Clinical and Experimental Allergy - Prof Mo Shamji and Dr Boyle

• Oral Immunotherapy Should Play a Key Role in Preschool Food Allergy Management

  Keywords Oral immunotherapy, food allergies, preschoolers, allergy research, immunology, safety, treatment, public health, pediatric allergies, clinical practice   Summary This podcast episode features Dr. Lianne Soller discussing the significance of oral immunotherapy (OIT) in preschoolers, emphasising its safety, the importance of early intervention, and the need for a shift in public health messaging regarding food allergies. The conversation explores the unique characteristics of preschoolers' immune systems that make them more responsive to treatment, practical applications of OIT in various healthcare settings, and the potential for OIT to become a standard approach in managing food allergies.   Takeaways Oral immunotherapy (OIT) is crucial for preschoolers. Starting OIT early prevents food aversion in children. Preschoolers' immune systems are more adaptable to treatment. OIT is safer for younger children than previously thought. Healthcare providers should reassure families about OIT safety. Telehealth can facilitate access to OIT for remote families. OIT protocols can be adjusted for individual patient needs. Public health messaging needs to evolve regarding food allergies. Shared decision-making is essential in allergy management. Normalising the introduction of allergens is important for children.  

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• Diagnosis and Management of Lipid Transfer Protein Allergy—A BSACI Clinical Practice Statement

  Keywords Allergy, lipid transfer protein, food allergy, pollen food syndrome, diagnosis, management, diet, adrenaline, co-factors, clinical research     Summary In this episode of the Clinical and Experimental Allergy podcast, hosts Mo Shamji and Robert Boyle engage with Dr. Isabel Skypala, a consultant allergy dietician, to discuss the increasing recognition of lipid transfer protein (LTP) allergy in the UK. Dr. Skypala shares insights into the challenges of diagnosing LTP allergy, particularly due to its overlap with pollen food syndrome, and emphasizes the importance of a thorough clinical history. The conversation also covers management strategies for patients with LTP allergy, including the role of co-factors, the creation of safe diets, and considerations for the use of adrenaline auto-injectors. Dr. Skypala highlights the need for individualized approaches in allergy management, ensuring that patients can maintain a balanced diet while avoiding triggers.   Takeaways LTP allergy is increasingly recognized in the UK. Diagnosis requires careful clinical history taking. Symptoms of LTP allergy can vary significantly. Cofactors like exercise and alcohol can trigger reactions. Individualized dietary plans are essential for patients. Food challenges can help identify safe foods. Different varieties of fruits may be tolerated differently. Adrenaline auto-injectors may be necessary for high-risk patients. Management strategies must consider lifestyle factors. Collaboration among clinicians is vital for effective allergy management. Chapters   00:00 Introduction to the speakers 01:17 Understanding Lipid Transfer Protein Allergy 02:54 Challenges in Diagnosing LTP Allergy 04:22 Management Strategies for LTP Allergy with co-factors 05:32 Dietary Considerations and Food Challenges 07:21 Adrenaline Auto-Injectors and Risk Assessment 08:41 Closing the podcast

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• Investigation of the Pathomechanism of Chronic Cough Using an In Vitro Approach

  Keywords Chronic cough, TRP receptors, P2X3 receptors, neuroplasticity, allergy, immunology, ATP release, bronchial epithelial cells, therapeutic approaches, research     Summary: In this episode of the Clinical and Experimental Allergy podcast, Dr. Jonathan Bernstein discusses his research on chronic cough, focusing on the role of TRP receptors and P2X3 receptors in understanding the mechanisms behind this condition. He shares insights from his in vitro studies, unexpected findings related to chronic cough pathways, and potential future therapeutic approaches targeting these receptors.   Takeaways Dr. Bernstein is a professor of medicine at the University of Cincinnati. His research focuses on chronic cough and its underlying mechanisms. In vitro assays help isolate different cell activation pathways. ATP release is critical for activating P2X3 receptors on bronchial epithelial cells. Unexpected pathways activated by ATP include FAC signaling and IL-4. P2X3 antagonists can down-regulate pathways promoting airway inflammation. TRP receptors are the first interface between the body and the environment. Nonspecific triggers can activate TRP receptors, leading to increased ATP release. Selective antagonists for TRP receptors are still lacking. The nervous system plays a critical role in cough reflex mechanisms.

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• Adherence to Treatment in Allergic Rhinitis During the Pollen Season in Europe: A MASK-air Study

  Keywords: Allergic Rhinitis, Treatment Adherence, Mobile Health, Clinical Guidelines, Patient-Centered Care, Research Study, Asthma, Medication Patterns, Visual Analog Scales, Health Technology   Summary:  In this podcast episode, Mo Shamji interviews Bernardo Sousa Pinto about his recent study on treatment adherence in allergic rhinitis during the pollen season in Europe. The discussion covers the rationale behind the study, the use of mobile health apps for data collection, unexpected findings regarding medication adherence, and the implications for future clinical guidelines. The conversation emphasizes the importance of understanding patient behavior and tailoring recommendations to improve treatment outcomes.   Takeaways The study focuses on adherence to treatment in allergic rhinitis. Patients often do not adhere to their medication regimens. Mobile health apps can provide valuable data on patient behavior. Adherence patterns vary by medication type. Unexpectedly, partially adherent patients had better symptom control with fixed combinations. The findings may influence future guidelines for allergic rhinitis treatment. A patient-centered approach is essential in developing recommendations. Observational data can inform clinical practice despite limitations. Future studies should explore intervention strategies for non-adherent patients. The integration of mobile health data can enhance understanding of treatment adherence. Titles Exploring Treatment Adherence in Allergic Rhinitis The Role of Mobile Health in Allergy Management   Chapters 00:00 Introduction to the Podcast and Guest 02:31 Understanding the Study's Rationale and Hypotheses 04:58 Exploring the MassCare App and Its Methodology 07:35 Unexpected Findings and Their Implications 10:29 Impact on Future Guidelines and Research Directions

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• NLRP1 Is a Prominent Inflammasome Sensor Found in Bronchial Epithelial Cells in Asthma and Can Be Activated by Rhinovirus A16

  Keywords: Asthma, inflammasome, NLRP1, rhinovirus, bronchial epithelial cells, chronic inflammatory diseases, microRNA, asthma exacerbations, therapeutic approaches, clinical research   Summary:   In this podcast episode, Professor Ana Rebane discusses her recent research on the NLRP1 inflammasome sensor in bronchial epithelial cells and its implications for asthma pathogenesis. She shares insights into her research background, the significance of NLRP1 in asthma exacerbations, and the surprising results from her in vitro studies. The conversation also touches on future research directions, potential therapeutic approaches for asthma, and the experience of publishing in Clinical and Experimental Allergy.   Takeaways NLRP1 is a prominent inflammasome sensor in asthma. Research focuses on RNA-mediated regulations in chronic inflammatory diseases. NLRP1 is a main target of rhinovirus during infections. The study highlights the complexity of inflammatory sensors in asthma. In vitro studies revealed unexpected results regarding NLRP1 activation. Targeting inflammasome pathways may be crucial for asthma treatment. The research utilized bronchial brushing specimens for accurate modeling. Surprising findings suggest other viruses may activate different pathways. Future research should explore various viruses and their inflammasome impacts. Publishing in Clinical and Experimental Allergy was a positive experience. Titles Exploring NLRP1: A Key Player in Asthma The Role of Inflammasomes in Asthma Pathogenesis   Chapters   00:00 Introduction to the Podcast and Guest 00:59 Professor Anna Rebane's Research Background 02:46 Understanding NLRP1 in Asthma Pathogenesis 05:21 Methodology and In Vitro Studies 07:39 Surprising Findings in Inflammasome Pathways 08:39 Implications for Future Research and Therapeutics 10:23 Publishing Experience and Conclusion

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