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Anaphylaxis: Spotlight on Inflammation 过敏反应:聚焦炎症。
IF 6.3 2区 医学 Q1 ALLERGY Pub Date : 2025-01-07 DOI: 10.1111/cea.14610
Emilio Nuñez-Borque, Timothy E. Dribin, Pablo Rodriguez Del Rio, Carlos A. Camargo Jr, Vanesa Esteban, George du Toit, Rodrigo Jiménez-Saiz, Mattia Giovannini
<p>Anaphylaxis is a medical condition for which several definitions have been proposed (Table 1 is available in the repository information at https://osf.io/sc2ey/?view_only=f66e841be31b42418eecf639caa0b24d). Charles Richet and Paul Portier coined the term ‘anaphylaxis’ in 1902. If discovered earlier, it might have invigorated the ongoing scientific debate in the late 19th century between Rudolf Virchow and Iliá Méchnikov on the detrimental versus beneficial nature of inflammation [<span>1</span>]. While inflammation typically serves as a response to tissue damage or infection, to restore homeostasis, anaphylaxis is a classic example of an immunopathological reaction in which an exaggerated and inappropriate response can lead, although rarely, to potentially fatal outcomes. Precisely, the role of inflammation has been underlined as central in several atopic diseases, but, surprisingly, not in anaphylaxis.</p><p>The most common triggers of anaphylaxis are foods, insect stings and medications, but the aetiology may be unknown in some cases (idiopathic). This reaction is a multisystem condition that may involve different findings from the skin/mucosal, respiratory, cardiovascular and/or gastrointestinal systems. However, patients may rarely present isolated respiratory or cardiovascular involvement, and skin/mucosal participation may be absent. In addition, anxiety about the possibility of a new episode of anaphylaxis significantly impairs the quality of life of patients and their relatives, restricting daily activities and increasing the state of constant alertness [<span>2</span>]. The foundations of acute anaphylaxis management are removing the trigger, proper patient positioning, immediate administration of adrenaline and repeat adrenaline injections if severe clinical manifestations do not resolve. Moreover, this treatment can be supplemented with the use of second-line medications (e.g., β2-adrenergic agonists), as well as with the administration of supportive treatments (e.g., oxygen) [<span>2, 3</span>]. Most patients treated with adrenaline experience prompt resolution of symptoms and signs. However, a minority of patients may require three or more doses of adrenaline (refractory anaphylaxis) or have recurrence after an asymptomatic period (biphasic anaphylaxis) [<span>4, 5</span>].</p><p>Different signalling pathways can mediate anaphylaxis (Figure 1). Among them, the classical one is mediated by immunoglobulin (Ig)E. In sensitised individuals, secreted IgE binds to its high-affinity receptor (FcεRI) on effector cells (mainly mast cells and basophils), which store preformed pro-inflammatory granules. Then, allergen binding by cell-bound IgE triggers effector cell activation, leading to the immediate release of potent pro-inflammatory mediators, such as histamine, tryptase, platelet-activating factor (PAF), prostaglandins, leukotrienes and TNF-α, which are responsible for the rapid clinical manifestations of anaphylaxis [<span>6</span>]. Ho
{"title":"Anaphylaxis: Spotlight on Inflammation","authors":"Emilio Nuñez-Borque,&nbsp;Timothy E. Dribin,&nbsp;Pablo Rodriguez Del Rio,&nbsp;Carlos A. Camargo Jr,&nbsp;Vanesa Esteban,&nbsp;George du Toit,&nbsp;Rodrigo Jiménez-Saiz,&nbsp;Mattia Giovannini","doi":"10.1111/cea.14610","DOIUrl":"10.1111/cea.14610","url":null,"abstract":"&lt;p&gt;Anaphylaxis is a medical condition for which several definitions have been proposed (Table 1 is available in the repository information at https://osf.io/sc2ey/?view_only=f66e841be31b42418eecf639caa0b24d). Charles Richet and Paul Portier coined the term ‘anaphylaxis’ in 1902. If discovered earlier, it might have invigorated the ongoing scientific debate in the late 19th century between Rudolf Virchow and Iliá Méchnikov on the detrimental versus beneficial nature of inflammation [&lt;span&gt;1&lt;/span&gt;]. While inflammation typically serves as a response to tissue damage or infection, to restore homeostasis, anaphylaxis is a classic example of an immunopathological reaction in which an exaggerated and inappropriate response can lead, although rarely, to potentially fatal outcomes. Precisely, the role of inflammation has been underlined as central in several atopic diseases, but, surprisingly, not in anaphylaxis.&lt;/p&gt;&lt;p&gt;The most common triggers of anaphylaxis are foods, insect stings and medications, but the aetiology may be unknown in some cases (idiopathic). This reaction is a multisystem condition that may involve different findings from the skin/mucosal, respiratory, cardiovascular and/or gastrointestinal systems. However, patients may rarely present isolated respiratory or cardiovascular involvement, and skin/mucosal participation may be absent. In addition, anxiety about the possibility of a new episode of anaphylaxis significantly impairs the quality of life of patients and their relatives, restricting daily activities and increasing the state of constant alertness [&lt;span&gt;2&lt;/span&gt;]. The foundations of acute anaphylaxis management are removing the trigger, proper patient positioning, immediate administration of adrenaline and repeat adrenaline injections if severe clinical manifestations do not resolve. Moreover, this treatment can be supplemented with the use of second-line medications (e.g., β2-adrenergic agonists), as well as with the administration of supportive treatments (e.g., oxygen) [&lt;span&gt;2, 3&lt;/span&gt;]. Most patients treated with adrenaline experience prompt resolution of symptoms and signs. However, a minority of patients may require three or more doses of adrenaline (refractory anaphylaxis) or have recurrence after an asymptomatic period (biphasic anaphylaxis) [&lt;span&gt;4, 5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Different signalling pathways can mediate anaphylaxis (Figure 1). Among them, the classical one is mediated by immunoglobulin (Ig)E. In sensitised individuals, secreted IgE binds to its high-affinity receptor (FcεRI) on effector cells (mainly mast cells and basophils), which store preformed pro-inflammatory granules. Then, allergen binding by cell-bound IgE triggers effector cell activation, leading to the immediate release of potent pro-inflammatory mediators, such as histamine, tryptase, platelet-activating factor (PAF), prostaglandins, leukotrienes and TNF-α, which are responsible for the rapid clinical manifestations of anaphylaxis [&lt;span&gt;6&lt;/span&gt;]. Ho","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"55 1","pages":"8-10"},"PeriodicalIF":6.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.14610","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hospitalisation Trends of Severe Paediatric Asthma in Tokyo 2015-2019. 东京2015-2019年严重儿科哮喘住院趋势
IF 6.3 2区 医学 Q1 ALLERGY Pub Date : 2025-01-05 DOI: 10.1111/cea.14620
Kazu Ishikawa, Kiwako Yamamoto-Hanada, Tatsuki Fukuie, Akira Ishiguro, Yukihiro Ohya
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引用次数: 0
Correction to “Prize-Winning Abstracts From BSACI 2024 Meeting”
IF 6.3 2区 医学 Q1 ALLERGY Pub Date : 2025-01-03 DOI: 10.1111/cea.14617

Mohamed H. Shamji and Robert J. Boyle, Prize-Winning Abstracts From BSACI 2024 Meeting. Clinical & Experimental Allergy, 54 (2024): 953955. https://doi.org/10.1111/cea.14599

Some text was missing from the article. The extra text is below, and should be added at the end of the article:

7. Allied Health Category Winner: Odette Rodda, University Hospital Dorset, UK

Assessing the need for an allergy service for Adolescents and Young Adults—a pilot study.

Timely, appropriate diagnosis and treatment are imperative in food allergy. This service evaluation aimed to explore the need for a dedicated allergy clinic for adolescents and young adults (AYA).

AYA aged 12–20 years with food allergies and other allergic conditions were approached during routine clinic appointments over 6 months. Fifty questionnaires were collected. Most (86%) knew how to recognise an allergic reaction and most (81.6%) had an adrenaline auto-injectors. However, only 12.8% rated their allergies as potentially causing anaphylaxis. Most (62%) AYA used antihistamines as rescue medications (62%) and most (59%) did not carry their autoinjector. Only 18.4% of respondents would tell friends about their allergies. Most (62%) would like to attend clinic with other AYA and 81% would prefer clinics in the afternoon or evening. Thematic analysis identified three themes ‘I have to take responsibility’, ‘I need peer support’ and ‘what happens next’. This pilot study identified AYA understanding and behaviours about their allergies and transition to adult services.

We apologize for this error.

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引用次数: 0
Food Allergy Prevalence in Two Population-Based UK Cohorts Born 12 Years Apart 相隔12年出生的两个英国人群的食物过敏患病率
IF 6.3 2区 医学 Q1 ALLERGY Pub Date : 2025-01-02 DOI: 10.1111/cea.14605
William Fong, Kaci Pickett-Nairne, Manzi Venter, Veeresh Patil, Syed Hasan Arshad, Graham C. Roberts, Tara Dean, Ramesh J. Kurukulaaratchy, Carina Venter

Background

Adverse food reactions include food allergy (FA; immune-mediated) and food intolerances (non-immune-mediated). FA are classified into IgE- and non-IgE-mediated FA. There is limited information available about changes in FA prevalence over time.

Methods

Two cohorts of children were evaluated, born on the Isle of Wight (IOW) 12 years apart, the IOW birth cohort (IOWBC; 1989–1990) and the FA and Intolerance Research birth cohort (FAIRBC; 2001–2002). We compared the prevalence of parental reported reactions to foods (adverse food reactions), allergic sensitisation to foods and FA between the IOWBC and FAIRBC, at ages 1, 2, 3–4 and 10 years. FA included both IgE- and non-IgE-mediated FA.

Results

Reported adverse reactions to food and sensitisation rates remained stable between the two cohorts. For example, FA at age 3–4 years was reported in 9.1% (95% CI: 7.5, 10.7) in IOWBC and 8.3% (95% CI: 6.5, 10.1) in FAIRBC (p = 0.57) and food sensitisation by skin prick test at age 3–4 years was found in 3.2% (95% CI: 2.1, 4.3) in IOWBC and 4.5% (95% CI: 2.9, 6.1) in FAIRBC (p = 0.20). Confirmed FA prevalence was lower in FAIRBC than IOWBC at ages 1, 2 and 3–4, but these differences were not significant after adjustment for multiple comparisons. For example, FA at age 3–4 years was confirmed in 5.0% (95% CI: 3.8, 6.2) in IOWBC and 3.0% (95% CI: 1.9, 4.2) in FAIRBC (p = 0.03, significance threshold after Bonferroni correction p < 0.004). Confirmed cow's milk allergy rate was higher in IOWBC than FAIRBC at 3 years (< 0.001) but not at other time points.

Conclusion

Our data show no evidence of changes in rates of adverse reactions to foods, food sensitisation or food allergy during the first 10 years of life between two cohorts born in England in 1989–1990 and 2001–2002.

背景:食物不良反应包括食物过敏(FA;免疫介导的)和食物不耐受(非免疫介导的)。FA分为IgE介导FA和非IgE介导FA。关于FA患病率随时间变化的信息有限。方法:对相隔12年出生在怀特岛(IOW)的两组儿童进行评估,IOW出生队列(IOWBC;1989-1990)和FA和不耐受研究出生队列(FAIRBC;2001 - 2002)。我们比较了IOWBC和FAIRBC在1岁、2岁、3-4岁和10岁时父母报告的食物反应(食物不良反应)、食物过敏和FA的患病率。FA包括IgE介导和非IgE介导的FA。结果:报告的食物不良反应和致敏率在两个队列之间保持稳定。例如,IOWBC中3-4岁的FA发生率为9.1% (95% CI: 7.5, 10.7), FAIRBC中为8.3% (95% CI: 6.5, 10.1) (p = 0.57), IOWBC中3-4岁皮肤点刺试验的食物致敏率为3.2% (95% CI: 2.1, 4.3), FAIRBC中为4.5% (95% CI: 2.9, 6.1) (p = 0.20)。在1岁、2岁和3-4岁时,FAIRBC确诊的FA患病率低于IOWBC,但经过多次比较调整后,这些差异并不显著。例如,在IOWBC中,3-4岁的FA发生率为5.0% (95% CI: 3.8, 6.2),在FAIRBC中为3.0% (95% CI: 1.9, 4.2) (p = 0.03,经Bonferroni校正后的显著性阈值)。结论:我们的数据显示,1989-1990年和2001-2002年在英格兰出生的两个队列中,没有证据表明在生命的前10年期间食物不良反应、食物致敏或食物过敏发生率发生变化。
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引用次数: 0
The Causal Relationship Between Serum Metabolites and Allergic Diseases: Mendelian Randomization Analysis. 血清代谢物与过敏性疾病的因果关系:孟德尔随机化分析。
IF 6.3 2区 医学 Q1 ALLERGY Pub Date : 2024-12-26 DOI: 10.1111/cea.14615
Yanli Qiu, Bing Zhang, Haocong Chen, Jialin Zhang, Yu Zhang, Junfeng Zhang, Hongxia Lin, Yinzhong Lu
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引用次数: 0
Introduction of Quick Response Coded Digital Allergy Patient Information Leaflets: Patient Perspectives and Key Digital Inclusion Considerations. 介绍快速响应编码数字过敏患者信息传单:患者观点和关键的数字纳入考虑。
IF 6.3 2区 医学 Q1 ALLERGY Pub Date : 2024-12-19 DOI: 10.1111/cea.14613
Oyindamola Stephanie Kayode, Cassim Akhoon, Annette Wagner, Olympia Tsilochristou, Stephen Till, Leonard Quok Chean Siew
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引用次数: 0
KITY Study Protocol: A Randomised Controlled Trial for Eczema Prevention by Ingestion of Kestose in High-Risk Neonates. KITY研究方案:高危新生儿摄入酮糖预防湿疹的随机对照试验。
IF 6.3 2区 医学 Q1 ALLERGY Pub Date : 2024-12-18 DOI: 10.1111/cea.14612
Mayako Saito-Abe, Kenji Toyokuni, Hisako Ogasawara, Kyongsun Pak, Yusuke Inuzuka, Daisuke Harama, Nozomi Ando, Yutaka Koyano, Tohru Kobayashi, Yuka Hayashi, Hideaki Morita, Kenji Matsumoto, Tatsuki Fukuie, Yukihiro Ohya, Kiwako Yamamoto-Hanada
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引用次数: 0
Impact of Co-Factors in Primary Hazelnut Allergy. 辅助因素对原发性榛子过敏的影响。
IF 6.3 2区 医学 Q1 ALLERGY Pub Date : 2024-12-18 DOI: 10.1111/cea.14611
Morten J Christensen, Annemarie Schaeffer Senders, Henrik Fomsgaard Kjaer, Carsten Bindslev-Jensen, Charlotte G Mortz
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引用次数: 0
Detection and Characterisation of Wasp Venom-Specific T Cells Using the ARTE Method in Allergic Patients. 用ARTE方法检测和鉴定过敏患者的黄蜂毒液特异性T细胞。
IF 6.3 2区 医学 Q1 ALLERGY Pub Date : 2024-12-15 DOI: 10.1111/cea.14606
Magdalena Kraft, Samira Saleh, Guido Heine, Alexander Scheffold, Petra Bacher, Margitta Worm
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引用次数: 0
Research Integrity in the Field of Atopic Dermatitis Treatment 特应性皮炎治疗领域的研究完整性。
IF 6.3 2区 医学 Q1 ALLERGY Pub Date : 2024-12-09 DOI: 10.1111/cea.14601
Robert J. Boyle, Mohamed H. Shamji
<p>In this month's issue of <i>Clinical and Experimental Allergy</i>, we highlight the prize-winners from the recent highly successful BSACI conference and present a Cochrane systematic review of topical anti-inflammatory treatments for eczema (atopic dermatitis). Prize-winner abstracts reflected the breadth and depth of research presented at the BSACI conference, which continues to grow and will move to a new, larger venue next year. Please mark 16–18 October at the International Convention Centre in Newport, Wales in your diary! The Cochrane review findings are striking. Not so much for the findings on effectiveness and safety of topical eczema treatments, but for the lack of independence and transparency in the included clinical trials. Eczema is a common, burdensome condition—probably the most burdensome skin condition affecting humans—and topical anti-inflammatory treatments have been used for generations to manage eczema symptoms. In this first comprehensive Cochrane review of the topic, authors identified almost 400 randomised controlled trials in over 50,000 people with eczema. One might hope that such a significant human effort would have yielded some reliable information to guide clinician, carers and people with eczema in making treatment decisions. However, the standout finding in this review was the lack of transparency in the field (Figure 1). Risk of bias was judged to be high in 89% of trials, with the most common issue being concern about selective reporting. While older clinical trials would not be expected to register their plans on a public clinical trial registry or to make their protocol publicly available—it is of some concern that even the modern trials commonly lacked appropriate trial registration. Trial findings were also rarely reported completely, meaning that for many trials and outcomes, it was not possible to include data in meta-analysis. A common issue here was trialists not stating the number of participants evaluated for an outcome.</p><p>This Cochrane review is a good example of the ways in which scientific progress, clinical practice and the health of relevant populations are held back when clinical trials are not conducted and reported in a transparent manner. It is relevant that only a tiny minority of these trials were funded independently—where stated, the funder was almost always the manufacturer of one of the topical treatments being tested. It is well-established that clinical trials funded in this way tend to report findings as more favourable, and in commercial trials, there are also obvious incentives for non-transparent reporting, unless this is legally mandated. While it is for the lawyers and regulators to legislate and oversee compliance with transparent reporting of clinical trials, journals also have a place in promoting better clinical trial practice. This is why <i>Clinical & Experimental Allergy</i> places great emphasis on transparency in reporting, especially for potentially influenti
在本月的《临床与实验变态反应》杂志上,我们重点介绍了最近非常成功的BSACI会议的获奖者,并发表了一篇关于局部抗炎治疗湿疹(特应性皮炎)的Cochrane系统综述。获奖者的摘要反映了在BSACI会议上展示的研究的广度和深度,该会议将继续发展,并将于明年搬到一个新的、更大的场地。请在您的日记中注明10月16日至18日在威尔士新港国际会议中心举行!Cochrane综述的发现是惊人的。不是因为局部湿疹治疗的有效性和安全性,而是因为在纳入的临床试验中缺乏独立性和透明度。湿疹是一种常见的、令人难以忍受的疾病——可能是影响人类的最令人难以忍受的皮肤疾病——几代人以来一直使用局部抗炎治疗来控制湿疹症状。在Cochrane对该主题的首次综合综述中,作者确定了近400项随机对照试验,涉及50,000多名湿疹患者。人们可能希望,如此重大的人类努力将产生一些可靠的信息,以指导临床医生,护理人员和湿疹患者做出治疗决定。然而,本综述的突出发现是该领域缺乏透明度(图1)。在89%的试验中,偏倚风险被认为是高的,最常见的问题是选择性报告。虽然老的临床试验不会被期望在公共临床试验登记处登记他们的计划或使他们的方案公开可用,但令人担忧的是,即使是现代试验也通常缺乏适当的试验注册。试验结果也很少被完整地报道,这意味着对于许多试验和结果,不可能将数据纳入荟萃分析。这里的一个常见问题是试验人员没有说明评估结果的参与者人数。这篇Cochrane综述是一个很好的例子,说明当临床试验没有以透明的方式进行和报告时,科学进步、临床实践和相关人群的健康都会受到阻碍。值得注意的是,这些试验中只有一小部分是独立资助的——在声明中,资助者几乎总是被测试的局部治疗之一的制造商。众所周知,以这种方式资助的临床试验往往会报告更有利的结果,而在商业试验中,也有明显的动机鼓励不透明的报告,除非法律强制要求这样做。虽然律师和监管机构有责任对临床试验的透明报告进行立法和监督,但期刊在促进更好的临床试验实践方面也有一席之地。这就是为什么Clinical &amp;实验过敏非常强调报告的透明度,特别是对于潜在的有影响力的手稿,如临床试验报告b[2]。我们发表研究方案和无效发现;我们鼓励作者公开所有相关材料——从试验前方案到统计分析计划、参与者信息表,以及在伦理可行的情况下,完整的临床试验数据集[3-7]。一个一直倡导提高临床试验报告透明度的慈善机构是Cochrane。我们定期在Clinical &amp;实验过敏。请与Parisut Kimkool [email protected]联系,如果你想写Cochrane Corner关于最近一篇与过敏领域相关的Cochrane综述。免疫学。在这一期,作者总结了最近Cochrane关于儿童胃食管反流的药物治疗的综述。这些治疗方法被广泛应用于儿童,包括增稠剂、促动力剂、H2拮抗剂和质子泵抑制剂。事实上,在婴儿中,有证据表明近年来这些产品的使用越来越多(图2)。在Cochrane综述的发现中有一个熟悉的模式。对于大多数纳入的试验,在公共领域没有可以提取的相关数据。即使对于那些可以提取数据的试验,试验设计和结果报告的异质性也意味着不能进行荟萃分析。部分原因是作者无法识别和分析涉及2251名儿童和成人的36项试验的相关结果,研究结果是不确定的——对所研究的干预措施的确定性证据非常低。作者得出结论,需要进一步的试验。然而,同样重要的是,这些未来的试验应该透明地报告,这样所有相关的临床试验数据都可以公开获得,以支持荟萃分析和循证决策。 为了解决某些临床试验缺乏透明度和报告的问题,系统审稿人有时使用的一种方法是使用来自已确定试验的个体参与者数据(IPD)。这似乎确实提高了数据质量和系统评价结论的确定性。IPD荟萃分析耗时且昂贵,需要与临床试验团队达成数据共享协议并建立关系。然而,直到临床试验小组在法律上有义务公开他们的研究前计划和完整的试验数据集之前,IPD将在证据生态系统中占有重要地位。写了初稿。M.H.S.审阅并批准了手稿。通讯作者对本文负全部责任。作者声明无利益冲突。
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