scholarly journals Immunological resilience and biodiversity for prevention

2021 ◽  
Author(s):  
Tari Haahtela ◽  
Harrri Alenius ◽  
Jenni Lehtimäki ◽  
Aki Sinkkonen ◽  
Nanna Fyhrquist ◽  
...  
Keyword(s):  
Protective Factors ◽  
Calcineurin Inhibitors ◽  
Allergic Diseases ◽  
Oral Immunotherapy ◽  
Allergy Prevention ◽  
Low Grade ◽  
Public Health Programme ◽  
First Results ◽  
Underlying Causes ◽  
Micro Organisms

Increase of allergic conditions has occurred at the same pace with the Great Accleration, 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 biologic 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 fastly urbanizing world, new approaches are called for allergy prevention, which also has a major cost saving potential.

scholarly journals Addressing Common Misconceptions in Food Allergy: A Review

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 497
Author(s):  
Aikaterini Anagnostou
Keyword(s):  
Food Allergy ◽  
The United States ◽  
Specific Ige ◽  
Oral Immunotherapy ◽  
Food Allergies ◽  
Allergy Prevention ◽  
Diagnosis And Management ◽  
Skin Prick Tests ◽  
Food Specific Ige ◽  
Common Misconceptions

Background: Food allergies are common, affecting 1 in 13 school children in the United States and their prevalence is increasing. Many misconceptions exist with regards to food allergy prevention, diagnosis and management. Objective: The main objective of this review is to address misconceptions with regards to food allergies and discuss the optimal, evidence-based approach for patients who carry this diagnosis. Observations: Common misconceptions in terms of food allergy prevention include beliefs that breastfeeding and delayed introduction of allergenic foods prevent the development of food allergies. In terms of diagnosis, statements such as ‘larger skin prick tests or/and higher levels of food-specific IgE can predict the severity of food-induced allergic reactions’, or ‘Tryptase is always elevated in food-induced anaphylaxis’ are inaccurate. Additionally, egg allergy is not a contraindication for receiving the influenza vaccine, food-allergy related fatalities are rare and peanut oral immunotherapy, despite reported benefits, is not a cure for food allergies. Finally, not all infants with eczema will develop food allergies and epinephrine auto-injectors may unfortunately be both unavailable and underused in food-triggered anaphylaxis. Conclusions and relevance: Healthcare professionals must be familiar with recent evidence in the food allergy field and avoid common misunderstandings that may negatively affect prevention, diagnosis and management of this chronic disease.

Anti CMV and/or Anti Adenovirus IFN-g-Positive CD4+ CD8+ T Lymphocytes for Treatment of Viral Infections After Allogeneic HSC Transplantation: First Results

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1906-1906
Author(s):  
Liliane Dal Cortivo ◽  
RITA Creidy ◽  
Aurélie Gabrion ◽  
Marianne Leruez-Ville ◽  
Sebastien Heritier ◽  
...  
Keyword(s):  
T Cells ◽  
Viral Load ◽  
T Lymphocytes ◽  
Viral Infections ◽  
Clinical Symptoms ◽  
Antiviral Treatment ◽  
Specific Cell ◽  
Low Grade ◽  
First Results

Abstract Abstract 1906 Reactivation of latent viruses such as cytomegalovirus (CMV) and adenovirus (AdV) is responsible for infections which may be life-threatening in HSCT recipients. In the post-transplantation period, severity and frequency of these infections depend on (a) the degree of donor-recipient HLA incompatibility and (b) the intensity of immunosuppressive therapy used to prevent immunological complications. Antiviral drugs may be partially effective, often toxic and cannot always control those viral infections.T cell immunity plays a major role in the control of viral infections. It has been demonstrated that the transfer of donor T lymphocytes specifically directed against viral antigens is capable of preventing, controlling and clearing viral infection (Feuchtinger T et al., 2004 and 2010). The present project aimed the evaluation of specific, cell-based immunity against CMV and AdV by injection of IFN-g-positive CD4+and CD8+ donor T lymphocytes isolated ex vivo after stimulation with viral peptides. Methods: Our protocol was designed for pediatric or adult patients treated by allogeneic HSCT and matching the following inclusion criteria: (1) biological and/or clinical symptoms of CMV and/or AdV infection 2) no response or contraindication to conventional antiviral treatment and (3) no or low grade pre-existing aGvHD at inclusion (≤ grade II) controlled by corticoids (<1 mg/kg). Antiviral treatments are allowed during the inclusion period. Donor IFN-g-positive T lymphocytes are isolated with the CliniMACS Cytokine Capture System (Miltenyi Biotech) after incubation with viral peptide pools. Primary evaluation criterion is the efficacy of the treatment on CMV viral load 21 days after the first injection. In the event of a negative or partial response and the absence of aGvHD, a second injection may be scheduled. Secondary evaluation criteria are (1) the occurrence of de novo aGvHD or aggravation of existing aGvHD, (2) the evolution of clinical symptoms potentially related to the infection, (3) the demonstration of biological in vivo expansion of injected T lymphocytes (as evidenced by the IFN-g secretion capacity and specific tetramer assays) and (4) for AdV infection, evaluation of efficacy (viral load, in vivo expansion of transfused lymphocytes, clinical symptoms) and the safety (occurrence of aGvHD) of this immunotherapy. Results: From September 2010 to July 2012, 9 patients were included: 3 male adults (46–54 years, 1 CLL, 1 CML and 1 AA, 2 geno- and 1 pheno-identical transplantation) and 6 children (age: 7–25 months, sex ratio F/M: 4/2, 4 FLH, 1 SCID and 1AA, 4 haplo, 1 geno- and 1 pheno-id transplantation). 4/9 patients were treated for CMV, 3/9 for AdV and 2/9 for CMV and AdV reactivation. 5/9 patients received 2 cytotoxic T lymphocytes (CTL) injections. Mean number of CD3 IFN-g positive cells injected was 4206/kg (1167–6000/kg) with 55% and 69% of CD4 and CD8 anti CMV-T cells and 56% and 61% of CD4 and CD8 anti AdV T cells respectively. Mean delay of first immunotherapy was 109 days (28–270) after transplantation. 2/9 patients were not evaluable due to early death (<21 days post injection) and 1/9 patient died of graft failure 43 days after CTL injection without efficacy on infectious evolution. 6 patients are still alive: 4 with complete, 1 with partial remission of virus replication and 1 recently included, is still under evaluation. An in vivo expansion of transfused CTL was observed (mean expansion was 33 and 35 fold for CD8-IFN-g and CD4-IFN-g positive cells respectively 42 days after injection) in parallel with the decrease of viral load in all alive patients. No aGvHD was detected in the 5/6 evaluated patients. One of 6 presenting cGvH at inclusion need increase of corticotherapy 3 months after second injection of CTL One patient presenting with CMV retinitis received 2 CTL injections without worsening of retina lesions which healed. Conclusion: The CliniMACS Cytokine Capture System allows the isolation of virus-specific T cells in a brief delay (24 hours) with a satisfactory enrichment of both CD4 and CD8 T cells. First results show efficacy of virus-specific T cells injection on viral load without signs of aGvHD in 5/6 evaluable patients. More patients need to be included in this trial in order to confirm these encouraging results. Disclosures: Cambouris: Miltenyi Biotec: Employment.

scholarly journals The main whys and wherefores of childlessness in Spain

2019 ◽  
pp. 1-4
Author(s):  
Albert Esteve ◽  
Rocío Treviño
Keyword(s):  
Life Cycle ◽  
Life Expectancy ◽  
Low Fertility ◽  
Fertility Survey ◽  
Natural Growth ◽  
Fertility Rates ◽  
National Statistics ◽  
The World ◽  
First Results ◽  
Underlying Causes

The Spanish National Statistics Institute (INE) has just published the microdata of the 2018 Fertility Survey. In a country that sets demographic records its publication has filled a void of more than two decades since the last survey was carried out in 1999. The figures for life expectancy in Spain are among of the highest in the world and those for fertility are among the lowest. The convergence of these two trends directly influences the structure of the population, curtailing its natural growth and increasing its average age. In such a situation, any attempt to restore fertility requires a sound diagnosis of the underlying causes. In this number of Perspectives Demogràfiques, we present the first results of the Fertility Survey and explore the causes of the low fertility rates, paying particular attention to women who have not had children (childlessness). The results show that more than half the women who are not mothers wished to have children and that there are several reasons, which vary over the life cycle, that have made this impossible.

scholarly journals Orally desensitized mast cells form a regulatory network with Treg cells for the control of food allergy

2020 ◽  
Author(s):  
Yoshihiro Takasato ◽  
Yosuke Kurashima ◽  
Masahiro Kiuchi ◽  
Kiyoshi Hirahara ◽  
Sayuri Murasaki ◽  
...  
Keyword(s):  
Food Allergy ◽  
T Cell ◽  
Mast Cells ◽  
Regulatory T Cell ◽  
Regulatory Network ◽  
Allergic Diseases ◽  
Treg Cells ◽  
Oral Immunotherapy ◽  
Cellular Mechanisms ◽  
Novel Strategy

AbstractOral immunotherapy (OIT) is an effective approach to controlling food allergy. Although the detailed molecular and cellular mechanisms of OIT are unknown currently, they must be understood to advance the treatment of allergic diseases in general. To elucidate the mechanisms of OIT, especially during the immunological transition from desensitization to allergy regulation, we generated a clinical OIT murine model and used it to examine immunological events of OIT. We found that in mice that completed OIT successfully, desensitized mast cells (MCs) showed functionally beneficial alterations, such as increased induction of regulatory cytokines and enhanced expansion of regulatory T cells. Importantly, these regulatory-T-cell-mediated inhibitions of allergic responses were dramatically decreased in mice lacking OIT-induced desensitized MC. Collectively, these findings show that the desensitization process modulates the activation of MCs, leading directly to enhanced induction of regulatory-T-cell expansion and promotion of clinical allergic unresponsiveness. Our results suggest that efficiently inducing regulatory MCs is a novel strategy for the treatment of allergic disease.

scholarly journals Oral tolerance as antigen-specific immunotherapy

2021 ◽  
Author(s):  
Natália Pinheiro-Rosa ◽  
Lícia Torres ◽  
Mariana de Almeida Oliveira ◽  
Marcos Felipe Andrade de Oliveira ◽  
Mauro Andrade de Freitas Guimaraes ◽  
...  
Keyword(s):  
Oral Tolerance ◽  
Inflammatory Diseases ◽  
Tolerance Induction ◽  
Allergic Diseases ◽  
Oral Route ◽  
Oral Immunotherapy ◽  
The Body ◽  
Factors Affecting ◽  
Oral Tolerance Induction ◽  
And Control

Abstract Oral tolerance is a physiological phenomenon described more than a century ago as a suppressive immune response to antigens that gain access to the body by the oral route. It is a robust and long-lasting event with local and systemic effects in which the generation of mucosally-induced regulatory T cells (iTreg) play an essential role. The idea of using oral tolerance to inhibit autoimmune and allergic diseases by oral administration of target antigens was an important development that was successfully tested in 1980’s. Since then, several studies have shown that feeding specific antigens can be used to prevent and control chronic inflammatory diseases in both animal models and clinically. Therefore, oral tolerance can be classified as an antigen-specific form of oral immunotherapy (OIT). In the light of novel findings on mechanisms, sites of induction and factors affecting oral tolerance, this review will focus on specific characteristics of oral tolerance induction and how they impact in its therapeutic application.

scholarly journals External therapy of allergic dermatoses in children (literature review)

2020 ◽  
pp. 41-47
Author(s):  
O.M. Mochulska ◽  
Keyword(s):  
Clinical Course ◽  
Life Quality ◽  
Allergic Inflammation ◽  
Local Therapy ◽  
Calcineurin Inhibitors ◽  
Allergic Diseases ◽  
Skin Lesions ◽  
Stevens Johnson Syndrome ◽  
Topical Calcineurin Inhibitors ◽  
Allergic Skin

Allergic dermatoses have a special place in the structure of allergic diseases in children due to their weight. The most common allergic skin lesions: simple and allergic contact dermatitis, atopic dermatitis, various forms of eczema, acute and chronic allergic urticaria, Quincke's edema, multiforme exudative erythema (Stevens—Johnson syndrome), acute epidermal necrolysis (Lyell's syndrome), toxicodermias, as well as less common dermatoses, in the pathogenesis of which are leading allergic reactions. Despite a number of research research, the difficulties in the determining of the therapeutic approach of allergic dermatoses in children are still observed. According to the international program documents EAACI (European Academy of Allergy and Clinical Immunology), AAAAI (American Academy of Allergy, Asthma & Immunology), PRACТALL (Practical Allergology Consensus Report) in treatment of allergic dermatoses the leading place takes external therapy, which requires an individual approach and daily care of skin. External therapy consists of local application of emollients, topical glucocorticosteroids, topical calcineurin inhibitors, topical antihistamines, keratolytic, keratoplastic, reparants, epithelializing and anti-inflammatory medications, in the case of complicated clinical course of the disease — antibacterial, antifungal, antiviral medications, also with skin care. Purpose — to increase information on modern possibilities of external therapy of allergic dermatoses in children. External pharmacotherapy of allergic dermatoses should be etiopathogenetic and should affect on the mechanisms of allergic inflammation in the skin, elimination of itching, dryness,so finding ways to improve it will help to control the clinical course of the disease, to reduce disability, will promote to improve the life quality in patients. No conflict of interest was declared by the author. Key words: children, allergy, allergic dermatoses, external therapy, local therapy.

scholarly journals The Effect of An Educational Program for Pregnant Women to Prevent Allergic Diseases In Infants: study protocol for a randomized controlled trial

2019 ◽  
Author(s):  
Rie Ito ◽  
Yoko Nezu ◽  
Nao Ishiguro ◽  
Masato Nakade ◽  
Yukiko Ishitsuka ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Educational Program ◽  
Controlled Trial ◽  
Allergic Diseases ◽  
Developed Countries ◽  
Primary Objective ◽  
Allergy Prevention ◽  
Prenatal Education ◽  
Pediatric Allergy ◽  
Randomized Controlled

Abstract Background Allergic diseases in infants have dramatically increased in developed countries during the past few decades. To date, extensive research has been done on risk factors for allergies in infancy, and preventive measures against it. However, the effect of the primary approach to preventing infants' allergy still remains limited. The aim of this trial is to evaluate whether prenatal education interventions, including the latest public research results on allergic diseases, prevent the infant allergies onset. Methods/Design We designed a randomized, controlled, two-arm (standard prenatal education vs our education), parallel-group, assessor-blind, trial. A sample of 120 pregnant women will be recruited at Chiba Aiyukai Kinen hospital and allocation is by computer-generated randomization. Pregnant women in the intervention arm participate in the childbirth education program established by the specialist and a pediatric allergy educator. The program was developed based on evidences supporting interventions on primary prevention, which are suggested to be beneficial to infant’s allergies in recent studies. The primary objective of the study is to determine whether it is possible to establish effective behaviors for allergy prevention during early infancy in pregnant women who participate in an educational program developed by pediatric allergy specialists. Four months after birth, their behaviors will be compared against those of pregnant women who did not participate in the program. Discussion Allergies are common in many individuals worldwide, and can be present from babyhood through the person’s lifetime. One of the strong points of this study is that it will provide pregnant women with accumulated information on preventive knowledge against allergy that can be effective in some cases, and women can apply a combination of these behavior before and after pregnancy. The results of our program will be publicized to help change the behaviors of mothers, and if the program is effective for preventing allergies in infants, it will be disclosed worldwide as a new preventive measure for allergy in infants.

scholarly journals Air pollutants and primary allergy prevention

2018 ◽  
Vol 28 (1) ◽  
pp. 5-15 ◽  
Author(s):  
Joachim Heinrich
Keyword(s):  
Allergic Rhinitis ◽  
Primary Prevention ◽  
Systematic Reviews ◽  
Air Pollutants ◽  
Allergic Sensitization ◽  
Allergic Diseases ◽  
Causal Role ◽  
Sufficient Evidence ◽  
Allergy Prevention ◽  
Extensive Literature

Abstract Background Air pollutants such as particulate matter (PM2.5) and nitrogen dioxide (NO2) in outdoor air have long been suspected of causing the development of asthma and allergic rhinitis. However, a variety of systematic reviews have reached different conclusions in the last 15 years on whether these air pollutants do in actual fact play a causal role in the onset of asthma, allergic rhinitis, and eczema. Methods Based on published systematic reviews and the most recent publications, the current state of knowledge on epidemiological evidence is presented and the potential for primary prevention of these allergic diseases by reducing or avoiding exposure to these air pollutants evaluated. Results Despite conducting an extensive literature search, analyzing the most recent results, and focusing on the birth cohort studies most relevant to the question in hand, epidemiological results do not adequately support the concept of a causal relationship between the two air pollutants in question, PM2.5 and NO2, and asthma. Epidemiological studies predominantly show no effect of these air pollutants on allergic sensitization and the onset of allergic rhinitis. The small number of studies that have investigated the link between air pollutants and eczema largely revealed there to be no link. Conclusion If the evidence for the causal role of air pollutants in the onset of allergies is inconclusive, one must assume that it is probably not possible to achieve primary prevention of allergies by improving air quality. However, there is sufficient evidence to show that air pollutants can trigger exacerbations of allergic diseases. This alone justifies ensuring that the existing threshold values for air pollutants are adhered to, in order to protect particularly allergy sufferers from health impairments.

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