246 research outputs found
Allergen immunotherapy for allergic asthma: protocol for a systematic review
Background: The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing the
EAACI Guidelines for Allergen Immunotherapy (AIT) for Allergic Asthma. We seek to critically assess the effectiveness,
cost-effectiveness and safety of AIT in the management of allergic asthma.
Methods: We will undertake a systematic review, which will involve searching international biomedical databases
for published, in progress and unpublished evidence. Studies will be independently screened against pre-defined
eligibility criteria and critically appraised using established instruments. Data will be descriptively and, if possible and
appropriate, quantitatively synthesised.
Discussion: The findings from this review will be used to inform the development of recommendations for EAACI’s
Guidelines on AIT
Intranasal corticosteroids in allergic rhinitis in COVID-19 infected patients : An ARIA-EAACI statement
Peer reviewe
Peak nasal inspiratory flow as outcome for provocation studies in allergen exposure chambers: a GA²LEN study
Background: The GA²LEN chamber has been developed as a novel mobile allergen
exposure chamber (AEC) allowing standardized multicenter trials in allergy.
Hitherto, subjective nasal symptom scores have been the most often used
outcome parameter, but in standardized modern trials objective parameters are
preferred. Despite its practicability, the objective parameter peak nasal
inspiratory flow (PNIF) has been rarely used for allergy trials in the setting
of allergen exposure chambers. This study aims to evaluate PNIF as an outcome
parameter for provocation studies in AECs. Methods: In a randomized controlled
blinded setting subjects suffering from allergic rhinitis were exposed to
grass pollen, birch pollen, house dust mite and/or placebo in the GA²LEN
chamber. Different allergen concentrations were used to evaluate symptom
severities. Patients had to perform PNIF before and every 30 min during a
challenge using a portable PNIF meter. Results: 86 subjects participated in
203 challenges, altogether. House dust mite provocations caused the greatest
reduction in PNIF values, followed by grass pollen and birch pollen.
Provocations with every allergen or pollen concentration led to a significant
decrease (p < 0.05) in PNIF compared to baseline. Furthermore, positive
correlations were obtained between PNIF and peak expiratory flow, height and
weight, and inverse correlations between PNIF and total nasal symptom score,
nasal congestion score and visual analog scale of overall subjective symptoms.
Conclusion: PNIF is a helpful and feasible tool for conducting provocation
trials with allergens, especially grass pollen and house dust mite, in an AEC
Recommended from our members
Emerging concepts and challenges in implementing the exposome paradigm in allergic diseases and asthma.
Exposome research can improve the understanding of the mechanistic connections between exposures and health to help mitigate adverse health outcomes across the life span. The exposomic approach provides a risk profile instead of single predictors and thus is particularly applicable to allergic diseases and asthma. Under the PRACTALL collaboration between the European Academy of Allergy and Clinical Immunology (EAACI) and the American Academy of Allergy, Asthma, and Immunology (AAAAI), we evaluated the current concepts and the unmet needs on the role of the exposome in allergic diseases and asthma
Hot topics in allergen immunotherapy, 2023: Current status and future perspective
The importance of allergen immunotherapy (AIT) is multifaceted, encompassing both clinical and quality‐of‐life improvements and cost‐effectiveness in the long term. Key mechanisms of allergen tolerance induced by AIT include changes in memory type allergen‐specific T‐ and B‐cell responses towards a regulatory phenotype with decreased Type 2 responses, suppression of allergen‐specific IgE and increased IgG and IgG, decreased mast cell and eosinophil numbers in allergic tissues and increased activation thresholds. The potential of novel patient enrolment strategies for AIT is taking into account recent advances in biomarkers discoveries, molecular allergy diagnostics and mobile health applications contributing to a personalized approach enhancement that can increase AIT efficacy and compliance. Artificial intelligence can help manage and interpret complex and heterogeneous data, including big data from omics and non‐omics research, potentially predict disease subtypes, identify biomarkers and monitor patient responses to AIT. Novel AIT preparations, such as synthetic compounds, innovative carrier systems and adjuvants, are also of great promise. Advances in clinical trial models, including adaptive, complex and hybrid designs as well as real‐world evidence, allow more flexibility and cost reduction. The analyses of AIT cost‐effectiveness show a clear long‐term advantage compared to pharmacotherapy. Important research questions, such as defining clinical endpoints, biomarkers of patient selection and efficacy, mechanisms and the modulation of the placebo effect and alternatives to conventional field trials, including allergen exposure chamber studies are still to be elucidated. This review demonstrates that AIT is still in its growth phase and shows immense development prospects
Real-life impact of COVID-19 pandemic lockdown on the management of pediatric and adult asthma:A survey by the EAACI Asthma Section
Background The restrictions imposed by the COVID-19 pandemic impact heavily the management of chronic diseases like asthma. This study aimed to evaluate the management of adults and children with asthma during COVID-19-related lockdown. Methods A survey was launched by the European Academy of Allergy and Clinical Immunology (EAACI) via e-mail, website, and social media to EAACI members and members of peer societies. Results The survey was completed by 339 healthcare professionals from 52 countries. 79% of follow-up consultations were replaced by phone calls, whereas 49% of newly referred patients attended the clinic. 62%, 76%, 66%, 76%, and 87% of responders did not conduct spirometry, impulse oscillometry, bronchodilator test, FeNO, or methacholine provocation, respectively, for asthma diagnosis in adults. The numbers were similar for children. 73% of responders based the initial asthma diagnosis and the prescription of inhaled therapy on clinical parameters only. Lung function tests were used in 29% of cases to monitor asthma worsening, and only 56% of participants were recommended to their patients ambulatory peak expiratory flow (PEF) measurements. Using a 1 (not at all) to 5 (very much) scale, the responders considered that the quality of healthcare provided and the patients' asthma status had deteriorated during the lockdown with 3.2 points and 2.8 points, respectively. Conclusion Collectively, these results suggest that all necessary resources should be allocated to ensure the performance of lung function tests for initial diagnosis, whereas digital remote monitoring should be reinforced for the follow-up of children and adults with asthma
Rhinovirus-induced epithelial RIG-I inflammasome suppresses antiviral immunity and promotes inflammation in asthma and COVID-19.
Rhinoviruses and allergens, such as house dust mite are major agents responsible for asthma exacerbations. The influence of pre-existing airway inflammation on the infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is largely unknown. We analyse mechanisms of response to viral infection in experimental in vivo rhinovirus infection in healthy controls and patients with asthma, and in in vitro experiments with house dust mite, rhinovirus and SARS-CoV-2 in human primary airway epithelium. Here, we show that rhinovirus infection in patients with asthma leads to an excessive RIG-I inflammasome activation, which diminishes its accessibility for type I/III interferon responses, leading to their early functional impairment, delayed resolution, prolonged viral clearance and unresolved inflammation in vitro and in vivo. Pre-exposure to house dust mite augments this phenomenon by inflammasome priming and auxiliary inhibition of early type I/III interferon responses. Prior infection with rhinovirus followed by SARS-CoV-2 infection augments RIG-I inflammasome activation and epithelial inflammation. Timely inhibition of the epithelial RIG-I inflammasome may lead to more efficient viral clearance and lower the burden of rhinovirus and SARS-CoV-2 infections
ARIA-EAACI statement on severe allergic reactions to COVID-19 vaccines - an EAACI-ARIA position paper
Coronavirus disease 2019 (COVID-19) vaccine BNT162b2 received approval and within the first few days of public vaccination several severe anaphylaxis cases occurred. An investigation is taking place to understand the cases and their triggers. The vaccine will be administered to a large number of individuals worldwide and concerns raised for severe adverse events might occur. With the current information, the European Academy of Allergy and Clinical Immunology (EAACI) states its position for the following preliminary recommendations that are to be revised as soon as more data emerges. To minimize the risk of severe allergic reactions in vaccinated individuals, it is urgently required to understand the specific nature of the reported severe allergic reactions, including the background medical history of the individuals affected and the mechanisms involved. To achieve this goal all clinical and laboratory information should be collected and reported. Mild and moderate allergic patients should not be excluded from the vaccine as the exclusion of all these patients from vaccination may have a significant impact on reaching the goal of population immunity. Health care practitioners vaccinating against COVID-19 are required to be sufficiently prepared to recognise and treat anaphylaxis properly with the ability to administer adrenaline. A mandatory observation period after vaccine administration of at least 15 minutes for all individuals should be followed. The current data has not shown any higher risk for patients suffering from allergic rhinitis or asthma and this message should be clearly stated by physicians to give our patients trust. The benefit of the vaccination clearly outweighs the risk of severe COVID-19 development including the more than 30% of the population suffering from allergic diseases
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