Purpose of Review
Atopic diseases such as asthma and allergic rhinitis are highly prevalent in children. Common triggers include tree and grass pollens, house dust mites, molds, and animal dander. These diseases are most often treated symptomatically; however, many patients show partial or poor response and require long-term medication use. Allergen immunotherapy (AIT) stands as the only treatment modality that can alter the underlying disease process and potentially offer a cure. In this review article, we discuss the merits of AIT with particular emphasis on its efficacy and safety in pediatric patients. We also discuss the challenges for AIT implementation and present an overview of current research that aims at improving its applicability for the treatment of allergic diseases.
Recent Findings
Subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are both safe and efficacious treatment options in children with allergic rhinitis and allergic asthma. Additionally, AIT has efficacy in preventing the development of asthma in children. Although there are clear advantages with AIT, there are challenges to overcome to optimize treatment. Solutions include improved diagnostics with pre-treatment biomarkers and molecular multiplex assays, biomarkers for prediction of response (e.g., basophil activation markers), improved allergen immunogenicity with the use of recombinant AIT, adjuvants, and allergoids, and lastly improved safety with the concurrent use of omalizumab.
Summary
AIT has shown safety and efficacy in major clinical trials for the treatment of allergic rhinitis and allergic asthma in children. AIT provides a curative treatment option for atopic disorders and should be considered in children with allergic rhinitis and allergic asthma. There are many continued advances being made in the field of allergy to further improve the safety and efficacy profile and shorten the duration of AIT treatment.
Drilling horizontal wells is a standard practice in the oil industry. Placing hydraulic fractures along the horizontal section of the well, to increase hydrocarbon production, is also rapidly gaining popularity, especially as more tight formations, even shale, are targeted. Understanding the behaviour of each individual fracture requires production logging. This results in additional cost and also puts the well under "operational risks".It is desirable to use pressure data to understand the well behaviour, as this is readily available due to modern completions usually having permanent pressure gauges installed. Also, pressure data can be obtained without putting well at any "operational risks". In the region around fractured horizontal well, multiple flow regimes occur simultaneously. In pressure transient data usually a combination of all the flow regimes is observed making characterisation of the reservoir difficult.In this paper, a comparison of the existing analytical approaches is made to analyse pressure transient data for a horizontal well intercepted by multiple fractures. Using the analytical solutions of the diffusivity equation presented by different authors for a multiply fractured horizontal well, the dimensions of Stimulated Reservoir Volume (SRV) are calculated. Also, the number of active fractures and the flow rate from each fracture are determined using the pressure data. The time for the start of interference is calculated and the time dependence of individual fracture flow rates is also estimated. An observation about the inability to find the orientation of fractures is also made.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.