Immunologically Mediated Diseases and Allergic Reactions
Julius P. Kreier in Infection, Resistance, and Immunity, 2022
Allergies to certain foods, dust, or animal dander can be controlled by avoidance of the allergen. However, ubiquitous allergens such as ragweed, grasses, or certain tree pollens are difficult to avoid. Many allergy patients undergo allergen immunotherapy, which is a technique that involves subcutaneous injection of increasing doses of an allergen over a period of weeks or months in hopes of reducing allergen-specific IgE levels. Allergen immunotherapy has proven successful for treatment of allergic asthma and rhinitis, but the mechanism by which this treatment improves clinical symptoms is not entirely clear. Following repeated injections of allergen, there is an increase in antigen-specific IgG antibodies, which are postulated to function by neutralizing antigen, by blocking the interaction of antigen and IgE, and by negatively regulating IgE production through antibody feedback mechanisms. Desensi tiza ti on through continued allergen injection could also downregulate IgE production by shifting the predominance of antigen-specific TH2 T lymphocytes to TH1 cells or by inducing specific T cell tolerance.
Asthma 1
Len Sperry in Behavioral Health, 2013
Paula J. is a 29-year-old married female with a 14-year history of asthma. Her asthma has worsened recently. About 3 months ago, she had started working in a pet store owned by a family friend. While she enjoys working with the animals and her fellow employees she has become noticeably aware of her exposure to animal dander in the store. Needless to say, she quickly found her allergic response to the dander further complicated her asthma. Seven weeks ago and again last week she experienced full-blown asthma attacks which were so severe she ended up in the emergency room. Prior to this time, her asthma was reasonably well controlled on medication and an inhaler, but now it was poorly controlled. Her internist, Dr. Samuels, proceeded to prescribe medications to control her new allergy but Paula didn’t tolerate the side effects and stopped taking it. She was referred to an allergist who suggested a desensitization treatment but Paula balked at the prospect of undergoing weekly treatment for three or more years. Paula had now missed several days of work and she agreed that both physical and emotional stressors, her dander allergy and her marital discord, were complicating her asthma. Since additional medication did not seem to help much, Dr. Samuels referred Paula to his colleague, Joanna Ibrahim, PhD, a mental health counselor specializing in chronic respiratory illnesses, to deal with Paula’s much more challenging chronic health condition.
Manufacturing arthropod and mammalian allergen extracts
Richard F. Lockey, Dennis K. Ledford in Allergens and Allergen Immunotherapy, 2020
The inhalation of skin-derived mammalian allergens is a common cause of allergic sensitization and allergic respiratory symptoms worldwide [13]. Their sensitization may occur at home by allergens derived from cats, dogs, horses, cows, and rodents present in up to 35% of European and 60% of U.S. households. In Sweden, in an unselected population including more than 4000 children, a significant increase in the rate of sensitization to cat, dog, and horse has been reported [14]. Mammalian allergens also play an important role in occupational settings, where veterinarians and laboratory animal workers, among others, may be exposed to large and small mammals and rodents, such as guinea pigs, rabbits, mice, and rats. In these settings, sensitization to rodents may affect between 11% and 44% of the exposed personnel. Sensitivity to mouse dander and urine is also common in inner-city children with asthma in the United States. It has been reported that mouse allergens are detectable in dust and bedrooms of an important population of atopic children. By contrast, several studies have indicated that early pet keeping could protect the infant from later allergy development. In a cross-sectional cohort in Sweden, allergy decreased from 49% in those with no pets, to 0% in those with five or more pets [15]. Sensitization to animals, as well as pollens, also decreased with an increasing number of animals in the household.
Family, neighborhood and psychosocial environmental factors and their associations with asthma in Australia: a systematic review and Meta-analysis
Published in Journal of Asthma, 2022
K. M. Shahunja,, Peter D. Sly,, Tahmina Begum, Tuhin Biswas, Abdullah Mamun
Although house dust mite and fungi exposures were associated with asthma-symptoms in some studies in Australia, the pooled estimate was not statistically significant. Some studies showed that the overall association with asthma-symptoms varied with the sensitization of different concentrations of HDM in the household (42,44–46). The odds for asthma-symptoms were different for HDM in different locations (bed, floor, etc.) (45), and for different allergens such as Der p 1, Der f 1, or in different concentrations (42–45). Dog dander is the principal source of Can f 1, and cat dander for Fel d 1 allergens (76). In places where pets live, the concentrations of HDM and these allergens are found to be higher. Therefore, the generalization of the association of all HDM and having furry pets with asthma-symptoms would be difficult. Similar findings occur in the case of fungi exposure. In meta-analysis, we did not find any overall significant association between increased amount (100 spores/m3) of total fungal spores’ exposure and asthma-symptoms. However, some studies showed that specific fungal spores such as Cladosporium, Alternaria, and Coprinus had significantly higher associations with asthma-symptoms (40–42).
Allergen immunotherapy against house dust mites in patients with local allergic rhinitis and asthma
Published in Journal of Asthma, 2022
Andrzej Bozek,, Beata Galuszka,, Radosław Gawlik,, Maciej Misiolek,, Wojciech Scierski,, Alicja Grzanka,, Giorgio Walter Canonica
Allergic diseases are highly prevalent in children and adults, and their prevalence continues to increase. One of the most common allergic diseases is allergic rhinitis (AR). Allergies to house dust mites (HDMs), pollen, molds, and some types of animal dander are responsible for AR (1). Many patients with AR develop asthma. At present, many different endotypes of AR are known, such as local allergic rhinitis (LAR) and systemic dual allergic rhinitis (as coincident AR with LAR), which have been described in detail (2,3). LAR is a clinical rhinitis phenotype characterized by the presence of nasal symptoms of AR in nonatopic patients with a negative skin prick test (SPT) and undetectable specific IgE (sIgE) in serum against inhalant allergens but with a positive nasal allergen provocation test (4).
Tolerance to exposure to essential oils exposure in patients with allergic asthma
Published in Journal of Asthma, 2019
Jean Levy, Catherine Neukirch, Isabelle Larfi, Pascal Demoly, Gabriel Thabut
Asthma is a chronic inflammatory airway disorder that leads to symptoms such as coughing, wheezing and chest tightness. Alterations of the airways in asthma are the result of complex interactions between inflammation, airflow obstruction, and bronchial hyperresponsiveness [1]. The dominant event leading to clinical symptoms in asthma is bronchoconstriction. The latter runs a variable course, with symptom-free periods interrupted by periods of exacerbations, often caused by viral infection, exposure to allergens, for allergic asthma, or fungi and indoor or outdoor pollutants [2]. Allergic sensitization to inhaled allergens such as house dust mites, animal dander, pollen or molds is found in a large proportion of patients (50 to 85%), and this is due to atopy, which is a predisposition to develop allergic hypersensitivity reactions and to produce IgE in response to allergens [1]. The international guidelines emphasize the importance of eliminating airborne allergens, notably those found indoors, such as dust mites, animal dander and molds, as the first step in the management of asthma [3].
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