Allergies, Volume 3, Issue 2 (June 2023) – 3 articles

Asthma is a common respiratory disease that affects people of all ages, characterized by considerable heterogeneity in age, clinical presentation, genetics, epigenetics, environmental factors, treatment response, and prognostic outcomes. Asthma affects more than 330 million people worldwide, of which 33% are children under 14 years, and 27% are adults whose first symptoms occurred in childhood. However, the genetic and epigenetic mechanisms of childhood allergic diseases and asthma are still not fully understood. Here, we conducted a biomedical narrative review of genes associated with the risk, severity, and susceptibility of childhood asthma since it differs from asthma in adults regarding their pathophysiology, development, and outcomes. We also systematized the available information on epigenetic changes associated with childhood asthma. Full article

Adrenaline auto injectors (AAI) are the mainstay of treatment in anaphylaxis. However, many caregivers of children with food allergies are unable to administer an AAI when assessed. One proposed factor for this finding is the lack of training and familiarity of the different AAI devices. The aim of this study is to explore the usage of different brands of adrenaline auto-injectors among caregivers of children with food allergies in Ireland. A cross-sectional study method was employed using an online questionnaire. An amount of 121 (75.58%) caregivers reported that their child carried an Epipen^®, 25 (15.82%) carried Jext^®, and 12 (7.59%) carried Anapen^®. An amount of 48.73% (n = 77) of caregivers had switched brands of AAI at least once before, with lack of availability of their usual device at their pharmacy being the most common reason for this. Factors associated with change were a household income >100,000 € (70% vs. 44.9% of those with less income; p = 0.04) and parents ≥40 years old (59.6% vs. 32.8% of patients whose parents younger; p < 0.01). When asked what they preferred about a particular AAI brand, caregivers appreciated a simple design with minimal steps involved in administration, clear colour coding, online resources, formal training from a healthcare professional, and first-hand experience in using the AAI. These findings show, for the first time, that switching brands is a common occurrence among caregivers of children with food allergies. These findings support the EAACI recommendation to train parents regularly in all available brands of AAI and to retrain parents when switching to different devices. Full article

The search for an effective treatment of allergic conditions is an ongoing global health challenge due to the high prevalence of allergies. Epinephrine and glucocorticosteroids remain the oldest and most widely used treatment regimen for allergy, and these medications are for short relief. In extreme allergy manifestations, the current treatment options aim to use monoclonal antibody (mAb) to target pathological pathways of inflammation involving mast cells, eosinophils, and basophils. These cells have the propensity to induce an allergic-inflammatory response. Studies have shown that they are responsible for several allergic diseases, such as allergic asthma, atopic dermatitis, rhinitis, and conjunctivitis. Studies evaluating monoclonal antibodies against serum IgE (Omalizumab), Th-2 cytokines, such as IL-4, IL-13 (dupilumab), and IL-5 suggest an attenuation of allergic symptoms and improvement in patients’ overall well-being. However, several factors such as cost of production (i.e., antibody purification), host immunogenicity, safety, and efficacy have hindered the availability of purified mAb in developing countries. Gene therapy is a promising tool for treating allergy, and emerging studies have suggested that antibody gene therapy may be the future for treating extreme cases of allergy manifestations. This paper describes the use of purified monoclonal antibodies for treating severe allergic responses and the associated limitations. It explores the prospects of antibody gene therapy for modulating allergy episodes. Full article