Text nabízí aktuální pohled na alergenovou imunoterapii (AIT) jako metodu velmi účinného navození tolerance na aeroalergeny roztočů, pylů a jedu blanokřídlého hmyzu. Má vliv nejen na zmírnění, event. vymizení příznaků rinokonjunktivitidy, ale pronikavě snižuje riziko rozvoje astmatu či zmírňuje jeho projevy. V případě alergie na jed blanokřídlých (vosa a včela) může velmi účinně předcházet anafylaxi, což je život ohrožující alergie. Informovanost internistů o současných možnostech moderních galenických forem AIT je důležitá a velmi žádoucí pro včasné indikace a doporučení ke specialistům, protože farmakoterapie řeší pouze následek, nikoli příčinu. Naopak AIT má i chorobu modifikující účinek, je však potřeba ji podávat alespoň po dobu tří let. Je vhodná v indikovaných případech pro děti starší 5 let a u dospělých do 65 let. Nové snadno rozpustitelné a z dutiny ústní se přímo resorbující tablety mimo jiné nesmírně napomáhají adherenci k léčbě. Vyžadují však jistou osobní disciplínu a odpovědnost za vedení léčby.

The text offers an up‐to‐date view of allergen immunotherapy (AIT) as a method of very effective induction of tolerance to aeroallergens of mites, pollens and venom of white‐winged insects. It has an effect not only on the alleviation or disappearance of rhinoconjunctivitis symptoms, but it pervasively reduces the risk of asthma development or alleviates its manifestations. In the case of allergy to the venom of white‐winged animals (wasp and bee), it can very effectively prevent anaphylaxis, which is a life‐threatening allergy. Awareness of internists about the current options of modern galenic forms of AIT is important and highly desirable for early indication and referral to specialists, as pharmacotherapy only addresses the effect not the cause. Conversely, AIT also has a disease‐modifying effect but needs to be administered for at least three years. It is suitable in indicated cases for children over 5 years and for adults up to 65 years. Among other things, the new easily dissolvable tablets, which are directly resorbable from the oral cavity, help enormously with adherence to treatment. However, they require some personal discipline and responsibility for treatment management.

• MeSH
• Rhinitis, Allergic drug therapy   immunology   MeSH
• Allergoids administration & dosage   therapeutic use   MeSH
• Asthma drug therapy   immunology   prevention & control   MeSH
• Desensitization, Immunologic * methods   adverse effects   MeSH
• Humans MeSH
• Food Hypersensitivity prevention & control   MeSH
• Venom Hypersensitivity prevention & control   MeSH
• Check Tag
• Humans MeSH

ext nabízí aktuální pohled na alergenovou imunoterapii (AIT) jako metodu velmi účinného navození tolerance na aeroalergeny roztočů, pylů a jedu blanokřídlého hmyzu. Má vliv nejen na zmírnění, event. vymizení příznaků rinokonjunktivitidy, ale pronikavě snižuje riziko rozvoje astmatu či zmírňuje jeho projevy. V případě alergie na jed blanokřídlých (vosa a včela) může velmi účinně předcházet anafylaxi, což je život ohrožující alergie. Informovanost internistů o současných možnostech moderních galenických forem AIT je důležitá a velmi žádoucí pro včasné indikace a doporučení ke specialistům, protože farmakoterapie řeší pouze následek nikoli příčinu. Naopak AIT má i chorobu modifikující účinek, je však potřeba ji podávat alespoň po dobu tří let. Je vhodná v indikovaných případech pro děti starší 5 let a u dospělých do 65 let. Nové snadno rozpustitelné a z dutiny ústní se přímo resorbující tablety mimo jiné nesmírně napomáhají adherenci k léčbě. Vyžadují však jistou osobní disciplínu a odpovědnost za vedení léčby.

The text offers an up-to-date view of allergen immunotherapy (AIT) as a method of very effective induction of tolerance to aeroallergens of mites, pollens and venom of white-winged insects. It has an effect not only on the alleviation or disappearance of rhinoconjunctivitis symptoms, but it pervasively reduces the risk of asthma development or alleviates its manifestations. In the case of allergy to the venom of white-winged animals (wasp and bee), it can very effectively prevent anaphylaxis, which is a life-threatening allergy. Awareness of internists about the current options of modern galenic forms of AIT is important and highly desirable for early indication and referral to specialists, as pharmacotherapy only addresses the effect not the cause. Conversely, AIT also has a disease-modifying effect but needs to be administered for at least three years. It is suitable in indicated cases for children over 5 years and for adults up to 65 years. Among other things, the new easily dissolvable tablets, which are directly resorbable from the oral cavity, help enormously with adherence to treatment. However, they require some personal discipline and responsibility for treatment management.

• MeSH
• Administration, Sublingual MeSH
• Asthma therapy   MeSH
• Desensitization, Immunologic * methods   MeSH
• Humans MeSH
• Food Hypersensitivity therapy   MeSH
• Check Tag
• Humans MeSH

Obor imunologie prochází v posledních desetiletích velmi výrazným vývojem, který se odrazil zvláště v počátku tohoto tisíciletí ve významných pokrocích v porozumění imunitnímu systému a v uplatnění těchto znalostí v praxi. Nečekaný pokrok a zrychlení výzkumů a pokroků na poli imunologie způsobil nečekaný nástup pandemie onemocnění covid-19 v roce 2020. Intenzivní vědecká práce vedla nejenom k rozvoji našeho porozumění imunitní odpovědi vůči virům, ale i k rychlé konverzi těchto znalostí do praktického zvládání pandemie ve světovém měřítku, jak je patrné na příkladu rychlého vývoje vakcín proti viru SARS‐CoV-2. Doba pandemie dále přispěla ke zrychlení aplikace nejenom biologických objevů, ale i technologických přístupů, jako jsou možnosti matematických a technických věd, informatiky a nově i umělé inteligence, které výrazně posouvají celé odvětví. V tomto sdělení přinášíme konkrétní pokroky v jednotlivých oblastech imunopatologických stavů, jimiž jsou hlavně alergie, imunodeficience, imunita a infekce, očkování, autoimunitní onemocnění a imunologie nádorových onemocnění.

The field of immunology has undergone a very significant development in recent decades, which has been reflected especially in the beginning of this millennium in significant advances in the understanding of the immune system and in the application of this knowledge in practice. The progress and acceleration of research and advances in the field of immunology was further prompt by the unexpected onset of the COVID-19 pandemic in 2020. The intense scientific work has not only led to the development of our understanding of the immune response to viruses, but also to the rapid conversion of this knowledge into practical pandemic management on a global scale, as exemplified by the development of vaccines against SARS-Cov-2 virus. The pandemic era has further contributed to the acceleration of the application of not only biological discoveries but also technological approaches into practical applications, such as use of advanced mathematics, computer science and, more recently, artificial intelligence which are all are adding to the advances that are significantly moving the field of immunology forward. In this communication, we present specific advances in particular areas of immunopathology, which are mainly allergy, immunodeficiency, immunity and infection, vaccination, autoimmune diseases and cancer immunology.

• MeSH
• Hypersensitivity * drug therapy   MeSH
• Autoimmune Diseases MeSH
• Humans MeSH
• Immunologic Deficiency Syndromes * diagnosis   MeSH
• Vaccination trends   MeSH
• Check Tag
• Humans MeSH

Lokální alergická rýma je definována klinickou symptomatologií alergické rýmy při současné negativitě kožních prick testů a sérového specifického IgE. Za kauzální alergeny jsou v současné době považovány především roztoči domácího prachu, pyly trav a pyly olivovníku. Pacienti mohou být součástí heterogenní skupiny nemocných s non alergickou rýmou. Nosní provokační test specifickým alergenem je nejdůle- non alergickou rýmou. Nosní provokační test specifickým alergenem je nejdůle-non alergickou rýmou. Nosní provokační test specifickým alergenem je nejdůle-žitějším diagnostickým nástrojem. Lokální alergická rýma je klinická entita s přirozeným průběhem směrem ke zhoršování symptomů a nízkým procentem přeměny na alergickou rýmu se systémovými projevy atopie. Lokalizovaná alergická reakce s lokální produkcí specifického IgE při absenci systémových projevů se označuje jako entopie.

Local allergic rhinitis is characterised by clinical symptoms similar to allergic rhinitis with the concomitant negativity of skin prick tests and the serum specific IgE. House dust mites, grass pollen and olive tree pollen are nowadays considered as major culprit allergens. The patients may be part of the group of non-allergic rhinitis sick persons. Nasal provocation test with specific allergen is the most important diagnostic tool. Local allergic rhinitis is a clinical entity with the natural tendency towards worsening of symptoms and the low percentage of conversion to systemic atopy. Entopy is the term for localized allergic reaction and local specific IgE production in the absence of systemic atopy.

• Keywords
• lokální alergická rýma,
• MeSH
• Allergens MeSH
• Rhinitis, Allergic * diagnosis   epidemiology   physiopathology   MeSH
• Anti-Allergic Agents therapeutic use   MeSH
• Bronchial Hyperreactivity complications   MeSH
• Bronchial Provocation Tests methods   MeSH
• Dermatophagoides pteronyssinus MeSH
• Humans MeSH
• Nasal Provocation Tests methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Due to the functional inactivation of the gene encoding for the enzyme that is involved in the oligosaccharide galactose-α-1,3-galactose (α-Gal) synthesis, humans and Old-World primates are able to produce a large amount of antibodies against the glycan epitope. Apart from being involved in the hyperacute organ rejection in humans, anti-α-Gal antibodies have shown a protective effect against some pathogenic agents and an implication in the recently recognized tick-induced mammalian meat allergy. Conversely, non-primate mammals, including dogs, have the ability to synthetize α-Gal and, thus, their immune system is not expected to naturally generate the antibodies toward this self-antigen molecule. However, in the current study, we detected specific IgG, IgM, and IgE antibodies to α-Gal in sera of clinically healthy dogs by an indirect enzyme-linked immunosorbent assay (ELISA) for the first time. Furthermore, in a tick infestation experiment, we showed that bites of Ixodes ricinus induce the immune response to α-Gal in dogs and that the resulting antibodies (IgM) might be protective against Anaplasma phagocytophilum. These findings may help lead to a better understanding of the underlying mechanisms involved in mammalian meat allergy and tick-host-pathogen interactions, but they also open up the question about the possibility that dogs could develop an allergy to mammalian meat after tick bites, similar to that in humans.

• Publication type
• Journal Article MeSH

Introduction: Subcutaneously administered immunoglobulin (SCIG) is increasingly used to treat patients with primary immunodeficiencies (PIDs). Octanorm (marketed as cutaquig® in USA and Canada) is a new 16.5% solution of human SCIG, manufactured by a process based on that of the intravenous preparation (IVIG) octagam®. Objectives: To investigate the efficacy, safety and tolerability of octanorm in a prospective, open-label, single-arm phase 3 study involving adult and pediatric patients with PIDs (NCT01888484; clinicaltrials.gov/ct2/show/NCT01888484). Methods: Patients who were previously treated with IVIG received a total of 64 weekly SCIG infusions, including 12 weekly infusions during the wash-in/wash-out period, followed by 52 weekly infusions during the evaluation period. Results: A total of 61 patients aged 2-73 years received 3,497 infusions of octanorm. The mean dose per patient was 0.175 g/kg/infusion. The mean calculated dose conversion factor from the patients' previous IVIG dose for octanorm was 1.37. No serious bacterial infections developed during the study. The rate of other infections per person-year during the primary observation period was 3.43 (upper 95% CI 4.57). All but one non-bacterial infection were mild or moderate in intensity. IgG trough levels were constant during the course of the study. Eleven patients (18.0%) experienced 14 mild or moderate systemic adverse events (AEs) related to octanorm. The rate of related AEs per infusion was 0.004. In 76.7% of infusions, no infusion site reactions were observed and only two (0.3%) reactions were deemed severe. The incidence of site reactions decreased with successive infusions. Conclusion: The new 16.5% SCIG octanorm was shown to be efficacious in preventing infections in PIDs, and was well tolerated.

• MeSH
• Child MeSH
• Adult MeSH
• Immunoglobulin G administration & dosage   blood   MeSH
• Immunoglobulins, Intravenous administration & dosage   pharmacokinetics   therapeutic use   MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Immunization, Passive * methods   MeSH
• Child, Preschool MeSH
• Aged MeSH
• Infusions, Subcutaneous MeSH
• Immunologic Deficiency Syndromes drug therapy   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Child, Preschool MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Case Reports MeSH
• Research Support, Non-U.S. Gov't MeSH

• MeSH
• Immunity MeSH
• Immune System physiology   physiopathology   MeSH
• Immunotherapy MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• alergologie a imunologie
• biologie
• fyziologie
• NML Publication type
• kolektivní monografie

Alergické choroby dnes postihujú čoraz viac ľudí a predstavujú špecifickú skupinu pacientov vo vzťahu k očkovaniu. Na základe viacerých štúdií bolo dokázané, že očkovanie vo všeobecnosti nezvyšuje riziko vzniku alergických chorôb a zároveň nepredstavuje rizikový faktor vo vzťahu k exacerbáciám základného alergického ochorenia. Naopak očkovanie vybranými vakcínami môže predstavovať protektívny faktor pred rozvojom alergií. Alergické reakcie po očkovaní sú relatívne zriedkavé, a to najmä systémové formy. Alergické reakcie po očkovaní sú najčastejšie vyvolané prídavnými látkami vo vakcínach (najmä želatína, antibiotiká, zriedkavo vaječné proteíny). Výskyt systémových anafylaktických reakcií po očkovaní, ktoré sú považované za jedinú univerzálnu kontraindikáciu ďalšieho očkovania danou konkrétnou vakcínou, je veľmi nízky, pričom aj u týchto pacientov ide väčšinou o kontraindikáciu relatívnu. Odhadovaná frekvencia anafylaktických reakcií po podaní vakcín je 0,65-1 prípad na 1 milión podaných dávok. Nevyhnutný je adekvátny prístup a reálne zhodnotenie alergického pôvodu, pretože pri nesprávnej interpretácii vzniknutej reakcie dochádza k stanoveniu falošnej trvalej kontraindikácie a zastaveniu ďalšieho očkovania. Očkovanie predstavuje zároveň aj významnú súčasť manažmentu pacientov s rôznymi formami alergických chorôb, a to najmä vzhľadom na prevenciu rôznych infekčných ochorení, ktoré môžu viesť k exacerbácii základného alergického ochorenia či zhoršenia jeho priebehu. Na druhej strane rôzne formy alergií nepredstavujú zásadné obmedzenia pre očkovanie jednotlivými vakcínami. Väčšina pacientov alergických na vaječné proteíny môže byť očkovaná vakcínami aj s obsahom vaječných proteínov, pričom opatrnosť je potrebná len u pacientov s anafylaktickými reakciami po vaječných proteínoch alebo po predchádzajúcej dávke danej vakcíny.

Allergic diseases affect more and more people and represent an important specific group of patients in relationship with vaccination. Based on the studies' results, it can be generally assumed that the vaccination in general does not increase the risk of allergic diseases development and does not represent a risk factor for exacerbations of allergic disease. Conversely, the vaccination with selected vaccines could present a protective factor against the allergies development. Allergic reactions after the vaccination are relatively rare, especially systemic reactions. Allergic reactions to vaccines are usually provoked by adjuvant substances presented in vaccines (especially gelatine, antibiotics; rarely egg proteins). Incidence of systemic anaphylactic reactions after the vaccination, which are considered to be the only universal contraindications for further vaccinations with concrete particular vaccine, is usually very low and also in these patients, is could be considered to be only relative contraindication. Expected frequency of anaphylactic reactions after vaccine application is 0.65 to 1 cases per 1 million of applied doses. It is essential to provide an adequate approach and realistic evaluation of allergic origin of observed reaction, because due to incorrect interpretation of reaction, the false contraindication is established and the further vaccination is wrongly stopped. Vaccination presents also an important part of the management of the patients with various forms of allergies, especially for prevention of infections, which can cause the exacerbations of allergic disease or the worsening of its course. On the other hand, different forms of allergies usually do not represent an important limitations for vaccination with particular vaccines. The majority of the patients with egg allergy can be vaccinated also with the vaccines with egg protein content, however, a special cautions should be given to the patients with history of anaphylactic reactions after egg exposure or previous egg protein-containing vaccine application.

• Keywords
• Imunitně podmíněné reakce na vakcíny a jejich složky,
• MeSH
• Hypersensitivity * complications   prevention & control   MeSH
• Anaphylaxis etiology   complications   prevention & control   MeSH
• Immunization * contraindications   methods   utilization   MeSH
• Humans MeSH
• Immune System Diseases * immunology   complications   MeSH
• General Practitioners MeSH
• Practice Guidelines as Topic MeSH
• Vaccination contraindications   adverse effects   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

• MeSH
• Immunity MeSH
• Immune System MeSH
• Immunotherapy MeSH
• Publication type
• Monograph MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• alergologie a imunologie
• biologie

The objective of this study was to analyze the mechanisms by which exposure to ambient air pollutants influences respiratory health may include altered prenatal immune development. To analyze associations between elevated cord serum Immunoglobulin E (IgE) levels and maternal air pollution exposure during each month of gestation. Total cord serum IgE was determined by the CAP system and mothers' total IgE levels by nephelometry for 459 births in the Czech Republic from May 1994 to mid-January 1997. Concentrations of polycyclic aromatic hydrocarbons (PAHs) and particulate matter <2.5 microns in diameter (PM(2.5) ) were measured in ambient air, and arithmetic means were calculated for each gestational month. Log binomial regression models were used to estimate prevalence ratios (PR) for elevated cord serum IgE (≥0.9 IU/ml) adjusting for district of residence, year of birth, and in further models, for maternal IgE (a surrogate for atopy) and gestational season. Heterogeneity by maternal atopy status was evaluated for associations of air pollution and of cigarette smoke. In adjusted models, PAH and PM(2.5) exposures in the second month of gestation were each associated with a lower prevalence of elevated cord serum IgE. For an average increase of 100 ng/m(3) of PAHs, the PR was 0.69 (95% confidence interval (CI): 0.50, 0.95); for 25 μg/m(3) increase in PM(2.5) , the PR was 0.77 (95% CI: 0.55, 1.07). Conversely, exposures later in gestation were associated with a higher prevalence of elevated cord IgE: in the fifth month, the PR for PAH exposure was 1.64 (95% CI: 1.29, 2.08), while for PM(2.5) in the sixth month, it was 1.66 (95% CI: 1.30, 2.13). In analyses stratified by maternal atopy, air pollutants were associated with altered cord serum IgE only among neonates with non-atopic mothers. Similarly, an association of cigarette smoke with elevated cord serum IgE was found only in non-atopic mothers. PAHs and PM(2.5) , constituents of both ambient air pollution and cigarette smoke, appear to influence fetal immune development, particularly among infants whose mothers are not atopic.

• MeSH
• Adult MeSH
• Fetal Blood immunology   MeSH
• Gestational Age * MeSH
• Immunoglobulin E blood   MeSH
• Smoking adverse effects   MeSH
• Air Pollutants adverse effects   MeSH
• Humans MeSH
• Young Adult MeSH
• Infant, Newborn MeSH
• Particulate Matter adverse effects   MeSH
• Polycyclic Aromatic Hydrocarbons adverse effects   MeSH
• Pregnancy MeSH
• Environmental Exposure MeSH
• Air Pollution adverse effects   MeSH
• Prenatal Exposure Delayed Effects immunology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Infant, Newborn MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH