[Innovative immunotherapies of respiratory allergic diseases]. / Immunothérapies innovantes des maladies allergiques respiratoires.

Allergen immunotherapy (AIT) is an effective method in the treatment of respiratory allergic diseases (asthma, rhinitis and conjunctivitis). In addition to reducing symptoms, AIT can alter the course of allergic disease and remains efficient long after it has been discontinued by inducing specific tolerance to the allergen. In current clinical practice, immunotherapy is administered by subcutaneous or sublingual routes. The duration of efficacy is 7 to 12 years. It can prevent the development of both asthma and sensitization to new allergens. Despite recent progresses, other approaches are needed, especially for allergies (atopic dermatitis, food allergies). The new AIT improvement approaches involve the use of adjuvants or recombinant allergies, peptides and new routes of administration.

[The implementation gap in asthma prevention and control?]. / Prévenir et contrôler l'asthme, quels sont les obstacles ? Comment les surmonter ?

Asthma and allergic diseases generally start early in life and persist throughout life but, for reasons we do not yet understand, they sometimes appear later Prevention, early diagnosis and treatment of these major chronic respiratory diseases is a recognized priority for EU public health policy and for the United Nations. As factors favoring allergy (rapid urbanization, pollution, climate change and infections) are not expected to change in the foreseeable future, it is crucial to develop, strengthen and optimize prevention and treatment. We have developed tools to control asthma but are still unable to prevent children from developing asthma and allergic diseases. This article examines what works and what does not, and analyzes the "missing links" between the creation and effective implementation of a prevention program, otherwise known as the implementation gap.

[Contribution of epidemiology to the prevention of drug allergies]. / Contribution de la recherche épidémiologique à la prévention des allergies médicamenteuses.

Drug allergies are heterogeneous and multifactorial. They can be life-threatening and lead to market withdrawal of particularly risky drugs. Immunological research has improved our understanding of drug allergies but has not yet been able to prevent them. In contrast, epidemiological research not only provides information on the incidence and risk factors of such reactions, but can now, in conjunction the most recent immunological data, also help to prevent some of them. For example, prior pholcodine consumption has been shown to increase the risk of anaphylaxis due to neuromuscular blocking agents during general anesthesia. This review examines the place of interventional epidemiology in the field of drug allergy, taking as examples both myorelaxant-induced anaphylaxis and abacavir-induced DRESS.

[Allergen-specific immunotherapy or desensitization]. / L'immunothérapie spécifique aux allergènes ou désensibilisation des maladies allergiques.

Allergen-specific immunotherapy or desensitization represents an etiological treatment option for patients with allergic respiratory diseases. First introduced in 1911, it was widely disparaged until its mechanism of action was better understood and its efficacy on both allergic rhinoconjunctivitis and allergic asthma was demonstrated in double-blind placebo-controlled studies. Its indications are now widely agreed and practical rules have been established. Several factors have contributed to its increasing use in patients with respiratory allergies, including better-quality allergen extracts, better understanding of the mechanism of action, the introduction of oral tablet forms, and rationalization of prescriptions. Specific immunotherapy can benefit patients with severe allergic respiratory diseases in whom pharmacological treatment is ineffective or poorly accepted. Further well-designed and strictly conducted randomized trials in adults and children with allergic rhinitis and asthma are needed, using patient-important endpoints. More information is also needed on patient selection, the treatment duration, and dosing schedules.

[Nasal allergy and asthma: one or two diseases?]. / Allergie nasale et asthme: maladies uniques ou différentes?

Epidemiological studies have shown that rhinitis and asthma are associated. At least four out of five asthmatics suffer from rhinitis and one out of four rhinitic subjects develop asthma. Recent progress in cellular and molecular biology confirms that the same inflammatory cells and similar mechanisms participate in the pathophysiology of the two diseases. Histological findings show that although nasal inflammation resembles bronchial inflammation, specific remodelling features that are present in asthma are lacking in rhinitis. This may be due to the different embryologic origin of the two organs. These similarities explain certain clinical interactions and are the basis of the ARIA (Allergic Rhinitis and its Impact on Asthma)--WHO guidelines recommending that symptoms of rhinitis be sought in asthmatic subjects and symptoms of asthma in rhinitic subjects.

[Identifying and understanding drug allergies]. / Identifier et comprendre les allergies médicamenteuses.

Drug hypersensitivity reactions frequently occur in hospitalized and out-patients. Clinical presentations are numerous and heterogeneous, from a mild urticaria to a dramatic anaphylactic shock and an extensive bullous skin disease. Allergic reactions are unpredictable reactions, related to immunologic mechanisms. Some reactions mimic allergic reactions but no drug specific antibody or T cell proliferation can be demonstrated. A true diagnosis is rarely set up and the tools for it are lacking. In this review, we will focus on the available epidemiological data concerning these reactions, including data on incidence and mortality and on the most recent advances in the pathophysiology and allergy diagnosis of drug hypersensitivity reactions.

Las alergias: el fin de un enigma / The allergy: the end of the enigma

La alergología ha adquirido considerable predicamento.Explican aquí los misterios de esas afecciones desconcertantes y caprichosas, responsables todos los años de millones de jornadas de trabajo perdidas y de millones de malestares entre la gente. Nuevas técnicas de desensibilización y medicamentos irreemplazables. Contiene:Alergia, una palabra de moda. La alergia imnmediata. Polvo doméstico, acaros y mohos. La alergia a los animales. De insectos a serpientes, picaduras, mordeduras. La alergia polínica. Alergias alimentarias: las verdaderas y las falsas. La alergia debida a los medicamentos. Algo mas para asociar con la alergia. La alergia: diagnóstico, principios de tratamiento y prevención. Medicamentos y medicinas antialérgicas. El asma alergica. Alergias de la nariz. De los ojos. De la piel. Otras alergias imprevistas. Alergia y sol

Las alergias: el fin de un enigma / The allergy: the end of the enigma

La alergología ha adquirido considerable predicamento.Explican aquí los misterios de esas afecciones desconcertantes y caprichosas, responsables todos los años de millones de jornadas de trabajo perdidas y de millones de malestares entre la gente. Nuevas técnicas de desensibilización y medicamentos irreemplazables. Contiene:Alergia, una palabra de moda. La alergia imnmediata. Polvo doméstico, acaros y mohos. La alergia a los animales. De insectos a serpientes, picaduras, mordeduras. La alergia polínica. Alergias alimentarias: las verdaderas y las falsas. La alergia debida a los medicamentos. Algo mas para asociar con la alergia. La alergia: diagnóstico, principios de tratamiento y prevención. Medicamentos y medicinas antialérgicas. El asma alergica. Alergias de la nariz. De los ojos. De la piel. Otras alergias imprevistas. Alergia y sol