scholarly journals Hymenoptera Venom Immunotherapy: Immune Mechanisms of Induced Protection and Tolerance

Cells ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1575
Author(s):  
Ajda Demšar Luzar ◽  
Peter Korošec ◽  
Mitja Košnik ◽  
Mihaela Zidarn ◽  
Matija Rijavec
Keyword(s):  
Current Knowledge ◽  
Allergic Diseases ◽  
Hymenoptera Venom ◽  
Venom Immunotherapy ◽  
Effector Cells ◽  
Immune Mechanisms ◽  
Protection Mechanisms ◽  
Sting Challenge ◽  
Effectiveness Data

Hymenoptera venom allergy is one of the most severe allergic diseases, with a considerable prevalence of anaphylactic reaction, making it potentially lethal. In this review, we provide an overview of the current knowledge and recent findings in understanding induced immune mechanisms during different phases of venom immunotherapy. We focus on protection mechanisms that occur early, during the build-up phase, and on the immune tolerance, which occurs later, during and after Hymenoptera venom immunotherapy. The short-term protection seems to be established by the early desensitization of mast cells and basophils, which plays a crucial role in preventing anaphylaxis during the build-up phase of treatment. The early generation of blocking IgG antibodies seems to be one of the main reasons for the lower activation of effector cells. Long-term tolerance is reached after at least three years of venom immunotherapy. A decrease in basophil responsiveness correlates with tolerated sting challenge. Furthermore, the persistent decline in IgE levels and, by monitoring the cytokine profiles, a shift from a Th2 to Th1 immune response, can be observed. In addition, the generation of regulatory T and B cells has proven to be essential for inducing allergen tolerance. Most studies on the mechanisms and effectiveness data have been obtained during venom immunotherapy (VIT). Despite the high success rate of VIT, allergen tolerance may not persist for a prolonged time. There is not much known about immune mechanisms that assure long-term tolerance post-therapy.

scholarly journals Tracing IgE-Producing Cells in Allergic Patients

Cells ◽  
2019 ◽  
Vol 8 (9) ◽  
pp. 994 ◽  
Author(s):  
Julia Eckl-Dorna ◽  
Sergio Villazala-Merino ◽  
Nicholas James Campion ◽  
Maria Byazrova ◽  
Alexander Filatov ◽  
...  
Keyword(s):  
Plasma Cells ◽  
Immunoglobulin E ◽  
Current Knowledge ◽  
Allergic Diseases ◽  
Specific Ige ◽  
Allergen Exposure ◽  
World Population ◽  
Effector Cells ◽  
Ige Receptors ◽  
Pre Treatment

Immunoglobulin E (IgE) is the key immunoglobulin in the pathogenesis of IgE associated allergic diseases affecting 30% of the world population. Recent data suggest that allergen-specific IgE levels in serum of allergic patients are sustained by two different mechanisms: inducible IgE production through allergen exposure, and continuous IgE production occurring even in the absence of allergen stimulus that maintains IgE levels. This assumption is supported by two observations. First, allergen exposure induces transient increases of systemic IgE production. Second, reduction in IgE levels upon depletion of IgE from the blood of allergic patients using immunoapheresis is only temporary and IgE levels quickly return to pre-treatment levels even in the absence of allergen exposure. Though IgE production has been observed in the peripheral blood and locally in various human tissues (e.g., nose, lung, spleen, bone marrow), the origin and main sites of IgE production in humans remain unknown. Furthermore, IgE-producing cells in humans have yet to be fully characterized. Capturing IgE-producing cells is challenging not only because current staining technologies are inadequate, but also because the cells are rare, they are difficult to discriminate from cells bearing IgE bound to IgE-receptors, and plasma cells express little IgE on their surface. However, due to the central role in mediating both the early and late phases of allergy, free IgE, IgE-bearing effector cells and IgE-producing cells are important therapeutic targets. Here, we discuss current knowledge and unanswered questions regarding IgE production in allergic patients as well as possible therapeutic approaches targeting IgE.

scholarly journals Long-term impact of hymenoptera venom immunotherapy on clinical course, immune parameters, and psychosocial aspects

2021 ◽  
Vol 5 (01) ◽  
pp. 57-66
Author(s):  
Jan Adelmeyer ◽  
Julia Pickert ◽  
Wolfgang Pfützner ◽  
Christian Möbs
Keyword(s):  
Clinical Course ◽  
Psychosocial Aspects ◽  
Hymenoptera Venom ◽  
Venom Immunotherapy ◽  
Immune Parameters ◽  
Long Term Impact

Basophil response and the induction of a tolerance in venom immunotherapy: a long-term sting challenge study

Allergy ◽  
2012 ◽  
Vol 67 (6) ◽  
pp. 822-830 ◽  
Author(s):  
R. Eržen ◽  
M. Košnik ◽  
M. Šilar ◽  
P. Korošec
Keyword(s):  
Venom Immunotherapy ◽  
Challenge Study ◽  
Sting Challenge

СОХРАНЕНИЕ ПРИВЕРЖЕННОСТИ К ТЕРАПИИ КАК ГАРАНТИЯ ЭФФЕКТИВНОСТИ СЛИТ

2019 ◽  
Author(s):  
K.S. Pavlova ◽  
D.S. Mdinaradze
Keyword(s):  
Allergic Diseases ◽  
Atopic Asthma ◽  
National Guidelines ◽  
Allergen Specific Immunotherapy ◽  
Dose Dependent ◽  
Methods Of Treatment ◽  
Choice Of Therapy ◽  
Dose Dependent Effect ◽  
Reduced Adherence

По данным ВОЗ, рекомендации врача выполняют не более 50 пациентов. В конечном итоге это приводит к снижению или отсутствию эффекта от назначаемого лечения. В связи с этим во всех последних международных и национальных руководствах говорится о необходимости учета предпочтений пациента при выборе терапии. Аллерген-специфическая иммунотерапия (АСИТ) является одним из основных методов лечения аллергических заболеваний, таких как аллергический ринит, конъюнктивит и атопическая бронхиальная астма, обладает болезнь-модифицирующими свойствами и долгосрочным эффектом после окончания лечения. АСИТ относится к профилактическому и продолжительному методу (рекомендовано на протяжении не менее 3 лет), что часто является причиной снижения приверженности к терапии. В различных исследованиях подтвержден зависимый от дозы аллергена эффект АСИТ, а следовательно, изменение режимов или сокращение сроков терапии могут влиять на конечный результат. При недостаточной эффективности АСИТ необходимо в первую очередь рассматривать вероятность низкого комплаенса. Сублингвальная АСИТ (СЛИТ) требует от пациента высокой вовлеченности в процесс лечения. Задачей врача в данном случае становится повышение терапевтического сотрудничества как одного из важнейших факторов обеспечения эффективности СЛИТ. Основными способами в данном случае являются улучшение понимания пациентом цели терапии и регулярный контроль со стороны врача.According to WHO at last 50 of the patient dont follow doctors recommendations. Ultimately, this leads to a decrease or absence of the treatment effect. In this regard, all the latest international and national guidelines mention the need to take into account the patients preferences in the choice of therapy. Allergen-specific immunotherapy (AIT) is one of the main methods of treatment of allergic diseases such as allergic rhinitis, allergic conjunctivitis and atopic asthma, and has disease modifying properties and the long-term efficacy after stop treatment. AIT refers to a preventive and long-term method (recommended for at least 3 years), that is often the cause of reduced adherence to therapy. Various studies have confirmed the dose-dependent effect of AIT, and, consequently, changes in regimens or shortening of therapy may affect the end result. In case of insufficient effectiveness of AIT, the probability of low compliance should be considered first of all. Sublingual AIT (SLIT) requires the patient to be highly involved in the treatment process. The task of the doctor in this case is increasing therapeutic cooperation, as one of the most important factors to ensure the effectiveness of SLIT. The main methods in this case are to improve the patients understanding of the purpose of the therapy and regular monitoring by the doctor.

scholarly journals Impact of mobile stroke units

2021 ◽  
pp. jnnp-2020-324005
Author(s):  
Klaus Fassbender ◽  
Fatma Merzou ◽  
Martin Lesmeister ◽  
Silke Walter ◽  
Iris Quasar Grunwald ◽  
...  
Keyword(s):  
Cost Efficiency ◽  
Current Knowledge ◽  
Vascular Imaging ◽  
Vessel Occlusion ◽  
Stroke Units ◽  
Stroke Treatment ◽  
Stroke Research ◽  
Mobile Stroke Unit ◽  
Novel Strategy

Since its first introduction in clinical practice in 2008, the concept of mobile stroke unit enabling prehospital stroke treatment has rapidly expanded worldwide. This review summarises current knowledge in this young field of stroke research, discussing topics such as benefits in reduction of delay before treatment, vascular imaging-based triage of patients with large-vessel occlusion in the field, differential blood pressure management or prehospital antagonisation of anticoagulants. However, before mobile stroke units can become routine, several questions remain to be answered. Current research, therefore, focuses on safety, long-term medical benefit, best setting and cost-efficiency as crucial determinants for the sustainability of this novel strategy of acute stroke management.

scholarly journals Cardiac Cell Therapy: Insights into the Mechanisms of Tissue Repair

2021 ◽  
Vol 22 (3) ◽  
pp. 1201
Author(s):  
Hsuan Peng ◽  
Kazuhiro Shindo ◽  
Renée R. Donahue ◽  
Ahmed Abdel-Latif
Keyword(s):  
Stem Cell ◽  
Immune Responses ◽  
Tissue Repair ◽  
Molecular Mechanisms ◽  
Clinical Evidence ◽  
Current Knowledge ◽  
Cell Delivery ◽  
Cardiac Cell Therapy ◽  
Stem Cell Treatment

Stem cell-based cardiac therapies have been extensively studied in recent years. However, the efficacy of cell delivery, engraftment, and differentiation post-transplant remain continuous challenges and represent opportunities to further refine our current strategies. Despite limited long-term cardiac retention, stem cell treatment leads to sustained cardiac benefit following myocardial infarction (MI). This review summarizes the current knowledge on stem cell based cardiac immunomodulation by highlighting the cellular and molecular mechanisms of different immune responses to mesenchymal stem cells (MSCs) and their secretory factors. This review also addresses the clinical evidence in the field.

scholarly journals Management of Myositis-Associated Interstitial Lung Disease

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 347
Author(s):  
Tomoyuki Fujisawa
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Current Knowledge ◽  
Strong Predictor ◽  
Calcineurin Inhibitors ◽  
Pulmonary Involvement ◽  
Trna Synthetase ◽  
Evidence Based Guidelines ◽  
Substantial Heterogeneity

Idiopathic inflammatory myopathies, including polymyositis (PM), dermatomyositis (DM), and clinically amyopathic DM (CADM), are a diverse group of autoimmune diseases characterized by muscular involvement and extramuscular manifestations. Interstitial lung disease (ILD) has major pulmonary involvement and is associated with increased mortality in PM/DM/CADM. The management of PM-/DM-/CADM-associated ILD (PM/DM/CADM-ILD) requires careful evaluation of the disease severity and clinical subtype, including the ILD forms (acute/subacute or chronic), because of the substantial heterogeneity of their clinical courses. Recent studies have highlighted the importance of myositis-specific autoantibodies’ status, especially anti-melanoma differentiation-associated gene 5 (MDA5) and anti-aminoacyl tRNA synthetase (ARS) antibodies, in order to evaluate the clinical phenotypes and treatment of choice for PM/DM/CADM-ILD. Because the presence of the anti-MDA5 antibody is a strong predictor of a worse prognosis, combination treatment with glucocorticoids (GCs) and calcineurin inhibitors (CNIs; tacrolimus (TAC) or cyclosporin A (CsA)) is recommended for patients with anti-MDA5 antibody-positive DM/CADM-ILD. Rapidly progressive DM/CADM-ILD with the anti-MDA5 antibody is the most intractable condition, which requires immediate combined immunosuppressive therapy with GCs, CNIs, and intravenous cyclophosphamide. Additional salvage therapies (rituximab, tofacitinib, and plasma exchange) should be considered for patients with refractory ILD. Patients with anti-ARS antibody-positive ILD respond better to GC treatment, but with frequent recurrence; thus, GCs plus immunosuppressants (TAC, CsA, azathioprine, and mycophenolate mofetil) are often needed in order to achieve favorable long-term disease control. PM/DM/CADM-ILD management is still a therapeutic challenge for clinicians, as evidence-based guidelines do not exist to help with management decisions. A few prospective clinical trials have been recently reported regarding the treatment of PM/DM/CADM-ILD. Here, the current knowledge on the pharmacologic managements of PM/DM/CADM-ILD was mainly reviewed.

scholarly journals COVID-19 Infection during Pregnancy: Risk of Vertical Transmission, Fetal, and Neonatal Outcomes

2021 ◽  
Vol 11 (6) ◽  
pp. 483
Author(s):  
Marwa Saadaoui ◽  
Manoj Kumar ◽  
Souhaila Al Khodor
Keyword(s):  
Pregnant Women ◽  
Vertical Transmission ◽  
Current Knowledge ◽  
Limited Data ◽  
Pregnancy Risk ◽  
Public Health Challenge ◽  
Short And Long Term ◽  
Critical Public Health ◽  
The Impact

The COVID-19 pandemic is a worldwide, critical public health challenge and is considered one of the most communicable diseases that the world had faced so far. Response and symptoms associated with COVID-19 vary between the different cases recorded, but it is amply described that symptoms become more aggressive in subjects with a weaker immune system. This includes older subjects, patients with chronic diseases, patients with immunosuppression treatment, and pregnant women. Pregnant women are receiving more attention not only because of their altered physiological and immunological function but also for the potential risk of viral vertical transmission to the fetus or infant. However, very limited data about the impact of maternal infection during pregnancy, such as the possibility of vertical transmission in utero, during birth, or via breastfeeding, is available. Moreover, the impact of infection on the newborn in the short and long term remains poorly understood. Therefore, it is vital to collect and analyze data from pregnant women infected with COVID-19 to understand the viral pathophysiology during pregnancy and its effects on the offspring. In this article, we review the current knowledge about pre-and post-natal COVID-19 infection, and we discuss whether vertical transmission takes place in pregnant women infected with the virus and what are the current recommendations that pregnant women should follow in order to be protected from the virus.

scholarly journals Global Analysis of Durable Policies for Free-Flowing River Protections

2021 ◽  
Vol 13 (4) ◽  
pp. 2347 ◽  
Author(s):  
Denielle Perry ◽  
Ian Harrison ◽  
Stephannie Fernandes ◽  
Sarah Burnham ◽  
Alana Nichols
Keyword(s):  
Global Analysis ◽  
Freshwater Ecosystems ◽  
Global Networks ◽  
Protection Mechanisms ◽  
The Creation ◽  
River Conservation ◽  
Protected Area Planning ◽  
Policy Types ◽  
Policy Mechanisms

Freshwater ecosystems are poorly represented in global networks of protected areas. This situation underscores an urgent need for the creation, application, and expansion of durable (long-term and enforceable) protection mechanisms for free-flowing rivers that go beyond conventional protected area planning. To address this need, we must first understand where and what types of protections exist that explicitly maintain the free-flowing integrity of rivers, as well as the efficacy of such policy types. Through policy analysis and an in-depth literature review, our study identifies three main policy mechanisms used for such protections: (1) River Conservation Systems; (2) Executive Decrees and Laws; and (3) Rights of Rivers. We found that globally only eight counties have national river conservation systems while seven countries have used executive decrees and similar policies to halt dam construction, and Rights of Rivers movements are quickly growing in importance, relative to other protection types. Despite the current extent of protection policies being insufficient to tackle the freshwater and biodiversity crises facing the world’s rivers, they do provide useful frameworks to guide the creation and expansion of protections. Ultimately, as countries act on global calls for protections, policy mechanisms must be tailored to their individual social and ecological geographies.

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