Portal de Periódicos da CAPES

New treatment directions in food allergy

2018; Elsevier BV; Volume: 120; Issue: 3 Linguagem: Inglês

10.1016/j.anai.2018.01.004

1534-4436

Vanitha Sampath, Sayantani Sindher, Wenming Zhang, Kari C. Nadeau,

Allergic Rhinitis and Sensitization

Key Messages•Desensitization with immunotherapy has shown promise in clinical trials, however, recurrence of allergenic sensitivity is common after discontinuation of therapy.•Oral immunotherapy with adjunct omalizumab, an anti-IgE antibody, expedites time to desensitization and enables simultaneous treatment of multiple allergies.•Other adjunctive therapies with oral immunotherapy that have shown promise are probiotics and Chinese herbal formula.•Sublingual immunotherapy has a better safety profile than oral immunotherapy but oral immunotherapy is more effective than sublingual immunotherapy in inducing desensitization.•Novel vaccines and biologics, such as lysosomal associated membrane protein (LAMP) DNA vaccine and anti-IL-33, respectively, are being evaluated in clinical trials for the treatment of food allergy.InstructionsCredit can now be obtained, free for a limited time, by reading the review article and completing all activity components. Please note the instructions listed below:•Review the target audience, learning objectives and all disclosures.•Complete the pre-test.•Read the article and reflect on all content as to how it may be applicable to your practice.•Complete the post-test/evaluation and claim credit earned. At this time, physicians will have earned up to 1.0 AMA PRA Category 1 CreditTM. Minimum passing score on the post-test is 70%.Overall PurposeParticipants will be able to demonstrate increased knowledge of the clinical treatment of allergy/asthma/immunology and how new information can be applied to their own practices.Learning ObjectivesAt the conclusion of this activity, participants should be able to:•Recognize the differences between tolerance, sustained unresponsiveness, and desensitization with immunotherapy•Determine the benefits and drawbacks of the different routes of immunotherapy and the adjunctive treatments that are being used with immunotherapy.Release Date: March 1, 2018Expiration Date: February 28, 2020Target AudiencePhysicians involved in providing patient care in the field of allergy/asthma/immunologyAccreditationThe American College of Allergy, Asthma & Immunology (ACAAI) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.DesignationThe American College of Allergy, Asthma & Immunology (ACAAI) designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.Disclosure PolicyAs required by the Accreditation Council for Continuing Medical Education (ACCME) and in accordance with the American College of Allergy, Asthma and Immunology (ACAAI) policy, all CME planners, presenters, moderators, authors, reviewers, and other individuals in a position to control and/or influence the content of an activity must disclose all relevant financial relationships with any commercial interest that have occurred within the past 12 months. All identified conflicts of interest must be resolved and the educational content thoroughly vetted for fair balance, scientific objectivity, and appropriateness of patient care recommendations. It is required that disclosure be provided to the learners prior to the start of the activity. Individuals with no relevant financial relationships must also inform the learners that no relevant financial relationships exist. Learners must also be informed when off-label, experimental/investigational uses of drugs or devices are discussed in an educational activity or included in related materials. Disclosure in no way implies that the information presented is biased or of lesser quality. It is incumbent upon course participants to be aware of these factors in interpreting the program contents and evaluating recommendations. Moreover, expressed views do not necessarily reflect the opinions of ACAAI.Disclosure of Relevant Financial RelationshipsAll identified conflicts of interest have been resolved. Any unapproved/investigative uses of therapeutic agents/devices discussed are appropriately noted.Planning Committee•Jonathan A. Bernstein, MD (Annals CME Subcommittee): Consultant, Grants/Fees: AstraZeneca, CSL Behring, Novartis, Pharming, Sanofi Regeneron, Shire; Consultant, Grant: BioCryst•Guha Krishnaswamy, MD (Annals CME Subcommittee): Author, Royalties: UpToDate; Research, Grant: CSL Behring; Reviewer, Honorarium: NIAID/AITC•Gailen D. Marshall, Jr, MD, PhD (Editor-in-Chief): Research, Grants: AstraZeneca, NIH, PCORI, Stallergenes•Anna Nowak-Wegrzyn, MD (CME Series Editor, Deputy Editor): Advisory Board, Fees: ALK Abello, Gerber, Merck; Contributor, Fees: UpToDate; Research, Grants: Astellas Pharma, DBV Technologies, Food Allergy Research and Education, NIH/NIAID Immune Tolerance Network, Nutricia, Thermo Fisher Scientific; Speaker, Grant/Fees: Nestle•John J. Oppenheimer, MD (Annals CME Subcommittee, Associate Editor): Consultant, Fees: AstraZeneca, Boehringer Ingelheim, DBV Technologies, GlaxoSmithKline, Kaleo, Novartis, SanofiAuthorThe following individuals have no relevant financial relationships to disclose:•Vanitha Sampath, PhD•Sayantani B. Sindher, MD•Wenming Zhang, PhD•Kari Christine Nadeau, MD, PhDRecognition of Commercial Support: This activity has not received external commercial support.Copyright Statement: ©2015-2018 ACAAI. All rights reserved.CME Inquiries: Contact the American College of Allergy, Asthma & Immunology at [email protected]or 847-427-1200. •Desensitization with immunotherapy has shown promise in clinical trials, however, recurrence of allergenic sensitivity is common after discontinuation of therapy.•Oral immunotherapy with adjunct omalizumab, an anti-IgE antibody, expedites time to desensitization and enables simultaneous treatment of multiple allergies.•Other adjunctive therapies with oral immunotherapy that have shown promise are probiotics and Chinese herbal formula.•Sublingual immunotherapy has a better safety profile than oral immunotherapy but oral immunotherapy is more effective than sublingual immunotherapy in inducing desensitization.•Novel vaccines and biologics, such as lysosomal associated membrane protein (LAMP) DNA vaccine and anti-IL-33, respectively, are being evaluated in clinical trials for the treatment of food allergy. Credit can now be obtained, free for a limited time, by reading the review article and completing all activity components. Please note the instructions listed below:•Review the target audience, learning objectives and all disclosures.•Complete the pre-test.•Read the article and reflect on all content as to how it may be applicable to your practice.•Complete the post-test/evaluation and claim credit earned. At this time, physicians will have earned up to 1.0 AMA PRA Category 1 CreditTM. Minimum passing score on the post-test is 70%. Participants will be able to demonstrate increased knowledge of the clinical treatment of allergy/asthma/immunology and how new information can be applied to their own practices. At the conclusion of this activity, participants should be able to:•Recognize the differences between tolerance, sustained unresponsiveness, and desensitization with immunotherapy•Determine the benefits and drawbacks of the different routes of immunotherapy and the adjunctive treatments that are being used with immunotherapy. Release Date: March 1, 2018 Expiration Date: February 28, 2020 Physicians involved in providing patient care in the field of allergy/asthma/immunology The American College of Allergy, Asthma & Immunology (ACAAI) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The American College of Allergy, Asthma & Immunology (ACAAI) designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. As required by the Accreditation Council for Continuing Medical Education (ACCME) and in accordance with the American College of Allergy, Asthma and Immunology (ACAAI) policy, all CME planners, presenters, moderators, authors, reviewers, and other individuals in a position to control and/or influence the content of an activity must disclose all relevant financial relationships with any commercial interest that have occurred within the past 12 months. All identified conflicts of interest must be resolved and the educational content thoroughly vetted for fair balance, scientific objectivity, and appropriateness of patient care recommendations. It is required that disclosure be provided to the learners prior to the start of the activity. Individuals with no relevant financial relationships must also inform the learners that no relevant financial relationships exist. Learners must also be informed when off-label, experimental/investigational uses of drugs or devices are discussed in an educational activity or included in related materials. Disclosure in no way implies that the information presented is biased or of lesser quality. It is incumbent upon course participants to be aware of these factors in interpreting the program contents and evaluating recommendations. Moreover, expressed views do not necessarily reflect the opinions of ACAAI. All identified conflicts of interest have been resolved. Any unapproved/investigative uses of therapeutic agents/devices discussed are appropriately noted. •Jonathan A. Bernstein, MD (Annals CME Subcommittee): Consultant, Grants/Fees: AstraZeneca, CSL Behring, Novartis, Pharming, Sanofi Regeneron, Shire; Consultant, Grant: BioCryst•Guha Krishnaswamy, MD (Annals CME Subcommittee): Author, Royalties: UpToDate; Research, Grant: CSL Behring; Reviewer, Honorarium: NIAID/AITC•Gailen D. Marshall, Jr, MD, PhD (Editor-in-Chief): Research, Grants: AstraZeneca, NIH, PCORI, Stallergenes•Anna Nowak-Wegrzyn, MD (CME Series Editor, Deputy Editor): Advisory Board, Fees: ALK Abello, Gerber, Merck; Contributor, Fees: UpToDate; Research, Grants: Astellas Pharma, DBV Technologies, Food Allergy Research and Education, NIH/NIAID Immune Tolerance Network, Nutricia, Thermo Fisher Scientific; Speaker, Grant/Fees: Nestle•John J. Oppenheimer, MD (Annals CME Subcommittee, Associate Editor): Consultant, Fees: AstraZeneca, Boehringer Ingelheim, DBV Technologies, GlaxoSmithKline, Kaleo, Novartis, Sanofi The following individuals have no relevant financial relationships to disclose:•Vanitha Sampath, PhD•Sayantani B. Sindher, MD•Wenming Zhang, PhD•Kari Christine Nadeau, MD, PhD Recognition of Commercial Support: This activity has not received external commercial support. Copyright Statement: ©2015-2018 ACAAI. All rights reserved. CME Inquiries: Contact the American College of Allergy, Asthma & Immunology at [email protected] or 847-427-1200.