Allergy/Clinical Immunology Topic Homepage
Allergy/Clinical Immunology Overview
Allergy is an over-reaction of the body's immune system to innocuous foreign substances or allergens.1 Allergens, by definition, are proteins that have the ability to elicit powerful T helper lymphocyte type 2 (Th2) responses, culminating in IgE antibody production (atopy).2 It has been proposed that allergens are linked by their ability to activate the innate immune system of mucosal surfaces, triggering an...
... initial influx of innate immune cells that subsequently promote Th2-polarized adaptive immune responses.2
Allergens are derived from a variety of environmental sources, such as plants, fungi, arthropods, and other mammals.2 Allergens constitute a diverse range of molecules, varying in size from small to large multi-domain proteins.2 It should be noted that, reductive experimental systems aside, natural exposure is not to single, purified proteins, but to a complex mixture of molecules.2
The most common allergies are; allergic rhinitis, asthma, and eczema.3 Symptoms are also very different depending on the affected organ, and can be numerous (pruritus, obstruction and / or nasal rhinorrhea, and oedema).4 Various organs may be affected by the inflammatory response (nose, eyes, skin, ears, respiratory and digestive system).
The prevalence of allergic diseases has increased dramatically over the past few decades2 and has become a major public health problem. Even if the allergy is mild in most cases, it may negatively impact daily life. 1,4 In order to effectively manage allergies, a diagnosis is necessary to determine which protein is responsible for the reaction before desensitising can begin.
Ultimately, a greater understanding of the fundamental origins of allergies should help define new preventive and therapeutic targets in allergic disease.2
1. Chigbu D.I. The management of allergic eye diseases in primary eye. Contact Lens and Anterior Eye. December 2009 ; 32 ( 6) : 260-272.
2. Wills-Karp M. et al. New insights into innate immune mechanisms underlying allergenicity free. Mucosal Immunology. December 2010 ; 3 : 104-110.
3. Guner S.N. et al. The prevalences of allergic diseases in rural and urban areas are similar. Allergologia et Immunopathologia . January 2011, In Press, Corrected Proof.
4. Juniper E. F. et al. Clinical outcomes and adverse effect monitoring in allergic rhinitis. Journal of Allergy and Clinical Immunology. March 2005 ; 115 ( 3-1) : S390-S413.
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Atopic Dermatitis
Atopic dermatitis is a chronic inflammatory non-communicable skin disorder characterised by periods of exacerbations, interspersed with periods of apparent remission. This highly prevalent disease has a significant impact on the quality of life of both patients and carers.
The current understanding of atopic dermatitis is that there are two forms, extrinsic and intrinsic. The cause of the former is best understood. A hypersensitivity reaction to environmental allergens (food, air-borne particles, soaps, perfumes and fabrics) generates an inflammatory response which in turn generates the release of histamine that contributes to the development of pruritus. Intrinsic atopic dermatitis causes identical symptoms in the absence of an initial hypersensitive response.
The evidence available that supports disease modification in atopic dermatitis has been well documented; however currently there is no clear definition of disease modification in atopic dermatitis.
Clinical management of atopic dermatitis is dependent on the severity of patient’s symptoms, however all patients should receive help and advice to aid in lifestyle changes that will decrease the risk of a disease flare. In addition to this, treatment with non-pharmaceutical products such as emollients and pharmaceutical agents such as topical corticosteroids is standard practice.
The Atopic Dermatitis Knowledge Centre is developed in collaboration with Astellas Pharma Europe Ltd.
Enter the Atopic Dermatitis Knowledge Centre
August 2012 DERM/12/0009/EUd
Drug News
Merck Inc files MK 3641 at FDA for treatment of Ragweed Pollen Allergies
10-05-2013Merck & Co. has announced that the FDA has accepted its biologics license application for MK 3641, a dissolvable tablet to treat Ragweed Pollen Allergies and expects the agency to complete its review in the first half of 2014.
Merck has partnered with ALK-Abello A/S to develop the sublingual allergy immunotherapy tablets for ragweed.
...European Commission approves Hexyon/Hexcima (Sanofi Pasteur) Six in One vaccine
22-04-2013
Sanofi Pasteur, the vaccines division of Sanofi has announced that the European Commission, on 22 April 2013, approved Sanofi Pasteur’s 6-in-1 pediatric vaccine Hexyon/Hexacima (DTaP-IPV-Hib-HepB vaccine) for primary and booster vaccination of infants from six weeks of age. Hexyon/Hexacima is the only fully liquid, ready-to-use, 6-in-1 vaccine to protect infants against diphtheria, tetanus,...
Ruconest (Santarus/Pharming) is re-filed with FDA for treatment of Hereditary Angioedema
19-04-2013
Santarus, Inc. and Pharming Group NV have announced the submission of a Biologics License Application (BLA) to the FDA to obtain marketing approval for Ruconest (recombinant human C1 esterase inhibitor) 50 U/kg, an investigational drug for the treatment of acute angioedema attacks in patients with Hereditary Angioedema (HAE). The safety and efficacy of Ruconest for the treatment of HAE...
Allergy/Clinical Immunology Drug Data - A-Z
Possible searches include drugs or medicines (by brand, generic ingredient or drug class), diseases, conditions and more.
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Recent Drug Updates
Avamys
07-05-2013Adults, adolescents (12 years and over) and children (6 – 11 years) Avamys is indicated for the treatment of: • the symptoms of allergic rhinitis...
Differin Cream
26-02-2013Differin Cream is proposed for the cutaneous treatment of mild to moderate acne vulgaris where comedones, papules and pustules predominate. Differin Cream is best suited for use on dry and fair...
Aqueous Calamine Cream BP
26-02-2013For relief of the symptoms of mild sunburn and other minor skin conditions....
Clinical Guidelines
Psoriasis - Assessment and management of psoriasis
Oct 2012This guideline aims to provide clear recommendations on the assessment and management of psoriasis..
... for all people with psoriasis. The diagnosis of psoriasis has not been included within the scope, partly for pragmatic reasons given that to cover psoriasis management itself is a considerable task, but also because there are no agreed diagnostic criteria or tests available and accurate diagnosis remains primarily a clinical one. In considering which specific aspects of psoriasis management to address, the guideline development group have focussed on areas most likely to improve the management and delivery of care for a majority of people affected, where practice is very varied and/or where clear consensus or guidelines on treatments are lacking.
Crohn's disease - Management in adults, children and young people
Oct 2012This guideline intends to show the place of both new and established treatments in the wider care..
... pathway for Crohn’s disease. This will be useful for clinicians and people with Crohn’s disease because new drugs have been licensed for Crohn’s disease in the last decade. The guideline also deals with those medications which are unlicensed for treatment of the condition, but which have been used in this way (off-label) for many years and their role is recognised in other NICE documents as well as the British National Formulary.They include azathioprine, mercaptopurine and methotrexate. The guideline aims to help improve the care offered to people with Crohn’s disease and provide information about the clinical and cost effectiveness of potential care pathways. Management of Crohn’s disease in specific populations (for example, in pregnancy) may require special consideration.
Online CME
Systemic Lupus Erythematosus
Apr 2013
... systemic lupus erythematosus (SLE) and highlights the important clinical trials and guidelines.
MIMS Dermatology: Managing Psoriasis in Primary Care
Apr 2013
... including first-line treatment for the scalp and face, systemic options and the psychological impact of psoriasis on quality of life.
Clinical Trials
The Effect of Per Oral Immunotherapy in Severe IgE Mediated Egg, Milk, and Nut Allergy in Adults
07-03-2013In Finland, the estimated prevalence of physician-diagnosed food allergy in 1-4 year old children is 9%, and the most common allergen is milk. The overall food allergy has been reported to be 3.7%. Hen's egg allergy is among the most common food allergies in childhood. In addition, it predicts later development of..
... allergic disease such as asthma. Most of the egg and milk allergy is transient and disappears in childhood. Currently, the standard of care for food allergy includes strict allergen avoidance. However, oral immunotherapy has been under investigation in children milk, egg, and wheat allergy. Previously, induction of clinical egg tolerance has been reported with egg oral immunotherapy in children aged from 3 to 13 years. In adults, strict avoidance is still the standard care but there is also growing interest in treatment of severe food allergy with oral immunotherapy or anti-IgE.
The investigators aim to analyse the results of per oral immunotherapy treatment in severe IgE-mediated egg, milk, and nut allergy in adults.
Could severe egg, milk and nut allergy be treated with oral immunotherapy treatment in stead of total allergen avoidance and could desensitization thus be achieved?
MEA115661: A multi-centre, open-label, long-term safety study of mepolizumab in asthmatic subjects who participated in the MEA115588 or MEA115575 trials.
20-02-2013To describe the safety profile of mepolizumab in subjects receiving long-term treatment
Medical Videos
Medical Journal Abstracts
Airway and systemic inflammation in obese children with asthma
European Respiratory Journal
Jan 2013
Obese asthma presents via altered airway and systemic inflammation in adults. This has not been comprehensively described in children. To compare airway and systemic inflammation in obese and non-obese asthmatic children and controls. In a cross-sectional study, children aged 8–17 yr were assigned to one of four..
The combination of IKKβ inhibitor and everolimus modulates expression of IL-10 in HTLV-1-infected T cells
Immunology
Dec 2012
Adult T-cell leukemia-lymphoma (ATLL) is an aggressive malignancy of CD4+/CD25+ T lymphocytes, and characterized with severely compromised immunosystem in which the human T-cell lymphotropic virus type 1 (HTLV-1) has been recognized as the etiologic agent. This study found that an IκB kinase β (IKKβ) inhibitor..
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