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Allergen Immunotherapy
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Suitable candidates for SCIT with inhalant allergens should have allergic rhinitis or allergic asthma. The use in atopic dermatitis, though the few reports are encouraging, must still be considered outside usual practice. The patient should have demonstrated sensitivity (preferably by a prick skin testing) to the allergens under consideration. There should be evidence that the allergens are present in sufficient concentrations in the patient’s environment and the patient’s pattern of symptoms should be consistent with the pattern of exposure to the aeroallergen. Finally, the degree of symptoms must be of sufficient severity and duration to warrant the risk, expense and inconvenience of injection immunotherapy. Since only immunotherapy can modify the underlying disease and produce improvement that persists for years after it is discontinued, it is not necessary that the patient’s symptoms be uncontrollable by symptomatic therapy.
Aeroallergen sampling
Published in Richard F. Lockey, Dennis K. Ledford, Allergens and Allergen Immunotherapy, 2020
Estelle Levetin, Josh D. McLoud
The Hirst-type spore trap is the most widely used instrument for the analysis of airborne pollen and fungal spores by aeroallergen sampling networks [8] and by independent investigators. This type of sampler was originally designed by James Hirst [35] as an instrument for plant pathologists to efficiently monitor airborne fungal spores. Current spore traps based on the Hirst design are available from Burkard Manufacturing Co. Ltd. (http://burkard.co.uk/) and Lanzoni, S.r.l. (https://www.lanzoni.it/). These instruments are generally supplied with a 7-day sampling head to permit continuous sampling.
Allergic Diseases
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Adam Fox, George Du Toit, Stephan Strobel
Aeroallergen exposure can impact on the severity of skin symptoms. In children with summer-pattern eczema, an association can be observed between disease severity and outdoor grass pollen counts. HDM allergen reduction is difficult to achieve and maintain due to the near ubiquitous exposure to HDMs. Knowledge of local pollen counts and the flowering seasons of the major allergenic plants is helpful in defining a culprit pollen.
B cells and upper airway disease: allergic rhinitis and chronic rhinosinusitis with nasal polyps evaluated
Published in Expert Review of Clinical Immunology, 2021
Harsha H Kariyawasam, Louisa K James
Rhinitis is the term used to define inflammation of the nasal mucosa. The clinical definition is by way of at least two of the following symptoms: nasal itching/sneezing, increased anterior secretions termed rhinorrhea and bilateral congestion for more than 1 h on most days. Chronicity of disease is arbitrarily defined by the persistence of such symptoms for more than three months [1]. AR is present when such symptoms are rapidly produced in response to a specific aeroallergen nasal exposure. Estimated to affect perhaps 400 million people worldwide, AR is accordingly one of the most persistent diseases. Worryingly prevalence is increasing [2], indeed, in some parts of Europe for example, the prevalence is as high as 50% of the population [3]. It is not only common but for many it is a disease that has a significant impact on general well-being, sleep quality, work productivity, school performance, and inevitably overall quality of life [4]. AR increases the risk of progression to asthma with an adjusted relative risk as high as 3.53 [5]. A trivial disease AR is not, despite being considered so by some health professionals, researchers, and government health bodies. There is an urgent need both to prevent and treat the disease more effectively, ultimately developing a cure.
Presentation, diagnosis, and the role of subcutaneous and sublingual immunotherapy in the management of ocular allergy
Published in Clinical and Experimental Optometry, 2021
Amruta Trivedi, Constance Katelaris
Atopic keratoconjunctivitis is severe, chronic, bilateral inflammation of the ocular surface. It is more common in adulthood, and up to 95 per cent of patients have a personal or family history of allergic disease. Atopic dermatitis is the most common associated condition,31 and atopic keratoconjunctivitis is considered the ‘ocular counterpart’ of atopic dermatitis. The eyelids have an eczematous appearance (Figure 2F), and madarosis or loss of eyelashes is often present. Other ocular findings include chemosis of the eyelid skin, with fine sandpaper‐like texture, conjunctival injection, and conjunctival scarring.32 Similar to vernal keratoconjunctivitis, small Trantas dots and papillae may be present. Patients may also develop atopic cataracts and may require cataract surgery at a young age.13 Corneal complications are common, and risk of vision‐threatening herpetic keratitis also increases.20 As seen in allergic conjunctivitis, many patients with atopic keratoconjunctivitis also test positive to aeroallergen sensitivity.
Thunderstorm asthma: an overview of mechanisms and management strategies
Published in Expert Review of Clinical Immunology, 2020
Francis Thien, Janet M. Davies, Mark Hew, Jo A. Douglass, Robyn E. O’Hehir
Thunderstorm asthma (TA) can be defined as observed cases of bronchospasm or exacerbations of asthma concomitant with a thunderstorm in the vicinity. While sporadic cases can occur, a characteristic propensity of TA to affect large numbers of individuals with an outbreak within a localized space over a short period of time is termed epidemic thunderstorm asthma (ETSA). A complex interaction of environmental and individual susceptibility factors has been proposed in the pathogenesis of TA [1]. In the majority of episodes, the following common factors have been reported: (i) the presence of a triggering aeroallergen (ii) an exposed susceptible population, and (iii) meteorological conditions including particular types of thunderstorms with strong gust fronts (Figure 1). This narrative review focuses on primary research articles on thunderstorm asthma published since 2017 and relevant historical studies.