Current opinion in allergy and clinical immunology
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Curr Opin Allergy Clin Immunol · Apr 2021
ReviewAsthma, severe acute respiratory syndrome coronavirus-2 and coronavirus disease 2019.
In December 2019, a novel respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first described and named coronavirus disease 2019 (COVID-19). Although the knowledge base surrounding COVID-19 and SARS-CoV-2 has grown rapidly, significant gaps in our knowledge remain and inaccurate information continues to circulate. This review will discuss the interaction between asthma and COVID-19 to provide a comprehensive understanding based on the currently available published data. ⋯ Data are rapidly evolving regarding COVID-19 and asthma. At this time, asthma does not appear to positively or negatively affect outcomes of COVID-19; however, it is imperative that practitioners keep abreast of the changing literature as we await a vaccine and control of this pandemic.
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Curr Opin Allergy Clin Immunol · Dec 2020
ReviewEosinophilic esophagitis as a complication of food oral immunotherapy.
Food oral immunotherapy (OIT) has emerged as way to mitigate serious allergic reactions including life-threatening anaphylaxis related to accidental ingestion. However, gastrointestinal-related adverse effects of OIT have been reported and are often cited as reasons for discontinuation of therapy. We summarize recent research on the prevalence of eosinophilic esophagitis (EoE) in patients undergoing OIT. ⋯ EoE is a rare but concerning side effect of OIT. More research is needed to better elucidate both the OIT-related and patient-related factors that may predispose individuals to develop EoE. The presence of comorbid conditions and/or preexisting subclinical esophageal eosinophilia may account for some of cases of EoE identified during OIT.
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Curr Opin Allergy Clin Immunol · Aug 2020
ReviewInvestigation of perioperative hypersensitivity reactions: an update.
The purpose of this review is to provide an update on how best to manage the investigation of suspected perioperative hypersensitivity reactions based on recent literature and key publications. ⋯ The investigation of perioperative hypersensitivity reactions is highly complex and aims to identify the correct culprit to ensure future avoidance but also to disprove allergy to other suspected culprits, making them available for subsequent anesthesia. To achieve this, close collaboration between anesthesiologists and allergists is called upon to ensure the best possible outcome for the patient.
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Severe asthma remains a debilitating disease and a challenge for the clinicians. Novel therapies have been introduced and have greatly improved asthma control and more are under development or in clinical studies. These include anti-IL5/IL5R, anti-IL4/IL4R, anti IL13, anti- thymic stromal lymphopoietin (TSLP) and more, and severe asthma is currently managed in personalized medicine approach. However, there is still an unmet need to discover new, clinically available biomarkers and targeted therapies for a large group of severe asthma patients, particularly those with T2-low asthma. In this review, we briefly present the phenotypes and endotypes of severe asthma, the omics technologies in asthma as well as current and future treatments for both T2-high and T2-low asthma. ⋯ Novel anti-IL5 agents have changed the management of T2-high asthma resulting in improved disease control, QoL and lung function and importantly, fewer exacerbations. Nevertheless, there is still the need to find new treatments, particularly for T2-low asthma, which remains a challenge.
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Curr Opin Allergy Clin Immunol · Apr 2020
ReviewChildhood asthma in the new omics era: challenges and perspectives.
Childhood asthma is a heterogeneous inflammatory disease comprising different phenotypes and endotypes and, particularly in its severe forms, has a large impact on the quality-of-life of patients and caregivers. The application of advanced omics technologies provides useful insights into underlying asthma endotypes and may provide potential clinical biomarkers to guide treatment and move towards a precision medicine approach. ⋯ Until now, omics studies have largely expanded our view on asthma heterogeneity, helped understand cellular processes underlying asthma, and brought us closer towards identifying (bio)markers that will allow the prediction of treatment responsiveness and disease progression. There is a clinical need for biomarkers that will guide treatment at the individual level, particularly in the field of biologicals. The integration of multiomics data together with clinical data could be the next promising step towards development individual risk prediction models to guide treatment. However, this requires large-scale collaboration in a multidisciplinary setting.