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  • February 2014

    BIBLIOGRAPHY UPDATES IN ALLERGOLOGY

    The Monthly choice
    Claude MOLINA* and Jacques GAYRAUD**

    1. Fatal Asthma: recent findings
    H.Oda et al Annals of Allergy, Asthma & Immunology
    Volume 112, Issue 1, Pages 23-28.1, January 2014

    Lung tissues were obtained at autopsy examination from 12 nonsmokers who had died of asthma disease (slow or sudden onset), then from 5 nonsmokers with well-controlled mild asthma and 10 nonsmokers who had undergone surgical resection.

    The numbers of eosinophils, neutrophils and lymphocytes, but not basophils or macrophages, as well as CD8+ T cells, (but not CD4+ T), were significantly increased in the lungs of patients with fatal asthma compared with the other 2 groups. IL-18 protein and IL-18 receptor were also strongly expressed. Possible blockade of IL 18 by immuno-biologic drugs may be of clinical benefit in these severe forms of asthma to prevent fatal issue.

    2. Psoriasis: Immunopathology
    JF.Nicolas: Bulletin de l’Académie Nle de Medecine: (France - in press)

    Psoriasis is an autoinflammatory skin disease mediated by the chronic interaction between keratinocytes, dendritic cells and T lymphocyte inducing a vicious circle of cell activation leading to the development and persistence of the skin lesions. Inflammatory cytokines produced by the 3 cell types, especially TNFα, IL-23 and IL-17, are central to the disease and are the target of the very effective immunobiological therapies that have been developed (such ustekimumab with outstanding improvement).

    Advances in the pathophysiology and treatment of psoriasis have applications far beyond the skin disease. Indeed, psoriasis serves as model for studies of mechanisms of chronic inflammation such as rheumatoid arthritis, Crohn’s disease, atherosclerosis and type 2 diabetes and for developing new targeted therapies for autoinflammatory diseases.

    3. Allergy to furry animals: Jon R. Konradsen 
    Pediatric Allergy and Immunology 2014 January - Early View

    Children with severe allergic asthma had higher specific IgE levels to cat, dog and horse than those with well-controlled asthma:       
    Refined assessment using molecular-based allergy diagnostics revealed a more complex molecular spreading of allergen components in children with the most severe disease.

    4. A link between Obesity and Asthma
    Juan C Celedón & Jay K Kolls NATURE Medicine
    January 2014- pp19 - 20

    The concordant epidemics of asthma and obesity are both associated with inflammation, and obesity has been shown to be an independent risk factor for asthma. A new study in mice indicates that part of the immunological connection between obesity and asthma involves inflammasome activation and production of the cytokine interleukin-17 by innate lymphoid cells in the lung (H.Y. Kim  et al pages 54–61).Inhibition of this pathway by a monoclonal antibody “anakinra” is promising.

    5. Aspirin allergy in patients with myocardial infarction: the allergist's role
    Kathryn L. McMullan, MDNext » Annals of Allergy, Asthma & Immunology
    Volume 112, Issue 2, Pages 90-93, February 2014
    Patients with coronary artery disease and  aspirin  hypersensitivity may be safely and effectively desensitized  by a 7 step protocol.

    Cl. Molina              J.Gayraud
    Analysis and comments in French are available on www.cefcap.com