIES, but cereal grains (rice, oat, and barley), fish, poultry, and vegetables may also cause FPIES. The majority of FPIES resolve by age of 3 years.