| 1. |
- Ainamo, Antti, 1963-, et al.
(författare)
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Progress in the treatment and outcome of pediatric inflammatory bowel disease patients
- 2016
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Ingår i: Expert Review of Clinical Immunology. - Borås / Helsinki : Taylor & Francis. - 1744-666X .- 1744-8409. ; , s. 1-33
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Forskningsöversikt (refereegranskat)abstract
- This review discusses how treatment of pediatric inflammatory bowel disease (IBD) patients has improved with attention to therapeutic quality and cost. The number of such patients in Western countries has increased rapidly. Similarly to what has been the trend in the management of adult IBD, the pediatric IBD therapy has become more active than earlier. High use of immunosuppressants has helped to control the extensive and aggressive course of pediatric IBD. Full disease control already at an early phase has advantages such as to preserve normal child growth and development, to maintain overall good health and quality of life, as well as to decrease the psychosocial burden of the disease. A key research direction is to develop the more active approach into a way to reduce healthcare costs by decreasing the so-far high rate of surgery of pediatric IBD patients.
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| 2. |
- Mincheva-Nilsson, Lucia, 1951-
(författare)
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Immune cells and molecules in pregnancy : friends or foes to the fetus?
- 2006
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Ingår i: Expert Review of Clinical Immunology. - : Future Drugs LTD. - 1744-666X .- 1744-8409. ; 2:3, s. 457-470
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Forskningsöversikt (refereegranskat)abstract
- Considering the allograft rejection as a basic feature of the immune system, the mammalian pregnancy is an immunologic paradox where the semiallogeneic fetus is not rejected. How are the demands of pregnancy solved in the context of the maternal immunity? Medawar`s original proposal of maternal immune inertness during pregnancy should be revised to active materno-placental tolerance. Multiple mechanisms are involved in the peripheral and local tolerance induction that prevents fetal rejection while maintaining competent immune surveillance and protection. The goal of this review is to discuss the major cellular and molecular components of the immune system during pregnancy that control and promote fetal survival.
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| 3. |
- West, Christina E., et al.
(författare)
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Probiotics for treatment and primary prevention of allergic diseases and asthma : looking back and moving forward
- 2016
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Ingår i: Expert Review of Clinical Immunology. - : Taylor & Francis. - 1744-666X .- 1744-8409. ; 12:6, s. 625-639
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Forskningsöversikt (refereegranskat)abstract
- Microbial ecosystems cover the surface of the human body and it is becoming increasingly clear that our modern environment has profound effects on microbial composition and diversity. A dysbiotic gut microbiota has been associated with allergic diseases and asthma in cross-sectional and observational studies. In an attempt to restore this dysbiosis, probiotics have been evaluated in randomized controlled trials. Here, we review treatment and primary prevention studies, recent meta-analyses, and discuss the current understanding of the role of probiotics in this context. Many meta-analyses have shown a moderate benefit of probiotics for eczema prevention, whereas there is less evidence of a benefit for other allergic manifestations. Because of very low quality evidence and heterogeneity between studies, specific advice on the most effective regimens cannot yet be given -not even for eczema prevention. To be able to adopt results into specific recommendations, international expert organizations stress the need for well-designed studies.
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| 4. |
- Brito-Zerón, Pilar, et al.
(författare)
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Early diagnosis of primary Sjögren's syndrome: EULAR-SS task force clinical recommendations.
- 2016
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Ingår i: Expert Review of Clinical Immunology. - 1744-8409. ; 12:2, s. 137-156
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Forskningsöversikt (refereegranskat)abstract
- Sjögren's syndrome (SjS) is a systemic autoimmune disease that mainly affects the exocrine glands, leading to generalized mucosal dryness. However, primary SjS may initially present with non-sicca (systemic) manifestations. When these features appear before the onset of an overt sicca syndrome, we may talk of an underlying 'occult' SjS. The European League Against Rheumatism (EULAR) has promoted and supported an international collaborative study group (EULAR-SS Task Force) aimed at developing consensual recommendations to provide a homogeneous approach to the patient with primary SjS presenting with systemic involvement. This review summarizes the key factors that should be taken into account in the diagnostic approach in a patient with suspected SjS according to the main clinical patterns of presentation, and is especially focused on organ-specific systemic disease presentations, including a consensus set of recommendations in order to reach an early diagnosis. Close collaboration with the different specialties involved through a comprehensive multidisciplinary approach is essential in SjS patients presenting with systemic involvements.
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| 5. |
- Diamant, Zuzana, et al.
(författare)
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Montelukast in the treatment of asthma and beyond
- 2009
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Ingår i: Expert Review of Clinical Immunology. - 1744-8409. ; 5:6, s. 639-658
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Forskningsöversikt (refereegranskat)abstract
- Asthma is a chronic inflammatory disease affecting over 300 million people worldwide. The common association with allergic rhinitis and the presence of proinflammatory cells and mediators in the circulation of patients qualify asthma as a systemic disease. This characteristic and the fact that the gold-standard therapy for persistent asthma, inhaled corticosteroids, cannot suppress all components of airway inflammation and fail to adequately penetrate into the small airways, warrant the quest for effective systemic anti-asthma therapies. This review describes the most important controlled studies of montelukast, a once-daily leukotriene receptor antagonist, in asthma and allergic rhinitis in both adults and children. Montelukast is a systemically active drug with a targeted, dual mechanism of action, acting both as a bronchodilator and anti-inflammatory. In patients of all ages, montelukast has shown a favorable safety profile and was well-tolerated. Both as monotherapy or in combination with inhaled corticosteroids, montelukast produced clinically relevant improvements in asthma-related parameters, including symptoms, lung function parameters, quality of life and the number of asthma exacerbations. Furthermore, bronchoprotective effects have been reported both against specific and nonspecific bronchoactive stimuli. Similarly, in patients with allergic rhinitis, montelukast produced substantial improvements in symptoms and quality of life. Long-term studies aimed to determine its effects on airway remodeling are still lacking.
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