Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2009

Abstract

This review highlights some of the research advances in anaphylaxis and hypersensitivity reactions to foods, drugs, and insects, as well as advances in allergic skin disease that were reported in the Journal in 2009. Among key epidemiologic observations, several westernized countries report that more than 1% of children have peanut allergy, and there is some evidence that environmental exposure to peanut is a risk factor. The role of regulatory T cells, complement, platelet-activating factor, and effector cells in the development and expression of food allergy were explored in several murine models and human studies. Delayed anaphylaxis to mammalian meats appears to be related to IgE binding to the carbohydrate moiety galactose-alpha-1,3-galactose, which also has implications for hypersensitivity to murine mAb therapeutics containing this oligosaccharide. Oral immunotherapy studies continue to show promise for the treatment of food allergy, but determining whether the treatment causes tolerance (cure) or temporary desensitization remains to be explored. Increased baseline serum tryptase levels might inform the risk of venom anaphylaxis and might indicate a risk for mast cell disorders in persons who have experienced such episodes. Reduced structural and immune barrier function contribute to local and systemic allergen sensitization in patients with atopic dermatitis, as well as increased propensity of skin infections in these patients. The use of increased doses of nonsedating antihistamines and potential usefulness of omalizumab for chronic urticaria was highlighted. These exciting advances reported in the Journal can improve patient care today and provide insights on how we can improve the diagnosis and treatment of these allergic diseases in the future.

Contrasting pathogenesis of atopic dermatitis and psoriasis—Part II: Immune cell subsets and therapeutic concepts

“…44,45 In patients with psoriasis, Treg cells were reported to be both quantitatively and functionally deficient in the ability to suppress T-cell activation. 46 In patients with AD, these cells were shown to be increased in the circulation, and their levels were shown to correlate with disease activity.…”

Does “autoreactivity” play a role in atopic dermatitis?

“…E16 Recent research has opened up many dimensions of possible pathogenic or perpetuating mechanisms of AD. 19,20 However, what remains largely unknown is what has gone wrong and in what sequence it went wrong. New longitudinal research is needed to determine whether an autoreactive subgroup of AD exists and whether the onset and extent of such autoreactivity can predict prognosis.…”

Inhibitory Effect of Farnesylthiosalicylic Acid on Mediators Release by Mast Cells: Preferential Inhibition of Prostaglandin D2 and Tumor Necrosis Factor-α Release

“…2c). The asterisk means statistically significant values between the groups, p<0.05. anaphylaxis [6]. Underlying the pathophysiology of allergy is the exposure to an allergen that activates MC, promoting immediate release of preformed mediators (histamine and tryptase), synthesis of arachidonic acid metabolites (prostaglandins and leukotrienes) and of delayed phase cytokines (e.g., TNF-α) [3].…”

“…The established pharmacological agents to treat allergic diseases are limited [6]. Options include antihistamines, leukotriene antagonists, glucocorticosteroids, and more recently omalizumab.…”