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.
Extrapulmonary – Treatable traits
Vibeke Backer, Peter G. Gibson, Ian D. Pavord in The Asthmas, 2023
Intranasal glucocorticoids (nCS) and oral/topical antihistamines are the most effective treatments for the symptoms of allergic rhino-conjunctivitis and should be the first-line therapy for mild to moderate disease. In moderate to severe disease that does not respond well to nCS, additional pharmacological therapies with cromolyn and leukotriene receptor antagonists are necessary. Allergen immunotherapy and non-pharmacological treatment with nasal irrigation are additional options. Regarding the use of oral steroids, the current documentation is limited as few studies are available; however, oral steroids seem to bring about a significant dose-dependent reduction in symptoms despite the differences between symptoms. Furthermore, one study has supported injection with steroids over oral treatment. Anyhow, the use of systemic steroids is strongly discouraged due to the substantial side effects. If needed, short courses are recommended and only in rare cases, with large respect to side effects when used for maintenance treatment.
Dermal filler complications and management
Michael Parker, Charlie James in Fundamentals for Cosmetic Practice, 2022
Anaphylaxis is a Type I hypersensitivity reaction and is in essence a severe allergic reaction causing systemic compromise which requires the presence of immunoglobulin E (IgE) antibodies being exposed to a particular allergen. Inevitably, every single one of us will at some point or another have IgE antibodies exposed to allergens; however, only about one in 1,000 people will ever experience a true anaphylactic reaction, suggesting there are likely a set of risk factors which make an individual more likely to develop anaphylaxis. It has been noted that a history of atopy may make an individual more likely to experience such a reaction, with asthma in particular being associated with increased mortality. It is unclear, however, if there is true causation between asthma and the severity of anaphylaxis, and it may just be that they are more likely to suffer life-threatening bronchospasm.
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.
Human mesenchymal stem cell-derived exosomes accelerate wound healing of mice eczema
Published in Journal of Dermatological Treatment, 2022
Miao Wang, Yang Zhao, Qingyi Zhang
Our results indicated that MSC-exs can inhibit the proliferation of peripheral mononuclear cells and promote their differentiation into Treg cells, suggesting that MSC-exs can regulate Th1/Th2 immune balance, inhibit local inflammatory reaction and reduce tissue damage. The exact pathogenesis of atopic eczema remains unclear. It is generally believed that based on genetic factors, allergens invade the skin, causing abnormal immune response and inflammation. Recent studies (4,25) have shown that CD4 + CD8+ T cells infiltrating in contact dermatitis can release inflammatory mediators and cause pathological reactions such as exudative edema, Tregs dysfunction and other pathological reactions. As a result, the suppressive function to Th2 cells is weakened, which leads to the hyperfunction of Th2 cells and a series of allergic reactions. Verhagen et al. (4) found that native Tregs were not detected locally in the skin lesions of patients with atopic dermatitis, and that adaptive Tregs and their cytokines and corresponding receptors were locally expressed in large quantities, suggesting that functional defects in natural regulatory Treg cells plays an important role in atopic dermatitis.
Development of allergic conjunctivitis induced by Acanthamoeba excretory-secretory protein and the effect of resolvin D1 on treatment
Published in Current Eye Research, 2021
Min Seung Kang, Jongsoo Lee, Sung Hee Park, Hak Sun Yu, Ji-Eun Lee
Allergic reactions are induced by various environmental allergens. Marsh et al. described highly purified and well-characterized allergens such as the pollen of grasses, weeds, and trees as well as house dust mites, fungal spores, and animal dander.1Acanthamoeba is a protozoan genus of pathogenic and opportunistic free-living amoebae that can survive in various environments and can be isolated from soil, dust, air, water, seawater, swimming pools, domestic tap water, and contact lenses and cases.2,3 Additionally, excretory-secretory proteins (ESPs) from Acanthamoeba species contain strong proteases,4,5 and our previous studies demonstrated that Acanthamoeba may be aero-allergens.6,7 Thus, we suggest that ESPs of Acanthamoeba could be allergens to conjunctival cells and induce ocular allergic conjunctivitis (AC).
Related Knowledge Centers
- Atopy
- Immunoglobulin E
- Parasitic Disease
- Pollen
- Type I Hypersensitivity
- Immune System
- Allergy
- Antigen
- Immune Response
- House Dust Mite