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A Prospective, Clinical Study on Asymptomatic Sensitisation and Development of Allergic Rhinitis: High Negative Predictive Value of Allergological Testing.

Asymptomatic aeroallergen sensitisation affects approximately 10% of Western adolescents and is an established risk factor for the development of respiratory allergy. The reported incidence is 2-20% annually. Previous studies are based on out-seasonal symptom recollection or selected populations, conferring bias towards higher incidence rates.

Objective: The aim was to determine the incidence of onset of symptoms among clinically well-characterised asymptomatic, sensitised subjects compared with controls, and to evaluate the predictive values of common allergological tests.

Methods: We performed a prospective, clinical, non-interventional, 2-year follow-up study on subjects (identified by population screening) with seasonal allergic birch or grass pollen rhinitis (n = 52), asymptomatic sensitisation to grass or birch (AS, n = 52) or non-atopic, healthy control subjects (n = 39). Experimental allergen susceptibility was assessed at inclusion and at follow-up by skin prick test, conjunctival challenge, intradermal late-phase reaction and measurement of specific IgE. Participants completed in-seasonal symptom and medication diaries during 2 subsequent seasons.

Results: We observed an annual incidence rate of 5% for the onset of symptoms in the AS group (healthy control group 0%). At baseline, the AS group displayed intermediate experimental allergen susceptibility. Subjects developing symptoms had higher levels of specific IgE and larger late-phase reaction than those persistently asymptomatic. However, the positive predictive values were low (14-27%) in contrast to the negative predictive values (95-100%).

Conclusion: In a well-characterised young population, asymptomatic aeroallergen sensitisation conferred a low risk for onset of symptoms during the 2-year follow-up. Persistent asymptomatic phenotype could be accurately predicted by negative results from simple allergological testing.

Clinical usefulness of B‐type natriuretic peptide in the diagnosis of pleural effusions due to heart failure

Conclusions:  In patients with pleural effusions of suspected cardiac origin, measurements of BNP in plasma and pleural fluid may be useful for the diagnosis of HF as the underlying cause.

Combination of endobronchial ultrasound guided transbronchial needle aspiration with standard bronchoscopic techniques for the diagnosis of stage I and stage II pulmonary sarcoidosis

Conclusions:  Combination of EBUS‐TBNA with standard bronchoscopic techniques is safe and feasible, and optimizes the diagnostic yield in patients with pulmonary sarcoidosis and enlarged intra‐thoracic lymphadenopathy.

Cellular therapies for lung disease: A distant horizon

Lung diseases constitute a major global burden of health and are characterized by inflammation and chronic fibrosis resulting in a loss of gas exchange units. To date there has been no effective treatment to reverse these chronic inflammatory changes and tissue remodelling.

Recently, stem cells have been shown to successfully treat animal models of lung disease. In addition, certain cells have demonstrated a capacity to differentiate into lung cells. Based on these preliminary data, there are clinical trials underway to examine the potential for cellular therapies in lung disease.

Recently, there have been a variety of cell examined for both their immunomodulatory effects on the lung as well as their potential for differentiation into lung cells. These range from lung progenitor ce...

Rhinovirus infection induces expression of airway remodelling factors in vitro and in vivo

Conclusions : RV infection and TLR ligands promote ECM deposition in isolated cell systems and RV induces ECM gene expression in vivo, thus demonstrating that RV has the potential to contribute to remodelling of the airways through induction of ECM deposition. (Source: Respirology)

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