Allergy

过敏
  • 文章类型: Journal Article
    过敏性疾病,以广泛的临床表现和症状为特征,涵盖了一类重要的IgE介导的特应性疾病,包括哮喘,过敏性鼻炎,特应性皮炎,和食物过敏。这些复杂的条件是遗传因素和环境因素之间错综复杂的相互作用而产生的,并且已知会导致全球社会经济负担。过敏性疾病研究的最新进展揭示了DNA甲基化(DNAm)在其发病机理中的关键作用。本文就DNAm在过敏性疾病中的影响因素及其作用机制进行综述。为临床医生提供有价值的观点。了解这些表观遗传修饰旨在为改进早期预防策略奠定基础。此外,我们对这些条件下DNAm机制的分析旨在增强诊断和治疗方法,为将来更有效地管理过敏性疾病铺平道路。
    Allergic diseases, characterized by a broad spectrum of clinical manifestations and symptoms, encompass a significant category of IgE-mediated atopic disorders, including asthma, allergic rhinitis, atopic dermatitis, and food allergies. These complex conditions arise from the intricate interplay between genetic and environmental factors and are known to contribute to socioeconomic burdens globally. Recent advancements in the study of allergic diseases have illuminated the crucial role of DNA methylation (DNAm) in their pathogenesis. This review explores the factors influencing DNAm in allergic diseases and delves into their mechanisms, offering valuable perspectives for clinicians. Understanding these epigenetic modifications aims to lay the groundwork for improved early prevention strategies. Moreover, our analysis of DNAm mechanisms in these conditions seeks to enhance diagnostic and therapeutic approaches, paving the way for more effective management of allergic diseases in the future.
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  • 文章类型: Journal Article
    自身免疫,过敏,移植排斥是目前无法治愈的慢性疾病的集合,大大降低了患者的生活质量,消耗大量的医疗资源。这些疾病中的每一种的基础是免疫系统失调,其导致针对自身或无害抗原的炎症反应的增加。因此,患病患者需要坚持多种免疫调节药物的终身治疗方案,以控制疾病和恢复机构。不幸的是,目前的免疫调节药物与无数的副作用和不良事件有关,例如癌症风险增加和严重感染风险增加,这会对患者的依从率和生活质量产生负面影响。免疫工程领域是一门新学科,旨在利用内源性生物途径来阻止疾病并使用基于生物材料的新型策略将副作用降至最低。我们强调和讨论具有固有免疫调节特性的聚合物微米/纳米颗粒,目前正在研究基于生物材料的治疗自身免疫的治疗方法。过敏,和移植排斥。
    Autoimmunity, allergy, and transplant rejection are a collection of chronic diseases that are currently incurable, drastically decrease patient quality of life, and consume considerable health care resources. Underlying each of these diseases is a dysregulated immune system that results in the mounting of an inflammatory response against self or an innocuous antigen. As a consequence, afflicted patients are required to adhere to lifelong regimens of multiple immunomodulatory drugs to control disease and reclaim agency. Unfortunately, current immunomodulatory drugs are associated with a myriad of side effects and adverse events, such as increased risk of cancer and increased risk of serious infection, which negatively impacts patient adherence rates and quality of life. The field of immunoengineering is a new discipline that aims to harness endogenous biological pathways to thwart disease and minimize side effects using novel biomaterial-based strategies. We highlight and discuss polymeric micro/nanoparticles with inherent immunomodulatory properties that are currently under investigation in biomaterial-based therapies for treatment of autoimmunity, allergy, and transplant rejection.
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  • 文章类型: Journal Article
    目的:除了描述局部SS的临床表现外,还描述了一个具有典型荨麻疹病变的蝎子刺痛(SS)的年轻患者。
    方法:在主要数据库中对1966年至2021年的文章进行了系统筛选。所有文章都包括SS和荨麻疹之间的关联。新病例报告将添加到发布的列表中。
    结果:文献检索发现5篇文章,29例SS和荨麻疹/过敏反应。我们通过添加我们目前的案例来进行分析,共30例。大多数是男性,他们的年龄从29岁到48岁不等。关于SS严重性,大多数是轻度或中度。在两篇文章中,患者有不止一次刺痛。过敏反应与荨麻疹不同,瘙痒,冲洗,血管性水肿,喘息,鼻漏,打喷嚏,意识改变,以及胃肠道和心血管改变。在5/6(83%)的文章中,患者在研究时间还活着。一名受试者死于过敏性休克。
    结论:本文系统回顾了所有已发表的SS和蝎毒过敏反应的病例。这是一种罕见的关联;大多数患者是男性,处于生产年龄,反应可能从轻度到重度不等,包括死亡。
    OBJECTIVE: To describe a young patient with scorpion sting (SS) with typical lesions of urticaria besides the local SS clinical picture.
    METHODS: A systematic screening of articles dating from 1966 to 2021 was conducted in the main databases. All articles included the association between SS and urticaria. A new case report is added to the published list.
    RESULTS: The literature search found 5 articles with 29 patients with SS and urticaria/allergic reactions. We performed our analysis by adding our present case, resulting in a total of 30 cases. Most were male, and their ages varied from 29 to 48 years. Regarding SS severity, most were mild or moderate. In two articles, patients had more than one sting. The allergic reaction varied from urticaria, pruritus, flushing, angioedema, wheezing, rhinorrhea, sneezing, consciousness alterations, and gastrointestinal and cardiovascular alterations. In 5/6 (83%) articles, the patients were alive at the study time. One subject died from anaphylactic shock.
    CONCLUSIONS: The present article systematically reviewed all published cases of SS and allergic reactions to scorpion venom. It is an infrequent association; most patients are male and in the productive age, and reaction may vary from mild to severe, including death.
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  • 文章类型: Journal Article
    目标:人工智能(AI),无论是神经网络,机器学习或深度学习,对医疗保健系统有许多有益的影响;然而,其潜在的应用和对免疫疾病的诊断能力还有待探索。了解人工智能系统可以帮助医护人员更好地将人工智能融入他们的实践中,并释放其在诊断方面的潜力。临床研究,和疾病管理。
    结果:我们回顾了人工智能系统的最新进展及其在医疗保健系统中的集成,以及它们在疾病诊断和管理方面的潜在好处。我们探索了用于过敏诊断的机器学习及其从患者数据集中的学习模式,以及在与过敏反应甚至远程监控相关的研究领域使用AI的可能优势。考虑到临床医生和患者在将AI整合到医疗保健中方面提出的道德挑战和隐私问题,我们探讨了由监管机构调整的新准则。尽管面临这些挑战,人工智能似乎已成功融入各种医疗保健系统,并提供以患者为中心的解决方案,同时帮助医护人员。人工智能为免疫疾病诊断领域提供了新的希望,监测,和管理,因此有可能彻底改变医疗保健系统。
    OBJECTIVE: Artificial intelligence (AI), be it neuronal networks, machine learning or deep learning, has numerous beneficial effects on healthcare systems; however, its potential applications and diagnostic capabilities for immunologic diseases have yet to be explored. Understanding AI systems can help healthcare workers better assimilate artificial intelligence into their practice and unravel its potential in diagnostics, clinical research, and disease management.
    RESULTS: We reviewed recent advancements in AI systems and their integration in healthcare systems, along with their potential benefits in the diagnosis and management of diseases. We explored machine learning as employed in allergy diagnosis and its learning patterns from patient datasets, as well as the possible advantages of using AI in the field of research related to allergic reactions and even remote monitoring. Considering the ethical challenges and privacy concerns raised by clinicians and patients with regard to integrating AI in healthcare, we explored the new guidelines adapted by regulatory bodies. Despite these challenges, AI appears to have been successfully incorporated into various healthcare systems and is providing patient-centered solutions while simultaneously assisting healthcare workers. Artificial intelligence offers new hope in the field of immunologic disease diagnosis, monitoring, and management and thus has the potential to revolutionize healthcare systems.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    虽然过敏和癌症之间的关系已经被广泛研究,过敏在头颈癌(HNC)中的作用似乎不那么一致。目前尚不清楚过敏是否可以独立影响HNC的风险存在的实质性环境危险因素。包括饮酒,槟榔,和香烟。本研究旨在找到这种关联。我们在一项基于医院的病例对照研究中检查了过敏与HNC风险之间的关系,该研究包括300例病例和375例匹配的对照。Logistic回归模型用于估计比值比(OR)和95%置信区间。控制年龄,性别,吸烟和鸦片使用史,酒精消费,和社会经济地位。我们的研究表明,在调整混杂因素后,与过敏症状相关的HNC风险显着降低。在任何类型的变态反应者中,HNC的风险大大降低(OR0.42,95%CI0.28,0.65)。对于不同类型的过敏,OR大大降低了58-88%。过敏性女性减少HNC的风险高于过敏性男性(71%vs.49%)。过敏在HNC发展的风险中起着重要作用。未来研究免疫生物标志物,包括细胞因子谱和遗传多态性,有必要进一步划定过敏与HNC之间的关系。了解过敏和HNC之间的关系可能有助于设计有效的策略来减少和治疗HNC。
    Although the relationship between allergies and cancer has been investigated extensively, the role of allergies in head and neck cancer (HNC) appears less consistent. It is unclear whether allergies can independently influence the risk of HNC in the presence of substantial environmental risk factors, including consumption of alcohol, betel quid, and cigarettes. This study aims to find this association. We examined the relationship between allergies and HNC risk in a hospital-based case-control study with 300 cases and 375 matched controls. Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals, controlling for age, sex, tobacco smoking and opium usage history, alcohol consumption, and socioeconomic status. Our study showed a significant reduction in the risk of HNC associated with allergy symptoms after adjusting for confounders. The risk of HNC was greatly reduced among those with any type of allergy (OR 0.42, 95% CI 0.28, 0.65). The ORs were considerably reduced by 58-88% for different kinds of allergies. The risk of HNC reduction was higher in allergic women than in allergic men (71% vs. 49%). Allergies play an influential role in the risk of HNC development. Future studies investigating immune biomarkers, including cytokine profiles and genetic polymorphisms, are necessary to further delineate the relationship between allergies and HNC. Understanding the relationship between allergies and HNC may help to devise effective strategies to reduce and treat HNC.
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  • 文章类型: Journal Article
    环境不匹配被定义为引起公共卫生危机的环境变化。众所周知,导致慢性疾病的不匹配包括促进不健康饮食和久坐不动的生活方式的技术的可用性,这两个因素都对心血管健康产生不利影响。这篇评论把这些不匹配放在生物群改变的背景下,涉及避免传染病所必需的卫生相关技术的环境不匹配。实施与卫生有关的技术会导致共生蠕虫和原生生物的流失,深刻影响免疫功能并促进各种慢性疾病,包括过敏性疾病,自身免疫性疾病,和一些炎症相关的神经精神疾病。不幸的是,尽管对支撑这种和其他环境不匹配的生物学有了既定的理解,公共卫生机构未能阻止由此导致的慢性病负担增加的趋势。生物医学研究和临床实践都继续关注无效和反应性以药物为基础的范例。有人认为,未来的医疗保健可以考虑到今天的生物学,有效和积极地应对环境不匹配和由此产生的慢性疾病负担。
    Environmental mismatches are defined as changes in the environment that induce public health crises. Well known mismatches leading to chronic disease include the availability of technologies that facilitate unhealthy diets and sedentary lifestyles, both factors that adversely affect cardiovascular health. This commentary puts these mismatches in context with biota alteration, an environmental mismatch involving hygiene-related technologies necessary for avoidance of infectious disease. Implementation of hygiene-related technologies causes a loss of symbiotic helminths and protists, profoundly affecting immune function and facilitating a variety of chronic conditions, including allergic disorders, autoimmune diseases, and several inflammation-associated neuropsychiatric conditions. Unfortunately, despite an established understanding of the biology underpinning this and other environmental mismatches, public health agencies have failed to stem the resulting tide of increased chronic disease burden. Both biomedical research and clinical practice continue to focus on an ineffective and reactive pharmaceutical-based paradigm. It is argued that the healthcare of the future could take into account the biology of today, effectively and proactively dealing with environmental mismatch and the resulting chronic disease burden.
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  • 文章类型: Journal Article
    背景:“卫生假说”指出,由于过度卫生的环境而减少对微生物抗原的暴露会增加患自身免疫性疾病的风险,包括特应性疾病和哮喘。近几十年来,随着卫生条件的改善,许多微生物的流行率逐渐下降。更具体地说,多项研究报道,幽门螺杆菌感染的减少与哮喘和过敏性疾病的增加呈负相关.
    目的:评估儿童人群中与幽门螺杆菌血清阳性相关的特应性疾病的患病率。
    方法:北撒丁岛的儿童,意大利,出于任何原因转诊到当地儿童医院,进行了调查以确定风险因素,尤其是幽门螺杆菌感染,与特应性疾病相关。一份经过验证的问卷,包括人口统计,房子大小,母乳喂养史,residence,学校或日托中心的出勤率,接触动物,并且由训练有素的儿科医生根据父母的回答和儿童记录填写了特应性疾病-包括哮喘的明确诊断。从每个参与者收集血液样品,并通过局部验证的ELISA测试评估针对幽门螺杆菌的免疫球蛋白G。
    结果:在492名儿童(240名女性)中,幽门螺杆菌感染的血清阳性率为11.7%。32名儿童确诊为哮喘,12名确诊为过敏。没有一个孩子表现出这两种情况。在有或没有特应性的儿童之间未检测到幽门螺杆菌血清阳性的统计学差异(8.4%与12.6;p=0.233)。尽管特应性疾病在暴露于传统特应性危险因素的儿童中更为常见,在调整所有协变量后,没有一个显示出显著。
    结论:血清学评估的幽门螺杆菌感染与儿童特应性疾病风险降低没有显著相关。
    BACKGROUND: The \"hygiene hypothesis\" states that reduced exposure to microbial antigens due to an excessively hygienic environment can increase the risk of developing autoimmune diseases, including atopic disorders and asthma. In recent decades, there has been a progressive decline in the prevalence of numerous microorganisms following improved hygienic-sanitary conditions. More specifically, several studies reported an inverse association between the reduction in Helicobacter pylori infection and the rise of asthma and allergic disorders.
    OBJECTIVE: To evaluate the prevalence of atopic disorders in a pediatric population in relation to seropositivity against H. pylori.
    METHODS: Children from Northern Sardinia, Italy, referred to the local Children\'s Hospital for any reason, were investigated to identify risk factors, especially H. pylori infection, associated with atopic disorders. A validated questionnaire, including demographics, house size, history of breastfeeding, residence, school or daycare center attendance, exposure to animals, and a defined diagnosis of atopy-including asthma-was filled out by a trained pediatrician according to parents\' answers and child records. A blood sample was collected from each participant and immunoglobulin G against H. pylori was assessed by a locally validated ELISA test.
    RESULTS: The seroprevalence of H. pylori infection was 11.7% among 492 children (240 females). Thirty-two children had a confirmed diagnosis of asthma and 12 of allergy. No one child showed both conditions. Statistically significant differences in H. pylori seropositivity were not detected between children with or without atopy (8.4% vs. 12.6; p = 0.233). Although atopic disorders were more frequent in children exposed to traditional atopic risk factors, none of them showed to be significant after adjusting for all covariates.
    CONCLUSIONS: Serologically assessed H. pylori infection was not significantly associated with a reduced risk of atopic diseases in children.
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  • 文章类型: Journal Article
    持续和未解决的炎症是在几种看似无关的人类疾病中观察到的常见潜在因素。包括心血管和神经退行性疾病。特别是,在特应性条件下,急性炎症反应,如昆虫毒液引发的炎症反应,食物或药物过敏也具有危及生命的潜力。然而,呼吸道过敏主要表现出与慢性炎症相关的晚期免疫反应,最终会发展成严重的表型,表现出与其他慢性炎症性疾病相似的特征,不受控制的严重哮喘也是如此。本文旨在探讨慢性过敏性炎症的不同方面和系统。包括组织重塑和免疫细胞失调等过程,以及遗传,代谢和微生物群的改变,这是常见的其他炎症条件。我们的目标是加深对慢性过敏性炎症等缠结疾病的理解,并揭示开发更好的诊断和干预策略的潜在途径。
    Persistent and unresolved inflammation is a common underlying factor observed in several and seemingly unrelated human diseases, including cardiovascular and neurodegenerative diseases. Particularly, in atopic conditions, acute inflammatory responses such as those triggered by insect venom, food or drug allergies possess also a life-threatening potential. However, respiratory allergies predominantly exhibit late immune responses associated with chronic inflammation, that can eventually progress into a severe phenotype displaying similar features as those observed in other chronic inflammatory diseases, as is the case of uncontrolled severe asthma. This review aims to explore the different facets and systems involved in chronic allergic inflammation, including processes such as tissue remodelling and immune cell dysregulation, as well as genetic, metabolic and microbiota alterations, which are common to other inflammatory conditions. Our goal here was to deepen on the understanding of an entangled disease as is chronic allergic inflammation and expose potential avenues for the development of better diagnostic and intervention strategies.
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  • 文章类型: English Abstract
    自我报告的青霉素过敏非常普遍。不同的研究估计,10%的人口被标记为这样。这个标签,证实或怀疑,迫使我们采取预防措施,用其他第二或第三选择替代抗生素治疗(通常是β-内酰胺),总体效果较差:副作用,阻力,成本,等。青霉素过敏标签,一旦放置,仍然在医疗记录中。仅在不到5%的患者中得到证实,要么是因为它放置不当,要么是因为随着时间的推移灵敏度降低并可能消失。青霉素过敏决策规则-PEN-FAST-是一个经过验证和简单的临床预测规则,可估计出现过敏反应的风险。它的使用,以及涉及初级保健和低风险患者去标签的算法,可以改变我们的临床实践。
    Self-reported penicillin allergy is highly prevalent. Different studies estimate that 10% of the population is labeled as such. This label, confirmed or suspected, forces us to take precautions and replace the antibiotic treatment of choice (frequently beta-lactams) with other 2nd or 3rd choice alternatives with worse overall results: side effects, resistance, costs, etc. The penicillin allergy label, once placed, remains in the medical record. It is only confirmed in less than 5% of patients, either because it has been placed inappropriately or because over time the sensitivity decreases and may disappear. Penicillin Allergy Decision Rule -PEN-FAST- is a validated and simple clinical prediction rule that estimates the risk of presenting an allergic reaction. Its use, together with algorithms that involve primary care in the study and delabeling of low-risk patients, can change our clinical practice.
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