17 research outputs found
IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper
Correction: Volume14 Issue7 Article Number100557 DOI10.1016/j.waojou.2021.100557Currently, testing for immunoglobulin E (IgE) sensitization is the cornerstone of diagnostic evaluation in suspected allergic conditions. This review provides a thorough and updated critical appraisal of the most frequently used diagnostic tests, both in vivo and in vitro. It discusses skin tests, challenges, and serological and cellular in vitro tests, and provides an overview of indications, advantages and disadvantages of each in conditions such as respiratory, food, venom, drug, and occupational allergy. Skin prick testing remains the first line approach in most instances; the added value of serum specific IgE to whole allergen extracts or components, as well as the role of basophil activation tests, is evaluated. Unproven, non-validated, diagnostic tests are also discussed. Throughout the review, the reader must bear in mind the relevance of differentiating between sensitization and allergy; the latter entails not only allergic sensitization, but also clinically relevant symptoms triggered by the culprit allergen.Peer reviewe
Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen).
Allergic rhinitis is a symptomatic disorder of the nose
induced after allergen exposure by an IgE-mediated
inflammation of the membranes lining the nose. It is a
global health problem that causes major illness and disability
worldwide. Over 600 million patients from all
countries, all ethnic groups and of all ages suffer from
allergic rhinitis. It affects social life, sleep, school and
work and its economic impact is substantial.
Risk factors for allergic rhinitis are well identified.
Indoor and outdoor allergens as well as occupational
agents cause rhinitis and other allergic diseases.
The role of indoor and outdoor pollution is probably
very important, but has yet to be fully understood
both for the occurrence of the disease and its manifestations.
In 1999, during the Allergic Rhinitis and its Impact on
Asthma (ARIA) WHO workshop, the expert panel
proposed a new classification for allergic rhinitis which
was subdivided into _intermittent_ or _persistent_ disease.
This classification is now validated.
The diagnosis of allergic rhinitis is often quite easy, but
in some cases it may cause problems and many patients
are still under-diagnosed, often because they do not
perceive the symptoms of rhinitis as a disease impairing
their social life, school and work.
The management of allergic rhinitis is well established
and the ARIA expert panel based its recommendations
on evidence using an extensive review of the literature
available up to December 1999. The statements of
evidence for the development of these guidelines followed
WHO rules and were based on those of Shekelle et al.
A large number of papers have been published since 2000
and are extensively reviewed in the 2008 Update using
the same evidence-based system. Recommendations for
the management of allergic rhinitis are similar in both the
ARIA workshop report and the 2008 Update. In the
future, the GRADE approach will be used, but is not yet
available.
Another important aspect of the ARIA guidelines was
to consider co-morbidities. Both allergic rhinitis and
asthma are systemic inflammatory conditions and often
co-exist in the same patients. In the 2008 Update, these
links have been confirmed.
TheARIAdocument is not intended to be a standard-ofcare
document for individual countries. It is provided as a
basis for physicians, health care professionals and
organizations involved in the treatment of allergic rhinitis
and asthma in various countries to facilitate the
development of relevant local standard-of-care documents
for patients
Mucosal B cells
Mucosal B cells are crucial for host defense. The mucosal surfaces exceed 300 m2 in humans and represent indeed the largest part of the body in which immune responses take place daily. Mucosal B cells, located in the gut, respiratory, and urogenital mucosae as well as in skin, salivary, mammary, and lacrimal glands, are very important to protect ourselves from infections. Most harmful pathogens enter the body through the mucosal surfaces by ingestion, inhalation, or sexual contact. This chapter focuses on the mechanisms that coordinate B-cell development as well as on the mechanisms used by mucosal B cells and mucosal IgA to give protection to the host
Development and implementation of guidelines in allergic rhinitis - an ARIA-GA2LEN paper
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