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1. After intranasal administration of sodium dodecyl sulfate, which epithelial cell-derived activator is found to be increased in the lungs by qPCR and ELISA? Look for the answer in the original article by Saito and colleagues.
2. Exposure to high levels of particulate matter with aerodynamic diameters ≤2.5 micrometers (PM2.5) in children increases the frequency of which monocyte population? Check the answer by reading the original article by Movassagh and colleagues.
3. According to the recent EAACI position paper published on Allergy related to digital biomarkers for allergic respiratory diseases and asthma, select one that is not a strength of digital biomarkers:
4. Among the novel therapies for food allergy, how many cases of anaphylaxis are estimated to occur during the administration of epicutaneous immunotherapy (EPIT). Access the data by reading the comprehensive review by Anasnostou et al. on “The future of food allergy: Challenging existing paradigms of clinical practice”.
5. Pharmacologic strategies currently approved for Allergic Rhinitis target immune cells and mediator molecules involved in allergic inflammation. Which is the mechanism of action of LRAs? Look for the answer in the original article by Luo Zhang and colleagues.
6. In Allergic Rhinitis animal model, Mesenchymal Stem Cells (MSCs) effectively decreased the number of sneezes and nose rubbing and alleviated local inflammation in the nasal mucosa. Which are the MSCs immunomodulatory effects mainly detected? Check the answer by reading the original article by Luo Zhang and colleagues.
7. Oral prednisone improves the inflammatory process caused by diphencyprone (DPCP) in delayed-type hypersensitivity reactions (DTH), as it showed a decrease in the International Contact Dermatitis Research Group (ICDRG) score and secondary hypersensitivity reaction (SHR) diameter compared to the placebo group. Related to this, what specific T-cell subpopulation seem to be involved in this improvement? You can find the answer by reading the original article by Mehta and colleagues.
8. Atopic dermatitis (AD) can initiate during childhood (pediatric-onset AD, POAD) or during adulthood (adult-onset AD, AOAD). Identifying the specific characteristics of each AD based on age of onset may be essential for the management of the disease, guiding specific therapeutic strategies. Compared to AOAD, which specific pathway is enriched in POAD-injured skin? You can find the correct answer by reading the original article by Facheris and colleagues.
9. Atopic dermatitis (AD) is a chronic inflammatory disease characterised by a complex pathogenesis and heterogeneous immune mechanisms. This makes it difficult to identify specific biomarkers, as well as to correctly treat and monitor AD patients. It is therefore important to better understand the immunological mechanisms of the disease. Among the mediators involved, CCL19 may represent a key molecule for the trafficking of different immune cells, such as dendritic cells or T cells, through the interaction with CCR7, in the leukocyte-infiltrated area lesions. In relation to CCL19, which specific cells are the most potent sources of CCL19 in leukocyte-infiltrated areas of lesioned skin in AD patients? You can find the answer by reading the original article by Mitatura and colleagues by clicking here.
10. Asthma induced by allergen exposure is mainly mediated by Th2 cells with recruitment and involvement of other immune cells into the lungs such as neutrophils or eosinophils. Anti-CD3 has been shown to be effective in reducing the activity of immune cells in different diseases. Therefore, anti-CD3 could also be used to reduce lung inflammation from initial exacerbation and re-challenges with house dust mite (DHM) undergoing several asthma exacerbations. Which specific immune cells were reduced in bronchoalveolar lavage fluid (BALF) after treatment with anti-CD3 (F(ab′)2 fragment) during exposure to DHM and blocking exacerbations of asthmatic inflammation? Find the correct answer by reading the original article by Sethi and colleagues by clicking here.
11. Food emulsifiers, such as polysorbate 20 (P20, E432) and polysorbate 80 (P80, E433) can compromise the integrity of the intestinal barrier. In relation to this, which specific genes involved in cytokine-cytokine interaction are significantly upregulated in response to both P20 and P80 in monolayer cultured Caco-2-cells? You can find the correct answer by reading the original article by Ogulur and colleagues.
12. Eosinophilic esophagitis (EoE) is a chronic inflammatory disease in response to food antigens. Janarthanam and colleagues studied the clonality of T-cell receptors (TCRs) from adults and children with active and non-active EoE and from healthy donors. Which of the following statements is correct? You can find the correct answer by reading the original article.
13. Locke and colleagues reviewed updates on the latest developments and highlights in food allergy. They nicely summarised the latest advances in the factors involved in the development of food allergy and natural tolerance, as well as new findings related to the epithelial barrier, the effect of emollient interventions and the immune mechanisms involved. Moreover, they evaluated novel immunotherapy strategies and the clinical management of food allergy. In relation to food allergen immunotherapy (AIT), what factors increase the risk of side effects during food AIT? Find the correct answer by reading the original article.
14. Bastin and colleagues analysed the potential predictive serological biomarkers in response to epicutaneous immunotherapy (EPIT) with investigational Viaskin™ peanut 250ug (DBV712). After 12 months of treatment, which unique biomarker reported the best value for predicting the peanut protein eliciting dose (ED) with both ≥ 300 mg and ≥ 1000 mg? Find the correct answer by reading the original article.
15. Related to food allergy/sensitization estimated prevalence in Europe in the past decade compared to the previous decade, which are the major changes in the past 10 years? Check the answer by reading the original article by Spolidoro and colleagues.
16. In difficult-to-treat asthma, specific “non- airway- centric profiles” have been identified. Which of the following features are characterized in specific “non- airway- centric profiles”? Look for the answer in the original article by Lin and colleagues.
17. De novo synthesis of Synthetic glucocorticoid (GC) occurs in murine lung. In which part specifically? Check the answer by reading the original article by Merk and colleagues.
18. To improve care for Ukrainian refugees with allergies and skin diseases, UCRAID (Ukrainian Citizen and refugee electronic support in Respiratory diseases, Allergy, Immunology and Dermatology) has been launched, which aims to provide solutions to different communication problems between them and health professionals. Among the expected benefits of UCRAID, which of the following is not true? Check the answer by reading the review article by Bousquet and colleagues.
19. To improve care for Ukrainian refugees with allergies and skin diseases, UCRAID (Ukrainian Citizen and refugee electronic support in Respiratory diseases, Allergy, Immunology and Dermatology) has been launched, which aims to provide solutions to different communication problems between them and health professionals. Among the expected benefits of UCRAID, which of the following is not true? Check the answer by reading the review article by Bousquet and colleagues.
20. Drugs can interact with immune receptors in many different ways, and drug hypersensitivity reactions (DHRs) can be explained by the Hapten hypothesis and/or the p-i concept. An important feature of delayed-onset DHRs is characterized by the presence of eosinophilia, in approximately 50% of DHRs. In a recent review, eosinophilia in drug hypersensitivity (EOS-DH) has been linked to an “aberrant” TCR signalosome due to p-i stimulation resulting in high IL-5 production. Compared to drug hypersensitivity without eosinophilia, which of the following statements is not true regarding drug hypersensitivity and eosinophilia? Check the answer by reading the review article by Pichler and colleagues.
21. It is estimated that the healthcare sector contributes to approximately 4.4% to 10% of total greenhouse gas emissions, with a significant impact on the consumption of resources, such as consumables, water and electricity, which directly and indirectly impact on people’s health. To reduce their impact, different alternatives can be implemented from a One Health perspective. The use of inhalers to treat chronic respiratory diseases such as asthma or COPD has an important impact on carbon emission. Converting metered-dose inhalers (MDI) to dry-powder inhalers (PDI) could reduce the CO2 emitted into the atmosphere. How many kg of CO2e per year and patient would this strategy be estimated to save? Check the answer by reading the review article by Pali-Schöll and colleagues.
22. Although not yet applicable to the field of allergy, medical applications using artificial intelligence and machine learning appear to be relevant in the near future of clinical practice. Specifically, applications of artificial intelligence could be important for clinical research, such as diagnosis of allergic diseases, prediction of asthma exacerbations, hospitalizations, and disease management; fundamental research: heterogeneity and endotype discovery, pathways, and disease mechanisms; and drug and therapy development and precision medicine: treatment response and drug repurposing. Nevertheless, to create a reliable model, a structured modelling process is needed. Based on this, which of the following workflows is correct for developing a supervised machine learning model for disease risk? Check the answer by reading the review article by van Breugel and colleagues.
23. The COVID-19 pandemic caused by SARS-CoV-2 affects more than 700 million people and causes nearly 7 million deaths. Most people are asymptomatic or have mild symptoms, but some develop severe disease, although the pathophysiological mechanism driving this condition is not fully understood. It has been suggested that an impaired epithelial barrier function may increase the susceptibility to COVID-19 infection or even aggravate the inflammatory process. The original article by Yazici and colleagues sheds light on potential serum biomarkers, both related to inflammation and barrier damage, that may predict disease severity and progression. Among all the serum biomarkers analyzed, which pair is associated with both the degree of severity on hospital admission and disease progression?
24. Chronic rhinosinusitis (CRS) and asthma often co-exist, although there are no data to determine whether CRS is a risk factor for the development of asthma. The original article by Schwartz and colleagues analyzed the relationship between people with previous CRS and the risk developing new-onset asthma. In relation to this, which specific CRS variable was associated with an increased risk to develop new-onset asthma in the following year? Check the correct answer by reading the article
25. Chronic rhinosinusitis with nasal polyps (CRSwNP) affects the quality of life of patients, and although dupilumab treatment has been shown to be effective in clinical trials, it has never been studied in real-life clinical practice. De Corso and colleagues therefore conducted a phase IV real-life, observational, retrospective, and multicenter study to determine the real benefit of Dupilumab treatment for CRSwNP. Related to this, and following the EPOS 2020 criteria at month 12, how many patients were excellent responders to the treatment? Check the correct answer by reading the article
26. A better understanding of the pathogenic pathways (endotypes) of allergic diseases allows a more detailed description of the diseases, being necessary the development of an updated nomenclature, from a pathomechanistic approach to a more established network of immunological and metabolic pathways, described by different biomarkers. Therefore, a new nomenclature is needed to better understand the aetiology, mechanism, prevention, diagnosis, and treatment of allergic diseases and hypersensitivity reactions. The recent EAACI position paper led by Marek Jutel, Ioana Agache, Cezmi Akdis and Beatrice Bilò provides a modern and updated nomenclature for allergic diseases. According to this new nomenclature, which specific cell subsets are mainly involved in type IVc (T3 immune response)? Check the correct answer by reading the article
27. Allergic asthma is one of the most common asthma phenotypes, from which asthmatic patients may benefit from allergen immunotherapy (AIT). Although AIT has been shown to provide long-term clinical benefits after the stop of the treatment, it remains unclear how to interpret the outcomes of AIT, especially in terms of asthma control. Different clinically applicable outcomes such as exacerbations, use of inhaled corticosteroids, symptom medication score, questionnaires, lung function evaluation, or biomarkers can be used to quantify this. Applicable to questionnaires (patient-reported outcome measures), which of the following is not correct? You can check the correct answer by reading the position paper by Kappen and colleagues.
28. Intestinal helminths appear to elicit potential benefits to human hosts by reducing the risk of allergy and autoimmune diseases, as demonstrated in several epidemiological, preclinical, and clinical studies. Such a protective role seems to be related to the alteration of the intestinal mucus layer, its benefit in the human microbiome, increased epithelial permeability and microbial translocation. In relation to the intestinal barrier, IL-13 is a key cytokine that exerts an important influence on mucus response during helminth infections. Based on this, which of the following is correct? You can check the correct answer by reading the review article by Mules and colleagues.
29. Dupilumab is a monoclonal antibody that blocks the IL-4/IL-13 receptor and has demonstrated effective in reducing severe asthma exacerbations, improving asthma control and lung function in patients with type 2 asthma. Nevertheless, its long-term impact in patients with moderate to severe asthma receiving high or medium doses of inhaled corticosteroids (ICs) remains unknown. In the TRAVERSE extension study, the improvement of different parameters such as exacerbation rate, asthma control questionnaires (ACQ-5 scores), ACQ-5 responder analysis, blood eosinophil counts, serum total IgE, or pre-bronchodilator FEV1 has been analysed. In relation to the latter, from what week after the start of the TRAVERSE study has an improvement in the pre-BD FEV1 been demonstrated in patients with both high- and medium-dose ICS? Check the correct answer by reading the original article by Pavord and colleagues.
30. Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by intensely pruritic, recurrent eczematous lesions of relapsing course. AD is mainly driven by type-2 cytokines such as IL-4 and IL-13. Nevertheless, although both cytokines share many overlapping effector functions, some studies suggest that IL-13 rather than IL-4, is the dominant cytokine involved in AD. Therefore, Tralokinumab, a fully human IgG4 monoclonal antibody that specifically neutralizes IL-13, has been evaluated for the treatment of AD of different severities. Which of the following is not correct regarding the administration of Tralokinumab for the treatment of AD? Check the correct answer by reading the review by Simpson and colleagues.
31. Severe asthma is a heterogeneous disease characterized by different clinical and molecular phenotypes. Among them, the neutrophilic inflammatory phenotype is characterized by type-1 inflammatory pathways with sputum neutrophilia, while the eosinophilic phenotype is mainly characterized by type-2 inflammation. Due to the influence of the microbiome and its contribution to inflammation, it is important to characterize the airway composition and abundance of microbial species in asthmatic patients with different severities and phenotypes. In relation to this, which bacterial species is increased in eosinophilic asthma, mainly related to severe asthmatic patients who are smokers and ex-smokers? Check the correct answer by reading the original article by Versi and colleagues.
32. Food allergy is a major health problem, and its prevalence is increasing in recent decades. Therefore, a correct allergy diagnosis has a very important impact on patients' lives. The EAACI guideline on the diagnosis of IgE-mediated food allergy aims to provide guidance to healthcare professionals, focusing mainly on the clinical management of IgE-mediated food allergy. According to the meta-analysis performed in the guideline, what is the mean sensitivity and specificity of the determination of sIgE to the Ara h2 component? Check the correct answer by reading the EAACI guideline by Alexandra Santos and colleagues
33. Eosinophils perform a wide range of biological activities, from the maintenance of health and homeostasis to the triggering of different diseases, thus being an important target cell population for the development of new therapies. In relation to eosinophils is asthmatic patients, which of the following statements is correct about the use of the monoclonal antibody Anti-IL-5R (benraluzumab)? Check the correct answer by reading the comprehensive review by Jesenak and colleagues.
34. Although IgE is the rarest isotype, its role as a key mediator in allergy and related diseases is clear. Although significant progress has been made in recent decades, several questions remain to be addressed about the mechanisms involved in cellular IgE response. In relation to IgE production, which combination of cytokines enhances IgE production? Check the correct answer by reading the review by Zhoujie Ding and colleagues
35. Autoimmunity is defined as the break of tolerance to self-antigens that causes organ-specific or systemic diseases. Some of them are characterized by the presence of autoreactive antibodies (AAb). Among all isotypes, IgG AAb are mostly pathogenic, but in recent years, the presence of IgE-AAb has also been linked to different autoimmune diseases, thus representing a potential therapeutic target for some autoimmune diseases. In relation to systemic lupus erythematosus, what is the estimated prevalence of autoreactive IgE against antinuclear antibodies? Check the correct answer by reading the review by Nicolas Charles and colleagues.
36. Understanding the recognition of IgE and IgG antibodies to different epitopes of pollen allergens such as Bet v 1 in sensitised and non-sensitised subjects is essential to better understand the immunological process during an allergic reaction, but also because it sheds light on the effect of allergen-specific immunotherapy. Related to this, which Bet v 1 epitope is preferentially recognised by specific IgG1 and IgG4 from birch pollen allergic patients? Check the correct answer by reading the original article by Brazhnikov and colleagues.
37. Two different subsets of circulating eosinophils can be distinguished based on the expression of surface markers such as CD62L, with inflammatory eosinophils (iEOs) expressing CD62Llow. The two subsets of Eos play different roles during tissue homeostasis and during inflammation such as in type 2 (eosinophilic) asthma. In relation to circulating eosinophils and type 2 asthma, which of the following clinical scores for asthma and nasal polyps does not correlate with % CD62Llow eosinophils in blood? Check the correct answer by reading the original article by Alessandra Vultaggio and colleagues
38. Atopic dermatitis (AD) is a chronic recurrent inflammatory skin disease that usually begins in childhood with a lower prevalence in adults (around 2-8%). Autoimmune responses against self-peptides have been described in AD and other skin-related diseases such as chronic spontaneous urticaria, bullous pemphigoid, and lupus erythematous. Of patients with AD and atopic comorbidities (type-2 diseases) and age group between 18 and 40 years, what is the % of highly positive cases of IgE autoantibodies against human keratinocytes? Check the correct answer by reading the original article by Inge Kortekaas Krohn and colleagues