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Topic Review
Biological Drugs in EoE and Their Targets
Eosinophilic esophagitis (EoE) is a multifaceted disease characterized by a wide heterogeneity of clinical manifestations, endoscopic and histopathologic patterns, and responsiveness to therapy. From the perspective of an effective approach to the patient, the different inflammatory mechanisms involved in the pathogenesis of EoE and biologics, in particular monoclonal antibodies (mAbs), targeting these pathways are needed. Currently, the most relevant is dupilumab, which interferes with both interleukin (IL)-4 and IL-13 pathways by binding IL-4 receptor α, and is the only mAb approved by the European Medicine Agency and US Food and Drug Administration for the treatment of EoE. Other mAbs investigated include mepolizumab, reslizumab, and benralizumab (interfering with IL-5 axis), cendakimab and dectrekumab (anti-IL-13s), tezepelumab (anti-TSLP), lirentelimab (anti-SIGLEG-8), and many others.
  • 547
  • 08 Feb 2024
Topic Review
Food Allergens of Plant Origin
The structures and structural components of the food allergens in the allergen families may provide further directions for discovering new food allergens. Answers as to what makes some food proteins allergens are still elusive. Factors to be considered in mitigating food allergens include the abundance of the protein in a food, the property of short stretches of the sequence of the protein that may constitute linear IgE binding epitopes, the structural properties of the protein, its stability to heat and digestion, the food matrix the protein is in, and the antimicrobial activity to the microbial flora of the human gastrointestinal tract.
  • 542
  • 06 Jun 2023
Topic Review
Asymptomatic Stroke in Percutaneous Non-Coronary Intervention Procedures
Advancements in clinical management, pharmacological therapy and interventional procedures have strongly improved the survival rate for cardiovascular diseases (CVDs). Nevertheless, the patients affected by CVDs are more often elderly and present several comorbidities such as atrial fibrillation, valvular heart disease, heart failure, and chronic coronary syndrome. Standard treatments are frequently not available for “frail patients”, in particular due to high surgical risk or drug interaction. In the past decades, novel less-invasive procedures such as transcatheter aortic valve implantation (TAVI), MitraClip or left atrial appendage occlusion have been proposed to treat CVD patients who are not candidates for standard procedures. These procedures have been confirmed to be effective and safe compared to conventional surgery, and symptomatic thromboembolic stroke represents a rare complication. However, while the peri-procedural risk of symptomatic stroke is low, several studies highlight the presence of a high number of silent ischemic brain lesions occurring mainly in areas with a low clinical impact. The silent brain damage could cause neuropsychological deficits or worse, a preexisting dementia, suggesting the need to systematically evaluate the impact of these procedures on neurological function. 
  • 538
  • 18 Jan 2022
Topic Review
The Spectrum of Dermatitis and Eczema
Dermatitis (eczema) is a noninfectious inflammation of the epidermis and dermis that manifests itself through an array of efflorescences, including erythema, edema, inflammatory infiltrate, papules, vesicles, scales, serous crusts and lichenification. Depending on the stage and intensity of the disease, these skin changes may emerge in various constellations simultaneously or may evolve from one another. They are typically accompanied by the subjective sensation of itch (pruritus), pain or stinging or burning sensations of various intensities. The histological picture of dermatitis/eczema includes spongiosis, acanthosis, parakeratosis or hyperkeratosis in the epidermis, in addition to lymphocytic and granulocytic infiltration of the upper dermis and epidermis. The term “dermatitis” means literally “inflammation of the skin”; however, its use in dermatology is restricted to a subgroup of non-infectious inflammatory skin diseases with similar clinical appearances, creating the spectrum of dermatitis and eczema (SoDE). Therefore, tinea (a fungal infection of the skin), psoriasis or inflammatory acne will not be referred to as “dermatitis” even though inflammation of the skin is their inherent feature. Depending on the country and dermatology school, the term “eczema” could refer to acute dermatitis (e.g., in the USA) or chronic dermatitis (e.g., in Germany). Moreover, some scholars maintain that “eczema” means dermatitis with a known cause, while “dermatitis” would suggest that there is no definite diagnosis yet. Finally, the term “eczema” is used by some scholars as a synonym of “atopic dermatitis” (AD), which should be strongly discouraged as misleading and confusing. In light of these contradictions, it seems most reasonable to consider the terms “dermatitis” and “eczema” synonyms.
  • 538
  • 26 Jul 2023
Topic Review
Cow’s Milk Allergy Preventive Nutritional Strategies
Cow’s milk allergy (CMA) is one of the most common pediatric food allergies. The prevalence and severity of CMA have increased dramatically in the last decades, under the pressure of environmental factors in genetically predisposed individuals. Among the environmental influences, nutritional factors play a crucial role. Diet is the most modifiable factor, representing a potential target for the prevention and treatment of CMA.
  • 537
  • 15 Aug 2023
Topic Review
Pathophysiological Basis of Mas-Related G Protein-Coupled Receptor X2
Mast cells (MCs) are immune cells that reside in tissues; particularly in the skin, and in the gastrointestinal and respiratory tracts. In recent years, there has been considerable interest in the Mas-Related G Protein-Coupled Receptor X2 (MRGPRX2), which is present on the surface of MCs and can be targeted by multiple exogenous and endogenous ligands. It is potentially implicated in non-IgE-mediated pseudoallergic reactions and inflammatory conditions such as asthma or atopic dermatitis.
  • 532
  • 27 Mar 2024
Topic Review
Environmental Exposure on Epigenetic Modifications in Allergic Diseases
Allergic diseases are one of the most common chronic conditions and their prevalence is on the rise. Environmental exposure, primarily prenatal and early life influences, affect the risk for the development and specific phenotypes of allergic diseases via epigenetic mechanisms. Exposure to pollutants, microorganisms and parasites, tobacco smoke and certain aspects of diet are known to drive epigenetic changes that are essential for immune regulation (e.g., the shift toward T helper 2-Th2 cell polarization and decrease in regulatory T-cell (Treg) differentiation).
  • 523
  • 10 Jan 2024
Topic Review
Physical Deactivation Oral Immunotherapy Methods for Food Allergens
Food allergies represent a serious health concern and, since the 1990s, they have risen gradually in high-income countries. Deactivation rather than degradation should be the way of attenuating the immune response. Methods involve both physical and chemo-enzymatic routes.
  • 517
  • 23 Oct 2023
Topic Review
Contribution of PM2.5 to Upper Airway Disorders
PM2.5 is one of the most harmful components of airborne pollution and includes particles with diameters of less than 2.5 μm. Almost 90% of the world’s population lives in areas with poor air quality exceeding the norms established by the WHO. PM2.5 exposure affects various organs and systems of the human body including the upper respiratory tract which is one of the most prone to its adverse effects. PM2.5 can disrupt nasal epithelial cell metabolism, decrease the integrity of the epithelial barrier, affect mucociliary clearance, and alter the inflammatory process in the nasal mucosa. Those effects may increase the chance of developing upper respiratory tract diseases in areas with high PM2.5 pollution. 
  • 513
  • 29 Jan 2024
Topic Review
Role of IL-33 in Rhinovirus Infection
Interleukin (IL)-33 is a key cytokine involved in type-2 immunity and allergic airway disease. At the level of lung epithelial cells, where it is clearly expressed, IL-33 plays an important role in both innate and adaptive immune responses in mucosal organs. It has been widely demonstrated that in the course of respiratory virus infections, the release of IL-33 increases, with consequent pro-inflammatory effects and consequent exacerbation of the clinical symptoms of chronic respiratory diseases.
  • 502
  • 01 Aug 2023
Topic Review
Food Allergen Immunotherapy for IgE-Mediated Food Allergy Treatment
Implementation of an elimination diet is not a sufficient therapeutic strategy in patients with food allergy, whose quality of life is significantly impaired. In recent years, new effective therapeutic strategies have been developed, such as the application of oral, sublingual, and epicutaneous immunotherapy. Oral immunotherapy is the most often applied strategy because of its effectiveness and ease of application, with an acceptable safety profile. The effectiveness of oral immunotherapy in patients with egg, cow’s milk, and peanut allergy has been proven both in terms of raising of the threshold and the development of tolerance, and in some patients, the development of sustainable unresponsiveness. Although oral immunotherapy is an effective treatment for food allergy, several limitations, including a long duration and a significant rate of reported adverse events, reduces its success.
  • 492
  • 19 Jan 2024
Topic Review
Magnetic Resonance-guided Focused Ultrasound Surgery
Osteoblastoma (OB) and osteoid osteoma (OO) are benign bone-forming tumors, with nearly identical basic microscopic features. The main difference is dimension (OO has usually a nidus measuring <2 cm in diameter). In addition, OB is biologically more active than OO, with a tendency to grow in size.
  • 489
  • 11 Jan 2022
Topic Review
Japanese Cedar (Cryptomeria japonica D. Don) Pollen Information
About 40% of cedar pollinosis patients living in the Yamagata Prefecture showed pollinosis symptoms before the first day of the pollen season, which was determined by Durham samplers, the standard sampler for pollen information in Japan. The amount of Cry j 1 (major cedar pollen allergen) per cedar pollen is reported to be six pg. This amount is difficult to measure using the ELISA method. It revealed that Cry j 1 exists in orbicles and tapetum. It is presumed that it is smaller than pollen, so it comes from a place where cedar are already in bloom. It is desirable to obtain real-time information on an hourly basis. Currently, information from automatic cedar pollen monitors is becoming main-stream. However, this monitor may count during snowfalls, Asian dust flying, etc., even when there was no apparent pollen examined with a microscope.
  • 489
  • 19 Jan 2024
Topic Review
Applications of Nasal Nitric Oxide in Allergic Rhinitis
Allergic rhinitis, a common allergic disease affecting a significant number of individuals worldwide, is observed in 25% of children and 40% of adults, with its highest occurrence between the ages of 20 and 40. Its pathogenesis, like other allergic diseases, involves innate and adaptive immune responses, characterized by immunologic hypersensitivity to environmental substances.
  • 477
  • 17 Aug 2023
Topic Review
Exhaled Nitric Oxide in Type 2 Diseases
Nitric oxide (NO) is a short-lived gas molecule which has been studied for its role as a signaling molecule in the vasculature and later, in a broader view, as a cellular messenger in many other biological processes such as immunity and inflammation, cell survival, apoptosis, and aging. Fractional exhaled nitric oxide (FeNO) is a convenient, easy-to-obtain, and non-invasive method for assessing active, mainly Th2-driven, airway inflammation, which is sensitive to treatment with standard anti-inflammatory therapy. Consequently, FeNO serves as a valued tool to aid the diagnosis and monitoring of several asthma phenotypes. FeNO has been evaluated in several other respiratory and/or immunological conditions, including allergic rhinitis, chronic rhinosinusitis with/without nasal polyps, atopic dermatitis, eosinophilic esophagitis, and food allergy.
  • 463
  • 02 Nov 2023
Topic Review
Managing Acute Respiratory Distress Syndrome (ARDS)
Acute Respiratory Distress Syndrome (ARDS) often complicates severe cases of COVID-19, typically as viral pneumonia progresses into diffuse alveolar damage, similar to ARDS from other etiologies. Here’s a structured approach to ARDS management, emphasizing strategies effective in Pneumonia, Sepsis, COVID, etc.
  • 366
  • 28 Oct 2024
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