228 results found
Drazdauskaite G, Layhadi JA, Shamji MH, 2021, Mechanisms of Allergen Immunotherapy in Allergic Rhinitis, CURRENT ALLERGY AND ASTHMA REPORTS, Vol: 21, ISSN: 1529-7322
Klimek L, Jutel M, Akdis CA, et al., 2020, ARIA-EAACI statement on severe allergic reactions to COVID-19 vaccines - an EAACI-ARIA position paper., Allergy
Coronavirus disease 2019 (COVID-19) vaccine BNT162b2 received approval and within the first few days of public vaccination several severe anaphylaxis cases occurred. An investigation is taking place to understand the cases and their triggers. The vaccine will be administered to a large number of individuals worldwide and concerns raised for severe adverse events might occur. With the current information, the European Academy of Allergy and Clinical Immunology (EAACI) states its position for the following preliminary recommendations that are to be revised as soon as more data emerges. To minimize the risk of severe allergic reactions in vaccinated individuals, it is urgently required to understand the specific nature of the reported severe allergic reactions, including the background medical history of the individuals affected and the mechanisms involved. To achieve this goal all clinical and laboratory information should be collected and reported. Mild and moderate allergic patients should not be excluded from the vaccine as the exclusion of all these patients from vaccination may have a significant impact on reaching the goal of population immunity. Health care practitioners vaccinating against COVID-19 are required to be sufficiently prepared to recognise and treat anaphylaxis properly with the ability to administer adrenaline. A mandatory observation period after vaccine administration of at least 15 minutes for all individuals should be followed. The current data has not shown any higher risk for patients suffering from allergic rhinitis or asthma and this message should be clearly stated by physicians to give our patients trust. The benefit of the vaccination clearly outweighs the risk of severe COVID-19 development including the more than 30% of the population suffering from allergic diseases.
Kirtland ME, Tsitoura DC, Durham SR, et al., 2020, Toll-Like Receptor Agonists as Adjuvants for Allergen Immunotherapy, FRONTIERS IN IMMUNOLOGY, Vol: 11, ISSN: 1664-3224
Sharif H, Acharya S, Dhondalay GKR, et al., 2020, Grass pollen immunotherapy alters chromatin landscape in circulating T follicular and regulatory cells, Journal of Allergy and Clinical Immunology, ISSN: 0091-6749
BACKGROUND: Allergen-specific immunotherapy (AIT) is a disease-modifying treatment that induces long-term T cell tolerance. OBJECTIVE: To evaluate the role of circulating CXCR5+PD-1+T follicular helper (cTFH) and T follicular regulatory (TFR) cells following grass pollen subcutaneous (SCIT) and sublingual (SLIT) immunotherapy and the accompanying changes in their chromatin landscape. METHODS: Phenotype and function of cTFH cells were initially evaluated in grass pollen-allergics (GPA, n= 28) and non-atopic controls (NAC, n=13) by mathematical algorithms developed to manage high-dimensional data and cell culture, respectively. cTFH and TFR cells were further enumerated in NAC (n=12), GPA (n=14), SCIT (n=10) and SLIT (n=8)-treated groups. Chromatin accessibility in cTFH and TFR cells was assessed by ATAC-seq to investigate epigenetic mechanisms underlying the differences between NAC, GPA, SCIT and SLIT. RESULTS: cTFH cells were shown to be distinct from TH2 and TH2A cell subsets, capable of secreting IL-4 and IL-21. Both cytokines synergistically promoted B cell class switching to IgE and plasma cell differentiation. Grass pollen allergen induced cTFH cell proliferation in GPA but not in NAC (P<.05). cTFH cells were higher in GPA compared to NAC and were lower in SCIT and SLIT (P<.01). Time-dependent induction of IL-4, IL-21 and IL-6 were observed in nasal mucosa following intranasal allergen challenge in GPA but not in SCIT and SLIT groups. TFR and IL-10+ cTFH cells were induced in SCIT and SLIT (all, P<.01). ATAC-seq analyses revealed differentially accessible chromatin regions in all groups. CONCLUSION: For the first time, we showed dysregulation of cTFH cells in GPA compared to NAC, SCIT and SLIT and induction of TFR and IL-10+ cTFH cells following SCIT and SLIT. Changes in the chromatin landscape were observed following AIT in cTFH and TFR cells.
Layhadi JA, Shamji MH, 2020, Uncovering the immunological properties of isolated lymphoid follicles, ALLERGY, ISSN: 0105-4538
Sokolowska M, Lukasik ZM, Agache I, et al., 2020, Immunology of COVID-19: Mechanisms, clinical outcome, diagnostics, and perspectives-A report of the European Academy of Allergy and Clinical Immunology (EAACI), ALLERGY, Vol: 75, Pages: 2445-2476, ISSN: 0105-4538
Alpan O, Layhadi J, Sønder SU, et al., 2020, Basophil Activation Test : A diagnostic, predictive and monitoring assay for Allergen Immunotherapy., Allergy
For decades, the approach to clinical care has involved the assessment of a fairly small set of patients' signs and symptoms, sampled over a short period of time with limited attention given to individual variations in aetiology and pathophysiology. Subsequently, a therapy is assigned predominantly with a "one shoe fits all" approach. Precision medicine approaches are now starting to change ways to test, treat and develop new therapies for allergic and immunological disorders. (Figure 1).
Klimek L, Hoffmann HJ, Kalpaklioglu AF, et al., 2020, In-vivo diagnostic test allergens in Europe: A call to action and proposal for recovery plan-An EAACI position paper, ALLERGY, Vol: 75, Pages: 2161-2169, ISSN: 0105-4538
Agache I, Akdis C, Akdis M, et al., 2020, EAACI Biologicals Guidelines-Recommendations for severe asthma, ALLERGY, ISSN: 0105-4538
Varricchi G, Bencivenga L, Poto R, et al., 2020, The emerging role of T follicular helper (T-FH) cells in aging: Influence on the immune frailty, AGEING RESEARCH REVIEWS, Vol: 61, ISSN: 1568-1637
Hoof I, Shamji MH, Andersen PS, 2020, Reply., J Allergy Clin Immunol, Vol: 146, Pages: 457-458
Hoof I, Schulten V, Layhadi JA, et al., 2020, Allergen-specific IgG+ memory B cells are temporally linked to IgE memory responses, Journal of Allergy and Clinical Immunology, Vol: 146, Pages: 180-191, ISSN: 0091-6749
BACKGROUND: Immunoglobulin E (IgE) are least abundant, tightly regulated and IgE producing B cells are rare. The cellular origin and evolution of IgE responses are poorly understood. OBJECTIVE: To investigate the cellular and clonal origin of IgE memory responses following mucosal allergen exposure by sublingual immunotherapy (SLIT). METHODS: In a randomized double-blind, placebo-controlled, time-course SLIT study, peripheral blood mononuclear cells (PBMCs) and nasal biopsies were collected from forty adults with seasonal allergic rhinitis at baseline, 4, 8, 16, 28 and 52 weeks. RNA was extracted from PBMCs, sorted B cells and nasal biopsies for VH repertoire sequencing. Moreover, monoclonal antibodies were derived from single B cell transcriptomes. RESULTS: Combining VH repertoire sequencing and single cell transcriptomics yielded direct evidence of a parallel boost of two clonally and functionally related B cell subsets of short-lived IgE+ plasmablasts and IgG+ memory B cells (termed IgGE). Mucosal grass pollen allergen exposure by SLIT resulted in highly diverse IgE and IgGE repertoires. These were extensively mutated and appeared relative stable as per heavy chain isotype, somatic hypermutations and clonal composition. Single IgGE + memory B cell and IgE+ pre-plasmablast transcriptomes encoded antibodies that were specific for major grass pollen allergens and were able to elicit basophil activation at very low allergen concentrations. CONCLUSION: For the first time, we have shown that upon mucosal allergen exposure, human IgE memory resides in allergen-specific IgG+ memory B cells. These rapidly switch isotype and expand into short-lived IgE+ plasmablasts and serve as a potential target for therapeutic intervention.
Klimek L, Jutel M, Akdis C, et al., 2020, Handling of allergen immunotherapy in the COVID-19 pandemic: An ARIA-EAACI statement, ALLERGY, Vol: 75, Pages: 1546-1554, ISSN: 0105-4538
Turner P, Boyle R, Durham S, et al., 2020, Cardiovascular changes during peanut-induced allergic reactions in human subjects, Journal of Allergy and Clinical Immunology, ISSN: 0091-6749
Background: Food allergy is the commonest cause of anaphylaxis. Changes in posture during acute reactions can trigger fatal outcomes, but the impact of allergic reactions on the cardiovascular system in non-fatal reactions remains poorly understood. Objective: To systematically evaluate changes in cardiovascular function during acute allergic reactions to peanut. Methods: Participants underwent double-blind placebo-controlled food challenge topeanut as part of a clinical trial. Changes in hemodynamic parameters (heart rate, stroke volume, blood pressure, peripheral blood flow) and electrocardiogram during food challenges were assessed using continuous monitoring. ClinicalTrials.gov Identifier: NCT02665793 Results: 57 adults (median age 24 (IQR 20-29) years, 53% female) participated; 22 (39%) had anaphylaxis. Acute reactions were associated with significant changes in stroke volume (mean decrease 4.2%, 95%CI 0.8 to 7.6; p=0.03), heart rate (mean increase 11.6%, 95%CI 8.4 to 14.8; p<0.0001) and peripheral blood flow (mean increase 19.7%, 95%CI 10.8 to 28.6; p<0.0001), irrespective of reaction severity. These changes were reproduced at subsequent repeat peanut challenge in 26 participants, and could be reversed with administration of intravenous fluids which resulted in faster resolution of abdominal symptoms. Conclusions: In this first detailed human study of cardiovascular changes during food-allergic reactions, we found evidence for significant fluid redistribution, independent of reaction severity. This provides a sound rationale for optimizing venous return during significant allergic reactions to food. Finally, these data provide a new paradigm for understanding severity in anaphylaxis, where poor outcomes occur due to a failure in compensatory mechanisms.Ruiz-Garcia et al 5 Clinical Implication: Significant changes in cardiovascular function, including decreased stroke volume, occur during peanut-induced allergic reactions in adults irrespective of severit
Bousquet J, Anto JM, Bachert C, et al., 2020, ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice., Allergy, ISSN: 0105-4538
Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis.It strengthens the ARIA change management strategy in the prevention and managementof airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.
Larson D, Patel P, Salapatek AM, et al., 2020, Nasal allergen challenge and environmental exposure chamber challenge: A randomized trial comparing clinical and biological responses to cat allergen, JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, Vol: 145, Pages: 1585-1597, ISSN: 0091-6749
Shamji MH, Akdis CA, Barber D, et al., 2020, EAACI Research and Outreach Committee: Improving standards and facilitating global collaboration through a Research Excellence Network, ALLERGY, Vol: 75, Pages: 1899-1901, ISSN: 0105-4538
Allergen immunotherapy is a cornerstone in the treatment of allergic children. The clinical efficiency relies on a well-defined immunologic mechanism promoting regulatory T cells and downplaying the immune response induced by allergens. Clinical indications have been well documented for respiratory allergy in the presence of rhinitis and/or allergic asthma, to pollens and dust mites. Patients who have had an anaphylactic reaction to hymenoptera venom are also good candidates for allergen immunotherapy. Administration of allergen is currently mostly either by subcutaneous injections or by sublingual administration. Both methods have been extensively studied and have pros and cons. Specifically in children, the choice of the method of administration according to the patient's profile is important. Although allergen immunotherapy is widely used, there is a need for improvement. More particularly, biomarkers for prediction of the success of the treatments are needed. The strength and efficiency of the immune response may also be boosted by the use of better adjuvants. Finally, novel formulations might be more efficient and might improve the patient's adherence to the treatment. This user's guide reviews current knowledge and aims to provide clinical guidance to healthcare professionals taking care of children undergoing allergen immunotherapy.
Agache I, Rocha C, Beltran J, et al., 2020, Efficacy and safety of treatment with biologicals (benralizumab, dupilumab and omalizumab) for severe allergic asthma: A systematic review for the EAACI Guidelines - recommendations on the use of biologicals in severe asthma, ALLERGY, Vol: 75, Pages: 1043-1057, ISSN: 0105-4538
Pfaar O, Agache I, Bergmann KC, et al., 2020, Placebo effects in allergen immunotherapy - an EAACI Task Force Position Paper., Allergy
The placebo (Latin "I will please") effect commonly occurs in clinical trials. The psychological and physiological factors associated with patients' expectations about a treatment's positive and negative effects have yet to be well characterized, although a functional prefrontal cortex and intense bidirectional communication between the central nervous system and the immune system appear to be prerequisites for a placebo effect. The use of placebo raises certain ethical issues, especially if patients in a placebo group are denied an effective treatment for a long period of time. The placebo effect appears to be relatively large (up to 77%, relative to pre-treatment scores) in controlled clinical trials of allergen immunotherapy (AIT), such as the pivotal, double-blind, placebo-controlled (DBPC) randomized clinical trials currently required by regulatory authorities worldwide. The European Academy of Allergy and Clinical Immunology (EAACI) therefore initiated a Task Force, in order to better understand the placebo effect in AIT and its specific role in comorbidities, blinding issues, adherence, measurement time points, variability, and the natural course of the disease. In this Position Paper, the EAACI Task Force highlights several important topics regarding the placebo effect in AIT such as i) regulatory aspects, ii) neuroimmunological and psychological mechanisms, iii) placebo effect sizes in AIT trials, iv) methodological limitations in AIT trial design and v) potential solutions in future AIT trial design. In conclusion, this Position Paper aims to examine the methodological problem of placebo in AIT from different aspects and also to highlight unmet needs and possible solutions for future trials.
Agache I, Song Y, Rocha C, et al., 2020, Efficacy and safety of treatment with dupilumab for severe asthma: A systematic review of the EAACI guidelines-Recommendations on the use of biologicals in severe asthma, ALLERGY, Vol: 75, Pages: 1058-1068, ISSN: 0105-4538
Bousquet J, Farrell J, Illario M, et al., 2020, Aligning the Good Practice MASK With the Objectives of the European Innovation Partnership on Active and Healthy Ageing, ALLERGY ASTHMA & IMMUNOLOGY RESEARCH, Vol: 12, Pages: 238-258, ISSN: 2092-7355
Konradsen JR, Grundstr J, Hellkvist L, et al., 2020, Intralymphatic immunotherapy in pollen-allergic young adults with rhinoconjunctivitis and mild asthma: A randomized trial, JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, Vol: 145, Pages: 1005-+, ISSN: 0091-6749
Agache I, Beltran J, Akdis C, et al., 2020, Efficacy and safety of treatment with biologicals (benralizumab, dupilumab, mepolizumab, omalizumab and reslizumab) for severe eosinophilic asthma, ALLERGY, Vol: 75, Pages: 1023-1042, ISSN: 0105-4538
Patel K, Vila-Nadal G, Shah J, et al., 2020, Is pollen-food syndrome a frequent comorbidity in adults with irritable bowel syndrome?, ALLERGY, Vol: 75, Pages: 1780-1783, ISSN: 0105-4538
Layhadi J, Lobo RM, Parkin R, et al., 2020, Allergenicity and Safety Profile of Depigmented-Polymerized Phleum pratense Extract for Use in Allergen-Specific Immunotherapy Treatments, Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology (AAAAI), Publisher: MOSBY-ELSEVIER, Pages: AB60-AB60, ISSN: 0091-6749
Parkin R, Eguiluz-Gracia I, Jaen MT, et al., 2020, Nasal Allergen Neutralizing Antibodies Correlate Closely with Tolerated Intranasal Allergen Challenge Dose Following Grass Pollen Subcutaneous Immunotherapy in Patients with Local Allergic Rhinitis, Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology (AAAAI), Publisher: MOSBY-ELSEVIER, Pages: AB184-AB184, ISSN: 0091-6749
Bousquet J, Schunemann HJ, Togias A, et al., 2020, Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence, JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, Vol: 145, Pages: 70-+, ISSN: 0091-6749
Ferastraoaru D, Bax HJ, Bergmann C, et al., 2020, AllergoOncology: ultra-low IgE, a potential novel biomarker in cancer-a Position Paper of the European Academy of Allergy and Clinical Immunology (EAACI)., Clin Transl Allergy, Vol: 10, ISSN: 2045-7022
Elevated serum IgE levels are associated with allergic disorders, parasitosis and specific immunologic abnormalities. In addition, epidemiological and mechanistic evidence indicates an association between IgE-mediated immune surveillance and protection from tumour growth. Intriguingly, recent studies reveal a correlation between IgE deficiency and increased malignancy risk. This is the first review discussing IgE levels and links to pathological conditions, with special focus on the potential clinical significance of ultra-low serum IgE levels and risk of malignancy. In this Position Paper we discuss: (a) the utility of measuring total IgE levels in the management of allergies, parasitosis, and immunodeficiencies, (b) factors that may influence serum IgE levels, (c) IgE as a marker of different disorders, and d) the relationship between ultra-low IgE levels and malignancy susceptibility. While elevated serum IgE is generally associated with allergic/atopic conditions, very low or absent IgE may hamper anti-tumour surveillance, indicating the importance of a balanced IgE-mediated immune function. Ultra-low IgE may prove to be an unexpected biomarker for cancer risk. Nevertheless, given the early stage of investigations conducted mostly in patients with diseases that influence IgE levels, in-depth mechanistic studies and stratification of malignancy risk based on associated demographic, immunological and clinical co-factors are warranted.
Pfaar O, Agache I, de Blay F, et al., 2019, Perspectives in allergen immunotherapy: 2019 and beyond, ALLERGY, Vol: 74, Pages: 3-25, ISSN: 0105-4538
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