Pub Date : 2022-07-28DOI: 10.1007/s40629-022-00220-x
Ludger Klimek, Ulrike Förster-Ruhrmann, Achim G. Beule, Adam M. Chaker, Jan Hagemann, Felix Klimek, Ingrid Casper, Tilman Huppertz, Thomas K. Hoffmann, Stefan Dazert, Thomas Deitmer, Heidi Olze, Sebastian Strieth, Holger Wrede, Wolfgang Schlenter, Hans-Jürgen Welkoborsky, Barbara Wollenberg, Christoph Bergmann, Mandy Cuevas, Caroline Beutner, Moritz Gröger, Sven Becker
Summary
Background
Chronic rhinosinusitis with nasal polyps (CRSwNP), an inflammatory disease of the paranasal mucosa, is primarily characterized by type 2 inflammation. Three antibodies (dupilumab, omalizumab, and mepolizumab) are now approved for the treatment of severe CRSwNP. Documentation of disease severity during the course of treatment is essential.
Methods
A literature search of Medline, PubMed, and the national and international trial and guideline register, and the Cochrane Library was performed to analyze the immunology of CRSwNP and determine the evidence for the effect of dupilumab, omalizumab, and mepolizumab in this disease. This has resulted in 3 position papers prepared by our group of authors, which form the basis of this summarizing review.
Results
Based on the information from the international literature, recommendations for the use of dupilumab, omalizumab, and mepolizumab in CRSwNP in the German health care system are given by an expert panel.
Conclusion
Dupilumab, omalizumab, and mepolizumab are approved for patients 18 years of age and older with CRSwNP as add-on therapy to intranasal corticosteroids when, for dupilumab and mepolizumab, therapy with systemic corticosteroids and/or surgery does not achieve sufficient disease control. Therapy with omalizumab is indicated when therapy with intranasal corticosteroids does not result in sufficient disease control. Dedicated recommendations for the documentation of the use in the German health care system are given, which are based on the position papers of our author group already published on this topic.
{"title":"Indicating biologics for chronic rhinosinusitis with nasal polyps (CRSwNP)","authors":"Ludger Klimek, Ulrike Förster-Ruhrmann, Achim G. Beule, Adam M. Chaker, Jan Hagemann, Felix Klimek, Ingrid Casper, Tilman Huppertz, Thomas K. Hoffmann, Stefan Dazert, Thomas Deitmer, Heidi Olze, Sebastian Strieth, Holger Wrede, Wolfgang Schlenter, Hans-Jürgen Welkoborsky, Barbara Wollenberg, Christoph Bergmann, Mandy Cuevas, Caroline Beutner, Moritz Gröger, Sven Becker","doi":"10.1007/s40629-022-00220-x","DOIUrl":"10.1007/s40629-022-00220-x","url":null,"abstract":"<div><h2>Summary</h2><div><h3>Background</h3><p>Chronic rhinosinusitis with nasal polyps (CRSwNP), an inflammatory disease of the paranasal mucosa, is primarily characterized by type 2 inflammation. Three antibodies (dupilumab, omalizumab, and mepolizumab) are now approved for the treatment of severe CRSwNP. Documentation of disease severity during the course of treatment is essential.</p><h3>Methods</h3><p>A literature search of Medline, PubMed, and the national and international trial and guideline register, and the Cochrane Library was performed to analyze the immunology of CRSwNP and determine the evidence for the effect of dupilumab, omalizumab, and mepolizumab in this disease. This has resulted in 3 position papers prepared by our group of authors, which form the basis of this summarizing review.</p><h3>Results</h3><p>Based on the information from the international literature, recommendations for the use of dupilumab, omalizumab, and mepolizumab in CRSwNP in the German health care system are given by an expert panel.</p><h3>Conclusion</h3><p>Dupilumab, omalizumab, and mepolizumab are approved for patients 18 years of age and older with CRSwNP as add-on therapy to intranasal corticosteroids when, for dupilumab and mepolizumab, therapy with systemic corticosteroids and/or surgery does not achieve sufficient disease control. Therapy with omalizumab is indicated when therapy with intranasal corticosteroids does not result in sufficient disease control. Dedicated recommendations for the documentation of the use in the German health care system are given, which are based on the position papers of our author group already published on this topic.</p></div></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00220-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43217495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-20DOI: 10.1007/s40629-022-00221-w
Juliana Schwaab, Johannes Lübke, Andreas Reiter, Georgia Metzgeroth
Sustained elevation of eosinophils above 5 × 109 /l in peripheral blood (PB) should prompt further investigation. Clonal eosinophilia accounts for the much smaller proportion of eosinophilias (< 10%), but exclusion of such a neoplasia is prognostically and therapeutically relevant. Molecular genetic analysis from PB, cytogenetics from bone marrow, and bone marrow histology are primarily used to exclude clonal eosinophilia. Far more common is reactive eosinophilia, the cause of which may be drugs, allergies, solid tumors, lymphomas, worm infections, autoimmune diseases, or idiopathic hypereosinophilic syndrome (HES). Because of the diverse organ infiltration patterns in eosinophilia, a specific search for possible organ involvement (including heart, lung, gastrointestinal tract, kidney, skin, etc.) should be performed, depending on the patient’s symptoms. The diagnosis of HES is made when organ infiltration with consecutive dysfunction is diagnosed in persistent eosinophilia after exclusion of other causes. Therapeutically, oral corticosteroids (OSC) are used in HES. This can also be helpful in the differential diagnosis, as patients with clonal eosinophilia are usually not expected to achieve remission with OCS. When OCS requirements are high, other immunosuppressants (e.g., methotrexate [MTX], cyclophosphamide) and the interleukin (IL)-5 antagonist mepolizumab are used. In clonal eosinophilia, tyrosine kinase inhibitors are the first-line therapy, depending on the underlying genetic alteration.
{"title":"Idiopathic hypereosinophilic syndrome—diagnosis and treatment","authors":"Juliana Schwaab, Johannes Lübke, Andreas Reiter, Georgia Metzgeroth","doi":"10.1007/s40629-022-00221-w","DOIUrl":"10.1007/s40629-022-00221-w","url":null,"abstract":"<div><p>Sustained elevation of eosinophils above 5 × 10<sup>9</sup> /l in peripheral blood (PB) should prompt further investigation. Clonal eosinophilia accounts for the much smaller proportion of eosinophilias (< 10%), but exclusion of such a neoplasia is prognostically and therapeutically relevant. Molecular genetic analysis from PB, cytogenetics from bone marrow, and bone marrow histology are primarily used to exclude clonal eosinophilia. Far more common is reactive eosinophilia, the cause of which may be drugs, allergies, solid tumors, lymphomas, worm infections, autoimmune diseases, or idiopathic hypereosinophilic syndrome (HES). Because of the diverse organ infiltration patterns in eosinophilia, a specific search for possible organ involvement (including heart, lung, gastrointestinal tract, kidney, skin, etc.) should be performed, depending on the patient’s symptoms. The diagnosis of HES is made when organ infiltration with consecutive dysfunction is diagnosed in persistent eosinophilia after exclusion of other causes. Therapeutically, oral corticosteroids (OSC) are used in HES. This can also be helpful in the differential diagnosis, as patients with clonal eosinophilia are usually not expected to achieve remission with OCS. When OCS requirements are high, other immunosuppressants (e.g., methotrexate [MTX], cyclophosphamide) and the interleukin (IL)-5 antagonist mepolizumab are used. In clonal eosinophilia, tyrosine kinase inhibitors are the first-line therapy, depending on the underlying genetic alteration.</p></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00221-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44735841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The food allergen protein profilin is responsible for oral epithelial remodelling and hypersensitive reactions in atopic individuals. Profilins are regarded as panallergens due to their IgE cross-reactivity.
Methods
The present study reports a bioinformatic pipeline including multiple sequence alignment, homology modelling, molecular dynamic simulation, virtual screening and bioavailability profiling techniques for pharmacophore screening against food allergen profilins to combat associated complications.
Results
Tertiary structure prediction of food allergen profilins from apple, pineapple, wheat and soybean revealed their structural-level conservation accounting for their IgE cross-reactivity, and molecular dynamics for 10 ns affirmed the fitness of modelled profilin structures. By virtue of virtual screening, we have identified the best pharmacophores against food allergen profilins from apple, pineapple, wheat and soybean, exhibiting a binding energy efficiency of −8.0, −7.2, −7.5 and −10.0 kcal/mol, respectively. Lastly, the bioavailability profiles of these identified pharmacophores designate their suitability to act as orally bioavailable compounds.
Conclusion
This information regarding binding affinity and stability of the identified pharmacophores against food allergen profilins designates them as lead molecules for in vitro studies.
{"title":"In silico investigation for drug-like pharmacophores against food allergen profilins","authors":"Bhupender Singh, Sadaf Jan, Atul Kumar Upadhyay, Neeta Raj Sharma","doi":"10.1007/s40629-022-00222-9","DOIUrl":"10.1007/s40629-022-00222-9","url":null,"abstract":"<div><h3>Purpose</h3><p>The food allergen protein profilin is responsible for oral epithelial remodelling and hypersensitive reactions in atopic individuals. Profilins are regarded as panallergens due to their IgE cross-reactivity.</p><h3>Methods</h3><p>The present study reports a bioinformatic pipeline including multiple sequence alignment, homology modelling, molecular dynamic simulation, virtual screening and bioavailability profiling techniques for pharmacophore screening against food allergen profilins to combat associated complications.</p><h3>Results</h3><p>Tertiary structure prediction of food allergen profilins from apple, pineapple, wheat and soybean revealed their structural-level conservation accounting for their IgE cross-reactivity, and molecular dynamics for 10 ns affirmed the fitness of modelled profilin structures. By virtue of virtual screening, we have identified the best pharmacophores against food allergen profilins from apple, pineapple, wheat and soybean, exhibiting a binding energy efficiency of −8.0, −7.2, −7.5 and −10.0 kcal/mol, respectively. Lastly, the bioavailability profiles of these identified pharmacophores designate their suitability to act as orally bioavailable compounds.</p><h3>Conclusion</h3><p>This information regarding binding affinity and stability of the identified pharmacophores against food allergen profilins designates them as lead molecules for in vitro studies.</p></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00222-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48268249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-07DOI: 10.1007/s40629-022-00218-5
Harris K. S. Hui, Tin Sum Li, Whitney L. W. Lo, Andy K. C. Kan, Shi Yeung Ho MBBS, FHKAM (ORL), Winnie Y. W. Yeung MBChB, FHKAM (Medicine), Jane C. Y. Wong MBBS, MRCP (UK), Valerie Chiang MBBS, Birgitta Y. H. Wong MBBS, FHKAM (ORL), Philip H. Li MBBS, FHKAM (Medicine)
Summary
Purpose
House dust mite (HDM) is the predominant cause of allergic rhinitis (AR) in Hong Kong but remains under-diagnosed and -treated. The association between patient-reported outcome measures (PROMs) and nasoendoscopy findings for AR have also not been investigated. This study investigated the demographics, sensitisation patterns, quality of life, use of sublingual immunotherapy and the association of PROMs and nasoendoscopy findings in AR patients through the first allergist–otorhinolaryngologists AR joint (ARJ) clinic in Hong Kong.
Methods
This single-centred, retrospective observational study was conducted between January 2021 and December 2021. Clinical data from AR patients attending the ARJ clinic were analysed to identify the prevalence of HDM allergens, change in PROMs and the association of PROMs with nasoendoscopy scores.
Results
The three most common sensitising HDM allergens were Dermatophagoides pterynosinus (94.4%), Dermatophagoides farinae (88.9%) and Euroglyphus maynei (88.9%). At the 13- to 32-week follow-up (median 28 weeks), patients who attended the ARJ clinic had significant improvement in Total Nasal Symptom Score (TNSS; p = 0.038). The visual analogue scale (VAS) was associated with nasoendoscopy score (p = 0.018). Patients using SLIT (sublingual immunotherapy) showed overall improvements in PROMs.
Conclusion
The ARJ clinic significantly improved AR symptoms. SLIT was effective and safe for patients who failed conventional treatments. VAS positively correlated with nasoendoscopy findings. Testing for Dermatophagoides pterynosinus as a single agent during skin testing was sufficient for the diagnosis of HDM AR and should be prioritized when resources are restricted. Further studies should be done to investigate the treatment outcome of AR patients and the effectiveness of SLIT in the Chinese population.
{"title":"Sensitisation profile of Chinese allergic rhinitis patients and effectiveness of a joint allergy-ENT clinic","authors":"Harris K. S. Hui, Tin Sum Li, Whitney L. W. Lo, Andy K. C. Kan, Shi Yeung Ho MBBS, FHKAM (ORL), Winnie Y. W. Yeung MBChB, FHKAM (Medicine), Jane C. Y. Wong MBBS, MRCP (UK), Valerie Chiang MBBS, Birgitta Y. H. Wong MBBS, FHKAM (ORL), Philip H. Li MBBS, FHKAM (Medicine)","doi":"10.1007/s40629-022-00218-5","DOIUrl":"10.1007/s40629-022-00218-5","url":null,"abstract":"<div><h2>Summary</h2><div><h3>Purpose</h3><p>House dust mite (HDM) is the predominant cause of allergic rhinitis (AR) in Hong Kong but remains under-diagnosed and -treated. The association between patient-reported outcome measures (PROMs) and nasoendoscopy findings for AR have also not been investigated. This study investigated the demographics, sensitisation patterns, quality of life, use of sublingual immunotherapy and the association of PROMs and nasoendoscopy findings in AR patients through the first allergist–otorhinolaryngologists AR joint (ARJ) clinic in Hong Kong.</p><h3>Methods</h3><p>This single-centred, retrospective observational study was conducted between January 2021 and December 2021. Clinical data from AR patients attending the ARJ clinic were analysed to identify the prevalence of HDM allergens, change in PROMs and the association of PROMs with nasoendoscopy scores.</p><h3>Results</h3><p>The three most common sensitising HDM allergens were <i>Dermatophagoides pterynosinus </i>(94.4%), <i>Dermatophagoides farinae </i>(88.9%) and <i>Euroglyphus maynei </i>(88.9%). At the 13- to 32-week follow-up (median 28 weeks), patients who attended the ARJ clinic had significant improvement in Total Nasal Symptom Score (TNSS; <i>p</i> = 0.038). The visual analogue scale (VAS) was associated with nasoendoscopy score (<i>p</i> = 0.018). Patients using SLIT (sublingual immunotherapy) showed overall improvements in PROMs.</p><h3>Conclusion</h3><p>The ARJ clinic significantly improved AR symptoms. SLIT was effective and safe for patients who failed conventional treatments. VAS positively correlated with nasoendoscopy findings. Testing for<i> Dermatophagoides pterynosinus</i> as a single agent during skin testing was sufficient for the diagnosis of HDM AR and should be prioritized when resources are restricted. Further studies should be done to investigate the treatment outcome of AR patients and the effectiveness of SLIT in the Chinese population.</p></div></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00218-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9488389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-20DOI: 10.1007/s40629-022-00216-7
Ludger Klimek, Jan Hagemann, Julia Döge, Laura Freudelsperger, Mandy Cuevas, Felix Klimek, Thomas Hummel
Summary
Loss of olfaction is one of the symptoms most commonly reported by patients with coronavirus disease 2019 (COVID-19). Although the spontaneous recovery rate is high, recent studies have shown that up to 7% of patients remain anosmic for more than 12 months after the onset of infection, leaving millions of people worldwide suffering from severe olfactory impairment. Olfactory training remains the first recommended treatment. With the continued lack of approved drug treatments, new therapeutic options are being explored. This article reviews the current state of science on COVID-19-related olfactory disorders, focusing on epidemiology, pathophysiology, cure rates, currently available treatment options, and research on new treatments.
{"title":"Olfactory and gustatory disorders in COVID-19","authors":"Ludger Klimek, Jan Hagemann, Julia Döge, Laura Freudelsperger, Mandy Cuevas, Felix Klimek, Thomas Hummel","doi":"10.1007/s40629-022-00216-7","DOIUrl":"10.1007/s40629-022-00216-7","url":null,"abstract":"<div><h2>Summary</h2><div><p>Loss of olfaction is one of the symptoms most commonly reported by patients with coronavirus disease 2019 (COVID-19). Although the spontaneous recovery rate is high, recent studies have shown that up to 7% of patients remain anosmic for more than 12 months after the onset of infection, leaving millions of people worldwide suffering from severe olfactory impairment. Olfactory training remains the first recommended treatment. With the continued lack of approved drug treatments, new therapeutic options are being explored. This article reviews the current state of science on COVID-19-related olfactory disorders, focusing on epidemiology, pathophysiology, cure rates, currently available treatment options, and research on new treatments.</p></div></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00216-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40401554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-14DOI: 10.1007/s40629-022-00215-8
Vera Mahler, Ann-Christine Junker
Summary
Anaphylaxis in connection with the administration of vaccines occurs only very rarely. Triggers of immunoglobulin IgE-mediated and non-IgE-mediated anaphylaxis—in addition to the active ingredient itself—may be excipients contained in the vaccine due to their special properties. Some of the excipients in medicinal products are the same compounds used as additives in food. Furthermore, residues from the manufacturing process (e.g., chicken egg white, casein, antibiotics, formaldehyde) or contaminants (e.g., from the primary packaging material) may be potential triggers of anaphylaxis in vaccines. This review article provides an overview of ingredients in vaccines that pose an allergenic risk potential. The components of COVID-19 vaccines approved and marketed in Germany are discussed with regard to their potential for triggering anaphylaxis and possible pathophysiological mechanisms involved.
{"title":"Anaphylaxis to additives in vaccines","authors":"Vera Mahler, Ann-Christine Junker","doi":"10.1007/s40629-022-00215-8","DOIUrl":"10.1007/s40629-022-00215-8","url":null,"abstract":"<div><h2>Summary</h2><div><p>Anaphylaxis in connection with the administration of vaccines occurs only very rarely. Triggers of immunoglobulin IgE-mediated and non-IgE-mediated anaphylaxis—in addition to the active ingredient itself—may be excipients contained in the vaccine due to their special properties. Some of the excipients in medicinal products are the same compounds used as additives in food. Furthermore, residues from the manufacturing process (e.g., chicken egg white, casein, antibiotics, formaldehyde) or contaminants (e.g., from the primary packaging material) may be potential triggers of anaphylaxis in vaccines. This review article provides an overview of ingredients in vaccines that pose an allergenic risk potential. The components of COVID-19 vaccines approved and marketed in Germany are discussed with regard to their potential for triggering anaphylaxis and possible pathophysiological mechanisms involved.</p></div></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00215-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40164731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-08DOI: 10.1007/s40629-022-00212-x
Daria Luschkova, Claudia Traidl-Hoffmann, Alika Ludwig MD
The climate crisis poses a major challenge to human health as well as the healthcare system and threatens to jeopardize the medical progress made in recent decades. However, addressing climate change may also be the greatest opportunity for global health in the 21st century. The climate crisis and its consequences, such as rising temperatures, forest fires, floods, droughts, and changes in the quality and quantity of food and water, directly and indirectly affect human physical and mental health. More intense and frequent heat waves and declining air quality have been shown to increase all-cause mortality, especially among the most vulnerable. Climate warming alters existing ecosystems and favors biological invasions by species that better tolerate heat and drought. Pathogen profiles are changing, and the transmission and spread of vector-borne diseases are increasing. The spread of neophytes in Europe, such as ragweed, is creating new pollen sources that increase allergen exposure for allergy sufferers. In addition, the overall milder weather, especially in combination with air pollution and increased CO2 levels, is changing the production and allergenicity of pollen. The phenomenon of thunderstorm asthma is also occurring more frequently. In view of the increasing prevalence of allergic diseases due to climate change, early causal immunomodulatory therapy is therefore all the more important. During a climate consultation, patients can receive individual advice on climate adaptation and resilience and the benefits of CO2 reduction—for their own and the planet’s health. Almost 5% of all greenhouse gas emissions in Europe come from the healthcare sector. It thus has a central responsibility for a climate-neutral and sustainable transformation.
{"title":"Climate change and allergies","authors":"Daria Luschkova, Claudia Traidl-Hoffmann, Alika Ludwig MD","doi":"10.1007/s40629-022-00212-x","DOIUrl":"10.1007/s40629-022-00212-x","url":null,"abstract":"<div><p>The climate crisis poses a major challenge to human health as well as the healthcare system and threatens to jeopardize the medical progress made in recent decades. However, addressing climate change may also be the greatest opportunity for global health in the 21st century. The climate crisis and its consequences, such as rising temperatures, forest fires, floods, droughts, and changes in the quality and quantity of food and water, directly and indirectly affect human physical and mental health. More intense and frequent heat waves and declining air quality have been shown to increase all-cause mortality, especially among the most vulnerable. Climate warming alters existing ecosystems and favors biological invasions by species that better tolerate heat and drought. Pathogen profiles are changing, and the transmission and spread of vector-borne diseases are increasing. The spread of neophytes in Europe, such as ragweed, is creating new pollen sources that increase allergen exposure for allergy sufferers. In addition, the overall milder weather, especially in combination with air pollution and increased CO<sub>2</sub> levels, is changing the production and allergenicity of pollen. The phenomenon of thunderstorm asthma is also occurring more frequently. In view of the increasing prevalence of allergic diseases due to climate change, early causal immunomodulatory therapy is therefore all the more important. During a climate consultation, patients can receive individual advice on climate adaptation and resilience and the benefits of CO<sub>2</sub> reduction—for their own and the planet’s health. Almost 5% of all greenhouse gas emissions in Europe come from the healthcare sector. It thus has a central responsibility for a climate-neutral and sustainable transformation.</p></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00212-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46264560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-31DOI: 10.1007/s40629-022-00214-9
Wolfgang Pfützner
Summary
In addition to the therapeutic agent, drugs contain excipients such as stabilizers, preservatives, solubilizers, or dyes, some of which are identical to additives in foods. Anaphylaxis to these excipients is probably an underestimated problem. After the first descriptions of anaphylactic reactions to drug excipients appeared more than 30 years ago, the number of corresponding reports has increased significantly over the years. However, a diagnostic gap exists in the clarification of drug allergic reactions when the index product is not known and/or is not available for testing. In the present work, individual excipients are presented as examples for which publications on anaphylaxis are available. Furthermore, the options of allergological testing both in vivo and in vitro are discussed. The pathogenesis of such reactions is still unresolved in many cases, and current concepts are briefly presented in the conclusion. With increasing knowledge about anaphylaxis to drug excipients, it is assumed that these can then be recognized more often and diagnostically clarified.
{"title":"Anaphylaxis to drug excipients","authors":"Wolfgang Pfützner","doi":"10.1007/s40629-022-00214-9","DOIUrl":"10.1007/s40629-022-00214-9","url":null,"abstract":"<div><h2>Summary</h2><div><p>In addition to the therapeutic agent, drugs contain excipients such as stabilizers, preservatives, solubilizers, or dyes, some of which are identical to additives in foods. Anaphylaxis to these excipients is probably an underestimated problem. After the first descriptions of anaphylactic reactions to drug excipients appeared more than 30 years ago, the number of corresponding reports has increased significantly over the years. However, a diagnostic gap exists in the clarification of drug allergic reactions when the index product is not known and/or is not available for testing. In the present work, individual excipients are presented as examples for which publications on anaphylaxis are available. Furthermore, the options of allergological testing both in vivo and in vitro are discussed. The pathogenesis of such reactions is still unresolved in many cases, and current concepts are briefly presented in the conclusion. With increasing knowledge about anaphylaxis to drug excipients, it is assumed that these can then be recognized more often and diagnostically clarified.</p></div></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00214-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49225585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-19DOI: 10.1007/s40629-022-00213-w
Iva Mikulic MD, Robert Likic MD, PhD, Ivana Cegec MD, Viktorija Erdeljic Turk MD, PhD, Matea Radacic Aumiler MD, PhD, Ksenija Makar Ausperger MD, PhD, Iveta Mercep MD, PhD
{"title":"Two severe perioperative hypersensitivity reactions in a single patient—a case report of a medication error","authors":"Iva Mikulic MD, Robert Likic MD, PhD, Ivana Cegec MD, Viktorija Erdeljic Turk MD, PhD, Matea Radacic Aumiler MD, PhD, Ksenija Makar Ausperger MD, PhD, Iveta Mercep MD, PhD","doi":"10.1007/s40629-022-00213-w","DOIUrl":"10.1007/s40629-022-00213-w","url":null,"abstract":"","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41566299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-17DOI: 10.1007/s40629-022-00210-z
Katharina Zednik, Isabella Pali-Schöll PhD
Summary
Background
In a world with rapidly increasing urbanization and loss of closeness to nature and biodiversity, the question arises to what extent our environment influences the health of people and animals. Moreover, in recent decades, the prevalence of respiratory diseases such as asthma and allergies has risen sharply. In this context, a direct link between the health of people and their environment seems plausible.
Results
Recent studies indicate that spending time in and being in contact with natural environments such as green spaces and associated soils is highly relevant to the health of people and companion animals. Green spaces in the environment of homes and schools of children and adults could contribute to the reduction of asthma and allergies. Especially the number and the structure of green spaces seems to be crucial. Home gardens and regular contact with animals can also reduce the risk of asthmatic and allergic diseases. In contrast, the increasing number of gray areas (roads, highways, construction sites, etc.) is likely to increase the risk of asthma and allergies. In the case of blue areas (rivers, lakes, sea), no correlation with atopic diseases has been found so far.
Conclusion
Biodiverse green spaces, especially forests and meadows, may offer some protection against asthma and allergies. Contact with soil and ground also seems important for the diverse skin microbiome, especially in childhood, and thus presumably beneficial for the immune system. Therefore, people and man’s best friend, the dog, should spend sufficient time in green, biodiverse environments, despite—or perhaps because—of rapid urbanization. People should also actively create such biodiverse surroundings in their closer living environment. On a broader level, in the spirit of the One Health concept, those responsible for city planning and transportation must take these connections into account.
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