Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: KEGG:D04296 (Asthma)
 25,733 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Monoclonal gammopathy is a condition characterized by the abnormal proliferation of a single clone of plasma cells, which produces a homogeneous monoclonal protein. It has been reported to occur in association with urticaria in the context of Schnitzler's syndrome and also has been observed to occur in angioedema with acquired C1 esterase inhibitor deficiency. We report 11 cases of monoclonal gammopathy presenting to practicing allergists (>2.5% of those screened) primarily in association with dermatologic disorders, i.e., urticaria, angioedema, and nonspecific dermatitis, but also with allergic respiratory disorders, i.e., allergic rhinitis, chronic sinusitis, and asthma. Most of the patients with dermatologic manifestations had respiratory disorders as well, three with chronic sinusitis. To our knowledge, these are the only such cases reported in patients with urticaria or angioedema in the absence of Schnitzler's syndrome or C1 inhibitor deficiency or in association with chronic sinusitis, allergic rhinitis, or asthma. Monoclonal gammopathy, angioedema, urticaria, allergic respiratory disorders, and sinusitis could be linked through antigenic stimulation as a trigger, either infectious, as in chronic sinusitis; self-antigens, as in autoimmunity; or the monoclonal gammopathy itself, causing idiotype-anti-idiotype immune complexes and inflammatory disease. The allergist, dermatologist, otolaryngologist, and primary care physician should all maintain a high index of suspicion for the occurrence of monoclonal gammopathy in the "allergic" population. Serum protein electrophoresis and/or serum immunofixation are useful screening tools. When monoclonal gammopathy is found, the presence of light chains in the urine should be assessed and the patient should be referred for prompt hematology-oncology evaluation with periodic monitoring for the development of plasma cell dyscrasias. Additional prospective study is necessary to determine the true prevalence of monoclonal gammopathy in the population presenting to the practicing allergist.
Allergy Asthma Proc
PMID:Monoclonal gammopathy in association with allergic disorders of the skin and respiratory tract. 1672 32

Chronic sinusitis comprises numerous disorders characterized by inflammation, mucous gland hyperplasia, and remodeling. Chronic hyperplastic eosinophilic sinusitis (CHES) is characterized by unrestrained proliferation of eosinophils, Th2-like lymphocytes, fibroblasts, goblet cells, and mast cells. The pathology of CHES is similar to that of asthma, and it is frequently diagnosed in association with asthma. It has been reported that exacerbations of CHES occur temporally with worsening of asthma; however, in the absence of well-controlled studies, this linkage remains unproven. In this article, the potential mechanisms linking these two diseases are examined.
Curr Allergy Asthma Rep 2006 Nov
PMID:The relationship between rhinosinusitis and asthma sinusitis. 1702 75

Clinical practice guidelines for the management of acute bacterial rhinosinusitis in children were published by the American Academy of Pediatrics in 2001. Changes in the antibiotic susceptibility patterns for the common pathogens causing both acute and chronic rhinosinusitis warrant a reevaluation and update of these recommendations. In addition, there was only a very brief discussion of chronic disease in this publication, with the conclusion that the pathogenesis and management of recurrent or prolonged infection were essentially unknown. Although there are still insufficient data in the literature to develop evidence-based clinical guidelines, a careful review of recent literature and the clinical experience of experts who manage pediatric chronic sinusitis are presented in an effort to provide some specific recommendations and to offer practical treatment options. Factors associated with chronic rhinosinusitis should be addressed individually and include environmental pollution, recurrent viral upper respiratory infections, allergic and nonallergic rhinitis, ciliary dyskinesia, cystic fibrosis, immunodeficiency, gastroesophageal reflux, and anatomic abnormalities.
Curr Allergy Asthma Rep 2006 Nov
PMID:Rhinosinusitis in children. 1702 77

Chronic rhinosinusitis (CRS) is a heterogenous disorder and represents a major public health problem. Although insights into the pathophysiology of CRS have largely expanded over the last two decades, the exact etiology and mechanism of persistence is still unrevealed. CRS is a multifactorial disease, and, with variable evidence, impaired ostial patency, mucociliary impairment, allergy, bacterial or fungal infection (or triggering), immunocompromised state, and environmental and genetic factors have been suggested to be associated or risk factors. Pathomechanisms in CRS are better understood currently, allowing us to characterize and differentiate the heterogeneous pathology of chronic sinonasal inflammation based on histopathology, inflammatory pattern, cytokine profile, and remodeling processes. In nasal polyposis (NP), but not CRS without NP, an abundant eosinophilic inflammation and local immunoglobulin E production could be demonstrated, and Staphylococcus-derived superantigens may at least modulate disease severity and expression. These findings question the current assumption that NP is a subgroup of CRS, but suggest that CRS and NP should probably be considered as distinct disease entities.
Curr Allergy Asthma Rep 2006 Nov
PMID:Pathogenesis of chronic rhinosinusitis. 1704 42

The dilemma of treating chronic sinusitis continues to confuse clinicians. When mucosal thickening does not respond to aggressive antibiotic therapy, other etiologies should be considered. Perhaps the most likely is the inflammatory response. In comparison with asthma, chronic sinusitis exhibits amazing similarities. Atopic dermatitis also exhibits similar inflammatory responses that lead to thickening of the skin in a manner not dissimilar to mucosal thickening. The interactions amid eosinophils, lymphocytes, leukotrienes, interleukins, and epithelial cells serve as a reminder that there is one immune response and similarities exist in the pathophysiology of these conditions.
Allergy Asthma Proc
PMID:What drives the inflammatory response in rhinosinusitis. 1717 76

Although the precise mechanism is unclear, asthma and chronic sinusitis are associated frequently. Computed tomography (CT) is a sensitive modality for documenting sinonasal mucosal abnormalities. The aim of this study was to evaluate paranasal mucosal abnormalities in asthma and whether there was a relationship with asthma severity. One hundred fifty-five patients with asthma and 36 normal control subjects were assessed with coronal sinus CT. Asthma was classified as mild, moderate, or severe. Scoring of paranasal sinus abnormalities were assessed for total sinus, total mucosal, and individual sites. The mean scores of total mucosal changes (8.45 points versus 4.67 points, p < 0.001) and total sinus scores (5.50 versus 2.69, p < 0.005) were significantly higher in the asthmatic patients compared with controls. Nasal passage and frontal sinus involvements were not statistically different between groups, but all other individual scores were significantly higher in asthmatic patients. There was an involvement site tendency with respect to increasing severity of asthma. Mean total mucosal CT scores (12.57 points versus 7.33 points, p < 0.05) and individual site scores were statistically higher in asthmatic patients with high blood eosinophil levels compared with those patients with normal blood eosinophil counts except for nasal passage disease. There was no significant relationship between total IgE level and CT scores. Total mucosal and sinus scores were significantly related with asthma severity. There was an involvement tendency of sinuses and sites. Nasal passage involvement was unrelated with asthma. Ethmoidal sinuses and ostiomeatal complexes were involved significantly in patients with mild asthma, whereas maxillary, frontal, and sphenoidal sinuses were involved significantly in patients with severe asthma.
Allergy Asthma Proc
PMID:Computed tomography evaluation of paranasal sinuses in asthma: is there a tendency of particular site involvement? 1717 86

Although formerly regarded as a nuisance disease, allergic rhinitis (AR) has a considerable effect on quality of life and can have significant consequences if left untreated. The total burden of this disease lies not only in impaired physical and social functioning but also in a financial burden made greater when considering evidence that AR is a possible causal factor in comorbid diseases such as asthma or sinusitis. Compared with matched controls, patients with AR have an approximate twofold increase in medication costs and 1.8-fold the number of visits to health practitioners. Hidden direct costs include the treatment of comorbid asthma, chronic sinusitis, otitis media, upper respiratory infection, and nasal polyposis. Nasal congestion, the most prominent symptom in AR, is associated with sleep-disordered breathing, a condition that can have a profound effect on mental health, including increased psychiatric disorders, depression, anxiety, and alcohol abuse. Furthermore, sleep-disordered breathing in childhood and adolescence is associated with increased disorders of learning performance, behavior, and attention. In the United States, AR results in 3.5 million lost workdays and 2 million lost schooldays annually. Patients struggle to alleviate their misery, frequently self-adjusting their treatment regimen of over-the-counter and prescription medications because of lack of efficacy, deterioration of efficacy, lack of 24-hour relief, and bothersome side effects. Ironically, health care providers overestimate patient satisfaction with therapy. Therefore, improvement in patient-practitioner communication may enhance patient adherence with prescribed regimens.
Allergy Asthma Proc
PMID:The burden of allergic rhinitis. 1739 Jul 49

Nonallergic rhinitis in children is a medical condition that has not been well defined and the true incidence is unknown. Current treatment recommendations are based on data obtained from adult studies. The mechanisms of pediatric nonallergic rhinitis are also unclear. The concept that laryngopharyngeal reflux (LPR) events may play a critical role in the pathogenesis of upper airway disease is presently under investigation. Although LPR is being better delineated and appropriate methods of diagnosis and treatment are being studied, substantial evidence links LPR with several disease states including rhinitis, sinus disease, and middle ear disease. Due to the lack of information concerning the etiology of nonallergic rhinitis in children, LPR should be considered in the differential diagnosis of a child with negative skin tests and chronic rhinitis symptoms. The clinician should especially give attention to this diagnosis when a child presents with recurrent co-morbid conditions such as chronic sinusitis or persistent middle ear disease.
Curr Allergy Asthma Rep 2007 May
PMID:Nonallergic rhinitis in children. 1743 81

Chronic rhinosinusitis (CRS) is presently classified into two subgroups: CRS without and CRS with nasal polyps. A variety of inflammatory mediators, including cytokines and chemokines, as well as adhesion molecules and matrix metalloproteinases, are upregulated in both subgroups of CRS; remodeling is also observed in both. However, there are also characteristic differences. Whereas CRS without nasal polyps has more neutrophilic infiltration, in CRS with nasal polyps (especially when associated with allergy/asthma) eosinophil infiltration is strikingly increased. Although several features of remodeling (eg, squamous metaplasia, basement membrane thickening, collagen deposition, hyperplasia of mucous glands, and goblet cells) are features seen in both subgroups of CRS, epithelial shedding as observed in asthma is not seen in either subgroup. Furthermore, pseudocyst formation seen in CRS with nasal polyps is not seen in CRS without nasal polyps.
Curr Allergy Asthma Rep 2007 Jun
PMID:Inflammatory mechanisms and remodeling in chronic rhinosinusitis and nasal polyps. 1744 32

Although sinusitis is one of the most common problems encountered in clinical practice, it can be a challenge to diagnose and treat appropriately. Sinusitis refers to inflammation (infectious or noninfectious) in the paranasal sinuses. Infectious sinusitis can be bacterial or viral. This article focuses on bacterial sinusitis. Acute bacterial sinusitis usually follows a viral upper respiratory infection (URI) but can also present with severe symptoms 3 to 5 days after onset. Chronic sinusitis has less prominent symptoms and can be easily missed. When antibiotic therapy is warranted, the antibiotic should be chosen based on knowledge of antimicrobial resistance in specific geographic areas and populations. Adjunctive measures include saline irrigation, steam inhalation, nasal and systemic steroids, mucolytics, and decongestants. It is important to identify and treat predisposing factors, including viral URIs, allergic rhinitis, nasal structural abnormalities, gastroesophageal reflux disease, and immune deficiencies.
Curr Allergy Asthma Rep 2007 Nov
PMID:Pediatric sinusitis. 1798 71


<< Previous 1 2 3 4 5 6 7 8 9 Next >>