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Publisher: Elsevier   (Total: 3159 journals)

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Showing 1 - 200 of 3159 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 9)
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 32, SJR: 1.655, CiteScore: 2)
Academic Radiology     Hybrid Journal   (Followers: 22, SJR: 1.015, CiteScore: 2)
Accident Analysis & Prevention     Partially Free   (Followers: 90, SJR: 1.462, CiteScore: 3)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.932, CiteScore: 2)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 34, SJR: 1.771, CiteScore: 3)
Achievements in the Life Sciences     Open Access   (Followers: 5)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 7)
Acta Astronautica     Hybrid Journal   (Followers: 407, SJR: 0.758, CiteScore: 2)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 2)
Acta Biomaterialia     Hybrid Journal   (Followers: 27, SJR: 1.967, CiteScore: 7)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 2)
Acta de Investigación Psicológica     Open Access   (Followers: 3)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.18, CiteScore: 1)
Acta Haematologica Polonica     Free   (Followers: 1, SJR: 0.128, CiteScore: 0)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.661, CiteScore: 2)
Acta Materialia     Hybrid Journal   (Followers: 245, SJR: 3.263, CiteScore: 6)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.504, CiteScore: 1)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.542, CiteScore: 1)
Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.834, CiteScore: 2)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription  
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 2, SJR: 0.307, CiteScore: 0)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 1, SJR: 1.793, CiteScore: 6)
Acta Poética     Open Access   (Followers: 4, SJR: 0.101, CiteScore: 0)
Acta Psychologica     Hybrid Journal   (Followers: 27, SJR: 1.331, CiteScore: 2)
Acta Sociológica     Open Access   (Followers: 1)
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.052, CiteScore: 2)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 3, SJR: 0.374, CiteScore: 1)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 2)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.344, CiteScore: 1)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 6, SJR: 0.19, CiteScore: 0)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 3)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 6)
Acute Pain     Full-text available via subscription   (Followers: 15, SJR: 2.671, CiteScore: 5)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.53, CiteScore: 4)
Addictive Behaviors     Hybrid Journal   (Followers: 16, SJR: 1.29, CiteScore: 3)
Addictive Behaviors Reports     Open Access   (Followers: 8, SJR: 0.755, CiteScore: 2)
Additive Manufacturing     Hybrid Journal   (Followers: 9, SJR: 2.611, CiteScore: 8)
Additives for Polymers     Full-text available via subscription   (Followers: 22)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 142, SJR: 4.09, CiteScore: 13)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.167, CiteScore: 4)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.694, CiteScore: 3)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.277, CiteScore: 1)
Advances in Agronomy     Full-text available via subscription   (Followers: 12, SJR: 2.384, CiteScore: 5)
Advances in Anesthesia     Full-text available via subscription   (Followers: 28, SJR: 0.126, CiteScore: 0)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 2)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 10, SJR: 0.992, CiteScore: 1)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 11, SJR: 1.551, CiteScore: 4)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, SJR: 2.089, CiteScore: 5)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 14, SJR: 0.572, CiteScore: 2)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.61, CiteScore: 7)
Advances in Botanical Research     Full-text available via subscription   (Followers: 2, SJR: 0.686, CiteScore: 2)
Advances in Cancer Research     Full-text available via subscription   (Followers: 30, SJR: 3.043, CiteScore: 6)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 7, SJR: 1.453, CiteScore: 2)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 1.992, CiteScore: 5)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 3)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 27, SJR: 0.156, CiteScore: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.713, CiteScore: 1)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 10, SJR: 1.316, CiteScore: 2)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 1.562, CiteScore: 3)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 19, SJR: 1.977, CiteScore: 8)
Advances in Computers     Full-text available via subscription   (Followers: 14, SJR: 0.205, CiteScore: 1)
Advances in Dermatology     Full-text available via subscription   (Followers: 15)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 9)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 24)
Advances in Ecological Research     Full-text available via subscription   (Followers: 43, SJR: 2.524, CiteScore: 4)
Advances in Engineering Software     Hybrid Journal   (Followers: 27, SJR: 1.159, CiteScore: 4)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 44, SJR: 5.39, CiteScore: 8)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 1)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 9)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 54, SJR: 0.591, CiteScore: 2)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 16)
Advances in Genetics     Full-text available via subscription   (Followers: 16, SJR: 1.354, CiteScore: 4)
Advances in Genome Biology     Full-text available via subscription   (Followers: 8, SJR: 12.74, CiteScore: 13)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 1.193, CiteScore: 3)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 21, SJR: 0.368, CiteScore: 1)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 11, SJR: 0.749, CiteScore: 3)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 22)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.193, CiteScore: 0)
Advances in Immunology     Full-text available via subscription   (Followers: 36, SJR: 4.433, CiteScore: 6)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 1.163, CiteScore: 2)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 2, SJR: 1.938, CiteScore: 3)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6, SJR: 0.176, CiteScore: 0)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 3)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.682, CiteScore: 2)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 14, SJR: 0.88, CiteScore: 2)
Advances in Mathematics     Full-text available via subscription   (Followers: 11, SJR: 3.027, CiteScore: 2)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.694, CiteScore: 2)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.158, CiteScore: 3)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 21)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 8)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.182, CiteScore: 0)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
Advances in Oncobiology     Full-text available via subscription   (Followers: 1)
Advances in Organ Biology     Full-text available via subscription   (Followers: 1)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 16, SJR: 1.875, CiteScore: 4)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.174, CiteScore: 0)
Advances in Parasitology     Full-text available via subscription   (Followers: 5, SJR: 1.579, CiteScore: 4)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.461, CiteScore: 1)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 10)
Advances in Pharmacology     Full-text available via subscription   (Followers: 16, SJR: 1.536, CiteScore: 3)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.574, CiteScore: 1)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.109, CiteScore: 1)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 5)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 0.791, CiteScore: 2)
Advances in Psychology     Full-text available via subscription   (Followers: 62)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 6, SJR: 0.371, CiteScore: 1)
Advances in Radiation Oncology     Open Access   (SJR: 0.263, CiteScore: 1)
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.101, CiteScore: 0)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Space Research     Full-text available via subscription   (Followers: 395, SJR: 0.569, CiteScore: 2)
Advances in Structural Biology     Full-text available via subscription   (Followers: 5)
Advances in Surgery     Full-text available via subscription   (Followers: 10, SJR: 0.555, CiteScore: 2)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 31, SJR: 2.208, CiteScore: 4)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 18)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 2.262, CiteScore: 5)
Advances in Water Resources     Hybrid Journal   (Followers: 46, SJR: 1.551, CiteScore: 3)
Aeolian Research     Hybrid Journal   (Followers: 6, SJR: 1.117, CiteScore: 3)
Aerospace Science and Technology     Hybrid Journal   (Followers: 337, SJR: 0.796, CiteScore: 3)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.42, CiteScore: 2)
African J. of Emergency Medicine     Open Access   (Followers: 6, SJR: 0.296, CiteScore: 0)
Ageing Research Reviews     Hybrid Journal   (Followers: 11, SJR: 3.671, CiteScore: 9)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 443, SJR: 1.238, CiteScore: 3)
Agri Gene     Hybrid Journal   (SJR: 0.13, CiteScore: 0)
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 16, SJR: 1.818, CiteScore: 5)
Agricultural Systems     Hybrid Journal   (Followers: 32, SJR: 1.156, CiteScore: 4)
Agricultural Water Management     Hybrid Journal   (Followers: 43, SJR: 1.272, CiteScore: 3)
Agriculture and Agricultural Science Procedia     Open Access   (Followers: 1)
Agriculture and Natural Resources     Open Access   (Followers: 2)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 57, SJR: 1.747, CiteScore: 4)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.589, CiteScore: 3)
Air Medical J.     Hybrid Journal   (Followers: 6, SJR: 0.26, CiteScore: 0)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.19, CiteScore: 0)
Alcohol     Hybrid Journal   (Followers: 11, SJR: 1.153, CiteScore: 3)
Alcoholism and Drug Addiction     Open Access   (Followers: 9)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.604, CiteScore: 3)
Alexandria J. of Medicine     Open Access   (Followers: 1, SJR: 0.191, CiteScore: 1)
Algal Research     Partially Free   (Followers: 10, SJR: 1.142, CiteScore: 4)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 2)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.504, CiteScore: 1)
Allergology Intl.     Open Access   (Followers: 5, SJR: 1.148, CiteScore: 2)
Alpha Omegan     Full-text available via subscription   (SJR: 3.521, CiteScore: 6)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, SJR: 0.201, CiteScore: 1)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 50, SJR: 4.66, CiteScore: 10)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4, SJR: 1.796, CiteScore: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4, SJR: 1.108, CiteScore: 3)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 6)
American Heart J.     Hybrid Journal   (Followers: 50, SJR: 3.267, CiteScore: 4)
American J. of Cardiology     Hybrid Journal   (Followers: 54, SJR: 1.93, CiteScore: 3)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 44, SJR: 0.604, CiteScore: 1)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 10)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.524, CiteScore: 3)
American J. of Human Genetics     Hybrid Journal   (Followers: 34, SJR: 7.45, CiteScore: 8)
American J. of Infection Control     Hybrid Journal   (Followers: 28, SJR: 1.062, CiteScore: 2)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 34, SJR: 2.973, CiteScore: 4)
American J. of Medicine     Hybrid Journal   (Followers: 45)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3, SJR: 1.967, CiteScore: 2)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 202, SJR: 2.7, CiteScore: 4)
American J. of Ophthalmology     Hybrid Journal   (Followers: 63, SJR: 3.184, CiteScore: 4)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 5, SJR: 0.265, CiteScore: 0)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.289, CiteScore: 1)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, CiteScore: 1)
American J. of Pathology     Hybrid Journal   (Followers: 27, SJR: 2.139, CiteScore: 4)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 28, SJR: 2.164, CiteScore: 4)
American J. of Surgery     Hybrid Journal   (Followers: 37, SJR: 1.141, CiteScore: 2)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.767, CiteScore: 1)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 6)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.144, CiteScore: 3)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 62, SJR: 0.138, CiteScore: 0)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 16, SJR: 0.411, CiteScore: 1)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 3, SJR: 0.277, CiteScore: 0)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription  
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 5, SJR: 4.849, CiteScore: 10)
Analytica Chimica Acta     Hybrid Journal   (Followers: 40, SJR: 1.512, CiteScore: 5)
Analytical Biochemistry     Hybrid Journal   (Followers: 172, SJR: 0.633, CiteScore: 2)
Analytical Chemistry Research     Open Access   (Followers: 10, SJR: 0.411, CiteScore: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 11)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 2)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 23, SJR: 0.683, CiteScore: 2)
Angiología     Full-text available via subscription   (SJR: 0.121, CiteScore: 0)
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1, SJR: 0.111, CiteScore: 0)
Animal Behaviour     Hybrid Journal   (Followers: 191, SJR: 1.58, CiteScore: 3)

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Journal Cover
Allergologia et Immunopathologia
Journal Prestige (SJR): 0.504
Citation Impact (citeScore): 1
Number of Followers: 1  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 0301-0546
Published by Elsevier Homepage  [3159 journals]
  • Preconceptional allergen immunization can induce offspring IL-17 secreting
           B cells (B17): do they share similarities with regulatory B10 cells'
    • Abstract: Publication date: Available online 7 July 2018Source: Allergologia et ImmunopathologiaAuthor(s): Aline Aparecida de Lima Lira, Marília Garcia de-Oliveira, Amanda Harumi Sabô Inoue, Giovanna Rossi Beltrame, Alberto José da Silva Duarte, Jefferson Russo VictorAbstractBackgroundIL-17-producing B cells can be identified in both mice and human and were named B17 cells. The role of B17 cells still needs to be elucidated and its inflammatory or regulatory functions remain controversial.ObjectiveWe evaluate the effect of maternal immunization with OVA on offspring B cells that produces IL-17 and can show a regulatory potential by IL-10 production.MethodsC57BL/6 WT, IL-10−/− or CD28−/− female mice were immunized or not with OVA in Alum, and immunized females were boosted after 10 and 20 days. Immunized and non-immunized females were mated, and pups from both groups were evaluated at 3 or 20 days old (d.o.). Some offspring from the aforementioned two groups were immunized with OVA at 3 d.o., boosted after 10 days and evaluated at 20 d.o.ResultsMaternal immunization with OVA induced offspring B cells to produce IL-17 at higher intensity compared to the control group of offspring at 3 d.o. This effect was maintained until 20 d.o. and even after neonatal immunization with OVA. The co-production of IL-10 on offspring IL-17 + B cells is up-regulated in response to maternal immunization with OVA. Maternal immunization with OVA on IL-10−/− mice reveals reduced percentage and mean of fluorescence intensity of IL-17 on B cells of offspring.ConclusionPreconception OVA immunization can induce offspring B cells that produce IL-17 at higher intensity and co-produce mainly IL-10. This could be the reason why B17 cells had been described in the literature with controversial roles upon their regulatory function.
       
  • Rosmarinic acid affects immunological and inflammatory mediator levels and
           restores lung pathological features in asthmatic rats
    • Abstract: Publication date: Available online 6 July 2018Source: Allergologia et ImmunopathologiaAuthor(s): F. Shakeri, N. Eftekhar, N. Mohammadian Roshan, R. Rezaee, A. Moghimi, M.H. BoskabadyAbstractBackgroundThe effects of rosmarinic acid (RA) on immunological and inflammatory mediator levels in bronchoalveolar lavage fluid (BALF) as well as lung pathological changes in asthmatic rats were investigated.MethodsThe levels of IFN-γ, IL-4, IFN-γ/IL-4 ratio, IgE, PLA2, and total protein (TP) in BALF and pathological changes in the lung were evaluated in control group (C), asthma group (sensitized to ovalbumin) (A), asthma groups treated with RA and dexamethasone.ResultsCompared to the control group, asthmatic rats showed increased levels of IL-4, IgE, PLA2, and TP as well as all pathological scores with decreased levels of IFN-γ and IFN-γ/IL-4 ratio (P 
       
  • What do we know about cancer immunotherapy' Long-term survival and
           immune-related adverse events
    • Abstract: Publication date: Available online 6 July 2018Source: Allergologia et ImmunopathologiaAuthor(s): Jesus Miranda Poma, Lorena Ostios Garcia, Julia Villamayor Sanchez, Gabriele D’erricoAbstractImmunotherapy delivered a new therapeutic option to the oncologist: Ipilimumab (anti-CTLA-4), Nivolumab and Pembrolizumab (anti-PD1), and Atezolizumab (anti-PD-L1) increase overall survival and show a better safety profile compared to chemotherapy in patients with metastatic melanoma, lung, renal cancer among others. But all that glitters is not gold and there is an increasing number of reports of adverse effects while using immune-checkpoint inhibitors. While chemotherapy could weaken the immune system, this novel immunotherapy could hyper-activate it, resulting in a unique and distinct spectrum of adverse events, called immune-related adverse events (IRAEs). IRAEs, ranging from mild to potentially life-threatening events, can involve many systems, and their management is radically different from that of cytotoxic drugs: immunosuppressive treatments, such as corticoids, infliximab or mycophenolate mofetil, usually result in complete reversibility, but failing to do so can lead to severe toxicity or even death. Patient selection is an indirect way to reduce adverse events minimizing the number of subjects exposed to this drugs: unfortunately PDL-1, the actual predictive biomarker, would not allow clinicians select or exclude patients for treatment with checkpoint inhibitors.
       
  • Anaphylaxis caused by lipid transfer proteins: an unpredictable clinical
           syndrome
    • Abstract: Publication date: Available online 5 July 2018Source: Allergologia et ImmunopathologiaAuthor(s): Inês Mota, Ângela Gaspar, Filipe Benito-Garcia, Magna Correia, Cristina Arêde, Susana Piedade, Graça Sampaio, Graça Pires, Cristina Santa-Marta, Luís-Miguel Borrego, Mário Morais-AlmeidaAbstractIntroductionLipid transfer proteins (LTPs) are panallergens found in many plant foods. They are a common cause of food-induced anaphylaxis (FIA) in adults living in the Mediterranean area. LTPs have also been proposed as a main cause of food-dependent exercise-induced anaphylaxis (FDEIA).ObjectivesDescribe clinical characteristics and allergen sensitization profiles in patients with FIA related to LTP.Materials and MethodsForty-three patients were included, aged 3–52 years with a clinical history of FIA and proven sensitization to LTP. Patients were tested with a multiple plant food and pollen panel and specific IgE to LTP allergens. LTP sensitization was assessed by in vivo (Pru p 3, LTP extract) and/or by in vitro tests (specific IgE, ImmunoCAP/ISAC®).ResultsMedian age of first anaphylactic episode was 24 years (range 2–51), 44% had asthma, 74% were atopic and 42% had pollinosis (olive, mugwort, plane tree, wall pellitory and cypress). Co-sensitization to profilins was found in 22%. Overall in our center, LTP-induced anaphylaxis represents 17% of all causes of FIA. Foods implicated in anaphylactic reactions were: fresh fruits 51%, tree nuts 42%, vegetables (including peanut) 40% and seeds 14%. Seven patients had FDEIA.ConclusionsLTPs are important allergens of FIA in Portugal. Clinical reactivity to several taxonomically unrelated plant foods may raise suspicion toward LTP sensitization. The association of LTP-induced anaphylaxis with pollinosis is relevant in our country. The unpredictable clinical expression depends on the effect of cofactors such as exercise. The management of avoidance plans can be challenging due to LTP being a widely cross-reacting allergen in plant foods.
       
  • Impulse oscillometry in the assessment of children's lung function
    • Abstract: Publication date: Available online 5 July 2018Source: Allergologia et ImmunopathologiaAuthor(s): P.P. de Oliveira Jorge, J.H.P. de Lima, D.C. Chong e Silva, D. Medeiros, D. Solé, G.F. WandalsenAbstractPurposeTo review available evidence in the literature on impulse oscillometry in the assessment of lung function in children with respiratory diseases, especially asthma.Data collectionResearch in the Medline, PubMed, and Lilacs databases, with the keywords forced oscillation, impulse oscillometry, asthma and impulse oscillometry.ResultsThe Impulse Oscillometry System (IOS) allows the measurement of resistance and reactance of airways and is used as a diagnostic resource. A significant association between the findings of the IOS and those of spirometry is observed. In asthma, the IOS has already been used to assess the bronchodilator response and the therapeutic response to different drugs and has shown to be a sensitive technique to evaluate disease control. There are limitations to this assessment, such as children with attention deficit and in some cases it is difficult to interpret the results from a clinical point of view.ConclusionThe IOS is a useful tool for the measurement of the lung function of children. It is an easy test, although its interpretation is not straightforward.
       
  • Laboratory and severity evaluation of pediatric atopic dermatitis and
           moisturizer response in different phenotypes
    • Abstract: Publication date: Available online 4 July 2018Source: Allergologia et ImmunopathologiaAuthor(s): S.B. BatmazAbstractIntroduction and objectivesAtopic dermatitis (AD) is an eczematous skin disease. Our aim was to evaluate the clinical and laboratory findings of children with AD and identify the higher responsive group to moisturizers.Materials and methodsTotal and specific IgE, eosinophil count, prick/patch test results of patients with AD were retrospectively analyzed. The presentation SCORAD was compared between the demographic and clinical subgroups. The SCORAD change (presentation to third month) between the intrinsic and extrinsic groups was compared. The effect of age, sex, disease duration, presentation SCORAD, being intrinsic/extrinsic, exclusive breastfeeding duration, familial atopy, total IgE, eosinophil count, concomitant illness presence, moisturizer use frequency and exacerbation frequency on SCORAD change was examined.ResultsThe mean age was 3.65 ± 3.77 years. Food allergy was found in 5.90% and inhalant allergy was found in 12.67% of patients. 158 (44.5%) were mild, 154 (43.4%) were moderate and 43 (12.1%) were severe AD. 141 (39.7%) were intrinsic AD. The SCORAD at 3rd visit and SCORAD change was different between the intrinsic and extrinsic groups. SCORAD change was positively associated with presentation SCORAD, eosinophil count, moisturizer use frequency and being extrinsic AD.ConclusionsThe clinical and laboratory findings of AD patients in our community were revealed. Higher SCORAD and eosinophils at presentation, frequent daily moisturizer use and being extrinsic increased the moisturizer response. Although the barrier defect was shown to be lesser in intrinsic AD by considering transepidermal water loss, this study is the first to evaluate intrinsic and extrinsic AD patients according to response to moisturizers.
       
  • Microbiome in the primary prevention of allergic diseases and bronchial
           asthma
    • Abstract: Publication date: Available online 3 July 2018Source: Allergologia et ImmunopathologiaAuthor(s): B. SozańskaAbstractTremendous progress in the ability to identify and test the function of microorganisms in recent years has led to a much better understanding of the role of environmental and host microbiome in the development of immune function, allergic sensitization and asthma. In this review, the most recent findings on the relationships between environmental microbiota, respiratory, intestinal microbiome, the consequences of early-life microbial exposure type and gut–lung microbial axis and the development of asthma and atopy are summarized. The current perspective on gut and airway microbiome manipulation for the primary prevention of allergic diseases and asthma is also discussed.
       
  • Association between environmental exposure and CD4+CD25+ regulatory T
           cells
    • Abstract: Publication date: Available online 3 July 2018Source: Allergologia et ImmunopathologiaAuthor(s): Fuss Piotr, Bal Katarzyna, Jerzyńska Joanna, Podlecka Daniela, Stelmach Włodzimierz, Stelmach IwonaAbstractBackgroundIt is considered that farm areas protect young patients from allergy and asthma due to high exposure to endotoxins.AimTo compare CD4+/CD25+ T-regulatory cells and forkhead transcription factor Foxp3 expression in asthmatic children allergic to house dust mites (HDM) living in rural and farm areas.Materials and MethodsThis was a prospective analysis of 35 children living in farm areas (n = 19) and rural areas (n = 16), aged 8–16, with allergic rhinitis (allergic to dust mites) and newly diagnosed asthma. Surface molecule CD4+CD25+Foxp3+ expression on cultured PBMCs was estimated by flow cytometry using fluorophore-conjugated monoclonal antibodies in each patient.ResultsThirty-five children were included into the analysis: 19 children living in farm areas and 16 in rural areas. Within and between-groups (farm area vs. rural area) differences in CD4+/CD25+ and CD4+/CD25+Foxp3+ cell expression did not reach the level of significance.ConclusionThe current analysis showed that CD4+/CD25+ and CD4+/CD25+Foxp3+ cell expression was not associated with place of living in asthmatic children sensitive to HDM.
       
  • Adherence to the Mediterranean diet and inflammatory markers in children
           with asthma
    • Abstract: Publication date: Available online 3 July 2018Source: Allergologia et ImmunopathologiaAuthor(s): Konstantinos Douros, Maria-Ioanna Thanopoulou, Barbara Boutopoulou, Anna Papadopoulou, Anastassios Papadimitriou, Andrew Fretzayas, Kostas N. PriftisAbstractIntroductionThere is accumulated evidence supporting a beneficial role of Mediterranean diet (MD) in the control of asthma symptoms. The aim of this study was to investigate the relationships between adherence to MD and serum levels of certain cytokines namely, interleukin (IL)-4, and IL-17 known to have a pathogenetic role in the airway changes associated with asthma.MethodsWe measured serum IL-4, IL-33, and IL-17, in 44 asthmatic and 26 healthy children, 5–15 years old. Their adherence to MD was estimated with the Mediterranean Diet Quality Index for children and adolescents (KIDMED) score.ResultsKIDMED score did not differ between the two groups (P = 0.59) and was not correlated with any of the three measured cytokines. However, when the analysis was restricted only to asthmatic children, the KIDMED score was correlated with IL-4, IL-33, and IL-17 (Beta: −0.56, P = 0.007; Beta: 0.57, P = 0.010; Beta: −0.62, P = 0.017, respectively).ConclusionOur results indicate that MD can modulate the production of some of the main inflammatory mediators of asthma, in asthmatic children.
       
  • Parental confusion may result when primary health care professionals show
           heterogeneity in their knowledge, attitudes, and perceptions regarding
           infant nutrition, food allergy, and atopic dermatitis
    • Abstract: Publication date: July–August 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 4Author(s): J.M.S. Yrjänä, R. Bloigu, P. KulmalaAbstractIntroduction and objectivesWhether the guidelines on infant nutrition, food allergy and atopic dermatitis confer real health benefits in practice at the population level has not been deeply studied. We aimed here to characterize the knowledge, attitudes, and perceptions regarding these issues among primary health care professionals. In addition, we surveyed available parent-reported information sources and the incidence of food-related symptoms, dietary restrictions, food allergy, and atopic dermatitis among one-year-old children in the general population.Materials and methodsAn online questionnaire was designed for public health nurses and general practitioners. In addition, parents of one-year-old children were recruited to a separate survey at the time of their regular check-up visit.ResultsAltogether, 80 professionals took part. The median overall knowledge score was 77% and significantly higher among the general practitioners than among the nurses (p = 0.004). However, only 35% of all the professionals recognized either severe airway or cardiovascular symptoms as potential food allergy-related symptoms. Moisturizers and emollients were thought to be adequate treatment for atopic dermatitis by 56%. Among 248 one-year-old children, the incidence of food allergy was 4% and atopic dermatitis 13%. During this period, parents intentionally avoided giving at least one food to 23% of the children, yet more than 80% of these restrictions can be regarded as unnecessary.ConclusionThe knowledge, attitudes and beliefs regarding infant feeding, food allergy, and atopic dermatitis varied significantly among the primary care professionals. This will likely result in heterogeneous guidance practices and confusion among the families at the population level.
       
  • Assessment of IL-31 levels and disease severity in children with atopic
           dermatitis
    • Abstract: Publication date: July–August 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 4Author(s): D. Ozceker, M. Bulut, A. Celik Ozbay, F. Dilek, M. Koser, Z. Tamay, N. GulerAbstractIntroduction and objectivesAtopic dermatitis is a chronic, relapsing, highly pruritic, inflammatory skin disease characterized by typical localization with increasing prevalence of 10–20% in children. Pruritus is one of the major diagnostic criteria of atopic dermatitis and also the main complaint altering quality-of-life of affected patients, inducing and aggravating inflammation. Although pruritus is the absolute symptom of AD, the etiology has not been fully explained yet and current antihistamine therapies are ineffective.The aim of the study was to assess the correlation between IL-31 level and disease severity in patients with atopic dermatitis through Severity SCORing of Atopic Dermatitis (SCORAD) index and the degree of itching assessed subjectively.Material and methodsOne hundred thirty-five children were enrolled in the study in total, 70 children with diagnosis of atopic dermatitis and 65 healthy children in control group. Data on demographic features (age, gender, family history of atopy) and laboratory values of serum eosinophil, total IgE, IgM, IgA, IgG levels and skin prick test results were collected through patient files. The disease severity was assessed by SCORAD index. IL-31 levels were measured with human IL-31 ELISA kit.ResultsThe statistical analysis showed that IL-31 level was significantly higher in AD patients than in the control group (AD vs CG, p 0.0001). There was no significant difference in IL-31 levels between the three subgroups divided according to the SCORAD severity score (p:0.27).ConclusionIL-31 levels were significantly higher in AD patients compared to control group but irrelevant to the disease severity.
       
  • Small-airway dysfunction precedes the development of asthma in children
           with allergic rhinitis
    • Abstract: Publication date: July–August 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 4Author(s): E. Skylogianni, M. Triga, K. Douros, K. Bolis, K.N. Priftis, S. Fouzas, M.B. AnthracopoulosAbstractBackgroundEpidemiological evidence suggests the existence of a direct link between allergic rhinitis (AR) and asthma. Several studies also support the presence of small-airway dysfunction (SAD) in non-asthmatic children with AR. However, it remains unknown whether SAD can predict the progression of AR to asthma. Our objective was to explore the existence of SAD in non-asthmatic children with AR and to assessed its ability to predict the development of asthma.MethodsSeventy-three 6-year-old children with intermittent moderate-severe AR but without asthma symptoms/medication within the last two years, underwent spirometry and measurement of respiratory resistance (Rrs) and reactance (Xrs) before and after bronchodilation (BD) (300 mcg salbutamol). Lung function measurements were performed in the absence of nasal symptoms and repeated at AR exacerbation. SAD was defined as>30% decrease in Rrs or>50% increase in Xrs at 6 or 8 Hz post-BD. Participants were followed for five years.ResultsTwenty-three children (31.5%) developed asthma; this group presented significant post-BD changes in Rrs and Xrs, but only at AR exacerbation. The ability of these changes to predict the development of asthma was exceptional and superior to that of the spirometric parameters. SAD (22 children, 30.1%), emerged as the single most efficient predictor of asthma, independently of other risk factors such as parental asthma, personal history of eczema and type of allergic sensitisation.ConclusionSAD precedes the development of asthma in children with AR. Changes in respiratory impedance at AR exacerbation may assist in identifying those at risk to progress to asthma.
       
  • From rhinitis to asthma: Is small airway disfunction the clue'
    • Abstract: Publication date: July–August 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 4Author(s): J. Valverde-Molina
       
  • Changing perspectives in atopic dermatitis
    • Abstract: Publication date: July–August 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 4Author(s): E. Serra-Baldrich, J.O. de Frutos, I. Jáuregui, J.C. Armario-Hita, J.F. Silvestre, L. Herraez, A. Martín-Santiago, A. Valero, J. SastreAbstractAtopic dermatitis (AD) is a multifaceted disease that involves a complex interplay between the skin and the immune system. The course of the disease depends strongly on the genetic background of the patient and on yet poorly-defined environmental factors. Changes in lifestyle could be behind the dramatic rise in the prevalence of AD across continents; including hygienic conditions, food, social habits, skin microbiome or exposure to a number of allergens. Although AD typically develops in childhood and disappears after a few years, in a relatively large number of patients it continues into adulthood. Adult AD can also appear de novo but it is often underdiagnosed and its treatment can be challenging. New, highly effective drugs are being developed to manage moderate and severe forms of the disease in adults. In this review, we highlight the most recent developments in diagnostic tools, current insights into the mechanistic basis of this disease, and therapeutic innovations.
       
  • Validation of the Children's Sleep Habits Questionnaire in a sample of
           Greek children with allergic rhinitis
    • Abstract: Publication date: July–August 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 4Author(s): A. Mavroudi, E.-A. Chrysochoou, R.J. Boyle, G. Trypsianis, I. Xinias, D. Cassimos, G. Imvrios, M. Katotomichelakis, A. Karagiannidou, N. Karantaglis, G. Kourentas, J.O. WarnerAbstractBackgroundObstructive respiratory disorders, such as allergic rhinitis and asthma may impair sleep quality. The aim of this study is to validate the Children's Sleep Habits Questionnaire (CSHQ) for Greek children from 6 to 14 years of age. No validated tool has been developed so far to assess sleep disturbances in Greek school-aged children.MethodsWe examined the reliability and validity of the CSHQ in a sample of children with allergic rhinitis (AR) and a non-clinical population of parents of these children as a proxy measure of children's AR quality of life (QoL) as evaluated by the Pediatric Allergic Rhinitis Quality of Life (PedARQoL) questionnaire.ResultsThe CSHQ questionnaire Child's Form (CF) had a moderate internal consistency with a Cronbach's alpha 0.671 and Guttman split-half coefficient of 0.563 when correlated with the PedARQoL (CF). There was also a moderate intraclass correlation of ICC = 0.505 between the responses to both questionnaires in the two visits. The CSHQ Parent's Form (PF) had a very good internal consistency with a Cronbach's alpha of 0.928 and Guttman split-half coefficient of 0.798. There was a high intraclass correlation of 0.643 between the responses in the two visits.ConclusionsThe Greek version of the CSHQ CF, but particularly the PF has proved to be a very reliable clinical instrument, which can be used in clinical trials for assessing sleep quality in school-aged children with sleep disturbances because of obstructive airway disorders, such as AR.
       
  • Haploidentical stem cell transplantation in a boy with chronic
           granulomatous disease
    • Abstract: Publication date: July–August 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 4Author(s): A. Regueiro-García, S. Fariña-Nogueira, J.Á. Porto-Arceo, J.M. Couselo-SánchezAbstractChronic granulomatous disease is a primary immunodeficiency caused by mutations in any one of the five components of the NADPH oxidase in phagocytic leucocytes. This causes impaired microbial killing, which leads to severe life-threatening bacterial and fungal infections. Currently, allogenic hematopoietic stem cell transplantation (HSCT) is the only curative treatment for chronic granulomatous disease, although gene therapy may provide a new therapeutic option for the treatment of patients with CGD. Haploidentical HSCT provides a potentially curative treatment option for patients who lack a suitably HLA-matched donor, but only a few cases have been reported in the literature. Herein, we report a boy with X-linked chronic granulomatous disease treated successfully by haploidentical HSCT with post-transplant cyclophosphamide using a treosulfan-based conditioning regimen.
       
  • Fluticasone in mild to moderate atopic dermatitis relapse: A randomized
           controlled trial
    • Abstract: Publication date: July–August 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 4Author(s): E. Rubio-Gomis, I. Martinez-Mir, F.J. Morales-Olivas, A. Martorell-Aragones, V. Palop-Larrea, A. Bernalte-Sesé, J.C. Cerda-Mir, P. Polo-Martín, I. Febrer, L. Aranda-Grau, I. Llosa-Cortes, Mª.J. Tejedor-Sanz, J.C. Julia-Benito, T. Alvarez-de-Laviada-Mulero, Mª.V. Planelles-Cantarino, E. Apolinar-Valiente, M. Loriente-Tur, A.M. Abella-Bazataqui, I. Alvarez-Gonzalez, C. Morales-CarpiAbstractBackgroundThe long-term efficacy of corticosteroids to prevent atopic dermatitis (AD) relapses has partially been addressed in children. This study compared an intermittent dosing regimen of fluticasone propionate (FP) cream 0.05% with its vehicle base in reducing the risk of relapse in children with stabilized AD.MethodsA randomized controlled, multicentric, double-blind trial was conducted. Children (2–10 years) with mild/moderate AD (exclusion criteria:>30% affected body surface area and/or head) were enrolled into an Open-label Stabilization Phase (OSP) of up to 2 weeks on twice daily FP. Those who achieved treatment success entered the Double-blind Maintenance Phase (DMP). They were randomly allocated to receive FP or vehicle twice-weekly on consecutive days for 16 weeks. The primary study endpoint was relapse rate; time to relapse and severity of disease were also studied. Kaplan–Meier estimates were calculated.ResultsFifty-four patients (29 girls) entered the OSP (23 mild AD) and 49 (26 girls) continued into the DMP. Mean age was 5.5 (SD: 2.8) and 5.1 (SD: 2.3) yrs for FP and vehicle groups, respectively. Four patients withdrew from the DMP (two in every group). Patients treated with FP twice weekly had a 2.7 fold lower risk of experiencing a relapse than patients treated with vehicle (relative risk 2.72, SD: 1.28; p = 0.034). FP was also superior to vehicle for delaying time to relapse. Both treatment therapies were well tolerated.ConclusionThis long-term study shows that twice weekly FP provides an effective maintenance treatment to control the risk of relapse in children with AD.
       
  • Resources to handle childhood asthma in Spain: The role of plans and
           guides and the participation of nurses
    • Abstract: Publication date: July–August 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 4Author(s): M.I. Úbeda-Sansano, A. Cano-Garcinuño, S. Rueda-Esteban, M. Praena-CrespoAbstractBackgroundDescribe the assistance provided to asthmatic patients by Primary Care Paediatricians (PCP) in Spain and the material and human resources available for diagnosis and follow-up.MethodsA cross-sectional descriptive study using an on-line survey, sent to PCP regarding the availability of diagnostic resources, carrying out programmed and educational activities, collaboration of nursing staff and their relationship with existing institutional plans to care for children with asthma. A latent class model (LCM) was used to describe the differences among paediatricians based on the variables studied.ResultsOf the 708 answers, 675 were considered valid; 76% of the paediatricians had a spirometer, 75% specific IgE, 17% prick-test, 95% had placebo inhalers and 97% inhalation chambers. 57% performed programmed activities with their patients, while 56% shared their care of asthmatic patients with their nursing staff, but only 25% of the nurses were involved in the follow-up and 12% in education. LCM identified four patterns. The two groups with greater access to diagnostic resources counted on institutional plans/guidelines. However, the only variable differentiating the groups with more programmed and educational activities was the participation of nurses.ConclusionsThe availability of asthma plans/guidelines and resources for diagnosis and follow-up is not sufficient to improve important aspects of primary care for children with asthma. Organisational changes are necessary to include programmed asthma-related visits and paediatric teams with greater involvement of the nurses when caring for these patients.
       
  • Loss of tolerance for fishes previously tolerated in children with fish
           food protein induced enterocolitis syndrome
    • Abstract: Publication date: July–August 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 4Author(s): S. Miceli Sopo, C. Fantacci, G. Bersani, A. Romano, S. MonacoAbstractWe describe two case reports presenting some novel information on fish FPIES. Fish FPIES to one fish does not always start at the same time to other fish. Additionally, development of tolerance to the index fish do not necessarily imply tolerance to other reactive fish. This reflects on the best management of children with FPIES fish.
       
  • Multispecies probiotics combination prevents ovalbumin-induced airway
           hyperreactivity in mice
    • Abstract: Publication date: July–August 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 4Author(s): Jui-Cheng Chen, Cheng-Chih Tsai, Chang-Chi Hsieh, Alice Lan, Chun-Chih Huang, Sew-Fen LeuAbstractBackgroundProbiotics could be beneficial to health and some of them have shown to modulate immune responses.AimThe aim of this study is to investigate if the probiotic strains including Lactobacillus and Pediococcus strains are able to alleviate allergic reactions in an ovalbumin-induced airway allergy model.MethodsLactobacillus multi-species preparation (LMP) was gavaged to BALB/c for total six weeks and BALB/c was challenged with ovalbumin in the last two weeks. A barometric whole-body plethysmography was used to assess enhanced pause (Penh) of airway hyperreactivity (AHR). Immunoglobulins (Ig) such as IgE, IgG1, IgG2a and cytokines such as IL-12, IFN-γ, IL-4, IL-5, TNF-α and IL-13 in bronchoalveolar lavage fluid were assayed using ELISA kits.ResultsThe results showed this LMP significantly reduced Th2 cytokines and enhanced Th1 cytokines production. OVA-specific IgE and IgG1 was lower in the probiotics-treated mice whereas IgG2a was increased. Most importantly, this murine model showed LMP supplementation significantly reduced AHR.ConclusionsOverall, this Lactobacillus multi-species preparation seemed to suppress OVA-sensitized airway hyperreactivity, thus serving as a possible candidate for therapeutic uses for allergic airway symptoms.
       
  • An international comparison of risk factors between two regions with
           distinct differences in asthma prevalence
    • Abstract: Publication date: July–August 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 4Author(s): K. Madani, E. Vlaski, D.C. Rennie, M. Sears, J.A. LawsonAbstractBackground and purposeInvestigation of the geographic variation in asthma prevalence can improve our understanding of asthma etiology and management. The purpose of our investigation was to compare the prevalence of asthma and wheeze among adolescents living in two distinct international regions and to investigate reasons for observed differences.MethodsA cross-sectional survey of 13–14 year olds was completed in Saskatoon, Canada (n = 1200) and Skopje, Republic of Macedonia (n = 3026), as part of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3 study. Surveys were self-completed by students following the ISAAC protocol. Multiple logistic regression models were used to investigate associations with reports of asthma and current wheeze. A mediation analysis was then completed.ResultsAsthma prevalence was much higher in Saskatoon than Skopje (21.3% vs. 1.7%) as was the prevalence of current wheeze (28.2% vs. 8.8%). Higher paracetamol (acetaminophen) use was a consistent risk factor for asthma and wheeze in both locations and showed dose-response relationships. In both countries, paracetamol use and physical activity mediated some of the association for both asthma and wheeze. In Saskatoon, among those with current wheeze, 42.6% reported ever having a diagnosis of asthma compared to 10.2% among Skopje adolescents.ConclusionsThe results suggest that the variation in risk factors between the two locations may explain some of the differences in the prevalence of asthma and wheeze between these two study sites. However, diagnostic labeling patterns should not be ruled out as another potential explanatory factor.
       
  • Asthma, exercise and metabolic dysregulation in paediatrics
    • Abstract: Publication date: Available online 28 June 2018Source: Allergologia et ImmunopathologiaAuthor(s): Manlio Milanese, Emanuele Miraglia del Giudice, Diego G. PeroniAbstractAsthma is the most frequent chronic disease in childhood. Chest tightness, cough, wheezing and dyspnoea during or after exercise may be unique manifestations of asthma in up to 90% of subjects. Physical activity may be reduced by uncontrolled asthma symptoms and parental beliefs, impairing physical fitness of asthmatic children. Clinicians working in the field of allergy are aware of evidence supporting the benefits of physical activity for patients with asthma. Treatment of asthma is required in order to obtain its control and to avoid any limitation in sports and active play participation. As exercise performance in children with controlled asthma is not different from that of healthy controls, any exercise limitation cannot be accepted. Overweight and obesity may interfere with asthma and exercise, leading to dyspnoea symptoms. Evidences on the effect of insulin resistance on airway smooth muscle and on bronchial hyperactivity are presented.ConclusionExercise is part of the strategy to obtain the best control of asthma in childhood, but we have to optimise the asthma control therapy before starting exercise programming. Furthermore, it is crucial to give best attention on the effects of obesity and insulin resistance, because they could in turn influence patients’ symptoms.
       
  • Sublingual immunotherapy of house dust mite respiratory allergy in China
    • Abstract: Publication date: Available online 18 June 2018Source: Allergologia et ImmunopathologiaAuthor(s): L. Cheng, W.-C. ZhouAbstractSublingual immunotherapy (SLIT) has been widely used for the treatment of allergic respiratory diseases, but many problems remain unsolved. Currently available data suggest that SLIT is very effective in children and adults with IgE-mediated respiratory diseases. Most allergists in China generally believe that SLIT is suitable for allergic rhinitis and asthma due to its safety and tolerability. SLIT for three years is suitable for patients to acquire stable therapeutic effects, and the efficacy of single-allergen SLIT for polysensitized patients has also been confirmed. Nevertheless, there are still several factors restricting its application in China, such as the uncertainty of its long-term effects and the prevention of new sensitizations onset, the risk of asthma attacks, the low public awareness of SLIT and poor compliance by patients. This is a narrative review of current evidence on SLIT coming from China.
       
  • Clinical and immunological profile of children aged 5–9 years with
           persistent egg allergy before oral immunotherapy with egg. A multicenter,
           randomized controlled trial of the Spanish Society of Pediatric Allergy,
           Asthma and Clinical Immunology (SEICAP)
    • Abstract: Publication date: Available online 24 May 2018Source: Allergologia et ImmunopathologiaAuthor(s): L. Echeverria, M.F. Martin-Muñoz, C. Martorell, M.T. Belver, E. Alonso Lebrero, L. Zapatero, V. Fuentes, M. Piqué, A. Plaza, C. Muñoz, A. Martorell, C. Blasco, B. Villa, C. Gómez, S. Nevot, J.M. García, R. MaderoAbstractBackgroundIn children with egg protein allergy (EA), the probability of overcoming the allergy decreases with age, and the possibility of suffering severe adverse reactions as a consequence of dietetic transgressions results in worsened quality of life. One treatment option in such cases is oral immunotherapy (OIT) with foods.MethodsWe present a cohort of children with EA scheduled for OIT with pasteurized raw egg white, describing their clinical and allergic characteristics before the start of OIT.ResultsThe median age was six years, and 93% of the patients also suffered other allergies (58% asthma and 38.6% allergy to more than two food groups). In the last year, 14.8% had suffered a severe reaction due to dietetic transgression with egg. The median IgE specific of egg white titer was 38.5 kU/l. A double-blind placebo-controlled food challenge with cooked egg white was performed, and if the test proved positive, it was repeated with pasteurized raw egg white. The mean symptoms-provoking dose was 1.26 g and 0.55 g for cooked egg white and raw egg white, respectively. An IgE specific of ovomucoid titer of
       
  • Evaluation of serum IgE in peach-allergic patients with systemic reaction
           by using recombinant Pru p 7 (gibberellin-regulated protein)
    • Abstract: Publication date: Available online 18 May 2018Source: Allergologia et ImmunopathologiaAuthor(s): Y. Mori, F. Okazaki, C. Inuo, Y. Yamaguchi, S. Masuda, S. Sugiura, T. Fukuie, M. Nagao, I. Tsuge, T. Yosikawa, A. Yagami, K. Matsunaga, T. Fujisawa, K. Ito, H. Narita, Y. Kondo, Fruits Allergy Component Study Group, JapanAbstractBackgroundLipid transfer protein (LTP) is a major fruit allergen. It has, however, recently been revealed that the systemic reaction in peach-allergic patients is related not only to LTP (Pru p 3) but also to gibberellin-regulated protein (Pru p 7). We investigated recombinant Pru p 7 (rPru p 7) for its potential use in worldwide standardization for the diagnosis of peach allergy.MethodsNatural Pru p 7 (nPru p 7) was purified from peach crude extract using a monoclonal antibody affinity column. Complementary DNA for Pru p 7 was cloned and expressed in Escherichia coli and Pichia pastoris. Serum immunoglobulin (Ig) E in peach-allergic patients was examined by enzyme-linked immunosorbent assay (ELISA) using nPru p 7 and rPru p 7 (E. coli product: erPru p 7 and P. pastoris product: prPru p 7).ResultsPeach-allergic patients (n = 27) were diagnosed and categorized into oral reaction (n = 10) or systemic reaction (n = 17). The nPru p 7 positivity based on serum IgE levels was 52% in the systemic-reaction group and 0% in the oral-reaction group (P 
       
  • Ameliorating effects of Nigella sativa oil on aggravation of inflammation,
           oxidative stress and cytotoxicity induced by smokeless tobacco extract in
           an allergic asthma model in Wistar rats
    • Abstract: Publication date: Available online 5 May 2018Source: Allergologia et ImmunopathologiaAuthor(s): T. Khaldi, N. Chekchaki, M. Boumendjel, F. Taibi, M. Abdellaoui, M. Messarah, A. BoumendjelAbstractBackgroundThe comparison of smokeless tobacco (ST) exposure versus Ovalbumin (Ova) sensitized rats or asthmatic patients has hardly been studied in the literature. Thus, the present study aims to investigate the aggravation of inflammation, exacerbation of asthma, oxidative stress and cytotoxicity induced by ST.MethodsST was given at the dose of 40 mg/kg in an allergic asthma model in Wistar rats. Furthermore, the effects of oral administration of Nigella sativa oil (NSO), at a dose of 4 mL/kg/day, were investigated.ResultsThe obtained results showed that ST clearly enhanced lung inflammation through interleukin-4 (IL-4) and Nitric oxide (NO) increased production. Actually, ST was found to intensify the oxidative stress state induced by Ova-challenge in rats, which was proven not only by augmenting lipid peroxidation and protein oxidation, but also by altering the non-enzymatic and enzymatic antioxidant status. Furthermore, the aggravation of inflammation and oxidative stress was obviously demonstrated by the histopathological changes observed in lung. In contrast, NSO administration has shown anti-inflammatory effects by reducing IL-4 and NO production, restoring the antioxidant status, reducing lipid peroxidation and improving the histopathological alterations by both protein oxidation and NSO treatment.ConclusionsOur data have proven that severe concurrent exposure to allergen and ST increases airway inflammation and oxidative stress in previously sensitized rats. They also suggest that the oral NSO treatment could be a promising treatment for asthma.
       
  • B-cell subsets imbalance and reduced expression of CD40 in
           ataxia-telangiectasia patients
    • Abstract: Publication date: Available online 5 May 2018Source: Allergologia et ImmunopathologiaAuthor(s): C.T.M. Pereira, D.C. Bichuetti-Silva, N.V.F. da Mota, R. Salomão, M.K.C. Brunialti, B.T. Costa-CarvalhoAbstractBackgroundAtaxia-telangiectasia (AT) is a well-known primary immunodeficiency with recurrent sinopulmonary infections and variable abnormalities in both the humoral and cellular immune system. Dysfunctions in immunoglobulin production, reduced number of B cells, and B-cell receptor excision circles copies have been reported. We aimed to understand the immunological mechanisms involving the humoral compartment in AT patients by analysing peripheral blood B cells subsets, B-T lymphocyte cooperation through the expression of CD40 and CD40 ligand (CD40L), and cytokines involved in class-switch recombination production.MethodsWe compared the proportion of B-cell subsets, the expression of CD40/CD40L, and the plasma levels of IL-6 and IFN-γ of 18 AT patients and 15 healthy age-sex-matched controls using flow cytometry.ResultsWe found that some steps in peripheral B cell development were altered in AT with a pronounced reduction of cell-surface CD40 expression. The proportions of transitional and naïve-mature B cells were reduced, whereas CD21-low, natural effector memory, IgM-only memory, and IgG atypical memory B cells were present in a higher proportion.ConclusionsThese findings revealed a disturbed B-cell homeostasis with unconventional maturation of B lymphocyte memory cells, which can explain the consequent impairment of humoral immunity.
       
  • Prolonged breastfeeding and delayed introduction of whole cow's milk into
           the diet are factors associated with egg sensitization: A matched
           case–control study
    • Abstract: Publication date: Available online 5 May 2018Source: Allergologia et ImmunopathologiaAuthor(s): M. Bedolla-Barajas, J. Morales-Romero, B.Y. Gaxiola-Arredondo, G. Alcalá-Padilla, E. Romero-VelardeAbstractBackgroundBoth breastfeeding and the moment at which introduction to solid food occurs have been associated with food allergy.ObjectiveTo evaluate whether prolonged breastfeeding and the delayed introduction of whole cow's milk into an infant's diet are factors that can be associated with egg sensitization.MethodsThis was a hospital-based case–control study, matched by age and sex: each study group comprised 97 atopic children. Additionally, logistic regression was used to identify the factors associated with egg protein sensitization.ResultsThe most common type of allergic disease among both groups was allergic rhinitis. After adjusting for possible confounding variables, a delayed introduction to whole cow's milk decreased the odds of egg protein sensitization; OR = 0.16 (95% CI: 0.07–0.36, p 
       
  • Exome sequencing revealed C1Q homozygous mutation in Pediatric Systemic
           Lupus Erythematosus
    • Abstract: Publication date: Available online 5 May 2018Source: Allergologia et ImmunopathologiaAuthor(s): S. Zoghi, V. Ziaee, T. Hirschmugl, R. Jimenez-Heredia, A. Krolo, K. Boztug, N. RezaeiAbstractIntroduction and objectivesPediatric Systemic Lupus Erythematosus (pSLE) is an autoimmune disorder of children. Early disease onset raises the probability of genetic etiology and it is more severe than adult SLE.Patients and methodsHerein an eight-year-old girl with pSLE from consanguineous parents is reported.ResultsAlthough she was diagnosed as pSLE since the age of two years, Whole Exome Sequencing (WES) revealed a rare stop-gained C>T mutation in C1QA gene. The variant was validated and segregated in patient and the family. Furthermore, serum levels of the C1q protein were measured and found to be much lower than normal ranges.ConclusionsThis study indicated that C1Q deficiency should be considered as a differential diagnosis of pSLE. Therefore, measurement of C1q should be recommended in all cases with pSLE.
       
  • The role of regulatory T cells in the acquisition of tolerance to food
           allergens in children
    • Abstract: Publication date: Available online 5 May 2018Source: Allergologia et ImmunopathologiaAuthor(s): E. Bernaldo de Quiros, E. Seoane-Reula, E. Alonso-Lebrero, M. Pion, R. Correa-RochaAbstractFood allergy is a pathological immune reaction that identifies certain harmless food proteins, usually tolerated by the majority of the people, as a threat. The prevalence of these food allergies is increasing worldwide and currently affects 8% of children. Exacerbated reactions to milk, egg and peanut are the most frequent in the pediatric population. It is well known that allergic diseases are a type 2 T-helper (Th2) immune response, characterized by the elevated production of IgE antibodies. However, little is known about the immune mechanisms responsible for the development of clinical tolerance toward food allergens. Recent studies have suggested the key role of regulatory T cells (Tregs) in controlling allergic inflammation. In this review, we discuss the importance of Tregs in the pathogenesis of food allergy and the acquisition of oral tolerance in children. Further investigation in this area will be crucial for the identification of predictive markers and the development of new therapies, which will represent a clinical and social benefit for these allergic diseases.
       
  • Change in gut microbiota for eczema: Implications for novel therapeutic
           strategies
    • Abstract: Publication date: May–June 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 3Author(s): Y. Kang, Y. Cai, W. PanAbstractEczema is one of the most common inflammatory diseases, often constituting a lifelong burden for afflicted individuals. The complex interaction of host genetic and multiple environmental factors contribute to its pathogenesis. A relationship between maladjustment of gut microbiota and eczema has been brought into the light of day in most previous studies. In eczema preclinical models, specific intestinal microbial species have been demonstrated to prohibit or dwindle immune responsiveness, indicating that these strains among commensal gut bacteria may exert either a morbific or phylactic function in eczema progression. As such, oral probiotics can serve as a medicinal approach for eczema therapy. Given that relative scientific work is still at the early stage, only limited data are available in the field. New sequencing techniques have been fortunately performed to gain access to an extended research on the relationship between gut bacterial flora and human diseases. In the current review, we identified the role of intestinal microbiota in the development of eczema and how specific bacterial strains adjust the immune responsiveness in the midst of disease progression. Probiotics as an applicable treatment for eczema were evaluated in other threads as well.
       
  • Flagellated protozoa detected in Dermatophagoides by light
           microscopy
    • Abstract: Publication date: May–June 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 3Author(s): R. Martínez-GirónAbstractHouse dust mites (HDM) are arthropods of medical importance due to their relationship with allergic diseases. House dust provides a detrital habitat for these organisms, in which human skin scales are a primary food source. For digestion, wall gut cells elaborate potent proteases.Nevertheless, the observation of flagellated protozoa in intestinal extracts of HDM by light microscopy might contribute to digestive processes in mites, opening a new avenue of research regarding the ecological interactions between mites and these microorganisms in the utilisation of such substrates, as well as with regard to allergic diseases.
       
  • Future prospect of faecal microbiota transplantation as a potential
           therapy in asthma
    • Abstract: Publication date: May–June 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 3Author(s): Y. Kang, Y. CaiAbstractThere is convincing evidence from both human and animal studies suggesting that the gut microbiota plays an important role in regulating immune responses associated with the development of asthma. Certain intestinal microbial strains have been demonstrated to suppress or impair immune responsiveness in asthma experimental models, suggesting that specific species among gut commensal microbiota may play either a morbific or phylactic role in the progression of asthma. Evidence to date suggests that the intestinal microbiota represent fertile targets for prevention or management of asthma. The faecal microbiota transplantation (FMT) is a rather straightforward therapy that manipulates the human gastrointestinal (GI) microbiota, by which a healthy donor microbiota is transferred into an existing but disturbed microbial ecosystem. The FMT may therefore represent a therapeutic approach for asthma treatment in the foreseeable future. At present, FMT therapy for asthma is very limited and should be actively studied. Considerable efforts are needed to increase our knowledge in the field of FMT therapy for asthma. In this review, we aimed to provide several insights into the development of FMT therapy for asthma.
       
  • Serum periostin is not related to asthma predictive index
    • Abstract: Publication date: May–June 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 3Author(s): J.A. Castro-Rodriguez, I. Atton, G. Villarroel, C.A. SerranoAbstractBackgroundIn contrast to adult asthmatic patients, studies on the role of serum periostin levels in schoolchildren with asthma are still conflictive, and very few studies have been performed in pre-schoolers. The aim of this study was to compare serum periostin levels in recurrent wheezer pre-schoolers according to their asthma predictive index (API) condition.MethodsWe performed a case–control study enrolling pre-schoolers with recurrent wheezing episodes (>3 episodes confirmed by physician) presented at one paediatric clinic in Santiago, Chile. The population was divided according to stringent API criteria into positive or negative.ResultsIn a one-year period, 60 pre-schoolers were enrolled. After excluding 12 (due to not fulfilment of inclusion criteria or refusal of blood sample extraction), 48 remaining pre-schoolers (27 males, age range from 24 to 71 months) completed the study; 34 were API positive and 14 were API negative. There were no significant differences in demographics between groups. The level of serum periostin levels for pre-schoolers with positive API and negative API were (median 46.7 [25.5–83.1] and 67.5 [20.5–131.8], p = 0.9, respectively). The area under the curve for the serum periostin levels for predict positive API was 0.5, 95% CI [0.29–0.70], p = 0.9. No significant correlation between serum periostin levels and peripheral blood eosinophils was found.ConclusionSerum periostin levels were no significantly different between wheezer pre-schoolers with positive and negative API. More studies are needed to confirm this finding.
       
  • Non-protease native allergens partially purified from bodies of eight
           domestic mites using p-aminobenzamidine ligand
    • Abstract: Publication date: May–June 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 3Author(s): T. Erban, R. KlubalAbstractBackgroundOptimised purification steps for concentrating trace target native antigens are needed. Combining the p-aminobenzamidine ligand with protease inactivation enables partial purification of mite non-protease allergens lacking proteases.ObjectiveWe sought to analyse in detail proteins obtained using this method from eight species of synanthropic acaridid mites and tested IgE reactivity using pooled human sera.Materials and methodsProteins affinity bound to p-aminobenzamidine as a ligand were identified by MALDI TOF/TOF. After electroblotting, the proteins were visualised using the fluorescent SYPRO-Ruby protein blot stain, and IgE reactivity was further analysed using pooled human sera collected from patients allergic to house dust mites.ResultsMS/MS identification confirmed previous results that no proteases were purified. Protein patterns corresponding to the allergens Der f 7, Der f 30 and actins indicated that these proteins are purified using p-aminobenzamidine and are present across a wide spectrum of acaridid mites. When using Dermatophagoides farinae, apolipophorins (Der f 14), chitinase-like Der f 15 and 18, 70-kDa heat shock protein, and a Der f Alt a10 allergen homolog (gi 37958173) were also detected. The target antigens tropomyosins and paramyosins showed similar IgE binding among the mite species tested. IgE reactivity with miscellaneous D. farinae antigen was also observed.ConclusionsPartial purification of mite non-protease antigens using a strategy combining p-aminobenzamidine with protease inactivation was verified by 1D-E and 2D-E analyses. IgE binding to p-aminobenzamidine-purified native non-protease mite antigens was tested using pooled sera. This preliminary study allows for further work on individual serum samples, allowing confirmation of immunoreactivity.
       
  • Wheezing in infants: A pandemic condition that need to be treated with
           patience
    • Abstract: Publication date: May–June 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 3Author(s): L. Garcia-Marcos
       
  • Comparing the effects of fluticasone, anti-IgE and anti-TNF treatments in
           a chronic asthma model
    • Abstract: Publication date: May–June 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 3Author(s): M.Y. Ozkars, O. Keskin, M. Tokur, M. Ulasli, B. Gogebakan, H. Ciralik, E. Kucukosmanoglu, C. Demirel, S. Oztuzcu, H. KahramanAbstractBackgroundCorticosteroids are used in the treatment of asthma. The aim of this study was to determine the efficacy of anti-IgE and anti-TNF alpha as asthma treatments.MethodsA mouse model of chronic asthma was developed. The fluticasone group was exposed to fluticasone and the anti-IgE and anti-TNF groups were administered anti-IgE or anti-TNF. IL-4, and IgE levels were measured, and histological analysis, pathological analysis and miRNA-126, miRNA-133a analyses were applied.ResultsThe cell concentration in the BAL fluid decreased in all the treatment groups. The rate of perivascular and peribronchial cell infiltration decreased in the lung in the high-dose anti-IgE and anti-TNF groups. Smooth muscle thickness decreased in the lung tissue in the low-dose anti-IgE and anti-TNF groups. Bronchial wall thickness decreased in the lung tissue in the fluticasone + anti-IgE group. The IL-4 level in BAL fluid decreased in the high-dose anti-IgE, fluticasone + anti-IgE and anti-TNF groups. IgE levels increased in the BAL fluid in the high-dose anti-IgE and anti-TNF groups. The lymphocyte level increased in the BAL fluid in the high-dose anti-IgE group. The macrophage level decreased in the BAL fluid in the anti-TNF group. The relative expression of miRNA-126 increased in all groups. The relative expression of miRNA-133a decreased in the placebo and fluticasone groups. The relative expression of miRNA-133a increased in the low-dose anti-IgE, high-dose anti-IgE, fluticasone + anti-IgE and anti-TNF groups.ConclusionsThe results showed that anti-IgE is successful as a treatment. Fluticasone + anti-IgE and anti-TNF were seen to be superior to other therapeutic modalities when used for prophylaxis.
       
  • Low efficacy of atopy patch test in predicting tolerance development in
           non-IgE-mediated cow's milk allergy
    • Abstract: Publication date: May–June 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 3Author(s): T.A. Gonzaga, F.A. Alves, M.F.A. Cheik, C.P. de Barros, E.R.M.A. Rezende, G.R.S. SegundoAbstractBackgroundThe food atopy patch (APT) test has been used in previous studies to help the diagnosis of non-IgE mediated food allergies (FA). The aim of this study was to evaluate the efficacy of different cow's milk APT preparations to predict oral tolerance in children with previous non-IgE-mediated cow's milk allergy (CMA) diagnosis.MethodsThirty-two patients non-IgE-mediated CMA diagnosed by oral food challenge (OFC) were enrolled to perform APT with three different cow's milk preparations (fresh, 2% in saline solution, 2% in petrolatum) and comparing with a new OFC after at least three months of diet exclusion.ResultsOnly six (18.7%) subjects presented positive OFC to cow's milk. No differences in gender, onset symptoms age, OFC age, Z-score, and exclusion period were found between positive and negative OFC patients. Preparations using fresh milk and powdered milk in petrolatum presented sensitivity equal to zero and specificity 92.3% and 96.1%. The preparation using powdered milk in saline solution showed sensitivity and specificity of 33.3% and 96.1%. Two patients presented typical IgE symptoms after OFC.ConclusionCow's milk APT presented a low efficacy to predict tolerance in patients with previous non-IgE-mediated CMA and should not be used in clinical routine. The presence of typical IgE reactions after OFC hallmark the necessity of previous IgE-mediated investigation for this patient group.
       
  • Component-resolved diagnosis in hymenoptera allergy
    • Abstract: Publication date: May–June 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 3Author(s): D. Antolín-Amérigo, B. Ruiz-León, E. Boni, T. Alfaya-Arias, M. Álvarez-Mon, J. Barbarroja-Escudero, D. González-de-Olano, C. Moreno-Aguilar, M. Rodríguez-Rodríguez, M.J. Sánchez-González, L. Sánchez-Morillas, A. Vega-CastroAbstractComponent-resolved diagnosis based on the use of well-defined, properly characterised and purified natural and recombinant allergens constitutes a new approach in the diagnosis of venom allergy. Prospective readers may benefit from an up-to-date review on the allergens. The best characterised venom is that of Apis mellifera, whose main allergens are phospholipase A2 (Api m1), hyaluronidase (Api m2) and melittin (Api m4). Additionally, in recent years, new allergens of Vespula vulgaris have been identified and include phospholipase A1 (Ves v1), hyaluronidase (Ves v2) and antigen 5 (Ves v5). Polistes species are becoming an increasing cause of allergy in Europe, although only few allergens have been identified in this venom.In this review, we evaluate the current knowledge about molecular diagnosis in hymenoptera venom allergy.
       
  • MHC class II deficiency: Report of a novel mutation and special review
    • Abstract: Publication date: May–June 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 3Author(s): S. Farrokhi, M. Shabani, Z. Aryan, S. Zoghi, A. Krolo, K. Boztug, N. RezaeiAbstractThe MHC II deficiency is a rare autosomal recessive primary immunodeficiency syndrome with increased susceptibility to respiratory and gastrointestinal infections, failure to thrive and early mortality. This syndrome is caused by mutations in transcription regulators of the MHC II gene and results in development of blind lymphocytes due to the lack of indicatory MHC II molecules. Despite homogeneity of clinical manifestations of patients with MHC II deficiency, the genetic defects underlying this disease are heterogeneous. Herein, we report an Iranian patient with MHC II deficiency harbouring a novel mutation in RFXANK and novel misleading clinical features. He had ataxic gait and dysarthria from 30 months of age. Epidemiology, clinical and immunological features, therapeutic options and prognosis of patients with MHC II are reviewed in this paper.
       
  • Scabies, crusted (Norwegian) scabies and the diagnosis of mite
           sensitisation
    • Abstract: Publication date: May–June 2018Source: Allergologia et Immunopathologia, Volume 46, Issue 3Author(s): M. Sánchez-Borges, L. González-Aveledo, A. Capriles-Hulett, F. Caballero-FonsecaAbstractScabies is observed with relatively high frequency in Allergy and Dermatology clinics in developing countries where poor sanitary conditions are prevalent and increasingly in some areas of the world with increased immigrant populations. Since the immunological response to scabies mites includes the production of IgE class antibodies to Sarcoptes scabiei allergens which cross-react with Dermatophagoides major allergens Der p 1 and Der p 2, positive immediate-type skin tests to house dust mite extracts should be interpreted cautiously. Additionally, scabies should be included routinely in the differential diagnosis of itchy rashes in patients living in those areas.
       
  • Hospitalizations for asthma exacerbation in Chilean children: A
           multicenter observational study
    • Abstract: Publication date: Available online 30 April 2018Source: Allergologia et ImmunopathologiaAuthor(s): A.M. Herrera, P. Brand, G. Cavada, A. Koppmann, M. Rivas, J. Mackenney, H. Sepúlveda, M.E. Wevar, L. Cruzat, S. Soto, M.A. Pérez, A. León, I. Contreras, C. Alvarez, B. Walker, C. Flores, V. Lezana, C. Garrido, M.E. Herrera, A. RojasAbstractBackgroundAsthma hospitalization rates in Chilean children have increased in the last 14 years, but little is known about the factors associated with this.ObjectiveDescribe clinical characteristics of children hospitalized for asthma exacerbation.MethodsObservational prospective cohort study in 14 hospitals. Over a one-year period, children five years of age or older hospitalized with asthma exacerbation were eligible for inclusion. Parents completed an online questionnaire with questions on demographic information, about asthma, indoor environmental contaminant exposure, comorbidities and beliefs about disease and treatment. Disease control was assessed by the Asthma Control Test. Inhalation technique was observed using a checklist.Results396 patients were enrolled. 168 children did not have an established diagnosis of asthma. Only 188 used at least one controller treatment at the time of hospitalization. 208 parents said they believed their child had asthma only when they had an exacerbation and 97 correctly identified inhaled corticosteroids as anti-inflammatory treatment. 342 patients used the wrong spacer and 73 correctly performed all steps of the checklist.ConclusionsAlmost half of the patients were not diagnosed with asthma at the time of hospitalization despite having a medical history suggestive of the disease. In the remaining patients with an established diagnosis of asthma potentially modifiable factors like bad adherence to treatment and poor inhalation technique were found. Implementing a nationwide asthma program including continued medical education for the correct diagnosis and follow up of these patients and asthma education for patients and caregivers is needed to reduce asthma hospitalization rates in Chilean children.
       
  • Features and roles of T helper 9 cells and interleukin 9 in immunological
           diseases
    • Abstract: Publication date: Available online 25 April 2018Source: Allergologia et ImmunopathologiaAuthor(s): R. Yazdani, S. Shapoori, M. Rezaeepoor, R. Sanaei, M. Ganjalikhani-Hakemi, G. Azizi, W. Rae, A. Aghamohammadi, N. RezaeiAbstractT helper 9 (TH9) cells are considered as newly classified helper T cells that have an important role in the regulation of immune responses. Since these cells preferentially produce IL-9, these cells are termed TH9 cells. Recently, the role of TH9 and its signature cytokine (IL-9) has been investigated in a wide range of diseases, including autoimmunity, allergy, infections, cancer and immunodeficiency. Herein, we review the most recent data concerning TH9 cells and IL-9 as well as their roles in disease. These insights suggest that TH9 cells are a future target for therapeutic intervention.
       
  • Is vitamin D level associated with the natural course of atopic
           dermatitis'
    • Abstract: Publication date: Available online 17 March 2018Source: Allergologia et ImmunopathologiaAuthor(s): M. DogruAbstractIntroduction and objectivesAtopic dermatitis (AD) is a chronic inflammatory disease of the skin. Apart from its well-known role on calcium metabolism, vitamin D is reported to affect skin functions. The study aims were to: compare the vitamin D levels of children with AD and healthy children; investigate the relationship between the severity of AD and vitamin D levels; and investigate the effect of vitamin D on the natural course of AD.Patients or materials and methodsSixty-nine patients with AD were enrolled. Seventy healthy children were assigned as control group. Clinical and demographic features of groups were recorded. The skin prick test, eosinophil counts, immunoglobulin (Ig) E levels and serum 25 OH cholecalciferol (25OHD3) levels were measured. After at least 4 years of follow-up, patients were re-evaluated for natural course of AD.ResultsMean 25OHD3 level was lower in patient group vs. control group; 19.86 ± 6.7 ng/mL (min–max: 6.8–40) vs. 24.07 ± 9.08 ng/mL, respectively, (p = 0.002). Mean 25OHD3 levels, and vitamin D status were significantly different between AD severity groups. (p 
       
  • Adherence to pharmacotherapy improves school performance in children with
           rhinitis and asthma
    • Abstract: Publication date: Available online 17 March 2018Source: Allergologia et ImmunopathologiaAuthor(s): J. Sánchez, A. Sánchez, R. CardonaAbstractBackgroundAdherence to pharmacotherapy reduces symptoms of asthma and rhinitis, however, little is known of its impact on school performance.ObjectiveTo evaluate the impact of pharmacotherapy in absenteeism and school performance in a child population.MethodsA cross-sectional study, carried out in eight schools. All participants and their parents were given a questionnaire assessing parameters related to respiratory diseases and pharmacotherapy. Data on school performance was obtained from the academic history of each child who participated in the study. Adherence to pharmacotherapy was classified as a correct use of therapy for more than five days per week.Results1109 children agreed to participate. Students were divided into two groups: symptomatic (36%) and asymptomatic (63%). The symptomatic group had a higher frequency of school absenteeism (1 vs. 3.1 days/year/patient p 
       
  • Iberian consensus on cow's milk allergy: The CIBAL Study
    • Abstract: Publication date: Available online 21 February 2018Source: Allergologia et ImmunopathologiaAuthor(s): E. Alonso-Lebrero, L. Bento, A. Martorell-Aragonés, L. Ribeiro, on behalf of Expert CIBAL PanelAbstractBackgroundThe present study explores the professional opinion of a wide range of experts from the Iberian Peninsula (Spain and Portugal) and their degree of consensus about CMPA's prevention, diagnosis, treatment and progression.Material and methodsA 57-item survey divided in four blocks: Prevention (14 items), Diagnosis (10 items), Treatment (19 items) and Progression (14 items) was completed by 160 panellists, experts in CPMA management (116 Spain, 44 Portugal). Each one answered the questionnaire, formulated in Portuguese and Spanish, by individually accessing an online platform in two consecutive rounds. Five possible answers were possible: “completely agree”, “agree”, “neither agree nor disagree”, “disagree” and “completely disagree”. A modified Delphi method was used.ResultsConsensus (more than 66% agree) was reached in 39 items (68.4%) and Discrepancy (less than 50% agree) in nine items (15.7%). Block separated analysis offers valuable differences regarding consensus. The Prevention block only reached 50%; the Diagnosis block 90%; the Treatment block 73.68%, showing a high degree of agreement on dietary treatment (15/16 items), and discrepancy or less agreement on immunotherapy treatments. The Progression block reached 71.4% consensus with discrepancy with regard to the time to perform oral food challenge and negatives prognosis consequences of accidental milk ingestion.ConclusionsThis study displays the current opinions of a wide group of experts on CMPA from the Iberian Peninsula and evidence discussion lines in CMPA management. The questions on which there were situations of discrepancy, provide us with very useful information for promoting new, rigorous research enabling us to draw conclusions on these controversial aspects.
       
  • Is food protein induced enterocolitis syndrome only a non IgE-mediated
           food allergy'
    • Abstract: Publication date: Available online 19 February 2018Source: Allergologia et ImmunopathologiaAuthor(s): S. Miceli Sopo, C. Fantacci, G. Bersani, A. Romano, L. Liotti, S. MonacoAbstractFood protein induced enterocolitis syndrome (FPIES) is classified as non-IgE-mediated or cell-mediated food allergy, although there is an atypical phenotype so defined for the presence of specific IgEs. All diagnostic criteria for FPIES include the absence of skin or respiratory symptoms of IgE-mediated type. We present four cases that suggest that specific IgEs may have a pathogenic role, resulting in the existence of different FPIES phenotypes. This could be important from a diagnostic and therapeutic point of view.
       
  • Increase of natural killer cells in children with liver
           transplantation-acquired food allergy
    • Abstract: Publication date: Available online 16 February 2018Source: Allergologia et ImmunopathologiaAuthor(s): F. Mori, C. Angelucci, A. Cianferoni, S. Barni, G. Indolfi, A. Casini, G. Mangone, M. Materassi, N. Pucci, C. Azzari, E. NovembreAbstractBackgroundTransplantation-acquired food allergies (TAFA) are frequently reported and considered to be caused by immunosuppressive therapy.The aim of this study was to investigate the allergic and immunologic responses in children who had liver or kidney transplantations.MethodsTwelve children receiving liver transplantations and 10 children receiving kidney transplantations were investigated. All children underwent the allergy work-up and in most of them, lymphocyte screening and serum cytokine measurements were also performed.ResultsTAFA were found in 7/12 (58%) children with liver transplantations and in none of the 10 children with kidney transplantations. The mean age at transplantation was significantly lower in children who underwent liver transplantations (p 
       
  • Diagnostic criteria for acute food protein-induced enterocolitis syndrome.
           Is the work in progress'
    • Abstract: Publication date: Available online 15 February 2018Source: Allergologia et ImmunopathologiaAuthor(s): S. Miceli Sopo, G. Bersani, C. Fantacci, A. Romano, S. MonacoAbstractFood protein-induced enterocolitis syndrome (FPIES) is a non IgE-mediated gastrointestinal food allergic disorder. Some diagnostic criteria have been published for acute FPIES. Of course, they are not all the same, so the clinician must choose which ones to adopt for his/her clinical practice. We present here a brief review of these criteria and, through two clinical cases, show how the choice of one or the other can change the diagnostic destiny of a child with suspect FPIES.
       
  • Exposure to dogs but not cats is associated to a decrease in the
           prevalence in atopic dermatitis amongst school-children
    • Abstract: Publication date: Available online 15 February 2018Source: Allergologia et ImmunopathologiaAuthor(s): M. Bedolla-Barajas, J. Morales-Romero, T.I. Bedolla-Pulido, T.R. Bedolla-Pulido, C. Meza-López, N.A. Pulido-GuillénAbstractIntroductionThe association regarding the exposure to pets, especially cats and dogs, and the prevalence of allergic diseases is inconsistent.ObjectiveWe analyzed the role played by early exposure to dogs or cats in the prevalence of allergic diseases amongst school-aged children.MethodThrough a cross-sectional study, we examined 756 children, aged 6–7; these candidates were selected through cluster sampling. We inquired about the exposure that these children had had to dogs and cats, and whether these pets spent most of their time indoors or outdoors during the first year of the child's life. In order to identify the prevalence of allergic diseases and their symptoms, each child's parent completed the International Study of Asthma and Allergies in Childhood questionnaire.ResultsExposure to outdoor dogs was associated to nocturnal coughing, odds ratio (OR) 0.64, with a confidence interval of 95% (95% CI) 0.43–0.95 and with atopic dermatitis (OR: 0.39; 95% CI: 0.20–0.76). Interestingly, exposure to outdoor cats was associated to nocturnal coughing (OR: 0.51; 95% CI: 0.32–0.83) and current rhinitis symptoms (OR: 0.59; 95% CI 0.36–0.97). After carrying out the multivariate analyses, only exposure to dogs, both indoor and outdoor, was significantly associated to a decrease in the prevalence of atopic dermatitis OR 0.40 (95% CI: 0.20–0.79) and OR 0.38 (95% CI: 0.18–0.83), respectively.ConclusionOur findings suggest that exposure to dogs, whether they be indoor or outdoor pets, is associated to a decreased prevalence in atopic dermatitis.
       
  • The roles of toll like receptor 3, 7 and 8 in allergic rhinitis
           pathogenesis
    • Abstract: Publication date: Available online 3 February 2018Source: Allergologia et ImmunopathologiaAuthor(s): A. Golshiri-Isfahani, M. Amizadeh, M.K. ArababadiAbstractAllergic rhinitis, as an allergic and nasal hypersensitivity disease, is associated with the inflammation of nasal mucosa. It appears that innate immune receptors are the important risk factors in the pathogenesis of the inflammatory disease. Toll-like receptors (TLRs) are the most important receptors of innate immunity; their crucial roles in the recognition of allergens and subsequently pathogenesis of allergic diseases have been evaluated recently. TLR3, 7 and 8 are the intracellular members of the innate immune receptors and recognize intracellular single and double strand RNAs. This review article collected the investigations regarding the roles of TLR3, 7 and 8 in the allergic rhinitis pathogenesis.
       
  • Development and characterization of an allergoid of cat dander for
           immunotherapy
    • Abstract: Publication date: Available online 17 January 2018Source: Allergologia et ImmunopathologiaAuthor(s): J.P. Sola, Y. Pedreño, A. Cerezo, M. Peñalver-MelladoAbstractBackgroundAllergy to cats is a frequent cause of sensitization to indoor allergens and currently there are few alternatives to specific immunotherapy with cat native extracts. The objective is to develop and characterize a new allergoid to increase the tools available for use in clinical practice.MethodsThe allergoid cat dander extract (ACD) was developed from a native cat dander extract (NCD) by modification with glutaraldehyde, and the optimal process control was determined by SDS-PAGE, DOT BLOT and determination of free amine groups. The ACD was characterized in protein profile by SDS-PAGE, size exclusion chromatography (SEC) and peptide footprint. The allergenic profile of ACD was determined by immunoblot, IgE CAP inhibition and IgG competition ELISA. The major allergen content in NCD was obtained by the ELISA sandwich protocol and was extrapolated to ACD.ResultsThe control process determined the optimal development of the allergoid. The ACD obtained contains 182.28 μg/mg of protein and 11.90 μg/mg of Fel d 1. SDS-PAGE and SEC confirmed the presence of high molecular weight proteins in ACD, and the peptide footprint showed the presence of Fel d 1 and Fel d 7. The high degree of polymerization was evidenced with the determination of the reduction of lysine residues in the allergoid, resulting 91.96%. The ACD showed a significant loss of allergenicity respect to NCD, while the IgG-binding capacity was maintained.ConclusionsThe ACD obtained presents a good safety profile, so would be a good alternative for treatment of cat allergy.
       
  • Knowledge on asthma, food allergies, and anaphylaxis: Assessment of
           elementary school teachers, parents/caregivers of asthmatic children, and
           university students in Uruguaiana, in the state of Rio Grande do Sul,
           Brazil
    • Abstract: Publication date: Available online 12 January 2018Source: Allergologia et ImmunopathologiaAuthor(s): M. Urrutia-Pereira, L.P. Mocellin, R.B. de Oliveira, L. Simon, L. Lessa, D. SoléAbstractIntroductionAllergic diseases have become an increasingly common reality in the last years, extending beyond the family context.ObjectiveAssessing the level of knowledge on asthma, food allergies and anaphylaxis of asthmatic children's parents/caregivers (PC), elementary school teachers (EST) and university students (US) in Uruguaiana, RS, Brazil.Method577 individuals (PC – N = 111; EST – N = 177; US – N = 299) took part in the study, answering the Newcastle Asthma Knowledge Questionnaire (validated for Portuguese) and another questionnaire on Food Allergy (FA) and anaphylaxis.ResultsAlthough PC have asthmatic children, their asthma knowledge level was average, slightly above that of EST and EU. The lack of knowledge on passive smoking, use of medications and their side effects should be highlighted. US have shown to be better informed about FA and anaphylaxis. However, even though a significant proportion of respondents know the most common symptoms of FA and anaphylaxis, few named subcutaneous adrenaline as the drug of choice for treating anaphylaxis. Although a significant number of respondents know about the possibility of anaphylactic reactions happening at school or in activities outside the school, we were surprised by the absence of conditions in schools to provide emergency care to such students.ConclusionDespite the high prevalence of allergic diseases in childhood, asthmatic children's parents/caregivers, elementary school teachers and university students have inadequate levels of knowledge to monitor these patients.
       
  • Mycoplasma pneumoniae and toll-like receptors: A mutual avenue
    • Abstract: Publication date: Available online 10 January 2018Source: Allergologia et ImmunopathologiaAuthor(s): M. Naghib, M. Hatam-Jahromi, M. Niktab, R. Ahmadi, A. KariminikAbstractMycoplasma pneumoniae is an intracellular bacterium leading to several complications in humans. M. pneumoniae is cleared in some cases and induces complications in others. The main responsible mechanisms regarding the controversy are yet to be cleared. Toll-like receptors (TLRs) are the important cell membrane and intracellular receptors which recognize a wide range of microbial macromolecules. The roles of TLRs in the eradication of several pathogens and also induction of their related complications have been demonstrated. This review article presents recent data about the roles of TLRs in the induction of immune responses which lead to M. pneumoniae eradication and related complications.
       
 
 
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