Publications by authors named "Cezmi A Akdis"

Prenatal stress (PS) is a repeated exposure to aversive situations during pregnancy, including high emotional strain, which is suspected to affect homeostatic systems in infants. Paediatric eczema develops quickly after birth at flexural sites subjected to continuous mechanical constraints. Although epidemiological studies have suggested an association between PS and a higher risk of eczema in children, no causative biological link has yet been identified.

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The epithelial barrier theory proposes that modern environmental exposures compromise skin and mucosal surfaces, initiating local inflammation that propagates systemically. The theory integrates epidemiological trends, molecular mechanistic data, and emerging clinical data to show how everyday exposures cause the development and exacerbation of more than 70 chronic noncommunicable diseases. A canonical epithelial cell and barrier injury cascade takes place, generating oxidative stress with increased reactive oxygen species, the release of alarmins, and multiple chemokines and epithelial barrier disruption.

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Chronic inflammatory diseases, like rheumatoid arthritis (RA) have been described to cause central nervous system (CNS) activation. Less is known about environmental factors that enable the CNS to suppress peripheral inflammation in RA. Here, we identified gut microbiota-derived histamine as such factor.

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The role of residential greenness exposure (RGE) in prevention and control of allergic diseases remains controversial. This systematic review evaluated the association between RGE and the risk of developing asthma, allergic rhinitis (AR), food allergy, atopic dermatitis (AD), and asthma control. MEDLINE and EMBASE searches retrieved 17 cohort and case-control longitudinal studies (12 for asthma, 6 AR, 1 food allergy, 1 ad).

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The prevalence of allergic diseases, including allergic rhinitis, chronic rhinosinusitis, asthma, eosinophilic esophagitis, food and drug allergies, and atopic dermatitis, has been increasing globally over the past few decades. Allergic diseases are closely linked to type 2 immunity, which is characterized by the coordinated interplay between innate and adaptive immune responses. Significant advancements have been achieved in elucidating the cellular and molecular mechanisms that govern type 2 immunity, chiefly mediated by type 2 cytokines, including IL-4, IL-5, IL-9, and IL-13, which are primarily secreted by T helper 2 cells and group 2 innate lymphoid cells.

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Exposure to fire smoke has become a global health concern and is associated with increased morbidity and mortality. There is a lack of understanding of the specific immune mechanisms involved in smoke exposure, with preventive and targeted interventions needed. After exposure to fire smoke, which includes PM, toxic metals and perfluoroalkyl and polyfluoroalkyl substances, epidemiology-based studies have demonstrated increases in respiratory (for example, asthma exacerbation), cardiac (for example, myocardial infarction, arrhythmias), neurological (for example, stroke) and pregnancy-related (for example, low birthweight, premature birth) outcomes.

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This systematic review evaluated the association between lower respiratory tract infections (LRTI) in infancy with respiratory syncytial virus (RSV), rhinovirus (RV) or infestation with helminths and the risk of developing asthma and allergic diseases. The risk of bias was assessed with ROBINS-E, and the certainty of evidence (CoE) with GRADE. Meta-analysis applied a random-effects model.

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The causative agents of respiratory allergies are bioaerosols, such as house dust mite feces, pollen grains, and fungal spores. Climate change and urbanization are considered to lead to an increase in the load of allergenic bioaerosols due to impacts on plant phenophases and allergenicity. Continuous and efficient monitoring of the atmospheric composition worldwide is essential, given the major changes involved and their impact on climate change.

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Background: There are conflicting data on a potential association between atopic dermatitis (AD) and cardiovascular diseases (CVD). The aim of this study was to further explore this connection and whether there are biomarkers indicating the risk for CVD in AD patients.

Methods: We included 677 AD patients and 79 nonatopic controls from an observational multicenter case-control study (ProRaD: Prospective longitudinal study investigating the remission phase in patients with atopic dermatitis and other allergy-associated diseases).

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Background: Viral infections and type 2 immune responses perpetuate airway epithelial barrier dysfunction and inflammation, leading to the development and progression of asthma. The synthetic cannabinoid WIN55,212-2 displays anti-inflammatory properties by acting on different immune system cells.

Objective: We sought to investigate the capacity of WIN55,212-2 to restore bronchial epithelial barrier function in asthma in the context of viral infections or type 2-driven inflammation.

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Immunoglobulin G4 (IgG4), a unique subclass of IgG antibodies, plays diverse roles in human health and disease. Its distinct features, such as Fab-arm exchange and specific mutations, confer reduced effector functions compared to other IgG subclasses. In health, IgG4 responses contribute to immune tolerance, particularly in the context of allergen-specific immunotherapy (AIT), where they can mediate tolerance to environmental antigens, inhibit IgE-dependent mast cell degranulation, and compete with IgE for allergen binding.

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Strenuous exercise in elite sports impacts the immune system, leading to high rates of upper respiratory tract infections and airway dysfunction, such as asthma and exercise-induced bronchoconstriction (EIB). Cross-country (XC) skiers and ice hockey (IH) players are particularly affected due to their training environments and sports disciplines. This systematic review (SR) evaluates immune and inflammatory responses and the risk of developing airway dysfunction in these athletes.

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Background: Monkeypox virus (mpox) outbreak since 2022 has already constituted a public health emergency of international concern. A comprehensive study on epidemiological features, symptoms and signs, complications, sequelae, and clinical outcomes has been lacking. Accordingly, we performed a large-scale multicenter study to comprehensively summarize the clinical, epidemiological, behavioral, laboratory, virological characteristics, and treatment-related outcomes of mpox in China.

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The EAACI Guidelines used the GRADE approach to evaluate the impact of major indoor air pollutants (dampness and mould, cleaning agents, volatile organic compounds and pesticides) on the risk of new-onset asthma and on asthma-related outcomes. The guideline also acknowledges the synergies among indoor air pollutants and other components of the indoor exposome (allergens, viruses, endotoxins). Very low to low certainty of evidence was found for the association between exposure to indoor pollutants and increased risk of new-onset asthma and asthma worsening.

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Significant advancements have been made in understanding the cellular and molecular mechanisms of type 2 immunity in allergic diseases such as asthma, allergic rhinitis, chronic rhinosinusitis, eosinophilic esophagitis (EoE), food and drug allergies, and atopic dermatitis (AD). Type 2 immunity has evolved to protect against parasitic diseases and toxins, plays a role in the expulsion of parasites and larvae from inner tissues to the lumen and outside the body, maintains microbe-rich skin and mucosal epithelial barriers and counterbalances the type 1 immune response and its destructive effects. During the development of a type 2 immune response, an innate immune response initiates starting from epithelial cells and innate lymphoid cells (ILCs), including dendritic cells and macrophages, and translates to adaptive T and B-cell immunity, particularly IgE antibody production.

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Human activities, primarily the burning of fossil fuels, widespread deforestation, soil erosion or machine-intensive farming methods, manufacturing, food processing, mining, construction, and the iron, cement, steel, and chemicals industries, have been the main drivers of the observed increase in Earth's average surface temperature and climate change. Rising global temperatures, extreme weather events, ecosystems disruption, agricultural impacts, water scarcity, problems in access to good quality water, food and housing, and profound environmental disruptions such as biodiversity loss and extreme pollution are expected to steeply increase the prevalence and severity of acute and chronic diseases. Its long-term effects cannot be adequately predicted or mitigated without a comprehensive understanding of the adaptive ecosystems.

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As the world still vividly recalls the previous monkeypox (mpox) outbreak that impacted over 120 countries worldwide with more than 99,000 cases in 2022, we are now facing a second wave of infections from the monkeypox virus (MPXV), characterized by an exponential increase in cases. The current 2024 outbreak has already recorded more than 20,000 cases in Africa, marking a dramatic escalation compared to previous outbreaks. The predominance of the newly identified clade Ib variant, first detected in the Democratic Republic of the Congo (DRC) and now identified across multiple African nations and beyond, underscores its enhanced transmissibility and potential for international spread, evidenced by cases in Sweden and Thailand.

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This European Academy of Allergy and Clinical Immunology (EAACI) guideline provides recommendations for the management of IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Following the confirmation of IgE-mediated food allergy diagnosis, allergen avoidance and dietary advice (with support of a specialised dietitian, if possible) together with the provision of a written treatment plan, education on the recognition of allergic symptoms and prescription of medication including adrenaline using an auto-injector are essential. Patients with significant anxiety and requirement for coping strategies may benefit from support from a clinical psychologist.

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Article Synopsis
  • - Epigenetic modifications play a crucial role in regulating gene expression, allowing cells to turn genes on and off, which is essential for maintaining different cell types.
  • - Environmental factors like diet and pollutants can alter these epigenetic modifications, meaning that an individual's surroundings can impact gene expression and health outcomes, potentially even affecting future generations.
  • - The review discusses how epigenetic changes can be passed down through generations, examines the mechanisms behind these changes, and emphasizes the importance of considering environmental health for both current and future populations.
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