To understand the connection between Muc5AC expression and the likelihood of rhinosinusitis, with the goal of providing insights into its prospective use as a biomarker.
Methods
We searched PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases for studies up to November 2023 to conduct a literature review. After screening and quality assessment, eligible studies meeting the criteria were included. Muc5AC expression and rhinosinusitis association was analyzed by STATA 14.0.
Results
Including weighted mean difference and 95% confidence interval, were reported. The meta-analysis included 16 studies with 1448 rhinosinusitis patients. MUC5AC expression was significantly up-regulated in both chronic rhinosinusitis with nasal polyps (CRSwNP; WMD: 0.52; 95% CI: 0.41–0.63) and chronic rhinosinusitis without nasal polyps (CRSsNP; WMD: 0.42; 95% CI: 0.28–0.56) patients compared to controls. IHC positive area analysis corroborated these findings, with elevated MUC5AC levels in CRSwNP (WMD: 25.61; 95% CI: 22.41–28.81) and CRSsNP (WMD: 39.74; 95% CI: 25.6–53.88) patients. Subgroup analysis based on tissue type (nasal tissue fluid and sinus mucosa) consistently supported the overall results.
Conclusion
Our meta-analysis robustly demonstrates a significant association between elevated MUC5AC expression and rhinosinusitis risk. This finding underscores the potential of MUC5AC as a molecular marker, providing valuable insights for future research and potential therapeutic interventions in rhinosinusitis management.
{"title":"The expression of MUC5AC in patients with rhinosinusitis: A systematic review and meta-analysis","authors":"Yitao Li","doi":"10.1002/clt2.70003","DOIUrl":"10.1002/clt2.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To understand the connection between Muc5AC expression and the likelihood of rhinosinusitis, with the goal of providing insights into its prospective use as a biomarker.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases for studies up to November 2023 to conduct a literature review. After screening and quality assessment, eligible studies meeting the criteria were included. Muc5AC expression and rhinosinusitis association was analyzed by STATA 14.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Including weighted mean difference and 95% confidence interval, were reported. The meta-analysis included 16 studies with 1448 rhinosinusitis patients. MUC5AC expression was significantly up-regulated in both chronic rhinosinusitis with nasal polyps (CRSwNP; WMD: 0.52; 95% CI: 0.41–0.63) and chronic rhinosinusitis without nasal polyps (CRSsNP; WMD: 0.42; 95% CI: 0.28–0.56) patients compared to controls. IHC positive area analysis corroborated these findings, with elevated MUC5AC levels in CRSwNP (WMD: 25.61; 95% CI: 22.41–28.81) and CRSsNP (WMD: 39.74; 95% CI: 25.6–53.88) patients. Subgroup analysis based on tissue type (nasal tissue fluid and sinus mucosa) consistently supported the overall results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our meta-analysis robustly demonstrates a significant association between elevated MUC5AC expression and rhinosinusitis risk. This finding underscores the potential of MUC5AC as a molecular marker, providing valuable insights for future research and potential therapeutic interventions in rhinosinusitis management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Systematic review registration</h3>\u0000 \u0000 <p>CRD42024518932.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 11","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557307","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}
Claudia Arasa, Niamh Hyland, Caroline Nilsson, Eva Sverremark-Ekström
<p>To the Editor,</p><p><i>Staphylococcus (S</i>.<i>) aureus</i> is an intermittent or permanent skin colonizer in 90% of patients with airway diseases, and staphylococcal enterotoxin-IgE serum levels have been linked to both allergy and severe asthma.<span><sup>1, 2</sup></span> During pregnancy, immune adaptation is required to ensure fetal growth,<span><sup>3</sup></span> and type 2 responses are enhanced. These changes potentially worsen allergic conditions and increase the susceptibility to certain infections.<span><sup>4</sup></span></p><p>Here we investigate the immune response to Staphylococcal enterotoxin A (SEA), a strong inducer of type 1 responses, in individuals with Th2-skewing,<span><sup>5</sup></span> using peripheral blood mononuclear cells (PBMC) from allergic and non-allergic, pregnant and non-pregnant women<span><sup>6</sup></span> (Figure 1A). Staphylococcal enterotoxins cause polyclonal T cell activation crosslinking the MHC-II on antigen-presenting cells (APCs) to the T-cell receptor (TCR) on T-cells (Figure 1B), leading to a strong proinflammatory response, potentially increasing IgE-production or disrupting the maternal-fetal tolerance.</p><p>Allergic individuals exhibited reduced Tbet expression (Figure 1C), associated with Th1 response, and lower type 1 cytokine production (IFN-γ and TNF; Figure 1D). These differences were not observed during pregnancy (Figure S1A). GATA3 expression, linked to Th2 responses, was lower in allergic individuals regardless of their pregnancy status (Figure 1E), but there was no difference in type 2 cytokine secretion (IL-5 and IL-13; Figure S1B and Figure 1F). Type 3- and regulatory T cell markers (RORγt or FoxP3 expression and IL-17 and IL-10 secretion, respectively) did not differ in any of the groups (Figure S1C,D). Analyzing IFN-γ and TNF production in conventional T cells outside of pregnancy showed comparable IFN-γ levels between allergic and non-allergic individuals (Figure 1G). During pregnancy, IFN-γ production was significantly reduced in non-allergic individuals (Figure 1H) but not in allergic (Figure 1I). TNF production was lower in allergic individuals, but it increased during pregnancy (Figure S2A).</p><p>We have previously shown that the response to SEA by unconventional lymphocytes is delayed, and that their activation strongly contributes to the elicited cytokine storm<span><sup>7</sup></span> (Figure 2A). Therefore, we wanted to elucidate whether the allergy-related differences seen in conventional T cell activation correlated with variations in the unconventional lymphocyte compartment. All the analyzed cell types showed a consistent pattern, characterized by a significantly lower expression of IFN-γ (Figure 2B) and TNF (Figure S2B) in allergic women. Furthermore, analyzing the longitudinal response of unconventional lymphocytes to SEA in pregnant allergic women, we identified significantly higher production of both IFN-γ (Figure 2C) and TNF (Figure S2C) across all the st
{"title":"Pregnancy impacts allergy-related differences in the response to a type-1 stimulus, staphylococcal enterotoxin A","authors":"Claudia Arasa, Niamh Hyland, Caroline Nilsson, Eva Sverremark-Ekström","doi":"10.1002/clt2.70007","DOIUrl":"10.1002/clt2.70007","url":null,"abstract":"<p>To the Editor,</p><p><i>Staphylococcus (S</i>.<i>) aureus</i> is an intermittent or permanent skin colonizer in 90% of patients with airway diseases, and staphylococcal enterotoxin-IgE serum levels have been linked to both allergy and severe asthma.<span><sup>1, 2</sup></span> During pregnancy, immune adaptation is required to ensure fetal growth,<span><sup>3</sup></span> and type 2 responses are enhanced. These changes potentially worsen allergic conditions and increase the susceptibility to certain infections.<span><sup>4</sup></span></p><p>Here we investigate the immune response to Staphylococcal enterotoxin A (SEA), a strong inducer of type 1 responses, in individuals with Th2-skewing,<span><sup>5</sup></span> using peripheral blood mononuclear cells (PBMC) from allergic and non-allergic, pregnant and non-pregnant women<span><sup>6</sup></span> (Figure 1A). Staphylococcal enterotoxins cause polyclonal T cell activation crosslinking the MHC-II on antigen-presenting cells (APCs) to the T-cell receptor (TCR) on T-cells (Figure 1B), leading to a strong proinflammatory response, potentially increasing IgE-production or disrupting the maternal-fetal tolerance.</p><p>Allergic individuals exhibited reduced Tbet expression (Figure 1C), associated with Th1 response, and lower type 1 cytokine production (IFN-γ and TNF; Figure 1D). These differences were not observed during pregnancy (Figure S1A). GATA3 expression, linked to Th2 responses, was lower in allergic individuals regardless of their pregnancy status (Figure 1E), but there was no difference in type 2 cytokine secretion (IL-5 and IL-13; Figure S1B and Figure 1F). Type 3- and regulatory T cell markers (RORγt or FoxP3 expression and IL-17 and IL-10 secretion, respectively) did not differ in any of the groups (Figure S1C,D). Analyzing IFN-γ and TNF production in conventional T cells outside of pregnancy showed comparable IFN-γ levels between allergic and non-allergic individuals (Figure 1G). During pregnancy, IFN-γ production was significantly reduced in non-allergic individuals (Figure 1H) but not in allergic (Figure 1I). TNF production was lower in allergic individuals, but it increased during pregnancy (Figure S2A).</p><p>We have previously shown that the response to SEA by unconventional lymphocytes is delayed, and that their activation strongly contributes to the elicited cytokine storm<span><sup>7</sup></span> (Figure 2A). Therefore, we wanted to elucidate whether the allergy-related differences seen in conventional T cell activation correlated with variations in the unconventional lymphocyte compartment. All the analyzed cell types showed a consistent pattern, characterized by a significantly lower expression of IFN-γ (Figure 2B) and TNF (Figure S2B) in allergic women. Furthermore, analyzing the longitudinal response of unconventional lymphocytes to SEA in pregnant allergic women, we identified significantly higher production of both IFN-γ (Figure 2C) and TNF (Figure S2C) across all the st","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 10","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496243","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}
We would like to thank the authors for their thoughtful and constructive comments on our publication, “Milk ladder versus early oral immunotherapy in infants with cow's milk protein allergy.” We appreciate their interest and engagement in this clinical discussion on the management of cow milk protein allergy (CMPA).
The use of dietary advancement therapies (DATs) such as milk and egg ladders is becoming widespread in the global allergy community. It is important to collect and share local data on these practices to expand our collective knowledge of the treatment of food allergies.
As the authors rightly pointed out, our study was conducted in a real-world clinical setting where, due to various practical constraints, we used parent-reported clinical histories and sensitization markers instead of the gold-standard Oral Food Challenge (OFC) for most patients. Data on patients who only had previous immediate allergic reactions due to the ingestion of cow milk protein is shown Table S1. The remaining patients had high levels of cow milk-specific IgE (>5 kUA/L), which exceeded 95% of the predicted value for diagnosing CMPA. We acknowledge that this is a limitation and agree that the absence of a challenge-proven allergy could have led to the inclusion of some children with asymptomatic sensitization or those with parent-reported symptoms without OFC. Nonetheless, we aimed to reflect the reality of clinical practice in which OFC is not always feasible or conducted in every case.
We also concur with the authors' insightful differentiation between the primary, secondary, and tertiary allergy prevention and the need to carefully classify patients undergoing milk introduction based on their clinical history and sensitization status. The suggestion that some patients in our study may have undergone the primary or secondary prevention is an important consideration. This underscores the complexity of managing food allergies in clinical settings where treatment protocols often overlap.
In agreement with the authors, we recognize that tolerance and reintroduction outcomes must be carefully labeled, particularly in the absence of prior confirmation of allergy through the OFC. We believe that further studies employing more rigorous diagnostic criteria will be crucial to refine treatment protocols and ensure that true allergic responses are addressed in our interventions.
Once again, we appreciate the authors' valuable feedback and our opportunity to further clarify and discuss the important aspects of CMPA management. We hope that our study contributes meaningfully to the ongoing advancement of DATs, such as Milk Ladder and Early Oral Immunotherapy, and we welcome further comments and discussions in this field.
Chisato Inuo: Writing—original draft. Yurika Matsumoto: Writing—review and editing.
{"title":"Response to comments on ‘Milk ladder versus early oral immunotherapy in infants with cow's milk protein allergy’","authors":"Chisato Inuo, Yurika Matsumoto","doi":"10.1002/clt2.70001","DOIUrl":"10.1002/clt2.70001","url":null,"abstract":"<p>Dear Editor,</p><p>We would like to thank the authors for their thoughtful and constructive comments on our publication, “Milk ladder versus early oral immunotherapy in infants with cow's milk protein allergy.” We appreciate their interest and engagement in this clinical discussion on the management of cow milk protein allergy (CMPA).</p><p>The use of dietary advancement therapies (DATs) such as milk and egg ladders is becoming widespread in the global allergy community. It is important to collect and share local data on these practices to expand our collective knowledge of the treatment of food allergies.</p><p>As the authors rightly pointed out, our study was conducted in a real-world clinical setting where, due to various practical constraints, we used parent-reported clinical histories and sensitization markers instead of the gold-standard Oral Food Challenge (OFC) for most patients. Data on patients who only had previous immediate allergic reactions due to the ingestion of cow milk protein is shown Table S1. The remaining patients had high levels of cow milk-specific IgE (>5 kU<sub>A</sub>/L), which exceeded 95% of the predicted value for diagnosing CMPA. We acknowledge that this is a limitation and agree that the absence of a challenge-proven allergy could have led to the inclusion of some children with asymptomatic sensitization or those with parent-reported symptoms without OFC. Nonetheless, we aimed to reflect the reality of clinical practice in which OFC is not always feasible or conducted in every case.</p><p>We also concur with the authors' insightful differentiation between the primary, secondary, and tertiary allergy prevention and the need to carefully classify patients undergoing milk introduction based on their clinical history and sensitization status. The suggestion that some patients in our study may have undergone the primary or secondary prevention is an important consideration. This underscores the complexity of managing food allergies in clinical settings where treatment protocols often overlap.</p><p>In agreement with the authors, we recognize that tolerance and reintroduction outcomes must be carefully labeled, particularly in the absence of prior confirmation of allergy through the OFC. We believe that further studies employing more rigorous diagnostic criteria will be crucial to refine treatment protocols and ensure that true allergic responses are addressed in our interventions.</p><p>Once again, we appreciate the authors' valuable feedback and our opportunity to further clarify and discuss the important aspects of CMPA management. We hope that our study contributes meaningfully to the ongoing advancement of DATs, such as Milk Ladder and Early Oral Immunotherapy, and we welcome further comments and discussions in this field.</p><p><b>Chisato Inuo</b>: Writing—original draft. <b>Yurika Matsumoto</b>: Writing—review and editing.</p>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 10","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496244","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}
Following the increased use of biological agents, a subset of patients experiences hypersensitivity reaction (HSR). We reported our experience with rapid drug desensitization (RDD) to nine biologics (rituximab, infliximab, cetuximab, trastuzumab, pertuzumab, nivolumab, brentuximab, tocilizumab and filgrastim) and identified risk factors for breakthrough reactions (BTRs).
Method
This was a retrospective review (2013–2022) of patients with immediate HSRs to biological agents. Initial HSRs were classified as grade 1, 2, or 3 in their severity. Skin prick tests (SPT)/intradermal tests (IDT) were performed using implicated agents. The phenotypes of HSRs were defined as Type I, cytokine-release syndrome (CRS), mixed reactions (cytokine-release + type I) based on history, clinical presentations and skin tests with implicated biologicals. A 12-step RDD protocol was used.
Results
The study comprised 45 patients (F/M: 31/14, median age: 55 (range: 20–69)). Majority of the patients reacted at the first infusion (n: 29/45, 64.4%). The majority of initial HSRs were grade 3 (n: 24/45, 53.3%) and grade 2 (n: 21/45, 46.6%); none were grade 1. Initial reactions were presented as type I (n: 20/45, 44.4%), CRS (n: 12/45, 26.6%) and mixed (n: 13/45, 28.8%). A total of 258 RDDs were performed and 98.4% of them were completed successfully. BTRs occurred in 36/258 (13.9%) infusions of RDDs. There was no significant association between the BTRs and age, drug cycle, SPT and IDT positivity, gender, comorbidities, or atopy.
Conclusion
In our experience, 98.4% of 258 RDDs to biologics were successfully completed; RDD was safe and effective for our population.
{"title":"Retrospective analysis of rapid drug desensitization with biologic agents: A single center experience","authors":"Döne Gülçin Unutmaz Erkaya, Makbule Seda Bayrak Durmaz, Begüm Görgülü Akın, Sevim Bavbek","doi":"10.1002/clt2.12397","DOIUrl":"10.1002/clt2.12397","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Following the increased use of biological agents, a subset of patients experiences hypersensitivity reaction (HSR). We reported our experience with rapid drug desensitization (RDD) to nine biologics (rituximab, infliximab, cetuximab, trastuzumab, pertuzumab, nivolumab, brentuximab, tocilizumab and filgrastim) and identified risk factors for breakthrough reactions (BTRs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This was a retrospective review (2013–2022) of patients with immediate HSRs to biological agents. Initial HSRs were classified as grade 1, 2, or 3 in their severity. Skin prick tests (SPT)/intradermal tests (IDT) were performed using implicated agents. The phenotypes of HSRs were defined as Type I, cytokine-release syndrome (CRS), mixed reactions (cytokine-release + type I) based on history, clinical presentations and skin tests with implicated biologicals. A 12-step RDD protocol was used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study comprised 45 patients (F/M: 31/14, median age: 55 (range: 20–69)). Majority of the patients reacted at the first infusion (<i>n</i>: 29/45, 64.4%). The majority of initial HSRs were grade 3 (<i>n</i>: 24/45, 53.3%) and grade 2 (<i>n</i>: 21/45, 46.6%); none were grade 1. Initial reactions were presented as type I (<i>n</i>: 20/45, 44.4%), CRS (<i>n</i>: 12/45, 26.6%) and mixed (<i>n</i>: 13/45, 28.8%). A total of 258 RDDs were performed and 98.4% of them were completed successfully. BTRs occurred in 36/258 (13.9%) infusions of RDDs. There was no significant association between the BTRs and age, drug cycle, SPT and IDT positivity, gender, comorbidities, or atopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In our experience, 98.4% of 258 RDDs to biologics were successfully completed; RDD was safe and effective for our population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 10","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11493553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459511","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}
Neera Chakrapani, Kyra Swiontek, Judith M. Hübschen, Jörg Fischer, Maria Ruiz-Castell, Francoise Codreanu-Morel, Farah Hannachi, Martine Morisset, Markus Ollert, Annette Kuehn, Claude P. Muller, Christiane Hilger
Background
The α-Gal syndrome (AGS) is characterized by the presence of specific IgE-antibodies to the carbohydrate galactose-α-1,3-galactose (α-Gal). Sensitization to α-Gal has been associated with tick bites and individuals exposed to ticks have an elevated risk of sensitization. The aim of this study was to analyze IgG and IgE antibody responses to α-Gal in a high-risk cohort of forestry employees (FE) in Luxembourg.
Methods
Questionnaires and serum samples of FE from Luxembourg (n = 219) were retrospectively analyzed. α-Gal specific IgE was quantified by ImmunoCAP, α-Gal specific IgG and subclasses IgG1–4 were determined by ELISA. Additionally, sera from population-based controls (n = 150) and two groups of food-allergic patients, patients with AGS (n = 45) and fish-allergic patients (n = 22) were assessed for IgG antibody responses to α-Gal and cod extract.
Results
Twenty-one percent of FE was sensitized to α-Gal (sIgE ≥ 0.1 kUA/L). Both sensitized and non-sensitized FE exhibited high levels of α-Gal specific IgG, IgG1 and IgG3 compared with controls, indicating a stimulation of IgG responses by recurrent tick bites, independent of the sensitization status. AGS patients had the highest levels of IgG1 and IgG2 antibodies, whereas the profile of fish-allergic patients was similar to the profile of the controls for which anti-α-Gal responses were dominated by IgG2 antibodies. α-Gal sIgG4 levels were either very low or undetectable in all groups.
Conclusion
Our study provides evidence for a continuous stimulation of α-Gal related immune responses by repeated tick bites, translating into highly elevated levels of IgG1 antibodies directed against α-Gal.
{"title":"Recurrent tick bites induce high IgG1 antibody responses to α-Gal in sensitized and non-sensitized forestry employees in Luxembourg","authors":"Neera Chakrapani, Kyra Swiontek, Judith M. Hübschen, Jörg Fischer, Maria Ruiz-Castell, Francoise Codreanu-Morel, Farah Hannachi, Martine Morisset, Markus Ollert, Annette Kuehn, Claude P. Muller, Christiane Hilger","doi":"10.1002/clt2.12396","DOIUrl":"https://doi.org/10.1002/clt2.12396","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The α-Gal syndrome (AGS) is characterized by the presence of specific IgE-antibodies to the carbohydrate galactose-α-1,3-galactose (α-Gal). Sensitization to α-Gal has been associated with tick bites and individuals exposed to ticks have an elevated risk of sensitization. The aim of this study was to analyze IgG and IgE antibody responses to α-Gal in a high-risk cohort of forestry employees (FE) in Luxembourg.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Questionnaires and serum samples of FE from Luxembourg (<i>n</i> = 219) were retrospectively analyzed. α-Gal specific IgE was quantified by ImmunoCAP, α-Gal specific IgG and subclasses IgG<sub>1–4</sub> were determined by ELISA. Additionally, sera from population-based controls (<i>n</i> = 150) and two groups of food-allergic patients, patients with AGS (<i>n</i> = 45) and fish-allergic patients (<i>n</i> = 22) were assessed for IgG antibody responses to α-Gal and cod extract.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-one percent of FE was sensitized to α-Gal (sIgE ≥ 0.1 kU<sub>A</sub>/L). Both sensitized and non-sensitized FE exhibited high levels of α-Gal specific IgG, IgG1 and IgG3 compared with controls, indicating a stimulation of IgG responses by recurrent tick bites, independent of the sensitization status. AGS patients had the highest levels of IgG1 and IgG2 antibodies, whereas the profile of fish-allergic patients was similar to the profile of the controls for which anti-α-Gal responses were dominated by IgG2 antibodies. α-Gal sIgG4 levels were either very low or undetectable in all groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study provides evidence for a continuous stimulation of α-Gal related immune responses by repeated tick bites, translating into highly elevated levels of IgG1 antibodies directed against α-Gal.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 10","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12396","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435630","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}
Anna Valerieva, Teresa Caballero, Markus Magerl, Joao P. Frade, Paul K. Audhya, Timothy Craig
Background
Hereditary angioedema (HAE) is a rare genetic disorder characterized by unpredictable, debilitating episodes of submucosal and/or subcutaneous tissue swelling, which may be life-threatening depending on anatomic location. The two primary management strategies for HAE are ready access to effective on-demand treatment in all patients and the prevention of attacks (short-term prophylaxis [STP] and long-term prophylaxis [LTP]) in appropriate patients. All approved on-demand and most LTP medications require subcutaneous or intravenous administration. Injection-related challenges include trypanophobia (fear of needles), difficulty with self-administration, injection-site reactions (e.g., pain, erythema, bleeding, bruising), and anxiety—all contributing to poor compliance and administration delays. Oral HAE treatments may improve outcomes by reducing treatment barriers.
Aim
To review oral therapies, approved or in development, for on-demand treatment and/or prevention of HAE attacks.
Materials and Methods
To provide a comprehensive review, data was obtained from publicly available resources through a targeted PubMed literature review and supplemented by information provided on company websites (search cutoff of May 31, 2024).
Results
Berotralstat, an oral plasma kallikrein (PKa) inhibitor, is approved for LTP. Sebetralstat, another PKa inhibitor, is the investigational first oral on-demand HAE treatment to complete a phase 3 trial. Deucrictibant, an oral bradykinin B2 receptor antagonist, has completed phase 2 trials for on-demand therapy and LTP. Several other oral PKa inhibitors (ATN249, VE-4666, and VE-4062) are in early development for LTP.
Conclusion
Substantial advances have been made in the development of oral treatments for HAE. These treatments have the potential to improve and optimize clinical outcomes, satisfaction, and quality of life among patients with HAE.
{"title":"Advent of oral medications for the treatment of hereditary angioedema","authors":"Anna Valerieva, Teresa Caballero, Markus Magerl, Joao P. Frade, Paul K. Audhya, Timothy Craig","doi":"10.1002/clt2.12391","DOIUrl":"10.1002/clt2.12391","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hereditary angioedema (HAE) is a rare genetic disorder characterized by unpredictable, debilitating episodes of submucosal and/or subcutaneous tissue swelling, which may be life-threatening depending on anatomic location. The two primary management strategies for HAE are ready access to effective on-demand treatment in all patients and the prevention of attacks (short-term prophylaxis [STP] and long-term prophylaxis [LTP]) in appropriate patients. All approved on-demand and most LTP medications require subcutaneous or intravenous administration. Injection-related challenges include trypanophobia (fear of needles), difficulty with self-administration, injection-site reactions (e.g., pain, erythema, bleeding, bruising), and anxiety—all contributing to poor compliance and administration delays. Oral HAE treatments may improve outcomes by reducing treatment barriers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To review oral therapies, approved or in development, for on-demand treatment and/or prevention of HAE attacks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>To provide a comprehensive review, data was obtained from publicly available resources through a targeted PubMed literature review and supplemented by information provided on company websites (search cutoff of May 31, 2024).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Berotralstat, an oral plasma kallikrein (PKa) inhibitor, is approved for LTP. Sebetralstat, another PKa inhibitor, is the investigational first oral on-demand HAE treatment to complete a phase 3 trial. Deucrictibant, an oral bradykinin B2 receptor antagonist, has completed phase 2 trials for on-demand therapy and LTP. Several other oral PKa inhibitors (ATN249, VE-4666, and VE-4062) are in early development for LTP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Substantial advances have been made in the development of oral treatments for HAE. These treatments have the potential to improve and optimize clinical outcomes, satisfaction, and quality of life among patients with HAE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11431061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342775","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}
Jianwei Wang, Yu Zhang, Ying Chen, Xinjun Xu, Yujuan Yang, Jiali Yin, Jing Guo, Pengyi Yu, Zhen Liu, Huifang Liu, Ting Zuo, Hongfei Zhao, Yan Hao, Bei Zhang, Xicheng Song
Background
Studies involving chronic rhinosinusitis with nasal polyps (CRSwNP) have mostly focused on bilateral cases, making unilateral CRSwNP inadequately recognized. This study examined the differences in clinical characteristics, outcomes, and risk factors for poor outcomes between unilateral and bilateral CRSwNP to facilitate a better assessment in the two groups.
Methods
Demographic information, tissue and blood cells, endoscopic scores, Lund-Mackay scores, recurrence rates, and disease control conditions were compared between 310 unilateral and 596 bilateral CRSwNP patients. Furthermore, the stepwise regression multivariate Cox proportional hazard models were performed to generate risk factors for poor outcomes in the two groups.
Results
Bilateral cases exhibited higher rates of smoking, AR, and asthma comorbidities, along with higher numbers of tissue eosinophils and blood inflammatory cells when compared to unilateral patients. Endoscopic nasal polyp score, total computed tomography (CT) score (with scores for each sinus cavity), and adjusted CT scores were significantly higher in the bilateral group, except for a markedly higher adjusted maxillary score in the unilateral group. Furthermore, significantly higher proportions of bilateral patients experienced nasal polyp recurrence, uncontrolled status, and most disease control-related symptoms at follow-up. The primary risk factors for poor outcomes were asthma, tissue eosinophils, and total CT score in the bilateral group and blood basophils in the unilateral group.
Conclusions
Bilateral CRSwNP patients experience worse disease severity and outcomes than their unilateral counterparts. Primarily, asthma, tissue eosinophils, and total CT score were risk factors for poor outcomes in bilateral CRSwNP patients, with blood basophils in unilateral cases.
{"title":"Risk factors investigation for different outcomes between unilateral and bilateral chronic rhinosinusitis with nasal polyps patients","authors":"Jianwei Wang, Yu Zhang, Ying Chen, Xinjun Xu, Yujuan Yang, Jiali Yin, Jing Guo, Pengyi Yu, Zhen Liu, Huifang Liu, Ting Zuo, Hongfei Zhao, Yan Hao, Bei Zhang, Xicheng Song","doi":"10.1002/clt2.12395","DOIUrl":"https://doi.org/10.1002/clt2.12395","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Studies involving chronic rhinosinusitis with nasal polyps (CRSwNP) have mostly focused on bilateral cases, making unilateral CRSwNP inadequately recognized. This study examined the differences in clinical characteristics, outcomes, and risk factors for poor outcomes between unilateral and bilateral CRSwNP to facilitate a better assessment in the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Demographic information, tissue and blood cells, endoscopic scores, Lund-Mackay scores, recurrence rates, and disease control conditions were compared between 310 unilateral and 596 bilateral CRSwNP patients. Furthermore, the stepwise regression multivariate Cox proportional hazard models were performed to generate risk factors for poor outcomes in the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Bilateral cases exhibited higher rates of smoking, AR, and asthma comorbidities, along with higher numbers of tissue eosinophils and blood inflammatory cells when compared to unilateral patients. Endoscopic nasal polyp score, total computed tomography (CT) score (with scores for each sinus cavity), and adjusted CT scores were significantly higher in the bilateral group, except for a markedly higher adjusted maxillary score in the unilateral group. Furthermore, significantly higher proportions of bilateral patients experienced nasal polyp recurrence, uncontrolled status, and most disease control-related symptoms at follow-up. The primary risk factors for poor outcomes were asthma, tissue eosinophils, and total CT score in the bilateral group and blood basophils in the unilateral group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Bilateral CRSwNP patients experience worse disease severity and outcomes than their unilateral counterparts. Primarily, asthma, tissue eosinophils, and total CT score were risk factors for poor outcomes in bilateral CRSwNP patients, with blood basophils in unilateral cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12395","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142320743","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}
Jean Bousquet, Bernardo Sousa-Pinto, Josep M. Anto, Anna Bedbrook, Wienczyslawa Czarlewski, Ignacio J. Ansotegui, Karl-C. Bergmann, Fulvio Braido, Luisa Brussino, Lorenzo Cecchi, Claudia Chaves Loureiro, Alvaro A. Cruz, Philippe Devillier, Alessandro Fiocchi, Bilun Gemicioglu, Tari Haahtela, Juan Carlos Ivancevich, Ludger Klimek, Marek Kulus, Piotr Kuna, Maciej Kupczyk, Violeta Kvedariene, Desiree E. Larenas-Linnemann, Gilles Louis, Renaud Louis, Michael Makris, Mario Morais-Almeida, Marek Niedoszytko, Ken Ohta, Markus Ollert, Nikolaos Papadopoulos, Vincenzo Patella, Benoit Pétré, Oliver Pfaar, Francesca Puggioni, Santiago Quirce, Frederico S. Regateiro, Nicolas Roche, Philip W. Rouadi, Boleslaw Samolinski, Joaquin Sastre, Florence Schleich, Nicola Scichilone, Luis Taborda-Barata, Sanna Toppila-Salmi, Arunas Valiulis, Ilgim Vardaloglu Koyuncu, Maria Teresa Ventura, Arzu Yorgancioglu, Joao A. Fonseca, Torsten Zuberbier
Patient-reported outcome measures (PROMs) are used to assess a patient's health status at a particular point in time. They are essential in the development of person-centred care. This paper reviews studies performed on PROMs for assessing AR and asthma control, in particular VAS scales that are included in the app MASK-air® (Mobile Airways Sentinel networK) for asthma and rhinitis. VASs were initially developed on paper and pencil and tested for their criterion validity, cut-offs and responsiveness. Then, a multicentric, multinational, double-blind, placebo-controlled, randomised control trial (DB-PC-RCT) using an electronic VAS form was carried out. Finally, with the development of MASK-air® in 2015, previously validated VAS questions were adapted to the digital format and further methodologic evaluations were performed. VAS for asthma, rhinitis, conjunctivitis, work and EQ-5D are included in the app. Additionally, two control-medication scores for allergic symptoms of asthma (e-DASTHMA) were validated for their criterion validity, cut-offs and responsiveness.
病人报告结果测量（PROMs）用于评估病人在特定时间点的健康状况。它们对于发展以人为本的护理至关重要。本文回顾了针对评估 AR 和哮喘控制的 PROMs 所做的研究，特别是针对哮喘和鼻炎的应用程序 MASK-air®（移动呼吸哨兵网络）中包含的 VAS 量表。VAS 量表最初是在纸笔上编制的，并对其标准有效性、临界值和响应性进行了测试。然后，使用电子 VAS 表开展了一项多中心、多国、双盲、安慰剂对照、随机对照试验（DB-PC-RCT）。最后，随着 2015 年 MASK-air® 的开发，之前经过验证的 VAS 问题被调整为数字格式，并进行了进一步的方法学评估。应用程序中包含了针对哮喘、鼻炎、结膜炎、工作和 EQ-5D 的 VAS。此外，针对哮喘过敏症状的两个对照用药评分（e-DASTHMA）的标准有效性、临界值和响应性也得到了验证。
{"title":"Concurrent validity, cut-offs and ability to change of patient-reported outcome measures for rhinitis and asthma in MASK-air®","authors":"Jean Bousquet, Bernardo Sousa-Pinto, Josep M. Anto, Anna Bedbrook, Wienczyslawa Czarlewski, Ignacio J. Ansotegui, Karl-C. Bergmann, Fulvio Braido, Luisa Brussino, Lorenzo Cecchi, Claudia Chaves Loureiro, Alvaro A. Cruz, Philippe Devillier, Alessandro Fiocchi, Bilun Gemicioglu, Tari Haahtela, Juan Carlos Ivancevich, Ludger Klimek, Marek Kulus, Piotr Kuna, Maciej Kupczyk, Violeta Kvedariene, Desiree E. Larenas-Linnemann, Gilles Louis, Renaud Louis, Michael Makris, Mario Morais-Almeida, Marek Niedoszytko, Ken Ohta, Markus Ollert, Nikolaos Papadopoulos, Vincenzo Patella, Benoit Pétré, Oliver Pfaar, Francesca Puggioni, Santiago Quirce, Frederico S. Regateiro, Nicolas Roche, Philip W. Rouadi, Boleslaw Samolinski, Joaquin Sastre, Florence Schleich, Nicola Scichilone, Luis Taborda-Barata, Sanna Toppila-Salmi, Arunas Valiulis, Ilgim Vardaloglu Koyuncu, Maria Teresa Ventura, Arzu Yorgancioglu, Joao A. Fonseca, Torsten Zuberbier","doi":"10.1002/clt2.12390","DOIUrl":"10.1002/clt2.12390","url":null,"abstract":"<p>Patient-reported outcome measures (PROMs) are used to assess a patient's health status at a particular point in time. They are essential in the development of person-centred care. This paper reviews studies performed on PROMs for assessing AR and asthma control, in particular VAS scales that are included in the app MASK-air<sup>®</sup> (Mobile Airways Sentinel networK) for asthma and rhinitis. VASs were initially developed on paper and pencil and tested for their criterion validity, cut-offs and responsiveness. Then, a multicentric, multinational, double-blind, placebo-controlled, randomised control trial (DB-PC-RCT) using an electronic VAS form was carried out. Finally, with the development of MASK-air<sup>®</sup> in 2015, previously validated VAS questions were adapted to the digital format and further methodologic evaluations were performed. VAS for asthma, rhinitis, conjunctivitis, work and EQ-5D are included in the app. Additionally, two control-medication scores for allergic symptoms of asthma (e-DASTHMA) were validated for their criterion validity, cut-offs and responsiveness.</p>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12390","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307192","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}
Hay fever (HF) presents with various symptoms, including allergic conjunctivitis and rhinitis, and requires cross-organ treatment. This study assessed the impact of the coronavirus disease 2019 (COVID-19) pandemic on HF treatment trends.
Methods
This retrospective cohort study utilized data from the JMDC database collected between January 2018 and May 2021. Patients with HF were identified based on the relevant International Classification of Diseases 10th Revision diagnosis codes and the prescription of HF-related medications. The treatment approaches were compared during the cedar and cypress pollen allergy season (January to May in Japan) before and during the COVID-19 pandemic (2018 and 2019, and 2020 and 2021, respectively).
Results
This study included 2,598,178 patients with HF. The numbers of prescribed HF-related claims in 2018, 2019, 2020, and 2021 were 3,332,854, 3,534,198, 2,774,380, and 2,786,681 times, respectively. Oral second-generation antihistamine prescriptions decreased by >10% from 2019 to 2020, with a <10% change in the subsequent year. Anti-allergic eye drop prescriptions also decreased by >10% from 2019 to 2020 but increased by >10% from 2020 to 2021. Compared with 2018, 2019, and 2020, the number of claims in the rhinitis symptoms dominant group was significantly decreased in 2021 (p < 0.001, all). In contrast, the number of claims in the eye symptoms dominant group and the rhinitis and eye symptoms dominant group increased in 2021 compared with that in 2018, 2019, and 2020 (p < 0.001, all).
Conclusion
Changes in HF treatment and related outcomes could be attributed to lifestyle modifications resulting from the COVID-19 pandemic. Measures, such as limiting outdoor activities and adopting mask-wearing practices may have influenced HF symptoms, preventive behaviors, and the overall approach to treating HF.
{"title":"The impact of COVID-19 on hay fever treatment in Japan: A retrospective cohort study based on the Japanese claims database","authors":"Yasutsugu Akasaki, Takenori Inomata, Masao Iwagami, Jaemyoung Sung, Ken Nagino, Takeya Adachi, Hideaki Morita, Mayumi Tamari, Keigo Kainuma, Keiko Kan-o, Hiroaki Ogata, Masafumi Sakashita, Masaki Futamura, Yosuke Kurashima, Saeko Nakajima, Katsunori Masaki, Yasushi Ogawa, Sakura Sato, Akihiro Miyagawa, Akie Midorikawa-Inomata, Keiichi Fujimoto, Yuichi Okumura, Kenta Fujio, Tianxiang Huang, Kunihiko Hirosawa, Yuki Morooka, Akira Murakami, Shintaro Nakao","doi":"10.1002/clt2.12394","DOIUrl":"https://doi.org/10.1002/clt2.12394","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hay fever (HF) presents with various symptoms, including allergic conjunctivitis and rhinitis, and requires cross-organ treatment. This study assessed the impact of the coronavirus disease 2019 (COVID-19) pandemic on HF treatment trends.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study utilized data from the JMDC database collected between January 2018 and May 2021. Patients with HF were identified based on the relevant International Classification of Diseases 10th Revision diagnosis codes and the prescription of HF-related medications. The treatment approaches were compared during the cedar and cypress pollen allergy season (January to May in Japan) before and during the COVID-19 pandemic (2018 and 2019, and 2020 and 2021, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 2,598,178 patients with HF. The numbers of prescribed HF-related claims in 2018, 2019, 2020, and 2021 were 3,332,854, 3,534,198, 2,774,380, and 2,786,681 times, respectively. Oral second-generation antihistamine prescriptions decreased by >10% from 2019 to 2020, with a <10% change in the subsequent year. Anti-allergic eye drop prescriptions also decreased by >10% from 2019 to 2020 but increased by >10% from 2020 to 2021. Compared with 2018, 2019, and 2020, the number of claims in the rhinitis symptoms dominant group was significantly decreased in 2021 (<i>p</i> < 0.001, all). In contrast, the number of claims in the eye symptoms dominant group and the rhinitis and eye symptoms dominant group increased in 2021 compared with that in 2018, 2019, and 2020 (<i>p</i> < 0.001, all).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Changes in HF treatment and related outcomes could be attributed to lifestyle modifications resulting from the COVID-19 pandemic. Measures, such as limiting outdoor activities and adopting mask-wearing practices may have influenced HF symptoms, preventive behaviors, and the overall approach to treating HF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12394","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142245070","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}
Axel De Greef, Alexia Degraeuwe, Nina Nielens, Anne-Sophie Darrigade, Céline Bugli, Laurence de Montjoye, Marie Baeck
<p>To the Editor,</p><p>The Harmonizing Outcome Measures for Eczema (HOME) group has established that the evaluation of patients with atopic dermatitis (AD) should measure clinical signs, patient-reported symptoms, long-term control of the disease, and patients' quality of life.<span><sup>1</sup></span> To date, the existing scores<span><sup>2</sup></span> often assess only one of the aspects and are time-consuming. Furthermore, these scores assess the severity only at a certain time-point or over a maximum of seven consecutive days, and do not take into account the disease <i>activity</i>, defined as the fluctuations of AD.<span><sup>3</sup></span> We stated the need for a score that effectively assesses this dynamic aspect of the disease.<span><sup>4</sup></span> Preliminary results of a newly developed score, the “Atopic Dermatitis Score 7” (ADS7), inspired by the Urticaria Activity Score 7 (UAS7), showed a good correlation with the scores currently used in AD (Figure 1).<span><sup>5</sup></span></p><p>The aims of the present study were (i) to demonstrate ADS7 correlation with SCORing Atopic Dermatitis (SCORAD) on a larger cohort, and (ii) to evaluate if ADS7 was able to highlight the <i>activity</i> of the disease. It was therefore renamed “Atopic Dermatitis Activity Score 7” (ADAS7). We prospectively enrolled 137 patients with AD between September 2021 and August 2023 from Belgian academic and non-academic hospitals (outpatient clinics). One hundred patients completed the score daily for a period of maximum 6 months and were included for analyses (37 were lost to follow-up). Study design, statistical analyses and descriptive analysis of the patients' cohort at baseline are detailed in Supporting Information S1.</p><p>Intraclass correlation coefficient was 0.594, with a 95% confidence interval of [0.451–0.708] (<i>p</i> < 0.001) when comparing ADAS7 values with SCORAD. Using a cut-off value of ≥18 (as defined and validated in the preliminary study<span><sup>5</sup></span>) to detect moderate-to-severe patients, positive and negative predictive values were 88.7% and 76.3%, respectively. Sensitivity and specificity were 85.9% and 80.5%, respectively. For a subset of 40 patients for whom long-term data were available, median ± interquartile range (IQR) ADAS7 scores were calculated and presented on boxplots to illustrate disease activity over a period of 15.5 ± 15.7, [9.2–25.0] weeks (median ± IQR, [quartile [Q]1 − Q3]) (Figure 2). Patients had “active” disease when their IQR value was >8.875 (median of the distribution of all patients' IQR values, used as threshold value—detailed demonstration of variability is provided in Supporting Information S1). Of these, 11/20 (55.0%) changed severity category (i.e., their IQR overlapped two categories) in contrast to 4/20 (20.0%) patients with non-active disease.</p><p>Effective management of AD patients and treatment adaptations must be based on reliable outcomes that reflect disease activity. With
阿克塞尔-德格里夫：构思；数据整理；形式分析；资金获取；调查；方法论；写作-原稿；写作-审阅和编辑。Alexia Degraeuwe：构思；数据整理；调查；方法论。妮娜-尼伦斯概念化；数据整理；调查；方法论。Anne-Sophie Darrigade：数据整理；调查Céline Bugli：概念化；方法论。Laurence de Montjoye：概念化；形式分析；调查；方法论；监督；写作-审阅和编辑。玛丽-贝克作者声明无利益冲突。
{"title":"Atopic Dermatitis Activity Score 7 (ADAS7): A tool for disease activity assessment","authors":"Axel De Greef, Alexia Degraeuwe, Nina Nielens, Anne-Sophie Darrigade, Céline Bugli, Laurence de Montjoye, Marie Baeck","doi":"10.1002/clt2.12393","DOIUrl":"https://doi.org/10.1002/clt2.12393","url":null,"abstract":"<p>To the Editor,</p><p>The Harmonizing Outcome Measures for Eczema (HOME) group has established that the evaluation of patients with atopic dermatitis (AD) should measure clinical signs, patient-reported symptoms, long-term control of the disease, and patients' quality of life.<span><sup>1</sup></span> To date, the existing scores<span><sup>2</sup></span> often assess only one of the aspects and are time-consuming. Furthermore, these scores assess the severity only at a certain time-point or over a maximum of seven consecutive days, and do not take into account the disease <i>activity</i>, defined as the fluctuations of AD.<span><sup>3</sup></span> We stated the need for a score that effectively assesses this dynamic aspect of the disease.<span><sup>4</sup></span> Preliminary results of a newly developed score, the “Atopic Dermatitis Score 7” (ADS7), inspired by the Urticaria Activity Score 7 (UAS7), showed a good correlation with the scores currently used in AD (Figure 1).<span><sup>5</sup></span></p><p>The aims of the present study were (i) to demonstrate ADS7 correlation with SCORing Atopic Dermatitis (SCORAD) on a larger cohort, and (ii) to evaluate if ADS7 was able to highlight the <i>activity</i> of the disease. It was therefore renamed “Atopic Dermatitis Activity Score 7” (ADAS7). We prospectively enrolled 137 patients with AD between September 2021 and August 2023 from Belgian academic and non-academic hospitals (outpatient clinics). One hundred patients completed the score daily for a period of maximum 6 months and were included for analyses (37 were lost to follow-up). Study design, statistical analyses and descriptive analysis of the patients' cohort at baseline are detailed in Supporting Information S1.</p><p>Intraclass correlation coefficient was 0.594, with a 95% confidence interval of [0.451–0.708] (<i>p</i> < 0.001) when comparing ADAS7 values with SCORAD. Using a cut-off value of ≥18 (as defined and validated in the preliminary study<span><sup>5</sup></span>) to detect moderate-to-severe patients, positive and negative predictive values were 88.7% and 76.3%, respectively. Sensitivity and specificity were 85.9% and 80.5%, respectively. For a subset of 40 patients for whom long-term data were available, median ± interquartile range (IQR) ADAS7 scores were calculated and presented on boxplots to illustrate disease activity over a period of 15.5 ± 15.7, [9.2–25.0] weeks (median ± IQR, [quartile [Q]1 − Q3]) (Figure 2). Patients had “active” disease when their IQR value was >8.875 (median of the distribution of all patients' IQR values, used as threshold value—detailed demonstration of variability is provided in Supporting Information S1). Of these, 11/20 (55.0%) changed severity category (i.e., their IQR overlapped two categories) in contrast to 4/20 (20.0%) patients with non-active disease.</p><p>Effective management of AD patients and treatment adaptations must be based on reliable outcomes that reflect disease activity. With","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12393","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142230917","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}
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