Mullol, J. (J.)

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    Molecular diagnosis in Allergology: application of the microarray tecnique
    (Esmon, 2009) Sastre, J. (Joaquín); Davila, I. (I.); Mullol, J. (J.); Jauregui, I. (I.); Montoro, J. (J.); Sanz, M.L. (María Luisa); Ferrer-Cardona, M. (Marta); Valero-Santiago, A. (Antonio); Cuvillo, A. (A.) del
    Recombinant and purified allergens are currently available for determining specific IgE targeted to different allergenic components. In this way it is possible to diagnose the sensitization profile of each individual patient. The microarray technique makes it possible to determine specific IgE against multiple allergens simultaneously in one same patient, with a minimum amount of serum, and even allows the determination of IgG and IgM against the same allergens in one same serum sample. Microarray procedures are being developed not only for the determination of antibodies but also for cell activation tests. In addition, microarray technology will help explain cross-reactions, and will facilitate the evaluation of subjects in which skin tests cannot be performed. These techniques will allow a great step forward in the development of immunotherapy specifically targeted to the sensitizations found in each individual patient, yielding especially hypoallergenic forms of great immunogenic capacity, and thus improving the safety and efficacy of immunotherapy. Lastly, microarrays will improve our understanding of the physiopathology of allergic diseases.
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    Effect of antihistamine up-dosing in chronic urticaria
    (ESMON Publicidad, 2011) Sastre, J. (Joaquín); Davila, I. (I.); Bartra, J. (Joan); Mullol, J. (J.); Jauregui, I. (I.); Montoro, J. (J.); Ferrer-Cardona, M. (Marta); Valero-Santiago, A. (Antonio); Cuvillo, A. (A.) del
    Chronic urticaria has an important impact upon patient quality of life, and no treatment has yet been developed capable of effectively controlling the disease. The most recent guidelines recommend the use of non-sedating antihistamines at high doses as second-step therapy before resorting to other treatments. The present review examines the studies published to date on the use of H1 antihistamines at doses higher than those indicated as therapeutic doses in chronic urticaria. Most of the studies report no significant differences among the studied doses – only a tendency towards increased response on elevating the dose.There are no clinically well designed, randomized double-blind trials comparing efficacy between therapeutic doses and doses higher than those indicated in the corresponding Summary of Product Characteristics. Likewise, there are insufficient data to conduct a meta-analysis and thus classify the degree of evidence of the few available studies, which moreover present contradictory results. At present, the prescription of high-dose H1 antihistamines is based only on experts opinion. However, considering the high safety profile of these drugs, it would be a good option to evaluate their efficacy at high doses, before moving on to other therapeutic steps.
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    Management of eosinophil-associated inflammatory diseases: the importance of a multidisciplinary approach
    (2023) Pozo, V. (Victoria) del; Cosio, B.G. (Borja G.); España, A. (Agustín); Mullol, J. (J.); Blanco, R. (Ricardo); Quirce, S. (Santiago); Santander, C. (Cecilio)
    Elevated eosinophil counts in blood and tissue are a feature of many pathological processes. Eosinophils can migrate and accumulate in a wide variety of tissues and, by infiltrating a target organ, can mediate the development of several inflammatory diseases. The normalization of eosinophilia is a common biomarker of a treatable trait and can also be used as a prognostic and predictive biomarker since it implies a reduction in type 2 inflammation that contributes to disease pathogenesis. Biological therapies targeting this cell type and its proinflammatory mediators have been shown to be effective in the management of a number of eosinophilic diseases, and for this reason they constitute a potential common strategy in the treatment of patients with various multimorbidities that present with type 2 inflammation. Various biological options are available that could be used to simultaneously treat multiple target organs with a single drug, bearing in mind the need to offer personalized treatments under the umbrella of precision medicine in all patients with eosinophil-associated diseases (EADs). In addition to reviewing these issues, we also discuss a series of perspectives addressing the management of EAD patients from a multidisciplinary approach, with the collaboration of health professionals from different specialties who manage the different multimorbidities that frequently occur in these patients. We examine the basic principles of care that this multidisciplinary approach must cover and present a multidisciplinary expert opinion regarding the ideal management of patients with EADs, from diagnosis to therapeutic approach and follow-up.
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    Pheno-endotyping antrochoanal nasal polyposis
    (Springer Nature Link, 2023) Garaycochea, O. (Octavio); Rodríguez-Van-Strahlen, C. (Camilo); Alobid, I. ( Isam); Mullol, J. (J.)
    Antrochoanal polyps (ACPs) are benign polypoid lesions arising from the inner wall of the maxillary sinus and extending into the choana. Although the diagnosis and treatment strategies of ACP have changed since this entity was first described, the underlying pathogenic mechanism of APC is poorly understood. This article reviews the current knowledge of the etiology, inflammatory parameters, and microscopic findings of ACP.