clair088

The initiation and perpetuation of chronic rhinosinusitis (CRS) is known to be associated with host-microbial interactions.   Many studies have investigated these interactions with CRS in order to understand the mechanisms of the disease and provide better treatment options.   Dr. Hamilos summarizes the knowledge of host-microbial interactions in regards to normal sinus physiology and pathology, patients with CRS with and without polyps, and allergic fungal rhinosinusitis (AFRS) ( J Allergy Clin Immunol 2014; 133(3): 640-653 ).   Much of the research on the subject of CRS has been on bacterial infection and potential defects in innate immunity that might predispose patients to sinus infections.   Of CRS patients undergoing surgical intervention, more than 50% have bacterial biofilm in their diseased sinus tissues.     Biofilm is an important survival mechanism of bacteria allowing for attachment to surfaces.   The biofilm has been described to have an ...

About 50% of asthmatics that are genetically screened have T helper type 2 (Th2)-driven inflammation that is characterized by improved symptoms with inhaled corticosteroid response, higher IgE levels, and higher peripheral blood eosinophils.   While this genetic profiling is highly valuable by elucidating the pathogenesis of asthma and tailoring individual treatment regimens, bronchial airway epithelium brushings are invasive which limits its application to childhood asthma research.   This realization led Poole et al to determine if less invasive nasal airway epithelium brushings can proxy expression changes seen in the bronchial airway transcriptome in children with asthma ( J Allergy Clin Immunol 2014, 133(3): 670-678 ) .  In a cohort of Puerto Rican children, the authors used whole transcriptome RNA sequencing (RNA-seq) on nasal airway brushings from 10 controls and 10 subjects with asthma and targeted RNA-seq on 50 asthmatics and 50 controls to profile 105 genes. Th...

The mechanisms contributing to clinical immune tolerance are largely unknown. The objective of Syed et al was to study the changes associated with clinical immune tolerance in antigen induced T cells, basophils, and antibodies in subjects undergoing oral immunotherapy (OIT) for peanut allergy ( J Allergy Clin Immunol 2014; 133(2): 500-510 ). The induction of regulatory T (Treg) cells has been a potential mechanism of maintaining immune tolerance, with Treg deficiencies implicated in the development of allergies.  Fork head box protein 3 (Foxp3) is a transcription factor that regulates Tregs, including natural regulatory Tregs (nTregs) and induced regulatory Tregs (iTregs). Epigenetic modifications to regions within the Foxp3 locus have been associated with stable Foxp3 expression and Treg cell-suppressive function.   The authors investigated whether antigen-induced Tregs (aiTregs) and humoral and basophil immune markers are induced by OIT in clinically immune tolerant (IT...

The prevalence of food allergy is on the rise with up to 10% of the population afflicted, though remarkable advances have occurred in understanding and managing food allergies.  In their review article, Sicherer and Sampson focus on advances and updates in epidemiology, pathogenesis, diagnosis and treatment of food allergy ( J Allergy Clin Immunol 2014; 133(2): 291-307 ).  They explain that numerous genetic and environmental risk factors have been identified, with rectifiable risk factors such as vitamin D insufficiency, excess dietary fat, obesity, increased hygiene and timing of exposure to foods as being potential targets to address in prevention for the future.  Interesting clinical insights on route of sensitization, allergen characterization and immune response provide guidance for diagnosis and treatment. Allergen avoidance and emergency treatment remain the current management option for patients, although numerous clinical trials are underway for more definitive t...

Food allergy is a growing public health concern due to its increasing prevalence and life threatening potential.  Mouse models of food allergy have become useful tools for identifying the mechanisms involved in the sensitization of food allergens which are normally harmless as well as delineating the critical immune components of the effector phase of allergic reactions to food. In their review, Oyoshi et al have summarized the importance of animal models in food allergy research contrary to concerns regarding the relevance murine models have in understanding human disease ( J Allergy Clin Immunol 2014; 133(2): 309-317 ).  Mouse models have been exceedingly useful in the study of atopic dermatitis (AD) and asthma, paving the way for food allergy research.  For example, allergic sensitization or tolerance can be induced to specific allergens under controlled environmental conditions within defined genetic backgrounds that cannot be matched in human studies. The importance ...

Mechanisms such as social, behavioral, and environmental factors during pregnancy that may affect the risk of childhood asthma have been studied, but only few studies have assessed the relationship between maternal psychological distress and childhood wheezing.  Guxens et al performed a population-based study among children from birth to 6 years of age while assessing maternal and paternal psychological distress during pregnancy ( J Allergy Clin Immunol 2014; 133(1): 59-67 ) .  This large study of 4,848 children was embedded within the Generation R study, a population-based prospective cohort from fetal life onwards in Rotterdam, The Netherlands.  Maternal and paternal distress data was collected at 20 weeks gestation and again at 2 and 6 months, and 3 years after delivery by using the Brief Symptom Inventory questionnaire. Wheezing was annually assessed in the children up to 4 years of age. Physician diagnosed ever asthma was reported by parents at age 6 years.  The...

It is well known that frequencies and severity of disease can differ among races.  The mixing of African, European, and Native American ancestries has resulted in a variety of different ethnic groups with varied diversity. There is robust evidence from various clinical trials that different ethnic groups have variable responses to specific therapeutic agents.  The study of pharmacogenetics is used to personalize therapies specific to individuals from different ethnic or racial groups and it has historically been composed of mostly non-Hispanic whites of European descent.  Ortega and Meyers summarize the genetic and epidemiologic basis for the variable genetic backgrounds observed between different, recently admixed ethnic groups such as African American or Hispanic ( J Allergy Clin Immunol 2014; 133(1): 16-26 ). Rare genetic variants appear to be more frequent among individuals of African ancestry and could account for inter-ethnic differences in drug responses especially...