Current opinion in allergy and clinical immunology
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Curr Opin Allergy Clin Immunol · Feb 2008
ReviewRole of staphylococcal superantigens in upper airway disease.
Chronic rhinosinusitis with nasal polyps often represents a chronic severe inflammatory disease of the upper airways and may serve as a model for lower airway diseases such as late-onset intrinsic asthma. Enterotoxins derived from Staphylococcus aureus have been implicated in the pathophysiology of nasal polyps as disease-modifying factors; recent findings using therapeutic proof-of-concept approaches support this hypothesis. ⋯ From this new understanding of chronic rhinosinusitis with nasal polyps, new therapeutic approaches emerge such as anti-interleukin-5, anti-immunoglobulin E, and antibiotic treatment. These may enlarge the nonsurgical armentarium.
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Curr Opin Allergy Clin Immunol · Dec 2007
ReviewHost defense genes in asthma and sepsis and the role of the environment.
There is growing evidence that innate immunity genes contribute to asthma pathogenesis. At the core of the innate immune response are ubiquitous, soluble fragments of bacterial lipopolysaccharide or endotoxin, and chronic exposure to domestic endotoxin has been shown to influence asthma severity. Asthmatic and atopic individuals are more sensitive to endotoxin than nonallergic individuals, suggesting a role for genetics in the innate immunity response, and the potential for gene-environment interactions. Variants in genes associated with classic innate immunity-related disorders, such as sepsis, may be unique candidates for asthma susceptibility. ⋯ Collectively, these observations suggest a greater role for the innate immunity response in allergic asthma than previously assumed, and implicate host defense genes in disease pathology.
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Curr Opin Allergy Clin Immunol · Oct 2007
ReviewThe role of human beta defensins and cathelicidins in atopic dermatitis.
Atopic dermatitis is a chronic inflammatory skin disease associated with significant barrier disruption, T-helper type 2 mediated skin inflammation, and an impaired innate immune response. These characteristics increase the susceptibility of atopic dermatitis patients to recurrent skin infections, some of which may have potentially fatal implications. The mechanisms resulting in this increased propensity for skin infections have been an area of active investigation. ⋯ The current review will examine recent literature on the role of antimicrobial peptides in atopic dermatitis in an effort to improve our understanding of why patients with the condition suffer from recurrent infections.
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Curr Opin Allergy Clin Immunol · Jun 2007
ReviewHealth technology assessment of asthma disease management programs.
To provide a critical opinion on the extent to which asthma disease management programs currently improve the effectiveness and efficiency of care and directions for future policy and research. ⋯ There is accumulating 'circumstantial' evidence that disease management programs reduce resource utilization. The analytical rigor and uniformity of health technology assessment of asthma disease management programs has improved, but the generalizability of results remains uncertain. Practical, multicentre, clinical trials including broad representative study samples should be performed in different settings to increase methodological quality and substantiate current findings.