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Atopic dermatitis (AD) is characterized by intense nocturnal pruritis, which can severely impact sleep continuity and quality. Sixty percent of children with AD experience sleep disturbance due to their condition, with 83% reporting disturbance during exacerbations. Sleep deprivation has been shown to alter immune function. In the case of school-aged children, it can impair linear growth, and in fact short stature has been described in children with AD only when associated with insufficient sleep. Fishbein et al review our current understanding of the role of sleep and circadian rhythms in nocturnal AD, current treatments, and future research directions ( J Allergy Clin Immunol 2015; 136: 1170-1177 ) . Despite the widespread prevalence of sleep dysfunction in children with AD, the mechanisms that lead to it are not well understood. Nighttime factors such as cortisol nadir, increased skin temperature, and poor barrier function may contribute to noctural AD exacerbations, as may circadia...

The CBM complex consists of three components: a capase recruitment domain (CARD) protein, B-cell lymphoma 10 (BCL10), and mucosa-associated lymphoid tissue lymphoma-translocation gene 1 (MALT1). For the first component, the complex uses one of three CARD family adaptors: CARD9, CARD10, or CARD11. These three proteins activate nuclear factor κB (NF- κB) in both innate and adaptive human immunity, and NF- κB plays a critical role in immune regulation, cell memory, cell survival/apoptosis, and cell-cycle progression. Much remains to be learned about the CBM complex, and inherited defects have been recently reported. Pérez de Diego et al discuss ( J Allergy Clin Immunol 2015; 136: 1139-1149 ). The authors summarize the reports on four patients with MALT1 deficiency, one patient with BCL10 deficiency, and two patients with autosomal recessive (AR) CARD11 deficiency. Most of these patients carried homozygous mutations with low levels of protein expression, and the broad range of clinical pre...

Atopic dermatitis (AD) is the most common inflammatory skin disease, with a large and currently unmet need for effective therapeutics. AD and psoriasis, another common skin disease, are recognized as polar inflammatory skin diseases. Psoriasis is emerging as an IL-23/T H 17-skewed disease, whereas AD is considered to be T H 2-centered. These distinctions are relevant to emerging therapies for each. To date, the characterization of AD in different patient populations has made the assumption that disease mechanisms are similar across them. Noda et al present evidence that this is not so ( J Allergy Clin Immunol 2015; 136: 1254-1264 ). The prevalence of AD among adults in Asia is 7% to 10%, which is considerably higher than in other populations. In addition, prominent T H 17 activation has been observed in blood and acute AD lesions of Asian AD patients. The high prevalence and increased IL-17 + T-cell expansion suggest that an Asian AD phenotype may have different immune and barrier cha...

Primary Immunodeficiency Diseases (PIDD) are inherited disorders of immune function that result in an increased rate and severity of infection, immune dysregulation, autoimmune disease, abnormal inflammatory responses, and malignancy. More than 300 disorders have been identified to date; they occur in as many as 1:2000 live births. Approximately half of those diagnosed with a PIDD have an antibody deficiency. The principal clinical manifestation of immunodeficiency is an increased susceptibility to infection. In its evaluation, it is critical to the extent possible to document the foci of infections, the organisms, and the response to treatment. This distinguishes specific infectious agents and may help determine other conditions such as non-infectious inflammation. It is important to note that allergy to environmental allergens, food, or both can be an important element of and diagnostic clue for many PIDDs. Under the aegis of the American Academy of Allergy, Asthma & Immunology (...