Wong T.,University of South Florida |
Hellermann G.,University of South Florida |
Mohapatra S.,University of South Florida |
Mohapatra S.,James ley Veterans Administration Hospital Medical Center
Immunology and Allergy Clinics of North America | Year: 2010
There has been significant progress in our knowledge about the relationship between infectious disease and the immune system in relation to asthma, but many unanswered questions still remain. Respiratory tract infections such as those caused by respiratory syncytial virus and rhinovirus during the first 2 years of life are still clearly associated with later wheezing and asthma, but the mechanism has not been completely worked out. Is there an " infectious march" triggered by infection in infancy that progresses to disease pathology or are infants who contract respiratory infections predisposed to developing asthma? This review focuses on the common themes in the interaction between microbes and the immune system, and presents a critical appraisal of the evidence to date. The various mechanisms whereby microbes alter the immune response and how this might influence asthma are discussed along with new and promising clinical practices for prevention and therapy. Recent advances in using sensitive polymerase chain reaction detection methods have allowed more rigorous testing of the causality hypothesis of virus infection leading to asthma, but the evidence is still equivocal. Various exceptions and inconsistencies in the clinical trials are discussed in light of new guidelines for subject inclusion/exclusion in hopes of providing some standardization. Despite past failures in vaccination and disappointing results of some clinical trials, the new strategies for prophylaxis including RNA interference and targeted delivery of microbicides offer a large dose of hope to a world suffering from an increasing incidence of asthma as well as a huge burden of health care cost and loss of quality of life. © 2010.
Fitzhugh D.J.,University of South Florida |
Fitzhugh D.J.,James ley Veterans Administration Hospital Medical Center |
Lockey R.F.,University of South Florida |
Lockey R.F.,James ley Veterans Administration Hospital Medical Center
Immunology and Allergy Clinics of North America | Year: 2011
Allergen-specific immunotherapy (SIT) defines and distinguishes the modern practice of clinical allergy and immunology as the 100th anniversary of this pioneering technique is celebrated. Despite the tremendous advancements made in therapeutics, pharmacology, and the basic science of allergy, SIT remains the only treatment modality that offers a potential cure for atopic diseases rather than simply an amelioration of symptoms. A historical perspective not only offers an opportunity to tell some of the fascinating stories that led to the conception of SIT but also gives an occasion to recognize, remember, and honor those individuals who have contributed to its development. © 2011 Elsevier Inc.