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Allergies
\"Describes what it is like to live with allergies, what its symptoms are, and how it is treated\"-- Provided by publisher.
Book
Chronic Rhinitis Treatment: Effects on Obstructive Sleep Apnea
Purpose of the Review
The coexistence of Obstructive Sleep Apnea (OSA) and chronic rhinitis, two very frequent entities with different relevance in terms of morbidity and mortality in general population, is well-known. This review summarizes the relationship of both, and how different treatments for chronic rhinitis can contribute significantly to the management of OSA. The connection between nasal inflammation and continuous positive airway pressure is also characterized.
Recent Findings
Nasal tolerance to Continous Airway Positive Pressure (CPAP) is sometimes problematic, and the occurrence of nasal irritation may lead to the abandonement of a useful alternative; however, it has been demonstrated through local biomarker measurements, improvement in the inflammation characteristic of chronic rhinitis, after the sustained use of CPAP. The biological markers that explain systemic inflammation in OSA (IL-1, IL-6, TNFα), are related to the development and perpetuation of rhinitis [
1
•,
2
••].
Among the rhinitis treatments that improve OSA, nasal corticosteroids should be mentioned in first place, with proven efficacy, especially in the group affected by allergic rinitis, with improvement in the quality of life but not in the apnea and hypopnea index (AHI). Allergic rhinitis is associated with high house dust mites’ concentrations in the CPAP filters [
3
] and the addition of nasal steroids improves the associated symptoms. Leukotriene receptor antagonists reduce inflammatory parameters in the pediatric population, and contribute synergistically with nasal steroids, thus reducing the severity of the sleep apnea symptoms [
4
–
6
].
Summary
This review focuses on chronic rhinitis treatments and their clinical efficacy in reducing the severity of OSA, in adult and pediatric populations, emphasizing on the pathophysiology from Starling’s obstructive model, and on the common inflammatory nature of both clinical conditions. Reducing the load of local inflammatory mediators that cause nasal congestion improves patients with mild OSA, although it is not as effective in patients with moderate and severe symptoms, in whom CPAP remains the best alternative.
Journal Article
Liberation from allergies : natural approaches to freedom and better health
Millions of Americans suffer with allergies, yet medicine has yet to determine exactly what causes a person to be allergic. In this comprehensive book, naturopath Chris D. Meletis examines a wide-range of allergies, including those to foodstuffs, dust and other airborne allergens, and materials like latex and chemicals. He explores theories of why allergies occur and are rising, including the \"hygiene hypothesis,\" which argues that overbathing and overuse of antibiotics and antibacterial agents means our immune systems never build up the necessary resistance to these substances when we are young.
Book
Aspirin Desensitization in NERD in the Era of Biologics: First or Last Resource?
Purpose of the Review
The classic treatment of non-steroidal anti-inflammatory drug (NSAID) exacerbated respiratory disease (NERD) includes aspirin desensitization (AD). Introduction of biologics in the treatment of asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) has raised the question: which of the two options may be the most suitable for NERD?
Recent Findings
NERD is a highly eosinophilic disease. Monoclonal antibodies targeting IL-5 or the IL-5 receptor, involved in eosinophil recruitment, have been shown to be effective in asthma and CRSwNP. However, no difference in clinical efficacy was observed between NERD and aspirin-tolerant patients. Dupilumab, an IL-4 alpha receptor antagonist, demonstrated greater efficacy in NERD than in aspirin-tolerant patients for some clinical symptoms in a sub-analysis. Patients with NERD respond very rapidly to omalizumab with improvement in asthma and CRSwNP symptoms associated with reductions in prostaglandin D2 and cysteinyl leukotrienes release. Furthermore, omalizumab and dupilumab partially or totally restored tolerance to aspirin in NERD patients.
Summary
The decision to treat a NERD patient with AD or a biologic depends on many variables, such as differences between countries in the use of AD treatment in specialized units, limitations in accessing very expensive treatment in low-income countries and in countries where insurance systems do not cover or partially cover the cost of treatment. Patients who live in countries with public health systems that fully fund biologic treatments are more likely to benefit from biologic treatment. The limited data available so far suggest that, among current biologics, dupilumab ranks best for the treatment of CRSwNP associated with NERD.
Journal Article
New Perspectives in Food Allergy
The improvement of the knowledge of the pathophysiological mechanisms underlying the tolerance and sensitization to food antigens has recently led to a radical change in the clinical approach to food allergies. Epidemiological studies show a global increase in the prevalence of food allergy all over the world and manifestations of food allergy appear increasingly frequent also in elderly subjects. Environmental and nutritional changes have partly changed the epidemiology of allergic reactions to foods and new food allergic syndromes have emerged in recent years. The deepening of the study of the intestinal microbiota has highlighted important mechanisms of immunological adaptation of the mucosal immune system to food antigens, leading to a revolution in the concept of immunological tolerance. As a consequence, new prevention models and innovative therapeutic strategies aimed at a personalized approach to the patient affected by food allergy are emerging. This review focuses on these new perspectives and their practical implications in the management of food allergy, providing an updated view of this complex pathology.
Journal Article
The Future of Food Allergy Management: Advancements in Therapies
Purpose of ReviewTo review current and future treatment options for IgE-mediated food allergy.Recent FindingsRecent years have seen major developments in both allergen-specific and allergen-non-specific treatment options, with the first FDA-approved peanut oral immunotherapy (OIT) product becoming available in 2020. In addition to OIT, other immunotherapy modalities, biologics, adjunct therapies, and novel therapeutics are under investigation.SummaryFood allergy is a potentially life-threatening condition associated with a significant psychosocial impact. Numerous products and protocols are under investigation, with most studies focusing on OIT. A high rate of adverse events, need for frequent office visits, and cost remain challenges with OIT. Further work is needed to unify outcome measures, develop treatment protocols that minimize adverse events, establish demographic and clinical factors that influence candidate selection, and identify patient priorities.
Journal Article
The complete guide to allergies : recognizing and treating today's most common and unusual allergens
While providing amusing anecdotes, games and allergy-free recipes, an allergist explores the world of the most common allergies and introduces us to the strangest and newest allergies that have impacted large numbers of the population in recent years.
Book
Inflammation and allergy drug design
Our knowledge and understanding of allergic diseases of the respiratory tract has improved to a point where new therapies are being developed for patient benefit.
Inflammation and Allergy Drug Design explains the biologic science that underpins the pathophysiology of asthma and related disorders, as well as their mechanisms. This authoritative guide consists of 25 chapters, each detailing the cutting-edge developments in a particular field. It is divided into three parts, covering cytokines, chemokines, grow factors and mediators.
This book allows immunologists, allergologists and researchers in the pharmaceutical industry to learn and appreciate the target biology in drug development. It also provides medical and pharmaceutical postgraduate
students and clinicians with a basic understanding of allergic diseases in the respiratory tract.
eBook