clair088

Allergic diseases are increasingly common, and it is estimated that up to 20% of the US population experiences atopic dermatitis, food allergy, asthma, allergic rhinitis, or conjunctivitis. The decrease in infectious diseases in developed countries has been associated with the risk for allergies, leading to the hygiene hypothesis for the rise of allergic disease. In order to inform World Allergy Organization guidelines, Cuello et al have examined the available data on the use of probiotics for the prevention of allergy ( J Allergy Clin Immunol 2015; 136(4):952-961 ). The composition of the gastrointestinal microbiota promotes potentially antiallergenic processes: T H 1-type immunity; generation of transforming growth factor (TGF), which has an essential role in suppressing T H 2-induced allergic inflammation and induction of oral tolerance; and IgA production, an essential component of mucosal immune defense. Alterations in these microbiota, the early and most massive source of microbi...

While pediatric atopic dermatitis (AD) is a common disorder among children, our current understanding of its mechanisms derives largely from studies of adults with long-standing disease. Defining the similarities and differences between activated polarized T-cells in adults and in children with early-onset AD is critical for understanding initial events in disease causation. Further, a better understanding of newly diagnosed disease could help clarify the sequence of events that leads to AD development. Czarnowicki et al compare differences between T-cell memory subset activation within the skin homing and non-skin homing systemic compartments, as well as frequencies of polarized T cell subsets in blood of pediatric and adult patients with AD ( J Allergy Clin Immunol 2015; 136(4):941-951 ). Specifically, they study children with AD, children of the same age without AD, and adults with AD of similar severity. The authors find that T H 2 activation, known to induce allergy, within skin-h...

Despite advances in care, asthma presents a significant burden on the pediatric population. The age of asthma diagnosis decreased from 4.7 years in 1993 to 2.6 year in 2000. Among children given a diagnosis before the age of 3 years, 35.6% to 45.2% continue to require care for the disease at age 6, and most of them already have lung function abnormalities. Early-onset asthma has long-lasting effects that continue into adolescence and adulthood, and severe childhood asthma is a risk factor for continued active disease as an adult. To date, no therapy has been able to prevent the development of pediatric asthma, and efforts continue to focus on achieving asthma control. Anderson and Szefler review the current and future approaches ( J Allergy Clin Immunol 2015; 136(4): 848-859 ). Adherence to controller therapies is essential to achieving disease control. Pediatric adherence specifically to inhaled corticosteroids (ICSs) has been reported to fall in the range of 20% to 33.9%, with only 4...