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Non-pharmacological interventions for asthma prevention and management across the life course: Umbrella review 在整个生命过程中对哮喘的预防和管理采取非药物干预措施:综述。
IF 4.4 2区 医学 Q2 ALLERGY Pub Date : 2024-02-29 DOI: 10.1002/clt2.12344
Xunliang Tong, Xinyue Zhang, Mengyuan Wang, Zijun Wang, Fawu Dong, Enying Gong, Torsten Zuberbier, Yanming Li

Background

The impact of non-pharmacological interventions (NPIs) on asthma prevention and management is insufficiently examined. We aim to comprehensively evaluate and synthesize existing evidence regarding the effectiveness of various NPIs throughout the life course.

Methods

We conducted a systematic search and screening of reviews that examined the effectiveness of various NPIs on asthma prevention and control in the Cochrane Library, PubMed, Embase, and Ovid databases. Data extraction was performed by considering the type of NPIs and the life course stages of the target population. Recommendations were provided by considering the quality of review assessed using the AMSTAR2 tool and the consistency of findings across reviews.

Results

We identified 145 reviews and mapped the evidence on the impact of 25 subtypes of NPIs on asthma prevention and control based on five stages of life course. Reviews indicated a shift of focus and various impacts of major NPIs on asthma prevention and control across life courses, while a few types of NPIs, such as physical exercise, appeared to be beneficial in children, adolescents and adults. Consistent and high-level evidence was observed only for psychological intervention on asthma control and quality of life among adults and older adults. Potential benefit with high-level evidence was reported on certain NPIs, such as vitamin D in reducing risk of developing asthma in offsprings in the prenatal stage, digital health interventions in improving asthma control from childhood to older adulthood, and breathing exercise in improving quality of life, asthma-related symptoms and lung function in adulthood and older adulthood.

Conclusion

This study emphasizes the significance of delivering NPIs to improve asthma prevention and management and highlights the heterogeneity regarding the impact of NPIs across life courses. High-quality research is urgently needed to further strengthen the evidence base of NPIs and tailored interventions should be considered in guideline development.

背景:非药物干预(NPI)对哮喘预防和管理的影响尚未得到充分研究。我们的目的是全面评估和综合现有证据,了解各种非药物干预措施在整个生命过程中的有效性:我们在 Cochrane Library、PubMed、Embase 和 Ovid 数据库中对研究各种 NPI 对哮喘预防和控制效果的综述进行了系统检索和筛选。提取数据时考虑了 NPI 的类型和目标人群的生命过程阶段。通过考虑使用 AMSTAR2 工具评估的综述质量以及各篇综述结论的一致性,提出建议:结果:我们确定了 145 篇综述,并根据生命历程的五个阶段对 25 种亚型非哮喘药物对哮喘预防和控制的影响进行了证据分析。综述表明,在不同的生命历程中,主要非营利性哮喘防治措施的重点有所转移,对哮喘防治的影响也各不相同,而体育锻炼等少数几种非营利性哮喘防治措施似乎对儿童、青少年和成人都有益处。只有心理干预对成人和老年人的哮喘控制和生活质量有一致的高水平证据。某些非哮喘干预措施的潜在益处具有高级别证据,如维生素 D 在产前阶段可降低后代患哮喘的风险,数字健康干预措施可改善儿童期至成年期的哮喘控制,呼吸运动可改善成年期和老年期的生活质量、哮喘相关症状和肺功能:本研究强调了提供非哮喘治疗方案对改善哮喘预防和管理的重要意义,并突出了非哮喘治疗方案在不同生命过程中产生的不同影响。目前急需开展高质量的研究,进一步加强 NPIs 的证据基础,在制定指南时应考虑量身定制的干预措施。
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引用次数: 0
Monitoring recurrent angioedema: Findings from the Turkish angioedema control test validation study 监测复发性血管性水肿:土耳其血管性水肿控制测试验证研究的结果。
IF 4.4 2区 医学 Q2 ALLERGY Pub Date : 2024-02-28 DOI: 10.1002/clt2.12342
Semra Demir, Deniz Eyice-Karabacak, Emek Kocatürk, Derya Ünal, İlkim Deniz Toprak, Pelin Korkmaz, Ayşe Feyza Aslan, Işıl Göğem İmren, Bahar Dikicier, Nevzat Kahveci, Nida Öztop, Rabia Öztaş Kara, Halim İşsever, Marcus Maurer, Karsten Weller, Aslı Gelincik

Background

Determination of control level in recurrent angioedema (RAE) is necessary to guide management. Here, we validated a Turkish version of the angioedema control test (AECT) for 4-week (AECT-4wk) and for 3-month (AECT-3mth) and assessed their utility in monitoring RAE.

Method

The recommended structured translation process for patient-reported outcome measures was completed. The final versions were administered to 51 patients with mast cell-mediated angioedema (MMAE) and 38 patients with hereditary angioedema, and the minimal clinically important difference (MCID) was determined. Additionally, anchor surveys comprising angioedema activity score for 28 days (AAS-28 day), visual analog score for angioedema control, Likert scale for the control level from the patient's perspective (LS-AEC), angioedema quality of life, short form-12 (SF-12) and patients' assessment of treatment sufficiency were applied.

Results

The Turkish AECT versions showed good convergent validity with a substantial correlation with anchor tools and known-group validity. Excellent internal consistency and reproducibility were observed. Equal or more than 10 of 16 points scored with the AECT-4wk and AECT-3mth identified patients with well-controlled disease. The disease activity, control and burden parameters were consistent with the disease control level defined depending on the cut-off point 10 of AECT. Three-point changes in AECT-4wk and -3 mt could detect MCID in disease control in all patients.

Conclusions

Turkish AECT versions are valid and reliable tools for assessing and monitoring disease control in patients with RAE. The use of the Turkish versions of the AECT in routine patient care, clinical trials and angioedema research is recommended.

背景:确定复发性血管性水肿(RAE)的控制水平对于指导治疗非常必要。在此,我们验证了土耳其版本的血管性水肿控制测试(AECT)4周(AECT-4wk)和3个月(AECT-3mth),并评估了其在监测RAE方面的实用性:方法:完成了建议的患者报告结果测量的结构化翻译过程。对51名肥大细胞介导的血管性水肿(MMAE)患者和38名遗传性血管性水肿患者实施了最终版本,并确定了最小临床重要差异(MCID)。此外,还采用了锚定调查,包括 28 天血管性水肿活动评分(AAS-28 天)、血管性水肿控制视觉模拟评分、患者角度的控制水平李克特量表(LS-AEC)、血管性水肿生活质量简表-12(SF-12)和患者对治疗充分性的评估:结果:土耳其 AECT 版本显示出良好的收敛效度,与锚定工具和已知组效度有很大的相关性。内部一致性和可重复性极佳。在 AECT-4wk 和 AECT-3mth 的 16 个得分点中,相同或超过 10 个得分点可识别出疾病控制良好的患者。疾病活动、控制和负担参数与根据 AECT 临界点 10 确定的疾病控制水平一致。AECT-4wk和-3mt的三点变化可检测出所有患者疾病控制的MCID:土耳其版 AECT 是评估和监测 RAE 患者疾病控制情况的有效而可靠的工具。建议在常规患者护理、临床试验和血管性水肿研究中使用土耳其版AECT。
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引用次数: 0
A global perspective on stepping down chronic spontaneous urticaria treatment: Results of the Urticaria Centers of Reference and Excellence SDown-CSU study 从全球视角看待慢性自发性荨麻疹的减量治疗:荨麻疹卓越参考中心 SDown-CSU 研究结果。
IF 4.4 2区 医学 Q2 ALLERGY Pub Date : 2024-02-14 DOI: 10.1002/clt2.12343
Murat Türk, Emek Kocatürk, Ragıp Ertaş, Luis Felipe Ensina, Silvia Mariel Ferrucci, Clive Grattan, Christian Vestergaard, Torsten Zuberbier, Marcus Maurer, Ana Maria Giménez-Arnau

Background

Although there have been significant advances in the treatment of chronic spontaneous urticaria (CSU) in recent years, there remains a lack of clear guidance on when and how to step down treatment in responders. This study aims to investigate stepping down approaches of different steps of CSU treatment from a global perspective.

Methods

“Stepping down chronic spontaneous urticaria treatment” (SDown-CSU) is an international, multicenter, observational, cross-sectional, survey-based study of the Urticaria Centers of Reference and Excellence (UCARE) network. The questionnaire included 48 questions completed by physicians in the UCARE network.

Results

Surveys completed by 103 physicians from 81 UCAREs and 34 countries were analyzed. Seventy-eight percent of the participants responded that they had a national urticaria management guideline written by their professional societies and 28% responded that they had to operate under a regulatory guideline proposed by central health funding organizations. Seventy-two and 58.7% of these national recommendations do not contain any detailed information on when and/or how CSU treatment should be discontinued. There was a lack of detailed information on antihistamines and cyclosporine in particular. A predefined maximum duration was generally not applicable to omalizumab and cyclosporine (81% and 82%, respectively). Nearly all UCAREs step down omalizumab within 6 months from the first controlled status and 42% discontinue cyclosporine after 6 months regardless of the control status.

Conclusions

The findings from the SDown-CSU study clearly highlight a global need for guidance on the process of stepping down treatment in CSU. Additionally, the study offers a step-down algorithm applicable to all stages of CSU treatment.

背景:尽管近年来慢性自发性荨麻疹(CSU)的治疗取得了重大进展,但对于应答者何时以及如何减量治疗仍缺乏明确的指导。本研究旨在从全球视角研究慢性自发性荨麻疹治疗不同步骤的减量方法:"慢性自发性荨麻疹减量治疗"(SDown-CSU)是一项国际性、多中心、观察性、横断面、基于调查的荨麻疹卓越参考中心(UCARE)网络研究。问卷包括 48 个问题,由 UCARE 网络的医生填写:分析了来自 81 个 UCARE 和 34 个国家的 103 名医生填写的调查问卷。78%的参与者回答说,他们拥有由其专业协会编写的国家荨麻疹管理指南,28%的参与者回答说,他们必须根据中央卫生筹资组织提出的监管指南开展工作。在这些国家级建议中,分别有 72% 和 58.7% 没有详细说明何时和/或如何停止 CSU 治疗。尤其缺乏关于抗组胺药和环孢素的详细信息。奥马珠单抗和环孢素一般不适用预定的最长疗程(分别为 81% 和 82%)。几乎所有 UCARE 都在首次控制状态后 6 个月内停用奥马珠单抗,42% 的 UCARE 在 6 个月后停用环孢素,无论控制状态如何:SDown-CSU研究的结果清楚地表明,全球都需要关于CSU减量治疗过程的指导。此外,该研究还提供了一种适用于 CSU 各个治疗阶段的减量算法。
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引用次数: 0
A cross talk between microbial metabolites and host immunity: Its relevance for allergic diseases 微生物代谢物与宿主免疫之间的交叉对话:与过敏性疾病的相关性
IF 4.4 2区 医学 Q2 ALLERGY Pub Date : 2024-02-11 DOI: 10.1002/clt2.12339
Purevsuren Losol, Magdalena Wolska, Tomasz P. Wypych, Lu Yao, Liam O'Mahony, Milena Sokolowska

Background

Allergic diseases, including respiratory and food allergies, as well as allergic skin conditions have surged in prevalence in recent decades. In allergic diseases, the gut microbiome is dysbiotic, with reduced diversity of beneficial bacteria and increased abundance of potential pathogens. Research findings suggest that the microbiome, which is highly influenced by environmental and dietary factors, plays a central role in the development, progression, and severity of allergic diseases. The microbiome generates metabolites, which can regulate many of the host’s cellular metabolic processes and host immune responses.

Aims and Methods

Our goal is to provide a narrative and comprehensive literature review of the mechanisms through which microbial metabolites regulate host immune function and immune metabolism both in homeostasis and in the context of allergic diseases.

Results and Discussion

We describe key microbial metabolites such as short-chain fatty acids, amino acids, bile acids and polyamines, elucidating their mechanisms of action, cellular targets and their roles in regulating metabolism within innate and adaptive immune cells. Furthermore, we characterize the role of bacterial metabolites in the pathogenesis of allergic diseases including allergic asthma, atopic dermatitis and food allergy.

Conclusion

Future research efforts should focus on investigating the physiological functions of microbiota-derived metabolites to help develop new diagnostic and therapeutic interventions for allergic diseases.

背景:近几十年来,包括呼吸道和食物过敏在内的过敏性疾病以及过敏性皮肤病的发病率急剧上升。在过敏性疾病中,肠道微生物组存在菌群失调,有益菌的多样性减少,潜在病原体的数量增加。研究结果表明,微生物组受环境和饮食因素的影响很大,在过敏性疾病的发生、发展和严重程度中起着核心作用。微生物组产生的代谢产物可以调节宿主的许多细胞代谢过程和宿主的免疫反应:我们的目标是对微生物代谢物在体内平衡和过敏性疾病中调节宿主免疫功能和免疫代谢的机制进行叙述性和全面的文献综述:我们描述了主要的微生物代谢物,如短链脂肪酸、氨基酸、胆汁酸和多胺,阐明了它们的作用机制、细胞靶点及其在调节先天性和适应性免疫细胞代谢中的作用。此外,我们还描述了细菌代谢物在过敏性疾病(包括过敏性哮喘、特应性皮炎和食物过敏)发病机制中的作用:结论:未来的研究工作应侧重于研究微生物群衍生代谢物的生理功能,以帮助开发新的过敏性疾病诊断和治疗干预措施。
{"title":"A cross talk between microbial metabolites and host immunity: Its relevance for allergic diseases","authors":"Purevsuren Losol,&nbsp;Magdalena Wolska,&nbsp;Tomasz P. Wypych,&nbsp;Lu Yao,&nbsp;Liam O'Mahony,&nbsp;Milena Sokolowska","doi":"10.1002/clt2.12339","DOIUrl":"10.1002/clt2.12339","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Allergic diseases, including respiratory and food allergies, as well as allergic skin conditions have surged in prevalence in recent decades. In allergic diseases, the gut microbiome is dysbiotic, with reduced diversity of beneficial bacteria and increased abundance of potential pathogens. Research findings suggest that the microbiome, which is highly influenced by environmental and dietary factors, plays a central role in the development, progression, and severity of allergic diseases. The microbiome generates metabolites, which can regulate many of the host’s cellular metabolic processes and host immune responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Methods</h3>\u0000 \u0000 <p>Our goal is to provide a narrative and comprehensive literature review of the mechanisms through which microbial metabolites regulate host immune function and immune metabolism both in homeostasis and in the context of allergic diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results and Discussion</h3>\u0000 \u0000 <p>We describe key microbial metabolites such as short-chain fatty acids, amino acids, bile acids and polyamines, elucidating their mechanisms of action, cellular targets and their roles in regulating metabolism within innate and adaptive immune cells. Furthermore, we characterize the role of bacterial metabolites in the pathogenesis of allergic diseases including allergic asthma, atopic dermatitis and food allergy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Future research efforts should focus on investigating the physiological functions of microbiota-derived metabolites to help develop new diagnostic and therapeutic interventions for allergic diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 2","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12339","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139717350","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
The long-term efficacy of intra-cervical lymphatic immunotherapy on adults with allergic rhinitis: A randomized controlled study 颈内淋巴免疫疗法对成人过敏性鼻炎的长期疗效:随机对照研究
IF 4.4 2区 医学 Q2 ALLERGY Pub Date : 2024-02-11 DOI: 10.1002/clt2.12341
Yang Qin, Weijun Huang, Rui Zheng, Qixing Wang, Qingqing Yu, Yin Li, Kai Wang, Jun Tang

Background

The efficacy and safety of the novel immunotherapy method, intra-cervical lymphatic immunotherapy (ICLIT), need to be investigated. Comparing it with subcutaneous immunotherapy (SCIT), we clarified the long-term efficacy and safety of intra-cervical lymphatic immunotherapy on allergic rhinitis (AR), and investigated the improvement of clinical efficacy of the booster injection at 1 year after ICLIT treatment.

Methods

Ninety adult patients with dust mite allergy were randomly divided into 3 groups: 30 in the SCIT group, 30 in the ILCLIT group, and 30 in ICLIT booster group. Changes in total symptom score (TSS), nasal symptom score (TNSS), ocular symptom score (TOSS) and total medication score (TMS) were evaluated in the three groups. Adverse reactions were recorded, and serum dust mite specific IgE (sIgE) and specific IgG4 were assessed in the ICLIT group and ICLIT booster group.

Results

TSS, TNSS, TOSS, and TMS scores were significantly lower in the three groups at 36 months after treatment (p < 0. 05). And at 36 months the ICLIT-booster group showed results similar to SCIT and superior to ICLIT (p < 0. 05). Serum specific IgE decreased in all three groups at 12 and 36 months after treatment, p < 0.01. The ICLIT group and the ICLIT booster group showed a significant increase in sIgG4, p < 0.01. None of the patients in the three groups had any serious systemic adverse effects during the 3-year follow-up.

Conclusion

The ICLIT treatment is effective and safe on AR. One booster injection of allergens at 1 year can greatly improve its long-term efficacy.

Trial Registry

Clinical trial registration number: ChiCTR1800017130.

背景 新型免疫疗法--颈内淋巴免疫疗法(ICLIT)的疗效和安全性有待研究。通过与皮下免疫疗法(SCIT)比较,我们明确了颈内淋巴免疫疗法对过敏性鼻炎(AR)的长期疗效和安全性,并研究了颈内淋巴免疫疗法治疗 1 年后加强注射对临床疗效的改善。 方法 将90例成年尘螨过敏患者随机分为3组:SCIT组30例、ILCLIT组30例、ICLIT加强组30例。评估三组患者的症状总分(TSS)、鼻部症状总分(TNSS)、眼部症状总分(TOSS)和用药总分(TMS)的变化。记录不良反应,并评估 ICLIT 组和 ICLIT 强化组的血清尘螨特异性 IgE(sIgE)和特异性 IgG4。 结果 在治疗后 36 个月,三组的 TSS、TNSS、TOSS 和 TMS 评分均显著降低(P < 0.)而在 36 个月时,ICLIT 强化组的结果与 SCIT 相似,优于 ICLIT(p < 0.)在治疗后的 12 个月和 36 个月,所有三组的血清特异性 IgE 都有所下降(p < 0.01)。ICLIT 组和 ICLIT 强化组的 sIgG4 显著增加(p < 0.01)。在为期 3 年的随访中,三组患者均未出现严重的全身不良反应。 结论 ICLIT 治疗对 AR 有效且安全。1 年注射一次过敏原加强剂可大大提高其长期疗效。 试验注册 临床试验注册号:ChiCTR1800017130。
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引用次数: 0
Food allergy outside the eight big foods in Europe: A systematic review and meta-analysis 欧洲八大食品之外的食物过敏:系统回顾和荟萃分析
IF 4.4 2区 医学 Q2 ALLERGY Pub Date : 2024-02-07 DOI: 10.1002/clt2.12338
Giulia C. I. Spolidoro, Sungkutu Nyassi, Daniil Lisik, Athina Ioannidou, Mohamed Mustafa Ali, Yohannes Tesfaye Amera, Graciela Rovner, Ekaterina Khaleva, Carina Venter, Ronald van Ree, Margitta Worm, Berber Vlieg-Boerstra, Aziz Sheikh, Antonella Muraro, Graham Roberts, Bright I. Nwaru

Background

The 2014 estimates of prevalence of food allergy (FA) in Europe published by the European Academy of Allergy and Clinical Immunology included only the eight so-called big foods (cow's milk/egg/wheat/soy/peanut/tree nuts/fish/shellfish). Those estimates have recently been updated. Complementing this, we sought to identify and estimate the prevalence of allergy to other foods that have been reported during the last decade.

Methods

Six databases were searched for studies published 2012–2021. Random-effects meta-analysis was performed to derive pooled prevalence of allergy to each food.

Results

Twenty-seven studies were included, containing a total of 66 FAs. Among the most frequently reported FAs, the lifetime and point prevalence range of self-reported kiwi allergy was 0.1%–1.0% and 0.2%–8.1%, respectively, while the food challenge (FC)-verified kiwi allergy point prevalence range was 0.01%–0.10%. The point prevalence range for self-reported peach allergy was 0.2%–3.2%, while the range for FC-verified peach allergy was 0.02%–0.05%. The lifetime and point prevalence range for self-reported tomato allergy was 0.01%–1.8% and 0.2%–2.1%, respectively.

Conclusion

Allergy to some foods traditionally not considered important are now emerging as relevant FAs. The focus on FA in Europe should not be limited to the so-called eight big FA, but extended to other types of foods which need to be considered both for clinical purposes and population risk assessment.

背景 欧洲过敏与临床免疫学学会 2014 年公布的欧洲食物过敏(FA)患病率估计值仅包括所谓的八大食物(牛奶/鸡蛋/小麦/大豆/花生/树坚果/鱼/贝类)。这些估计值最近已得到更新。作为补充,我们试图确定和估算过去十年间报道的对其他食物过敏的患病率。 方法 在六个数据库中检索了 2012-2021 年发表的研究。进行随机效应荟萃分析,得出对每种食物过敏的总流行率。 结果 共纳入 27 项研究,包含 66 种 FA。在最常报告的过敏原中,自我报告的猕猴桃过敏的终生和点流行率范围分别为 0.1%-1.0% 和 0.2%-8.1%,而经食物挑战 (FC) 验证的猕猴桃过敏的点流行率范围为 0.01%-0.10%。自我报告的桃子过敏的点流行率范围为 0.2%-3.2%,而经 FC 验证的桃子过敏的流行率范围为 0.02%-0.05%。自述番茄过敏的终生患病率和点患病率范围分别为 0.01%-1.8% 和 0.2%-2.1%。 结论 一些传统上被认为不重要的食物过敏现在已成为相关的食物过敏原。欧洲对 FA 的关注不应仅限于所谓的八大 FA,还应扩展到其他类型的食物,这些食物在临床和人群风险评估中都需要加以考虑。
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引用次数: 0
Pets, furry animal allergen components, and asthma in childhood 宠物、毛茸茸的动物过敏原成分与儿童哮喘
IF 4.4 2区 医学 Q2 ALLERGY Pub Date : 2024-02-05 DOI: 10.1002/clt2.12337
Katariina Lajunen, Anette M. Määttä, Kristiina Malmström, Satu Kalliola, Hanna Knihtilä, Terhi Savinko, L. Pekka Malmberg, Anna S. Pelkonen, Mika J. Mäkelä

Background

The use of component-resolved allergy diagnostics has provided a clearer understanding of the species-specific sensitization and severity of potential allergic reactions. This cross-sectional study aimed to determine whether sensitization to allergen components in furry animals is indicative of blood eosinophilia, a positive fractional exhaled nitric oxide (FeNO) test, abnormal lung function, and asthma symptoms in children. Additionally, we investigated whether having pets during childhood affects the development of asthma or allergic sensitization to furry animals.

Methods

We recruited 203 children aged 4–17 years with asthma diagnosis based on abnormal lung function and 33 controls. IgE-sensitization to allergen components for dogs, cats, and horses was analyzed using a multiplex microarray. Children were tested with FeNO, impulse oscillometry, spirometry, methacholine challenge, and skin prick test. A questionnaire was used to investigate pet ownership and symptom profile.

Results

FeNO results and blood eosinophilia revealed a correlation with sensitization to all furry animal allergens, particularly lipocalins (r = 0.203–0.560 and 0.206–0.560, respectively). Can f 3 was found to correlate with baseline R5 (r = 0.298). No association between methacholine challenge results and sensitization to furry animal allergens was found. Children with asthma who were sensitized to Can f 1, Can f 6, or both frequently reported asthma symptoms. Dog ownership was associated with a lower level of IgE-sensitization to lipocalins, fewer asthma symptoms, and less blood eosinophilia.

Conclusion

Furry animal allergen component IgE-sensitization is a risk factor for type 2-inflammation and asthma symptoms.

背景成分解析过敏诊断法的使用使人们对物种特异性过敏和潜在过敏反应的严重程度有了更清楚的了解。本横断面研究旨在确定对毛茸茸动物中过敏原成分的过敏是否会导致儿童血液中出现嗜酸性粒细胞增多、呼出一氧化氮(FeNO)检测呈阳性、肺功能异常和哮喘症状。此外,我们还研究了童年时期饲养宠物是否会影响哮喘或对毛茸茸动物过敏的发生。 方法 我们招募了 203 名根据肺功能异常诊断为哮喘的 4-17 岁儿童和 33 名对照组儿童。使用多重芯片分析了狗、猫和马过敏原成分的 IgE 致敏情况。对儿童进行了 FeNO、脉冲振荡仪、肺活量测定、甲基胆碱挑战和皮肤点刺试验。调查问卷用于调查宠物拥有情况和症状特征。 结果 FeNO 结果和血液嗜酸性粒细胞增多与所有毛茸茸的动物过敏原的致敏性有关,尤其是脂钙蛋白(r 分别为 0.203-0.560 和 0.206-0.560)。Can f 3 与基线 R5 相关(r = 0.298)。未发现甲基胆碱挑战结果与毛茸茸动物过敏原致敏之间存在关联。对 Can f 1、Can f 6 或两者都过敏的哮喘患儿经常报告哮喘症状。养狗与脂联素的 IgE 致敏水平较低、哮喘症状较少和血液嗜酸性粒细胞减少有关。 结论 毛茸茸的动物过敏原成分 IgE 致敏是导致 2 型炎症和哮喘症状的危险因素。
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引用次数: 0
Risk assessment behaviour when eating out in adults with food hypersensitivity 食物过敏症成人外出就餐时的风险评估行为
IF 4.4 2区 医学 Q2 ALLERGY Pub Date : 2024-01-31 DOI: 10.1002/clt2.12336
Rebecca C. Knibb, Lily Hawkins, Cassandra Screti, M. Hazel Gowland, Mamidipudi Thirumala Krishna, George du Toit, Christina J. Jones

Background

Food hypersensitivity (FHS) management requires daily risk assessments of all food and drinks consumed to prevent unpleasant and potentially fatal adverse reactions. Most research has focussed on food allergy in children and families. Little is known about the impact on adults or those with other FHS, such as food intolerance or coeliac disease. This study assessed differences in practices and risk assessment behaviours when eating out for adults with FHS.

Methods

Adult UK residents (N = 930; 820 females, 90 males; 95% White; mean age 50 years [±16.6SD]), with food allergy (18%), food intolerance (23%) coeliac disease (44%) or multiple FHS (15%) completed an online survey.

Results

Adults checked information to identify foods causing a reaction always or most of the time when eating out. However, adults with food intolerance reported checking significantly less often than adults with other FHS (all ps < 0.001). Adults reporting more severe FHS, medical rather than self-diagnosis of FHS, previous anaphylaxis, had called an ambulance or been in hospital due to a reaction checked information significantly more often (all ps < 0.001), but were also less confident in the information provided (all ps < 0.05). Adults with allergy, coeliac disease or multiple FHS were also less confident in written and verbal information provided than those with food intolerance (p < 0.01). The type of FHS, greater perceived severity of FHS and having a medical diagnosis consistently predicted risk assessment behaviours when eating out (all ps < 0.001).

Conclusion

Clinicians, patients and the food industry should be aware that the type of FHS, patient-perceived severity and past experience of reactions affect risk assessment behaviours when eating out. This should be considered when providing clinical advice and emergency plans.

背景 食物过敏(FHS)管理要求每天对食用的所有食物和饮料进行风险评估,以防止出现令人不快甚至可能致命的不良反应。大多数研究都集中在儿童和家庭的食物过敏问题上。而对于成年人或患有其他食物过敏症(如食物不耐受症或腹腔疾病)的人来说,他们所受的影响却知之甚少。本研究评估了患有 FHS 的成年人外出就餐时的做法和风险评估行为的差异。 方法 英国成年居民(N = 930;820 名女性,90 名男性;95% 白人;平均年龄 50 岁 [±16.6SD])、食物过敏症患者(18%)、食物不耐受患者(23%)、乳糜泻患者(44%)或多种食物过敏症患者(15%)完成了一项在线调查。 结果 成人在外出就餐时,总是或大部分时间都会查看信息,以确定会引起反应的食物。然而,患有食物不耐受症的成年人比患有其他食物过敏症的成年人检查的次数要少得多(所有数据均为 0.001)。报告有更严重的食物不耐受症、食物不耐受症的医学诊断而非自我诊断、曾发生过敏性休克、曾因反应而叫过救护车或住过医院的成年人检查信息的频率明显更高(所有 ps < 0.001),但他们对所提供信息的信心也更低(所有 ps < 0.05)。与食物不耐受者相比,患有过敏症、腹腔疾病或多种食物过敏症的成年人对所提供的书面和口头信息的信心也较低(P < 0.01)。食物不耐受症的类型、食物不耐受症的严重程度以及是否有医学诊断一致地预示着外出就餐时的风险评估行为(所有 ps 均为 0.001)。 结论 临床医生、患者和食品行业应该意识到,FHS 的类型、患者感知的严重程度和以往的反应经验会影响外出就餐时的风险评估行为。在提供临床建议和应急计划时应考虑到这一点。
{"title":"Risk assessment behaviour when eating out in adults with food hypersensitivity","authors":"Rebecca C. Knibb,&nbsp;Lily Hawkins,&nbsp;Cassandra Screti,&nbsp;M. Hazel Gowland,&nbsp;Mamidipudi Thirumala Krishna,&nbsp;George du Toit,&nbsp;Christina J. Jones","doi":"10.1002/clt2.12336","DOIUrl":"https://doi.org/10.1002/clt2.12336","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Food hypersensitivity (FHS) management requires daily risk assessments of all food and drinks consumed to prevent unpleasant and potentially fatal adverse reactions. Most research has focussed on food allergy in children and families. Little is known about the impact on adults or those with other FHS, such as food intolerance or coeliac disease. This study assessed differences in practices and risk assessment behaviours when eating out for adults with FHS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adult UK residents (<i>N</i> = 930; 820 females, 90 males; 95% White; mean age 50 years [±16.6SD]), with food allergy (18%), food intolerance (23%) coeliac disease (44%) or multiple FHS (15%) completed an online survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Adults checked information to identify foods causing a reaction always or most of the time when eating out. However, adults with food intolerance reported checking significantly less often than adults with other FHS (all <i>p</i>s &lt; 0.001). Adults reporting more severe FHS, medical rather than self-diagnosis of FHS, previous anaphylaxis, had called an ambulance or been in hospital due to a reaction checked information significantly more often (all <i>p</i>s &lt; 0.001), but were also less confident in the information provided (all <i>p</i>s &lt; 0.05). Adults with allergy, coeliac disease or multiple FHS were also less confident in written and verbal information provided than those with food intolerance (<i>p</i> &lt; 0.01). The type of FHS, greater perceived severity of FHS and having a medical diagnosis consistently predicted risk assessment behaviours when eating out (all <i>p</i>s &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Clinicians, patients and the food industry should be aware that the type of FHS, patient-perceived severity and past experience of reactions affect risk assessment behaviours when eating out. This should be considered when providing clinical advice and emergency plans.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 2","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12336","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139655588","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
Proteomic analysis of horse hair extracts provides no evidence for the existence of a hypoallergenic Curly Horse breed 马毛提取物的蛋白质组分析无法证明存在低过敏性卷毛马品种
IF 4.4 2区 医学 Q2 ALLERGY Pub Date : 2024-01-29 DOI: 10.1002/clt2.12329
Bente Janssen-Weets, Antoine Lesur, Gunnar Dittmar, François Bernardin, Eva Zahradnik, Monika Raulf, François Hentges, Carsten Bindslev-Jensen, Markus Ollert, Christiane Hilger

Background

The American Bashkir Curly Horse is frequently advertised to horse-allergic riders and claimed to be a so-called hypoallergenic breed that elicits fewer symptoms. Previous studies quantifying selected allergens in different breeds did not find a reduced allergen content in Curly Horses. Here, we provide a comprehensive proteomic analysis of horse hair extracts and a molecular analysis of the major allergen Equ c 1 with the aim of identifying differences in the Curly Horse breed that might explain their presumed reduced allergenic potential.

Methods

Horse hair extracts were prepared from Curly and American Quarter Horse breeds, separated by gender and castration status, extracts from other breeds served as controls. Extracts and native Equ c 1 (nEqu c 1) were analyzed by mass spectrometry. IgE-binding capacities of nEqu c 1 and its recombinant variants were tested by ELISA using sera of patients sensitized to horses. Structures and ligand binding abilities were analyzed by computational modeling and fluorescence quenching assays.

Results

All known respiratory horse allergens are present in hair extracts of Curly and Quarter Horses and share identical allergen-specific peptides. Lipocalin allergens are the most abundant proteins in horse hair extracts and contain several post-translational modifications. We identified two new variants of Equ c 1 that have similar IgE-binding capacities but show structural differences in their binding cavities and altered ligand binding behavior. There are no differences in IgE-binding of Equ c 1 derived from Curly Horses compared to other horse breeds.

Conclusion

Our data do not support the claim that Curly Horses are less allergenic than other breeds.

背景 美国巴什基尔卷毛马经常向对马匹过敏的骑手做广告,声称它是一种所谓的低过敏性品种,引起的症状较少。以前对不同品种的选定过敏原进行量化的研究并未发现卷毛马的过敏原含量有所降低。在此,我们对马毛提取物进行了全面的蛋白质组分析,并对主要过敏原 Equ c 1 进行了分子分析,目的是找出卷毛马品种的差异,以解释其过敏可能性降低的原因。 方法 从按性别和阉割状态区分的卷毛马和美国季马品种中提取马毛萃取物,其他品种的萃取物作为对照。提取物和原生 Equ c 1(nEqu c 1)通过质谱法进行分析。使用对马过敏的患者血清,通过 ELISA 方法检测了 nEqu c 1 及其重组变体的 IgE 结合能力。通过计算建模和荧光淬灭试验分析了其结构和配体结合能力。 结果 所有已知的呼吸道马过敏原都存在于卷毛马和四角马的毛发提取物中,并且具有相同的过敏原特异性肽。脂联素过敏原是马毛提取物中含量最高的蛋白质,包含多种翻译后修饰。我们发现了 Equ c 1 的两种新变体,它们具有相似的 IgE 结合能力,但在结合腔结构上存在差异,配体结合行为也有所改变。与其他马种相比,来自卷毛马的 Equ c 1 的 IgE 结合能力没有差异。 结论 我们的数据并不支持卷毛马过敏性低于其他马种的说法。
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引用次数: 0
Chronic spontaneous urticaria: Evidence of systemic microcirculatory changes 慢性自发性荨麻疹:全身微循环变化的证据。
IF 4.4 2区 医学 Q2 ALLERGY Pub Date : 2024-01-27 DOI: 10.1002/clt2.12335
Yora Mostmans, Marcus Maurer, Bertrand Richert, Vanessa Smith, Karin Melsens, Viviane De Maertelaer, Ines Saidi, Francis Corazza, Olivier Michel

Background

Chronic spontaneous urticaria (CSU) is a chronic inflammatory skin disease where activation of endothelial cells (ECs) at sites of skin lesions leads to increased blood flow, leakage of fluid into the skin, cellular infiltration, and vascular remodeling. To understand the disease duration and the sometimes vague systemic symptoms accompanying flares, the objective of this study was to examine if CSU comes with systemic vascular changes at the microcirculatory level.

Methods

We investigated CSU patients (n = 49) and healthy controls (HCs, n = 44) for microcirculatory differences by nailfold videocapillaroscopy (NVC) and for blood levels of the soluble EC biomarkers serum vascular endothelial growth factor (VEGF), soluble E-selectin, and stem cell factor (SCF). Patients were also assessed for clinical characteristics, disease activity, and markers of autoimmune CSU (aiCSU).

Results

CSU patients had significantly lower capillary density, more capillary malformations, and more irregular capillary dilations than HCs on NVC. Serum levels of VEGF, soluble E selectin and SCF were similar in CSU patients and HCs. CSU patients with higher VEGF levels had significantly more abnormal capillaries. Patients with markers of aiCSU, that is, low IgE levels or increased anti-TPO levels, had significantly more capillaries and less capillary dilations than those without.

Conclusion

Our results suggest that CSU comes with systemic microcirculatory changes, which may be driven, in part, by VEGF.

背景:慢性自发性荨麻疹(CSU)是一种慢性炎症性皮肤病:慢性自发性荨麻疹(CSU)是一种慢性炎症性皮肤病,皮肤病变部位的内皮细胞(EC)活化会导致血流量增加、液体渗入皮肤、细胞浸润和血管重塑。为了了解疾病的持续时间和有时伴随复发的模糊的全身症状,本研究旨在探讨 CSU 是否会在微循环水平上引起全身血管变化:方法:我们通过甲折摄像显微镜(NVC)和血清血管内皮生长因子(VEGF)、可溶性E-选择素和干细胞因子(SCF)等可溶性EC生物标志物的血液水平,对CSU患者(49人)和健康对照组(44人)的微循环差异进行了调查。此外,还对患者的临床特征、疾病活动性和自身免疫性CSU(aiCSU)标志物进行了评估:结果:CSU 患者的毛细血管密度、毛细血管畸形和不规则毛细血管扩张均明显低于接受 NVC 治疗的 HC 患者。CSU 患者和 HCs 血清中的血管内皮生长因子、可溶性 E 选择素和 SCF 水平相似。血管内皮生长因子水平较高的 CSU 患者异常毛细血管明显增多。具有 aiCSU 标记(即 IgE 水平低或抗-TPO 水平升高)的患者的毛细血管数量和毛细血管扩张程度均明显高于无 aiCSU 标记的患者:我们的研究结果表明,CSU 伴随着全身微循环的变化,而这种变化可能部分是由血管内皮生长因子驱动的。
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引用次数: 0
期刊
Clinical and Translational Allergy
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