Limits...
Research needs in allergy: an EAACI position paper, in collaboration with EFA.

Papadopoulos NG, Agache I, Bavbek S, Bilo BM, Braido F, Cardona V, Custovic A, Demonchy J, Demoly P, Eigenmann P, Gayraud J, Grattan C, Heffler E, Hellings PW, Jutel M, Knol E, Lötvall J, Muraro A, Poulsen LK, Roberts G, Schmid-Grendelmeier P, Skevaki C, Triggiani M, Vanree R, Werfel T, Flood B, Palkonen S, Savli R, Allegri P, Annesi-Maesano I, Annunziato F, Antolin-Amerigo D, Apfelbacher C, Blanca M, Bogacka E, Bonadonna P, Bonini M, Boyman O, Brockow K, Burney P, Buters J, Butiene I, Calderon M, Cardell LO, Caubet JC, Celenk S, Cichocka-Jarosz E, Cingi C, Couto M, Dejong N, Del Giacco S, Douladiris N, Fassio F, Fauquert JL, Fernandez J, Rivas MF, Ferrer M, Flohr C, Gardner J, Genuneit J, Gevaert P, Groblewska A, Hamelmann E, Hoffmann HJ, Hoffmann-Sommergruber K, Hovhannisyan L, Hox V, Jahnsen FL, Kalayci O, Kalpaklioglu AF, Kleine-Tebbe J, Konstantinou G, Kurowski M, Lau S, Lauener R, Lauerma A, Logan K, Magnan A, Makowska J, Makrinioti H, Mangina P, Manole F, Mari A, Mazon A, Mills C, Mingomataj E, Niggemann B, Nilsson G, Ollert M, O'Mahony L, O'Neil S, Pala G, Papi A, Passalacqua G, Perkin M, Pfaar O, Pitsios C, Quirce S, Raap U, Raulf-Heimsoth M, Rhyner C, Robson-Ansley P, Alves RR, Roje Z, Rondon C, Rudzeviciene O, Ruëff F, Rukhadze M, Rumi G, Sackesen C, Santos AF, Santucci A, Scharf C, Schmidt-Weber C, Schnyder B, Schwarze J, Senna G, Sergejeva S, Seys S, Siracusa A, Skypala I, Sokolowska M, Spertini F, Spiewak R, Sprikkelman A, Sturm G, Swoboda I, Terreehorst I, Toskala E, Traidl-Hoffmann C, Venter C, Vlieg-Boerstra B, Whitacker P, Worm M, Xepapadaki P, Akdis CA - Clin Transl Allergy (2012)

Bottom Line: More disturbingly, its prevalence and impact are on the rise, a development that has been associated with environmental and lifestyle changes accompanying the continuous process of urbanization and globalization.Nonetheless, currently arising treatments, mainly in the fields of immunotherapy and biologicals, hold great promise for targeted and causal management of allergic conditions.Active involvement of all stakeholders, including Patient Organizations and policy makers are necessary to achieve the aims emphasized herein.

View Article: PubMed Central - HTML - PubMed

Affiliation: Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece. ngp@allergy.gr.

ABSTRACT
In less than half a century, allergy, originally perceived as a rare disease, has become a major public health threat, today affecting the lives of more than 60 million people in Europe, and probably close to one billion worldwide, thereby heavily impacting the budgets of public health systems. More disturbingly, its prevalence and impact are on the rise, a development that has been associated with environmental and lifestyle changes accompanying the continuous process of urbanization and globalization. Therefore, there is an urgent need to prioritize and concert research efforts in the field of allergy, in order to achieve sustainable results on prevention, diagnosis and treatment of this most prevalent chronic disease of the 21st century.The European Academy of Allergy and Clinical Immunology (EAACI) is the leading professional organization in the field of allergy, promoting excellence in clinical care, education, training and basic and translational research, all with the ultimate goal of improving the health of allergic patients. The European Federation of Allergy and Airways Diseases Patients' Associations (EFA) is a non-profit network of allergy, asthma and Chronic Obstructive Pulmonary Disorder (COPD) patients' organizations. In support of their missions, the present EAACI Position Paper, in collaboration with EFA, highlights the most important research needs in the field of allergy to serve as key recommendations for future research funding at the national and European levels.Although allergies may involve almost every organ of the body and an array of diverse external factors act as triggers, there are several common themes that need to be prioritized in research efforts. As in many other chronic diseases, effective prevention, curative treatment and accurate, rapid diagnosis represent major unmet needs. Detailed phenotyping/endotyping stands out as widely required in order to arrange or re-categorize clinical syndromes into more coherent, uniform and treatment-responsive groups. Research efforts to unveil the basic pathophysiologic pathways and mechanisms, thus leading to the comprehension and resolution of the pathophysiologic complexity of allergies will allow for the design of novel patient-oriented diagnostic and treatment protocols. Several allergic diseases require well-controlled epidemiological description and surveillance, using disease registries, pharmacoeconomic evaluation, as well as large biobanks. Additionally, there is a need for extensive studies to bring promising new biotechnological innovations, such as biological agents, vaccines of modified allergen molecules and engineered components for allergy diagnosis, closer to clinical practice. Finally, particular attention should be paid to the difficult-to-manage, precarious and costly severe disease forms and/or exacerbations. Nonetheless, currently arising treatments, mainly in the fields of immunotherapy and biologicals, hold great promise for targeted and causal management of allergic conditions. Active involvement of all stakeholders, including Patient Organizations and policy makers are necessary to achieve the aims emphasized herein.

No MeSH data available.


Related in: MedlinePlus

Mechanisms of allergic inflammation in asthma. Epithelial cell activation by allergens, viruses, bacteria and pollutants takes place and their proinflammatory cytokines and chemokines induce inflammation and contribute to Th2 response with TNF-α, IL-13, TSLP, IL-31, IL-33. Th2 response involves multiple cytokines such as IL-4, IL-5, IL-9, IL-13, IL-25, IL-33, eosinophilia, and local and systemic IgE production. A series of chemokines are produced and migration of inflammatory cells to the allergic tissues takes place. In addition, other effector T cell subsets, such as Th9, Th17 and Th22 cells play inflammatory roles. Cross-linking of IgE receptor FcεRI on the surface of mast cells and basophils and their degranulation, induces a type 1 allergic response. The activation of smooth muscle cells, myofibroblasts, angiogenesis and subepithelial fibrosis, lead to remodeling. Bronchial hyperreactivity takes place, with enhanced susceptibility to bronchoconstriction. Innate lymphoid cells may contribute to many aspects of allergic inflammation by the help of multiple cytokines. Epithelial apoptosis and shedding are essential in the mechanisms of eczema and asthma [23,24]. Survival and reactivation of migrating inflammatory cells and their interaction with resident tissue cells and other inflammatory cells augment allergic inflammation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3539924&req=5

Figure 1: Mechanisms of allergic inflammation in asthma. Epithelial cell activation by allergens, viruses, bacteria and pollutants takes place and their proinflammatory cytokines and chemokines induce inflammation and contribute to Th2 response with TNF-α, IL-13, TSLP, IL-31, IL-33. Th2 response involves multiple cytokines such as IL-4, IL-5, IL-9, IL-13, IL-25, IL-33, eosinophilia, and local and systemic IgE production. A series of chemokines are produced and migration of inflammatory cells to the allergic tissues takes place. In addition, other effector T cell subsets, such as Th9, Th17 and Th22 cells play inflammatory roles. Cross-linking of IgE receptor FcεRI on the surface of mast cells and basophils and their degranulation, induces a type 1 allergic response. The activation of smooth muscle cells, myofibroblasts, angiogenesis and subepithelial fibrosis, lead to remodeling. Bronchial hyperreactivity takes place, with enhanced susceptibility to bronchoconstriction. Innate lymphoid cells may contribute to many aspects of allergic inflammation by the help of multiple cytokines. Epithelial apoptosis and shedding are essential in the mechanisms of eczema and asthma [23,24]. Survival and reactivation of migrating inflammatory cells and their interaction with resident tissue cells and other inflammatory cells augment allergic inflammation.

Mentions: An increasing body of evidence indicates that immune responses in allergy involve a comprehensive network of cellular and molecular interactions (Figure 1). Novel insights from implicated environmental influences on the development of allergy have increased interest in innate immune responses preceding and directing the adaptive immune response. In parallel, we have now identified a role of the local tissue immune response, not only in determining the implication of a specific tissue in allergy (i.e. atopic asthma vs. atopic dermatitis) but also the role of structural cells such as epithelial cells in the innate immune responses to environmental triggers, including allergens.


Research needs in allergy: an EAACI position paper, in collaboration with EFA.

Papadopoulos NG, Agache I, Bavbek S, Bilo BM, Braido F, Cardona V, Custovic A, Demonchy J, Demoly P, Eigenmann P, Gayraud J, Grattan C, Heffler E, Hellings PW, Jutel M, Knol E, Lötvall J, Muraro A, Poulsen LK, Roberts G, Schmid-Grendelmeier P, Skevaki C, Triggiani M, Vanree R, Werfel T, Flood B, Palkonen S, Savli R, Allegri P, Annesi-Maesano I, Annunziato F, Antolin-Amerigo D, Apfelbacher C, Blanca M, Bogacka E, Bonadonna P, Bonini M, Boyman O, Brockow K, Burney P, Buters J, Butiene I, Calderon M, Cardell LO, Caubet JC, Celenk S, Cichocka-Jarosz E, Cingi C, Couto M, Dejong N, Del Giacco S, Douladiris N, Fassio F, Fauquert JL, Fernandez J, Rivas MF, Ferrer M, Flohr C, Gardner J, Genuneit J, Gevaert P, Groblewska A, Hamelmann E, Hoffmann HJ, Hoffmann-Sommergruber K, Hovhannisyan L, Hox V, Jahnsen FL, Kalayci O, Kalpaklioglu AF, Kleine-Tebbe J, Konstantinou G, Kurowski M, Lau S, Lauener R, Lauerma A, Logan K, Magnan A, Makowska J, Makrinioti H, Mangina P, Manole F, Mari A, Mazon A, Mills C, Mingomataj E, Niggemann B, Nilsson G, Ollert M, O'Mahony L, O'Neil S, Pala G, Papi A, Passalacqua G, Perkin M, Pfaar O, Pitsios C, Quirce S, Raap U, Raulf-Heimsoth M, Rhyner C, Robson-Ansley P, Alves RR, Roje Z, Rondon C, Rudzeviciene O, Ruëff F, Rukhadze M, Rumi G, Sackesen C, Santos AF, Santucci A, Scharf C, Schmidt-Weber C, Schnyder B, Schwarze J, Senna G, Sergejeva S, Seys S, Siracusa A, Skypala I, Sokolowska M, Spertini F, Spiewak R, Sprikkelman A, Sturm G, Swoboda I, Terreehorst I, Toskala E, Traidl-Hoffmann C, Venter C, Vlieg-Boerstra B, Whitacker P, Worm M, Xepapadaki P, Akdis CA - Clin Transl Allergy (2012)

Mechanisms of allergic inflammation in asthma. Epithelial cell activation by allergens, viruses, bacteria and pollutants takes place and their proinflammatory cytokines and chemokines induce inflammation and contribute to Th2 response with TNF-α, IL-13, TSLP, IL-31, IL-33. Th2 response involves multiple cytokines such as IL-4, IL-5, IL-9, IL-13, IL-25, IL-33, eosinophilia, and local and systemic IgE production. A series of chemokines are produced and migration of inflammatory cells to the allergic tissues takes place. In addition, other effector T cell subsets, such as Th9, Th17 and Th22 cells play inflammatory roles. Cross-linking of IgE receptor FcεRI on the surface of mast cells and basophils and their degranulation, induces a type 1 allergic response. The activation of smooth muscle cells, myofibroblasts, angiogenesis and subepithelial fibrosis, lead to remodeling. Bronchial hyperreactivity takes place, with enhanced susceptibility to bronchoconstriction. Innate lymphoid cells may contribute to many aspects of allergic inflammation by the help of multiple cytokines. Epithelial apoptosis and shedding are essential in the mechanisms of eczema and asthma [23,24]. Survival and reactivation of migrating inflammatory cells and their interaction with resident tissue cells and other inflammatory cells augment allergic inflammation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539924&req=5

Figure 1: Mechanisms of allergic inflammation in asthma. Epithelial cell activation by allergens, viruses, bacteria and pollutants takes place and their proinflammatory cytokines and chemokines induce inflammation and contribute to Th2 response with TNF-α, IL-13, TSLP, IL-31, IL-33. Th2 response involves multiple cytokines such as IL-4, IL-5, IL-9, IL-13, IL-25, IL-33, eosinophilia, and local and systemic IgE production. A series of chemokines are produced and migration of inflammatory cells to the allergic tissues takes place. In addition, other effector T cell subsets, such as Th9, Th17 and Th22 cells play inflammatory roles. Cross-linking of IgE receptor FcεRI on the surface of mast cells and basophils and their degranulation, induces a type 1 allergic response. The activation of smooth muscle cells, myofibroblasts, angiogenesis and subepithelial fibrosis, lead to remodeling. Bronchial hyperreactivity takes place, with enhanced susceptibility to bronchoconstriction. Innate lymphoid cells may contribute to many aspects of allergic inflammation by the help of multiple cytokines. Epithelial apoptosis and shedding are essential in the mechanisms of eczema and asthma [23,24]. Survival and reactivation of migrating inflammatory cells and their interaction with resident tissue cells and other inflammatory cells augment allergic inflammation.
Mentions: An increasing body of evidence indicates that immune responses in allergy involve a comprehensive network of cellular and molecular interactions (Figure 1). Novel insights from implicated environmental influences on the development of allergy have increased interest in innate immune responses preceding and directing the adaptive immune response. In parallel, we have now identified a role of the local tissue immune response, not only in determining the implication of a specific tissue in allergy (i.e. atopic asthma vs. atopic dermatitis) but also the role of structural cells such as epithelial cells in the innate immune responses to environmental triggers, including allergens.

Bottom Line: More disturbingly, its prevalence and impact are on the rise, a development that has been associated with environmental and lifestyle changes accompanying the continuous process of urbanization and globalization.Nonetheless, currently arising treatments, mainly in the fields of immunotherapy and biologicals, hold great promise for targeted and causal management of allergic conditions.Active involvement of all stakeholders, including Patient Organizations and policy makers are necessary to achieve the aims emphasized herein.

View Article: PubMed Central - HTML - PubMed

Affiliation: Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece. ngp@allergy.gr.

ABSTRACT
In less than half a century, allergy, originally perceived as a rare disease, has become a major public health threat, today affecting the lives of more than 60 million people in Europe, and probably close to one billion worldwide, thereby heavily impacting the budgets of public health systems. More disturbingly, its prevalence and impact are on the rise, a development that has been associated with environmental and lifestyle changes accompanying the continuous process of urbanization and globalization. Therefore, there is an urgent need to prioritize and concert research efforts in the field of allergy, in order to achieve sustainable results on prevention, diagnosis and treatment of this most prevalent chronic disease of the 21st century.The European Academy of Allergy and Clinical Immunology (EAACI) is the leading professional organization in the field of allergy, promoting excellence in clinical care, education, training and basic and translational research, all with the ultimate goal of improving the health of allergic patients. The European Federation of Allergy and Airways Diseases Patients' Associations (EFA) is a non-profit network of allergy, asthma and Chronic Obstructive Pulmonary Disorder (COPD) patients' organizations. In support of their missions, the present EAACI Position Paper, in collaboration with EFA, highlights the most important research needs in the field of allergy to serve as key recommendations for future research funding at the national and European levels.Although allergies may involve almost every organ of the body and an array of diverse external factors act as triggers, there are several common themes that need to be prioritized in research efforts. As in many other chronic diseases, effective prevention, curative treatment and accurate, rapid diagnosis represent major unmet needs. Detailed phenotyping/endotyping stands out as widely required in order to arrange or re-categorize clinical syndromes into more coherent, uniform and treatment-responsive groups. Research efforts to unveil the basic pathophysiologic pathways and mechanisms, thus leading to the comprehension and resolution of the pathophysiologic complexity of allergies will allow for the design of novel patient-oriented diagnostic and treatment protocols. Several allergic diseases require well-controlled epidemiological description and surveillance, using disease registries, pharmacoeconomic evaluation, as well as large biobanks. Additionally, there is a need for extensive studies to bring promising new biotechnological innovations, such as biological agents, vaccines of modified allergen molecules and engineered components for allergy diagnosis, closer to clinical practice. Finally, particular attention should be paid to the difficult-to-manage, precarious and costly severe disease forms and/or exacerbations. Nonetheless, currently arising treatments, mainly in the fields of immunotherapy and biologicals, hold great promise for targeted and causal management of allergic conditions. Active involvement of all stakeholders, including Patient Organizations and policy makers are necessary to achieve the aims emphasized herein.

No MeSH data available.


Related in: MedlinePlus