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Microbiota composition and associated metabolic activities are essential for the education and development of a healthy immune system. Microbial dysbiosis, caused by risk factors such as diet, birth mode, or early infant antimicrobial therapy, is associated with the inception of allergic diseases. In turn, allergic diseases increase the risk for irrational use of antimicrobial therapy. Microbial therapies, such as probiotics, have been studied in the prevention and treatment of allergic diseases, but evidence remains limited due to studies with high heterogeneity, strain‐dependent effectiveness, and variable outcome measures. In this review, we sketch the relation of microbiota with allergic diseases, the overuse and rationale for the use of antimicrobial agents in allergic diseases, and current knowledge concerning the use of bacterial products in allergic diseases. We urgently recommend 1) limiting antibiotic therapy in pregnancy and early childhood as a method contributing to the reduction of the allergy epidemic in children and 2) restricting antibiotic therapy in exacerbations and chronic treatment of allergic diseases, mainly concerning asthma and atopic dermatitis. Future research should be aimed at antibiotic stewardship implementation strategies and biomarker‐guided therapy, discerning those patients that might benefit from antibiotic therapy. [ABSTRACT FROM AUTHOR]

Abstract Due to an increasing awareness of the potential hazardousness of air pollutants, new laws, rules and guidelines have recently been implemented globally. In this respect, numerous studies have addressed traffic-related exposure to particulate matter using stationary technology so far. By contrast, only few studies used the advanced technology of mobile exposure analysis. The Mobile Air Quality Study (MAQS) addresses the issue of air pollutant exposure by combining advanced high-granularity spatial-temporal analysis with vehicle-mounted, person-mounted and roadside sensors. The MAQS-platform will be used by international collaborators in order 1) to assess air pollutant exposure in relation to road structure, 2) to assess air pollutant exposure in relation to traffic density, 3) to assess air pollutant exposure in relation to weather conditions, 4) to compare exposure within vehicles between front and back seat (children) positions, and 5) to evaluate "traffic zone"-exposure in relation to non-"traffic zone"-exposure. Primarily, the MAQS-platform will focus on particulate matter. With the establishment of advanced mobile analysis tools, it is planed to extend the analysis to other pollutants including NO2, SO2, nanoparticles and ozone.

Abstract Background Isocyanates are extensively used in the manufacture of polyurethane foams, plastics, coatings or adhesives. They are a major cause of occupational asthma in a proportion of exposed workers. Recent findings in animal models have demonstrated that isocyanate-induced asthma does not always represent an IgE-mediated sensitization, but still a mixed profile of CD4+ Th1 and TH2, as well as a CD8+ immune response. Despite immunologic similarities between this pathology and IgE-mediated food allergies, this co-morbidity is rarely reported. Case presentation A 50-year old man employed as vehicle body painter, for 8 years complained about breathlessness, wheezing, sneezing, nasal obstruction and excessive production of mucus during the use of DuPont Refinish Centari Tintings – an acrylic enamel tint. Symptoms occurred 15–20 minutes after workplace exposure and usually persisted until evening, or at times, up to two consecutive days. The above mentioned symptoms were associated with a decrease of lung functions parameters. The use of inhaled adrenergic bronchio-dilatators and steroids relived the symptoms. In addition, three years ago he developed an anaphylactic reaction due to peanut consumption, experiencing urticaria, angioedema and airway obstruction. He was successfully treated in the hospital. Later, the subject exhibited labial itching, as well as orbital and perioral angioedema, 20 minutes after stationary performance of challenge test with peanuts. Evaluating the reported data, this process might be developed rather due to induction of a TH2 profile, because in both cases have occurred IgE-mediated symptoms. A less plausible mechanism could be the presence of isocyanates in peanuts due to a probable contamination by pesticides resulting in an allergic reaction after "consumption" of di-isocyanate as long as the isocyanate contamination of peanuts has not been proven. Conclusion Despite the lack of relevant laboratory findings, this might be the first case of isocyanate-induced occupational asthma described in a patient who developed peanut allergy symptoms later in his life. However, in order to take further suitable precautions, further studies are necessary to elucidate the questions posed in this report.

Allergic conjunctivitis (AC), rhinitis (AR), and bronchial asthma (BA) are allergic IgE-mediated pathologies, while their management consists on pharmacological treatment and specific immunotherapy (SIT). This study aims to evaluate clinical symptoms and monitor maintenance treatment of patients during. Subjects with AC, AR, or/and BA who initiated subcutaneous SIT during period 2008-2012 (Lofarma, Italy) are monitored along 3 years. A questionnaire that compromised a clinical score for relative symptoms and maintenance medicaments is filled out by every patient at beginning of SIT, as well as 1 and 3 years later (0 - absent, 4 - maximal expression of symptom; yes/no answer for treatment with a subclass medication). Data are shown in average (±SE), and comparisons are undergone due to t Student and Fisher exact. P < 0.05 was considered as significant. Study data demonstrated that both symptoms score and medicaments need were significantly reduced in the majority of cases during the first SIT, independently to allergen type or pathology. Oral glucocorticoids were completely eliminated from the treatment within the first year, whereas antihistamines were the mostly used during the SIT. In summary, this study demonstrates that symptom score and medication monitoring can be useful in the evaluation of SIT efficacy. [ABSTRACT FROM AUTHOR]

Background: The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing the EAACI Guidelines for Allergen Immunotherapy (AIT) for the Management of Insect Venom Allergy. We seek to critically assess the effectiveness, cost-effectiveness and safety of AIT in the management of insect venom allergy. Methods: We will undertake a systematic review, which will involve searching international biomedical databases for published, in progress and unpublished evidence. Studies will be independently screened against pre-defined eligibility criteria and critically appraised using established instruments. Data will be descriptively and, if possible and appropriate, quantitatively synthesised. Discussion: The findings from this review will be used to inform the development of recomendations for EAACI's Guidelines on AIT. [ABSTRACT FROM AUTHOR]

Allergic rhinitis (AR) is an allergen-induced, upper-airway inflammatory disease, highly coexistent in allergic asthma patients, characterized by hyperactive airway mucosa and episodes of chronic symptoms with periods of acute exacerbation, during exposure to highly allergen-concentrated environments. In our prospective study, we report results on allergic rhinitis in 116 asthmatic patients sensitized by house dust mites. Multidisciplinary Tirana polyclinics 1 and 3 have provided the study data on patients with asthma history of 2 years up to 20 years, all sensitized by house dust mites. We found persistent symptoms of allergic rhinitis in 67 patients; intermittent symptoms in 31, and 18 did not manifest any symptoms at all. Within the subgroup of patients with persistent rhinitis symptoms, almost 40% of the patients referred to have a minimal persistent nasal obstruction only when asked by the specialist. Within the group of 98 patients with persistent and intermittent rhinitis symptoms, we found that 73 patients or 74% reported rhinitis, cough and dyspnea symptoms when exposed to highly concentrated environments with house dust mites such as closed living and working places or air conditioned and not properly ventilated closed spaces. The purpose of this study is to show the high incidence of allergic intermittent or persistent rhinitis, in asthmatic subjects sensitized by house dust mites, and the importance of the environmental factors contributing to the severity and frequency of symptoms onset. [ABSTRACT FROM AUTHOR]

Venom immunotherapy (VIT) protects patients with hymenoptera venom anaphylaxis from subsequent potentially life-threatening reactions. The most important side effects during VIT are systemic anaphylactic reactions (SAR), which are more prevalent during honeybee VIT. Despite the demonstrated diversity with regard to venom compounds, previous publications did not mention the plausible reason that can justify the difference of SAR frequency between honeybee and wasps. On the other hand, pre-treatment with H1-blocking antihistamines reduces the frequency and intensity of local and mild systemic anaphylactic reactions during VIT, but not appropriately moderate adverse reactions such as abdominal pain or angioedematous reactions, which can occur more prevalently also during honeybee VIT. In contrast to hymenoptera venom (HV) anaphylaxis, these symptoms are very common during hereditary angioedema (HAE). In addition, in some patients who repeatedly experienced anaphylactic reactions during hyposensitization with HV are reported significantly lower renin, angiotensinogen I, and angiotensinogen II plasma levels. These facts may indicate that during honeybee VIT could be occurred a defective implication of renin-angiotensin system. This may be possible, because among hymenoptera, only the HV contains the antigen melittin, a potent kallikrein activator. These effects during honeybee VIT are similar to the HAE, because melittin-induced kallikrein activation on the first hand, as well as the implication of complement classical pathway during HAE on the second one, can lead both to increased bradykinin (BK) secretion, plasma extravasation, and therefore to the occurrence of angioedema and abdominal symptoms. Consequently, the clinical effectiveness of BK receptor and generator blockers such as icatibant, ecallantide or NPC 18884, shown recently during the treatment of HAE attacks and acetic acidinduced abdominal constrictions in mice, may lead to the hypothesis that a similar strategy could be useful during honeybee VIT in order to manage or prevent BK-induced symptoms such as angioedema and abdominal pain. However, the evaluation of this idea needs further appropriate experimental and clinical trials. [ABSTRACT FROM AUTHOR]

Nerve growth factor (NGF) is the founder-member of neurotrophins family that provides growth and surviving effect not only for neuronal tissue but also for various non-neuronal cellular populations. It effectuates its physiologic or pathologic functions in sensorial neuronal system and some certain tissues through NGF-receptors such as tyrosinkinase A and p75, involving also transient receptor potential vanilloid 1, substance P and its receptor NK1 (members of NGF-pathways - NGFP). In different situations, such as stress-related or inflammatory pathologies (including allergy, asthma, depression, multiple chemical sensivity, stressful or dangerous events, etc), are reported elevated local and serologic concentrations of these mediators. Reflecting on the pleiotropic effects of mentioned substances, it could be suggested that over-regulation of NGFP mediators is generally required during identification of somatic or psycho-emotional integrity threatening like a surviving proclaim. In this context, the identification of a danger may induce NGFP-mediated growth stimuli to assure better surviving possibilities for the organism, maybe as a compensatory effect. Experiments in knockout animals with regards to genes of NGFP mediators could be helpful for the verification of its role as leader of information in the mentioned processes. Some investigations in such animals have demonstrated their abnormal passivity to fight for vital demands, whereas the behavior of subjects with down-regulation of aforementioned factors is associated with sensory or cognitive disorders such as congenital insensivity for pain with anhidrosis, schizophrenia, diabetes, or self-mutilatory behaviors. The last mentioned facts manifest the inability to recognize the situation of bodily and mental integrity during the NGFP insufficiency, leading to the necessity for further pharmacologic investigations with regards to NGFP mediators in the related pathologies. [ABSTRACT FROM AUTHOR]

Gluten intolerance is an autoimmune enteropathy caused by heterogeneous mixture of wheat storage proteins. Malabsorption symptoms imply diarrhoea, abdominal pain/bloating and weight loss. This case describes a 22-year-old female subject, who had chronic headache, joint pain, urticaria and long period of amenorrhea. Skin prick tests revealed a sensitisation to α-gliadin, while neurological, gynaecological, endocrine and clinical-laboratory examinations did not justify the above-mentioned symptoms. Gluten-free diet resolved chronic symptoms and re-established the menstrual cycle, whereas a temporary gliadin daily diet re-exacerbated all clinical symptoms. Urticaria occurred 20 min and the chronic headache the next day after exposure to the gliadin-rich diet. In addition, the missing of the expected menstrual bleeding was observed. This case demonstrates that gliadin intake can induce malabsorption and 'idiopathic' neuronal or gynaecological symptoms. [ABSTRACT FROM AUTHOR]

Unlabelled: The absence of a consistent link between parasitoses and skin allergic symptoms in the clinical investigations contrasts to the fact that some parasites are the most potent inducers of immunoglobulin E that exist in nature. To shed some light into this question, this review is focused on the actual knowledge regarding parasites life cycle, interactions with host immunity, the influence on host behavior, and finally the role of all these factors on the skin allergy. The collected data demonstrate that parasites could manipulate the host behavior for its own benefit in different ways, altering its (epi)genetic, biochemical, immunologic or physiologic functions as well as altering its behavior and activity. In this context, skin allergy may be associated with certain stages of the parasites' life cycle and migration into biological barriers, but not necessarily with presence of the parasitosis in the host organism. As compared to T helper (Th) 1 response, the Th2 one, the eosinophilic infiltration and the complement inhibition could assure better conditions for the development of some parasites. Taken together, the suggested hypotheses could be a plausible explanation for the epidemiological puzzle regarding urticaria occurrence, Th2 response and parasitoses, but further studies are necessary to provide better-based conclusions., Keywords: Eosinophilic Infiltration; Host behavior; Parasites life cycle; Skin allergy; Th1/Th2 response.