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1.
Emerg Med Clin North Am ; 40(1): 119-133, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34782083

RESUMEN

Scombroid poisoning, systemic mastocytosis, and hereditary alpha tryptasemia all present with episodes that resemble allergic reactions. Knowledge regarding systemic mastocytosis and hereditary alpha tryptasemia is quickly evolving. Epidemiology, pathophysiology, and strategies to identify and diagnose are discussed. Evidence-based management in the emergency setting and beyond is also explored and summarized. Key differences are described between these events and allergic reactions.


Asunto(s)
Angioedema/diagnóstico , Hipersensibilidad/diagnóstico , Toxinas Marinas/biosíntesis , Angioedema/fisiopatología , Mimetismo Biológico , Humanos , Hipersensibilidad/fisiopatología , Toxinas Marinas/metabolismo , Triptasas/análisis , Triptasas/deficiencia
2.
Emerg Med Clin North Am ; 40(1): 1-17, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34782082

RESUMEN

Allergic reactions and anaphylaxis occur on a severity continuum from mild and self-limited to potentially life-threatening or fatal reactions. Anaphylaxis is typically a multiorgan phenomenon involving a broad range of effector cells and mediators. Emergency department visits for anaphylaxis are increasing, especially among children. There is a broad differential diagnosis for anaphylaxis, and the diagnosis of anaphylaxis can be aided by the use of the National Institutes of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network clinical diagnostic criteria. Risk factors for severe anaphylaxis include older age, delayed epinephrine administration, and cardiopulmonary comorbidities.


Asunto(s)
Anafilaxia/fisiopatología , Hipersensibilidad/fisiopatología , Anafilaxia/diagnóstico , Epinefrina/uso terapéutico , Humanos , Hipersensibilidad/diagnóstico , Factores de Riesgo
3.
Handb Exp Pharmacol ; 268: 3-19, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34424388

RESUMEN

Allergy has shown a dramatic increase in prevalence in the last decades. However, allergic diseases are probably not new. Asthma and eczema have been described in ancient societies like Egypt, China and in the Greco-Roman culture. In the middle-ages descriptions of hay fever can be found in Persian-Arabian literature (called "rose fever"). Scientific allergology started in the nineteenth century with descriptions of hay fever and experimental studies showing pollen as elicitors. Milestones in the twentieth century comprise the description of anaphylaxis, the creation of the terms "allergy" and "atopy", the Prausnitz-Küstner test and finally the discovery of IgE and the development of the Radio-Allergo-Sorbent-Test (RAST) for routine detection of specific IgE antibodies. Progress in cellular immunology led to the description of T-cell subsets Th1 and Th2. Mast cell and basophil research progressed since the first description to histamine release studies. Leukotrienes were detected. Pharmacotherapy started in the early twentieth century with adrenaline (epinephrine) followed by antihistamines and cortisone. Allergen-specific immunotherapy was introduced. Epidemiologic studies pointed to a role of environmental pollutants as allergy enhancing factors and protective influences from farm environment. Through the progress in experimental allergology and immunology targeted therapeutics have been developed for various atopic conditions.


Asunto(s)
Asma , Hipersensibilidad , Rinitis Alérgica Estacional , Basófilos , Humanos , Hipersensibilidad/terapia , Inmunoglobulina E
4.
Handb Exp Pharmacol ; 268: 313-329, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34085121

RESUMEN

Asthma genes have been identified through a range of approaches, from candidate gene association studies and family-based genome-wide linkage analyses to genome-wide association studies (GWAS). The first GWAS of asthma, reported in 2007, identified multiple markers on chromosome 17q21 as associates of the childhood-onset asthma. This remains the best replicated asthma locus to date. However, notwithstanding undeniable successes, genetic studies have produced relatively heterogeneous results with limited replication, and despite considerable promise, genetics of asthma and allergy has, so far, had limited impact on patient care, our understanding of disease mechanisms, and development of novel therapeutic targets. The paucity of precise replication in genetic studies of asthma is partly explained by the existence of numerous gene-environment interactions. Another important issue which is often overlooked is that of time of the assessment of the primary outcome(s) and the relevant environmental exposures. Most large GWASs use the broadest possible definition of asthma to increase the sample size, but the unwanted consequence of this is increased phenotypic heterogeneity, which dilutes effect sizes. One way of addressing this is to precisely define disease subtypes (e.g. by applying novel mathematical approaches to rich phenotypic data) and use these latent subtypes in genetic studies.


Asunto(s)
Asma , Hipersensibilidad , Asma/genética , Niño , Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo , Humanos , Hipersensibilidad/genética
5.
Handb Exp Pharmacol ; 268: 151-170, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34085123

RESUMEN

Chronic rhinosinusitis (CRS) is a clinical syndrome stemming from persistent inflammation of the sinonasal mucosa. Phenotypically, it is traditionally and widely described according to the presence or absence of polyps. While this distinction is simple to use, it has little bearing on prognosis and treatment, for CRS is essentially an inflammatory disease resulting from dysregulated interaction between a multitude of host and environmental factors. Allergy is merely one of them and, like many of the proposed aetiologies, has been subject to much debate which will be discussed here. As our understanding of CRS continues to evolve, previous so-called conventional wisdom about phenotypes (e.g. CRS with nasal polyps is associated with Type 2 inflammation) is being challenged, and new phenotypes are also emerging. In addition, there is growing interest in defining the endotypes of CRS to deliver precise and personalised treatment, especially pertaining to the development of biologics for the group of severe, difficult-to-treat CRS patients. A proposed model of precision medicine tailored to management of CRS will also be introduced to readers, which can be continually modified to adapt to new discoveries about this exciting condition.


Asunto(s)
Hipersensibilidad , Pólipos Nasales , Rinitis , Sinusitis , Enfermedad Crónica , Humanos , Pólipos Nasales/tratamiento farmacológico , Medicina de Precisión , Rinitis/diagnóstico , Rinitis/tratamiento farmacológico , Rinitis/etiología , Sinusitis/diagnóstico , Sinusitis/tratamiento farmacológico , Sinusitis/etiología
6.
Handb Exp Pharmacol ; 268: 393-403, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34173866

RESUMEN

Diagnostics in type-1 allergy rely on medical history and clinical examination. Extent and severity of signs and symptoms can be documented by standardized scores and questionnaires. Both skin prick test and intradermal test are useful for search of immunoglobulin E-mediated sensitizations but the availability of commercially available diagnostic extracts has been markedly reduced during the last years. Investigation of total and of specific serum IgE is the most important in vitro diagnostic analyte in type-1 allergy. Identification of the individual molecules to which patients are sensitized, known as molecular or component-resolved diagnostics (CRD), has recently markedly improved management of type-1 allergy to pollen, food and hymenoptera venoms. Main features of CRD are increased analytic sensitivity, detection of cross-reactivity and determination of individual sensitization profiles which allow for risk assessment and facilitate decisions for or against allergen immunotherapy. Basophil activation test as well as determination of selected biomarkers (e.g. tryptase) may also be helpful in some cases. If any allergy test is positive, one will have to distinguish reactions, which are clinically relevant, from those, which are not. In vivo provocation tests (e.g. nasal provocation, oral drug or food challenge) may help to clarify the relevance of a sensitization.


Asunto(s)
Alérgenos , Hipersensibilidad , Desensibilización Inmunológica , Humanos , Hipersensibilidad/diagnóstico , Inmunoglobulina E , Polen
7.
Handb Exp Pharmacol ; 268: 249-264, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34196808

RESUMEN

B cells are key players in the mechanisms underlying allergic sensitization, allergic reactions, and tolerance to allergens. Allergen-specific immune responses are initiated when peptide:MHCII complexes on dendritic cells are recognized by antigen-specific receptors on T cells followed by interactions between costimulatory molecules on the surfaces of B and T cells. In the presence of IL-4, such T-B cell interactions result in clonal expansion and isotype class-switching to IgE in B cells, which will further differentiate into either memory B cells or PCs. Allergic reactions are then triggered upon cross-linking of IgE-FcɛRI complexes on basophils and mast cells, leading to cell degranulation and the release of pro-inflammatory mediators.Mechanisms underlying effective allergen-specific immunotherapy (AIT) involve the induction of Tregs and the secretion of blocking IgG4 antibodies, which together mediate the onset and maintenance of immune tolerance towards non-hazardous environmental antigens. However, the importance of regulatory B cells (Breg) for tolerance induction during AIT has gained more attention lately. Studies in grass pollen- and house dust mite-allergic patients undergoing SCIT reported increased frequencies of IL-10+ Breg cells and a positive correlation between their number and the improvement of clinical symptoms. Thus, Breg are emerging as biomarkers for monitoring tolerance to allergens under natural exposure conditions and during AIT. Further research on the role of other anti-inflammatory cytokines secreted by Breg will help to understand their role in disease development and tolerance induction.


Asunto(s)
Desensibilización Inmunológica , Hipersensibilidad , Alérgenos , Linfocitos B , Humanos , Hipersensibilidad/terapia , Tolerancia Inmunológica
8.
Handb Exp Pharmacol ; 268: 367-390, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34196809

RESUMEN

The prevalence of allergic diseases is increasing rapidly and has already reached an epidemic level. Two major drivers of this development are climate change and globalization, which both induce an increase in allergens. Concomitant climate change fosters the spreading of the latter on a global scale. The increase in allergens not only aggravates the symptoms and the degree of suffering for patients who already are allergic, but also gives rise to new cases of allergies. The distribution of allergies in society follows a steep socioeconomic gradient worldwide. According to well-established theories of justice such a distribution of the allergy burden is unfair. This fact adds a major ethical dimension and challenge to the allergy epidemic. This chapter draws on the key points of policies for allergy prevention and treatment. It shows how related programs and measures can be conceptualized and prioritized according to the principles of distributional justice.


Asunto(s)
Hipersensibilidad , Polen , Alérgenos , Cambio Climático , Humanos , Hipersensibilidad/epidemiología , Internacionalidad
9.
Handb Exp Pharmacol ; 268: 437-448, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34196812

RESUMEN

Since allergic diseases are of great public health relevance, effective primary prevention strategies are urgently needed. This chapter gives an overview of existing primary prevention programs on environmental exposures and dietary strategies based on epidemiological studies which have defined risk- and protective factors for the development of allergic diseases.The allergy protective effect mediated by growing up on a traditional farm environment is well studied. But the exact underlying mechanisms have still not been fully clarified and have not yet led to concrete prevention strategies. The beneficial effect of avoiding cigarette smoke exposure, indoor moisture and molds in pregnancy and childhood on the development of asthma is well documented. Whereas the avoidance of house dust mite exposure is not recommended to prevent eczema or allergy. Dietary supplementation with vitamins, pre- and probiotics in pregnant woman and their offspring is not harmful but evidence for the prevention of allergic diseases is still lacking. Fish oil consumption was shown to be asthma protective. The early introduction of peanuts and egg protein to prevent peanut and egg allergy in children with atopic dermatitis is promising. Further studies are needed to increase the overall evidence in allergy prevention. Most studies lack methodological standards such as randomization and blinding. More evidence is in demand on the potential beneficial impact of multifaceted interventional studies. The future of allergy prevention strategies might be based on individual risk assessment. Therefore, research in the immunological and molecular basis of allergic diseases needs to be promoted.


Asunto(s)
Asma , Dermatitis Atópica , Eccema , Hipersensibilidad , Niño , Dieta , Femenino , Humanos , Hipersensibilidad/prevención & control , Lactante , Embarazo
10.
Handb Exp Pharmacol ; 268: 331-357, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34223997

RESUMEN

There has been a substantial increase in the incidence and the prevalence of allergic disorders in the recent decades, which seems to be related to rapid environmental and lifestyle changes, such as higher exposure to factors thought to exert pro-allergic effects but less contact with factors known to be associated with protection against the development of allergies. Pollution is the most remarkable example of the former, while less contact with microorganisms, lower proportion of unprocessed natural products in diet, and others resulting from urbanization and westernization of the lifestyle exemplify the latter. It is strongly believed that the effects of environmental factors on allergy susceptibility and development are mediated by epigenetic mechanisms, i.e. biologically relevant biochemical changes of the chromatin carrying transcriptionally-relevant information but not affecting the nucleotide sequence of the genome. Classical epigenetic mechanisms include DNA methylation and histone modifications, for instance acetylation or methylation. In addition, microRNA controls gene expression at the mRNA level. Such epigenetic mechanisms are involved in crucial regulatory processes in cells playing a pivotal role in allergies. Those include centrally managing cells, such as T lymphocytes, as well as specific structural and effector cells in the affected organs, responsible for the local clinical presentation of allergy, e.g. epithelial or airway smooth muscle cells in asthma. Considering that allergic disorders possess multiple clinical (phenotypes) and mechanistic (endotypes) forms, targeted, stratified treatment strategies based on detailed clinical and molecular diagnostics are required. Since conventional diagnostic or therapeutic approaches do not suffice, this gap could possibly be filled out by epigenetic approaches.


Asunto(s)
Asma , Hipersensibilidad , Metilación de ADN , Epigénesis Genética , Humanos , Hipersensibilidad/epidemiología , Hipersensibilidad/genética , Hipersensibilidad/prevención & control , Procesamiento Proteico-Postraduccional
11.
Handb Exp Pharmacol ; 268: 101-115, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34236520

RESUMEN

Atopic eczema (AE) is a chronic inflammatory disease hallmarked by intense pruritus and eczematous lesions. It depicts one of the most common skin diseases affecting a major part of children and several percentages of adults.Both pathogenesis and pathophysiology are based on complex orchestrated interactions of skin barrier defects, immunological changes, the environment, and an abundance of other contributing factors. Frequently, AE displays the starting point for other allergic diseases such as allergic asthma and rhinoconjunctivitis. Additionally, the risk of developing food allergy is increased. Furthermore, the disease is accompanied by a susceptibility to bacterial, fungal, and viral infections. The development of new therapies received great impetus by an ample research of the pathophysiological mechanisms, leading to a new era in the treatment of severe atopic eczema due to targeted treatments, e.g. the IL-4R alpha specific monoclonal antibody dupilumab.This article provides an overview of the causative and pathophysiological characteristics, the clinical and diagnostic aspects as well as current and future therapeutical possibilities focusing allergic aspects contributing to the course of the disease.


Asunto(s)
Asma , Dermatitis Atópica , Eccema , Hipersensibilidad , Adulto , Niño , Dermatitis Atópica/tratamiento farmacológico , Humanos
12.
Handb Exp Pharmacol ; 268: 265-296, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34247282

RESUMEN

T helper (Th) and regulatory T (Treg) cells represent important effectors of adaptive immunity. They mediate communication between the immune system and tissue sites and thereby coordinate effective defense against environmental threats or maintain tolerance, respectively. Since the discovery of two prototypic T helper cells, Th1 and Th2, additional phenotypic and functional distinct subsets have been described ranging from Th17, Th22, Th9, and T follicular helper cells. The same holds true for regulatory T cells that represent a family with functionally distinct subsets characterized by co-expression of the transcription factors T-bet, Gata3, or RORγt. Here, we summarize the current knowledge on differentiation and function of T helper and regulatory T cell subsets and discuss their lineage stability versus plasticity towards other subsets. In addition, we highlight the direct and indirect contribution of each subset to the pathology of allergies and indicate novel therapies for specific targeting the effector functions of T helper and regulatory T cells.


Asunto(s)
Hipersensibilidad , Linfocitos T Reguladores , Humanos , Tolerancia Inmunológica , Subgrupos de Linfocitos T
13.
Handb Exp Pharmacol ; 268: 31-41, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34255192

RESUMEN

Hypersensitivity reactions are overreactions of the immune system clinically seen as allergic and autoimmune diseases. Gell and Coombs originally described four different types of hypersensitivity reactions almost 60 years ago, and their description still applies in large parts. However, some modifications and extensions have been included in original definition. Especially in allergic diseases, it became clear that often, multiple types of hypersensitivity reaction can occur simultaneously. This improved insight is not only important for a better understanding of hypersensitivity disorders, but is especially of importance for improved diagnostics and directing therapeutic interventions.


Asunto(s)
Hipersensibilidad , Humanos , Hipersensibilidad/diagnóstico , Hipersensibilidad/etiología
14.
Handb Exp Pharmacol ; 268: 135-149, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34268615

RESUMEN

During the last decades a substantial increase of allergic diseases has been noticed including allergic asthma and rhinoconjunctivitis as well as food allergies. Since efficient avoidance of airborne - and often hidden - food allergens is not possible, allergen immunotherapy (AIT) is the only causative treatment with the goal of inducing allergen tolerance in affected individuals. Efficacy as well as safety of AIT significantly depends on how the allergen is presented to the immune system, meaning both the route and the form of its application. Here, new ways of allergen administration have lately been explored, some of which are auspicious candidates for successful implementation in the therapeutic management of immediate-type allergies. While the first oral AIT has been approved recently by the FDA for the treatment of peanut allergy, further interesting routes of allergen application include either epicutaneous, intradermal, intranasal, or intralymphatic delivery. Besides, rather the immunologically relevant peptides instead of whole allergen may be administered to develop tolerance. In this chapter, we will describe these new and promising avenues of allergen application in the field of AIT. In addition, we will discuss their potential for future treatment of IgE-mediated allergic diseases enhancing therapeutic efficiency while further minimizing the risks of adverse events.


Asunto(s)
Asma , Hipersensibilidad , Alérgenos , Desensibilización Inmunológica , Humanos , Hipersensibilidad/terapia , Tolerancia Inmunológica
15.
Handb Exp Pharmacol ; 268: 213-225, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34031758

RESUMEN

Occupational allergies are among the most common recorded occupational diseases. The skin and the upper and lower respiratory tract are the classical manifestation organs. More than 400 occupational agents are currently documented as being potential "respiratory sensitizers" and new reported causative agents are reported each year. These agents may induce occupational rhinitis (OR) or occupational asthma (OA) and can be divided into high-molecular weight (HMW) and low-molecular weight (LMW) agents. The most common occupational HMW agents are (glycol)proteins found in flour and grains, enzymes, laboratory animals, fish and seafood, molds, and Hevea brasiliensis latex. Typical LMW substances are isocyanates, metals, quaternary ammonium persulfate, acid anhydrides, and cleaning products/disinfectants. Diagnosis of occupational respiratory allergy is made by a combination of medical history, physical examination, positive methacholine challenge result or bronchodilator responsiveness, determination of IgE-mediated sensitization, and specific inhalation challenge tests as the gold standard. Accurate diagnosis of asthma is the first step to managing OA as shown above. Removal from the causative agent is of central importance for the management of OA. The best strategy to avoid OA is primary prevention, ideally by avoiding the use of and exposure to the sensitizer or substituting safer substances for these agents.


Asunto(s)
Asma Ocupacional , Hipersensibilidad , Enfermedades Profesionales , Alérgenos , Animales , Asma Ocupacional/diagnóstico , Asma Ocupacional/epidemiología , Asma Ocupacional/etiología , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/etiología , Factores de Riesgo
16.
Handb Exp Pharmacol ; 268: 359-366, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34159483

RESUMEN

Air pollution is worldwide a major public health problem and affects large part of the population. Air pollution does not only harm the respiratory tract system but also the other organs of the body. The damage may result directly from the pollutants toxicity, because the pollutant enters into the organs through a direct route or indirectly through systemic inflammation. There is accumulating evidence suggesting that ambient air pollution not only affects the human lung and the cardiovascular system, but also has negative effects on allergic diseases. In this regard, it has been shown that exposure increases the risk of allergies and eczema in children and adults. However, the mechanism how ambient air pollution affects the skin is not well investigated up to now and needs further research.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Hipersensibilidad , Adulto , Contaminantes Atmosféricos/análisis , Contaminantes Atmosféricos/toxicidad , Contaminación del Aire/análisis , Contaminación del Aire/estadística & datos numéricos , Niño , Humanos , Hipersensibilidad/epidemiología , Hipersensibilidad/etiología , Pulmón , Factores de Riesgo
17.
Artículo en Inglés | MEDLINE | ID: mdl-34769816

RESUMEN

Multiple chemical sensitivity (MCS) is a multisystem, recurrent, environmental disorder that flares in response to different exposures (i.e., pesticides, solvents, toxic metals and molds) under the threshold limit value (TLV) calculated for age and gender in the general population. MCS is a syndrome characterized by cutaneous, allergic, gastrointestinal, rheumatological, endocrinological, cardiological and neurological signs and symptoms. We performed a systematic review of the literature to summarize the current clinical and therapeutic evidence and then oriented an eDelphi consensus. Four main research domains were identified (diagnosis, treatment, hospitalization and emergency) and discussed by 10 experts and an MCS patient. Thus, the first Italian MCS consensus had the double aim: (a) to improve MCS knowledge among healthcare workers and patients by standardizing the clinical and therapeutic management to MCS patients; and (b) to improve and shed light on MCS misconceptions not supported by evidence-based medicine (EBM).


Asunto(s)
Hipersensibilidad , Sensibilidad Química Múltiple , Consenso , Humanos , Italia/epidemiología , Sensibilidad Química Múltiple/diagnóstico , Sensibilidad Química Múltiple/epidemiología , Sensibilidad Química Múltiple/terapia , Solventes
18.
Rev Prat ; 71(7): 729-734, 2021 Sep.
Artículo en Francés | MEDLINE | ID: mdl-34792908

RESUMEN

WHAT IS KNOWN ABOUT THE ACTION OF ENDOCRINE DISRUPTORS ON THE IMMUNE SYSTEM? The immune system (innate and adaptive immunity), involves different tissues and cell types to defend the body against external aggressions. This physiological mechanism involves some hormonal systems for its proper functioning. Moreover, new relationships between the immune system and endocrine processes have been recently described. Immunotoxicology is therefore a rapidly expanding field of research. Many environmental pollutants, such as organochlorine pesticides, polycyclic aromatic hydrocarbons or heavy metals, have an impact on the immune response leading either to a deficiency or a hyperactivation (autoimmune disease, allergy). More recently, other endocrine disruptors such as organofluorines are suspected to be immunotoxic. Low-level exposure to pollutants in the general population probably does not explain the development of all the pathologies, but it sentisizes organisms to the development of these pathologies, weakening certain key processes of the immune system.


Asunto(s)
Disruptores Endocrinos , Contaminantes Ambientales , Hipersensibilidad , Hidrocarburos Policíclicos Aromáticos , Disruptores Endocrinos/toxicidad , Contaminantes Ambientales/toxicidad , Humanos , Sistema Inmunológico/química , Hidrocarburos Policíclicos Aromáticos/análisis , Hidrocarburos Policíclicos Aromáticos/toxicidad
19.
Kyobu Geka ; 74(12): 983-986, 2021 Nov.
Artículo en Japonés | MEDLINE | ID: mdl-34795138

RESUMEN

A 75-year-old male with a history of allergy to iodinated contrast media was referred for the treatment of the left subclavian artery aneurysm. The aneurysm was saccular and maximum diameter over 30 mm. Stent grafting was performed with the use of gadolinium-based contrast agent and intravascular ultrasound (IVUS). Ipsilateral vertebral artery was temporarily occluded with a balloon catheter to protect against distal embolism. The IVUS reduced the amount of gadolinium-based contrast agent. There were no neurological, renal or other complications after the treatment. Stent grafting of the left subclavian artery aneurysm may be safely performed with gadolinium-based contrast agent and IVUS, even if iodinated contrast media is contraindicated.


Asunto(s)
Medios de Contraste , Hipersensibilidad , Anciano , Medios de Contraste/efectos adversos , Gadolinio , Humanos , Masculino , Stents/efectos adversos , Ultrasonografía Intervencional
20.
Hautarzt ; 72(12): 1103-1112, 2021 Dec.
Artículo en Alemán | MEDLINE | ID: mdl-34792615

RESUMEN

Since the first report of allergen-specific immunotherapy (AIT) by Noon et al. 110 years ago, a multitude of clinical and in vitro studies have been performed to identify the effects of the only curative treatment for allergies. However, in atopic dermatitis (AD), one of the most prevalent skin diseases, it is rarely used, despite evidence showing that aeroallergens can contribute to disease exacerbation. This review gives an overview about the studies, meta-analyses, and current guideline recommendations regarding AIT in AD patients. There is a distinct heterogeneity in the study designs, different allergens and application forms, endpoints and patient cohorts, which hinders the comparability of studies. Several trials depict a beneficial effect of AIT in AD patients suggesting that at least a subgroup of patients can benefit from treatment. Further developments in the field of AIT may advocate broader use in AD patients.


Asunto(s)
Dermatitis Atópica , Eccema , Hipersensibilidad , Alérgenos , Dermatitis Atópica/diagnóstico , Dermatitis Atópica/terapia , Desensibilización Inmunológica , Humanos
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