Raccolta di pubblicazioni interessanti su allergie, asma, eczema atopico e intolleranze alimentari.
The following list of interesting publications on allergies, asthma, atopic eczema and food intolerances adresses to professionals. There is no claim to completeness or balance. The list is updated regularly.
Epithelial barrier hypothesis: Effect of external exposome on microbiome and epithelial barriers in allergic disease
Sozener et al. Allergy. 2022. 00:1–32.
Environmental exposure plays a major role in the development of allergic diseases. The exposome can be classified into internal (e.g., aging, hormones, and metabolic processes), specific external (e.g., chemical pollutants or lifestyle factors), and general external (e.g., broader socioeconomic and psychological contexts) domains, all of which are interrelated. All the factors we are exposed to, from the moment of conception to death, are part of the external exposome. Several hundreds of thousands of new chemicals have been introduced in modern life without our having a full understanding of their toxic health effects and ways to mitigate these effects. Climate change, air pollution, microplastics, tobacco smoke, changes and loss of biodiversity, alterations in dietary habits, and the microbiome due to modernization, urbanization, and globalization constitute our surrounding environment and external exposome. Some of these factors disrupt the epithelial barriers of the skin and mucosal surfaces, and these disruptions have been linked in the last few decades to the increasing prevalence and severity of allergic and inflammatory diseases such as atopic dermatitis, food allergy, allergic rhinitis, chronic rhinosinusitis, eosinophilic esophagitis, and asthma. The epithelial barrier hypothesis provides a mechanistic explanation of how these factors can explain the rapid increase in allergic and autoimmune diseases. In this review, we discuss factors affecting the planet’s health in the context of the ‘epithelial barrier hypothesis,’ including climate change, pollution, changes and loss of biodiversity, and emphasize the changes in the external exposome in the last few decades and their effects on allergic diseases. In addition, the roles of increased dietary fatty acid consumption and environmental substances (detergents, airborne pollen, ozone, microplastics, nanoparticles, and tobacco) affecting epithelial barriers are discussed. Considering the emerging data from recent studies, we suggest stringent governmental regulations, global policy adjustments, patient education, and the establishment of individualized control measures to mitigate environmental threats and decrease allergic disease.
EAACI statement on the diagnosis, management and prevention of severe allergic reactions to COVID-19 vaccines.
Sokolowska et al. Allergy. 2021;76:1629–1639.
The first approved COVID-19 vaccines include Pfizer/BioNTech BNT162B2, Moderna mRNA-1273 and AstraZeneca recombinant adenoviral ChAdOx1-S. Soon after approval, severe allergic reactions to the mRNA-based vaccines that resolved after treatment were reported. Regulatory agencies from the European Union, Unites States and the United Kingdom agree that vaccinations are contraindicated only when there is an allergy to one of the vaccine components or if there was a severe allergic reaction to the first dose. This position paper of the European Academy of Allergy and Clinical Immunology (EAACI) agrees with these recommendations and clarifies that there is no contraindication to administer these vaccines to allergic patients who do not have a history of an allergic reaction to any of the vaccine components. Importantly, as is the case for any medication, anaphylaxis may occur after vaccination in the absence of a history of allergic disease. Therefore, we provide a simplified algorithm of prevention, diagnosis and treatment of severe allergic reactions and a list of recommended medications and equipment for vaccine centres. We also describe potentially allergenic/immunogenic components of the approved vaccines and propose a workup to identify the responsible allergen. Close collaboration between academia, regulatory agencies and vaccine producers will facilitate approaches for patients at risks, such as incremental dosing of the second injection or desensitization. Finally, we identify unmet research needs and propose a concerted international roadmap towards precision diagnosis and management to minimize the risk of allergic reactions to COVID-19 vaccines and to facilitate their broader and safer use.
Immunological resilience and biodiversity for prevention of allergic diseases and asthma.
Haahtela et al. Allergy. 2021;00:1–14.
Increase of allergic conditions has occurred at the same pace with the Great Acceleration, which stands for the rapid growth rate of human activities upon earth from 1950s. Changes of environment and lifestyle along with escalating urbanization are acknowledged as the main underlying causes. Secondary (tertiary) prevention for better disease control has advanced considerably with innovations for oral immunotherapy and effective treatment of inflammation with corticosteroids, calcineurin inhibitors, and biological medications. Patients are less disabled than before. However, primary prevention has remained a dilemma. Factors predicting allergy and asthma risk have proven complex: Risk factors increase the risk, while protective factors counteract them. Interaction of human body with environmental biodiversity with micro-organisms and biogenic compounds as well as the central role of epigenetic adaptation in immune homeostasis have given new insight. Allergic diseases are good indicators of the twisted relation to environment. In various non-communicable diseases, the protective mode of the immune system indicates low-grade inflammation without apparent cause. Giving microbes, pro- and prebiotics, has shown some promise in prevention and treatment. The real-world public health programme in Finland (2008–2018) emphasized nature relatedness and protective factors for immunological resilience, instead of avoidance. The nationwide action mitigated the allergy burden, but in the lack of controls, primary preventive effect remains to be proven. The first results of controlled biodiversity interventions are promising. In the fast urbanizing world, new approaches are called for allergy prevention, which also has a major cost saving potential.
Early life microbial exposures and allergy risks: opportunities for prevention
Harald Renz and Chrysanthi Skevaki. Nature Reviews Immunology. 2021. Vol. 21. 177–191
Allergies, including asthma, food allergy and atopic dermatitis, are increasing in prevalence, particularly in westernized countries. Although a detailed mechanistic explanation for this increase is lacking, recent evidence indicates that, in addition to genetic predisposition, lifestyle changes owing to modernization have an important role. Such changes include increased rates of birth by caesarean delivery, increased early use of antibiotics, a westernized diet and the associated development of obesity, and changes in indoor and outdoor lifestyle and activity patterns. Most of these factors directly and indirectly impact the formation of a diverse microbiota, which includes bacterial, viral and fungal components; the microbiota has a leading role in shaping (early) immune responses. This default programme is markedly disturbed under the influence of environmental and lifestyle risk factors. Here, we review the most important allergy risk factors associated with changes in our exposure to the microbial world and the application of this knowledge to allergy prevention strategies.
Advances and novel developments in environmental influences on the development of atopic diseases.
Alkotob et al. Allergy. 2020;75:3077–3086.
Although genetic factors play a role in the etiology of atopic disease, the rapid increases in the prevalence of these diseases over the last few decades suggest that environmental, rather than genetic factors are the driving force behind the increasing prevalence. In modern societies, there is increased time spent indoors, use of antibiotics, and consumption of processed foods and decreased contact with farm animals and pets, which limit exposure to environmental allergens, infectious parasitic worms, and microbes. The lack of exposure to these factors is thought to prevent proper education and training of the immune system. Increased industrialization and urbanization have brought about increases in organic and inorganic pollutants. In addition, Caesarian birth, birth order, increased use of soaps and detergents, tobacco smoke exposure and psychosomatic factors are other factors that have been associated with increased rate of allergic diseases. Here, we review current knowledge on the environmental factors that have been shown to affect the development of allergic diseases and the recent developments in the field.
A biodiversity hypothesis.
Biodiversity hypothesis states that contact with natural environments enriches the human microbiome, promotes immune balance and protects from allergy and inflam‐ matory disorders. We are protected by two nested layers of biodiversity, microbiota of the outer layer (soil, natural waters, plants, animals) and inner layer (gut, skin, air‐ ways). The latter inhabits our body and is colonized from the outer layer. Explosion of human populations along with cultural evolution is profoundly changing our environ‐ ment and lifestyle. Adaptive immunoregulatory circuits and dynamic homeostasis are at stake in the newly emerged urban surroundings. In allergy, and chronic inflamma‐ tory disorders in general, exploring the determinants of immunotolerance is the key for prevention and more effective treatment. Loss of immunoprotective factors, de‐ rived from nature, is a new kind of health risk poorly acknowledged until recently. The paradigm change has been implemented in the Finnish allergy programme (2008‐2018), which emphasized tolerance instead of avoidance. The first results are promising, as allergy burden has started to reduce. The rapidly urbanizing world is facing serious biodiversity loss with global warming, which are interconnected. Biodiversity hypothesis of health and disease has societal impact, for example, on city planning, food and energy production and nature conservation. It has also a mes‐ sage for individuals for health and well‐being: take nature close, to touch, eat, breathe, experience and enjoy. Biodiverse natural environments are dependent on planetary health, which should be a priority also among health professionals.
The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children
The Role of Maternal Dietary Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction
of Allergenic Complementary Foods.
Greer et al. Pediatrics. 2019. 143 (4)
AR101 Oral Immunotherapy for Peanut Allergy (PALISADE)
The PALISADE Group of Clinical Investigators
Current state of follow-up care for patients with Hymenoptera venom anaphylaxis in southwest Germany
Manmohan M et al. Allergo J Int 2018;27:4-14
Immunothérapie sublinguale pour le traitement de la rhinoconjonctivite et l’asthme allergique: guide pratique
Ghosn J, Spertini F, Comte D. Rev Med Suisse 2018; 14: 735-9
Thema Stillen und Allergieprävention
van Ginkel et al. 2018. Retrospective observational cohort study regarding the effect of breastfeeding on challenge-proven food allergy. European Journal of Clinical nutrition. 72:557–563
Diet during pregnancy and infancy and risk of allergic or autoimmune disease: A systematic review and meta-analysis
Vanessa Garcia-Larsen, Despo Ierodiakonou, Katharine Jarrold, Sergio Cunha, Jennifer Chivinge, Zoe Robinson, Natalie Geoghegan, Alisha Ruparelia, Pooja Devani, Marialena Trivella, Jo Leonardi-Bee, Robert J. Boyle. 2018 Published: February 28, 2018
Neue Aspekte zur Allergie-Edukation: Beispiel Anaphylaxie
Ring J, Brockow K, Kugler C, Gebert N, Grando K, Götz D,
Hutegger I, Lüthi H, Münch D, Spindler T, Schmid-Grendelmeier P, Gieler U. New aspects in allergy education with special emphasis on anaphylaxis. Allergo J Int 2017;26:267–72 https://doi.org/10.1007/s40629-017-0032-0
The Integrated Care of Asthma in Switzerland (INCAS) Study: Changes in Asthma Control and Perception of Health Care through Asthma Education
S. Dürr, K.E. Hersberger, A. Zeller, J. Scheuzger, D. Miedinger, C. Gregoriano, L. Joos Zellweger, C. Steurer-Stey, J.D Leuppi
Multiple Drug Hypersensitivity
Werner J. Pichler, Yuttana Srinoulprasert, James Yun, Oliver Hausmann
Celiac Disease and Nonceliac Gluten Sensitivity. A Review
Maureen M. Leonard, MD, MMSc; Anna Sapone,MD, PhD; Carlo Catassi, MD, MPH; Alessio Fasano,MD
Incomplete and incorrect epinephrine auto-injector training to food-allergic patients by pharmacists in the Netherlands.
J. Saleh-Langenberg, S. de Vries, E. Bak, B. J. Kollen, B. M. J. Flokstra-de Blok & A. E. J. Dubois
Food protein-induced enterocolitis syndrome – a review of the literature with focus on clinical management
Michelet M, Schluckebier D, Petit LM, Caubet JC
Allergie auf Penicillin
Jörg L, Fricker M, Helbling A. Schweiz Med Forum 2017;17(10):236-240
Ballmer-Weber B, Helbling A . Schweiz Med Forum 2017;17(08):0
Gschwend A, Jörg L, Helbling A. Schweiz Med Forum 2017;17(08):0
The Risk of Recurrent Anaphylaxis
O'Keefe, Andrew et al. The Journal of Pediatrics , Volume 180 , 217 - 221
Timing of Allergenic Food Introduction to the Infant Diet and Risk of Allergic or Autoimmune Disease: A Systematic Review and Meta-analysis.
Ierodiakonou D., Garcia-Larsen V., Logan A., et al. JAMA.2016;316(11):1181-1192.
Ernährung im Säuglingsalter; eine Stellungnahme zur Primärprävention von Allergien
Roethlisberger et al. Paediatrica 2016;27:1
Gluten Introduction and the Risk of Coeliac Disease: A Position Paper by the European Society for Pediatric Gastonenterologiy, Hepatology, and Nutrition
Szajewska et al. J Pediatr Gastroenterol Nutr. 2016 Mar;62(3):507-13
The integrated care of asthma in Switzerland (INCAS)–study: Patients' perspective of received asthma care and their interest in asthma education
Selina Dürr, Kurt E. Hersberger, Andreas Zeller, Jonas Scheuzger, David Miedinger, Claudia Gregoriano, Jörg D. Leuppi, and Claudia Steurer-Stey. Journal of Asthma Vol. 53 , Iss. 9,2016
Évolution du profil de sensibilisation moléculaire avec l’âge / Component-resolved diagnosis according to age
Drug Hypersensitivity: How Drugs Stimulate T Cells via Pharmacological Interaction with Immune Receptors
Werner J. Pichler, Jacqueline Adam, Stephen Watkins, Natascha Wuillemin, James Yun, Daniel Yerly
Alternativmedizin und atopisches Ekzem. Wissenschaftliche Datenlage zu den einzelnen Methoden
Theiler M, Weibel L. DERMATOLOGIE PRAXIS 2015; Vol. 25, Nr. 6
Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention
Simpson, Eric L. et al. Journal of Allergy and Clinical Immunology , Volume 134 , Issue 4 , 818 - 823
Climate change, air pollution and extreme events leading to increasing prevalence of allergic respiratory diseases
D’Amato et al. Multidisciplinary Respiratory Medicine. 2013. 8 (12)
La découverte d’un nouvel allergène: le galactose-alpha-1,3-galactose
Bircher A, Scherer Hofmeier K, Michel S. Schweiz Med Forum 2013;13(0102):19-21
Predictors of incorrect inhalation technique in patients with asthma or COPD: a study using a validated videotaped scoring method.
Geert N. Rootmensen, Anton R.J. van Keimpema, Henk M. Jansen, and Rob J. de Haan. Journal of Aerosol Medicine and Pulmonary Drug Delivery. October 2010, 23(5): 323-328. doi:10.1089/jamp.2009.0785.
Aspects pratiques du diagnostic et de la prise en charge de l'anaphylaxie chez l'enfant.
Eigenmann et al. Paediatrica 2009;20:2
Recommandations pour la prise en charge de l’allergie aux venins d’hyménoptères chez l’enfant.
Wassenberg et al. Paediatrica 2006;17:3
aha! Swiss Allergy Centre in co-operation with the Scientific Advisory Board and aha! Experts.