Atopik dermatit'in patogenezinde immunolojik mekanizmalar

Aktive T-hücreleri ve ürünleri, psöriasis ve atopik dermatit (AD) gibi birçok cilt hastalığının patogenezinde önemli bir rol oynarlar. Aktivasyonu takiben, periferik kandaki T hücrelerinin derideki selektif yerleşimi ve efektör işlevleri, patogenezdeki immunolojik olaylar dizinini temsil eder. Kutanöz lenfositle ilişkili antijen (CLA), bellek/efektör T hücresinin deriye migrasyonunda rol oynayan bir yerleşim reseptörüdür. CLA, farklılaşma sürecinde Th1 hücreleri üzerinde belirir ve Th2 hücreleri üzerinde de bakteriyel super antigen ve/veya IL-12 uyarısıyla indüklenebilir. Muhtemelen, deriye özgü yerleşim, işlevsel ve fenotipik T hücre subsetleri ile sı- nırlı değildir. Bazı T hücre reseptörlerinde değişken β zinciri ekspresyonu veya IL-12Rβ ekspresyonu ile karakterize IL-12 ve/veya süperantijen yanıtı, T hücreleri üzerindeki CLA ekspresyonunu kontrol eden faktörlerdir. CLA taşıyan CD4 ve CD8 T hücreleri, AD hastalarının periferik kanındaki aktive bellek/efektör T hücre subsetlerini temsil eder. Bunlar, IgE’yi IL-13 aracılığıyla uyarırlar ve eosinofil yaşam süresini de IL-5 aracılığıyla uzatırlar. Atopik hastalıklardaki periferik Th2 yanıtının bir mekanizması olarak, dolaşımdaki aktive bellek/efektör Th1 hücreleri selektif olarak aktivasyon ile indüklenen hücre ölümüne uğrayarak, immün yanıtı hayatta kalan Th2 hücrelerinden yana kaydırır. Atopik dermatitde, T hücreleri, dendritik hücreler ve keratinositlerden oluşan bir kemokin ağı, inşamatuvar hücrelerin deriye infiltrasyonunu kontrol eder. Aktive olan bu T hücreleri, Fas bağımlı bir yol ile keratinosit apoptozisini indükler ki bu spongiosis ve ekzematöz lezyonların oluşumunda önemli bir patogenetik faktördür

B regulatory cells in allergy

B cells have classically been recognized for their unique and indispensable role in the production of antibodies. Their potential as immunoregulatory cells with anti-inflammatory functions has received increasing attention during the last two decades. Herein, we highlight pioneering studies in the field of regulatory B cell (Breg) research. We will review the literature on Bregs with a particular focus on their role in the regulation of allergic inflammation.Novartis ForschungsstiftungSchweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (320030-15987/310030‐179428)Promedica StiftungSean N. Parker Center for Allergy and Asthma Research, Stanford Universit

Developmental determinants in non-communicable chronic diseases and ageing

Prenatal and peri-natal events play a fundamental role in health, development of diseases and ageing (Developmental Origins of Health and Disease (DOHaD)). Research on the determinants of active and healthy ageing is a priority to: (i) inform strategies for reducing societal and individual costs of an ageing population and (ii) develop effective novel prevention strategies. It is important to compare the trajectories of respiratory diseases with those of other chronic diseases

Adherence to treatment in allergic rhinitis using mobile technology. The MASK Study

Background: Mobile technology may help to better understand the adherence to treatment. MASK-rhinitis (Mobile Airways Sentinel NetworK for allergic rhinitis) is a patient-centred ICT system. A mobile phone app (the Allergy Diary) central to MASK is available in 22 countries. Objectives: To assess the adherence to treatment in allergic rhinitis patients using the Allergy Diary App. Methods: An observational cross-sectional study was carried out on all users who filled in the Allergy Diary from 1 January 2016 to 1 August 2017. Secondary adherence was assessed by using the modified Medication Possession Ratio (MPR) and the Proportion of days covered (PDC) approach. Results: A total of 12 143 users were registered. A total of 6 949 users reported at least one VAS data recording. Among them, 1 887 users reported ≥7 VAS data. About 1 195 subjects were included in the analysis of adherence. One hundred and thirty-six (11.28%) users were adherent (MPR ≥70% and PDC ≤1.25), 51 (4.23%) were partly adherent (MPR ≥70% and PDC = 1.50) and 176 (14.60%) were switchers. On the other hand, 832 (69.05%) users were non-adherent to medications (MPR <70%). Of those, the largest group was non-adherent to medications and the time interval was increased in 442 (36.68%) users. Conclusion and clinical relevance: Adherence to treatment is low. The relative efficacy of continuous vs on-demand treatment for allergic rhinitis symptoms is still a matter of debate. This study shows an approach for measuring retrospective adherence based on a mobile app. This also represents a novel approach for analysing medication-taking behaviour in a real-world setting