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Disease Knowledge Centres

Allergy and Clinical Immunology - Disease Topic 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.

Third Party Website - Asthma and COPD

Understanding Asthma

Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role.

The chronic inflammation is associated with airway hyperresponsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning.

Learn more about Asthma…by visiting our website

Understanding Chronic Obstructive Pulmonary Disease (COPD)

COPD’s pulmonary component is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases.

Learn more about COPD…

Asthma Care

Asthma is a chronic disorder with significant impacts on patients, their family and society. Although there is no cure for asthma, appropriate management often leads to control of the disease.

Learn more about Asthma Care…

COPD Care

COPD is a progressive disease: lung function is expected to worsen over time. Therefore, adherence to therapy and a continuous assessment of the pathology progression are important.
Learn more about COPD Care…

Asthma Therapy

Asthma is a chronic disorder with significant impacts on patients, their family and society. Although there is no cure for asthma, appropriate management often leads to control of the disease.

Learn more about Asthma Therapy…

COPD Therapy

COPD is a progressive disease: lung function is expected to worsen over time. Therefore, adherence to therapy and a continuous assessment of the pathology progression are important.

Learn more about COPD Care…

Resources

A wealth of useful resources including a slide sharing portal, device area, expert’s tips, conference and events calendar and more.

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Asthma is a disorder defined by its clinical, physiological, and pathological characteristics. The main physiological feature of asthma is episodic airway obstruction characterized by expiratory airflow limitation. The dominant pathological feature is airway inflammation, sometimes associated with airway structural changes.

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Atopic Dermatitis
Atopic dermatitis is a highly prevalent disease in developed countries, affecting 10-30% of children and 1-3% of adults in developed countries. Often referred to as 'eczema', atopic dermatitis is a chronic inflammatory skin disorder that starts in childhood and can persist into adolescence and adulthood.

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Atopic dermatitis, a chronic inflammatory skin disorder, affects 10-30% of children and 1-3% of adults^1,2 in developed countries.

Atopic dermatitis has traditionally been characterised by periods of exacerbations, known as flares, interspersed with periods of apparent remission.³ It affects patients to varying degrees and is categorised as mild, moderate or severe. The progression of atopic dermatitis also differs considerably from person to person.

The precise cause of the disease is poorly understood but the most common form, extrinsic atopic dermatitis, is strongly associated with a hypersensitivity reaction to environmental allergens.

The specific combination of signs and symptoms associated with atopic dermatitis varies from person to person. However, patients will usually suffer from dry, erythematous skin, with pruritus being a core symptom of the condition.

Following a diagnosis of atopic dermatitis, the choice of management strategy depends on the severity of the condition, and should take into account the patient's and their family's needs and concerns.

There are a number of different treatment options currently available for atopic dermatitis including non-pharmacological options like emollient creams to improve symptoms, and pharmacological options, such as topical corticosteroids or topical calcineurin inhibitors.⁴

Enter the Atopic Dermatitis Knowledge Centre

What's in the Atopic Dermatitis Knowledge Centre?
References

1. Leung DY, Boguniewicz M, Howell MD, et al. New insights into atopic dermatitis. J Clin Invest 2004; 113: 651-7.
2. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Lancet 1998; 351: 1225-32.
3. Langan SM, Thomas KS, Williams HC. What is meant by a ""flare"" in atopic dermatitis? A systematic review and proposal. Arch Dermatol 2006; 142: 1190-6.
4. Severity scoring of atopic dermatitis: the SCORAD index. Consensus Report of the European Task Force on Atopic Dermatitis. Dermatology 1993; 186: 23-31.

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Latest Multi Media

A Journey Through the Immune System - in healthy individuals and during diseases.

Allergy and Clinical Immunology Drug Data - A-Z English

Drug Updates

Benadryl Plus Capsules

This product is indicated for the symptomatic relief of allergic rhinitis.

Daktacort Ointment

For the topical treatment of inflamed dermatoses where infection by susceptible organisms and inflammation co-exist, eg intertrigo and infected eczema.

Zineryt

Topical treatment of acne vulgaris.

Latest Drug News

Study finds benefits of Xolair for Allergic Asthma treatment - 29-09-2011

New results from the APEX trial of Xolair (omalizumab), from Novartis, show that the drug considerably reduces patients need for steroid use, while at the same time helping disease control and lowering the amount of Asthma exacerbations. Usual treatment for Allergic Astham is oral steroids, but these are associated with weight gain, hypertension, osteoporosis and depression. The data, presented at the 2011 European Respiratory Society congress, shows that in the 12 months after patients started on Xolair (p<0.001), the mean total dose of oral corticosteroids per individual reduced by 34%, with 49% of individuals stopping the oral steroids altogether and 64% considerably reducing their oral corticosteroid dosage. Compared to the previous year, patients experienced a considerable reduction in the amount of asthma exacerbations after 12 months of treatment (53%, 1.7 versus 3.7, 95% CI, p<0.001). Lung function was also found to improve.

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Latest Journal Publications

Journal of Medical Virology

Enterovirus 71 (EV71) infection may cause severe neurological complications, particularly in young children. Despite the risks, there are still no commercially available EV71 vaccines. Hence, a candidate vaccine construct, containing recombinant Newcastle disease virus capsids that display an EV71 VP1 fragment (NPt-VP11-100) protein, was evaluated in a mouse model of EV71 infection. Previously, it was shown that this protein construct provoked a strong immune response in vaccinated adult rabbits. That study, however, did not address the issue of its effectiveness against EV71 infection in young animals. In the present study, EV71 viral challenge in vaccinated newborn mice resulted in more than 40% increase in survival rate. Significantly, half of the surviving mice fully recovered from their paralysis. Histological analysis of all of the surviving mice revealed a complete clearance of EV71 viral antigens from their brains and spinal cords. In hind limb muscles, the amounts of the antigens detected correlated with the degrees of tissue damage and paralysis. Findings from this study provide evidence that immunization with the NPt-VP11-100 immunogen in a newborn mouse model confers partial protection against EV71 infection, and also highlights the importance of NPt-VP11-100 as a possible candidate vaccine for protection against EV71 infections.

Journal of Medical Virology

Genotype-specific effects of parvovirus B19 (B19V) infections on left ventricular function in patients with dilated cardiomyopathy (DCM) have not been investigated so far. In this prospective clinical study, the prevalences of B19V genotypes in endomyocardial biopsies from patients presenting with inflammatory heart disease and DCM were determined. A total of 139 consecutive patients were included in the study; among them 53 patients were diagnosed as DCM. Among the total study cohort, B19V DNA was detected in 65 study participants (46.8%). Genotyping of the B19V genomes in the total cohort identified genotype 1 in 38 samples (27.3%), genotype 2 in 25 samples (18.0%), and genotype 3 in only two patients (1.4%). During an average follow-up period of 8 months left ventricular ejection fraction (LVEF) improved significantly both in B19V-positive (7.1 ± 13.8%, n = 17, P = 0.038) as well as B19V-negative patients with DCM (9.5 ± 13.9%, n = 20, P = 0.017). However, mean LVEF improved only in patients with genotype 1 (11.0 ± 14.4%, n = 7), whereas it even decreased in patients with genotype 2 (−6.2 ± 6.3%, n = 5, P = 0.033). These data from a small sample of patients diagnosed as DCM suggested that myocardial function during short-time follow-up differed between genetic variants of B19V. Patients with genotype 1 were on average younger than genotype 2 and appeared to be more prone to a beneficial course of left ventricular function than patients with genotype 2. Future studies with larger sample sizes and longer follow-up periods will be required to confirm this observation.