Allergen Immunotherapy for Local Respiratory Allergy

Eguiluz‐Gracia, Ibon; Ariza, Adriana; Testera‐Montes, Almudena; Rondón, Carmen; Campo, Paloma

doi:10.1007/s11882-020-00920-w

Cited by 19 publications

(24 citation statements)

References 76 publications

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“…This approach will pave the way for a holistic and personalized therapeutic strategy 28 . Of note, a comprehensive intervention including both avoidance measures and AIT 21,29 during childhood might prevent rhinitis progression and asthma onset during later periods of life 30 …”

Section: Discussionmentioning

confidence: 99%

Systematic evaluation of allergic phenotypes of rhinitis in children and adolescents

Prieto

Rondón

Eguiluz‐Gracia

et al. 2021

Pediatric Allergy Immunology

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Background Three allergic phenotypes of rhinitis have been described in adults: allergic rhinitis (AR), local allergic rhinitis (LAR), and dual allergic rhinitis (DAR, coexistence of AR and LAR). Nevertheless, most centers follow a diagnostic approach only based on skin prick test and serum allergen–specific IgE (collectively called atopy tests, AT). This approach prevents the recognition of LAR and DAR, the diagnosis of which requires a nasal allergen challenge (NAC). Here, we investigate the existence of LAR and DAR phenotypes in children and adolescents, and the misdiagnosis rate associated with a work‐up exclusively based on AT. Methods Clinical data were obtained during physician‐conducted interviews, and AT and NAC were systematically performed in 5‐ to 18‐year‐old patients with chronic rhinitis. The misdiagnosis rate was defined as the proportion of cases where AT and NAC results were discordant. Results A total of 173 patients (mean age 15.1 years, 39.9% male) completed the study. AR (positive AT and NAC), LAR (negative AT and positive NAC), DAR (positive AT and NAC for some allergens and negative AT and positive NAC for other allergens), and non‐allergic rhinitis (negative NAC) were diagnosed in 45.7%, 24.9%, 11.6%, and 17.9% of individuals, respectively. The clinical profile was comparable among allergic phenotypes, but allergic patients had a significantly earlier rhinitis onset, higher conjunctivitis prevalence, and more severe disease than NAR individuals. A diagnostic work‐up exclusively based on AT misclassified 37.6% of patients. Conclusions LAR and DAR represent relevant differential diagnosis in pediatric rhinitis. NAC increases the diagnostic accuracy of clinical algorithms for rhinitis in children and adolescents.

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Section: Discussionmentioning

confidence: 99%

Systematic evaluation of allergic phenotypes of rhinitis in children and adolescents

Prieto

Rondón

Eguiluz‐Gracia

et al. 2021

Pediatric Allergy Immunology

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“…Respiratory allergies can display different forms and symptoms. They can be triggered by an allergen such as pollen, house dust mites, animal dander, molds, and inhaled food proteins ( Jeebhay et al, 2019 ; Eguiluz-Gracia et al, 2020 ). The most common respiratory disorders, widely linked with hypersensitivity type I, are rhinitis and asthma.…”

Section: Introductionmentioning

confidence: 99%

Impact of Probiotic Bacteria on Respiratory Allergy Disorders

Jakubczyk

Górska

2021

Front. Microbiol.

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Respiratory allergy is a common disease with an increased prevalence worldwide. The effective remedy is still unknown, and a new therapeutic approach is highly desirable. The review elaborates the influence of probiotic bacteria on respiratory allergy prevention and treatment with particular emphasis on the impact of the current methods of their administration – oral and intranasal. The background of the respiratory allergy is complex thus, we focused on the usefulness of probiotics in the alleviation of different allergy factors, in particular involved in pathomechanism, local hypersensitive evidence and the importance of epithelial barrier. In this review, we have shown that (1) probiotic strains may vary in modulatory potential in respiratory allergy, (2) probiotic bacteria are beneficial in oral and intranasal administration, (3) recombinant probiotic bacteria can modulate the course of respiratory allergy.

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“…No study has investigated to date the effect of AIT on HDM-driven LAA [79]. In a clinical trial published in 2016, 36 Spanish patients with LAR due to HDM were randomized to receive either SCIT (Pangramin Plus ® Dermatophagoides pteronyssinus 1000 STU/mL, ALK-Abello, Hørsholm, Denmark) or placebo for two years [80].…”

Section: Local Allergic Asthmamentioning

confidence: 99%

Precision Medicine in House Dust Mite-Driven Allergic Asthma

Eguiluz‐Gracia

Palomares

Salas

et al. 2020

JCM

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House dust mites (HDMs) are the allergenic sources most frequently involved in airway allergy. Nevertheless, not every sensitized patient develops respiratory symptoms upon exposure to HDM, and there is a clinical need to differentiate allergic asthmatics (AAs) from atopic non-allergic asthmatics with HDM sensitization. This differentiation sometimes requires in vivo provocations like the bronchial allergen challenge (BAC). Interestingly, recent data demonstrate that non-atopic patients with asthma can also develop positive BAC results. This novel phenotype has been termed local allergic asthma (LAA). The interest in identifying the allergic triggers of asthma resides in the possibility of administering allergen immunotherapy (AIT). AIT is a disease-modifying intervention, the clinical benefit of which persists after therapy discontinuation. Recently, new modalities of sublingual tablets of HDM immunotherapy registered as pharmaceutical products (HDM-SLIT tablets) have become commercially available. HDM-SLIT tablets have demonstrated a robust effect over critical asthma parameters (dose of inhaled corticosteroids, exacerbations, and safety), thus being recommended by international guidelines for patients with HDM-driven AA. In this review, we will summarize the current knowledge on the phenotype and endotype of HDM-driven AA, and LAA, address the difficulties for BAC implementation in the clinic, and discuss the effects of AIT in AA and LAA.

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Allergen Immunotherapy for Local Respiratory Allergy

Cited by 19 publications

References 76 publications

Systematic evaluation of allergic phenotypes of rhinitis in children and adolescents

Systematic evaluation of allergic phenotypes of rhinitis in children and adolescents

Impact of Probiotic Bacteria on Respiratory Allergy Disorders

Precision Medicine in House Dust Mite-Driven Allergic Asthma

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