Max D. Bermingham, Karina Klekotko, Maria A. Oliver, J. Blaxland
To the Editor, Despite allergy and allergic reactions to honey being widely regarded as rare, there have been documented systemic allergic reactions following ingestion of honey.1 Current literature suggests that pollens and components derived from bees are the main cause of such reactions.1,2 However, interestingly and perhaps unknown to many allergic patients and allergists, there are also reports of supplementary bee feeding with food allergenloaded mixtures of soybean flour, dried brewer's yeast (containing high levels of residual gluten from brewing processes) and dry skimmed milk with sugar and water.3 Furthermore, there have been reports of mould contamination within beehives.4 Both factors suggest a potential for gluten, food and mould allergen protein presence in honey, which could account for some of the reported reactions following honey consumption. As such, the aim of this study was to determine if commercially available honey contained undeclared gluten and/or food or mould allergens, and at levels which could present a risk to individuals with hypersensitivities. To investigate this, honey samples (n = 40) of UK, EU, NonEU and blended NonEU/EU origin were extracted and analysed for gluten using the Neogen Veratox Gliadin R5 Gluten ELISA, which is regarded as the gold standard for gluten measurements in the food industry. Major allergen content was measured using InBio MARIA and MARIA for Foods quantitative multiplex arrays for cow's milk, egg, peanut, soy, hazelnut, cashew and mould allergens. The MARIA immunoassay is based on xMAP® technology (Luminex Corp.) which uses polystyrene or magnetic microspheres that are internally labelled to create distinct sets of beads. Separate bead sets are covalently coupled with allergenspecific monoclonal antibodies, enabling the simultaneous capture and detection of multiple allergens in a single sample.5 Gluten (gliadin) assays were conducted according to manufacturer instruction. Honey samples were extracted by transferring 250 mg of honey to a 50ml sterile centrifuge tube to which 2.5 ml of renaturing cocktail solution (Neogen 8515, 8515B, 8515S) was added. The resultant suspension was vortex mixed for 30 s and incubated in a water bath at 50°C for 40 min. Samples were then cooled for 10 min at room temperature (RT), and 80% v/v ETOH was added. Samples were mixed as previously described for 20 s and then rotated at 200 rpm for 60 min before 100 μl of the resultant solution was added to 1.25 ml of phosphate buffered saline (PBS). A negative honey control was employed during testing for the presence of Gliadin R 5, this was produced on the day of testing and consisted of; 28 g glucose, 14 g fructose and 8 g of Sterile distilled water. In all tests, the negative control did not produce a result above the assay limit of detection of 2.5 parts per million (ppm) of gliadin, or 5 ppm of gluten. Analysis was repeated on two separate occasions and results are an average of these two measurements. App
致编辑:尽管对蜂蜜的过敏和过敏反应被广泛认为是罕见的，但有记录表明，摄入蜂蜜后会出现全身性过敏反应目前的文献表明，花粉和来自蜜蜂的成分是这种反应的主要原因。然而，有趣的是，许多过敏患者和过敏症专家可能不知道，也有报道称，补充蜜蜂喂养含有过敏原的食物混合物，这些混合物包括大豆粉、干啤酒酵母(酿造过程中含有大量残留的麸质)和加糖和水的干脱脂牛奶此外，有报道称蜂箱内有霉菌污染这两个因素都表明蜂蜜中可能存在麸质、食物和霉菌过敏原蛋白，这可能是食用蜂蜜后报告的一些反应的原因。因此，本研究的目的是确定市售蜂蜜是否含有未申报的麸质和/或食物或霉菌过敏原，以及其含量可能对过敏个体构成风险。为了研究这一点，我们提取了英国、欧盟、非欧盟和非欧盟/欧盟混合产地的蜂蜜样本(n = 40)，并使用Neogen Veratox麦胶蛋白R5谷蛋白酶联免疫吸附试验(ELISA)分析了谷蛋白含量，该酶联免疫吸附试验被认为是食品行业谷蛋白测定的金标准。主要过敏原的含量采用InBio MARIA和MARIA for Foods定量多重阵列法测定，分别为牛奶、鸡蛋、花生、大豆、榛子、腰果和霉菌过敏原。MARIA免疫分析法基于xMAP®技术(Luminex Corp.)，该技术使用内部标记的聚苯乙烯或磁性微球来创建不同的珠子组。单独的头集与过敏原特异性单克隆抗体共价偶联，能够在单个样品中同时捕获和检测多个过敏原麸质(麦胶蛋白)测定按照生产厂家说明进行。将250 mg蜂蜜转移到50ml无菌离心管中，其中加入2.5 ml复性鸡尾酒溶液(Neogen 8515, 8515B, 8515S)，提取蜂蜜样品。将得到的悬浮液涡旋混合30 s，在50°C的水浴中孵育40 min。然后在室温(RT)下冷却10 min，加入80% v/v的ETOH。将样品按上述方法混合20s，然后以200 rpm旋转60 min，然后将所得溶液100 μl加入1.25 ml磷酸缓冲盐水(PBS)中。在测试期间，采用阴性蜂蜜对照来检测麦胶蛋白r5的存在，这是在测试当天产生的，包括;28克葡萄糖，14克果糖和8克无菌蒸馏水。在所有的测试中，阴性对照没有产生超过检测百万分之2.5 (ppm)麦胶蛋白或百万分之5谷蛋白的测定极限的结果。在两个不同的场合重复分析，结果是这两个测量的平均值。大约50%的面筋以麦胶蛋白的形式存在。因此，麦胶蛋白的结果乘以2来确定谷蛋白的水平。两个MARIA阵列用于样品分析。用于食品多重阵列的MARIA允许同时定量花生(Ara h 3, Ara h 6)，牛奶(Bos d 5, Bos d 11)，鸡蛋(Gal d 1, Gal d 2)，腰果(Ana o 3)，榛子(Cor A 9)和大豆(Gly m 5)过敏原。第二个MARIA多路阵列允许同时定量霉菌(Asp f1, Alt a1)过敏原。该阵列使用高度纯化的过敏原标准物来定量样品中的特定过敏原蛋白。实验按照Filep和chapman的描述进行。5分析前，样品(1 g)在20 ml PBS 0.05% Tween20, pH 7.4中提取。样品在摇床上短暂旋转并在室温下孵育120分钟。得到的提取物在分析前保存在- 20°C。通过重复提取(每个蜂蜜n = 4 - 5个样品)证实了阳性结果，结果显示为重复提取的平均值。样品提取物在两倍稀释系列中进行分析，范围从纯净到1:80。通过生产蜂蜜样品，从蜂蜜中回收过敏原蛋白进行验证(如在线开放科学框架存储库:https://osf.io/vd28j/， 10.17605/ OSF.IO/VD28J所述)。在分析的40个样本中，观察到40个样本中有8个(20%)含有面筋，其含量在5 ppm至13.8 ppm之间。按产地分类的阳性蜂蜜样本详情见表1。在分析的21份非欧盟蜂蜜样本中，有6份检测出谷蛋白阳性。从九个英国和九个欧盟/非欧盟混合蜂蜜样本中，每个样本都有一个谷蛋白阳性。这表明非欧盟、英国和欧盟/非欧盟混合的麸质阳性样本率分别为28.6%和11.1%。牛奶过敏原bod5和bod11在7.5%的样品中检出。阳性结果范围从0.368 ppm (mg/kg)到0。
{"title":"Low levels of gluten and major milk allergens Bos d 5 and Bos d 11 identified in commercially available honey","authors":"Max D. Bermingham, Karina Klekotko, Maria A. Oliver, J. Blaxland","doi":"10.1111/cea.14159","DOIUrl":"https://doi.org/10.1111/cea.14159","url":null,"abstract":"To the Editor, Despite allergy and allergic reactions to honey being widely regarded as rare, there have been documented systemic allergic reactions following ingestion of honey.1 Current literature suggests that pollens and components derived from bees are the main cause of such reactions.1,2 However, interestingly and perhaps unknown to many allergic patients and allergists, there are also reports of supplementary bee feeding with food allergenloaded mixtures of soybean flour, dried brewer's yeast (containing high levels of residual gluten from brewing processes) and dry skimmed milk with sugar and water.3 Furthermore, there have been reports of mould contamination within beehives.4 Both factors suggest a potential for gluten, food and mould allergen protein presence in honey, which could account for some of the reported reactions following honey consumption. As such, the aim of this study was to determine if commercially available honey contained undeclared gluten and/or food or mould allergens, and at levels which could present a risk to individuals with hypersensitivities. To investigate this, honey samples (n = 40) of UK, EU, NonEU and blended NonEU/EU origin were extracted and analysed for gluten using the Neogen Veratox Gliadin R5 Gluten ELISA, which is regarded as the gold standard for gluten measurements in the food industry. Major allergen content was measured using InBio MARIA and MARIA for Foods quantitative multiplex arrays for cow's milk, egg, peanut, soy, hazelnut, cashew and mould allergens. The MARIA immunoassay is based on xMAP® technology (Luminex Corp.) which uses polystyrene or magnetic microspheres that are internally labelled to create distinct sets of beads. Separate bead sets are covalently coupled with allergenspecific monoclonal antibodies, enabling the simultaneous capture and detection of multiple allergens in a single sample.5 Gluten (gliadin) assays were conducted according to manufacturer instruction. Honey samples were extracted by transferring 250 mg of honey to a 50ml sterile centrifuge tube to which 2.5 ml of renaturing cocktail solution (Neogen 8515, 8515B, 8515S) was added. The resultant suspension was vortex mixed for 30 s and incubated in a water bath at 50°C for 40 min. Samples were then cooled for 10 min at room temperature (RT), and 80% v/v ETOH was added. Samples were mixed as previously described for 20 s and then rotated at 200 rpm for 60 min before 100 μl of the resultant solution was added to 1.25 ml of phosphate buffered saline (PBS). A negative honey control was employed during testing for the presence of Gliadin R 5, this was produced on the day of testing and consisted of; 28 g glucose, 14 g fructose and 8 g of Sterile distilled water. In all tests, the negative control did not produce a result above the assay limit of detection of 2.5 parts per million (ppm) of gliadin, or 5 ppm of gluten. Analysis was repeated on two separate occasions and results are an average of these two measurements. App","PeriodicalId":10148,"journal":{"name":"Clinical & Experimental Allergy","volume":"9 1","pages":"904 - 906"},"PeriodicalIF":0.0,"publicationDate":"2022-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80330673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic rhinitis, manifesting as sneezing, nasal itching, congestion and rhinorrhoea, is a global health problem affecting up to 40% of the population.1 A quarter to a half of patients with chronic rhinitis have nonallergic rhinitis (NAR), defined as persistent symptoms of rhinitis with no obvious allergic, infectious or anatomical cause.2,3 The treatment options include avoidance of known triggers, medication and surgery. A number of medications are used to treat NAR; however, the role and benefit of individual medications in this multifaceted disease are poorly understood. This review focuses on the use of intranasal corticosteroids for treating NAR and compares it to other medications or no treatment.
{"title":"Cochrane corner: Intranasal corticosteroids for non‐allergic rhinitis","authors":"I. Gregory, A. Grewal","doi":"10.1111/cea.14151","DOIUrl":"https://doi.org/10.1111/cea.14151","url":null,"abstract":"Chronic rhinitis, manifesting as sneezing, nasal itching, congestion and rhinorrhoea, is a global health problem affecting up to 40% of the population.1 A quarter to a half of patients with chronic rhinitis have nonallergic rhinitis (NAR), defined as persistent symptoms of rhinitis with no obvious allergic, infectious or anatomical cause.2,3 The treatment options include avoidance of known triggers, medication and surgery. A number of medications are used to treat NAR; however, the role and benefit of individual medications in this multifaceted disease are poorly understood. This review focuses on the use of intranasal corticosteroids for treating NAR and compares it to other medications or no treatment.","PeriodicalId":10148,"journal":{"name":"Clinical & Experimental Allergy","volume":"82 1","pages":"836 - 838"},"PeriodicalIF":0.0,"publicationDate":"2022-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79960559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
system in Japan, the findings may not apply to other regions or dif-ferent healthcare systems. In conclusion, OFCs are conducted nationwide in general hospitals and clinics, not only in allergy- specialized facilities, as part of daily medical services in Japan. The proportion of anaphylaxis during OFC was relatively low, and there were no life- threatening events in both clinics and hospitals, as exemplified by the low number of adrenaline injections. There were also no life- threatening events during the procedure. However, we should still be very careful when performing OFC in patients with a history of anaphylaxis and wheezing.
{"title":"Oral food challenge management in Japan: A retrospective analysis of health insurance claims data","authors":"Hisako Ogasawara, Hiroyuki Ohbe, H. Yasunaga","doi":"10.1111/cea.14154","DOIUrl":"https://doi.org/10.1111/cea.14154","url":null,"abstract":"system in Japan, the findings may not apply to other regions or dif-ferent healthcare systems. In conclusion, OFCs are conducted nationwide in general hospitals and clinics, not only in allergy- specialized facilities, as part of daily medical services in Japan. The proportion of anaphylaxis during OFC was relatively low, and there were no life- threatening events in both clinics and hospitals, as exemplified by the low number of adrenaline injections. There were also no life- threatening events during the procedure. However, we should still be very careful when performing OFC in patients with a history of anaphylaxis and wheezing.","PeriodicalId":10148,"journal":{"name":"Clinical & Experimental Allergy","volume":"41 1","pages":"898 - 900"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89791609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Loke, Kuang-Chih Hsiao, A. Lozinsky, S. Ashley, M. Lloyd, Sigrid Pitkin, C. Axelrad, K. Jayawardana, D. Tey, E. Su, M. Robinson, A. Leung, A. Dunn Galvin, M. Tang
Peanut allergy persists for life in the majority of patients. Current management relies on allergen avoidance; however, about 50% of patients have accidental exposures within 1 year. 1 Peanut oral im munotherapy (OIT) is effective at inducing desensitization and can induce sustained unresponsiveness (SU) in a subset of treated pa tients; however, data on long- term effectiveness and health- related quality- of- life (HRQL) impact are lacking. OIT- induced SU may be short- lived, with up to 67% of treatment responders losing their SU within 12 months. 2 Furthermore, a meta- analysis found that peanut OIT was associated with frequent adverse events (AE) and no signif icant improvement in HRQL. 3 We previously reported results from a proof- of- concept random ized trial (PPOIT- 001), which showed that 18- month treatment with combined probiotic and peanut oral immunotherapy (PPOIT) in duced 2- to 6- week SU in 74.2% of children aged 1– 10 years. 4 A long-term follow- up of PPOIT- 001 patients showed that PPOIT- induced SU persisted to 4- year post- treatment in 70% of initial treatment responders. 5 Weaknesses of the parent PPOIT- 001 study included participant selection based upon the clinical history of reaction and positive peanut skin prick test (SPT) or specific- IgE (sIgE) rather than double- blind placebo- controlled food challenge (DBPCFC), and the assessment of SU at 2- to 6- week post- treatment rather than after
{"title":"Probiotic peanut oral immunotherapy is associated with long‐term persistence of 8‐week sustained unresponsiveness and long‐lasting quality‐of‐life improvement","authors":"P. Loke, Kuang-Chih Hsiao, A. Lozinsky, S. Ashley, M. Lloyd, Sigrid Pitkin, C. Axelrad, K. Jayawardana, D. Tey, E. Su, M. Robinson, A. Leung, A. Dunn Galvin, M. Tang","doi":"10.1111/cea.14137","DOIUrl":"https://doi.org/10.1111/cea.14137","url":null,"abstract":"Peanut allergy persists for life in the majority of patients. Current management relies on allergen avoidance; however, about 50% of patients have accidental exposures within 1 year. 1 Peanut oral im munotherapy (OIT) is effective at inducing desensitization and can induce sustained unresponsiveness (SU) in a subset of treated pa tients; however, data on long- term effectiveness and health- related quality- of- life (HRQL) impact are lacking. OIT- induced SU may be short- lived, with up to 67% of treatment responders losing their SU within 12 months. 2 Furthermore, a meta- analysis found that peanut OIT was associated with frequent adverse events (AE) and no signif icant improvement in HRQL. 3 We previously reported results from a proof- of- concept random ized trial (PPOIT- 001), which showed that 18- month treatment with combined probiotic and peanut oral immunotherapy (PPOIT) in duced 2- to 6- week SU in 74.2% of children aged 1– 10 years. 4 A long-term follow- up of PPOIT- 001 patients showed that PPOIT- induced SU persisted to 4- year post- treatment in 70% of initial treatment responders. 5 Weaknesses of the parent PPOIT- 001 study included participant selection based upon the clinical history of reaction and positive peanut skin prick test (SPT) or specific- IgE (sIgE) rather than double- blind placebo- controlled food challenge (DBPCFC), and the assessment of SU at 2- to 6- week post- treatment rather than after","PeriodicalId":10148,"journal":{"name":"Clinical & Experimental Allergy","volume":"68 1","pages":"806 - 811"},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91223106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Pur Ozyigit, M. Odemyr, E. Bradatan, C. Brall, R. Porz, G. Scadding
{"title":"Social and ethical factors in anaphylaxis","authors":"L. Pur Ozyigit, M. Odemyr, E. Bradatan, C. Brall, R. Porz, G. Scadding","doi":"10.1111/cea.14118","DOIUrl":"https://doi.org/10.1111/cea.14118","url":null,"abstract":"","PeriodicalId":10148,"journal":{"name":"Clinical & Experimental Allergy","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82296919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Systematic summaries of the available evidence are a fundamental component in achieving optimal health outcomes.1 Traditional evidence hierarchies place systematic reviews and metaanalyses at their pinnacle. Metaanalyses (MA) can be subdivided into two analytic approaches: those that primarily combine existing published data using the values reported in individual studies, called ‘aggregate data metaanalysis’, where individual trials are a kind of unit of analysis; and those that seek to combine the raw study data from multiple studies, called ‘individual patient data [IPD] metaanalysis’, where the unit of analysis is individual participants that are clustered within individual studies. IPD metaanalyses have been claimed to be the ‘gold standard’ of evidence synthesis. What are the merits of IPD MA and why are investigators not doing more of them? In this issue, Van Vogt, Cro and colleagues, representing the Skincare interventions for the prevention of atopic dermatitis (SCiPAD) collaboration leadership, report a comparison of aggregate MA vs IPD MA of skin care interventions, primarily moisturizers (emollients), vs standard care for the prevention of atopic dermatitis and IgEmediated food allergy in infants.2 Smartly planned, excellently done, spectacularly interpreted and impactfully informative, they report similar effect estimates using both analytic approaches, and the IPD approach better addressed the betweenstudy heterogeneity, allowed more sophisticated statistical analyses and could
系统总结现有证据是实现最佳健康结果的基本组成部分传统的证据层次将系统评价和元分析置于其顶峰。荟萃分析(MA)可以细分为两种分析方法:一种主要是将现有已发表的数据与个别研究报告的值结合起来，称为“汇总数据荟萃分析”，其中单个试验是一种分析单位;另一种是试图将多个研究的原始研究数据结合起来，称为“个体患者数据[IPD]元分析”，其分析单位是单个研究中聚集的个体参与者。IPD荟萃分析被认为是证据合成的“黄金标准”。IPD MA的优点是什么?为什么调查人员没有做更多的IPD MA ?在这一期中，Van Vogt, Cro及其同事，代表皮肤护理干预预防特应性皮炎(SCiPAD)合作领导，报告了皮肤护理干预的总体MA与IPD MA的比较，主要是保湿剂(润肤剂)，与预防婴儿特应性皮炎和ige介导的食物过敏的标准护理巧妙的计划，出色的完成，引人注目的解释和有影响力的信息，他们使用两种分析方法报告了相似的效果估计，IPD方法更好地解决了研究之间的异质性，允许更复杂的统计分析，并且可以
{"title":"Individual‐patient data and aggregate evidence syntheses and the future of allergy‐immunology research","authors":"D. Chu","doi":"10.1111/cea.14144","DOIUrl":"https://doi.org/10.1111/cea.14144","url":null,"abstract":"Systematic summaries of the available evidence are a fundamental component in achieving optimal health outcomes.1 Traditional evidence hierarchies place systematic reviews and metaanalyses at their pinnacle. Metaanalyses (MA) can be subdivided into two analytic approaches: those that primarily combine existing published data using the values reported in individual studies, called ‘aggregate data metaanalysis’, where individual trials are a kind of unit of analysis; and those that seek to combine the raw study data from multiple studies, called ‘individual patient data [IPD] metaanalysis’, where the unit of analysis is individual participants that are clustered within individual studies. IPD metaanalyses have been claimed to be the ‘gold standard’ of evidence synthesis. What are the merits of IPD MA and why are investigators not doing more of them? In this issue, Van Vogt, Cro and colleagues, representing the Skincare interventions for the prevention of atopic dermatitis (SCiPAD) collaboration leadership, report a comparison of aggregate MA vs IPD MA of skin care interventions, primarily moisturizers (emollients), vs standard care for the prevention of atopic dermatitis and IgEmediated food allergy in infants.2 Smartly planned, excellently done, spectacularly interpreted and impactfully informative, they report similar effect estimates using both analytic approaches, and the IPD approach better addressed the betweenstudy heterogeneity, allowed more sophisticated statistical analyses and could","PeriodicalId":10148,"journal":{"name":"Clinical & Experimental Allergy","volume":"4 1","pages":"598 - 599"},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89159183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nurhan Kasap, Kubra Aslan, Leman Tuba Karakurt, H. Bozkurt, H. Canatan, O. Cavkaytar, A. Eken, M. Arga
{"title":"A novel gain‐of‐function mutation in STAT5B is associated with treatment‐resistant severe atopic dermatitis","authors":"Nurhan Kasap, Kubra Aslan, Leman Tuba Karakurt, H. Bozkurt, H. Canatan, O. Cavkaytar, A. Eken, M. Arga","doi":"10.1111/cea.14148","DOIUrl":"https://doi.org/10.1111/cea.14148","url":null,"abstract":"","PeriodicalId":10148,"journal":{"name":"Clinical & Experimental Allergy","volume":"11 1","pages":"907 - 910"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81649982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Varandas, M. C. Pereira-Santos, Marta Neto, A. Sousa, A. Lopes, Susana L. Silva
We investigated here the interleukin- 22 (IL- 22)/IL- 22 Binding Protein (IL- 22BP) axis in Atopic Dermatitis (AD) and its modulation upon treatment with Dupilumab, and our findings support its relevance in the clinical management of severe AD. IL- 22 has been emerging as an important player in AD, and its serum levels were shown to be increased in moderate- to- severe AD. 1 IL- 22 assumes major cross- talk functions between immune and epithelial cells, promoting epithelia homeostasis and skin barrier integrity. 2,3 However, it should be tightly regulated, as IL- 22 constitutes one of the cytokines which leads to local inflammation, induction of keratinocyte proliferation and inhibition of its terminal differentiation. 3,4 Part of these effects are likely associated with the role of IL- 22 in the regulation of molecules critically involved in skin barrier. 5 Interestingly, recent data showed that targeting IL- 22 may positively impact on severe AD in the subgroup of patients expressing high level of IL- 22 at baseline. 4 This preliminary study evaluating the clinical outcomes of a small cohort of moderate-to- severe AD with the anti- IL- 22 antibody, Fezakinumab, 4 further supports the relevance of the IL- 22 pathway in AD, given the significant improvement of SCORAD at week 20 ( p = .049). Another player in this axis is the IL- 22BP that inhibits the IL- 22 binding to its membrane bound receptor, IL- 22R. 3,6,7 IL- 22BP was shown to bind IL- 22 with a considerable higher affinity, up to 2000fold, than
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