Immunoengineering methods for cytokine treatment.
 Background A high prevalence (9.5-30%) of eosinophilic esophagitis (EoE) in patients with esophageal atresia (EA) has been reported. The application of the EoE criteria to EA patients might be problematic. To date, only studies using a "routine" biopsy approach, even in asymptomatic patients, have been performed. The aim of the study was to establish the prevalence of EoE among symptomatic EA patients (EA/EoE group) without anastomotic stricture (AS) and to compare their characteristics with those of EoE patients from general population (EoE group). Methods From 2005 to 2018, we reviewed charts of children with EA and EoE. "Selective" biopsy approach only in EA children without AS and/or endoscopic feature of EoE was performed. Characteristics of EA/EoE and EoE groups were compared. Results Among 370 EA and 118 EoE, 15 EA/EoE patients were detected (4.0% of EA patients). Male predominance and a high prevalence of allergy without differences between EA/EoE and EoE groups was observed.  https://www.selleckchem.com/products/cx-5461.html  EA/EoE children were significantly younger (p  less then  0.0001). PPI-responder patients were significantly more prevalent in EA/EoE group (p = 0.045). Conclusion Our data confirm that EA patients are at high risk for developing EoE. High incidence, early onset, and high prevalence of PPI-responders might suggest that esophageal motility disorders interact to increase propensity to EoE in EA patients. However, our study also suggests that overdiagnosis of EoE may occur in EA and that adapted criteria for EoE diagnosis should be developed for EA patients. Trial registration Not applicable for this retrospective study. © 2020 The Authors.Effects of airborne biological particulate matter (BioPM; from livestock farms) on the pulmonary airways are not well studied. The aim of the present study was to investigate whether fine ( less then 2.5 μm) BioPM derived from indoor animal stables (two chicken and two pig farms) could modify airway allergic responses by using a mouse model of allergic airway disease (allergic asthma). After intraperitoneal ovalbumin (OVA) sensitization mice were either intranasally challenged with OVA (allergic mice) or saline (non-allergic controls). Mice were also intranasally treated with farm-derived BioPM. Bronchoalveolar lavage fluid (BALF), blood and lung tissues were collected one day after intranasal exposure. BioPM from all the farms caused an acute neutrophilic inflammatory response in non-allergic mice. In allergic mice, BioPM derived from pig farm 2 induced a larger cellular inflammatory response than other farm-derived BioPM. All farm BioPM elicited Th17 cytokine (Interleukin (IL)-23) production except chicken farm 2, whereas Th2 cytokine (IL-5) increase was only induced by BioPM collected from chicken farm 2. These results indicate the exposure of BioPM from chicken and pig farms may cause the enhancement of airway allergic response in mice following exposure to OVA. More variation in the responses between farms was observed in allergic than non-allergic mice. Understanding the source and doses of BioPM that may affect the airway allergic response could help susceptible individuals to avoid worsening their respiratory diseases. © 2020 The Author(s).Background Asthma is a chronic airway inflammatory condition of the airway and is classified as controlled, partially controlled, and uncontrolled. Patients with uncontrolled asthma are at greater risk for hospitalizations and visits to emergencies, and the condition has greater impact on their daily lives. The aim of this study was to evaluate asthma control, the use of health resources, and asthma's impact on the activities of daily living of patients with different age groups in 5 Latin American countries. Methods This was a retrospective analysis of The Latin America Asthma Insights and Management (LA AIM) study carried out in Argentina, Brazil, Mexico, Venezuela, and Puerto Rico. Asthmatics were splited into 3 age groups 12-17, >17-40 and > 40 years old. An interview face to face was carried out and patients answered a questionnaire of 53 questions related to 5 main domains of asthma symptoms, impact of asthma on daily living activities, patients' perceptions of asthma control, exacerbations, and treatment/medication. Results A total of 2167 asthmatics were interviewed. There was a low percentage of controlled patients (mean 9%) in all 3 groups with no particular difference among the five countries, but Venezuelan patients had a 71% chance of having uncontrolled asthma (p  less then  0.001). Conclusion In the 3 age groups, patients experienced poor asthma control, with no significant differences among the countries. Patients who used control medication had a greater chance of controlling their asthma, and those who had emergency health care visits had a greater chance of having uncontrolled asthma. © 2020 Published by Elsevier Inc. on behalf of World Allergy Organization.Allergic rhinitis affects the quality of life of millions of people worldwide. Air pollution not only causes morbidity, but nearly 3 million people per year die from unhealthy indoor air exposure. Furthermore, allergic rhinitis and air pollution interact. This report summarizes the discussion of an International Expert Consensus on the management of allergic rhinitis aggravated by air pollution. The report begins with a review of indoor and outdoor air pollutants followed by epidemiologic evidence showing the impact of air pollution and climate change on the upper airway and allergic rhinitis. Mechanisms, particularly oxidative stress, potentially explaining the interactions between air pollution and allergic rhinitis are discussed. Treatment for the management of allergic rhinitis aggravated by air pollution primarily involves treating allergic rhinitis by guidelines and reducing exposure to pollutants. Fexofenadine a non-sedating oral antihistamine improves AR symptoms aggravated by air pollution.  https://www.selleckchem.com/products/cx-5461.html  However, more efficacy studies on other pharmacological therapy of coexisting AR and air pollution are currently lacking. © 2020 The Authors.Purpose of Review This review summarizes recent literature for applying pharmacogenomics to antifungal selection and dosing, providing an approach to implementing antifungal pharmacogenomics in clinical practice. Recent Findings The Clinical Pharmacogenetics Implementation Consortium published guidelines on CYP2C19 and voriconazole, with recommendations to use alternative antifungals or adjust voriconazole dose with close therapeutic drug monitoring (TDM). Recent studies demonstrate an association between CYP2C19 phenotype and voriconazole levels, clinical outcomes, and adverse events. Additionally, CYP2C19-guided preemptive dose adjustment demonstrated benefit in two prospective studies for prophylaxis. Pharmacokinetic-pharmacodynamic modeling studies have generated proposed voriconazole treatment doses based on CYP2C19 phenotypes, with further validation studies needed. Summary Sufficient evidence is available for implementing CYP2C19-guided voriconazole selection and dosing among select patients at risk for invasive fungal infections.