clair088

While the prevalence of asthma and allergic diseases continues to rise, the consumption of dietary antioxidants is decreasing around the world.  The western diet is becoming more popular around the world even though it is characterized by a reduction of fresh fruits and vegetables with an increase of processed foods and antioxidant enriched foods. As pulmonary and systemic oxidative stress increase allergic inflammation, dietary or supplemental antioxidants have been proposed to counteract the incidence and morbidity of allergic disease.  Moreno-Macias and Romieu summarize various studies associated with the effects of antioxidants on asthma and allergic diseases ( J Allergy Clin Immunol 2014; 133(5): 1237-44 ). Meta-analyses of epidemiologic studies of variable quality suggest associations of low dietary intake of antioxidants and increased asthma and allergy. Compared to asthma, few trials have looked at associations between diet and atopic dermatitis, allergic rhinitis, or ...

The relationship between maternal diet and childhood allergy and asthma is controversial.  Not long ago, the American Academy of Pediatrics advised that maternal dietary restrictions are not necessary with the possible exception of excluding peanuts.  Subsequent systematic reviews concluded that the evidence was inadequate to support any dietary restrictions during pregnancy. In fact, recent research suggests that fetal exposure to common food allergens may be beneficial. Bunyavanich et al examined the associations between maternal intake of common childhood food allergens during pregnancy and childhood asthma and allergies ( J Allergy Clin Immunol 2014; 133(5): 1373-1382 ).   The authors studied a healthy pre-birth cohort of 1277 mother-child pairs from the United States and used food frequency questionnaires administered during pregnancy. Children were assessed for food allergy, asthma, allergic rhinitis, and atopic dermatitis by questionnaire and serum specific IgE lev...

Along with all allergic diseases, the prevalence of food allergies has increased markedly in recent decades in industrialized nations. An estimated 5% of children and up to 4% of adults are living with food allergy and the fear of having a life threatening allergic reaction. Incidentally, atopic dermatitis (AD) is a known risk factor for developing food allergies later in life. However, the mechanisms through which antigen sensitization in the skin can predispose to allergic inflammation in the intestine remain unclear. Considering AD skin lesions are associated with elevated thymic stromal lymphopoietin (TSLP) expression and basophil infiltration, Noti et al determined that TSLP-elicited basophils promote antigen-induced intestinal food allergy ( J Allergy Clin Immunol 2014; 133(5): 1390-99 ).  The authors employed a new model of food allergy by sensitizing mice to food antigens on an AD-like skin lesion that predisposed to allergic inflammation in the intestine upon oral antigen ...

The recent discovery of innate lymphoid cells (ILCs) has changed our understanding of immune regulation and uncovers the importance of innate immunity in the development of asthma. Historically, asthma was thought to be a Th2 mediated disease of the adaptive immune system but it has recently become clear that there are several different phenotypes of asthma some of which are non-allergic. In their review, Yu et al discuss the various roles of ILCs in the immune system specific to different asthma phenotypes and other allergic diseases ( J Allergy Clin Immunol 2014; 133(4): 943-950 ). ILCs are lymphocytes that produce a variety of cytokines similar to CD4+ T cells, but are antigen non-specific, which allows them to function independently of adaptive immunity.  The authors explain that ILC1s are similar to Th1 cells and have been shown to inhibit eosinophilic airway inflammation by promoting eosinophil apoptosis. Several studies show the likeness of ILC2s to Th2 cells in that they pr...

Live vaccines and the growing neglect of adherence to routine immunizations can be life-threatening to immunodeficient patients.  This prompted the Medical Advisory Committee of the Immune Deficiency Foundation to issue recommendations based on the literature and the collective experience of the committee members. Shearer et al describe the relative risk for a child with severe immunodeficiency from close-contact spread of infectious diseases that are vaccine-preventable or from the shedding of live virus or bacteria from individuals who have received a live vaccine ( J Allergy Clin Immunol 2014; 133(4): 961-966 ) .   The risk of acquiring an infection is well known to immediate family members of an immunodeficient child. However, relatives and non-family members who have not been vaccinated or have been vaccinated with live virus or bacteria pose a serious threat to these patients. Complacency is prevalent in society regarding pertussis, measles, mumps, and rubella vacci...

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...