Treg cells or regulatory T cells constitute a large population of cellular infiltrate in atopic/allergic inflammation and a dysregulated immune response appears to be an important pathogenetic factor. Cardinal events during allergic inflammation can be classified as activation, organ-selective homing, survival and reactivation, and effector functions of immune system cells. T cells are activated by aeroallergens, food antigens, autoantigens, and bacterial exotoxins superantigens in allergic inflammation. They are under the influence of the skin, lung, or nose-related chemokine network and show organ-selective homing. (more…)

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A general pattern of factors influencing development of asthma seems to be emerging, including family allergy history/ asthma genetics, smoking, diet, obesity, and inactivity, all of which seem to influence the development of asthma and disease outcomes (Table bellow).

Many clinical or area studies have reported substantially higher rates of asthma prevalence, hospitalization, and mortality among racial and ethnic minorities. However, asthma is also most common among low socioeconomic groups, regardless of race. While black children have higher rates of asthma than white children, most studies have found that black race is not a significant correlate of asthma after controlling for location of residence and socioeconomic status (SES). The basis for the effects of poverty and urban residence on asthma prevalence is not known. One potential asthma factor is allergen exposure and allergen sensitization are common in urban environments. Black children in inner city Atlanta are exposed to high levels of dust mites and cockroach allergen, and a high proportion of the children with asthma were sensitized to these allergens. Litonjua and colleagues also concluded that a large proportion of racial/ethnic differences in asthma prevalence can be explained by factors related to income, area of residence, and level of education.

Asthma Factors that Influence Disease Development and Severity

Income is a determinant of access to health care, and frequently, the quantity and quality of health care available. Persons who have low income, regardless of race or ethnicity, are more likely to be uninsured, to encounter delays or be denied care, to rely on hospital clinics in emergency departments for health services, and to receive substandard care. The usual socioeconomic indicators, education and personal or household income, serve only as surrogates for more complicated correlates of individuals within populations and multiple asthma factors that can impact both on prevalence of asthma and adverse outcomes from the disease.

Studies from Germany comparing the populations of East and West Germany have shown the prevalence of hay fever and asthma as significantly higher in West German children, suggesting that asthma environmental factors explain the difference in prevalence in these ethnically similar populations. Early exposure to infections (as with being in a day-care environment early in life) or exposure to endotoxin (as with growing up on a farm with close exposure to the farm animals) are associated with a decreased prevalence of asthma. In contrast, growing up in an urban environment or generally with an increased standard of living are associated with an increased prevalence of asthma. Such correlates are also present for atopic disorders other than asthma. In fact, Strachan, who noted that prevalence of hay fever was inversely related to family size, was the first to recognize the importance of early exposures on atopic disease. In the USA, asthma is more prevalent in African-Americans and Puerto Ricans. These findings are not explained by the observations on the role of social class in European studies. Given the ethnic differences between African-Americans and whites, these studies may represent gene-by-environment interaction producing varied phenotypic outcomes.

Allergen-specific immunotherapy is highly effective in the treatment of IgE-mediated allergy diseases such as rhinitis, conjunctivitis, asthma, and venom allergy hypersensitivity. It is the only treatment that leads to lifelong tolerance against previously disease-causing allergens due to restoration of the normal immunity. (more…)

An emerging concept is that pro-inflammatory signals lead to loss of Regulatory T Cells (Treg) function. Pasare and Medzhitov (2003) demonstrated that activation of DCs through TLRs led to the production of signals, including IL-6, which blocked the suppressive effect of CD4+CD25+ Treg. Subsequent studies support these observations. For example in a mouse model of allergic airway disease, IL-6 is proposed to act via two mechanisms to promote disease: direct enhancement of Th2 responses and by overcoming the suppressive function of CD4+CD25+ Treg. Tumor necrosis factor (TNF) as well as IL-7 and IL-15 have also been proposed to overcome regulatory activity in other human immunologic diseases. (more…)

The induction of immune tolerance and specific immune suppression are essential processes in the control of immune responses. Regulatory T cells (Treg) play a central role in immune control in the periphery. Two broad categories of Treg have been described: naturally occurring Treg that are present in all individuals and antigen-induced Treg that secrete inhibitory cytokines such as interleukin (IL)-10 and/or transforming growth factor (TGF)-ß. (more…)

The immune system consists of proteins, cells and organs that are concerned with defense of the individual, primarily against the threat of disease caused by infectious organisms. An infectious organism that causes disease is called a pathogen and the individual (person or animal) that is infected by a pathogen is called the host. Not all infectious organisms cause disease and some are actually beneficial, for example bacteria living in the gut help to digest certain foods. Infectious organisms that help the host are called commensalism organisms. (more…)

The Tcell Ig domain and mucin domain (TIM) proteins, the genes for which are located on chromosome 5q, have been suggested to be involved in allergic disease. This study examined allergies genetic association of sequence variants of the TIM1 and TIM3 genes in an African-American population. Case–control and family based association analyses were performed for three SNPs each in the TIM1 and TIM3 genes, and an insertion/deletion polymorphism in Tcell Ig domain and mucin domain 1. (more…)

Treating allergic rhinitis may have a downstream effect on concomitant asthma and this may be due to attenuation of the underlying inflammatory process.

Fexofenadine and montelukast exhibited additive effects to moderately high doses of inhaled corticosteroids when used as add-on therapy in the treatment of patients with persistent atopic asthma. (more…)

Allergic rhinitis is a very common problem associated with poor quality of life, reductions in social and work activities and poor interpersonal relationships. The main goal of the management of allergic rhinitis is to improve the quality of life. Immunotherapy is a specific therapy for allergic rhinitis and several reports have documented the safety and efficacy of this treatment . Safety has been a key issue in immunotherapy and various modalities are being investigated to make allergy immunotherapy more tolerable and safe to administer. (more…)

Breast milk contains a variety of bioactive substances, among them soluble CD14 (sCD14), which plays an important role in innate immunity. The authors analysed data of a large prospective birth cohort study to examine the determinants of sCD14 in breast milk, and investigated whether breast-feeding practice and sCD14 concentrations in breast milk are determinants of the risk of Atopic Dermatitis and asthma in children. Eight hundred and three mothers and their newborn infants were included in this analysis. (more…)