Clinical and Translational Allergy最新文献_第4页

Digital Monitoring of Symptoms and Lung Function During Birch Pollen Season in Pediatric Patients 儿科桦树花粉季节症状和肺功能的数字监测。

IF 4 2区医学 Q2 ALLERGY

Clinical and Translational Allergy

Pub Date : 2025-09-29 DOI: 10.1002/clt2.70101

Tiina Helena Tanninen, Paula Hannele Reiterä, Annika Saarto, Janne Burman, Anna Susanna Pelkonen, Mika Juhani Mäkelä

Background

Mobile health (mHealth) applications for asthma and allergic rhinitis (AR) may guide patients in following medication use, symptoms, and lung function supporting self-management.

Objective

The primary study objective was to investigate the objective effect of birch pollen on asthma and AR symptoms and medicine use in pediatric patients with varying levels of birch-specific immunoglobulin E (IgE) during the 2022 birch pollen season using digital tools. The secondary objectives were to determine the effect of birch pollen on Asthma Control Test scores, and to record the subjective benefits in self-management while using the application.

Methods

Altogether, 48 pediatric participants were categorized into three groups based on their birch-specific IgE levels. Participants continued their existing asthma control therapy. For allergic rhinitis and conjunctivitis, antihistamines, intranasal corticosteroids (INCS) or a combination of INCS and intranasal antihistamines, and cromoglicates or local antihistamines were prescribed. The study involved daily asthma and allergic rhinitis symptom and medication reporting via the mHealth application (KAMU Health, Finland) combined with microspirometry during the birch pollen season in Helsinki, Finland.

Results

The patients preferred oral AR treatment. However, the low birch pollen levels may have contributed to moderate adherence to AR treatment. A low birch pollen load does not significantly impair lung function in young patients receiving anti-asthmatic treatment regularly. The majority of patients perceived this digital approach as beneficial, irrespective of their level of birch-specific sensitization.

Conclusion

Digital tools support asthma and AR care by enabling disease monitoring, patient engagement, and provide real-world insights for clinicians.

背景：哮喘和过敏性鼻炎（AR）的移动健康（mHealth）应用程序可以指导患者跟踪药物使用、症状和肺功能，支持自我管理。目的：主要研究目的是利用数字化工具，探讨2022年桦树花粉季节桦树花粉对不同水平桦树特异性免疫球蛋白E （IgE）患儿哮喘和AR症状及用药的客观影响。次要目标是确定桦树花粉对哮喘控制测试分数的影响，并记录使用该应用程序时自我管理的主观益处。方法：48名儿童参与者根据桦树特异性IgE水平分为三组。参与者继续他们现有的哮喘控制治疗。对于变应性鼻炎和结膜炎，开抗组胺药、鼻内皮质类固醇（INCS）或INCS与鼻内抗组胺药的组合，以及克罗莫酸盐或局部抗组胺药。该研究涉及在芬兰赫尔辛基桦树花粉季节期间，通过移动健康应用程序（KAMU Health，芬兰）每日哮喘和过敏性鼻炎症状和药物报告，并结合微肺活量测定。结果：患者首选口服AR治疗。然而，较低的桦树花粉水平可能有助于对AR治疗的中等依从性。在定期接受抗哮喘治疗的年轻患者中，低桦树花粉负荷不会显著损害肺功能。大多数患者认为这种数字化方法是有益的，无论他们的桦树特异性致敏程度如何。结论：数字工具通过实现疾病监测、患者参与和为临床医生提供真实世界的见解来支持哮喘和AR护理。

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引用次数: 0

Improving Diagnostic Accuracy in Respiratory Allergy: Monocentric Reevaluation of the GA2LEN Panel in Germany 提高呼吸道过敏的诊断准确性：德国GA2LEN小组的单中心重新评估

IF 4 2区医学 Q2 ALLERGY

Clinical and Translational Allergy

Pub Date : 2025-09-24 DOI: 10.1002/clt2.70102

Caroline Beutner, Christian Meyer, Moritz Maximilian Hollstein, Katharina Klara Hahn, Michael Peter Schön, Timo Buhl

Background

European guidelines recommend using a standardized baseline series of skin prick test (SPT) allergens for the diagnosis of airway allergies. In addition, local adaptation and/or extension of test panels according to regional exposure and sensitization patterns are increasingly being discussed.

Methods

Regional sensitization rates according to SPTs based on the most recent GA²LEN baseline series in Central Germany were retrospectively analyzed for 960 consecutive patients with respiratory symptoms at our university outpatient clinic. Additional SPT allergens of interest were further analyzed.

Results

High sensitization rates to the baseline SPT series were observed in our highly selected study cohort. The positivity rates were particularly high for olive pollen (30.8%) and plantain pollen (33.4%). Positive olive and birch pollen SPTs were found in 98.5% of olive-ash-birch pollen tested patients. High SPT positivity rates (98.1%) for plane tree and olive tree pollen were found, whereas only six patients (1.9%) were diagnosed with exclusive cypress pollen sensitization. Subgroup analysis of SPTs for palm tree pollen revealed that 92% of patients with palm tree positivity showed polysensitization, and all but one patient had concomitant grass pollen sensitization.

Conclusion

Regular evaluations of SPT series may be necessary because of climate change, extract production, and increasing population mobility. Ash and cypress pollen extracts could currently be removed from the baseline SPT panel without significantly decreasing diagnostic accuracy. Positive SPTs to non-native palm tree pollen may indicate the presence of IgE to cross-reacting panallergens, which may help to differentiate primary sensitization from cross-reactivity directly. Limitations include the retrospective monocentric design and lack of molecular IgE confirmation.

背景：欧洲指南推荐使用标准化基线系列皮肤点刺试验（SPT）过敏原来诊断气道过敏。此外，正在越来越多地讨论根据区域暴露和敏化模式进行局部调整和/或扩展试验小组。方法回顾性分析德国中部地区以最新GA2LEN基线系列为基础的spt区域致敏率，对我院门诊960例连续出现呼吸道症状的患者进行分析。进一步分析其他感兴趣的SPT过敏原。结果在我们精心挑选的研究队列中观察到对基线SPT系列的高敏化率。橄榄花粉（30.8%）和车前草花粉（33.4%）的阳性率最高。98.5%的橄榄灰桦树花粉检测患者发现橄榄和桦树花粉SPTs阳性。梧桐树和橄榄树花粉的SPT阳性率高达98.1%，而柏树花粉仅为6例（1.9%）。棕榈树花粉的SPTs亚组分析显示，92%的棕榈树阳性患者表现为多敏化，除1例患者外，其余患者均伴有草花粉敏化。结论由于气候变化、提取物生产和人口流动的增加，定期评估SPT系列可能是必要的。目前可以从基线SPT面板中去除白蜡树和柏树花粉提取物，而不会显著降低诊断准确性。对非本地棕榈树花粉的阳性SPTs可能表明存在对交叉反应的泛过敏原的IgE，这可能有助于直接区分原发性致敏性和交叉反应性。局限性包括回顾性单中心设计和缺乏分子IgE确认。

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引用次数: 0

Identifying Genetic Variants in Patients With Cefaclor-Induced Anaphylaxis Using Human Leukocyte Antigen Typing and Whole-Exome Sequencing 使用人类白细胞抗原分型和全外显子组测序鉴定头孢氯诱导的过敏反应患者的遗传变异。

IF 4 2区医学 Q2 ALLERGY

Clinical and Translational Allergy

Pub Date : 2025-09-20 DOI: 10.1002/clt2.70103

Sung-Ryeol Kim, Da Eun Lee, Hyun Young Jung, In-Wha Kim, Hye-Ryun Kang, Kyung Hee Park, Jung-Won Park, Jung-Mi Oh, Jae-Hyun Lee

Background

Cefaclor is a commonly prescribed β-lactam antibiotic and a known major cause of immediate-type drug hypersensitivity in Korea. However, its genetic risk factors remain poorly understood. We aimed to identify genetic variants associated with cefaclor-induced anaphylaxis and evaluate their potential clinical implications.

Methods

Whole-exome sequencing and HLA genotyping were performed in 33 patients with cefaclor-induced anaphylaxis and 41 drug-tolerant controls. Associations were assessed using logistic regression. Selected variants were validated in an independent Korean population. Gene set enrichment analysis (GSEA) was performed using association statistics from all variants to investigate relevant biological pathways.

Results

A rare missense variant, rs765144578 in TPSAB1 was strongly associated with anaphylaxis and remained significant in the validation control group. It was found in 90.91% of patients with hypotension, suggesting a link to reaction severity. Rs192498095 in HLA-DRB5 showed a significant association in the discovery cohort. However, it was not detected in the replication set, likely due to its rarity and polymorphic nature. Co-occurrence of rs765144578 in TPSAB1 and rs192498095 in HLA-DRB5 markedly increased risk. GSEA revealed significant enrichment of the TNF-α signaling via NF-κB pathway, reflecting pathway-level immune activation.

Conclusion

Genetic variants in TPSAB1 and HLA-DRB5 may contribute to the risk of cefaclor-induced anaphylaxis, and TPSAB1 may also be associated with severity. These findings may support the development of future screening strategies or individualized risk prediction models in β-lactam allergy.

背景：头孢克洛是一种常用的β-内酰胺类抗生素，也是韩国已知的直接型药物过敏的主要原因。然而，其遗传风险因素仍然知之甚少。我们的目的是确定与头孢氯致过敏反应相关的遗传变异，并评估其潜在的临床意义。方法：对33例头孢氯致过敏反应患者和41例耐药对照进行全外显子组测序和HLA基因分型。使用逻辑回归评估相关性。选择的变异在独立的韩国人群中得到验证。利用所有变异的关联统计数据进行基因集富集分析（GSEA），以研究相关的生物学途径。结果：TPSAB1中罕见的错义变异rs765144578与过敏反应密切相关，并且在验证对照组中仍然显著。在90.91%的低血压患者中发现，这表明与反应严重程度有关。在发现队列中，HLA-DRB5中的Rs192498095显示出显著相关性。然而，在复制集中没有检测到它，可能是由于它的稀有性和多态性。TPSAB1基因中rs765144578和HLA-DRB5基因中rs192498095的共存显著增加了风险。GSEA显示NF-κB通路TNF-α信号显著富集，反映通路水平的免疫激活。结论：TPSAB1和HLA-DRB5基因变异可能增加头孢氯致过敏反应的风险，TPSAB1也可能与过敏反应的严重程度有关。这些发现可能支持未来β-内酰胺过敏筛查策略或个体化风险预测模型的发展。

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引用次数: 0

Reference Values and Determinants of Fractional Exhaled Nitric Oxide in a Representative Adult Population in Western Sweden 瑞典西部代表性成人呼出一氧化氮含量的参考值和决定因素

IF 4 2区医学 Q2 ALLERGY

Clinical and Translational Allergy

Pub Date : 2025-09-18 DOI: 10.1002/clt2.70107

Reshed Abohalaka, Selin Ercan, Lauri Lehtimäki, Saliha Selin Özuygur Ermis, Daniil Lisik, Muwada Bashir Awad Bashir, Radhika Jadhav, Linda Ekerljung, Göran Wennergren, Jan Lötvall, Teet Pullerits, Helena Backman, Madeleine Rådinger, Bright I. Nwaru, Hannu Kankaanranta

Background

Fractional exhaled nitric oxide (FE_NO) is used to differentiate asthma inflammatory phenotypes and guide its management. However, data on FE_NO reference values in a representative adult population is limited. We aim to derive reference values and determinants of FE_NO in a representative adult population.

Methods

The West Sweden Asthma Study is a clinical-epidemiological population-representative study of randomly selected adults in Western Sweden. From this cohort, 943 subjects participated in comprehensive clinical investigations, including skin prick testing (SPT), specific immunoglobulin E (sIgE) analysis, and FE_NO measurement. Clinical allergy was defined as co-occurrence of atopy (positivity to SPT or sIgE) and self-reported allergic symptoms to the same allergen family. FE_NO levels were analysed in relation to the presence or absence of clinical allergy, asthma, and other factors.

Results

The 95^th percentile of FE_NO ranged from 34 parts per billion (ppb) in those between 30 and 40 years old to 52 ppb in those ≤ 30 years old in the entire sample (N = 943), and from 26 to 37 ppb in those without clinical allergy, asthma, or chronic obstructive pulmonary disease (COPD) (n = 587), depending on age. Sex, smoking, clinical allergy, atopy, asthma, and hypertension influenced FE_NO levels, meanwhile, age, asthma, clinical allergy, and reversibility-related variables were significant determinants of FE_NO levels.

Conclusion

The 95^th percentile (upper normal limit) for FE_NO ranges from 34 to 52 ppb overall, and from 26 to 37 ppb in those without clinical allergy, asthma, or COPD, depending on age. These findings provide a guide for interpreting FE_NO in the general population.

背景：呼气一氧化氮分数（FENO）用于区分哮喘炎症表型并指导其治疗。然而，关于具有代表性的成年人群的FENO参考值的数据是有限的。我们的目标是在一个有代表性的成年人群中得出参考值和FENO的决定因素。方法：西瑞典哮喘研究是一项临床流行病学人群代表性研究，随机选择瑞典西部的成年人。从该队列中，943名受试者参加了全面的临床调查，包括皮肤点刺试验（SPT）、特异性免疫球蛋白E （sIgE）分析和FENO测量。临床变态反应被定义为特应性（SPT或sIgE阳性）和自我报告的对同一过敏原家族的过敏症状的共同发生。分析了FENO水平与是否存在临床过敏、哮喘和其他因素的关系。结果：在整个样本中，年龄在30至40岁之间的FENO的第95百分位范围从十亿分之34 （ppb）到≤30岁的52 ppb (N = 943)，而在没有临床过敏、哮喘或慢性阻塞性肺疾病（COPD）的人群中（N = 587），根据年龄的不同，FENO的第95百分位范围从26到37 ppb。性别、吸烟、临床变态反应、特应性、哮喘和高血压影响FENO水平，年龄、哮喘、临床变态反应和可逆性相关变量是FENO水平的重要决定因素。结论：FENO的第95百分位（正常上限）总体范围为34至52 ppb，无临床过敏、哮喘或COPD的患者范围为26至37 ppb，具体取决于年龄。这些发现为解释一般人群的FENO提供了指导。

{"title":"Reference Values and Determinants of Fractional Exhaled Nitric Oxide in a Representative Adult Population in Western Sweden","authors":"Reshed Abohalaka, Selin Ercan, Lauri Lehtimäki, Saliha Selin Özuygur Ermis, Daniil Lisik, Muwada Bashir Awad Bashir, Radhika Jadhav, Linda Ekerljung, Göran Wennergren, Jan Lötvall, Teet Pullerits, Helena Backman, Madeleine Rådinger, Bright I. Nwaru, Hannu Kankaanranta","doi":"10.1002/clt2.70107","DOIUrl":"10.1002/clt2.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Fractional exhaled nitric oxide (FE<sub>NO</sub>) is used to differentiate asthma inflammatory phenotypes and guide its management. However, data on FE<sub>NO</sub> reference values in a representative adult population is limited. We aim to derive reference values and determinants of FE<sub>NO</sub> in a representative adult population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The West Sweden Asthma Study is a clinical-epidemiological population-representative study of randomly selected adults in Western Sweden. From this cohort, 943 subjects participated in comprehensive clinical investigations, including skin prick testing (SPT), specific immunoglobulin E (sIgE) analysis, and FE<sub>NO</sub> measurement. Clinical allergy was defined as co-occurrence of atopy (positivity to SPT or sIgE) and self-reported allergic symptoms to the same allergen family. FE<sub>NO</sub> levels were analysed in relation to the presence or absence of clinical allergy, asthma, and other factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 95<sup>th</sup> percentile of FE<sub>NO</sub> ranged from 34 parts per billion (ppb) in those between 30 and 40 years old to 52 ppb in those ≤ 30 years old in the entire sample (<i>N</i> = 943), and from 26 to 37 ppb in those without clinical allergy, asthma, or chronic obstructive pulmonary disease (COPD) (<i>n</i> = 587), depending on age. Sex, smoking, clinical allergy, atopy, asthma, and hypertension influenced FE<sub>NO</sub> levels, meanwhile, age, asthma, clinical allergy, and reversibility-related variables were significant determinants of FE<sub>NO</sub> levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The 95<sup>th</sup> percentile (upper normal limit) for FE<sub>NO</sub> ranges from 34 to 52 ppb overall, and from 26 to 37 ppb in those without clinical allergy, asthma, or COPD, depending on age. These findings provide a guide for interpreting FE<sub>NO</sub> in the general population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 9","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Distinct Phenotypes of Peripheral Innate Lymphoid Cells and T Cells in Type 2 and Non-Type 2 Asthma 2型和非2型哮喘患者外周血固有淋巴样细胞和T细胞的不同表型

IF 4 2区医学 Q2 ALLERGY

Clinical and Translational Allergy

Pub Date : 2025-09-18 DOI: 10.1002/clt2.70108

Maura M. Kere, Sophia Björkander, Simon Kebede Merid, Natalia Hernandez-Pacheco, Paul Maier, Anne-Sophie Merritt, Anna Bergström, Inger Kull, Carsten O. Daub, Jenny Mjösberg, Christopher Andrew Tibbitt, Erik Melén

Background

Investigation of T cell and innate lymphoid cell (ILC) subsets in type 2 (T2) and non-type 2 (non-T2) asthma are needed to elucidate disease mechanisms. In this study, we aimed to identify ILC, CD4+, and CD8+ T cell populations in blood that differentiate between T2 and non-T2 features in subjects with and without asthma.

Methods

The study population included 86 young adults selected from the Swedish population-based BAMSE cohort. Asthma and non-asthma subjects with sensitization to inhalant allergens and/or blood eosinophil count ≥ 0.3 × 10⁹/L were classified into T2 groups. Non-T2 groups were defined by the absence of sensitization to inhalant allergens and blood eosinophil count < 0.3 × 10⁹/L. PBMC samples underwent 18-parameter flow cytometry to identify ILC and CD4+ and CD8+ T cell populations. Logistic regression models were employed on normalized flow cytometry data after hierarchical clustering.

Results

A higher frequency of CD4+ CRTH2+ T memory cells was associated with T2 features independent of asthma status. The frequency of CD62L+ ILC2s was higher and CD4+ KLRG1+ central memory T cells was lower specifically in T2 asthma. Non-T2 asthma was associated with increased frequencies of CD45RO+ ILC2s and CD8+ memory T cells.

Conclusion

Our results suggest that T2 asthma and non-T2 asthma are characterized by distinct features related to ILC and T cell populations. Further investigation of particularly ILC and CD8+ T cell subsets in non-T2 asthma could offer a deeper understanding of underlying disease mechanisms for this endotype.

背景：需要研究2型（T2）和非2型（非T2）哮喘中的T细胞和先天淋巴样细胞（ILC）亚群来阐明疾病机制。在这项研究中，我们的目的是鉴定血液中ILC、CD4+和CD8+ T细胞群，这些细胞群在有和没有哮喘的受试者中区分T2和非T2特征。方法：研究人群包括从瑞典人群为基础的BAMSE队列中选择的86名年轻人。对吸入性过敏原致敏和/或血嗜酸性粒细胞计数≥0.3 × 109/L的哮喘和非哮喘患者分为T2组。非t2组通过对吸入性过敏原无致敏和血嗜酸性粒细胞计数9/L来定义。PBMC样品采用18参数流式细胞术检测ILC、CD4+和CD8+ T细胞群。分层聚类后的归一化流式细胞仪数据采用Logistic回归模型。结果：CD4+ CRTH2+ T记忆细胞的较高频率与T2特征相关，与哮喘状态无关。CD62L+ ILC2s频率增高，CD4+ KLRG1+中枢记忆T细胞频率降低。非t2哮喘与CD45RO+ ILC2s和CD8+记忆T细胞的频率增加有关。结论：我们的研究结果表明，T2哮喘和非T2哮喘具有与ILC和T细胞群相关的不同特征。进一步研究ILC和CD8+ T细胞亚群在非t2哮喘中的作用，可以更深入地了解这种内型的潜在疾病机制。

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引用次数: 0

Food Sensitization Is Associated With Atopic Dermatitis Severity, Gut-Derived Metabolites and Leaky Gut in Adults 食物致敏与成人特应性皮炎严重程度、肠道衍生代谢物和肠漏有关

IF 4 2区医学 Q2 ALLERGY

Clinical and Translational Allergy

Pub Date : 2025-09-18 DOI: 10.1002/clt2.70094

Leszek Blicharz, Emilia Samborowska, Radosław Zagożdżon, Joanna Czuwara, Michał Zych, Aleksander Roszczyk, Michał Zaremba, Michał Dadlez, Zbigniew Samochocki, Małgorzata Olszewska, Lidia Rudnicka

Background

Gut microbiome dysbiosis may cause metabolic dysregulation and intestinal barrier impairment. The latter are hypothesized to provoke food allergy and aggravate cutaneous inflammation. Our objective was to determine the prevalence of food sensitization in adult patients with atopic dermatitis and relate it to the disease severity and the biomarkers of the gut-skin axis.

Methods

50 adult patients with atopic dermatitis and 25 controls were enrolled in this cross-sectional study. Disease severity was determined by using SCORAD and EASI scores. Liquid chromatography-mass spectrometry, Luminex, and Polycheck immunoassays were performed to detect serum concentrations of total IgE, food-specific IgEs, gut-derived metabolites, and leaky gut-related biomarkers.

Results

Food sensitization was significantly more prevalent in patients with atopic dermatitis than in the controls. The severity of atopic dermatitis (EASI, SCORAD) was higher in patients with food sensitization and correlated with the number of positive food-specific IgEs. Higher concentrations of total IgE and higher numbers of positive food-specific IgEs were associated with lower concentrations of short-chain fatty acids and higher concentrations of indoxyl and leaky gut-related biomarkers (LBP, syndecan-4, IL-10, IL-22).

Conclusion

The results suggest a relationship between food sensitization and the severity of atopic dermatitis. This could be partly associated with gut-derived metabolites and intestinal barrier impairment. Fiber-rich diet and restriction of protein could hold potential for upregulating short-chain fatty acids and downregulating indoxyl, which may translate to decreasing the likelihood of food sensitization in atopic dermatitis. Notably, the cross-sectional nature of this exploratory study limits the ability to draw causal inferences, which should be further examined in future prospective research.

背景：肠道微生物群失调可引起代谢失调和肠道屏障损伤。后者被认为会引起食物过敏并加重皮肤炎症。我们的目的是确定成人特应性皮炎患者食物致敏的患病率，并将其与疾病严重程度和肠道-皮肤轴的生物标志物联系起来。方法：50例成人特应性皮炎患者和25例对照者进行横断面研究。采用SCORAD和EASI评分确定疾病严重程度。采用液相色谱-质谱法、Luminex和Polycheck免疫分析法检测血清总IgE、食物特异性IgE、肠道衍生代谢物和漏肠相关生物标志物的浓度。结果：食物致敏在特应性皮炎患者中比在对照组中更为普遍。食物致敏患者的特应性皮炎（EASI， SCORAD）严重程度较高，且与食物特异性IgEs阳性数量相关。较高浓度的总IgE和较高数量的阳性食物特异性IgE与较低浓度的短链脂肪酸和较高浓度的吲哚酚和漏肠相关生物标志物（LBP, syndecan-4, IL-10, IL-22）相关。结论：食物致敏与特应性皮炎的严重程度有关。这可能与肠源性代谢物和肠屏障损伤部分相关。富含纤维的饮食和限制蛋白质可能具有上调短链脂肪酸和下调吲哚酚的潜力，这可能转化为降低特应性皮炎患者食物致敏的可能性。值得注意的是，这项探索性研究的横断面性质限制了得出因果推论的能力，这应该在未来的前瞻性研究中进一步研究。

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引用次数: 0

The Role of Air Pollution in the Pathogenesis of Atopic Dermatitis, With a Focus on Oxidative Stress 空气污染在特应性皮炎发病机制中的作用，以氧化应激为重点。

IF 4 2区医学 Q2 ALLERGY

Clinical and Translational Allergy

Pub Date : 2025-09-15 DOI: 10.1002/clt2.70104

Chen-Xi Liu, Li Li, Yue-Ping Zeng

Background

Atopic Dermatitis (AD) is a chronic inflammatory skin condition characterized by intensely itchy eczematous lesions and dryness. Recent epidemiological studies have indicated a notable increase in the prevalence of AD in industrialized countries, suggesting that air pollution may significantly influence the onset and progression of AD.

Body

This review primarily describes the mechanistic roles of major air pollutants in the pathogenesis of AD, focusing particularly on oxidative stress, skin barrier dysfunction, and immune dysregulation. Moreover, the potential of targeting these pathways to prevent and manage AD is discussed.

Conclusion

Air pollution contributes to the pathogenesis of AD by inducing oxidative stress, skin barrier dysfunction, and immune dysregulation through pathways such as AhR and NF-κB. Mitigating its impact necessitates both personal protective measures and public health policies. Future research should investigate pollutant-climate interactions and develop novel therapies targeting these mechanisms.

背景：特应性皮炎（AD）是一种慢性炎症性皮肤疾病，其特征是强烈的瘙痒性湿疹病变和干燥。最近的流行病学研究表明，工业化国家阿尔茨海默病的患病率显著增加，这表明空气污染可能显著影响阿尔茨海默病的发病和进展。本综述主要描述了主要空气污染物在AD发病机制中的作用，特别关注氧化应激、皮肤屏障功能障碍和免疫失调。此外，本文还讨论了针对这些途径预防和管理AD的潜力。结论：空气污染通过AhR、NF-κB等途径诱导氧化应激、皮肤屏障功能障碍和免疫失调，参与AD的发病机制。减轻其影响需要个人防护措施和公共卫生政策。未来的研究应该调查污染物与气候的相互作用，并针对这些机制开发新的治疗方法。

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引用次数: 0

Persistent Off-Season Dysregulation of Memory B Cell Subsets in Allergic Rhinitis 变应性鼻炎中记忆B细胞亚群的持续淡季失调

IF 4 2区医学 Q2 ALLERGY

Clinical and Translational Allergy

Pub Date : 2025-09-12 DOI: 10.1002/clt2.70100

Maryam Jafari, Eric Hjalmarsson, Laila Hellkvist, Eirini Paziou, Agnetha Karlsson, Susanna Kumlien Georén, Lars-Olaf Cardell

Introduction

Allergic rhinitis (AR) is a common allergic airway disease. Although B cells play essential roles in AR pathogenesis, their subset distribution outside the allergen exposure period remains poorly characterized.

Objective

To profile peripheral blood B cell subsets in AR patients during the pollen-free season and compare them with healthy controls (HC), aiming to identify persistent immunological alterations and potential biomarkers.

Methods

Peripheral blood mononuclear cells (PBMCs) were collected from a total of 28 participants, 14 patients with allergic rhinitis (AR) and 14 healthy controls (HC) during the off-season. B cell subsets were identified using flow cytometry based on IgD and CD27 expression, classifying cells as naïve (IgD⁺CD27⁻), unswitched memory (IgD⁺CD27⁺), switched/conventional memory (IgD⁻CD27⁺), and unconventional memory B cells (IgD⁻CD27⁻). CD38 and CD24 were utilized to further distinguish transitional, naïve, memory, and plasma cell phenotypes. Immunoglobulin isotypes (IgG1-4, IgA1⁺/IgA2⁺) were assessed specifically within conventional memory B cells, while CD86 expression was evaluated on IgM⁺ memory-like and naïve B cells. Additionally, kappa (κ) and lambda (λ) light chain usage was analyzed to assess light chain distribution.

Results

AR patients displayed lower frequencies of IgG1⁺, IgG2⁺, and IgA1⁺/IgA2⁺ memory B cells, along with elevated frequencies of IgG4⁺ and κ⁺ B cells. Additionally, CD86⁺IgM⁺ memory-like B cells were significantly reduced in AR, suggesting altered activation dynamics. No significant differences were observed in CD24/CD38 profiling.

Conclusion

Even outside allergen exposure, AR patients exhibit systemic B cell dysregulation, characterized by skewed class switching, altered subset distribution, and reduced activation markers expression. These findings underscore persistent immune imbalance in AR, identify potential off-season biomarkers of allergic inflammation.

过敏性鼻炎（Allergic rhinitis， AR）是一种常见的过敏性气道疾病。尽管B细胞在AR发病机制中起重要作用，但其在过敏原暴露期外的亚群分布仍不清楚。目的分析AR患者在无花粉季节的外周血B细胞亚群，并与健康对照（HC）进行比较，以确定持续的免疫改变和潜在的生物标志物。方法在淡季采集28例受试者、14例变应性鼻炎（AR）患者和14例健康对照（HC）的外周血单个核细胞（PBMCs）。利用基于IgD和CD27表达的流式细胞术鉴定B细胞亚群，将细胞分类为naïve （IgD+CD27−）、未切换记忆（IgD+CD27+）、切换/传统记忆（IgD - CD27+）和非常规记忆B细胞（IgD - CD27−）。CD38和CD24被用来进一步区分过渡性、naïve、记忆和浆细胞表型。免疫球蛋白同型（IgG1-4, IgA1+/IgA2+）在常规记忆B细胞中特异性评估，而CD86在IgM+记忆样和naïve B细胞中表达评估。此外，还分析了kappa （κ）和lambda （λ）轻链的使用情况，以评估轻链的分布。结果AR患者IgG1+、IgG2+和IgA1+/IgA2+记忆B细胞频率较低，IgG4+和κ+ B细胞频率较高。此外，CD86+IgM+记忆样B细胞在AR中显著减少，表明激活动力学发生了改变。在CD24/CD38分析中未观察到显著差异。结论：即使暴露于外部过敏原，AR患者也表现出全身性B细胞失调，其特征是类别转换偏转、亚群分布改变和激活标记物表达降低。这些发现强调了AR中持续的免疫失衡，确定了过敏性炎症的潜在淡季生物标志物。

{"title":"Persistent Off-Season Dysregulation of Memory B Cell Subsets in Allergic Rhinitis","authors":"Maryam Jafari, Eric Hjalmarsson, Laila Hellkvist, Eirini Paziou, Agnetha Karlsson, Susanna Kumlien Georén, Lars-Olaf Cardell","doi":"10.1002/clt2.70100","DOIUrl":"https://doi.org/10.1002/clt2.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Allergic rhinitis (AR) is a common allergic airway disease. Although B cells play essential roles in AR pathogenesis, their subset distribution outside the allergen exposure period remains poorly characterized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To profile peripheral blood B cell subsets in AR patients during the pollen-free season and compare them with healthy controls (HC), aiming to identify persistent immunological alterations and potential biomarkers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Peripheral blood mononuclear cells (PBMCs) were collected from a total of 28 participants, 14 patients with allergic rhinitis (AR) and 14 healthy controls (HC) during the off-season. B cell subsets were identified using flow cytometry based on IgD and CD27 expression, classifying cells as naïve (IgD<sup>+</sup>CD27<sup>−</sup>), unswitched memory (IgD<sup>+</sup>CD27<sup>+</sup>), switched/conventional memory (IgD<sup>−</sup>CD27<sup>+</sup>), and unconventional memory B cells (IgD<sup>−</sup>CD27<sup>−</sup>). CD38 and CD24 were utilized to further distinguish transitional, naïve, memory, and plasma cell phenotypes. Immunoglobulin isotypes (IgG1-4, IgA1<sup>+</sup>/IgA2<sup>+</sup>) were assessed specifically within conventional memory B cells, while CD86 expression was evaluated on IgM<sup>+</sup> memory-like and naïve B cells. Additionally, kappa (<i>κ</i>) and lambda (<i>λ</i>) light chain usage was analyzed to assess light chain distribution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AR patients displayed lower frequencies of IgG1<sup>+</sup>, IgG2<sup>+</sup>, and IgA1<sup>+</sup>/IgA2<sup>+</sup> memory B cells, along with elevated frequencies of IgG4<sup>+</sup> and κ<sup>+</sup> B cells. Additionally, CD86<sup>+</sup>IgM<sup>+</sup> memory-like B cells were significantly reduced in AR, suggesting altered activation dynamics. No significant differences were observed in CD24/CD38 profiling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Even outside allergen exposure, AR patients exhibit systemic B cell dysregulation, characterized by skewed class switching, altered subset distribution, and reduced activation markers expression. These findings underscore persistent immune imbalance in AR, identify potential off-season biomarkers of allergic inflammation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 9","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sputum Eosinophil and Macrophage Changes After Aspirin Challenge in Patients With Nonsteroidal Anti-Inflammatory Drug–Exacerbated Respiratory Disease 非甾体抗炎药加重呼吸系统疾病患者服用阿司匹林后痰中嗜酸性粒细胞和巨噬细胞的变化

IF 4 2区医学 Q2 ALLERGY

Clinical and Translational Allergy

Pub Date : 2025-09-10 DOI: 10.1002/clt2.70079

Gabriela Trąd-Wójcik, Piotr Szatkowski, Adam Ćmiel, Radosław Kacorzyk, Adam Stępień, Lucyna Mastalerz

Background

Induced sputum cell count is crucial for assessing airway inflammatory phenotypes. This study investigated how aspirin-induced bronchospasm affects sputum cell counts in patients with nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD), comparing systemic versus local aspirin administration.

Methods

Seventy-eight patients with N-ERD and 39 with aspirin-tolerant asthma (ATA) participated. In the N-ERD group, induced sputum was collected before aspirin challenge and during aspirin-induced bronchospasm. We assessed changes in the percentages of eosinophils, neutrophils, lymphocytes, and macrophages, and airway inflammatory phenotypes classified by sputum cells into: (A) eosinophilic, neutrophilic, paucigranulocytic, and mixed; and (B) eosinophilic and noneosinophilic.

Results

Baseline sputum neutrophil percentage was lower in the N-ERD than in the ATA (32.9% ± 20.8% vs. 41.6% ± 22.5%; p = 0.02). Inflammatory phenotypes at baseline differed between groups in both classifications (A: p = 0.041; B: p = 0.044). In the N-ERD group, sputum eosinophil percentage decreased after both oral (8.9% ± 11.6% vs. 6.1% ± 8.9%, p = 0.009) and inhaled (10.4% ± 16.1% vs. 4.8% ± 6.3%, p = 0.045) challenges, without altering inflammatory phenotypes. The ATA group showed no changes. Sputum macrophage percentage dropped after oral challenge in both groups (N-ERD: 40.5% ± 18.5% vs. 35.6% ± 21.5%; p = 0.004; ATA: 36.5% ± 23.6% vs. 26.7% ± 20.4%; p = 0.0003). In the N-ERD group, baseline sputum lymphocyte and eosinophil percentages were inversely correlated with the provocative dose of aspirin that resulted in a 20% decrease in baseline forced expiratory volume in 1 s following oral aspirin challenge (R = −0.31, p = 0.02 and R = −0.33, p = 0.02, respectively).

Conclusion

In N-ERD, sputum eosinophil percentage decreased after aspirin challenge regardless of administration route. In both N-ERD and ATA, sputum macrophage percentage decreased after oral aspirin challenge.

诱导痰细胞计数是评估气道炎症表型的关键。本研究探讨了非甾体抗炎药加重呼吸系统疾病（N-ERD）患者阿司匹林诱导的支气管痉挛对痰细胞计数的影响，比较了全身和局部阿司匹林给药。方法对78例N-ERD患者和39例阿斯匹林耐受性哮喘（ATA）患者进行研究。在N-ERD组，在阿司匹林刺激前和阿司匹林引起的支气管痉挛期间收集诱导痰。我们评估了嗜酸性粒细胞、中性粒细胞、淋巴细胞和巨噬细胞百分比的变化，以及按痰细胞分类的气道炎症表型：(A)嗜酸性粒细胞、嗜中性粒细胞、少粒细胞和混合型；(B)嗜酸性和非嗜酸性。结果N-ERD组痰中性粒细胞基线百分比低于ATA组（32.9%±20.8% vs 41.6%±22.5%;p = 0.02）。两组的炎症表型在基线时存在差异（A: p = 0.041; B: p = 0.044）。在N-ERD组，口服（8.9%±11.6% vs. 6.1%±8.9%,p = 0.009）和吸入（10.4%±16.1% vs. 4.8%±6.3%,p = 0.045）刺激后痰嗜酸性粒细胞百分比下降，未改变炎症表型。ATA组没有变化。两组口腔攻毒后痰中巨噬细胞百分比均下降（N-ERD: 40.5%±18.5% vs. 35.6%±21.5%,p = 0.004; ATA: 36.5%±23.6% vs. 26.7%±20.4%,p = 0.0003）。在N-ERD组中，基线痰淋巴细胞和嗜酸性粒细胞百分比与阿司匹林刺激剂量呈负相关，阿司匹林刺激剂量导致口服阿司匹林刺激后1 s内基线用力呼气量减少20% （R = - 0.31, p = 0.02和R = - 0.33, p = 0.02）。结论在N-ERD中，不论给药途径如何，阿司匹林刺激后痰嗜酸性粒细胞百分比均下降。在N-ERD和ATA中，口服阿司匹林后痰中巨噬细胞百分比下降。

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引用次数: 0

Innovative Strategies to Reduce Exposure and Expression of the Major Cat Allergen Fel d 1 减少猫主要过敏原feld的暴露和表达的创新策略

IF 4 2区医学 Q2 ALLERGY

Clinical and Translational Allergy

Pub Date : 2025-09-09 DOI: 10.1002/clt2.70098

Simone Colosimo, Cristiana Indolfi, Vittoria Frattolillo, Gianluca Mondillo, Alessandra Perrotta, Mariapia Masino, Fabio Decimo, Michele Miraglia del Giudice

Background

Fel d 1, the primary allergen produced by cats, is a glycoprotein found mainly in their salivary and sebaceous glands. Due to its small size and stability, it easily becomes airborne and adheres to surfaces, posing a persistent problem for allergic individuals.

Methods

This article reviews innovative strategies aimed at reducing Fel d 1 expression and exposure and mitigating its allergic effects on humans.

Results

A key approach involves dietary supplementation with chicken egg-derived IgY antibodies specific to Fel d 1. These antibodies neutralize the allergen in the saliva, significantly reducing its transfer to the fur and environmental presence, with clinical studies showing a notable decrease in nasal symptoms among allergic individuals. Additional dietary factors, such as omega-3 fatty acids, polyphenols, and low-glycemic index foods, may further modulate allergen production via hormonal and sebaceous pathways. Immunotherapy options include the Fel-CuMV vaccine for cats and human-targeted treatments with monoclonal antibodies like REGN1908-1909, both of which demonstrate significant reductions in allergic symptoms. Genetic modification and hormonal manipulation (e.g., neutering) offer further avenues to lower Fel d 1 expression. Environmental strategies, including HEPA filters and protease treatments, can also help reduce allergen load in households.

Conclusions

Together, these approaches form a multifaceted framework for managing cat allergies, potentially allowing allergic individuals to coexist with their pets. Future research should aim to optimize these interventions and explore synergistic combinations to achieve more effective and personalized allergy management.

Key Message

This review summarizes innovative methods for reducing Fel d 1 production in cats, including genetic, immunological and dietary approaches, with potential implications for allergy prevention in humans.

猫产生的主要过敏原feld1是一种糖蛋白，主要存在于猫的唾液腺和皮脂腺中。由于其体积小且稳定，它很容易通过空气传播并附着在物体表面，对过敏的人造成持久的问题。方法本文综述了降低Fel d1表达和暴露、减轻其对人体过敏作用的创新策略。结果一个关键的方法是在饮食中添加针对Fel d1的鸡蛋源性IgY抗体。这些抗体中和唾液中的过敏原，显著减少其向皮毛和环境的转移，临床研究显示过敏个体的鼻症状显著减少。其他饮食因素，如ω -3脂肪酸、多酚和低血糖指数食物，可能通过激素和皮脂腺途径进一步调节过敏原的产生。免疫治疗方案包括针对猫的fell - cumv疫苗和针对人类的单克隆抗体（如REGN1908-1909）治疗，这两种方法都能显著减少过敏症状。基因改造和激素控制（例如，绝育）提供了进一步降低Fel d1表达的途径。环境策略，包括高效微粒过滤器和蛋白酶治疗，也可以帮助减少家庭中的过敏原负荷。总之，这些方法形成了一个管理猫过敏的多方面框架，潜在地允许过敏个体与他们的宠物共存。未来的研究应旨在优化这些干预措施，并探索协同组合，以实现更有效和个性化的过敏管理。本文综述了减少猫体内Fel d 1产生的创新方法，包括遗传、免疫和饮食方法，这些方法对预防人类过敏有潜在的指导意义。

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引用次数: 0