Mechanisms of asthma and allergic inflammation
Advances in mechanisms of allergy

https://doi.org/10.1016/j.jaci.2004.02.016Get rights and content

Abstract

This review summarizes selected Mechanisms of Allergy articles appearing between 2002 and 2003 in the Journal of Allergy and Clinical Immunology. Articles chosen include those dealing with human airways disease pathophysiology, pharmacology, cell biology, cell recruitment, and genetics, as well as information from allergen challenge models in both human and nonhuman systems. When appropriate, articles from other journals have been included to supplement the topics being presented.

Section snippets

Predictors and prevention of allergic disease development

Three studies in the JACI focused predominantly on young children and infants, attempting to identify surrogate markers in this population that would be predictive of allergic disease development. Gore et al1 showed that urinary eosinophil protein X (U-EPX) levels, measured prospectively from birth through the first 3 years of life, were slightly increased in nonatopic children with wheezing or eczema compared with those in nonatopic asymptomatic children. However, children who had allergic

Development of allergic sensitization and airway inflammation

A first step in the development of allergic diseases and inflammation is allergen sensitization and the production of IgE. The factors regulating these processes provide insight into mechanisms of disease at many levels, including initiation, progression, and persistence. Furthermore, these processes become eventual therapeutic targets.

With the development and availability of mAbs against TNF-α, this cytokine has gained importance and interest. Iwasaki et al7 evaluated the effect of TNF-α on

Genetics and asthma

Gene-by-environment interaction is an important component in the eventual expression of asthma. To illustrate, Colilla et al,16 in the Collaborative Study for the Genetics of Asthma, examined the hypothesis that environmental tobacco smoke exposure might interact with susceptible genes to determine the expression of asthma. These areas were identified with nominal evidence for linkage and showed a significant increase from baseline lod score; 2 other areas not meeting nominal significance also

Pathophysiology of allergic diseases

One of the problems faced by clinicians and scientists is the issue of disease heterogeneity. It would thus be useful, both for research and clinical purposes, to have other ways of classifying disease activity or severity in such a way as to predict pathophysiology and response to specific classes of medications. An example of one such study is the article by Prosperini et al,18 which examined the effects of an inhaled steroid, budesonide, on induced sputum cytology and airway

Respiratory infections and their relationship to asthma

Respiratory infections are a major cause of asthma exacerbations. Although these attacks are usually caused by respiratory viruses, Chlamydia pneumoniae has recently also been identified as a causative agent. Little is known, however, about host factors that lead to patient susceptibility to these consequences of respiratory infections. To address this void, Nagy et al39 measured the immune response to C pneumoniae infection in 139 children with asthma compared with that in 174 healthy control

Eosinophil, basophil, and mast cell biology

As recently reviewed in the JACI,41., 42. the role of the eosinophil in asthma pathophysiology remains controversial. The disappointing lack of therapeutic benefit from IL-5–directed therapies in asthma must be tempered with the understanding that this therapy failed to completely eliminate eosinophils from the airways. Indeed, very recent reports with IL-5 antibody show promise for treatment of other hypereosinophilic disorders.43., 44. Given the continued correlation of eosinophils and

Conclusion

This review summarized selected articles appearing between 2002 and 2003 in the Mechanisms of Allergy section of the JACI (and a few other selected journals). Articles chosen include those dealing with predictors and prevention of allergic disease development, development of allergic sensitization and airway inflammation, genetics and asthma, pathophysiology of allergic diseases, respiratory infections and their relationship to asthma, and eosinophil, basophil, and mast cell biology (Table I).

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