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Background: In a number of previous studies, patients with reported penicillin allergies have been documented to experience higher rates of dental implant failure than those who had not reported this allergy. The authors of this study aimed to determine whether an increased risk of implant failure is associated with patient‐reported penicillin allergy and which antibiotic was administered. Methods and Materials: A retrospective study was conducted through chart review of patients who received dental implants at the New York University College of Dentistry. Participants were eligible if they received one or more dental implants at the College and provided at least 1 year of follow‐up data. Results: The overall implant failure rate was 12.9%. The failure rate in patients who reported no allergy to penicillin and took amoxicillin was 8.4%, while the failure rate in the allergy‐reporting group was 17.1% (adjusted OR = 2.22, 95% CI = 1.44–3.44). The failure rate in allergy‐reporting patients who took Clindamycin was also higher than in those who took amoxicillin (19.9%; adjusted OR = 2.9, 95% CI = 1.77–4.47) or any antibiotic other than amoxicillin (20.9%; adjusted OR = 2.77, 95% CI = 1.77–4.32). Conclusions: Significant findings included a lower implant failure rate in patients taking amoxicillin than in patients taking other antibiotics. There was a significant increase in early implant failure in allergy reporting patients. [ABSTRACT FROM AUTHOR]

Primary eosinophilic gastrointestinal disorders (EGID) are increasingly prevalent, immune‐mediated, chronic conditions which primarily affect pediatric and young adult patients, leading to substantial disease burden, and poor quality of life. EGID may either involve single portions of the gastrointestinal tract (i.e., esophagus, stomach, small bowel, and colon) or a combination. Their strong association with allergic disorders has been recently recognized, and although their shared pathophysiological basis remains partly elusive, this feature greatly impacts the diagnostic and treatment work‐up. We herein critically discuss the current knowledge on the association of EGID and allergic disorders, including atopic dermatitis, allergic rhinitis, allergic asthma, and food or drug allergy. In particular, we reviewed the literature focusing on their epidemiology, pathophysiological basis and mechanisms, and diagnostic strategies. Finally, we discuss the currently ongoing clinical trials targeting EGID and allergic diseases, including, among others the monoclonal antibodies dupilumab, mepolizumab, benralizumab, and lirentelimab. [ABSTRACT FROM AUTHOR]

Background: Health workers (HWs) are exposed to diverse cleaning agents in large hospitals. This study determined the prevalence of work‐related symptoms, allergic sensitization, and lung function abnormalities in HWs of two tertiary hospitals in Southern Africa. Methods: A cross‐sectional study of 699 HWs (South Africa: SAH, n = 346; Tanzania: TAH, n = 353) was conducted. Health outcomes were assessed using a standardized ECRHS questionnaire, immunological tests (specific IgE antibody to common aero‐allergens and to occupational allergens: natural rubber latex [NRL] Hev b5 and Hev b6.02, chlorhexidine, and ortho‐phthalaldehyde [OPA]), spirometry [pre‐and post‐ bronchodilator], methacholine challenge, and fractional exhaled nitric oxide (FeNO). Results: A large proportion of participants (78%) were women. Median age was 42 years, with 76% nurses, 12% cleaners, and 5% administrative workers. Current smoking was more common in SAHWs (12%) than TAHWs (1%). The overall prevalence of doctor‐diagnosed asthma was 7%. Atopy was present in 43% of HWs, while 4% were sensitized to OPA, 2% to NRL, and 1% to chlorhexidine. Prevalence of work‐related ocular‐nasal symptoms (16%) was higher than skin (12%) and chest (7%) symptoms. TAHWs had significantly lower mean lung volumes, higher degrees of significant airflow obstruction and impaired lung function. The prevalence of bronchial hyperresponsiveness in SAHWs (14%) was high. Overall, 23% of HWs had abnormal FeNO; 6% having high (>50 ppb) levels. FeNO was positively associated with sensitization to occupational allergens, primarily OPA and NRL. Conclusions: HWs from both hospitals had similar prevalence of work‐related respiratory symptoms. Sensitization to OPA and NRL appears to be contributing to allergic airway inflammation in these HWs. [ABSTRACT FROM AUTHOR]

Background: The European Academy of Allergy and Clinical Immunology has developed a guideline to provide evidence‐based recommendations for healthcare professionals to support the transitional care of adolescents and young adults (AYA) with allergy and/or asthma. The goal of this work was to ensure that the draft recommendations are also important for patients. Methods: We surveyed patients aged 11–25 years with allergy and/or asthma and their parents across Europe between 17 February and 16 March 2020. The multilingual survey was distributed through national allergy and asthma patient organizations in Europe as well as through social media. Results: A total of 1210 responses from 24 European countries were collected. There were 415 (34.3%) AYA and 795 (65.7%) parents. The majority of AYA (72.3%) and parents (81.9%) were female. Patients had a history of asthma (61.1%), allergic rhinoconjunctivitis (54.1%), food allergy (53.8%), atopic eczema (42.6%) and anaphylaxis (28.8%). All recommendations achieved the median score of either 'important' or 'very important'. The least supported recommendations were the use of joint clinics with both paediatric and adult physicians attending and the use of web‐based or mobile technologies for communication with the AYA. The most supported recommendation was checking that the AYA is knowledgeable and compliant with their prescribed medication. Qualitative analysis revealed conditional approval for some recommendations. Conclusions: There was agreement from patients and parents on the importance of the draft recommendations on transitional care for AYA with allergy and/or asthma and their parents. The recommendations now need to be implemented into clinical practice across Europe. [ABSTRACT FROM AUTHOR]

Background: To investigate association between keratoconus and allergic eye diseases, eye rubbing, and atopy. Methods: PubMed, Web of Science, Scopus, and Cochrane were searched for relevant published studies from inception to April 2021 without restrictions or filters. We included case–control, cohort, and cross‐sectional studies that investigated eye allergy, atopy, or eye rubbing as possible risk factors for KC. Two authors independently screened all titles and abstracts against predefined inclusion and exclusion criteria. This study analysed keratoconus prevalence and risk factors including eye rubbing, family history of keratoconus, atopy, and allergic eye diseases. The National Institute of Health Study Quality Assessment tool was utilised. Pooled data were presented as odds ratio (OR) and 95% confidence intervals (CI). Analysis was conducted using RevMan version 5.3 software. Results: Out of 573 articles, we excluded 161 duplicates than 361 articles by title and abstract screening. The remaining 51 articles underwent full‐text screening, and 29 articles were excluded. Twenty‐one studies were included in the qualitative synthesis and fifteen for quantitative synthesis. There was no significant association found between KC and allergic eye diseases (OR = 1.03, 95% CI [0.96, 1.11], p = 0.45), eye rubbing (OR = 1.59, 95% CI [0.70, 3.63], p = 0.27), or atopy (OR = 1.08, 95% CI [0.80, 1.44], p = 0.62). Conclusion: No significant association was observed between KC and allergic eye disease, eye rubbing, or atopy. Further prospective studies are needed to clarify and validate these findings. [ABSTRACT FROM AUTHOR]

The yellow‐legged or Asian wasp (Vespa velutina nigrithorax) has spread rapidly across Europe since its first introduction in France, in 2004. Originally from South‐East Asia, it is considered an invasive species outside its native region. Apart from the ecological and economic implications of its presence, it may cause health problems to humans due to the toxic and allergenic components of its venom. Vespa velutina nigrithorax has become the most prevalent cause of anaphylaxis due to Hymenoptera venom in some regions of Spain. Although sIgE against both antigen 5 (Vesp v 5) and A1‐phospholipase (Vesp v 1) has been detected in these patients, only Vesp v 5 may be considered a dominant allergen. Interestingly, Vesp v 1 appears to be a glycosylated allergen different from A1‐phospholipases from other species. Inhibition studies suggest that Vespula spp venom could behave as primary sensitizer. Besides, changes in sIgE and sIgG4 during Vespula venom immunotherapy in patients with anaphylaxis due to V. velutina support the use of Vespula venom extracts to treat these patients. The purpose of this review is to explore the biological behaviour of V. velutina and to summarize the current knowledge of the allergic reactions provoked by this wasp. [ABSTRACT FROM AUTHOR]

Societal Impact Statement: Pollen relates to many aspects of human and environmental health, which protection and improvement are endorsed by the United Nations Sustainable Development Goals. By highlighting these connections in the frame of current challenges in monitoring and research, we discuss the need of more integrative and multidisciplinary pollen research related to societal needs, improving health of humans and our ecosystems for a sustainable future. Summary: Pollen is at once intimately part of the reproductive cycle of seed plants and simultaneously highly relevant for the environment (pollinators, vector for nutrients, or organisms), people (food safety and health), and climate (cloud condensation nuclei and climate reconstruction). We provide an interdisciplinary perspective on the many and connected roles of pollen to foster a better integration of the currently disparate fields of pollen research, which would benefit from the sharing of general knowledge, technical advancements, or data processing solutions. We propose a more interdisciplinary and holistic research approach that encompasses total environmental pollen diversity (ePD) (wind and animal and occasionally water distributed pollen) at multiple levels of diversity (genotypic, phenotypic, physiological, chemical, and functional) across space and time. This interdisciplinary approach holds the potential to contribute to pressing human issues, including addressing United Nations Sustainable Development Goals, fostering social and political awareness of these tiny yet important and fascinating particles. [ABSTRACT FROM AUTHOR]

Background: Primary prevention strategies for asthma are lacking. Its inception probably starts in utero and/or during the early postnatal period as the developmental origins of health and disease (DOHaD) paradigm suggests. Objectives: The main objective of Nutrition in Early Life and Asthma (NELA) cohort study is to unravel whether the following factors contribute causally to the developmental origins of asthma: (1) maternal obesity/adiposity and foetal growth; (2) maternal and child nutrition; (3) outdoor air pollution; (4) endocrine disruptors; and (5) maternal psychological stress. Maternal and offspring biological samples are used to assess changes in offspring microbiome, immune system, epigenome and volatilome as potential mechanisms influencing disease susceptibility. Population: Randomly selected pregnant women from three health areas of Murcia, a south‐eastern Mediterranean region of Spain, who fulfilled the inclusion criteria were invited to participate at the time of the follow‐up visit for routine foetal anatomy scan at 19–22 weeks of gestation, at the Maternal‐Fetal Medicine Unit of the "Virgen de la Arrixaca" University Clinical Hospital over a 36‐month period, from March 2015 to April 2018. Design: Prospective, population‐based, maternal‐child, birth cohort study. Methods: Questionnaires on exposures and outcome variables were administered to mothers at 20–24 gestation week; 32–36 gestation week; and delivery. Children were surveyed at birth, 3 and 18 months of age and currently at 5 years. Furthermore, physical examinations were performed; and different measurements and biological samples were obtained at these time points. Preliminary results: Among the 1350 women invited to participate, 738 (54%) were finally enrolled in the study and 720 of their children were eligible at birth. The adherence was high with 612 children (83%) attending the 3 months' visit and 532 children (72%) attending the 18 months' visit. Conclusion: The NELA cohort will add original and unique knowledge to the developmental origins of asthma. [ABSTRACT FROM AUTHOR]

Allergic diseases like asthma, allergic rhinitis, food allergy, hymenoptera allergy, or atopic dermatitis are highly prevalent in women of childbearing age and may affect up to 30% of this age group. This review focuses on the management of allergic diseases during pregnancy. Furthermore, we discuss the challenges of counseling women with allergic diseases in the reproductive age, including considerations relevant to the ongoing SARS‐CoV‐2 pandemic. To create the optimal milieu for the unborn child, a multitude of immunological changes occur during pregnancy which may favor type 2 responses and aggravate disease phenotypes. In co‐occurrence with suboptimal preconception disease control, this elevated Th2 responses may aggravate allergic disease manifestations during pregnancy and pose a risk for mother and child. Due to limitations in conducting clinical trials in pregnant women, safety data on anti‐allergic drugs during pregnancy are limited. The lack of information and concerns among pregnant patients demands counseling on the benefits of anti‐allergic drugs and the potential and known risks. This includes information on the risk for mother and child of disease aggravation in the absence of treatment. By doing so, informed decisions and shared decision‐making can take place. [ABSTRACT FROM AUTHOR]

Background: Regulatory T cells (Tregs) are known to protect against allergies. Moreover, the decrease in the frequency and efficiency of Tregs amplifies allergic symptoms. Aim: This study investigated whether expanding Tregs in vivo with an IL‐2/IL‐2 antibody complex could be safe, well tolerated and efficient in a therapeutic setting in allergies. Methods: We produced an anti‐IL‐2 antibody (1C6) and demonstrated that when it is complexed to human IL‐2, it increases IL‐2 efficiency to induce Tregs in vivo without any detectable side effects. Furthermore, the IL‐2/1C6 complex induces an increase in Helios expression by Tregs, suggesting that it not only elevated Treg numbers but also boosted their functions. Using mouse models of house‐dust‐mite‐induced airway inflammation and wheat‐gliadin‐induced food allergies, we investigated the therapeutic potential of the IL‐2/1C6 complex in allergies. Results: IL‐2/1C6 treatment significantly reduced allergic symptoms, specific IgE production, the adaptive immune response and tissue damage. Interestingly, IL‐2/1C6 treatment modulated innate lymphoid cells by increasing ILC2s in asthma and decreasing ILC3s in food allergies. Conclusion: In conclusion,complexed IL‐2/anti‐IL‐2 may restore Treg numbers and function in respiratory and food allergies, thereby improving allergic markers and symptoms. Our IL‐2/anti‐IL‐2 complex offers new hope for reestablishing immune tolerance in patients with allergies. [ABSTRACT FROM AUTHOR]

Background: High‐altitude therapy has been used as add‐on treatment for allergic asthma with considerable success. However, the underlying mechanisms remain unclear. In order to investigate the possible therapeutic effects of high‐altitude therapy on allergic asthma, we utilized a new in vivo mouse model. Methods: Mice were treated with house dust mite (HDM) extract over 4 weeks and co‐exposed to 10% oxygen (Hyp) or room air for the final 2 weeks. Experimental asthma was assessed by airway hyper‐responsiveness, mucus hypersecretion and inflammatory cell recruitment. Isolated immune cells from mouse and allergic patients were stimulated in vitro with HDM under Hyp and normoxia in different co‐culture systems to analyse the adaptive immune response. Results: Compared to HDM‐treated mice in room air, HDM‐treated Hyp‐mice displayed ameliorated mucosal hypersecretion and airway hyper‐responsiveness. The attenuated asthma phenotype was associated with strongly reduced activation of antigen‐presenting cells (APCs), effector cell infiltration and cytokine secretion. In vitro, hypoxia almost completely suppressed the HDM‐induced adaptive immune response in both mouse and human immune cells. While hypoxia did not affect effector T‐cell responses per‐se, it interfered with antigen‐presenting cell (APC) differentiation and APC/effector cell crosstalk. Conclusions: Hypoxia‐induced reduction in the Th2‐response to HDM ameliorates allergic asthma in vivo. Hypoxia interferes with APC/T‐cell crosstalk and confers an unresponsive phenotype to APCs. [ABSTRACT FROM AUTHOR]

Background: Food allergen immunotherapy (FA‐AIT) practice is known to vary globally. This project aims to identify and characterize European centres performing FA‐AIT. Methods: An EAACI task force conducted an online survey to gather relevant information regarding FA‐AIT practice and setting‐specific resources after reviewing the published literature and congress abstracts throughout Europe. Results: We identified 102 FA‐AIT centres in 18 countries; only Spain (n = 39) and France (n = 16) had ≥10 such centres. Overall, most facilities were hospital‐based (77.5%), publicly funded (80.4%) and delivered FA‐AIT as routine clinical care (80.4%). On average, departments had 3 allergists/paediatric allergists and 2 nurses. Surveyed centres had provided FA‐AIT for a median of 9 years [1–24] to a median of 105 [5–2415] patients. The estimated total number of treated patients was 24875, of whom 41.3% received AIT for milk, 34.2% egg, 12.8% peanut and 11.7% other foods. Anaphylaxis to AIT doses requiring over 4–6 h of observation was reported by 70.6% of centres, ICU admissions by 10.8% and eosinophilic esophagitis by 45.1%. Quality of life and sustained unresponsiveness were evaluated in 20.6% and 54.9% of centres, respectively. The main contraindications for food AIT were severe asthma (57%‐63%), eosinophilic esophagitis (56%‐48%) and age below 5 years (47%‐41%). Conclusions: In Europe, FA‐AIT is provided mostly in clinical practice. Significant variation is seen in the number of centres per country, facility characteristics and inclusion/exclusion criteria, and in certain aspects of protocols. Potential inequality in access to AIT has been identified as well as the need for education and guidance for treatment standardization. [ABSTRACT FROM AUTHOR]

Background: Immune cells and immune proteins play a pivotal role in host responses to pathogens, allergens and cancer. Understanding the crosstalk between allergic response and cancer, immune surveillance, immunomodulation, role of immunoglobulin E (IgE)‐mediated functions and help to develop novel therapeutic strategies. Allergy and oncology show two opposite scenarios: whereas immune tolerance is desired in allergy, it is detrimental in cancer. Aim: The current review provides an update on the role of immune cells and immune proteins in allergy and cancer fields. Methods: Authors investigated the role of relevant immunological markers and the correlation with cancer progression or cancer suppression. Results: Activated immune cells such as macrophages 'M1', dendritic cells (DCs), innate lymphoid cells (ILC2), NK cells, Th1, follicular T helper cells (TFH), TCD8+, B lymphocytes and eosinophils have inhibitory effects on tumourigenesis, while tolerogenic cells such as macrophages 'M2,' tolerogenic DCs, ILC3, T and B regulatory lymphocytes appear to favour carcinogenesis. Mastocytes and alarmins can have both effects. RIgE antibodies and CCCL5 chemokine have an anticancer role, whereas IgG4, free light chains, Il‐10, TGF‐β, lipocalin‐2, CCL1 chemokine promote cancer progression. Fundamental is also the contribution of epigenetic changes regulated by the microRNA in cancer progression. Conclusion: This knowledge represents the key to developing new anticancer therapies. [ABSTRACT FROM AUTHOR]

Zataria multiflora (Z. multiflora) is used in traditional and modern medicine for therapeutic objectives especially in respiratory disorders. Therefore, updated experimental and clinical studies on the effects of Z. multiflora on respiratory, allergic, and immunologic disorders are reviewed. Various electronic search engines including PubMed, Science Direct, Scopus, and Google Scholar were searched using appropriate keywords until the end of November 2021. Books, thesis‐hard copies of some articles were also included. The effects of Z. multiflora on respiratory disorders including asthma, chronic obstructive pulmonary disease (COPD), lung infection, and lung cancer were shown. Extracts of Z. multiflora showed the relaxant effect with various mechanisms. The preventive effects of Z. multiflora were also demonstrated by mechanisms such as antioxidant, immunomodulatory, and antiinflammatory properties in the experimental animal models of different respiratory diseases. Carvacrol and thymol are probably responsible for the therapeutic effect of plant among 56 constituents of Z. multiflora. In addition, bronchodilatory and preventive effects of the plant and its constituents on asthma, COPD, lung disorders due to noxious agents and allergic and immunologic disorders were shown in the clinical studies. Therefore Z. multiflora and its constituents may be considered as a preventive and/or relieving therapy in various respiratory diseases. [ABSTRACT FROM AUTHOR]

Recovery was full in all patients, as other studies have published.2,6,10,11 Although, 37.5% of our asthmatic patients remained with exercise exacerbated asthma after COVID-19 disease. Nevertheless, more studies are needed to assess the influence of asthma and allergy in COVID-19 disease due to the low number of patients included in all series. Allergy and asthma in children and adolescents during the COVID outbreak: what we know and how we could prevent allergy and asthma flares. Keywords: allergy; asthma; children; COVID-19; pediatric population EN allergy asthma children COVID-19 pediatric population 1 7 7 03/29/22 20220301 NES 220301 ACKNOWLEDGEMENTS None. [Extracted from the article]

Objectives: To determine whether subcutaneous immunotherapy (SCIT) or sublingual immunotherapy (SLIT) better improves patient outcomes and quality of life for adults with allergic rhinitis or rhinoconjunctivitis (AR/C) with or without mild to moderate asthma. Methods: Systematic review methodology was based on the Cochrane Collaboration handbook and Preferred Reporting Items for Systematic Reviews and Meta‐analyses. Four databases (PubMed, Cochrane Library, EMBASE, and Web of Science) were queried from inception to July 30, 2020. Two independent reviewers screened potentially relevant studies and assessed risk of bias. Outcomes of interest were symptom score (SS), medication score (MS), combined symptom medication score (CSMS), and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Meta‐analyses with an adjusted indirect comparison were conducted in RevMan 5.4.1. Results: Seven SCIT versus SLIT randomized controlled trials (RCTs) demonstrated no significant differences for any outcomes, but insufficient data precluded direct meta‐analysis. For the adjusted indirect comparison, 46 RCTs over 39 studies were included for SCIT versus placebo (n = 13) and SLIT versus placebo (n = 33). Statistically significant results favoring SCIT were found for SS (standardized mean difference [SMD] = 0.40; 95% confidence interval [CI] = 0.31–0.49), MS (SMD = 0.26; 95% CI = 0.14–0.39), CSMS (SMD = 0.42; 95% CI = 0.17–0.67), and RQLQ (MD = 0.24; 95% CI = 0.04–0.44). Statistically significant results favoring SLIT were found for SS (SMD = 0.42; 95% CI = 0.32–0.53), MS (SMD = 0.40; 95% CI = 0.28–0.53), CSMS (SMD = 0.37; 95% CI = 0.29–0.45), and RQLQ (MD = 0.32; 95% CI = 0.20–0.43). No significant differences were found between SCIT and SLIT for SS (SMD = −0.02; 95% CI = −0.15 to 0.11), MS (SMD = −0.14; 95% CI = −0.31 to 0.03), CSMS (SMD = 0.05; 95% CI = −0.21 to 0.31), or RQLQ (MD = −0.08; 95% CI = −0.31 to 0.15). Conclusion: SCIT and SLIT are comparably effective treatments for adults with AR/C. More RCTs analyzing SCIT versus SLIT are needed to directly compare the two. Laryngoscope, 132:499–508, 2022 [ABSTRACT FROM AUTHOR]

Introduction: Humidity is commonly associated with increased airway hyperresponsiveness in asthma. Objective: To examine mold sensitization in patients with allergic asthma or allergic rhinitis and self-reports of humidity as exacerbating factors of clinical symptoms. Methods: A retrospective, cross-sectional study at a University hospital outpatient allergy and asthma clinic was performed. A total of 106 patients with either allergic asthma or allergic rhinitis completed standard prick-puncture skin testing with 17 allergens and controls and completed standardized forms addressing trigger factors for clinical symptoms. Results: Allergic asthmatics sensitized to Cladosporium were more likely to have a more severe asthma severity class (odds ratio = 4.26, confidence interval = 1.30-16.93). Sensitization to Alternaria, Cladosporium, Helminthosporium, Aspergillus and Dermatophagoides pteronyssinus in asthma was associated with higher likelihood for previous hospitalization, while sensitization to Cladosporium, Helminthosporium, Aspergillus, Dermatophagoides pteronyssinus and cockroach in asthma was associated with higher likelihood of having reduced pulmonary function based on forced expiratory volume in 1 s. Furthermore, allergic asthmatics more commonly reported humidity as an exacerbating factor of symptoms than did patients only with allergic rhinitis (68.42% vs 42.86%, respectively; P < 0.05). Conclusion: Mold sensitization is highly associated with more severe asthma, while humidity is more of an exacerbating factor in patients with allergic asthma as compared with allergic rhinitis alone. Further delineation between mold sensitization and humidity is needed to determine whether these are independent factors in asthma. Please cite this paper as: Hayes D Jr, Jhaveri MA, Mannino DM, Strawbridge H and Temprano J. The effect of mold sensitization and humidity upon allergic asthma. Clin Respir J 2013; 7: 135-144. [ABSTRACT FROM AUTHOR]

In this issue of British Journal of Pharmacology, Biffen and colleagues present a novel Toll-like receptor 7 (TLR7) antedrug to treat allergic disease that is rapidly metabolized in the lung to limit side effects due to systemic exposure. Asthma is characterized as an allergic disease of the lung, and TLR7 agonists are proposed to ameliorate allergic inflammation in the lung, a characteristic of prophylactic medications. We have previously shown that TLR7 agonists of multiple structural classes are acute bronchodilators, characteristic of rescue medication for asthma attacks. It will be interesting to determine whether the bronchodilating effect extends to the novel class of TLR7 agonists described here for a prophylactic and rescue therapy in one drug. Combined with the antedrug approach, this would further limit side effects improving on current combination therapies. LINKED ARTICLE This article is a commentary on Biffen et al., pp. 573-586 of this issue. To view this paper visit [ABSTRACT FROM AUTHOR]

Swimming is recommended for asthmatics. However, many competitive swimmers report asthmatic symptoms. While some studies identify the swimming environment as a trigger for allergy and asthmatic symptoms, even more studies suggest swimming to be suitable for people with allergies and asthma. The factors behind the symptoms were studied first by determining the prevalence of asthma, allergy and self-reported asthmatic symptoms in experienced Finnish swimmers and then by examining the relationships between the reported symptoms and the main triggering factors: medical history, environment and exercise intensity. Top swimmers ( n = 332) of the Finnish Swimming Association registry ( N = 4578) were asked to complete a structured questionnaire on their medical history, swimming background, swimming environment and symptoms in different swimming intensities. Two hundred experienced swimmers, 107 females and 93 males, with an average age of 18.5 [standard deviation (SD) = 3.0] years and a swimming training history of 9 (SD = 3.8) years completed the questionnaire. Physician-diagnosed asthma was reported by 32 swimmers (16%), including 24 (12%) with exercise-induced asthma. Physician-diagnosed allergy was reported by 81 (41%) swimmers. Asthmatic symptoms during swimming were described by 84 subjects (42%). Most symptoms occurred when swimming exceeded speeds corresponding to the lactic/anaerobic threshold. Family history of asthma was significant and the most important risk factor for asthmatic symptoms. The prevalence of asthma in swimmers was higher than in the general population but not different from that in other endurance athletes. Family history of asthma and increased swimming intensity had the strongest associations with the reported asthmatic symptoms. Please cite this paper as: Päivinen MK, Keskinen KL and Tikkanen HO. Swimming and asthma: factors underlying respiratory symptoms in competitive swimmers. The Clinical Respiratory Journal 2010; 4: 97-103. [ABSTRACT FROM AUTHOR]

Transferable picture tattoos for the skin are popular among children. There is however very little knowledge about the colourants that may be present in the picture tattoos and thus of the risk of contact allergic reactions. In the present investigation, 36 picture tattoos were analysed for the content of 129 organic colourants listed in the Cosmetic Directive, to which these products should comply as they are used on the skin. Only 11 of the cosmetic colourants could be identified in the analysed samples. Allergenic potential of 7 of these colourants (CI 15850, CI 11920, CI 45220, CI 75300, CI 13015, CI 45100 and CI 15525, maximum concentration 35–4479 p.p.m.) was evaluated on the basis of published scientific data. Only scarce information regarding contact allergy to these substances was found in the available literature. Most information in the literature regarding contact allergy has concerned CI 75300, curcumin, which is reported to have caused a few cases of contact allergy as a colourant in food or in disinfectants used prior to surgery. In no case, allergic reactions to any of the colourants have been verified from transferable picture tattoos. On the basis of this investigation, the risk of allergic reactions from the colourants in the transferable picture tattoos seems to be limited. [ABSTRACT FROM AUTHOR]

There is an ongoing debate whether there is a link between a history of atopy and cancer risk. The purpose of this paper is to review the published epidemiological studies on the association between atopy and the risk of cancers. Through an electronic search (January 1986–April 2004) with an additional review of cited references, we identified studies with quantitative data on the relation of atopy (irrespective of its definition or subtype) to cancer (different cancer sites). The protective effect of atopy in colorectal cancer has been observed consistently in the case–control studies, but not in cohort studies. A consistent inverse association between self-reported atopy and glioma risk has been shown, but there is absence of such an association for meningioma. In most studies, the risk of leukaemia, in particular childhood leukaemia, tends to be lower among people with a history of atopy. Studies, which looked at, the association between atopic diseases and risk of cancers of pancreatic, breast, lymphoma showed varying outcomes. Most studies on the atopy–pancreatic cancer relation suggested an inverse association. For lymphoma, most studies have shown no substantial association. Overall evidence indicates an increased risk of lung cancer among persons with a history of asthma. Despite the mixed results, the emerging picture from most of the currently available epidemiological data indicate that atopic disease is associated with a reduced risk for cancer. Further research should focus on a more carefully defined ‘atopy’ status and manifestation of different atopic diseases, to advance our understanding of the role that allergies might play in the risk of developing cancer. [ABSTRACT FROM AUTHOR]

Allergy to recombinant human (rDNA) insulin preparations is a rare complication of insulin therapy. However, insulin preparations contain several allergens, and several disorders can resemble insulin allergy. Studies evaluating the diagnostic procedures on suspected insulin allergy are extremely few.Since January 1998, we have used a standardized investigative procedure during admittance to the medical ward allowing observation and repeated recording of reactions to intradermal skin test (performed with a commercially available kit containing isolated insulin allergens). Data on all investigated cases until April 2003 were collected retrospectively, and self-reported efficacy of intervention was compared to clinical data.Twenty-two patients were included. In nine (41%) cases, non-insulin allergic causes were discovered and successfully treated: poor injection technique (n = 5), skin disease (n = 3) and other systemic allergy (n = 1). Nine other patients were found to be allergic to protamine (n = 3) or rDNA insulin (n = 6), and specific treatment was associated with relief in 8 patients (89%). Four patients had local reactions of unknown causes but symptom relief was obtained in three cases by unspecific therapy. Overall, 20 (91%) reported relief of symptoms.Our standardized investigative procedure of suspected insulin preparation (IP) allergy was associated with relief of symptoms in>90% of patients. IP allergy was diagnosed in 41%, and intradermal testing with isolated insulin allergens was a prerequisite in identification of culprit allergen and targeting of treatment.Diabet. Med. (2004) [ABSTRACT FROM AUTHOR]

Background: Penicillin allergy is the most reported adverse drug reaction (ADR). Being labelled with 'penicillin allergy' is associated with suboptimal antibiotic therapy and poor patient outcomes. Most labelled with 'penicillin allergy' are at low risk of harm from penicillins and guidelines recommend testing for accurate diagnosis. Although skin testing is recommended to exclude immunoglobulin E (IgE)‐mediated reactions, there is limited access in most settings. Aims: To evaluate oral amoxicillin challenge without prior skin testing for patients labelled with 'penicillin allergy' assessed as low risk during hospital admission. Methods: General Medical inpatients with a 'penicillin allergy' label were assessed. For those who had tolerated a penicillin since the index event, the ADR label was removed. Those assessed as 'low risk' were administered 250 mg amoxicillin orally without prior skin testing. The durability of de‐labelling was subsequently assessed by review of clinical records. Results: Of 224 patients with a history of a penicillin ADR, 162 (72%) were low risk. A further 12 were excluded and of the remaining 150, 56 (37%) had tolerated penicillins since their index reaction and were de‐labelled without challenge, 15 (10%) with a non‐allergic history were de‐labelled. The remaining 79 were offered an oral amoxicillin challenge; 38 declined and 41 tolerated amoxicillin. Overall, 112 of the 224 (50%) patients had their ADR label removed. Conclusions: A careful ADR history enables de‐labelling of many patients. An oral amoxicillin challenge without prior skin testing is safe and feasible for low‐risk penicillin allergic patients while in hospital. [ABSTRACT FROM AUTHOR]

Background/Objectives: Allergic contact dermatitis, photoallergic contact dermatitis and irritant reactions to sunscreens are common reasons for dermatology consultation. Patch testing for contact allergy relies on up‐to‐date knowledge of allergen exposures. The aim of this study was to investigate contact allergens and photoallergens in sunscreens commercially sold on the shelves of supermarkets and pharmacies in New Zealand. Methods: A comprehensive market data review of suppliers' websites was performed from March to August 2019 to obtain a list of the commonly sold sunscreens in our region. Ingredients were collated and analysed according to International Nomenclature of Cosmetic Ingredients (INCI) names. Ultraviolet (UV) filters, preservatives and fragrances were included for analysis. Place of sale and cost of sunscreens were also recorded. Results: Ninety‐five sunscreens were analysed: 36% sold in supermarkets, 43% in pharmacies and the remainder available in both. The most frequent UV filters were butyl methoxydibenzoylmethane (contained in 70% of products) followed by octocrylene (63%) and homosalate (50%). The common photoallergen benzophenone 3 was found in 19% of products. Phenoxyethanol was the most common preservative (68%) followed by disodium EDTA (30%) and propylparaben (26%). Two sunscreens contained methylisothiazolinone. Sixty‐one per cent contained at least one fragrance, the most frequent being limonene (17%) and linalool (13%). There was an average of 1.1 New Zealand baseline series allergens per product (range 0 to 6, standard deviation 1.27). Conclusion: Common allergens including those with high sensitising potential were frequently found in New Zealand sunscreen. Knowledge of ingredients used by manufacturers is useful in dermatological assessment of skin contact reactions. [ABSTRACT FROM AUTHOR]

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Background: The COVID‐19 pandemic has affected health care systems unexpectedly. However, data focusing on practical considerations experienced by health care professionals (HCPs) providing care to allergic patients is scarce. Methods: Under the framework of the European Academy of Allergy and Clinical Immunology (EAACI), a panel of experts in the field of immunotherapy developed a 42‐question online survey, to evaluate real‐life consequences of the COVID‐19 pandemic in allergy practice. Results: The respondents in the survey were 618. About 80% of HCPs indicated being significantly affected in their allergy practice. A face‐to‐face visit reduction was reported by 93% of HCPs and about a quarter completely interrupted diagnostic challenges. Patients with severe uncontrolled asthma (59%) and anaphylaxis (47%) were prioritized for in‐person care. About 81% maintained an unaltered prescription of inhaled corticosteroids (ICS) in asthmatics. About 90% did not modify intranasal corticosteroids (INCS) in patients with allergic rhinitis. Nearly half of respondents kept biological prescriptions unmodified for asthma. About 50% of respondents kept their allergen immunotherapy (AIT) prescription patterns unchanged for respiratory allergies; 60% for insect venom allergies. Oral immunotherapy (OIT) for food allergies was initiated by 27%. About 20% kept carrying out up‐dosing without modifications and 14% changed to more prolonged intervals. Telemedicine practice was increased. Conclusions: HCPs providing care to allergic patients were affected during the pandemic in diagnostic, management, and therapeutic approaches, including AIT for respiratory, insect‐venom, and food allergies. Most HCPs maintained controller treatments for both asthma, and allergic rhinitis consistent with international recommendations, as well as biological agents in asthma. Remote tools are valuable in delivering allergy care. [ABSTRACT FROM AUTHOR]

Background: Guidelines for management of patients with allergic conditions are available, but the added value of nurses, allied healthcare professionals (AHPs), and general practitioners (GPs), in the management of allergic disease, has not been fully clarified. The European Academy of Allergy and Clinical Immunology (EAACI) appointed a task force to explore this issue. Aim: To investigate the added value of nurses, AHPs, and GPs in management of allergic diseases, in an integrated model of care. Methods: A search was made of peer‐reviewed literature published between 2010 and December 2020 (Cochrane Library, PubMed, and CINAHL) on the involvement of the various specific healthcare providers (HCPs) in the management of allergic diseases. Results: Facilitative models of care for patients with allergies can be achieved if HCP collaborates in the diagnosis and management. Working in multi‐disciplinary teams (MDT) can increase patients' understanding of the disease, adherence to treatment, self‐care capabilities, and ultimately improve quality of life. The MDT competencies and procedures can be improved and enhanced in a climate of mutual respect and shared values, and with inclusion of patients in the planning of care. Patient‐centered communication among HCPs and emphasis on the added value of each profession can create an effective integrated model of care for patients with allergic diseases. Conclusion: Nurses, AHPs, and GPs, both individually and in collaboration, can contribute to the improvement of the management of patients with allergic disease. The interaction between the HCPs and the patients themselves can ensure maximum support for people with allergies. [ABSTRACT FROM AUTHOR]

Background: Allergic diseases pose a health problem worldwide. Pollen are widespread aeroallergens which can cause symptoms like shortness of breath, cough, itchy eyes, or rhinitis. Apart from preventive measures and pharmacological treatment, also non‐pharmacological interventions have been suggested to reduce symptoms. The objective of this work was to review studies investigating the effectiveness of non‐pharmacologic interventions to reduce allergic symptoms. Methods: PubMed, EMBASE, and CENTRAL were systematically reviewed in July 2018 and April 2020. Several authors worked on the screening of titles, abstracts, and full texts. One author for each literature search performed the data extraction and the risk of bias assessment. Studies were included if they met the inclusion criteria defined by the PECOs. Studies which investigating the effect of non‐pharmacologic interventions on patients with allergic rhinitis were included. Results: Twenty‐nine studies investigating eleven types of non‐pharmacologic interventions to avoid and reduce allergic symptoms due to pollen exposure were included in this review. Out of all studies, seven studies addressed nasal rinsing and 22 included acupuncture, air filtering, artisanal tears, individual allergen avoidance advice, various nasal applications, self‐hypnosis, rhinophototherapy, and wraparound sunglasses. Conclusion: Most studies had a high risk of bias and small sample sizes. There were only a few high‐quality studies that give hints about the effectiveness of non‐pharmacological interventions. For future research, more high‐quality studies are required to confirm the effectiveness of simple, safe, and cost‐effective interventions. [ABSTRACT FROM AUTHOR]

Interest of families with allergic children in the prediction of (A) course of current allergic disease or developing a further allergic disease (left) and if the answer is yes/not sure, which allergic disease are you interested in (right); (B) What probability of your child to develop an additional allergic disease do you count as reliable; (C) How important do you consider certain fields of action and research in health? Keywords: allergy; biomarker; childhood; cohorts; health-related quality of life; prediction; survey EN allergy biomarker childhood cohorts health-related quality of life prediction survey 1 6 6 01/05/22 20220101 NES 220101 ACKNOWLEDGEMENTS We would like to thank all participating families. CHAMP is a novel multicentre German allergy consortium, which investigates the critical needs of children with allergic diseases, namely prediction of allergic diseases and improvement of health-related quality of life (HrQoL). When asked about the importance of distinct research priorities and fields of action (Figure 1C), doctor's training was ranked as most important (86.9%), allergy prevention as second (73.8%), followed by research into care (65.9%), new drug therapy (63.6%) and a better understanding of allergy in general (65.5%). [Extracted from the article]

Background: Parents report that children with aluminium contact allergy and vaccination granulomas may react to aluminium‐containing sunscreen following application. Objectives: To evaluate whether contact dermatitis develops following repeated application of aluminium‐containing sunscreens in children with aluminium sensitization and vaccination granulomas. Methods: Sixteen children aged 2‐9 years (mean age 5 years) with vaccination granulomas and a positive patch test reaction to aluminium chloride hexahydrate 2%/10% petrolatum completed a blinded repeated open application test (ROAT) with two daily applications of two sunscreens for 14 days. One cream contained aluminium and the other did not. The children served as their own controls. Results: Sixteen children completed the study. Only one child (6%) had a positive skin reaction during ROAT on day 2 to the sunscreen with aluminium. None reacted to the sunscreen without aluminium. Conclusions: Use of aluminium‐containing sunscreens may on a case basis lead to allergic contact dermatitis in aluminium allergic children. [ABSTRACT FROM AUTHOR]

Background: The immune system plays a key role in the pathogenesis of asthma and allergy, but the role of the airway cytokine and chemokine composition in vivo in early life prior to symptom development has not been described previously. Here, we aimed to examine whether the neonatal airway immune composition associates with development of allergy and asthma in childhood. Methods: We measured unstimulated levels of 20 immune mediators related to the Type 1, Type 2, Type 17, or regulatory immune pathways in the airway mucosal lining fluid of 620 one‐month‐old healthy neonates from the COPSAC2010 birth cohort. Allergy and asthma were diagnosed at our research clinic by predefined algorithms and objective assessments at age 6 years. Principal component analyses were used to describe the airway cytokine and chemokine composition. Results: A neonatal airway immune profile particularly characterized by enhanced IL‐1β and reduced CCL26 was significantly associated with later development of elevated specific IgE to inhaled allergens, a positive skin prick test, and allergic rhinitis, but not with food sensitization. Conversely, reduced Type 17 immune‐associated markers, including IL‐1β and CXCL8, showed trend of association with development of early asthma endpoints. Conclusions: Development of early asthma endpoints and inhalant allergy during the first 6 years of life seems associated with distinctly perturbed airway immune profiles in neonatal life, which is suggestive of an early origin and different pathogenesis of childhood asthma and allergy. These exploratory findings suggest pre‐ and perinatal life as an important window of opportunity for prevention of asthma and inhalant allergy. [ABSTRACT FROM AUTHOR]

Asparaginase (ASP) is an essential component for the acute lymphoblastic leukemia (ALL) treatment, but toxicities, such as allergy, frequently limit its use. Although the potentially lower PEG‐ASP formulation immunogenicity, few studies with conflicting results have compared the allergy incidence between Escherichia coli‐ASP and PEG‐ASP in the same protocol. We aimed at comparing the allergy incidence in children receiving native E. coli‐ASP versus PEG‐ASP within the same clinical protocol (Spanish Society of Pediatric Hematology and Oncology ALL‐SEHOP‐PETHEMA 2013). One hundred and twenty‐six children (1–19 years) diagnosed with ALL from 2013 to 2020 were included. Patients in group 1 received a sequential scheme of native E. coli‐ASP 10,000 IU/m2 intramuscularly (IM) followed by PEG‐ASP 1000 IU/m2 IM. Patients in group 2 received PEG‐ASP 1000 IU/m2 IM upfront. Clinical allergy incidence was compared between both groups. Serum ASP activity (SAA) was measured in a subgroup of patients, and silent inactivation was recorded. The cumulative incidence of clinical allergy was significantly higher in group 1 (native followed by PEG‐ASP) than in group 2 (PEG‐ASP upfront), 24.7% versus 4.1% (p = 0.0085). Adequate ASP activity was achieved with PEG‐ASP 1000 IU/m2 dose in most patients (median SAA 412.5 and 453.0 IU/L at days 7 and 14). The incidence of silent inactivation in PEG‐ASP upfront patients was very low. PEG‐ASP‐used upfront was associated with a lower incidence of clinical allergy than that observed in the sequential use of native E. coli‐ASP followed by PEG‐ASP. PEG‐ASP at 1000 IU/m2 was effective in achieving enough ASP activity in most patients. [ABSTRACT FROM AUTHOR]

The "epithelial barrier hypothesis" proposes that the exposure to various epithelial barrier–damaging agents linked to industrialization and urbanization underlies the increase in allergic diseases. The epithelial barrier constitutes the first line of physical, chemical, and immunological defense against environmental factors. Recent reports have shown that industrial products disrupt the epithelial barriers. Innate and adaptive immune responses play an important role in epithelial barrier damage. In addition, recent studies suggest that epithelial barrier dysfunction plays an essential role in the pathogenesis of the atopic march by allergen sensitization through the transcutaneous route. It is evident that external factors interact with the immune system, triggering a cascade of complex reactions that damage the epithelial barrier. Epigenetic and microbiome changes modulate the integrity of the epithelial barrier. Robust and simple measurements of the skin barrier dysfunction at the point‐of‐care are of significant value as a biomarker, as recently reported using electrical impedance spectroscopy to directly measure barrier defects. Understanding epithelial barrier dysfunction and its mechanism is key to developing novel strategies for the prevention and treatment of allergic diseases. The aim of this review is to summarize recent studies on the pathophysiological mechanisms triggered by environmental factors that contribute to the dysregulation of epithelial barrier function. [ABSTRACT FROM AUTHOR]

Background: Although widely practiced for over 80 years, the role of specific immunotherapy (SIT) in pediatric asthma treatment is still controversial. We assessed the effects of a 3-year period of subcutaneous administration of a standardized preparation of Dermatophagoides pteronyssinus ( D pt ) on the respiratory health in a group of asthmatic children monosensitized to house dust mite (HDM). Methods: A randomized clinical trial was performed after 1-year run-in period. Fifteen children receiving SIT for HDM and 14 controls (four drop-outs), matched for age, allergen sensitization, asthma severity, lung function, and non-specific bronchial reactivity (BHR), were studied during the 3-year treatment period. During the whole trial, respiratory symptoms, pharmacological and respiratory function parameters were regularly evaluated. Skin prick tests and methacholine challenge were performed at the beginning and end of the study. Results: In the SIT group significant improvement in asthmatic symptoms and marked reduction in drug intake was observed. The SIT group also showed a significant decrease in non-specific bronchial BHR. No new sensitivity occurred during the study period in the SIT group only. No major local or systemic side-effects were reported during the study. Conclusions: Our results confirm that SIT is effective in asthmatic children sensitive to mites. It is associated with a decrease in BHR and it may prevent the development of new sensitizations in monosensitized subjects. [ABSTRACT FROM AUTHOR]

BackgroundSpecific immunotherapy is the only currently available allergen-orientated treatment able to modify the natural history of respiratory allergic diseases. Safety and clinical efficacy of this treatment are well documented, but evidence about the ability to reduce new sensitizations is still poor. ObjectiveWe report a retrospective study conducted in order to assess the prevention of new sensitizations in monosensitized subjects treated with specific immunotherapy vs. monosensitized patients treated with anti-allergic drugs. Methods8396 monosensitized patients with respiratory symptoms were selected according to an open, retrospective design. Group A included 7182 patients submitted to specific immunotherapy (and anti-allergic drugs when needed) for 4 years and then treated with drugs for at least 3 years. Group B included 1214 patients treated only with drugs for at least 7 years. All patients underwent prick test with a standard panel of allergens and total and specific IgE determination before and after 4 years of treatment and again 3 years later. ResultsGroups were well balanced. Polysensitized subjects were 23.75% in Group A and 68.03% in Group B after 4 years (P < 0.0001) and 26.95% and 76.77%, respectively, after 7 years (P < 0.0001). Asthmatic subjects were more prone to develop polysensitization in comparison to subjects suffering only from rhinitis (32.14% instead of 27.29% after 4 years, 36.5% instead of 31.33% after 7 years; P < 0.0001). Specific IgE decreased by 24.11% in Group A and increased by 23.87% in Group B (P < 0.0001). Total IgE decreased by 17.53% in Group A and increased by 13.71% in Group B (P < 0.0001). ConclusionsSpecific immunotherapy was observed retrospectively to reduce new sensitizations in monosensitized subjects suffering from respiratory allergic diseases. [ABSTRACT FROM AUTHOR]

Allergy, belt-like rashes, corticosteroids, hypersensitivity, patch test, prednisolone acetate, wheal Belt-like rashes caused by systemic prednisolone acetate Keywords: allergy; belt-like rashes; corticosteroids; hypersensitivity; patch test; prednisolone acetate; wheal EN allergy belt-like rashes corticosteroids hypersensitivity patch test prednisolone acetate wheal 5238 5240 3 11/02/22 20221001 NES 221001 ACKNOWLEDGEMENT The authors would like to thank the patient in this manuscript has given written informed consent to the publication of her case details. [Extracted from the article]

After a suspected allergic reaction to first dose of mRNA COVID‐19 vaccine, given the PEG skin tests negativity and tolerance in vivo to PEG containing drugs, five patients were vaccinated with the second dose of Pfizer‐Biontech undergoing a fractional protocol, with antihistamine premedication, without presenting immediate or delayed reactions. Our aim was to strengthen that, after an allergological valuation, a fractionated administration of undiluted vaccine seems to be safe and secure in patients with a suspected previous nonsevere allergic reaction to Pfizer‐BioNTech COVID‐19 vaccine. [ABSTRACT FROM AUTHOR]

Interleukin‐33 (IL‐33) is an epithelial‐derived cytokine that plays an important role in immune‐mediated diseases such as asthma, atopic dermatitis, and rheumatoid arthritis. Although IL‐33 is considered a potential target for the treatment of allergy‐related diseases, no small molecule that inhibits IL‐33 has been reported. Based on the structure‐activity relationship and in vitro 2D NMR studies employing 15N‐labeled IL‐33, we identified that the oxazolo[4,5‐c]‐quinolinone analog 7 c binds to the interface region of IL‐33 and IL‐33 receptor (ST2), an orphan receptor of the IL‐1 receptor family. Compound 7 c effectively inhibited the production of IL‐6 in human mast cells in a dose‐dependent manner. Compound 7 c is the first low molecular weight IL‐33 inhibitor and may be used as a prototype molecule for structural optimization and investigation of the IL‐33/ST2 signaling pathway. [ABSTRACT FROM AUTHOR]

Background: Worldwide 10–20% of the population is tattooed. However, tattoo complications can occur, such as allergic tattoo reactions, infections, and manifestations of autoimmune dermatoses. Despite the growing popularity of tattoos and changes in tattoo ink composition over the last decades, little is known about these complications, its clinical aspects, pathomechanism, and relative occurrence. Objective: The aim of this article is to describe the types and clinical aspects of dermatological tattoo complications, its relative occurrence and underlying conditions. Methods: We performed a retrospective cohort study enrolling all patients with tattoo complications from the Tattoo Clinic. Tattoo complications were categorized into infections, inflammatory tattoo reactions, neoplasms, or miscellaneous reactions and correlated to clinical data. Results: Of the total of 326 patients, 301 patients were included with 308 complications. The majority of the complications were chronic: 91.9%. Allergic red tattoo reactions and chronic inflammatory black tattoo reactions (CIBTR) accounted for 50.2% and 18.2%, respectively, of all tattoo complications. Of these CIBTR reactions, extracutaneous involvement was found in 21.4%, including tattoo‐associated uveitis (7.1%) and systemic sarcoidosis (14.2%). Of all black tattoo reactions, systemic sarcoidosis was found in 7.8%. Conclusion: Tattoos can cause a wide range in complications that may start years after getting the tattoo. The most frequent tattoo reactions are allergic red tattoo reactions and chronic inflammatory black tattoo reactions, making these the most relevant for the dermatologist. CIBTR have a high percentage of multi‐organ involvement, and therefore, screening for sarcoidosis, including ocular involvement, is advised. [ABSTRACT FROM AUTHOR]

Summary: Chickpea (Cicer arietinum L.) is one of the most grown and consumed pulses and it is traditionally commercialised as seeds, flour or canned foods. In the frame of alternative protein sources, chickpea emerged as a rich source of dietary proteins (17–22%) that can be dry‐ or wet‐extracted. The application of chickpea proteins as food ingredients is still in the early stages, where their properties and how they interact within food matrices are scarcely studied. Therefore, this review provides recent advances in processing, characteristics and applications of chickpea proteins. Nutritionally, these proteins have various biological activities, adequate levels of essential amino acids and protein digestibility. Technologically, their bland flavour, neutral taste and light colour make them suitable ingredients for new products development including noodles, breads, cookies and sausages. Chickpea proteins and particularly hydrolysates are a promising alternative to be used more broadly as functional ingredients. [ABSTRACT FROM AUTHOR]

Microbiota composition and associated metabolic activities are essential for the education and development of a healthy immune system. Microbial dysbiosis, caused by risk factors such as diet, birth mode, or early infant antimicrobial therapy, is associated with the inception of allergic diseases. In turn, allergic diseases increase the risk for irrational use of antimicrobial therapy. Microbial therapies, such as probiotics, have been studied in the prevention and treatment of allergic diseases, but evidence remains limited due to studies with high heterogeneity, strain‐dependent effectiveness, and variable outcome measures. In this review, we sketch the relation of microbiota with allergic diseases, the overuse and rationale for the use of antimicrobial agents in allergic diseases, and current knowledge concerning the use of bacterial products in allergic diseases. We urgently recommend 1) limiting antibiotic therapy in pregnancy and early childhood as a method contributing to the reduction of the allergy epidemic in children and 2) restricting antibiotic therapy in exacerbations and chronic treatment of allergic diseases, mainly concerning asthma and atopic dermatitis. Future research should be aimed at antibiotic stewardship implementation strategies and biomarker‐guided therapy, discerning those patients that might benefit from antibiotic therapy. [ABSTRACT FROM AUTHOR]

Eotaxin at 10 nM significantly enhanced basophil histamine release triggered by anti-IgE antibody and C5a (Figure 1A); release was similarly enhanced in highly pure (purity: ~90%) basophils (Figure 1B). Keywords: allergy; basophils; eotaxin (CCL11); histamine; leukotriene C4 EN allergy basophils eotaxin (CCL11) histamine leukotriene C4 3549 3552 4 11/01/21 20211101 NES 211101 ACKNOWLEDGEMENTS The authors thank Drs Kei Onuma, Ryo Hatano (Juntendo University) and Hiroshi Kawasaki (JCHO Yugawara Hospital) for kindly providing us with anti-CCR3 hybridoma, Ms Sayaka Igarashi for helpful advice on the experimental procedures, Dr Hirokazu Sakasegawa for his critical reading of this manuscript, and Ms Yasuko Asada for her excellent secretarial work. [Extracted from the article]

Nanotechnology is science, engineering and technology conducted at the nanoscale, which is about 1–100 nm. It has led to the development of nanomaterials, which behave very differently from materials with larger scales and can have a wide range of applications in biomedicine. The physical and chemical properties of materials of such small compounds depend mainly on the size, shape, composition and functionalization of the system. Nanoparticles, carbon nanotubes, liposomes, polymers, dendrimers and nanogels, among others, can be nanoengineeried for controlling all parameters, including their functionalization with ligands, which provide the desired interaction with the immunological system, that is dendritic cell receptors to activate and/or modulate the response, as well as specific IgE, or effector cell receptors. However, undesired issues related to toxicity and hypersensitivity responses can also happen and would need evaluation. There are wide panels of accessible structures, and controlling their physico‐chemical properties would permit obtaining safer and more efficient compounds for clinical applications goals, either in diagnosis or treatment. The application of dendrimeric antigens, nanoallergens and nanoparticles in allergy diagnosis is very promising since it can improve sensitivity by increasing specific IgE binding, mimicking carrier proteins or enhancing signal detection. Additionally, in the case of immunotherapy, glycodendrimers, liposomes, polymers and nanoparticles have shown interest, behaving as platforms of allergenic structures, adjuvants or protectors of allergen from degradation or having a depot capacity. Taken together, the application of nanotechnology to allergy shows promising facts facing important goals related to the improvement of diagnosis as well as specific immunotherapy. [ABSTRACT FROM AUTHOR]

Background: Metal alloys containing contact sensitizers (nickel, palladium, titanium) are extensively used in medical devices, in particular dentistry and orthopaedic surgery. The skin patch test is used to test for metal allergy. Objective: To determine whether metal salts, when applied to freshly excised skin at patch test–relevant concentrations and using a method which mimics skin patch testing, cause in changes in the epidermis and dermis. Methods: Tissue histology, apoptosis, metabolic activity, and inflammatory cytokine release were determined for two nickel salts, two palladium salts, and four titanium salts. Results: Patch test–relevant concentrations of all metal salts caused localized cytotoxicity. This was observed as epidermis separation at the basement membrane zone, formation of vacuoles, apoptotic nuclei, decreased metabolic activity, and (pro)inflammatory cytokine release. Nickel(II) sulfate hexahydrate, nickel(II) chloride hexahydrate, titanium(IV) bis(ammonium lactato)dihydroxide, and calcium titanate were highly cytotoxic. Palladium(II) chloride, sodium tetrachloropalladate(II), titanium(IV) isopropoxide, and titanium(IV) dioxide showed mild cytotoxicity. Conclusion: The patch test in itself may be damaging to the skin of the patient being tested. These results need further verification with biopsies obtained during clinical patch testing. The future challenge is to remain above the elicitation threshold at noncytotoxic metal concentrations. [ABSTRACT FROM AUTHOR]

This guideline advises on the management of patients with egg allergy. Most commonly egg allergy presents in infancy, with a prevalence of approximately 2% in children and 0.1% in adults. A clear clinical history will confirm the diagnosis in most cases. Investigation by measuring egg‐specific IgE (by skin prick testing or specific IgE assay) is useful in moderate‐severe cases or where there is diagnostic uncertainty. Following an acute allergic reaction, egg avoidance advice should be provided. Egg allergy usually resolves, and reintroduction can be achieved at home if reactions have been mild and there is no asthma. Patients with a history of severe reactions or asthma should have reintroduction guided by a specialist. All children with egg allergy should receive the MMR vaccine. Most adults and children with egg allergy can receive the influenza vaccine in primary care, unless they have had anaphylaxis to egg requiring intensive care support. Yellow Fever vaccines should only be considered in egg‐allergic patients under the guidance of an allergy specialist. This guideline was prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI) and is intended for allergists and others with a special interest in allergy. The recommendations are evidence based. Where evidence was lacking, consensus was reached by the panel of specialists on the committee. The document encompasses epidemiology, risk factors, diagnosis, treatment, prognosis and co‐morbid associations. [ABSTRACT FROM AUTHOR]

Allergic diseases, including asthma, food allergy, eczema, and allergic rhinitis, are common diseases increasing in prevalence. Allergy, a failure of immune tolerance to innocuous environmental allergens, is characterized by allergen‐specific immune responses, including IgE antibodies and T helper and T follicular helper cells producing type 2 cytokines. Despite the central role of adaptive immunity in pathophysiology of allergy, there is a growing body of evidence indicating an important role for the innate immune system in allergic disease. In this review, we focus on epithelial–mononuclear phagocyte communication in the control of allergy and tolerance. We discuss studies on early life environmental exposures and allergy susceptibility, and the evidence for innate training of mononuclear phagocytes as the mechanistic link between exposure and health or disease. [ABSTRACT FROM AUTHOR]

Natural products and their derivatives are known to be useful for treating numerous diseases since ancient times. Because of their high therapeutic potentials, the use of different medicinal plants is possible to treat varied inflammation‐mediated chronic diseases. Among natural products, phytosteroids have emerged as promising compounds mostly because they have diverse pharmacological activities. Currently, available medications exert numerous systemic toxicities, including hypertension, immune suppression, osteoporosis, and metabolic abnormalities. Thus, further research on phytosteroids to subside these complications is of significant importance. In this study, the information on phytosteroids, their types, and actions against inflammation, and allergic complications was collected by a systematic survey of literature on several scientific search engines. The literature review suggested that phytosteroids exhibit antiinflammatory action via different modes through transrepression or selective COX‐2 enzymes. Also, in silico ADMET analysis was carried out on available phytosteroids to uncover their pharmacokinetic properties. Our analysis has shown that eight compounds: withaferin A, stigmasterol, β‐sitosterol, guggulsterone, diosgenin, sarsasapogenin, physalin A, and dioscin, −isolated from medicinal plants show similar pharmacokinetic properties as compared to dexamethasone, commercially available glucocorticoid. These phytosteroids could be useful for the treatment of inflammatory diseases, such as rheumatoid arthritis, inflammatory bowel diseases, multiple sclerosis, asthma, and cardiovascular diseases. Thus, systematic research is required to explore potent phytosteroids with lesser side effects, which might substitute the current medications. [ABSTRACT FROM AUTHOR]

Introduction: Inhibitors develop less frequently in haemophilia B (HB) than haemophilia A (HA). However, when present, the success of tolerization by immune tolerance induction (ITI) therapy is lower and the risk of complications higher. Aim: To evaluate the use and outcome of ITI in patients with HB and inhibitors. Methods: Subjects include singletons or siblings with a current/history of inhibitors enrolled in B‐Natural—an observational study designed to increase understanding of clinical management of patients with HB. Patients were followed for 6 months and information on demographics, medical and social history, and treatment were recorded. Results: Twenty‐nine patients with severe HB and inhibitors were enrolled in 24 centres. Twenty‐two underwent one or more courses of ITI with or without immune suppression. Eight patients (36.4%) were successfully tolerized after the first course of ITI. One of these successes (12.5%) experienced allergic manifestations, whereas the corresponding number for the 10 treatment failures was five (50%). One of seven (14.2%) patients with large deletions and three of eight (37.5%) with nonsense mutations were tolerized at the first attempt, and all patients experiencing nephrosis either failed or were on‐going. At study end, 11 (50%) were considered successfully tolerized after one or more ITI courses, three were unsuccessful, and eight were still undergoing treatment. Conclusion: Our data underscore the possibilities and difficulties of achieving tolerization in patients with HB with inhibitors. The type of mutation and complications appear to correlate with ITI outcome, but more accurate definitions of successful ITI are warranted. [ABSTRACT FROM AUTHOR]

Dermatologists use gloves as a major tool in universal precautions to prevent transmission of infections particularly human immunodeficiency virus (HIV) and hepatitis. We need to know how much protection is conferred by gloves and what problems are associated with glove use. This paper looks at these issues and reports the results of a survey on glove use by Australian dermatologists. The survey found a lack of awareness regarding gloves as a protective measure, suggesting the need to improve knowledge in this area so that realistic precautions can be adopted. Dermatologists have a high rate of glove use and reactions to gloves were noted by 13% of respondents. The authors recommend the use of non-powdered, low-allergen latex gloves. Handwashing prior to using non-powdered latex gloves needs further investigation. Handwashing after wearing latex gloves may decrease sensitization risk. [ABSTRACT FROM AUTHOR]