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J Allergy Clin Immunol ; 144(2): 381-392, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31247266


Many notable advances in drug allergy, urticaria, angioedema, and anaphylaxis were reported in 2018. Broad-spectrum antibiotic use and, consequently, antibiotic resistance are widespread, and algorithms to clarify ß-lactam allergy and optimize antibiotic use were described. Meaningful data emerged on the pathogenesis of delayed drug hypersensitivity reactions. Progress not only in defining biomarkers but also in understanding the effect on quality of life and developing better treatments has been made for patients with chronic idiopathic urticaria. Patients with hereditary angioedema (HAE) have gained additional access to highly efficacious therapies, with associated improvements in quality of life, and some progress was made in our understanding of recurrent angioedema in patients with normal laboratory results. Guidelines have defined clear goals to help providers optimize therapies in patients with HAE. The epidemiology and triggers of anaphylaxis and the mechanisms underlying anaphylaxis were elucidated further. In summary, these disorders (and labels) cause substantial burdens for individual persons and even society. Fortunately, publications in 2018 have informed on advancements in diagnosis and management and have provided better understanding of mechanisms that potentially could yield new therapies. This progress should lead to better health outcomes and paths forward in patients with drug allergy, urticaria, HAE, and anaphylaxis.

Expert Rev Clin Immunol ; 14(9): 771-780, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30113236


INTRODUCTION: Acid suppressant medications (ASMs), such as proton pump inhibitors and histamine-2 receptor antagonists, are used often and throughout the lifespan. These medications have been linked to the development of a variety of allergic diseases. Areas covered: This review discusses prior studies investigating the association between acid ASM exposure and the development of allergic diseases. We performed a thorough literature search to identify potentially relevant studies for inclusion. In summary, exposure to these medications prenatally, in childhood and in adulthood, may increase the risk of allergic diseases. The current evidence is limited by primarily observational study design and potential bias and confounding. The mechanism of action is not yet known, but there are several proposed theories. Expert commentary: There is a growing body of evidence to support that exposure to acid ASMs increases the risk of developing allergic diseases. Further research is needed to not only clarify this relationship but to define the potential mechanism of action. If further research confirms these observations, we believe that could warrant changes in the patterns of prescribing and use of acid ASMs.

Antialérgicos/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Refluxo Gastroesofágico/tratamento farmacológico , Antagonistas dos Receptores Histamínicos/efeitos adversos , Hipersensibilidade/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Inibidores da Bomba de Prótons/efeitos adversos , Adolescente , Adulto , Antialérgicos/uso terapêutico , Viés , Feminino , Refluxo Gastroesofágico/complicações , Humanos , Hipersensibilidade/etiologia , Gravidez , Inibidores da Bomba de Prótons/uso terapêutico , Risco
Cardiol Rev ; 22(5): 253-61, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24618931


Anacetrapib is a cholesteryl ester transfer protein (CETP) inhibitor currently in Phase III of development as a treatment for those with dyslipidemia and the risk of cardiovascular disease. The agent acts by inhibiting the CETP, which mediates the transfer of cholesterol esters from high-density lipoprotein cholesterol (HDL-C) to other lipoproteins. HDL-C has been inversely linked to cardiac risk and is thus a potential target for decreasing residual cardiovascular risk, which remains despite aggressive low-density lipoprotein cholesterol therapy with statin drugs. Anacetrapib has been shown to raise HDL-C by up to 138% and decrease low-density lipoprotein cholesterol by up to 39% compared with placebo. The HDL-C molecules treated with anacetrapib have also been shown to retain their function in cholesterol efflux and reverse cholesterol transport and their anti-inflammatory properties. Unlike the previously tested CETP inhibitor torcetrapib, anacetrapib has not been shown to elevate blood pressure, alter electrolytes, or cause any significant side effects. Future studies will determine whether these alterations in the lipid profile decrease the cardiovascular risk of morbidity and mortality. If these studies show promising results, anacetrapib could become a vital pharmacologic therapy for decreasing cardiovascular risk in patients.

Anticolesterolemiantes/uso terapêutico , Proteínas de Transferência de Ésteres de Colesterol/antagonistas & inibidores , Dislipidemias/tratamento farmacológico , Oxazolidinonas/uso terapêutico , Anticolesterolemiantes/farmacologia , HDL-Colesterol/metabolismo , Humanos , Oxazolidinonas/farmacologia