Natasha C. Gunawardana

Experimental rhinovirus infection in COPD: implications for antiviral therapies.

Abstract Chronic obstructive pulmonary disease (COPD) is a major public health problem and will be one of the leading global causes of mortality over the coming decades. Much of the morbidity, mortality and health care costs of COPD are attributable to acute exacerbations, the commonest causes of which are respiratory infections. Respiratory viruses are frequently detected in COPD exacerbations but direct proof of a causative relationship has been lacking. We have developed a model of COPD exacerbation using experimental rhinovirus infection in COPD patients and this has established a causative relationship between virus infection and exacerbations. In addition it has determined some of the molecular mechanisms linking virus infections to COPD exacerbations and identified potential new therapeutic targets. This new data should stimulate research into the role of antiviral agents as potential treatments for COPD exacerbations. Testing of antiviral agents has been hampered by the lack of a small animal model for rhinovirus infection and experimental rhinovirus infection in healthy volunteers has been used to test treatments for the common cold. Experimental rhinovirus infection in COPD subjects offers the prospect of a model that can be used to evaluate the effects of new treatments for virus-induced COPD exacerbations, and provide essential data that can be used in making decisions regarding large scale clinical trials.

Sesame allergy in adults: Investigation and outcomes of oral food challenges

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Biphasic activation of complement and fibrinolysis during the human nasal allergic response

Complement, coagulation and fibrinolysis contribute to the pathology of many respiratory diseases. Here we detail the biphasic activation of these pathways following nasal allergen challenge. Understanding these mechanisms may lead to therapeutic insight in common respiratory diseases.

Nutritional Management of Patients With Pollen Food Syndrome: Is There a Need?

Purpose of reviewPollen food syndrome (PFS) is a highly prevalent condition causing mild oropharyngeal reactions to plant foods due to recognition by pollen-specific antibodies. It is most frequent in adults, but it can also occur in children. This review aims to establish the pitfalls of diagnosis and the nutritional consequences, and whether individuals with PFS require an individualised dietary and nutritional management strategy.Recent findingsThe diagnosis of PFS can be made through history alone but is greatly enhanced by undertaking component-resolved diagnostic (CRD) tests to individual allergens in birch pollen and relevant foods. Management of PFS requires dietary avoidance of trigger foods, but often, many foods have to be avoided, which can affect quality of life and nutritional intake. Not all symptoms are mild, especially if concentrated forms of allergen are taken, which may occur more frequently with the increased emphasis of the health benefits of fruits and vegetables. Oral food challenge (OFC) and, in the future, novel immunotherapy may minimise necessary avoidance.SummaryDue to the high homology of the allergens involved, multiple allergy tests can result in mass exclusion of antioxidant-rich fruits and vegetables, which are important nutritional contributors to the diet. Thus, those with PFS should receive individual dietary counselling to prevent deficiency diseases, especially expectant mothers, children and those who are avoiding multiple foods.

The effects of house dust mite sublingual immunotherapy (SLIT)-tablet effects on immunological biomarkers and nasal allergen challenge symptoms

Summary SQ HDM SLIT-tablet significantly increased serum HDM-specific IgG 4 and IgE blocking factor, and significantly decreased early phase nasal symptoms after nasal allergen challenge. No significant effects on cytokines or gene expression in nasal mucosa were observed.

Letter to the EditorThe effects of house dust mite sublingual immunotherapy tablet on immunologic biomarkers and nasal allergen challenge symptoms

Summary SQ HDM SLIT-tablet significantly increased serum HDM-specific IgG 4 and IgE blocking factor, and significantly decreased early phase nasal symptoms after nasal allergen challenge. No significant effects on cytokines or gene expression in nasal mucosa were observed.

The effects of house dust mite sublingual immunotherapy tablet on immunologic biomarkers and nasal allergen challenge symptoms

Summary SQ HDM SLIT-tablet significantly increased serum HDM-specific IgG 4 and IgE blocking factor, and significantly decreased early phase nasal symptoms after nasal allergen challenge. No significant effects on cytokines or gene expression in nasal mucosa were observed.