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Feeling Feelings, Being Human
Published in Joi Andreoli, The Recovery Cycle, 2023
Desensitization, I told my friend, means getting used to experiencing uncomfortable feelings, with small-dose, incremental exposure to the thing that causes discomfort. And desensitization doesn’t mean becoming less sensitive, as my friend thought.
Allergic Rhinosinusitis
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
‘Immunotherapy’ has enjoyed increased popularity in recent years. The principle is that controlled exposure to the allergen may bring about desensitisation. Two methods are commonly employed: sublingual immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT). These may be available in a small number of centres and in limited circumstances, but the evidence base for their use in children is currently poor, and there is a risk of anaphylaxis.
Syphilis
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Desensitization is a straightforward, relatively safe procedure that can be done orally or intravenously. Oral desensitization is regarded as safer, and is easier to perform. Patients should be desensitized in a hospital setting because serious IgE-mediated allergic reaction can rarely occur. Desensitization is typically completed in approximately 4 hours, after which the first treatment dose of penicillin is administered. After desensitization, patients must be maintained on a penicillin regimen for the duration of therapy if multiple weekly doses are indicated by stage of disease.
Oral immunotherapy for food allergy in children: is it worth it?
Published in Expert Review of Clinical Immunology, 2022
Sharanya Nagendran, Nandinee Patel, Paul J Turner
The outcomes reported in clinical trials may not correspond to what patients (and their carers) want (Table 1). Rather than achieve a specific level of desensitization, patients may prefer to increase protection from accidental exposures to allergen, both in relation to any reaction and reducing the risk of a severe reaction. However, longer-term data is lacking in terms of OIT resulting in a reduction of symptoms due to accidental reactions to the trigger food following OIT, as highlighted in 2 recent cost-effectiveness analyses [28,49]. Given up to 50% of patients who undergo OIT report significant and ongoing taste aversion to the food they are allergic to (even during maintenance, following initial OIT)[5], sustained unresponsiveness may arguably also be a key outcome for patients following OIT.
Systemic manifestations of Ehlers-Danlos syndrome
Published in Baylor University Medical Center Proceedings, 2021
Bo Song, Peter Yeh, John Harrell
Mast cell activation syndrome can present as flushing, pruritus, hypotension, asthma, diarrhea, bloating, and cramping.1 Patients may also exhibit food insensitivity and intolerance, and laboratory testing can reveal increased blood levels of mast cells and mast cell mediators such as histamine and tryptase.1 Cheung and Vadas reported a prevalence of 66% with mast cell syndrome as opposed to 24% in our study.26 This disparity could be due to several reasons. For one, mast cell activation syndrome can present similarly to common conditions such as seasonal allergies or the common cold.1 In addition, accurate diagnosis of mast cell activation syndrome often requires an allergist and utilization of advanced laboratory or tissue sampling measures.1 As no cure yet exists for mast cell activation syndrome, patients are treated symptomatically.27 Desensitization therapy can be used initially, and medications such as antihistamines, omalizumab, or leukotriene antagonists are alternatives.27 However, steroids should be avoided.2 Caution should also be exercised with using taping treatments for musculoskeletal pain as the skin can be hypersensitive to adhesives.28
Current Trend in Immunotherapy for Peanut Allergy
Published in International Reviews of Immunology, 2018
Chong Joo Chan, Timmy Richardo, Renee Lay Hong Lim
Although OIT shows clinical efficacy on desensitisation and are more often evaluated compared to SLIT and EPIT, the later may be better in terms of safety compared to OIT.52,53 SLIT has a good safety profile especially for inhalant allergy, inducing lower amount of effector cells (thus lower risk of allergic reaction) but abundant antigen-presenting dendritic cells which promote the induction of tolerogenic Treg cells in the sublingual mucosa.54,55 Peanut allergen applied on the skin in EPIT has shown no systemic reaction, only common local eczematous skin reactions.56 This may be because the skin epidermal layer is not well vascularised and contain high amount of antigen-presenting cells with immune modulation ability, thus limiting the systemic reaction. The better safety profile of SLIT and EPIT may appear to surpass OIT; however the lower doses use in SLIT and EPIT may limit the efficacy.57,58 In addition, the efficacy of EPIT and SLIT is comparable due to low dosage use, but the small increment in reactive dose may not be sufficient to provide protection in the case of true accidental exposures.38,59 More research and systematic review are needed to outline the risk of these different routes of immunotherapy and to standardise the regiment, dosage and desensitisation strategy.