Digital tools in allergy and respiratory care

Patient care in the allergy and respiratory fields is advancing rapidly, offering the possibility of the inclusion of a variety of digital tools that aim to improve outcomes of care. Impaired access to several health care facilities during the COVID-19 pandemic has considerably increased the appetite and need for the inclusion of e-health tools amongst end-users. Consequently, a multitude of different e-health tools have been launched worldwide with various registration and access options, and with a wide range of offered benefits. From the perspective of both patients and healthcare providers (HCPs), as well as from a legal and device-related perspective, several features are important for the acceptance, effectiveness,and long-term use of e-health tools. Patients and physicians have different needs and expectations of how digital tools might be of help in the care pathway. There is a need for standardization by defining quality assurance criteria.Therefore, the Upper Airway Diseases Committee of the World Allergy Organization (WAO) has taken the initiative to define and propose criteria for quality, appeal, and applicability of e-health tools in the allergy and respiratory care fields from a patient, clinician, and academic perspective with the ultimate aim to improve patient health and outcomes of care

Gene expression of TMEM178, which encodes a negative regulator of NFATc1, decreases with the progression of asthma severity

Abstract In two independent microarray studies involving primary airway epithelial cells, the relative gene expression of TMEM178 decreases with the progression of asthma severity. Our manuscript creates a paradigm for future studies dissecting the role of Tmem178 in the pathogenesis of severe asthma

Youtube and Food Allergy: An Appraisal of the Educational Quality of Information

Background: Food allergy affects an estimated 8% of children and 3% of adults in the United States. Food‐allergic individuals increasingly use the web for medical information. We sought to determine the educational quality of food allergy YouTube videos. Methods: We performed a YouTube search using keywords “food allergy” and “food allergies”. The 300 most viewed videos were included and analyzed for characteristics, source, and content. Source was further classified as healthcare provider, alternative medicine provider, patient, company, media, and professional society. A scoring system (FA‐DQS) was created to evaluate quality (−10 to +34 points). Negative points were assigned for misleading information. Eight reviewers scored each video independently. Results: Three hundred videos were analyzed, with a median of 6351.50 views, 19 likes, and 1 dislike. More video presenters were female (54.3%). The most common type of video source was alternative medicine provider (26.3%). Alternative treatments included the following: water fast, juicing, Ayurveda, apple cider, yoga, visualization, and sea moss. Controversial diagnostics included kinesiology, IgG testing, and pulse test. Almost half of the videos depicted a non‐IgE‐mediated reaction (49.0%).Videos by professional societies had the highest FA‐DQS (7.27). Scores for videos by professional societies were significantly different from other sources (P \u3c .001). There was a high degree of agreement among reviewers (ICC = 0.820; P \u3c .001). Conclusion: YouTube videos on food allergy frequently recommend controversial diagnostics and commonly depict non‐IgE‐mediated reactions. There is a need for high‐quality, evidence‐based, educational videos on food allergy

Pentoxifylline in the Treatment of Cutaneous Leishmaniasis: A Randomized Clinical Trial in Colombia

Addition of the immunomodulator pentoxifylline (PTX) to antimonial treatment of mucosal leishmaniasis has shown increased efficacy. This randomized, double-blind, placebo-controlled trial evaluated whether addition of pentoxifylline to meglumine antimoniate (MA) treatment improves therapeutic response in cutaneous leishmaniasis (CL) patients. Seventy-three patients aged 18–65 years, having multiple lesions or a single lesion ≥ 3 cm were randomized to receive: intramuscular MA (20 mg/kg/day × 20 days) plus oral PTX 400 mg thrice daily (intervention arm, n = 36) or MA plus placebo (control arm, n = 37), between 2012 and 2015. Inflammatory gene expression was evaluated by RT-qPCR in peripheral blood mononuclear cells from trial patients, before and after treatment. Intention-to-treat failure rate was 35% for intervention vs. 25% for control (OR: 0.61, 95% CI: 0.21–1.71). Per-protocol failure rate was 32% for PTX, and 24% for placebo (OR: 0.50, 95% CI: 0.13–1.97). No differences in frequency or severity of adverse events were found (PTX = 142 vs. placebo = 140). Expression of inflammatory mediators was unaltered by addition of PTX to MA. However, therapeutic failure was associated with significant overexpression of il1β and ptgs2 (p < 0.05), irrespective of study group. No clinical benefit of addition of PTX to standard treatment was detected in early mild to moderate CL caused by Leishmania (V.) panamensis

Sex differences in a murine model of asthma are time and tissue compartment dependent.

ConclusionSexual dimorphism in lung inflammation is both time and tissue compartment dependent. Spatiotemporal variability in sex differences in a murine model of asthma must be accounted for when planning experiments to model the sex bias in allergic inflammation

Sex differences in lung tissue expression of inflammasome and tissue injury and repair markers during allergic inflammation.

(A) mRNA expression of inflammasome markers Caspase-1, NLRP3, and IL-1β in lung tissue. (B) Expression of tissue injury/repair markers Aldolase A, Sox2, Nestin, Tenascin-C, Vimentin, and Periostin in lung tissue. Two-way ANOVA: *p < 0.05; **p < 0.01; #p < 0.001; †p < 0.0001 for assessment of time responses (challenge vs. baseline). Gray shaded boxes represent statistically significant sexual dimorphism (p < 0.05) for any given time point in the model. N = 4 mice of each sex per time point for “Baseline” and “Challenge 6” groups, N = 7 mice/sex per time point for “Challenge 1–5” groups. Data are from a single experiment representative of two independent experiments.</p

Sex differences in BALF and lung tissue neutrophils, monocytes, T cells, and alveolar macrophages during allergic inflammation.

Quantification of neutrophils (A), monocytes (B), T cells (C), and alveolar macrophages (D) in bronchoalveolar lavages (left) and lung homogenates (right) of male and female mice by multi-color flow cytometry. Data represented as absolute cell counts. When comparing challenge time point responses (1–6) relative to baseline (for either male or female data) by two-way ANOVA: *p < 0.05; **p < 0.01; #p < 0.001; †p < 0.0001. Gray shaded boxes represent a statistically significant difference (p < 0.05) between males and females at that particular time-point. N = 4 mice of each sex per time point for “Baseline” and “Challenge 6” groups, N = 8 mice/sex per time point for “Challenge 1–5” groups. Data are from a single experiment representative of two independent experiments.</p

Sexual dimorphism in lung tissue expression of cytokines and chemokines in an OVA model.

(A) Expression of Type 2 cytokines IL-4, IL-5, IL-13, and IL-10 by qPCR in lung tissue. (B) Expression of chemokines Ccl2, Ccl5, Ccl11, and Ccl24 by qPCR in lung tissue. The housekeeping gene was glyceraldehyde-3-phosphate dehydrogenase (GAPDH). Two-way ANOVA: *p < 0.05; **p < 0.01; #p < 0.001; †p < 0.0001 for assessment of time responses (challenge vs. baseline). Gray shaded boxes represent statistically significant sexual dimorphism (p < 0.05) for any given time point in the model. N = 4 mice of each sex per time point for “Baseline” and “Challenge 6” groups, N = 7 mice/sex per time point for “Challenge 1–5” groups. Data are from a single experiment representative of two independent experiments.</p