Current Issues on Immunotherapy in Children

Therapy of allergic diseases in children implicates avoidance of allergens, standard pharmacotherapy, and immunotherapy. Immunotherapy is the only treatment for allergic diseases with the ability to change the natural course of the disease, thus stopping its further progression as well as the development of new allergic diseases and new sensibilizations. The objective of this chapter is to give insight into the latest data on immunotherapy in treating children with allergic diseases. Methods: The study involved a search for relevant articles on the MEDLINE and PubMed up to 2017. Results: Numerous studies have shown that the sublingual application of allergen-specific immunotherapy is adequate, safe, and efficient in the therapy of immunoglobulin E (IgE)-mediated allergic diseases of the respiratory tract in children, but there are still some questions to be solved concerning the usage of SLIT in children younger than 5 years old, SLIT for polysensitized patients, duration of SLIT, long-lasting effects of SLIT. Conclusions: In order to improve the clinical efficacy of SLIT, we are looking for new routes of administration, new allergens, new protocols as well as combination of SLIT with other immune modulatory treatments

A cost-effectiveness analysis of respiratory syncytial virus (RSV) prophylaxis in infants in the United Kingdom /

Background: Respiratory syncytial virus (RSV) is a common cause of respiratory infection that is highly prevalent in infants. Severe cases of RSV infection require hospitalisation; this is most likely to occur in infant populations at high risk. The study assesses the cost-effectiveness of palivizumab versus no prophylaxis in infants at high risk of hospitalisation with RSV in the United Kingdom (UK). Methods: A decision tree model was developed to reflect the clinical pathway of infants at high risk of severe RSV infection who receive either prophylaxis with palivizumab or no prophylaxis. The main outcome was the incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were performed to assess the degree of uncertainty surrounding the results. A threshold analysis considered the impact of clinical and environmental risk factors on the cost-effectiveness in the subgroup of preterm infants 33-35 weeks gestational age (wGA). Results: Prophylaxis with palivizumab compared with no prophylaxis is associated with the following ICERs; £33,216 for infants with congenital heart disease; £19,168 for infants with chronic lung disease; £3,845 for preterm infants < 29 wGA; £30,205 for preterm infants 29-32 wGA; and £99,056 for preterm infants 33-35 wGA. One-way sensitivity analysis suggests that these results are highly sensitive to the input data. Threshold analysis in the preterm 33-35 wGA subgroup demonstrates that an adjusted RSV-hospitalisation baseline risk of 17.94% or higher would result in an ICER below the £30,000 per quality-adjusted life-year threshold. Discussion: Palivizumab is cost-effective compared to no prophylaxis in the United Kingdom in many of the subgroups considered, showing that palivizumab would be a cost-effective use of National Health Service resources

Targeting the superoxide/nitric oxide ratio by L-arginine and SOD mimic in diabetic rat skin

AbstractSetting the correct ratio of superoxide anion (O2•-) and nitric oxide (•NO) radicals seems to be crucial in restoring disrupted redox signaling in diabetic skin and improvement of •NO physiological action for prevention and treatment of skin injuries in diabetes. In this study we examined the effects of L-arginine and manganese(II)-pentaazamacrocyclic superoxide dismutase (SOD) mimic – M40403 in diabetic rat skin. Following induction of diabetes by alloxan (blood glucose level ≥12 mMol l −1) non-diabetic and diabetic male Mill Hill hybrid hooded rats were divided into three subgroups: (i) control, and receiving: (ii) L-arginine, (iii) M40403. Treatment of diabetic animals started after diabetes induction and lasted for 7 days. Compared to control, lower cutaneous immuno-expression of endothelial NO synthase (eNOS), heme oxygenase 1 (HO1), manganese SOD (MnSOD) and glutathione peroxidase (GSH-Px), in parallel with increased NFE2-related factor 2 (Nrf2) and nitrotyrosine levels characterized diabeti..

Probiotics in Allergic Diseases

Allergic diseases are the most common chronic diseases in children and no complete agreement on effective measures for primary prevention is available. Atopic family history is one of the most important risk factors for the development of asthma. A decline in microbial diversity due to modern lifestyle particularly in urban areas was proposed to have an important role in allergic epidemic. Recent studies are more focused on the specific mode of prevention such as probiotic usage in early pregnancy and infants period. It is well known that the composition of the gastrointestinal microbiota has been postulated to play a role in the development of allergies because it promotes potentially antiallergenic processes: TH1-type immunity, generation of TGF (which has an essential role in suppression of TH2-induced allergic inflammation and induction of oral tolerance), and IgA production, an essential component of mucosal immune defenses. Probiotic interventions administered during pregnancy and breastfeeding offer a unique opportunity to influence a range of important maternal and infant outcomes

The effect of infectious dose on humoral and cellular immune responses in Chlamydophila caviae primary ocular infection

Following infection, the balance between protective immunity and immunopathology often depends on the initial infectious load. Several studies have investigated the effect of infectious dose; however, the mechanism by which infectious dose affects disease outcomes and the development of a protective immune response is not known. The aim of this study was to investigate how the infectious dose modulates the local and systemic humoral and the cellular immune responses during primary ocular chlamydial infection in the guinea pig animal model. Guinea pigs were infected by ocular instillation of a Chlamydophila caviae-containing eye solution in the conjunctival sac in three different doses: 1x10(2), 1x10(4), and 1x10(6) inclusion forming units (IFUs). Ocular pathology, chlamydial clearance, local and systemic C. caviae-specific humoral and cellular immune responses were assessed. All inocula of C. caviae significantly enhanced the local production of C. caviae-specific IgA in tears, but only guinea pigs infected with the higher doses showed significant changes in C. caviae-specific IgA levels in vaginal washes and serum. On complete resolution of infection, the low dose of C. caviae did not alter the ratio of CD4(+) and CD8(+) cells within guinea pigs' submandibular lymph node (SMLN) lymphocytes while the higher doses increased the percentages of CD4(+) and CD8(+) cells within the SMLN lymphocytes. A significant negative correlation between pathology intensity and the percentage of CD4(+) and CD8(+) cells within SMLN lymphocyte pool at selected time points post-infection was recorded for both 1x10(4), and 1x10(6) IFU infected guinea pigs. The relevance of the observed dose-dependent differences on the immune response should be further investigated in repeated ocular chlamydial infections

En kvalitativ studie om unga vuxnas syn på skuldsättning och på konsumtion som leder till skuldsättning

Tidigare studier har visat att skuldsättning har ökat till resultat av avregleringar och ökad tillgängligheten av olika typer av krediter och lån. Dessutom fanns det få forskning om unga vuxnas syn på skuldsättning och skuldsättning för konsumtion. Därför har författarna valt att studera det på grund av ökat intresse för ämnet. Syftet med studien är att öka förståelse, beskriva och analysera unga vuxnas syn på skuldsättning. Studien fokuserar också på att öka förståelse för unga vuxnas syn på konsumtion som leder till skuldsättning. Studiens målgrupp att rikta sig in är personer mellan 18-25 år i båda kön. Studien är en kvalitativ forskning som använder intervju som metod. Det är 12 respondenter som intervjuades genom telefon, skriftligt form och i verkligheten. Studiens forskningsresultat visar att unga vuxna har en negativ syn på skuldsättning men när det gäller studielån eller bostadslån är det inte inkluderad som skuldsättning. Dessutom saknar unga vuxna en korrekt förståelse för skuldsättning.Previous studies have shown that indebtedness has increased as a result of deregulation and increased availability of different types of credits and loans. In addition, there was little research on young adults' views on indebtedness and indebtedness for consumption. Therefore, the authors have chosen to study it due to increased interest in the subject. The purpose of the study is to increase understanding, describe and analyze young adults' views on indebtedness. The study also focuses on increasing understanding of young adults' views on consumption that lead to indebtedness. The study's target group people between 18-25 years in both sexes. The study is qualitative research that uses interviews as a method. There are 12 respondents who were interviewed by telephone, in writing and in real life. The study's research results show that young adults have a negative view of indebtedness, but when it comes to student loans or housing loans, it is not included as indebtedness. In addition, young adults lack a proper understanding of indebtedness. Keywords