Current opinion in allergy and clinical immunology
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Curr Opin Allergy Clin Immunol · Apr 2015
ReviewAirway molecular endotypes of asthma: dissecting the heterogeneity.
This review will cover advances over the past year in defining airway endotypes in asthma by gene expression and the relationship between these endotypes and clinical traits. ⋯ Molecular endotyping of asthmatic patients using gene expression profiling of airway samples is helping to uncover disease mechanisms and potential novel treatment targets. The advancement of endotyping methods holds the promise of future personalized treatment for asthma.
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Curr Opin Allergy Clin Immunol · Apr 2015
ReviewChildhood asthma and chronic obstructive pulmonary disease: outcomes until the age of 50.
There has been recent interest in understanding the origins of chronic obstructive pulmonary disease. Epidemiological studies suggest that chronic obstructive pulmonary disease clearly has other causes apart from tobacco smoke. ⋯ Children with severe asthma are at increased risk of developing chronic obstructive pulmonary disease.
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GATA2 deficiency is a germline disease that causes a wide spectrum of phenotypes including viral and bacterial infections, cytopenias, myelodysplasia, myeloid leukemias, pulmonary alveolar proteinosis and lymphedema. The age of clinical presentation ranges from early childhood to late adulthood, with most occurring in adolescence to early adulthood. We review the expanding GATA2-deficient phenotype, molecular genetics of disease and developments in treatment. ⋯ GATA2 is a zinc finger transcription factor essential for embryonic and definitive hematopoiesis as well as lymphatic angiogenesis. GATA2 deficiency is caused by a variety of mutations in the GATA2 gene and can have variable presentation, onset and outcome. Patients are susceptible to mycobacterial, viral and fungal infections and can develop myelodysplasia, acute or chronic leukemias, lymphedema and pulmonary alveolar proteinosis. Hematopoietic stem cell transplantation reverses most of the clinical phenotype with good long-term outcomes.
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Curr Opin Allergy Clin Immunol · Dec 2014
ReviewWhen less is more: primary immunodeficiency with an autoinflammatory kick.
Next-generation sequencing is revolutionizing the molecular taxonomy of human disease. Recent studies of patients with unexplained autoinflammatory disorders reveal germline genetic mutations that target important regulators of innate immunity. ⋯ These findings underscore the power of next-generation sequencing, demonstrating how the primary deficiency of key molecular regulators or even regulatory motifs may lead to autoinflammation, and suggesting a possible role for cat eye syndrome chromosome region, candidate 1 and phospholipase Cγ₂ in common diseases.
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Curr Opin Allergy Clin Immunol · Dec 2014
ReviewSublingual immunotherapy in children: the recent experiences.
Sublingual immunotherapy (SLIT) is indicated for the use in pediatric patients suffering from allergic rhinitis or allergic rhinoconjunctivitis caused by environmental allergens, such as ragweed pollen, grass pollen, and dust mite. This review focuses on recent and relevant studies associated with the use of SLIT for these allergens in children by examining efficacy, safety, and immunological data in comparison to subcutaneous immunotherapy, therapeutic treatments, and placebo. ⋯ SLIT treatment is a well tolerated and effective approach to treat allergic rhinitis and allergic rhinoconjunctivitis in pediatric patients. Three SLIT tablets are currently approved by the US Food and Drug Administration to treat grass and ragweed allergies. The research discussed in this review will further the knowledge of physicians searching for an alternative treatment for their pediatric patients.