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The development of sensitisation to SM could be secondary to occupational exposure rather than to cross-reaction.
Indeed, the latency period for the development of sensitisation to aeroallergens in professional bakers is short and longer for the occurrence of respiratory symptoms.
Further investigation into the mechanisms by which ATI negatively affect the efficacy of IFX and strategies to prevent the development of sensitisation are a research priority.
Restoring skin barrier function in filaggrin deficient people in early life may help prevent the development of sensitisation and halt the development and progression of allergic disease.
In favour of such a mechanism, Bønnelykke et al recently found a filaggrin-associated pattern of atopic diseases in early childhood characterised by early onset of atopic dermatitis, early onset of asthma (independent of atopic dermatitis status) with severe exacerbations and later development of sensitisation.
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Kitaj et al., however, reported lowered pain thresholds in chronic migraine patients compared to episodic migraine patients, even when measured interictally, indicating that disease duration could contribute to the development of central sensitisation.
Few epidemiological studies to date have collected data prospectively and at frequent intervals on the early development of atopic sensitisation (for instance [39]) or on factors related to increased responsiveness to viral infections in early life [4], [30], [40], [41].
In pain hypersensitivity states, the N-Methyl-D-aspartate (NMDA) receptor has been implicated in the development of central sensitisation.
39 In addition HCWs must be continuously monitored for the development of latex sensitisation and alternate latex-free gloves must be made available for them.
Whilst other genotypes developed enhanced responses to noxious heat and mechanical stimuli within a few hours, Mc1re females did not show development of inflammation-induced sensitisation until 24 hours post-injection.
17 Overall this work underscores the importance of filaggrin gene defects in increasing the risk of sensitisation and the development of a range of allergic clinical phenotypes, most probably through exposure to allergens through the skin.
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