Childhood exposure to microbiological agents may influence the development of allergic and respiratory diseases. Apart from home, children spend most of their time at school, which represents an environment of significant exposure to indoor air microbes. Therefore, we aimed to assess how the prevalence of allergic sensitization and asthma in schoolchildren is affected by microbiological exposure within classrooms. Spirometry with bronchodilation, exhaled nitric oxide measurements and skin-prick tests data were retrieved from 858 children aged 8 to 10 years old attending 71 classrooms in 20 primary schools. Air samples were collected in all classrooms using a single-stage microbiological air impactor through agar plates. Gram-negative endotoxins were collected using flow control pumps and analysed by limulus amebocyte lysate assay. Diversity scores were established as the number of different fungal species found in each classroom. Classrooms with increased diversity scores showed a s...

Although numerous studies demonstrate the participation of nitric oxide (NO) in various inflammatory diseases, the precise function of NO in allergic asthma remains unclear. We investigated whether iNOS inhibition could interfere with the kinetics of VLA-4 and Mac-1 expression and adhesion properties of bone marrow and peripheral blood eosinophils of sensitized mice after antigen exposure. Treatment of allergic mice with 1400W (iNOS inhibitor) increased the adhesion of bone marrow eosinophils to ICAM-1, but not blood eosinophils, at 24 h and 48 h after OVA-challenge. Conversely, adhesion of blood eosinophils from 1400W-treated mice to VCAM-1 diminished at 24 h and was almost completely blocked at 48 h. 1400W did not induce any change in the adhesion of bone marrow eosinophils to VCAM-1, at 24 h, but cells collected 48 h after challenge showed significantly lower adherence. Flow cytometry demonstrated that 1400W resulted in a significantly increased Mac-1 expression on bone marrow eosinophils at 24 h, as compared to control mice. However, at 24 h, 1400W significantly decreased Mac-1 and VLA-4 expressions on blood eosinophils. At 48 h, the expressions of both Mac-1 and VLA-4 returned to previous levels. Results show a temporal effect of iNOS upon Mac-1 expression and function, the chief adhesion molecule involved in the eosinophil efflux from the bone marrow at 24 h. In contrast, Mac-1 and VLA-4 were involved in eosinophil mobilization from blood to lungs at 48 h after antigen challenge. Data suggest an important role of the Mac-1 and VLA-4 in the iNOS-modulated migration of eosinophils to the lungs of allergic mice.

Although new antihistamines exert additional antiallergic properties besides blocking histamine, (II,) receptors, their potential for prophylactic treatment of asthma has not been thoroughly investigated. Thls study compared the efficacy and tolerability of loratadine with those of cromolyn sodium, the nonsteroidal prophylactic treatment of choice for mild-to-moderate childhood perennial allergic asthma. A total of 122 children (mean age, 10 * 2 years) with mild-to-moderate perennial allergic asthma were enrolled in a multicenter, double-masked, double-dummy, randomized, parallelgroup study. They received either cromolyn sodium (two 5-mg puffs four times daily) or loratadine (10 mg if body weight was C30 hg or 20 mg if >30 hg) for 8 weeks. The efficacy was assessed by wheezing, cough, and asthma symptom scores, overall assessment of asthma severity, peak expiratory flow recordings, forced expiratory volume in 1 second (FEV,) measurements, and use of inhaled beta,agonists. Tolerability was assessed by recording possible adverse reactions and blood test results. Wheezing decreased significantly in patients ln both groups from day 0 to day 56; cough decreased significantly only in the loratadine group. Similarly, asthma score decreased significantly only in the loratadlne group. Physicians and parents reported a highly significant reduction in asthma severity and in the number of patients using be--agonists in both groups. Peak-flow and FEV, values remained constant in both groups throughout the study. No statisticalIy significant difference was observed between the treatment groups in any variable. In addition, tolerability was similar and satisfactory for both groups. Results of this study suggest that loratadine could be an alternative to cromolyn sodium in the treatment of mild-to-moderate childhood perennial allergic asthma.

Asthma is the most common chronic inflammatory disorder of the airways among children. It is a complex clinical disease characterized by airway obstruction, airway inflammation and airway hyperresponsiveness to a variety of stimuli. The development of allergic asthma exists of three phases, namely the induction phase, the early-phase asthmatic reaction (EAR) and the late-phase asthmatic reaction (LAR). Each phase is characterized by the production and interplay of various cell-derived mediators. In the induction phase, T helper cytokines are important in the development of asthma. Most important mediators in the EAR are preformed mediators, newly synthesized lipid mediators and cytokines that are produced by mast cells. During the LAR, inflammatory molecules are produced by various cell types, such as eosinophils, neutrophils, T cells, macrophages, dendritic cells, and structural cells. Chronical inflammation leads to structural changes of the airway architecture. In this review, the most important mediators involved in the induction phase, the early-phase and late-phase asthmatic reaction are discussed. (K. Bloemen), sandra.verstraelen@vito.be (S. Verstraelen).

Chronic obstructive pulmonary disease (COPD) is a major global health problem and is predicted to become the third most common cause of death by 2020. Apart from the important preventive steps of smoking cessation, there are no other specific treatments for COPD that are as effective in reversing the condition, and therefore there is a need to understand the pathophysiological mechanisms that could lead to new therapeutic strategies. The development of experimental models will help to dissect these mechanisms at the cellular and molecular level. COPD is a disease characterized by progressive airflow obstruction of the peripheral airways, associated with lung inflammation, emphysema and mucus hypersecretion. Different approaches to mimic COPD have been developed but are limited in comparison to models of allergic asthma. COPD models usually do not mimic the major features of human COPD and are commonly based on the induction of COPD-like lesions in the lungs and airways using noxious...

Asthma is a disease characterized by wide variations in
pathogenesis that cause resistance to flow in intrapulmonary
airways. The dramatic changes in the architecture of the airway
walls are usually connected to allergic reaction or other forms of
hyper sensitivity, causing marked spasms that lead to difficulty in
breathing. It is possible to relieve or remove the symptoms in the
majority of patients by adopting the clinical guidelines for
pharmacotherapy of asthma which include inhaled corticosteroids,
long and short acting beta agonists, muscarinic antagonists,
leukotriene modifiers, xanthine drugs and some allergy medicines.
The proper use of these agents can aid in reducing or reversing
many symptoms of asthma. Certain methods of using medicines,
for example the correct use of the inhaler for relief and
maintenance therapy, are also associated with a significant
reduction in symptoms. This can be achieved by a pharmacist’s
intervention that can provide a detailed understanding of the
current rational drug choices and proper medication use to the
patient. Nowadays massive resources are being ploughed into
research in a concerted effort to halt the progress of this illness
that can strike in all ages.

Allergic rhinitis is a global health problem due to its impact on quality of life of the patient and its health-care costs. The authors propose a consensus statement (Guidelines) on the diagnosis and management of allergic rhinitis exclusive of epidemiology and pathophysiology. They have followed the ADAPTE procedure, validated by the French health authorities to adapt ARIA to the French

Background: Asthma is a significant public health problem in the Caribbean. Prevalence surveys using standardized measures of asthma provide valid prevalence estimates to facilitate regional and international comparisons and monitoring of trends. This paper describes methods used in the Jamaica Asthma and Allergies National Prevalence Survey, challenges associated with this survey and strategies used to overcome these challenges.

Now a day shwas (Asthma) is one of the major disease that causes more medical emergences. There are many risk factor which triggers this disease. In this clinical study the efficacy of vasadi kawath in tamak shwas .we have studied patients of different age group from 16-65 years of age and both sex i.e. male and female. Also we have studied socio economical status of the patient and it is observed this disease is present in all economical groups. It is found in more patients who are working in highly polluted areas and living in wet and cool areas. The patients of this disease are found in both married and unmarried peoples. Family history is also one of the important factors. This disease is found in patients having both type of diet. We have studied this disease with various sign and symptoms with vasadi kawath and conducted open non comparative study and result are satisfactory. Many symptoms are mark ably reduced and it is found that the drug vasadi kawath is effective in tamak shwasa.

The cashew tree grows in abundance in the hills and plains of Goa, India. Because of the financial yield, more and more trees are being planted each year. The cashew tree flowers once a year between January and March, but pollination is mostly entomophilous. Objective: For the first time, a study was conducted to establish the possible role of the cashew pollen in triggering allergic asthma.

dates back to the 19th century, major improvements in the diagnosis and therapy of mold allergy have been hampered by the fact that fungal extracts are highly variable in their protein composition due to strain variabilities, batch-tobatch variations, and by the fact that extracts may be prepared from spores and/or mycelial cells. Nonetheless, about 150 individual fungal allergens from approximately 80 mold genera have been identified in the last 20 years. First clinical studies with recombinant mold allergens have demonstrated their potency in clinical diagnosis. This review aims to give an overview of the biology of molds and diseases caused by molds in humans, as well as a detailed summary of the latest results on recombinant fungal allergens.

The increasing trend in allergic diseases has become obvious in the present day, especially in developing countries like India, because of many factors such as change in ambient air quality, increased air pollution, metamorphic change in living habits and lifestyle, and climate. 1 Mites present in house dust represent a major source of allergens, resulting in different allergic manifestations all over the world, and hypersensitivity to these dust mites may play a pivotal role in pathogenesis of several allergic complaints including bronchial asthma. The present study evaluated the sensitization toward house dust and house dust mites among patients residing in Kolkata metropolis, India, who are suffering from allergic asthma. Methods: The skin prick test was performed on a total of 1079 patients (585 males and 494 females) between the age group 5-50 years and 50 healthy controls using a variety of 16 common aero-allergenic extracts including 4 allergens of interest, viz. Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis and total house dust allergens. Total serum IgE level was measured by using the EIA technique and specific IgE levels against aforesaid allergens were detected with the Pharmacia ImmunoCAP 100 System. The influence of age and sex, if any, on allergen sensitivity was also investigated. All statistical analyses were performed using SPSS 10.0 for Windows and Zar. 2 Results: The responses among patients with asthma to house dust and house dust mite allergen tests were as follows: house dust (96.22%), D. pteronyssinus (75.06%), B. tropicalis (72%), and D. farinae (63.72%). The frequency of positive skin response was found to be independent of age and sex. The total serum IgE levels in patients varied between 7.3 and 4040 IU/ml (mean 369 Ϯ 26.51 IU/ml). Specific IgE antibody test proved that 83% patients showed sensitivity toward at least 1 of the allergens tested.

The overarching goals of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) are to enable European citizens to lead healthy, active and independent lives while ageing. The EIP on AHA includes 74 Reference Sites. The aim of this study is to transfer innovation from an App developed by the MACVIA-France EIP on AHA reference site (Allergy Diary) to other reference sites. The phenotypic characteristics of rhinitis and asthma multimorbidity in adults and the elderly will be compared using validated information and communication technology (ICT) tools (i.e. the Allergy Diary and CARAT: Control of Allergic Rhinitis and Asthma Test) in 22 Reference Sites or regions across Europe. This will improve understanding, assessment of burden, diagnosis and management of rhinitis in the elderly by comparison with an adult population. Specific objectives will: (i) assess the percentage of adults and elderly who are able to use the Allergy Diary, (ii) study phenotypic characteristics and treatment over a period of one year of rhinitis and asthma multimorbidity at baseline (cross-sectional study) and (iii) follow-up using visual analogue scale (VAS). This part of the study may provide some insight into the differences between the elderly and adults in terms of response to treatment and practice. Finally (iv) work productivity will be examined in adults.

Omalizumab reduces bronchial mucosal IgE and improves lung function in non-atopic asthma
Prathap Pillai, Yih-Chih Chan, Shih-Ying Wu, Line Ohm-Laursen, Clare Thomas, Stephen R. Durham, Andrew Menzies-Gow, Raj K. Rajakulasingam, Sun Ying, Hannah J. Gould, Chris J. Corrigan
European Respiratory Journal 2016; DOI: 10.1183/13993003.01501-2015
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Abstract
Omalizumab therapy of non-atopic asthmatics reduces bronchial mucosal IgE and inflammation and preserves/improves lung function when disease is destabilised by staged withdrawal of therapy.
18 symptomatic, non-atopic asthmatics were randomised (1:1) to receive omalizumab or identical placebo treatment in addition to existing therapy for 20 weeks. Bronchial biopsies were collected before and after 12–14 weeks of treatment, then the patients destabilised by substantial, supervised reduction of their regular therapy. Primary outcome measures were changes in bronchial mucosal IgE+ cells at 12–14 weeks, prior to regular therapy reduction, and changes in lung function (forced expiratory volume in 1 s) after destabilisation at 20 weeks. Quality of life was also monitored.
Omalizumab but not placebo therapy significantly reduced median total bronchial mucosal IgE+ cells (p<0.01) but did not significantly alter median total mast cells, plasma cells, B lymphocytes, eosinophils and plasmablasts, although the latter were difficult to enumerate, being distributed as disperse clusters. By 20 weeks, lung function declined in the placebo-treated patients but improved in the omalizumab treated patients, with significant differences in absolute (p=0.04) and % predicted forced expiratory volume in 1 s (p=0.015).
Omalizumab therapy of non-atopic asthmatics reduces bronchial mucosal IgE+ mast cells and improves lung function despite withdrawal of conventional therapy.
Abstract
Omalizumab reduces mucosal IgE and improves lung function in non-atopic asthma http://ow.ly/CHFu3034fcC
Footnotes
• This article has supplementary material available from erj.ersjournals.com
• Clinical trial: This study is registered at clinicaltrials.gov with identifier number NCT01113437.
• Support statement: This study was supported by research grants from i) Guy's and St. Thomas' Charity and ii) Novartis UK. The authors acknowledge financial support from the Department of Health via the National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre award to Guy's & St Thomas' NHS Foundation Trust in partnership with King's College London and King's College Hospital NHS Foundation Trust. Funding information for this article has been deposited with the Open Funder Registry.
• Conflict of interest: Disclosures can be found alongside this article at erj.ersjournals.com
Received September 9, 2015.
Accepted August 3, 2016.
Copyright ©ERS 2016
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The prevalence of asthma and allergic diseases are on the rise globally. Despite advances in the diagnostic tools and treatment modalities, control of such diseases has not been possible. The etiological or allergenic factors responsible for inducing asthma and allergy in genetically predisposed or susceptible individuals are present in outdoor and indoor environment. In this review, published data for aeroallergens from countries in the Middle East and some neighboring countries are presented. The data indicated their qualitative and quantitative variations in the region. Some plant species were found to be different from those prevalent in western part of the world. In Saudi Arabia, weed pollen, including Amaranthus viridis, Chenopodium murale and Salsola imbricata, were amongst the most common outdoor allergens. As regards to indoor allergens, House Dust Mites, cat, American cockroach, German cockroach and Oriental cockroach as well as fungal spores such as Alternaria alternata, Ulocladium atrium and Cladosporium sphaerospermum were found in the region. However, not all the countries in the region have reported detailed information on aeroallergens. Therefore, there is still a lack of information from most of the countries in the region. Further studies are required from most countries in the region in order to ascertain etiological factors and their prevalence in the region. The data presented in this review can thus be improved by further investigations and evaluating the clinical impact of dominating factors in both outdoor and indoor environment. The information can also be utilized for the implementation of environmental control in the respective region.

Eosinophilic conditions are reviewed briefly, including the fact that early misunderstanding likely led to the now largely discredited idea that eosinophils are crucial to their the pathogenesis of these chronic allergic conditions. They can be relieved effectively by a range of herbal medicines—just a small selection of the large number of such medicines that have been studied, which are reviewed here.

Ephedra sinica (ma huang) is discussed in some detail as one of the strongest traditional antiallergic agents in Chinese medicine. Many studies—including those involving ma huang-dominated formulas such as Dìng Chuăn Tāng (Arrest Wheezing Decoction) and Má Huáng Fù Ziõ Xì Xīn Tāng (Ephedra Aconite Asiasarum formula)—have shown ma huang to be effective for people with eosinophilic conditions.

Ammi visnaga (khella) and a semisynthetic medication made from its compound khellin, cromolyn, are reviewed in depth. Yù Píng Fēng Săn (Jade Windscreen Powder) has been shown to be synergistic with cromolyn.

Quercetin, a flavonoid in wide clinical use by natural practitioners for patients with allergies, and a related flavonoid, luteolin, are discussed as potentially effective antieosinophilic compounds.

Finally, the immunomodulating herb Astragalus membranaceus (astragalus; huáng qí) is reviewed as a very different and effective agent directed toward T-cell problems underlying eosinophilic diseases.

Astma je hronična opstruktivna zapaljenska bolest disajnih puteva koja uzrokuje probleme pri disanju. Karakterišu je jak imunološki odgovor i hronična upala traheobronhijalnog stabla. Bolest se kod osetljivih osoba manifestuje otežanim disanjem, zviždanjem u grudima (vizing) i kašljem, udruženim s opstrukcijom u disajnim putevima, često reverzibilnom, spontano ili usled terapije. Bolest se karakteriše pojačanom reaktivnošću bronhija na različite nadražaje. Javlja se u epizodama, tj. akutna pogoršanja bolesti izmenjuju se periodima u kojima nema simptoma astme. Do napada dolazi pri pogoršanju upale, obično jer je u neposrednoj okolini prisutan neki provokativni faktor astme.

The evidence of exercise-induced bronchoconstriction (EIB) without asthma (EIBw A) occurring in athletes led to speculate about different endotypes inducing respiratory symptoms within athletes. Classical postulated mechanisms for bronchial obstruction in this population include the osmotic and the thermal hypotheses. More recently, the presence of epithelial injury and inflammation in the airways of athletes was demonstrated. In addition, neuronal activation has been suggested as a potential modulator of bronchoconstriction. Investigation of these emerging mechanisms is of major importance as EIB is a significant problem for both recreational and competitive athletes and is the most common chronic condition among Olympic athletes, with obvious implications for their competing performance, health and quality of life. Hereby, we summarize the latest achievements in this area and identify the current gaps of knowledge so that future research heads toward better defining the etiologic factors and mechanisms involved in development of EIB in elite athletes as well as essential aspects to ultimately propose preventive and therapeutic measures.

The prevalence of childhood allergic diseases, such as allergic asthma, allergic rhinitis, and atopic dermatitis, has increased exponentially. In Singapore, the prevalence of asthma at all ages exceeds 20%, and around 50% of Singaporean children show features of an underlying allergy. The exact environmental causes for the increase of allergic diseases have not yet been identified, but most researchers agree that a decreased bacterial load in young children may be one of the reasons for the increase. However, the causes of allergy are multiple, and the development of an allergic disease is the result of complex interactions between genetic constitution and environmental factors. In this review article, different aspects of allergic sensitization are covered, including prenatal and postnatal sensitization. The phenomenon of the Ballergic march[ (switching from one clinical expression of allergy to another) and its underlying mechanisms are discussed. The last part of this review article is on prevention and treatment of allergic diseases, including the role of bacterial products (probiotics, prebiotics, and synbiotics) and the role of immunotherapy, including sublingual immunotherapy.

Three new homoisoflavonoids (1À3) were isolated from the roots of Ophiopogon japonicus (Liliaceae). The structures of new metabolites were determined on the basis of spectroscopic analyses including 2D NMR. The anti-inflammatory activities of new compounds (1À3) were investigated by their effects on the release of the inflammatory chemokine eotaxin, stimulated by IL-4 and the combination of IL-4 and TNF-a in BEAS-2B cells, which mimics the in vivo conditions in bronchial allergic asthma.

Background: In Iranian ancient medical books, the therapeutic effects of Satureja hortensis
on respiratory diseases have been reported. In order to verify these reports, the relaxant
effect of aqueous-ethanolic extract of Satureja hortensis on guinea pig trachea was
examined.
Methods: The relaxant effects of 6 cumulative concentrations of extract (0.15, 0.3, 0.45,
0.6, 0.75 and 0.9 g %) in comparison with saline and 4 cumulative concentrations of
theophylline (0.15, 0.3, 0.45, and 0.6 mM) by their effects on precontracted tracheal chains
of guinea pig by 10 μM methacholine (group 1) or 60 mM KCl in two different conditions
including: non-incubated tissues (group 2) and incubated tissues with 1 μM propranolol, 1
μM chlorpheniramine and 1 μM atropine (group 3, for each group n=6) were examined.
Results: In group 1, the extract and theophylline showed concentration dependent relaxant
effects compared to that of saline (p<0.05 to p<0.001). In group 2, three last concentrations
of theophylline and four higher concentrations of extract showed significant relaxant effects
compared to that of saline (p<0.05 to p<0.001). The effects of four lower concentrations of
extracts in groups 1 and 2 were significantly lower than those of theophylline (p<0.05
p<0.001). In group 3, the extract did not show any significant relaxant effect. There were
significant correlations between the relaxant effects and concentrations of extract and
theophylline in groups 1 and 2 (p<0.001 for all cases).
Conclusion: These results showed a potent relaxant effect of Satureja hortensis on guinea
pigs trachea which was comparable to that of theophylline.

Bronchial asthma is one of the most common chronic inflammatory diseases. Complementary and alternative medicine is increasingly used for treating bronchial asthma. Ten electronic databases were searched to investigate whether honey alone or in combination with other ingredients can be considered as the potential treatment for bronchial asthma. Combinations of honey and Nigella sativa (NS) showed significant improvement in all pulmonary functions, including forced expiratory volume (FEV1) (MD = 0.52, P < .001), forced vital capacity (FVC) (MD = 0.55, P = .002), and peak expiratory flow rate (PEFR) (MD = 80.60, P < .001), in both moderate and severe, uncontrolled persistent asthma compared with baseline. Asthma control test scores also improved significantly (MD = 11.22, P < .001) in patients using combinations of honey and NS compared with baseline. Patients with a less severe grade of asthma showed a significant positive response in clinical parameters upon using honey. One study showed that using celery seeds and honey was associated with clinical improvement of both lung functions, FEV1 (MD = 18.09, P < .001) and FVC (MD = 24.23, P < .001), and respiratory parameters compared with baseline. In conclusion, honey alone has no strong evidence of being effective in controlling asthma. However, when used in combination with other substances, it showed a relatively high efficacy in patients with asthma. This finding may help in asthma control with lower cost alternatives and better outcomes.

Comparison of allergen-induced changes in bronchial hyperresponsiveness and airway in¯ammation between mildly allergic asthma patients and allergic rhinitis patients Bronchial eosinophilic in¯ammation and bronchial hyperresponsiveness (BHR) are the main features of allergic asthma (AA), but they have also been demonstrated in allergic rhinitis (AR), suggesting a continuity between both diseases. In spite of not fully reproducing natural allergenic exposure, the allergen bronchial provocation test (A-BPT) has provided important knowledge of the pathophysiology of AA. Our aim was to verify the existence of a behavior of AA and AR airways different from the allergen bronchial challenge-induced airway eosinophilic in¯ammation and BHR changes. We studied a group of 31 mild and short-evolution AA and 15 AR patients, sensitized to Dermatophagoides pteronyssinus. The A-BPT was performed with a partially biologically standardized D. pteronyssinus extract, and known quantities of Der p 1 were inhaled. Peripheral blood (eosinophils and ECP) and induced sputum (percentage cell counts, ECP, albumin, tryptase, and interleukin [IL]-5) were analyzed, before and 24 h after A-BPT. Methacholine BHR, assessed before and 32 h after the A-BPT, was de®ned by M-PD 20 values and, when possible, by maximal response plateau (MRP). The A-BPT was well tolerated by all the patients. AA presented a lower Der p 1 PD 20 and a higher occurrence of latephase responses (LPR). M-PD 20 values decreased in AA, but not in AR, patients. MRP values increased in both groups. Eosinophils numbers and ECP levels increased in blood and sputum from both AA and AR, but only the absolute increment of sputum ECP levels was higher in AA than AR patients (P=0.025). The A-BPT induced no change in sputum albumin, tryptase, or IL-5 values. We conclude as follows:

This review first describes the mechanism and cell types involved in allergic asthma, which is a complex clinical disease characterized by airway obstruction, airway inflammation and airway hyperresponsiveness to a variety of stimuli. The development of allergic asthma exists of three phases, namely the induction phase, the early-phase asthmatic reaction (EAR) and the late-phase asthmatic reaction (LAR). In the induction phase, antigen-presenting cells play a major role. Most important cells in the EAR are mast cells, and during the LAR, various cell types, such as eosinophils, neutrophils, T cells, macrophages, dendritic cells (DCs), and cells that endow structure are involved. In occupational asthma, this immunological mechanism is involved in 90% of the cases. The second part of this review gives an overview of in vitro models to assess the hazardous potential of high-and low-molecular weight chemicals on the respiratory system. In order to develop a good in vitro model for respiratory allergy, the choice of appropriate cell types is important. Epithelial cells, macrophages and DCs are currently the most used models in this field of research.

Background

The rise in consultations for asthma or wheezing in primary and hospital care in recent years suggests a progressive increase in the prevalence of this disease, causing morbidity and considerable medical expenses. However, in Honduras no information about the prevalence of asthma and its trends is available. The aim was to determine the prevalence of asthma in the school-aged and adolescent population in several coastal communities in Honduras.

Methods

We performed a multi-centre, observational, cross-sectional study, for which we took a random sample of 805 school-aged children and adolescents between the ages of 6 and 17 years residing in the coastal communities of Coxen Hole, French Harbour, Los Fuertes, Sandy Bay, Punta Gorda, Travesía and Bajamar. The prevalence and severity of asthma were determined using the validated International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire answered by the child's parents. Point and cumulative prevalence were estimated, stratified by ethnic group, community, sex, and family history of asthma.

Results

We found an overall prevalence of wheezing in the past of 40.5% (95% CI 37.1, 43.9); of wheezing in the last 12 months of 28.0% (95% CI 24.9, 31.1); and have or have had asthma of 31.7% (95% CI 28.5, 34.9). The community with the highest prevalence was Bajamar with 51.0% (95% CI 44.0, 58.0), and in general, the Garifuna ethnic group with 36.5% (95% CI 31.0, 41.9).

Conclusion

The prevalence of asthma was higher than in other Latin American regions, with the most cases in participants of African descent, and those with a family history of asthma. The results will provide important data on asthma in Honduras and will contribute to the identification of risk groups.

Objective. Chronic asthma is characterized by ongoing recruitment of inflammatory cells and airway hyperresponsiveness leading to structural airway remodeling. Although a4b1 and b2 integrins regulate leukocyte migration in inflammatory diseases and play decisive roles in acute asthma, their role has not been explored under the chronic asthma setting. To extend our earlier studies with a4 D/D and b2 L/L mice, which showed that both a4 and b2 integrins have nonredundant regulatory roles in acute ovalbumin (OVA)-induced asthma, we explored to what extent these molecular pathways control development of structural airway remodeling in chronic asthma. Materials and Methods. Control, a4 D/D , and b2 L/L mouse groups, sensitized by intraperitoneal OVA as allergen, received intratracheal OVA periodically over days 8 to 55 to induce a chronic asthma phenotype. Post-OVA assessment of inflammation and pulmonary function (airway hyperresponsiveness), together with airway modeling measured by goblet cell metaplasia, collagen content of lung, and transforming growth factor b1 expression in lung homogenates, were evaluated. Results. In contrast to control and b2 L/L mice, a4 D/D mice failed to develop and maintain the composite chronic asthma phenotype evaluated as mentioned and subepithelial collagen content was comparable to baseline. These data indicate that b2 integrins, although required for inflammatory migration in acute asthma, are dispensable for structural remodeling in chronic asthma. Conclusion. a4 integrins appear to have a regulatory role in directing transforming growth factor b-induced collagen deposition and structural alterations in lung architecture likely through interactions of Th2 cells, eosinophils, or mast cells with endothelium, resident airway cells, and/or extracellular matrix. Ó

New developments in the fi eld of allergy and immunology have yielded a variety of novel therapeutic approaches in recent years, and more agents are at the clinical trial stage. Among the therapeutic approaches discussed in this review are Toll-like receptor agonists, immunostimulatory oligodeoxynucleotides, orally and parenterally administered cytokine blockers, and specifi c cytokine receptor antagonists. Transcription factor modulators targeting syk kinase, peroxisome proliferator-activated receptor-γ, and nuclear factor-κB are also being evaluated in the treatment of asthma. The anti-IgE monoclonal antibody omalizumab has established effectiveness in patients with allergic asthma, but the criteria for selecting patients who are most likely to benefi t from it are less clear. This review summarizes data from human clinical trials with immunomodulators to discuss the rationale for their use, their effi cacy, and adverse events associated with them.

Background: Psychological factors can be associated with allergic disorders. However, no particular personality pattern associated with these disorders has yet been identified. Objectives: This study aimed at comparing the personality profiles of patients with perennial allergic rhinitis and normal controls. Materials & Methods: This cross-sectional study was done on 50 adult people with persistent allergic rhinitis for at least one year and 50 age- and sex-matched normal controls that completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). A multivariate covariance analysis (MANCOVA) was carried out to discover possible personality differences between the two groups. The data were analyzed by SPSS v. 19 software.
Results: The results of the MMPI showed no significant difference between the two groups in the validity scales (P=0.29). The most common modal validity presentation style in both groups was neutral self-presentation. The MANCOVA analysis showed significantly high scores on the hypochondriasis (F=18.13, P<0.005, partial η2 =0.16) and hysteria scales in allergic rhinitis subjects (F=8.68, P=0.04, partial η2 =0.08) compared with normal controls. The most common profiles with high scores in the allergic rhinitis subjects were schizophrenia (52%, P<0.01) and hypochondriasis (50%, P<0.01). These scales emphasized the feelings of isolation and discomfort in allergic people. The frequency of psychasthenia scale, which measures long lasting anxiety, was significantly different between the two groups (40% in allergic rhinitis subjects vs. 10% in normal controls, odds ratio=6 [95%CI 1.9-22.3], P<0.001).
Conclusion: The score of psychological health is lower among allergic people than in normal controls.Schizophrenia and hypochondriasis are the most common profiles in the allergic rhinitis subjects.

In the pathogenesis of allergic asthma/rhinitis, 2 main types of cells play a role: hematolymphatic cells (mast cells, eosinophils, T cells, B cells) and nonhematolymphatic cells (airway smooth muscle cells, epithelial cells). It is not known which one of the 2 cell types plays the primary role. Here we review the literature on allergic disease transfer and potential cure with allogeneic hematopoietic cell transplantation (HCT), as transferability and curability would support a primary role of hematolymphatic cells and have implications for donor selection for HCT and possible future treatment of severe allergic disease with HCT. A total of 18 nonallergic recipients were reported to develop allergic disease after transplantation; however, conclusive information for transfer was available for only 5 cases. Allergic disease was reported to abate in 3 allergic recipients; however, conclusive information for “cure” was available for only 2 cases. Problems in interpreting the reports inc...

Active fungal proteinases are powerful allergens that induce experimental allergic lung disease strongly resembling atopic asthma, but the precise relationship between proteinases and asthma remains unknown. Here, we analyzed dust collected from the homes of asthmatic children for the presence and sources of active proteinases to further explore the relationship between active proteinases, atopy, and asthma. Active proteinases were present in all houses and many were derived from fungi, especially Aspergillus niger. Proteinase-active dust extracts were alone insufficient to initiate asthma-like disease in mice, but conidia of A. niger readily established a contained airway mucosal infection, allergic lung disease, and atopy to an innocuous bystander antigen. Proteinase produced by A. niger enhanced fungal clearance from lung and was required for robust allergic disease. Interleukin 13 (IL-13) and IL-5 were required for optimal clearance of lung fungal infection and eosinophils showed potent anti-fungal activity in vitro . Thus, asthma and atopy may both represent a protective response against contained airway infection due to ubiquitous proteinase-producing fungi.

The overarching goals of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) are to enable European citizens to lead healthy, active and independent lives while ageing. The EIP on AHA includes 74 Reference Sites. The aim of this study is to transfer innovation from an App developed by the MACVIA-France EIP on AHA reference site (Allergy Diary) to other reference sites. The phenotypic characteristics of rhinitis and asthma multimorbidity in adults and the elderly will be compared using validated information and communication technology (ICT) tools (i.e. the Allergy Diary and CARAT: Control of Allergic Rhinitis and Asthma Test) in 22 Reference Sites or regions across Europe. This will improve understanding, assessment of burden, diagnosis and management of rhinitis in the elderly by comparison with an adult population. Specific objectives will: (i) assess the percentage of adults and elderly who are able to use the Allergy Diary, (ii) study phenotypic charact...