Novel Therapeutic Approaches and Targets for Treatment of Chronic Urticaria: New Insights and Promising Targets for a Challenging Disease

2020 ◽  
Vol 22 (1) ◽  
pp. 32-45
Author(s):  
Emanuela Martina ◽  
Federico Diotallevi ◽  
Tommaso Bianchelli ◽  
Matteo Paolinelli ◽  
Annamaria Offidani
Keyword(s):  
English Language ◽  
Life Experience ◽  
Case Reports ◽  
Immunosuppressive Agents ◽  
Real Life ◽  
Chronic Spontaneous Urticaria ◽  
New Targets ◽  
Current State ◽  
Pubmed Database ◽  
Novel Drugs

Background: Chronic Spontaneous Urticaria (CSU) is a disease characterized by the onset of wheals and/or angioedema over 6 weeks. The pathophysiology for CSU is very complex, involving mast cells and basophils with a multitude of inflammatory mediators. For many years the treatment of CSU has been based on the use of antihistamines, steroids and immunosuppressive agents with inconstant and frustrating results. The introduction of omalizumab, the only licensed biologic for antihistamine- refractory CSU, has changed the management of the disease. Objective: The aim of this article is to review the current state of the art of CSU, the real-life experience with omalizumab and the promising drugs that are under development. Methods:: An electronic search was performed to identify studies, case reports, guidelines and reviews focused on the new targets for the treatment of chronic spontaneous urticaria, both approved or under investigation. The search was limited to articles published in peer-reviewed journals in the English Language in the PubMed database and trials registered in Clinicaltrials.gov. Results:: Since the advent of omalizumab, the search for new therapies for chronic spontaneous urticaria has had a new impulse. Anti-IgE drugs will probably still be the cornerstone of therapy, but new targets may prove effective in syndromic urticaria or refractory cases. Conclusion:: Although omalizumab has been a breakthrough in the treatment of CSU, many patients do not completely get benefit and even require more effective treatments. Novel drugs are under investigation with promising results.

Over-the-Counter Medications in Cardiac Transplant Recipients: Guidelines for Use

1992 ◽  
Vol 26 (12) ◽  
pp. 1566-1575 ◽  
Author(s):  
Kathleen D. Lake ◽  
Jacqueline G. Nolen ◽  
Ralph A. Slaker ◽  
Thomas J. Reutzel ◽  
Sherry K. Milfred ◽  
...  
Keyword(s):  
Transplant Recipient ◽  
English Language ◽  
Case Reports ◽  
Data Extraction ◽  
Immunosuppressive Agents ◽  
Cardiac Transplant ◽  
Transplant Recipients ◽  
Over The Counter ◽  
English Language Journal ◽  
Cardiac Transplant Recipient

OBJECTIVE: The purpose of this article is to review the pathophysiology of the denervated heart and the factors that need to be considered before recommending the use of over-the-counter (OTC) medications in the cardiac transplant recipient. DATA SOURCES: Pharmacology and therapeutic textbooks, English-language journal articles, and physiology textbooks published between 1969 and 1991. DATA EXTRACTION: Case reports, controlled case studies, and textbook chapters evaluating drug interactions with immunosuppressive agents were reviewed. The effects of various OTC medications on the denervated heart were examined and relevant material was extrapolated. DATA ANALYSIS: The number of cases or studies in which a particular effect or interaction occurred was reported. Those findings that were less well documented were either identified as such or were not included in the review. DATA SYNTHESIS: Common pharmacokinetic and pharmacodynamic interactions with the primary immunosuppressive agents (e.g., cyclosporine, azathioprine, prednisone) are reviewed. The physiology and altered responses of the denervated heart to various medications are also explained. Using this information, recommendations are given for the use and monitoring of OTC analgesics, antacids, laxatives, sleep aids, stimulants, and other medications that may be used in the cardiac transplant recipient. CONCLUSIONS: Many OTC medications can be used safely in the cardiac transplant recipient. In each situation, risk/benefit assessments must always be made and therapy should be monitored closely. Most important, patients should always notify the transplant team before adding an OTC product to their immunosuppressive regimen.

Long-term omalizumab therapy for refractory chronic spontaneous urticaria: a real-life experience

2015 ◽  
Vol 115 (6) ◽  
pp. 536 ◽  
Author(s):  
Luis Felipe Ensina ◽  
Alex Eustáquio de Lacerda ◽  
Ligia Maria de Oliveira Machado ◽  
Inês Camelo-Nunes ◽  
Dirceu Solé
Keyword(s):  
Life Experience ◽  
Real Life ◽  
Chronic Spontaneous Urticaria

Omalizumab in elderly patients with chronic spontaneous urticaria: An Italian real-life experience

2018 ◽  
Vol 120 (3) ◽  
pp. 318-323 ◽  
Author(s):  
Eustachio Nettis ◽  
Luca Cegolon ◽  
Elisabetta Di Leo ◽  
Walter Giorgio Canonica ◽  
Aikaterini Detoraki ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Life Experience ◽  
Real Life ◽  
Chronic Spontaneous Urticaria

scholarly journals The efficacy and safety of omalizumab in refractory chronic spontaneous urticaria: real-life experience in Turkey

2018 ◽  
Vol 27 (3) ◽  
Author(s):  
Isil Bulur ◽  
Emel Bulbul Baskan ◽  
Mustafa Ozdemir ◽  
Ali Balevi ◽  
Emek Kocatürk Göncü ◽  
...  
Keyword(s):  
Life Experience ◽  
Real Life ◽  
Chronic Spontaneous Urticaria ◽  
Efficacy And Safety

scholarly journals Pituitary Involvement in Granulomatosis with Polyangiitis: A Retrospective Analysis in a Single Chinese Hospital and a Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Shixuan Liu ◽  
Yan Xu ◽  
Naishi Li ◽  
Shi Chen ◽  
Shangzhu Zhang ◽  
...  
Keyword(s):  
Literature Review ◽  
Diabetes Insipidus ◽  
Granulomatosis With Polyangiitis ◽  
Case Reports ◽  
Systemic Disease ◽  
Immunosuppressive Agents ◽  
Case Series ◽  
Record System ◽  
Radiographic Findings ◽  
Pubmed Database

Purpose. Granulomatosis with polyangiitis (GPA) is an anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis that can involve virtually many organs, including the pituitary. Pituitary involvement in GPA is rare, with only case reports or small case series published previously. Methods. We used the electronic medical record system in our hospital to identify four patients of pituitary involvement in GPA. We summarized the clinical characteristics, radiographic findings, treatments, and clinical outcomes of the four patients. We further performed a systematic literature review of 66 GPA cases with pituitary involvement that were published on the PubMed database. Results. The four women in our report were between 57 and 73 years of age. All patients had pituitary abnormalities on radiology; three developed diabetes insipidus (DI). All patients had multisystem involvement. After treatment with glucocorticoids and cyclophosphamide (CYC), all patients showed clinical improvement but pituitary function did not resume. Literature review identified 66 additional patients with pituitary involvement in GPA; diabetes insipidus (57/66, 86.4%) and hypogonadism (34/66, 51.5%) were the most frequent pituitary disorders, and the most frequent imaging lesion was an enlarged pituitary (25/64, 39.1%). After treatment with corticosteroids and/or immunosuppressive agents, most patients (45/66, 68.2%) developed remission from systemic disease, 13 patients (13/57, 22.8%) showed remission of DI, and 8 patients (8/46, 17.4%) showed remission of hormone deficiencies. Conclusions. GPA should be carefully considered as a potential cause of pituitary dysfunction (PD), especially when multisystem dysfunction exists. Conventional treatment with corticosteroids and/or immunosuppressive agents improves systemic symptoms, but pituitary disorders persisted in most patients.

scholarly journals Omalizumab in Chronic Spontaneous Urticaria: A Brazilian Real-Life Experience

2016 ◽  
Vol 169 (2) ◽  
pp. 121-124 ◽  
Author(s):  
Luis Felipe Ensina ◽  
Solange Oliveira Rodrigues Valle ◽  
Ana Paula Juliani ◽  
Michel Galeane ◽  
Rosaly Vieira dos Santos ◽  
...  
Keyword(s):  
Life Experience ◽  
Real Life ◽  
Chronic Spontaneous Urticaria

scholarly journals Fish Bone Foreign Body: The Role of Imaging

2018 ◽  
Vol 23 (01) ◽  
pp. 110-115 ◽  
Author(s):  
Ayala Klein ◽  
Sharon Ovnat-Tamir ◽  
Tal Marom ◽  
Ofer Gluck ◽  
Naomi Rabinovics ◽  
...  
Keyword(s):  
Foreign Body ◽  
English Language ◽  
Case Reports ◽  
Fish Bone ◽  
Upper Aerodigestive Tract ◽  
Imaging Studies ◽  
Medical Subject Headings ◽  
Mesh Terms ◽  
Pubmed Database ◽  
Rigid Esophagoscopy

Introduction Fish bone foreign body (FFB) impaction in the upper aerodigestive tract is a common cause for emergency department referral. Its management varies in both diagnosis and treatment paradigms. Fish bone foreign bodies are more commonly found in the oropharynx in cases of patients < 40 years old, and in the esophagus in cases of patients > 40 years old. Symptoms are typically non-indicative for the location of the FFB, with the exception of foreign body sensation at/superior to the cervical esophagus. A lack of findings during the physical examination is routinely followed by imaging, with computed tomography (CT) being the preferred modality. In practice, many patients undergo unnecessary imaging studies, including CT scans. Objectives To identify patients with suspected fish bone impaction who do not require CT imaging and can be safely discharged. Data Synthesis We have searched the PubMed database for the following medical subject headings (MeSH) terms: fish bone, fish foreign body AND oropharynx, hypopharynx, esophagus, flexible esophagoscopy, and rigid esophagoscopy. Our search in the English language yielded 32 papers. Case reports were included, since they highlighted rare and serious complications. Conclusion In patients > 40 years old suspected of fish bone impaction, non-contrast CT is recommended and should be urgently performed, even in the presence of ambiguous symptoms. However, in patients < 40 years old presenting within 24 hours from ingestion, imaging has little diagnostic value due to the low probability of esophageal fish bones. For this specific subgroup, in the absence of clinical findings, discharge without imaging studies may be considered safe.

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