Adriana Muntean - Academia.edu (original) (raw)

Papers by Adriana Muntean

Alergologia, 2018

<jats:p>Respiratory viruses represent an important trigger of asthma exacerbations, in both... more <jats:p>Respiratory viruses represent an important trigger of asthma exacerbations, in both adults and children. Upper respiratory viral infections are responsible for 80% of asthma exacerbation in children and for 50% of acute episodes in adults. The interactions between the virulence of viruses, genetic factors and environmental exposure (airway microbiome) could determine more severe respiratory illness, which increase the risk of progression to asthma. The most frequently noticed respiratory infections involved in asthma exacerbations or in its inception are human rhinoviruses and respiratory syncytial viruses. The association of a specific viral infection with asthma exacerbation is variable among different geographic areas, according to the age and the type of studied population. Recent studies have proven an inverse association between allergic respiratory disease and viral infections: the presence of allergic inflammation may favor the occurrence of specific viral infections. </jats:p>

Alergologia, 2019

Allergic respiratory diseases, like asthma and allergic rhinitis, are chronic inflammatory disord... more Allergic respiratory diseases, like asthma and allergic rhinitis, are chronic inflammatory disorder with an increasing prevalence. Pulmonary and systemic oxidative stress enhances inflammatory process responsible for asthma and rhinitis. Diet-derived antioxidants protect against lipid peroxidation, so changes in exposure to antioxidants could play an important role in the management of allergic diseases. A few studies suggest that specific antioxidants from diet or vitamin supplements might improve asthma control or lung function in both children or adults with asthma, or it might prevent its occurrence. Responses to dietary antioxidants might be modified by patients age, genetic profile, and environmental sources of oxidative stress. The allergic respiratory diseases might be influenced by factors that are present during intrauterine period, so it is essential to identify and to change the risk factors in order to limit diseases occurrence. A, C and E vitamins might limit the pulmo...

Experimental and Therapeutic Medicine, 2019

Despite proven effectiveness and safety of vaccinations, immunization rates are decreasing across... more Despite proven effectiveness and safety of vaccinations, immunization rates are decreasing across Europe, most countries having suboptimal vaccination coverage, leading to an increase in the number of cases of preventable contagious diseases. In recent years, the number of parents who have refused to vaccinate their children in Romania has decreased substantially, while the number of fatal complications due to measles outbreak is one of the highest in Europe. Since healthcare professionals have been identified as the main advocates for immunization, knowledge and attitudes of medical students and nurses is of particular interest. A cross-sectional survey was carried out on 278 participants, divided into three groups: 183 medical students, 54 nurses and 41 non-medical professionals. The questionnaire included questions on demographics of participants, personal experience with vaccines, knowledge and attitude toward vaccination. The data was collected, centralized and analyzed using statistical methods. The survey was given to the medical students at the beginning of the Immunology course and again at the end, to test whether information received influenced their responses. The study revealed that a great majority of participants were themselves vaccinated [N=262 (94%)] and had/or would vaccinate their children [N=247 (95%)]. Satisfactory overall knowledge about effectiveness and safety concerns was observed, with 98% (N=270) considering vaccines as useful and over 96% (N=276) correctly identified their usefulness. When asked about adverse effects, concerning numbers [N=32, (19%)] of medical students answered incorrectly. After the Immunology course, however, there was significant improvement in knowledge on this topic (P<0.001), correlating with a positive shift in attitude towards current and future vaccines. We predict that better knowledge about vaccines, their efficacy and safety would help build the health provider's confidence in recommending vaccination and thus increased coverage rates.

Alergologia, 2019

Grain allergies are common food allergies, that are typically but not only seen in individuals wi... more Grain allergies are common food allergies, that are typically but not only seen in individuals with other associated food allergies. The immunologic responses to grain proteins can be IgE and/or non-IgE mediated. Wheat allergy is the most common of the cereal grain allergies. It usually begins in early childhood and is outgrown by adolescence, although some retain it beyond the teenage years. Immunoglobulin E (IgE)-mediated wheat allergy is reported to affect 0.2 to 1.3 percent of children in Europe and 0.4 percent of children in the United States. The onset of wheat allergy in adulthood is typically not seen, unless it is related to an occupational exposure. Epidemiologic data for the other grains is largely missing. Immunoglobulin E (IgE)-mediated food-triggered reactions generally occur immediately, within minutes to two hours after ingestion. These reactions can present with skin, oropharyngeal, upper and lower respiratory tract, gastrointestinal tract, and/or cardiovascular sig...

Clinical and Translational Allergy, 2017

Introduction: Incidence of anaphylaxis is increasing. Data regarding anaphylaxis mortality are li... more Introduction: Incidence of anaphylaxis is increasing. Data regarding anaphylaxis mortality are limited, but conflicting. Our objective was to document anaphylaxis mortality rate (deaths per million population), time trends and specificities according to triggers (iatrogenic, venom, food, unknown), age groups, sex and geographical regions (North and South) in France, between 1979 and 2011. Methods: Data were obtained (1) from database of the National Mortality Center (CEPIDC) to collect cases in which anaphylaxis was included as a cause of death, sex, age, and geographic region of death, (2) from the database of the National Institute for Economical and Statistical studies (INSEE) to define the referent populations. We used a multivariable log-linear Poisson regression model to assess the impact of time period, age, sex and geographic region on anaphylaxis deaths. Results: During the period study, 1603 deaths were collected: 1564 in adults and 39 in children (age <18 year). The overall prevalence of anaphylaxis fatalities was 0.84 per million population (95% IC 0.80-0.88), ranging from 0.08 per million (95% IC 0.05-0.10) in pediatric population to 1.12 per million (95% CI 1.06 to 1.17) in adult population. Annual percentage change for case fatality rate was −2.0% (95% CI −2.5 to −1.5; p < 10 −4) indicating a decrease in case fatality rate during the study period. Anaphylaxis fatality rate was higher in men (1.08 per million [95% IC 1.00 1.16] than women (0.86 per million [95% IC 0.80-0.92]) (p < 10 −4). Triggers of anaphylaxis fatalities were iatrogenic (63%), mostly drugs, venom (14%) and food (0.6%). Unspecified anaphylaxis was frequent (23%). The highest rate was in persons aged >70 years (3.50 per million population per year [95% IC 3.25-3.76]) and the lowest in the pediatric population (p < 10 −4). Only venom-induced mortality rate was higher in South of France (0.16 per million [95% IC 0.13-0.19]) compared with the North (0.11 per million [95% IC 0.09-0.13]) (p = 0.004). Only 8 food-induced fatalities were recorded (age <35 years in 7 cases). Conclusion: Overall anaphylaxis mortality rate is decreasing over the three last decades in France. We confirm that iatrogenic causes are the most frequent causes. Older age and male sex are risk factors of fatal anaphylaxis of any cause except for food-induced anaphylaxis.

International Journal of Celiac Disease, 2016

Old age seems to be the greatest risk factor for celiac disease. Strict adherence to a gluten-fre... more Old age seems to be the greatest risk factor for celiac disease. Strict adherence to a gluten-free diet is difficult for these patients. We present the clinical reassessment in the case of a third age patient, with celiac disease under gluten-free diet and multiple related diseases.

World Allergy Organization Journal, 2012

Background: Our investigation aimed to visualize the 3-D spatial distribution of nasal cavity muc... more Background: Our investigation aimed to visualize the 3-D spatial distribution of nasal cavity mucosal swelling under levocetirizine prophylactic treatment on exposure to allergens. This study made use of standard rhinologic diagnostics such as rhinomanometry and acoustic rhinometry, as well as 24 hours rhinometry and magnetic resonance imaging (MRI). Methods: A suitable test subject with a history of allergic rhinitis was identified during the symptom-free interval after the pollen season when she showed signs of "minimal persistent inflammation," consisting of pronounced reaction to nasal challenge with allergens. Provocation with birch pollen caused moderate symptoms of allergic rhinitis. Nasal provocation tests were performed before and after 2 and 5 weeks of treatment with levocetirizine 5 mg OD. Long-term rhinometry was carried out to detect the progress of the nasal cycle and relative flow variances over 24 hours. Flexible air tubes required for this new procedure made it possible to quantify relative pressure changes. High resolution MRI was also used to capture, visualize, and process the geometrical data of the nasal cavity immediately before and after the challenge tests. Based upon the MRI data, we computed the nasal airflow using a computational fluid dynamics (CFD) nasal model to visualize intranasal pressure and flow. Rhinomanometry and acoustic rhinometry were performed to validate the results. Results: After 36 days of treatment with levocetirizine, a 16% improvement in the nasal flow relative to baseline and an increase by 3.4 cm 3 of the total nasal baseline volume were documented as compared to the allergen challenge of the untreated case. 3-D images illustrated that treatment inhibited the allergen provocation effects on nasal airflow and normalised nasal flow velocity and pressure, including in the olfactory region. Conclusions: Besides improving the nasal airflow to an almost normal pattern, levocetirizine also helps prevents the patient from having an allergic response, even 24 hours after last drug intake. Furthermore, it can improve olfaction by restoring airflow to the olfactory region.

World Allergy Organization Journal, 2012

IgG2a level. AEBSF could effectively reduce the proteolytic activity in BALF. IL-4 and IL-5 decre... more IgG2a level. AEBSF could effectively reduce the proteolytic activity in BALF. IL-4 and IL-5 decreased significantly (P # 0.05) after AEBSF treatment while a significant (P # 0.05) increase was observed in IL-10 in BALF. Airway inflammation reduced significantly as revealed by lung histopathology, EPO activity and cysteinyl leukotrienes in BALF after treatment. AEBSF also suppressed oxidative stress in terms of 8-isoprostane in BALF. Among the treatment doses, 10 and 50 mg of AEBSF were most effective in reducing majority of the inflammatory parameters. Conclusions: Prophylactic and therapeutic treatment of AEBSF attenuates the airway inflammation in mouse model of airway allergy and have potential for the treatment of inflammatory allergic diseases.

World Allergy Organization Journal, 2007

World Allergy Organization Journal, 2007

Experimental and Therapeutic Medicine, 2019

Chronic spontaneous urticaria is a debilitating disorder, which has a major impact on the quality... more Chronic spontaneous urticaria is a debilitating disorder, which has a major impact on the quality of life of affected individuals, and is a substantial global burden. Refractory, difficult to treat cases pose a difficult challenge to patients and clinicians alike. Advances in the field of immunotherapy have led to novel and effective therapeutic strategies. Omalizumab, an immunomodulatory anti-IgE monoclonal antibody, inaugurated a new era in the treatment of refractory chronic urticaria. Several multicenter clinical trials have proven omalizumab to be a safe and effective option for the treatment of refractory symptoms of chronic spontaneous urticaria, while some small studies have shown its efficacy in chronic inductible urticaria as well. In this study, we bring forth updates in chronic urticaria approach, with a focus on our experience with anti-IgE therapy in different forms of chronic urticaria treated at the Allergy Department of the Professor

World Allergy Organization Journal, 2012

In allergic diseases; we all know that allergens may have regional variations. That's why; the al... more In allergic diseases; we all know that allergens may have regional variations. That's why; the allergen profiles of the regions must be determined and the dermal Prick tests must be prepared accordingly. Mostly grass and cereal mixtures and mites are responsible from the allergic rhinitis cases due to our observations in our clinic. The other important allergens that are linked to the flora and climate of the region are olive and the cockroaches. High asthma prevalence in people living in shanties and in housewives may be due to exposure to house dust mites.

Experimental and Therapeutic Medicine, 2020

Angiotensin-converting enzyme inhibitors (ACEIs) represent an important group of pharmacological ... more Angiotensin-converting enzyme inhibitors (ACEIs) represent an important group of pharmacological compounds, largely prescribed for more than 30 years. They have been extensively evaluated in clinical trials, demonstrating significant reduction of morbidity and mortality of patients with cardiovascular diseases, mainly high blood pressure, myocardial infarction, heart failure and stroke. Besides their beneficial effects and a general good safety profile, it was proven that ACEIs might also induce adverse effects in some patients, most notably angioedema (AE) and chronic cough. The occurrence rate of adverse events induced by ACEIs is low, but the number of suffering patients is relatively high, since ACEIs is one of the most frequently prescribed medication worldwide. The aim of our study was to evaluate clinical pattern, risk factors and general management of ACEI-induced angioedema in a cohort of patients addressed for allergist evaluation in one university hospital in Romania, during a period of 32 months. It was found that ACEI-induced angioedema (ACEI-AE) represented more than half of the total number of patients addressed for angioedema without urticaria, with variable clinical and time-patterns. Most of the patients were referred by general practitioners (GPs) with diagnosis of urticaria or other skin allergy and continued to take ACEIs for months and years after onset of angioedema. We concluded that the awareness of acquired, non-allergic angioedema induced by ACEI therapy in medical practice is still low and there is a need for improved knowledge and interdisciplinary collaboration in this field.

mites, exposure to a new type of allergens and chronic stress (Mösges & Klimek 2007). Allergic in... more mites, exposure to a new type of allergens and chronic stress (Mösges & Klimek 2007). Allergic inflammation is the key to understanding these diseases. The relationship between asthma and AR is not completely understood. This concept could be explained by the presence of inflammatory cells and mediators from the upper airway in the lower one, acting as triggering factors in bronchial inflammation (Canonica & Complati 2009). We found similar inflammatory cells in both asthma and rhinitis, such as eosinophils, mast cells, T lymphocytes and monocytes, and the same proinflammatory mediators (histamine, cytokines like IL-4, IL-5, IL-13, GM-CSF, eotaxine and adhesion molecules) (Bousquet et al. 2008, Bousquet et al. 2003, Leynaert et al. 2004). The amplitude of allergic inflammation is not necessarily identical in nasal and bronchial mucosa, but eosinophilic airway inflammation is present in the nasal mucosa of patients with asthma, even if they don’t have nasal symptoms (Bousquet et al. ...

The primary source of IL-10 is macrophages (Trifunović et al 2015), as well as B and T lymphocyte... more The primary source of IL-10 is macrophages (Trifunović et al 2015), as well as B and T lymphocytes, especially regulatory T cells (Tregs) that produce IL-10 (Del Prete et al 1993). IL-10 is also synthesized by Th1 and Th2 lymphocytes, cytotoxic T cells, dendritic cells, monocytes and mast cells (Trifunović et al 2015; Del Prete et al 1993), but also by some human carcinoma cell lines (Gastl et al 1993). IL-10 exerts its biological effects acting on a specific receptor complex formed by two subunits: IL-10R1 and IL-10R2. IL-10R1 is the signaling subunit, while IL-10R2 is the common component of the entire family (Commins et al 2008). Receptor stimulation induces a consecutive activation of JAK1 and tyrosine kinase 2, signal transducer and activator of transcription STAT1, and STAT3 (Commins et al 2008). Some studies assumed that other kinases and enzymes could be involved in IL-10 receptor signaling (Commins et al 2008; Swiątek 2012). Although IL-10 was first considered a Th2-type cytokine with an anti-inflammatory effect (Commins et al 2008), it has been proven that it has multiple immunoregulatory functions, mainly determining the suppression of immune responses. Under certain conditions, it may trigger a stimulatory activity (Commins et al 2008; Swiątek 2012; De Vries 1995; Akdis&Blaser 2001). IL-10 plays an important role as a regulatory factor of immune responses in both health and immune-mediated diseases (Swiątek 2012). On one hand, it is involved in innate and adaptive immune responses, being associated with the persistence of viral and bacterial infections (Swiątek 2012; Zdrenghea et al 2015). On the other hand, IL-10 prevents the development of pathological lesions that result from an exacerbated protective immune response (Mege et al 2006). In cancer cells, IL-10 has Abstract.IL-10 is an important immunoregulatory cytokine mainly determining the suppression of immune responses. There are many genetic variants of the IL-10 gene, but the promoter region polymorphisms are the most studied ones, especially the IL-10-1082 G/A polymorphism. Several studies have shown that the IL-10-1082 G/A polymorphism is associated with different diseases, including allergies, playing an important role in their pathophysiology and evolution.This review summarizes published literature data about the association between IL-10-1082 G/A polymorphisms and expression patterns with asthma, atopic dermatitis or food allergy.

Healthcare

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Alergologia, 2018

<jats:p>Respiratory viruses represent an important trigger of asthma exacerbations, in both... more <jats:p>Respiratory viruses represent an important trigger of asthma exacerbations, in both adults and children. Upper respiratory viral infections are responsible for 80% of asthma exacerbation in children and for 50% of acute episodes in adults. The interactions between the virulence of viruses, genetic factors and environmental exposure (airway microbiome) could determine more severe respiratory illness, which increase the risk of progression to asthma. The most frequently noticed respiratory infections involved in asthma exacerbations or in its inception are human rhinoviruses and respiratory syncytial viruses. The association of a specific viral infection with asthma exacerbation is variable among different geographic areas, according to the age and the type of studied population. Recent studies have proven an inverse association between allergic respiratory disease and viral infections: the presence of allergic inflammation may favor the occurrence of specific viral infections. </jats:p>

Alergologia, 2019

Allergic respiratory diseases, like asthma and allergic rhinitis, are chronic inflammatory disord... more Allergic respiratory diseases, like asthma and allergic rhinitis, are chronic inflammatory disorder with an increasing prevalence. Pulmonary and systemic oxidative stress enhances inflammatory process responsible for asthma and rhinitis. Diet-derived antioxidants protect against lipid peroxidation, so changes in exposure to antioxidants could play an important role in the management of allergic diseases. A few studies suggest that specific antioxidants from diet or vitamin supplements might improve asthma control or lung function in both children or adults with asthma, or it might prevent its occurrence. Responses to dietary antioxidants might be modified by patients age, genetic profile, and environmental sources of oxidative stress. The allergic respiratory diseases might be influenced by factors that are present during intrauterine period, so it is essential to identify and to change the risk factors in order to limit diseases occurrence. A, C and E vitamins might limit the pulmo...

Experimental and Therapeutic Medicine, 2019

Despite proven effectiveness and safety of vaccinations, immunization rates are decreasing across... more Despite proven effectiveness and safety of vaccinations, immunization rates are decreasing across Europe, most countries having suboptimal vaccination coverage, leading to an increase in the number of cases of preventable contagious diseases. In recent years, the number of parents who have refused to vaccinate their children in Romania has decreased substantially, while the number of fatal complications due to measles outbreak is one of the highest in Europe. Since healthcare professionals have been identified as the main advocates for immunization, knowledge and attitudes of medical students and nurses is of particular interest. A cross-sectional survey was carried out on 278 participants, divided into three groups: 183 medical students, 54 nurses and 41 non-medical professionals. The questionnaire included questions on demographics of participants, personal experience with vaccines, knowledge and attitude toward vaccination. The data was collected, centralized and analyzed using statistical methods. The survey was given to the medical students at the beginning of the Immunology course and again at the end, to test whether information received influenced their responses. The study revealed that a great majority of participants were themselves vaccinated [N=262 (94%)] and had/or would vaccinate their children [N=247 (95%)]. Satisfactory overall knowledge about effectiveness and safety concerns was observed, with 98% (N=270) considering vaccines as useful and over 96% (N=276) correctly identified their usefulness. When asked about adverse effects, concerning numbers [N=32, (19%)] of medical students answered incorrectly. After the Immunology course, however, there was significant improvement in knowledge on this topic (P<0.001), correlating with a positive shift in attitude towards current and future vaccines. We predict that better knowledge about vaccines, their efficacy and safety would help build the health provider's confidence in recommending vaccination and thus increased coverage rates.

Alergologia, 2019

Grain allergies are common food allergies, that are typically but not only seen in individuals wi... more Grain allergies are common food allergies, that are typically but not only seen in individuals with other associated food allergies. The immunologic responses to grain proteins can be IgE and/or non-IgE mediated. Wheat allergy is the most common of the cereal grain allergies. It usually begins in early childhood and is outgrown by adolescence, although some retain it beyond the teenage years. Immunoglobulin E (IgE)-mediated wheat allergy is reported to affect 0.2 to 1.3 percent of children in Europe and 0.4 percent of children in the United States. The onset of wheat allergy in adulthood is typically not seen, unless it is related to an occupational exposure. Epidemiologic data for the other grains is largely missing. Immunoglobulin E (IgE)-mediated food-triggered reactions generally occur immediately, within minutes to two hours after ingestion. These reactions can present with skin, oropharyngeal, upper and lower respiratory tract, gastrointestinal tract, and/or cardiovascular sig...

Clinical and Translational Allergy, 2017

Introduction: Incidence of anaphylaxis is increasing. Data regarding anaphylaxis mortality are li... more Introduction: Incidence of anaphylaxis is increasing. Data regarding anaphylaxis mortality are limited, but conflicting. Our objective was to document anaphylaxis mortality rate (deaths per million population), time trends and specificities according to triggers (iatrogenic, venom, food, unknown), age groups, sex and geographical regions (North and South) in France, between 1979 and 2011. Methods: Data were obtained (1) from database of the National Mortality Center (CEPIDC) to collect cases in which anaphylaxis was included as a cause of death, sex, age, and geographic region of death, (2) from the database of the National Institute for Economical and Statistical studies (INSEE) to define the referent populations. We used a multivariable log-linear Poisson regression model to assess the impact of time period, age, sex and geographic region on anaphylaxis deaths. Results: During the period study, 1603 deaths were collected: 1564 in adults and 39 in children (age <18 year). The overall prevalence of anaphylaxis fatalities was 0.84 per million population (95% IC 0.80-0.88), ranging from 0.08 per million (95% IC 0.05-0.10) in pediatric population to 1.12 per million (95% CI 1.06 to 1.17) in adult population. Annual percentage change for case fatality rate was −2.0% (95% CI −2.5 to −1.5; p < 10 −4) indicating a decrease in case fatality rate during the study period. Anaphylaxis fatality rate was higher in men (1.08 per million [95% IC 1.00 1.16] than women (0.86 per million [95% IC 0.80-0.92]) (p < 10 −4). Triggers of anaphylaxis fatalities were iatrogenic (63%), mostly drugs, venom (14%) and food (0.6%). Unspecified anaphylaxis was frequent (23%). The highest rate was in persons aged >70 years (3.50 per million population per year [95% IC 3.25-3.76]) and the lowest in the pediatric population (p < 10 −4). Only venom-induced mortality rate was higher in South of France (0.16 per million [95% IC 0.13-0.19]) compared with the North (0.11 per million [95% IC 0.09-0.13]) (p = 0.004). Only 8 food-induced fatalities were recorded (age <35 years in 7 cases). Conclusion: Overall anaphylaxis mortality rate is decreasing over the three last decades in France. We confirm that iatrogenic causes are the most frequent causes. Older age and male sex are risk factors of fatal anaphylaxis of any cause except for food-induced anaphylaxis.

International Journal of Celiac Disease, 2016

Old age seems to be the greatest risk factor for celiac disease. Strict adherence to a gluten-fre... more Old age seems to be the greatest risk factor for celiac disease. Strict adherence to a gluten-free diet is difficult for these patients. We present the clinical reassessment in the case of a third age patient, with celiac disease under gluten-free diet and multiple related diseases.

World Allergy Organization Journal, 2012

Background: Our investigation aimed to visualize the 3-D spatial distribution of nasal cavity muc... more Background: Our investigation aimed to visualize the 3-D spatial distribution of nasal cavity mucosal swelling under levocetirizine prophylactic treatment on exposure to allergens. This study made use of standard rhinologic diagnostics such as rhinomanometry and acoustic rhinometry, as well as 24 hours rhinometry and magnetic resonance imaging (MRI). Methods: A suitable test subject with a history of allergic rhinitis was identified during the symptom-free interval after the pollen season when she showed signs of "minimal persistent inflammation," consisting of pronounced reaction to nasal challenge with allergens. Provocation with birch pollen caused moderate symptoms of allergic rhinitis. Nasal provocation tests were performed before and after 2 and 5 weeks of treatment with levocetirizine 5 mg OD. Long-term rhinometry was carried out to detect the progress of the nasal cycle and relative flow variances over 24 hours. Flexible air tubes required for this new procedure made it possible to quantify relative pressure changes. High resolution MRI was also used to capture, visualize, and process the geometrical data of the nasal cavity immediately before and after the challenge tests. Based upon the MRI data, we computed the nasal airflow using a computational fluid dynamics (CFD) nasal model to visualize intranasal pressure and flow. Rhinomanometry and acoustic rhinometry were performed to validate the results. Results: After 36 days of treatment with levocetirizine, a 16% improvement in the nasal flow relative to baseline and an increase by 3.4 cm 3 of the total nasal baseline volume were documented as compared to the allergen challenge of the untreated case. 3-D images illustrated that treatment inhibited the allergen provocation effects on nasal airflow and normalised nasal flow velocity and pressure, including in the olfactory region. Conclusions: Besides improving the nasal airflow to an almost normal pattern, levocetirizine also helps prevents the patient from having an allergic response, even 24 hours after last drug intake. Furthermore, it can improve olfaction by restoring airflow to the olfactory region.

World Allergy Organization Journal, 2012

IgG2a level. AEBSF could effectively reduce the proteolytic activity in BALF. IL-4 and IL-5 decre... more IgG2a level. AEBSF could effectively reduce the proteolytic activity in BALF. IL-4 and IL-5 decreased significantly (P # 0.05) after AEBSF treatment while a significant (P # 0.05) increase was observed in IL-10 in BALF. Airway inflammation reduced significantly as revealed by lung histopathology, EPO activity and cysteinyl leukotrienes in BALF after treatment. AEBSF also suppressed oxidative stress in terms of 8-isoprostane in BALF. Among the treatment doses, 10 and 50 mg of AEBSF were most effective in reducing majority of the inflammatory parameters. Conclusions: Prophylactic and therapeutic treatment of AEBSF attenuates the airway inflammation in mouse model of airway allergy and have potential for the treatment of inflammatory allergic diseases.

World Allergy Organization Journal, 2007

World Allergy Organization Journal, 2007

Experimental and Therapeutic Medicine, 2019

Chronic spontaneous urticaria is a debilitating disorder, which has a major impact on the quality... more Chronic spontaneous urticaria is a debilitating disorder, which has a major impact on the quality of life of affected individuals, and is a substantial global burden. Refractory, difficult to treat cases pose a difficult challenge to patients and clinicians alike. Advances in the field of immunotherapy have led to novel and effective therapeutic strategies. Omalizumab, an immunomodulatory anti-IgE monoclonal antibody, inaugurated a new era in the treatment of refractory chronic urticaria. Several multicenter clinical trials have proven omalizumab to be a safe and effective option for the treatment of refractory symptoms of chronic spontaneous urticaria, while some small studies have shown its efficacy in chronic inductible urticaria as well. In this study, we bring forth updates in chronic urticaria approach, with a focus on our experience with anti-IgE therapy in different forms of chronic urticaria treated at the Allergy Department of the Professor

World Allergy Organization Journal, 2012

In allergic diseases; we all know that allergens may have regional variations. That's why; the al... more In allergic diseases; we all know that allergens may have regional variations. That's why; the allergen profiles of the regions must be determined and the dermal Prick tests must be prepared accordingly. Mostly grass and cereal mixtures and mites are responsible from the allergic rhinitis cases due to our observations in our clinic. The other important allergens that are linked to the flora and climate of the region are olive and the cockroaches. High asthma prevalence in people living in shanties and in housewives may be due to exposure to house dust mites.

Experimental and Therapeutic Medicine, 2020

Angiotensin-converting enzyme inhibitors (ACEIs) represent an important group of pharmacological ... more Angiotensin-converting enzyme inhibitors (ACEIs) represent an important group of pharmacological compounds, largely prescribed for more than 30 years. They have been extensively evaluated in clinical trials, demonstrating significant reduction of morbidity and mortality of patients with cardiovascular diseases, mainly high blood pressure, myocardial infarction, heart failure and stroke. Besides their beneficial effects and a general good safety profile, it was proven that ACEIs might also induce adverse effects in some patients, most notably angioedema (AE) and chronic cough. The occurrence rate of adverse events induced by ACEIs is low, but the number of suffering patients is relatively high, since ACEIs is one of the most frequently prescribed medication worldwide. The aim of our study was to evaluate clinical pattern, risk factors and general management of ACEI-induced angioedema in a cohort of patients addressed for allergist evaluation in one university hospital in Romania, during a period of 32 months. It was found that ACEI-induced angioedema (ACEI-AE) represented more than half of the total number of patients addressed for angioedema without urticaria, with variable clinical and time-patterns. Most of the patients were referred by general practitioners (GPs) with diagnosis of urticaria or other skin allergy and continued to take ACEIs for months and years after onset of angioedema. We concluded that the awareness of acquired, non-allergic angioedema induced by ACEI therapy in medical practice is still low and there is a need for improved knowledge and interdisciplinary collaboration in this field.

mites, exposure to a new type of allergens and chronic stress (Mösges & Klimek 2007). Allergic in... more mites, exposure to a new type of allergens and chronic stress (Mösges & Klimek 2007). Allergic inflammation is the key to understanding these diseases. The relationship between asthma and AR is not completely understood. This concept could be explained by the presence of inflammatory cells and mediators from the upper airway in the lower one, acting as triggering factors in bronchial inflammation (Canonica & Complati 2009). We found similar inflammatory cells in both asthma and rhinitis, such as eosinophils, mast cells, T lymphocytes and monocytes, and the same proinflammatory mediators (histamine, cytokines like IL-4, IL-5, IL-13, GM-CSF, eotaxine and adhesion molecules) (Bousquet et al. 2008, Bousquet et al. 2003, Leynaert et al. 2004). The amplitude of allergic inflammation is not necessarily identical in nasal and bronchial mucosa, but eosinophilic airway inflammation is present in the nasal mucosa of patients with asthma, even if they don’t have nasal symptoms (Bousquet et al. ...

The primary source of IL-10 is macrophages (Trifunović et al 2015), as well as B and T lymphocyte... more The primary source of IL-10 is macrophages (Trifunović et al 2015), as well as B and T lymphocytes, especially regulatory T cells (Tregs) that produce IL-10 (Del Prete et al 1993). IL-10 is also synthesized by Th1 and Th2 lymphocytes, cytotoxic T cells, dendritic cells, monocytes and mast cells (Trifunović et al 2015; Del Prete et al 1993), but also by some human carcinoma cell lines (Gastl et al 1993). IL-10 exerts its biological effects acting on a specific receptor complex formed by two subunits: IL-10R1 and IL-10R2. IL-10R1 is the signaling subunit, while IL-10R2 is the common component of the entire family (Commins et al 2008). Receptor stimulation induces a consecutive activation of JAK1 and tyrosine kinase 2, signal transducer and activator of transcription STAT1, and STAT3 (Commins et al 2008). Some studies assumed that other kinases and enzymes could be involved in IL-10 receptor signaling (Commins et al 2008; Swiątek 2012). Although IL-10 was first considered a Th2-type cytokine with an anti-inflammatory effect (Commins et al 2008), it has been proven that it has multiple immunoregulatory functions, mainly determining the suppression of immune responses. Under certain conditions, it may trigger a stimulatory activity (Commins et al 2008; Swiątek 2012; De Vries 1995; Akdis&Blaser 2001). IL-10 plays an important role as a regulatory factor of immune responses in both health and immune-mediated diseases (Swiątek 2012). On one hand, it is involved in innate and adaptive immune responses, being associated with the persistence of viral and bacterial infections (Swiątek 2012; Zdrenghea et al 2015). On the other hand, IL-10 prevents the development of pathological lesions that result from an exacerbated protective immune response (Mege et al 2006). In cancer cells, IL-10 has Abstract.IL-10 is an important immunoregulatory cytokine mainly determining the suppression of immune responses. There are many genetic variants of the IL-10 gene, but the promoter region polymorphisms are the most studied ones, especially the IL-10-1082 G/A polymorphism. Several studies have shown that the IL-10-1082 G/A polymorphism is associated with different diseases, including allergies, playing an important role in their pathophysiology and evolution.This review summarizes published literature data about the association between IL-10-1082 G/A polymorphisms and expression patterns with asthma, atopic dermatitis or food allergy.

Healthcare

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY