A comparison between IgE and IgG4 as markers of allergy in children: an experimental trial in a model of natural antigen avoidance

Alpine altitude climate treatment for severe and uncontrolled asthma: An EAACI position paper

Currently available European Alpine Altitude Climate Treatment (AACT) programs combine the physical characteristics of altitude with the avoidance of environmental triggers in the alpine climate and a personalized multidisciplinary pulmonary rehabilitation approach. The reduced barometric pressure, oxygen pressure, and air density, the relatively low temperature and humidity, and the increased UV radiation at moderate altitude induce several physiological and immunological adaptation responses. The environmental characteristics of the alpine climate include reduced aeroallergens such as house dust mites (HDM), pollen, fungi, and less air pollution. These combined factors seem to have immunomodulatory effects controlling pathogenic inflammatory responses and favoring less neuro‐immune stress in patients with different asthma phenotypes. The extensive multidisciplinary treatment program may further contribute to the observed clinical improvement by AACT in asthma control and quality of life, fewer exacerbations and hospitalizations, reduced need for oral corticosteroids (OCS), improved lung function, decreased airway hyperresponsiveness (AHR), improved exercise tolerance, and improved sinonasal outcomes. Based on observational studies and expert opinion, AACT represents a valuable therapy for those patients irrespective of their asthma phenotype, who cannot achieve optimal control of their complex condition despite all the advances in medical science and treatment according to guidelines, and therefore run the risk of falling into a downward spiral of loss of physical and mental health. In the light of the observed rapid decrease in inflammation and immunomodulatory effects, AACT can be considered as a natural treatment that targets biological pathways.

Converging findings from linkage between periodontal pathogen with atopic and allergic immune response

This study aims to explore a relationship between exposures of whole-cell Porphyromonas gingivalis in various doses with atopic inflammatory responses at experimental mice. A pretest-posttest controlled group design, with 16 Wistar rats (Rattus novergicus) randomized into four groups. Group 1 was the control group. Group 2 was given low-dose (9 × 10⁷ colony-forming unit) of P. gingivalis. Group 3 was given medium-dose (9 × 10⁹ colony-forming unit) of P. gingivalis. Group 4 was given high-dose (9 × 10¹¹ colony-forming unit) of P. gingivalis. Interleukin-4, Interleukin-5, Interleukin-17F, Interleukin-21, Immunoglobulin-E, Immunoglobulin-G₄, and γ-Interferon were measured by direct-sandwich ELISA just before the treatments began, day-4, and day-11 after treatments. There is a sudden increase of Interleukin-4 in the group 4 (23.79 ± 0.91 pg/ml to 54.17 ± 0.79 pg/ml; p = 0.01) and slight increase of Interleukin-5 in the group 4 (207.60 ± 11.15 pg/ml to 243.40 ± 9.33 pg/ml; p = 0.03). No change was observed for Interleukin-17F in all groups. Serum concentration of Immunoglobulin-E was decreased in group 2 (-10.44 ± 8.13 pg/ml), but increased in group 4 (+1.03 ± 4.57 pg/ml). Taken together, some cytokines are up-regulated and others are down-regulated after exposure to whole-cell P. gingivalis. Moreover, study of host responses during periodontal infection may offer critical key insight that contribute to the development of atopy. CLINICAL IMPLICATIONS: We introduced and explained the potential role of periodontal pathogen Porphyromonas gingivalis in systemic immune responses, along with its virulence factor inside the oral cavity. Our results consider several changes and differences of cytokines and immunoglobulins following whole-cell Porphyromonas gingivalis exposure. However, results of the study need to be interpreted with caution due to its limitations. CAPSULE SUMMARY: Interleukin (IL)-4 and IL-5 had been found increase after exposure to the periodontal pathogens Porphyromonas gingivalis, whereas no or minimal change had been found in the level of IL-17F, Ig-G₄, and IFN-γ. The various cytokines and immunoglobulins shown in this study do not prove a causal relationship, and the precise role of Porphyromonas gingivalis in the regulation of atopic immune response warrants further investigation. Nevertheless, these findings may provide some critical key insight into the host responses following Porphyromonas gingivalis infection.

Serum biomarkers for allergy in children

A large number of studies investigating various biomarkers for allergy have been published over the past decades. The aim of this review was to evaluate these biomarkers on their diagnostic and/or predictive value. To this date, no single or specific biomarker for allergy has been identified. As allergy is not one disease, but a collection of a number of allergic conditions, it is more plausible a combination of clinical history, clinical readouts, and diagnostic markers will be needed.