Current opinion in allergy and clinical immunology
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Curr Opin Allergy Clin Immunol · Feb 2005
Review Comparative StudyIs there a difference between chronic airway inflammation in chronic severe asthma and chronic obstructive pulmonary disease?
The lack of a universally accepted definition of chronic severe asthma and the continuous changes in the classification of the severity of stable chronic obstructive pulmonary disease in the last 10 years make it difficult to compare the many studies available. The aim of the review is to compare studies on chronic severe asthma that have a control group of patients with mild to moderate persistent asthma and studies on stable chronic obstructive pulmonary disease that have an age-matched control group of smokers with normal lung function (with or without chronic bronchitis). ⋯ These differences in chronic airway inflammation support the consensus that asthma and chronic obstructive pulmonary disease are different diseases along all their stages of severity.
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Atopic dermatitis is a chronic relapsing, pruritic inflammation of the skin, affecting 10-20% of children and 1-3% adults worldwide, with increasing prevalence in highly industrialized countries. Here we review relevant studies, published since June 2002, about immunological triggers in atopic dermatitis, with emphasis on the role of microbial colonization. ⋯ New insights into the important role of microorganisms and their key immunomodulatory pathways in atopic dermatitis may have important implications from a therapeutic point of view because patients with atopic dermatitis may benefit from more than just anti-inflammatory treatment in the future.
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Anaphylaxis due to ant sting is increasingly being recognized as a significant problem. Severe allergic reactions to ants are well described in the south-eastern United States, but have only been recognized in recent years as being important in other parts of the world. There are many different ant species and their distribution around the world varies. The purpose of this review is to familiarize the reader with the epidemiology and clinical characteristics of ant allergy in Asia and Australia. ⋯ The study of ant allergy in Asia is in its infancy. Clinicians in Asia need to be aware of ant stings as a cause of severe allergic reactions. Certain species that cause allergic reactions are unique to Asia and Australia and deserve further research. The allergens in the venom of the different ant species need to be identified. We should aim for improved understanding of the epidemiology of ant-sting anaphylaxis, formulation of better diagnostic tests and possibly the introduction of immunotherapeutic strategies.
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Curr Opin Allergy Clin Immunol · Aug 2004
ReviewCough and angioedema from angiotensin-converting enzyme inhibitors: new insights into mechanisms and management.
Angiotensin-converting enzyme inhibitors are widely prescribed for hypertension and heart failure. These drugs are commonly associated with cough, and are less commonly associated with angioedema, which may be potentially life threatening. This review describes data that extend our understanding of the mechanisms of these reactions, and provides guidance about clinical management. ⋯ Although data are incomplete, it appears that angiotensin-converting enzyme inhibitors cause cough and angioedema through a cascade of effects that begins with the accumulation of kinins, and then involves arachidonic acid metabolism and nitric oxide generation. Most patients who develop either cough or angioedema from angiotensin-converting enzyme inhibitors can tolerate angiotensin-II receptor blocking agents.