Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2009

• Published in: Journal of allergy and clinical immunology Vol. 125; no. 1; pp. 85 - 97
• Main Authors: Sicherer, Scott H., Leung, Donald Y.M.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.01.2010; Elsevier; Elsevier Limited
• Subjects: Adult; Allergic diseases; Allergies; allergy; Allergy and Immunology; anaphylaxis; Anaphylaxis - drug therapy; Anaphylaxis - immunology; Anaphylaxis - prevention & control; Animals; Anti-Allergic Agents - therapeutic use; Arachis hypogaea; Arthropod Venoms - adverse effects; atopic dermatitis; Biological and medical sciences; Child; Child, Preschool; Dermatitis, Atopic - diagnosis; Dermatitis, Atopic - drug therapy; Dermatitis, Atopic - immunology; Dermatology; Diarrhea; drug; Drug dosages; Drug Hypersensitivity - diagnosis; Drug Hypersensitivity - drug therapy; Drug Hypersensitivity - immunology; Experiments; Food; Food allergies; Food Hypersensitivity - diagnosis; Food Hypersensitivity - drug therapy; Food Hypersensitivity - immunology; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Human subjects; Humans; Hypersensitivity - diagnosis; Hypersensitivity - drug therapy; Hypersensitivity - immunology; Hypersensitivity - physiopathology; hypersensitivity disorders; Immunopathology; insect venom; Lymphocytes; Medical prognosis; Medical sciences; Mice; Milk; Multivariate analysis; Mutation; Obesity; Peanuts; Randomized Controlled Trials as Topic; Risk Factors; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Skin; Skin allergic diseases. Stinging insect allergies; skin disease; Skin diseases; Skin Diseases - diagnosis; Skin Diseases - drug therapy; Skin Diseases - immunology; Studies; urticaria; Young Adult; EPL; VIT; IL-10R2; ADVN; APT; atopic dermatitis; HBD; ASST; drug; GDM; ADEH; dsRNA; AD; AE; Dermatology; EAC; allergy; DKO; MIF; α-gal; CsA; SEB; KIT; OIT; OVA; TCI; FLG; VV; TCS; anaphylaxis; insect venom; OFC; APST; NHL; hypersensitivity disorders; TLR; OR; KO; TSLP; Treg; skin disease; food; CU; ACU; PAF; FAHF-2; urticaria; PG; DC; Filaggrin; Autologous plasma skin test; Chronic urticaria; Human β-defensin; IL-10 receptor 2 chain; Food Allergy Herbal Formula-2; Atopic dermatitis with history of eczema herpeticum; Regulatory T; Toll-like receptor; ϵ-Polylysine; Dendritic cell; Oral food challenge; Prostaglandin; Double-stranded RNA; Oral immunotherapy; Autologous serum skin test; Non-Hodgkin lymphoma; Staphylococcal aureus enterotoxin B; Galactose-α-1,3-galactose; Double knockout; Gestational diabetes; Mast/stem cell growth factor receptor gene; Platelet-activating factor; Cyclosporin A; Experimental allergic conjunctivitis; Topical corticosteroid; Acquired cold urticaria; Topical calcineurin inhibitor; Ovalbumin; Venom immunotherapy; Atopic eczema; Knockout; Macrophage migration inhibitory factor; Vaccinia virus; Thymic stromal lymphopoietin; Atopy patch test; Odds ratio; Atopic Dermatitis Vaccinia Network; Drug; Allergy; Immunopathology; Skin disease; Urticaria; Hypersensitivity; Insecta; Atopy; Anaphylaxis; Immunology; Atopic dermatitis; Arthropoda; Venom; Invertebrata; Food
• ISSN: 0091-6749; 1097-6825; 1097-6825
• DOI: 10.1016/j.jaci.2009.11.031

This review highlights some of the research advances in anaphylaxis and hypersensitivity reactions to foods, drugs, and insects, as well as advances in allergic skin disease that were reported in the Journal in 2009. Among key epidemiologic observations, several westernized countries report that more than 1% of children have peanut allergy, and there is some evidence that environmental exposure to peanut is a risk factor. The role of regulatory T cells, complement, platelet-activating factor, and effector cells in the development and expression of food allergy were explored in several murine models and human studies. Delayed anaphylaxis to mammalian meats appears to be related to IgE binding to the carbohydrate moiety galactose-α-1,3-galactose, which also has implications for hypersensitivity to murine mAb therapeutics containing this oligosaccharide. Oral immunotherapy studies continue to show promise for the treatment of food allergy, but determining whether the treatment causes tolerance (cure) or temporary desensitization remains to be explored. Increased baseline serum tryptase levels might inform the risk of venom anaphylaxis and might indicate a risk for mast cell disorders in persons who have experienced such episodes. Reduced structural and immune barrier function contribute to local and systemic allergen sensitization in patients with atopic dermatitis, as well as increased propensity of skin infections in these patients. The use of increased doses of nonsedating antihistamines and potential usefulness of omalizumab for chronic urticaria was highlighted. These exciting advances reported in the Journal can improve patient care today and provide insights on how we can improve the diagnosis and treatment of these allergic diseases in the future.