Current opinion in allergy and clinical immunology
-
Curr Opin Allergy Clin Immunol · Apr 2013
ReviewRemodeling, inflammation and airway responsiveness in early childhood asthma.
Remodeling and inflammation together with airway hyperresponsiveness are essential components of asthma but their role in development of the disease is still obscure. ⋯ Even young children with chronic asthma have detectable elements of airway remodeling, inflammation and increased airway responsiveness, which all contribute to impaired lung function.
-
Curr Opin Allergy Clin Immunol · Apr 2013
ReviewThe use of specific inhalation challenge in hypersensitivity pneumonitis.
The diagnosis of hypersensitivity pneumonitis remains a dilemma because of the absence of any characteristic features able to distinguish it from other interstitial lung diseases. We analyze the current role of the specific inhalation challenge (SIC) in the diagnosis of this entity. ⋯ Hypersensitivity pneumonitis remains a diagnostic challenge. Given that the main cause of the disease is sensitization and hyper-responsiveness to specific antigens in susceptible individuals, SIC is an obvious candidate as the gold standard for diagnosis of this entity. The present review analyzes the reasons for the test's limited use, assesses its diagnostic utility, and proposes a basis for its standardization.
-
Antihistamines exert pharmacologic effects by binding to four histamine receptors (H1-H4) at different affinities, producing variable effects depending on the receptor they predominantly bind to. This review's purpose is to determine the relative potency of antihistamines by comparing their binding affinities to these receptors. Studies on binding affinities of antihistamines to histamine receptors were reviewed and the dissociation constant for inhibitor binding (Ki) analyzed to determine the most and least potent antihistamine for each receptor. ⋯ This review summarizes the relative potency of antihistamines based on their binding affinities to the four histamine receptors. Although data on binding affinities of antihistamines to the H4 receptor are sparse, it is apparent that further research on these histamine subtypes may open new venues for more direct treatment with a higher therapeutic efficacy on allergic disorders including those affecting the ocular surface.
-
Both atopy and diseases from the spectrum of dermatitis and eczema are among the most frequent clinical problems worldwide; nevertheless, they are still poorly defined and too frequently misdiagnosed. In the present review, studies pertinent to this topic were systematized and critically assessed with particular attention to definitions of relevant diseases. ⋯ The interplay between atopy and diseases from the spectrum of dermatitis and eczema is not fully understood; nevertheless, their coexistence and overlapping are not rare. Therefore, every patient with eczema - regardless of age, sex or atopic status - should undergo an extensive diagnostic programme including each atopic eczema, irritant contact dermatitis, allergic contact dermatitis, and protein contact dermatitis. Better definitions and well designed studies are necessary to achieve detailed information on the complex relationships between each atopy, atopic eczema, and the three contact dermatitides.
-
Mastocytosis in adults is associated with a history of anaphylaxis in 22-49%. In addition, monoclonal mast cell activation syndrome has been described presenting with anaphylaxis, especially in patients with hymenoptera venom anaphylaxis. Data on patients with drug hypersensitivity and mast cell diseases are scarce. ⋯ The association between immediate drug hypersensitivity and undetected mast cell diseases appears to be moderate, but nevertheless basal serum tryptase determination and examination for skin signs of mast cell disorders are recommended. An ongoing European multicenter study by the European Network for Drug Allergy will provide more information on this topic.