Allergo Journal International最新文献

Background

In allergology practice, efficient counselling of cat owners is often frustrating because the topic of allergen avoidance is mostly a “no-go” and there are only few studies on allergen immunotherapy that prove its efficacy. In the end, what patients are mostly offered in allergy consultations are allergen reduction measures and symptomatic therapy.

Results

Sensitisation to the main cat allergen Fel d 1 occurs more frequently in atopic conditions and then represents a risk for allergic rhinitis and asthma. Current guidelines are therefore cautious about the first-time acquisition of a cat in the first months of life in atopic families. However, sensitisation occurs in many cases even without contact with an own cat at home.

Conversely, it has been observed in adult patients that in the case of high Fel d 1 exposure immunological tolerance can also develop through the induction of specific IgG4. The fact that many cat allergic patients keep their animals despite diagnosis is, however, partly due to the psychological phenomenon of coping.

Conclusion

In this review, we present current literature and facts that should make everyday life easier for patients, even without giving up the animal. We also review best practices in the management of cat allergy and present new management options and concepts from the development pipeline that our patients are eagerly awaiting.

This review aims to summarize our current knowledge of the impact of advanced glycation products (AGEs) in the diet on the development of allergies. The association between modern dietary patterns that contain high amounts of thermally processed food products, and the development of allergies is of great concern. One group of molecules generated by such dietary patterns is AGEs resulting from the Maillard reaction (MR). Evidence suggests that the MR could influence the allergenicity of food proteins because it alters the structure of proteins by modifying lysine and arginine residues with various types of AGE structures. Several studies, including ours, have indicated that certain AGEs affect innate immune responses via the engagement of AGE-binding receptors. AGEs could also influence the composition of the gut microbiome and its metabolites. Collectively, AGEs may alter the risk of multiple disorders, including allergies, by interacting with innate immunity and changing the gut microbiome.

Summary

Background

As a vegan diet is per definition a plant-based diet, consumers rely on plant protein sources in order to substitute animal proteins. Plant protein sources commonly used in this context are the following: cereals, like wheat (Triticum aestivum, Triticum durum), oat flakes; pseudo cereals like quinoa; nuts and oil seeds like cashew (Anacardium occidentale), hazelnut (Corylus avellana), walnut (Juglans regia); seeds like psyllium seeds (Plantago ovata), sesame (Sesamum indicum), and chia seed (Salvia hispanica).

Methods

In order to assess the allergy risk posed by vegan diet, a literature search focusing on the composition of this particular diet and whether the respective foods are potentially allergenic was performed.

Results

At first glance, it is evident for allergologists that these protein sources are well-known allergen sources. Particularly nuts and legumes harbour storage proteins, oleosins, and lipid transfer proteins that as such are associated with severe allergic reactions to food. In addition, there is increasing evidence that the simultaneous consumption of several of these foods may produce a summation effect where many single allergens of high allergenic potential sum up, thereby inducing anaphylaxis. Furthermore, food processing—or the lack of it—puts patients with pollen-associated food allergy at risk to react to some of the plant foods used in vegan diets.

Conclusion

Therefore, individuals with a history of atopy should be educated regarding the allergy risk of a vegan diet.

Background

Cefalexin is a commonly prescribed oral antibiotic, with a similar side chain to amoxicillin. The objectives of this study were to (1) describe the frequency and nature of previously recorded cefalexin adverse reaction (AR) labels in the electronic medical record (EMR) in a medical inpatient cohort, (2) evaluate the accuracy of these labels and (3) examine the association between a cefalexin allergy label and the antibiotics prescribed during an inpatient admission.

Methods

Consecutive admissions under general medicine in a tertiary hospital over a 1-year period were included in this retrospective cohort study. Data regarding cefalexin adverse reaction (AR) history, and antibiotics prescribed during admission were collected from the EMR. Cefalexin allergy descriptions were reviewed using expert criteria to determine whether the described reaction was most consistent with allergy or intolerance.

Results

The number of admissions included in this study was 12,134. Of the 224 (1.9%) admissions with a recorded cefalexin AR, 196 (87.5%) had a label of allergy and 28 (12.5%) of intolerance. Following the application of expert criteria, 43 (21.9%) of cefalexin allergy labels were found to be consistent with intolerance. The presence of a low-risk cefalexin allergy was associated with an increased likelihood of receiving non-penicillin antibiotics including clindamycin and ciprofloxacin.

Conclusion

Cefalexin AR are common, and frequently incorrectly classified in the electronic medical record with consequences for in-hospital antibiotic prescribing and antimicrobial stewardship.

As a widespread disease, contact dermatitis affects all age groups with a high prevalence and incidence. In addition to a reduction in the quality of life, it causes considerable health and socioeconomic costs. Essentially, five subtypes can be distinguished, namely irritant contact dermatitis, phototoxic contact dermatitis, allergic contact dermatitis with its two special forms of hematogenous and aerogenous contact dermatitis, photoallergic contact dermatitis, and protein contact dermatitis. The diagnosis is based on a detailed history and clinical skin findings as well as the exposure-related performance of allergological in vivo and in vitro tests. Once the contact substance—irritant or allergen—has been identified, the key to therapeutic success lies in its strict avoidance. Symptomatic therapy of contact dermatitis should always be individualized and based on the stage of eczema. Topical glucocorticoids are considered first-line therapy for both irritant and allergic contact dermatitis. The always accompanying basic therapy with skin care products plays a central role for sustainable therapeutic success. Systemic therapy is considered when topical therapy is ineffective or not feasible. In this context, the short-term use of systemic glucocorticoids should be limited to extensive or clinically severe acute contact dermatitis and exacerbations of chronic contact dermatitis. The efficacy of the use of newer biologics and Janus kinase inhibitors in contact dermatitis is currently being evaluated in several clinical trials.