Respiratory disorders
Michael Horvat, Ronald V. Croce, Caterina Pesce, Ashley Fallaize in Developmental and Adapted Physical Education, 2019
One type of asthma, called allergic asthma is caused by the reaction or hypersensitivity of an individual to the introduction of normally harmless substances. These substances are called allergens and usually affect the child during the early school years. Allergic asthma is the most common type of asthma in children at 80%. Allergens include pollens, dust, molds, animal fur, fumes, and smoke. Nonallergic asthma is not as prevalent as allergic asthma but is nevertheless often encountered by physical education teachers. At one time, nonallergic asthma was thought to be caused by emotional stress and/or fatigue. Strong emotional expressions may exacerbate symptoms, but the symptoms generally disappear when the cause of the emotional tension is removed. Asthma can also be precipitated by physical activity. This type of asthma is commonly referred to as exercise-induced asthma (EIA) or exercise-induced bronchospasm (EIB). Mixed asthma is a combination of both allergic and nonallergic asthma, generally occurring in late childhood or adolescence and exhibiting itself more often in females than males. In addition, the severity of asthma may vary with intermittent symptoms of persistence that can be mild, moderate, or severe in regard to control.
Allergic Rhinosinusitis
Raymond W Clarke in Diseases of the Ear, Nose & Throat in Children, 2023
AR is an inflammatory condition caused by the cellular response to an allergen to which the child has earlier been exposed. It is mediated by immunoglobulin E (IgE) which binds to receptor cells – ‘mast cells’ – in the host. The nasal mucosa is especially sensitive but the pharynx, the oral cavity and particularly the conjunctival mucosa are frequently involved, such that the term AR is now best thought of as allergic rhinoconjunctivitis. Degranulation of these cells releases a variety of inflammatory mediators such as histamine, leukotriene C4 and others which cause swelling, oedema and hypersensitivity of the mucosa. The typical allergens at play in children are the house dust mite, grass and tree pollens, moulds and spores, and animal (pet) dander. There is a strong genetic component to the aetiology of AR. It is more common in western populations and, while the exact reasons for this are unknown, smaller family size, earlier exposure to environmental pollutants and reduced exposure to community infections may be some of the factors at play.
Nasal, bronchial, conjunctival, and food challenge techniques and epicutaneous immunotherapy of food allergy
Richard F. Lockey, Dennis K. Ledford in Allergens and Allergen Immunotherapy, 2020
Allergic rhinitis (AR) is an upper airway disorder characterized by IgE-mediated inflammation of the nasal mucosa. After inhalation of sensitized allergens, AR patients experience nasal and ocular symptoms such as sneezing, nasal itching and congestion, rhinorrhea, and itchy/watery eyes [1,2]. In clinical practice, nasal allergen challenges (NACs) can serve as a diagnostic tool for AR. NACs can also be used to evaluate AR pathophysiology and AR medications such as intranasal corticosteroids and antihistamines. During NACs, allergen is directly delivered into the nasal cavity, producing an immediate allergic response. The subsequent sections that follow provide an overview of two different nasal challenge protocols along with the different methods of symptom assessments, allergen delivery, and implications.
Pharmacoeconomics of allergy immunotherapy versus pharmacotherapy
Published in Expert Review of Clinical Immunology, 2021
Most cost-effectiveness AIT studies considered single allergen AIT for SAR. Most allergic patients are sensitized to more than one allergen. It is not known if the cost-effectiveness of single allergen AIT can be assumed with multiallergen AIT. However, it is likely the majority of patients in the 12-year Florida Medicaid database study received multiallergen SCIT, as the typical US approach to AIT is to include all allergens identified in allergy testing. The cost difference between multiallergen and single allergen SLIT may be significantly greater because of SLIT’s dosing frequency. More research is needed to compare the cost-effectiveness of multiallergen SCIT and SLIT and different durations of AIT. In the next 5 years, data from clinical registries, such as the American Academy of Allergy, Asthma, and Immunology’s Quality Clinical Data Registry and government insurance databases may provide useful information about healthcare utilization and costs of AIT for different conditions and duration.
Allergen immunotherapy: progress and future outlook
Published in Expert Review of Clinical Immunology, 2023
Lara Šošić, Marta Paolucci, Stephan Flory, Fadi Jebbawi, Thomas M. Kündig, Pål Johansen
Allergies are a group of conditions caused by the hypersensitivity of the immune system to otherwise innocuous environmental compounds [1]. The allergens are mostly proteins and typically contained in various natural sources, such as plant pollen, animal dander, dust mites, foods, fungi, and insect venoms. Allergies can manifest with a wide range of symptoms in various organs, and the symptoms can be anything from just tedious or annoying to life-threatening. Accordingly, the type of treatment varies from case to case. A majority of all allergy patients are self-treated with symptom-relieving medicines, while allergen immunotherapy (AIT) is the only causative treatment option. This review will aim to give an overview of the state-of-the-art allergy management, including the use of new biologics and the application of biomarkers and a special emphasis and discussion on current research trends in the field of AIT.
In vitro prediction of in vivo pseudo-allergenic response via MRGPRX2
Published in Journal of Immunotoxicology, 2021
Linu M. John, Charlotte M. Dalsgaard, Claus B. Jeppesen, Kilian W. Conde-Frieboes, Katrine Baumann, Niels P. H. Knudsen, Per S. Skov, Birgitte S. Wulff
Mast cells (MC) are important modulators of the innate and adaptive immune response and are often located at boundaries between tissues and the external milieu (Shelburne and Abraham 2011; Elieh Ali Komi et al. 2020). This strategic localization supports the immune system in the early detection of pathogens. MCs circulate in the blood as precursors originating from bone marrow and carry out their differentiation upon arrival at the resident tissue into granulated cells according to tissue specific signals (Elieh Ali Komi et al. 2020). Degranulation of MC and release of mediators of inflammation (e.g., histamine, prostaglandins, proteases) occurs upon activation by IgE-dependent or -independent pathways via many different antigens (Gaudenzio et al. 2016; Bulfone-Paus et al. 2017). The resulting anaphylaxis (IgE-mediated) or anaphylactoid (pseudo-allergenic; non-IgE-mediated) reactions can present with a variety of clinical symptoms (e.g., swelling/edema, hypotension, bronchospasm, skin rashes/hives), depending on the mediators that are released (Theoharides et al. 2019).
Related Knowledge Centers
- Atopy
- Immunoglobulin E
- Parasitic Disease
- Pollen
- Type I Hypersensitivity
- Antigen
- Allergy
- Immune System
- Immune Response
- House Dust Mite