House dust mite (HDM) allergy is a prevalent global health concern, with varying sensitization profiles observed across populations. We aimed to provide a comprehensive assessment of molecular allergen sensitization patterns in the Lithuanian population, with a focus on Dermatophagoides pteronyssinus (Der p), and investigate patterns of concomitant reactivity among different allergens to enhance the accuracy of HDM allergy diagnostics.
Methods
A comprehensive analysis of 1520 patient test results in Lithuania from 2020 to 2022 was performed. Sensitization patterns to major (Der p 1, Der p 2, and Der p 23) and minor (Der p 5, Der p 7, and Der p 21) Der p allergen components were described using molecular-based diagnostics. Additionally, we investigated sensitization to allergen components from other allergen sources, including tropomyosins (Der p 10, Per a 7, Pen m 1, Ani s 3, Blo t 10) and arginine kinases (Pen m 2, Bla g 9, Der p 20).
Results
This study reveals a high prevalence of HDM sensitization in Lithuania - 481 individuals (45.38% of the sensitized group) exhibited sensitization to at least one Der p allergen component. Importantly, within the sensitized group, 37.21% of patients were sensitized to Der p 5, Der p 7, or Der p 21 in addition to major allergenic components. Distinct sensitization patterns were observed across different age groups, indicating the influence of age-related factors. Furthermore, we confirmed cross-reactivity between Der p 5 and Blo t 5 as well as between Der p 21 and Blo t 21, emphasizing the clinical relevance of these associations. We also highlighted the complexity of sensitization patterns among tropomyosins and arginine kinases.
Conclusion
This study provides valuable insights into HDM allergy sensitization profiles in Lithuania, emphasizing the importance of considering major and minor HDM allergen components for accurate diagnosis and management of HDM-related allergic diseases. Differences between populations and age-related factors impact sensitization patterns. Understanding concomitant reactivity among allergens, such as Der p 5 and Blo t 5, Der p 21 and Blo t 21, tropomyosins, and arginine kinases, is crucial for improving diagnostic strategies and developing targeted interventions for allergic individuals.
背景 家庭尘螨（HDM）过敏是全球普遍关注的健康问题，不同人群的过敏情况各不相同。我们的目的是全面评估立陶宛人群的分子过敏原致敏模式，重点是Dermatophagoides pteronyssinus (Der p)，并研究不同过敏原之间的伴随反应模式，以提高HDM过敏诊断的准确性。 方法 对立陶宛 2020 年至 2022 年期间 1520 名患者的检测结果进行了综合分析。使用分子诊断方法描述了主要（Der p 1、Der p 2 和 Der p 23）和次要（Der p 5、Der p 7 和 Der p 21）Der p 过敏原成分的致敏模式。此外，我们还研究了对其他过敏原来源的过敏原成分的致敏性，包括肌球蛋白（Der p 10、Per a 7、Pen m 1、Ani s 3、Blo t 10）和精氨酸激酶（Pen m 2、Bla g 9、Der p 20）。 结果 这项研究揭示了立陶宛人对 HDM 过敏的高发病率--481 人（占过敏人群的 45.38%）至少对一种 Der p 过敏原成分过敏。重要的是，在致敏人群中，37.21% 的患者除了对主要过敏原成分过敏外，还对 Der p 5、Der p 7 或 Der p 21 过敏。在不同年龄组中观察到了不同的致敏模式，这表明了年龄相关因素的影响。此外，我们还证实了 Der p 5 和 Blo t 5 之间以及 Der p 21 和 Blo t 21 之间的交叉反应，强调了这些关联的临床意义。我们还强调了肌球蛋白和精氨酸激酶之间致敏模式的复杂性。 结论 本研究为了解立陶宛人对 HDM 过敏的致敏情况提供了有价值的见解，强调了考虑主要和次要 HDM 过敏原成分对于准确诊断和治疗 HDM 相关过敏性疾病的重要性。人群之间的差异和年龄相关因素会影响过敏模式。了解过敏原（如 Der p 5 和 Blo t 5、Der p 21 和 Blo t 21、肌肽和精氨酸激酶）之间的伴随反应性对于改进诊断策略和为过敏个体制定有针对性的干预措施至关重要。
{"title":"Sensitization profiles to house dust mite Dermatophagoides pteronyssinus molecular allergens in the Lithuanian population: Understanding allergic sensitization patterns","authors":"Gabija Biliute, Monika Miskinyte, Asta Miskiniene, Aukse Zinkeviciene, Violeta Kvedariene","doi":"10.1002/clt2.12332","DOIUrl":"https://doi.org/10.1002/clt2.12332","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>House dust mite (HDM) allergy is a prevalent global health concern, with varying sensitization profiles observed across populations. We aimed to provide a comprehensive assessment of molecular allergen sensitization patterns in the Lithuanian population, with a focus on <i>Dermatophagoides pteronyssinus</i> (Der p), and investigate patterns of concomitant reactivity among different allergens to enhance the accuracy of HDM allergy diagnostics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive analysis of 1520 patient test results in Lithuania from 2020 to 2022 was performed. Sensitization patterns to major (Der p 1, Der p 2, and Der p 23) and minor (Der p 5, Der p 7, and Der p 21) Der p allergen components were described using molecular-based diagnostics. Additionally, we investigated sensitization to allergen components from other allergen sources, including tropomyosins (Der p 10, Per a 7, Pen m 1, Ani s 3, Blo t 10) and arginine kinases (Pen m 2, Bla g 9, Der p 20).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study reveals a high prevalence of HDM sensitization in Lithuania - 481 individuals (45.38% of the sensitized group) exhibited sensitization to at least one Der p allergen component. Importantly, within the sensitized group, 37.21% of patients were sensitized to Der p 5, Der p 7, or Der p 21 in addition to major allergenic components. Distinct sensitization patterns were observed across different age groups, indicating the influence of age-related factors. Furthermore, we confirmed cross-reactivity between Der p 5 and Blo t 5 as well as between Der p 21 and Blo t 21, emphasizing the clinical relevance of these associations. We also highlighted the complexity of sensitization patterns among tropomyosins and arginine kinases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides valuable insights into HDM allergy sensitization profiles in Lithuania, emphasizing the importance of considering major and minor HDM allergen components for accurate diagnosis and management of HDM-related allergic diseases. Differences between populations and age-related factors impact sensitization patterns. Understanding concomitant reactivity among allergens, such as Der p 5 and Blo t 5, Der p 21 and Blo t 21, tropomyosins, and arginine kinases, is crucial for improving diagnostic strategies and developing targeted interventions for allergic individuals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12332","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139550552","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}
Chronic rhinosinusitis (CRS) is usually accompanied by mucin hypersecretion that can lead to mucus accumulation and impair nasal mucociliary clearance, thus exacerbating airway inflammation. Abnormal mucin hypersecretion is regulated by different T helper (Th) cytokines, which are associated with different endotype-driven inflammatory responses. Therefore, it is of great significance to understand how these factors regulate mucin hypersecretion to provide precise treatment strategies for different endotypes of CRS.
Body
Thus far, the most common endotypes of CRS are classified as type 1, type 2, or type 3 immune responses based on innate and adaptive cell-mediated effector immunity, and the representative Th cytokines in these immune responses, such as IFN-γ, TNF-α, IL-4, IL-5, IL-13, IL-10, IL-17, and IL-22, play an important regulatory role in mucin secretion. We reviewed all the related literature in the PubMed database to determine the expression of these Th cytokines in CRS and the role they play in the regulation of mucin secretion.
Conclusion
We believe that the main Th cytokines involved in specific endotypes of CRS play a key role in regulating abnormal mucin secretion, which contributes to better understanding of the pathogenesis of CRS and provides therapeutic targets for airway inflammatory diseases associated with mucin hypersecretion.
{"title":"Characteristics of mucin hypersecretion in different inflammatory patterns based on endotypes of chronic rhinosinusitis","authors":"Zhaoxue Zhai, Liting Shao, Zhaoyang Lu, Yujuan Yang, Jianwei Wang, Zhen Liu, Huikang Wang, Yang Zheng, Haoran Lu, Xicheng Song, Yu Zhang","doi":"10.1002/clt2.12334","DOIUrl":"10.1002/clt2.12334","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic rhinosinusitis (CRS) is usually accompanied by mucin hypersecretion that can lead to mucus accumulation and impair nasal mucociliary clearance, thus exacerbating airway inflammation. Abnormal mucin hypersecretion is regulated by different T helper (Th) cytokines, which are associated with different endotype-driven inflammatory responses. Therefore, it is of great significance to understand how these factors regulate mucin hypersecretion to provide precise treatment strategies for different endotypes of CRS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Body</h3>\u0000 \u0000 <p>Thus far, the most common endotypes of CRS are classified as type 1, type 2, or type 3 immune responses based on innate and adaptive cell-mediated effector immunity, and the representative Th cytokines in these immune responses, such as IFN-γ, TNF-α, IL-4, IL-5, IL-13, IL-10, IL-17, and IL-22, play an important regulatory role in mucin secretion. We reviewed all the related literature in the PubMed database to determine the expression of these Th cytokines in CRS and the role they play in the regulation of mucin secretion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We believe that the main Th cytokines involved in specific endotypes of CRS play a key role in regulating abnormal mucin secretion, which contributes to better understanding of the pathogenesis of CRS and provides therapeutic targets for airway inflammatory diseases associated with mucin hypersecretion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12334","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139539987","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}
Ivan Cherrez-Ojeda, Jean Bousquet, Zouina Sarfraz, Azza Sarfraz, Monica Rodriguez Gonzales, Anna Bedbrook, Nelson Rosario, Benjamin Zepeda-Ortega, Guillermo Guidos, Ulbio Alcivar Molina, Miguel Felix, Emanuel Vanegas, Karla Robles-Velasco, Luc J. Zimmermann, Antonio W. D. Gavilanes
Introduction
Information and communication technologies (ICTs) improve patient-centered care and are routinely used in Allergic Rhinitis (AR), but patients' preferences and attitudes are unexplored. This study examines AR-related information preferences and ICT use by AR patients.
Methods
A survey-based cross-sectional study was carried out in Ecuador from July to September 2019 in seven centers of reference for allergic disease. Participants were 18 years or older, diagnosed with AR and had access to ICT and the Internet. Descriptive and binomial logistic regressions were performed. A value of less than 0.05 was considered statistically significant.
Results
217 patients were included. 47% (n = 102) used ICTs to learn about AR, of which 38.2% (n = 83) found it useful. Most of participants (75%, n = 164) did not think that ICTs reduce their need to see a doctor. Individuals with poorer quality of life were more likely to utilize ICTs to contact their doctor (OR 1.27, 95% CI 1.04–1.55), and more likely to be interested in AR-related content (OR 1.23, 95% CI 1.00–1.52). Patients with long-term AR or other allergies were less likely to use ICTs (OR 0.92 and OR 0.40 respectively). Higher education and lower quality of life may increase AR apps adoption (OR 4.82, 95% CI 1.11–21.00). Academic preparation five-fold increased ICT use for health provider communication (OR 5.29, 95% CI 1.18–23.72). Mild-persistent AR enhanced the probabilities of using ICTs to share experiences and communicate with other patients (OR 12.59, 95% CI 1.32–120.35).
Conclusions
Our study emphasizes the importance of tailoring digital resources to patient needs by considering factors such as quality of life, education, and specific subgroups within the AR patient population. Additionally, the findings suggest that while ICTs can play a valuable role in patient education and support, they should complement, rather than replace, traditional medical care for many AR patients.
导言：信息和通信技术（ICTs）可改善以患者为中心的护理，并已在过敏性鼻炎（AR）中得到常规应用，但患者的偏好和态度尚未得到研究。本研究探讨了过敏性鼻炎患者对与过敏性鼻炎相关的信息的偏好以及对 ICT 的使用情况。 方法 2019 年 7 月至 9 月，在厄瓜多尔的七个过敏性疾病参考中心开展了一项基于调查的横断面研究。参与者年满 18 周岁，确诊为 AR 患者，可使用 ICT 和互联网。研究进行了描述性和二项逻辑回归。小于 0.05 的值被视为具有统计学意义。 结果 共纳入 217 名患者。47%（n = 102）的患者使用信息和通信技术了解 AR，其中 38.2%（n = 83）的患者认为 AR 有用。大多数参与者（75%，n = 164）认为信息和通信技术不会减少他们看医生的需求。生活质量较差的人更有可能利用信息和通信技术联系医生（OR 1.27，95% CI 1.04-1.55），也更有可能对 AR 相关内容感兴趣（OR 1.23，95% CI 1.00-1.52）。长期患有 AR 或其他过敏症的患者不太可能使用信息和通信技术（OR 分别为 0.92 和 OR 0.40）。教育程度较高和生活质量较低的患者可能会更多地采用 AR 应用程序（OR 4.82，95% CI 1.11-21.00）。学业准备可将信息和通信技术的使用率提高五倍（OR 5.29，95% CI 1.18-23.72）。轻度持续性 AR 提高了使用信息和通信技术与其他患者分享经验和交流的概率（OR 12.59，95% CI 1.32-120.35）。 结论 我们的研究强调了通过考虑生活质量、教育程度和 AR 患者群体中的特定亚群等因素来定制符合患者需求的数字资源的重要性。此外，研究结果表明，虽然信息和通信技术在患者教育和支持方面可以发挥重要作用，但对于许多 AR 患者来说，它们应该是传统医疗护理的补充，而不是替代。
{"title":"Exploring the role of information and communication technologies in allergic rhinitis in specialist centers: Patient perspectives on usefulness, value, and impact on healthcare","authors":"Ivan Cherrez-Ojeda, Jean Bousquet, Zouina Sarfraz, Azza Sarfraz, Monica Rodriguez Gonzales, Anna Bedbrook, Nelson Rosario, Benjamin Zepeda-Ortega, Guillermo Guidos, Ulbio Alcivar Molina, Miguel Felix, Emanuel Vanegas, Karla Robles-Velasco, Luc J. Zimmermann, Antonio W. D. Gavilanes","doi":"10.1002/clt2.12325","DOIUrl":"https://doi.org/10.1002/clt2.12325","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Information and communication technologies (ICTs) improve patient-centered care and are routinely used in Allergic Rhinitis (AR), but patients' preferences and attitudes are unexplored. This study examines AR-related information preferences and ICT use by AR patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A survey-based cross-sectional study was carried out in Ecuador from July to September 2019 in seven centers of reference for allergic disease. Participants were 18 years or older, diagnosed with AR and had access to ICT and the Internet. Descriptive and binomial logistic regressions were performed. A value of less than 0.05 was considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>217 patients were included. 47% (<i>n</i> = 102) used ICTs to learn about AR, of which 38.2% (<i>n</i> = 83) found it useful. Most of participants (75%, <i>n</i> = 164) did not think that ICTs reduce their need to see a doctor. Individuals with poorer quality of life were more likely to utilize ICTs to contact their doctor (OR 1.27, 95% CI 1.04–1.55), and more likely to be interested in AR-related content (OR 1.23, 95% CI 1.00–1.52). Patients with long-term AR or other allergies were less likely to use ICTs (OR 0.92 and OR 0.40 respectively). Higher education and lower quality of life may increase AR apps adoption (OR 4.82, 95% CI 1.11–21.00). Academic preparation five-fold increased ICT use for health provider communication (OR 5.29, 95% CI 1.18–23.72). Mild-persistent AR enhanced the probabilities of using ICTs to share experiences and communicate with other patients (OR 12.59, 95% CI 1.32–120.35).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study emphasizes the importance of tailoring digital resources to patient needs by considering factors such as quality of life, education, and specific subgroups within the AR patient population. Additionally, the findings suggest that while ICTs can play a valuable role in patient education and support, they should complement, rather than replace, traditional medical care for many AR patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139504581","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}
Acute asthma exacerbation in children is often caused by respiratory infections. In this study, a coordinated national surveillance system for acute asthma hospitalizations and causative respiratory infections was established. We herein report recent trends in pediatric acute asthma hospitalizations since the COVID-19 pandemic in Japan.
Methods
Thirty-three sentinel hospitals in Japan registered all of their hospitalized pediatric asthma patients and their causal pathogens. The changes in acute asthma hospitalization in children before and after the onset of the COVID-19 pandemic and whether or not COVID-19 caused acute asthma exacerbation were investigated.
Results
From fiscal years 2010–2019, the median number of acute asthma hospitalizations per year was 3524 (2462–4570), but in fiscal years 2020, 2021, and 2022, the numbers were 820, 1,001, and 1,026, respectively (the fiscal year in Japan is April to March). This decrease was observed in all age groups with the exception of the 3- to 6-year group. SARS-CoV-2 was evaluated in 2094 patients from fiscal years 2020–2022, but the first positive case was not detected until February 2022. Since then, only 36 of them have been identified with SARS-CoV-2, none of which required mechanical ventilation. Influenza, RS virus, and human metapneumovirus infections also decreased in FY 2020. In contrast, 24% of patients had not been receiving long-term control medications before admission despite the severity of bronchial asthma.
Conclusion
SARS-CoV-2 was hardly detected in children with acute asthma hospitalization during the COVID-19 pandemic. This result indicated that SARS-CoV-2 did not induce acute asthma exacerbation in children. Rather, infection control measures implemented against the pandemic may have consequently reduced other respiratory virus infections and thus acute asthma hospitalizations during this period. However, the fact that many hospitalized patients have not been receiving appropriate long-term control medications is a major problem that should be addressed.
{"title":"Suppressed pediatric asthma hospitalizations during the COVID-19 pandemic in Japan, from a national survey","authors":"Seigo Korematsu, Takao Fujisawa, Naruo Saito, Junichiro Tezuka, Katsushi Miura, Ichiro Kobayashi, Ippei Miyata, Yujiro Kosugi, Yuji Gohda, Yumi Koike, Ami Suda, Akiko Matsuo, Michiyo Sasaki, Yousuke Handa, Michimasa Fujiwara, Atsushi Ono, Shinya Koizumi, Taku Oishi, Takayuki Tanaka, Yusuke Ando, Naohiko Taba, Yuki Tsurinaga, Takeshi Sato, Rei Kanai, Masato Yashiro, Toshiyuki Takagi, Shinya Hida, Masashi Harazaki, Takayuki Hoshina, Seigo Okada, Motoko Yasutomi, Setsuko Nakata, Ayako Muto, Saori Tanabe, Yutaka Ueda, Shunji Hasegawa, Makoto Kameda, Keiko Tanaka-Taya, Tsuguto Fujimoto, Kenji Okada","doi":"10.1002/clt2.12330","DOIUrl":"https://doi.org/10.1002/clt2.12330","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acute asthma exacerbation in children is often caused by respiratory infections. In this study, a coordinated national surveillance system for acute asthma hospitalizations and causative respiratory infections was established. We herein report recent trends in pediatric acute asthma hospitalizations since the COVID-19 pandemic in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty-three sentinel hospitals in Japan registered all of their hospitalized pediatric asthma patients and their causal pathogens. The changes in acute asthma hospitalization in children before and after the onset of the COVID-19 pandemic and whether or not COVID-19 caused acute asthma exacerbation were investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From fiscal years 2010–2019, the median number of acute asthma hospitalizations per year was 3524 (2462–4570), but in fiscal years 2020, 2021, and 2022, the numbers were 820, 1,001, and 1,026, respectively (the fiscal year in Japan is April to March). This decrease was observed in all age groups with the exception of the 3- to 6-year group. SARS-CoV-2 was evaluated in 2094 patients from fiscal years 2020–2022, but the first positive case was not detected until February 2022. Since then, only 36 of them have been identified with SARS-CoV-2, none of which required mechanical ventilation. Influenza, RS virus, and human metapneumovirus infections also decreased in FY 2020. In contrast, 24% of patients had not been receiving long-term control medications before admission despite the severity of bronchial asthma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SARS-CoV-2 was hardly detected in children with acute asthma hospitalization during the COVID-19 pandemic. This result indicated that SARS-CoV-2 did not induce acute asthma exacerbation in children. Rather, infection control measures implemented against the pandemic may have consequently reduced other respiratory virus infections and thus acute asthma hospitalizations during this period. However, the fact that many hospitalized patients have not been receiving appropriate long-term control medications is a major problem that should be addressed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12330","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139494603","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}
Twan Sia, Amanda Miller, Leeon Bacchus, Jennie Young, Aditya P. Narayan, Rachel Solecki, Jerry Fu, Yuting Jiang, Raisa Khuda, Stanley Liu, Kathleen Love, Shibani Mallik, Amina Sara Matmatte, Paige McDonald, Tanvi Telukunta, Alyssa Roby, Saad Shami, Michelle Zheng, Madison Headen, John Leung
<p>Dupilumab is a human monoclonal antibody against interleukin-4 receptor alpha subunit. Dupilumab is an approved treatment for inducing remission of eosinophilic esophagitis (EoE).<span><sup>1</sup></span> EoE histologic remission with dupilumab has only been demonstrated in patients after at least 12 weeks of treatment.<span><sup>2-6</sup></span> Current guidelines recommend waiting for histologic re-evaluation of EoE until after 20–24 weeks of dupilumab.<span><sup>1</sup></span> It is unknown if increasing dupilumab treatment length improves its efficacy. Because histologic re-evaluation of EoE requires invasive biopsies, and inducing remission of EoE is important to prevent progressive esophageal damage, research investigating the effects of dupilumab on EoE prior to 12 weeks of treatment is warranted.</p><p>We conducted a retrospective study at a single medical clinic. The electronic medical record was searched between 2017 and 2023 using International Classifications of Disease, 10th revision code K20.0 eosinophilic esophagitis. We excluded patients who had (1) never started dupilumab; (2) no histologic confirmation of EoE defined by ≥ 15 eos/hpf; or (3) no histologic re-evaluation of EoE while on dupilumab. Histologic evaluation of EoE assessed at least 2 biopsies each of the proximal, middle, and distal esophagus. Endpoints were peak eosinophil counts (eosinophils per high-power field; eos/hpf), EoE endoscopic reference scores (EREFS), and a composite symptom score in which each symptom (dysphagia, food impaction/choking, regurgitation/vomiting, heartburn/chest pain, and abdominal pain) was graded (0 = absent, 1 = mild, 2 = moderate, and 3 = severe) and summed. This study was deemed exempt from institutional review board approval by the WCG IRB.</p><p>From the electronic medical record, 658 patients with EoE were identified, of which 534 had never initiated dupilumab, 6 did not have histologic confirmation of EoE, and 39 did not have a repeat histologic evaluation after dupilumab initiation. Therefore, 79 patients were included in this study. The median age was 27.6 years (Q1 to Q3, 21.8–36.1), 48 patients (60.8%) were male, and 12 patients (15.2%) were pediatric (Table 1). Sixty patients (75.9%) had an atopic comorbidity, including allergic rhinitis (43 patients, 54.4%), asthma (27 patients, 34.2%), atopic dermatitis (13 patients, 16.5%), and food allergies (30 patients, 38.0%).</p><p>Patients were on dupilumab for median 22.7 weeks (Q1 to Q3, 16–26.7). Dosages included 300 mg every week (71 patients, 89.9%), 300 mg every other week with a loading dose of 600 mg for atopic dermatitis (7 patients, 8.9%), and 200 mg every other week with a loading dose of 400 mg for atopic dermatitis (1 patient, 1.3%).</p><p>Of 79 patients, 12 patients (15.2%) were on dupilumab for 0–12 weeks. Patients on dupilumab for 0–12 weeks had a median composite symptom score of 5.5 (Q1 to Q3, 4–6), which significantly decreased to 0 (Q1 to Q3, 0–1; Wilcoxon matche
{"title":"Dupilumab improves clinical and histologic features of eosinophilic esophagitis prior to 12 weeks of treatment","authors":"Twan Sia, Amanda Miller, Leeon Bacchus, Jennie Young, Aditya P. Narayan, Rachel Solecki, Jerry Fu, Yuting Jiang, Raisa Khuda, Stanley Liu, Kathleen Love, Shibani Mallik, Amina Sara Matmatte, Paige McDonald, Tanvi Telukunta, Alyssa Roby, Saad Shami, Michelle Zheng, Madison Headen, John Leung","doi":"10.1002/clt2.12333","DOIUrl":"https://doi.org/10.1002/clt2.12333","url":null,"abstract":"<p>Dupilumab is a human monoclonal antibody against interleukin-4 receptor alpha subunit. Dupilumab is an approved treatment for inducing remission of eosinophilic esophagitis (EoE).<span><sup>1</sup></span> EoE histologic remission with dupilumab has only been demonstrated in patients after at least 12 weeks of treatment.<span><sup>2-6</sup></span> Current guidelines recommend waiting for histologic re-evaluation of EoE until after 20–24 weeks of dupilumab.<span><sup>1</sup></span> It is unknown if increasing dupilumab treatment length improves its efficacy. Because histologic re-evaluation of EoE requires invasive biopsies, and inducing remission of EoE is important to prevent progressive esophageal damage, research investigating the effects of dupilumab on EoE prior to 12 weeks of treatment is warranted.</p><p>We conducted a retrospective study at a single medical clinic. The electronic medical record was searched between 2017 and 2023 using International Classifications of Disease, 10th revision code K20.0 eosinophilic esophagitis. We excluded patients who had (1) never started dupilumab; (2) no histologic confirmation of EoE defined by ≥ 15 eos/hpf; or (3) no histologic re-evaluation of EoE while on dupilumab. Histologic evaluation of EoE assessed at least 2 biopsies each of the proximal, middle, and distal esophagus. Endpoints were peak eosinophil counts (eosinophils per high-power field; eos/hpf), EoE endoscopic reference scores (EREFS), and a composite symptom score in which each symptom (dysphagia, food impaction/choking, regurgitation/vomiting, heartburn/chest pain, and abdominal pain) was graded (0 = absent, 1 = mild, 2 = moderate, and 3 = severe) and summed. This study was deemed exempt from institutional review board approval by the WCG IRB.</p><p>From the electronic medical record, 658 patients with EoE were identified, of which 534 had never initiated dupilumab, 6 did not have histologic confirmation of EoE, and 39 did not have a repeat histologic evaluation after dupilumab initiation. Therefore, 79 patients were included in this study. The median age was 27.6 years (Q1 to Q3, 21.8–36.1), 48 patients (60.8%) were male, and 12 patients (15.2%) were pediatric (Table 1). Sixty patients (75.9%) had an atopic comorbidity, including allergic rhinitis (43 patients, 54.4%), asthma (27 patients, 34.2%), atopic dermatitis (13 patients, 16.5%), and food allergies (30 patients, 38.0%).</p><p>Patients were on dupilumab for median 22.7 weeks (Q1 to Q3, 16–26.7). Dosages included 300 mg every week (71 patients, 89.9%), 300 mg every other week with a loading dose of 600 mg for atopic dermatitis (7 patients, 8.9%), and 200 mg every other week with a loading dose of 400 mg for atopic dermatitis (1 patient, 1.3%).</p><p>Of 79 patients, 12 patients (15.2%) were on dupilumab for 0–12 weeks. Patients on dupilumab for 0–12 weeks had a median composite symptom score of 5.5 (Q1 to Q3, 4–6), which significantly decreased to 0 (Q1 to Q3, 0–1; Wilcoxon matche","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12333","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139488369","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}
Caroline Nilsson, Andrea Vereda, Magnus P. Borres, Mats Andersson, Eva Södergren, Magnus Rudengren, Alex Smith, Reyna J. Simon, Robert Ryan, Montserrat Fernández-Rivas, Daniel Adelman, Brian P. Vickery
Background
Immunoglobulin E (IgE) and immunoglobulin G4 (IgG4) to peanut and its components may influence the clinical reactivity to peanut. Allergen-specific immunotherapy is known for modifying both IgE and IgG4. Peanut oral immunotherapy may influence these serological parameters.
Methods
Exploratory analyses of serological data from participants receiving peanut (Arachis hypogaea) allergen powder-dnfp (PTAH) and placebo in the double-blind, randomized, phase 3 PALISADE trial were conducted to evaluate potential relationships between peanut-specific and peanut component–specific (Ara h 1, Ara h 2, Ara h 3, Ara h 6, Ara h 8, and Ara h 9) IgE and IgG4 levels and clinical outcomes.
Results
A total of 269 participants (PTAH, n = 202; placebo, n = 67) were analyzed. No relationship was observed between specific IgE and IgG4 levels at screening and maximum tolerated peanut protein dose during screening or response status during exit double-blind placebo-controlled food challenge (DBPCFC). In PTAH-treated participants, no relationship was observed between IgE and IgG4 levels at screening and maximum symptom severity during exit DBPCFC. Postscreening ratios (ie, postscreening/screening) in the PTAH group were significant at the end of updosing and exit visit for most components. Postscreening changes in specific IgE levels were more pronounced with PTAH versus placebo for most components.
Conclusions
Specific IgE and IgG4 levels at screening are not correlated with screening or exit DBPCFC results, and are not predictive of clinical response to PTAH. Peanut (Arachis hypogaea) allergen powder-dnfp contains the relevant and immunodominant allergens, inducing immunological changes with the treatment.
Clinical Trial Registration
ClinicalTrials.gov identifier: NCT02635776.
背景 花生及其成分的免疫球蛋白 E (IgE) 和免疫球蛋白 G4 (IgG4) 可能会影响对花生的临床反应性。已知过敏原特异性免疫疗法可改变 IgE 和 IgG4。花生口服免疫疗法可能会影响这些血清学参数。 方法 对双盲、随机、3 期 PALISADE 试验中接受花生（Arachis hypogaea）过敏原粉末-dnfp（PTAH）和安慰剂的参与者的血清学数据进行探索性分析，以评估花生特异性和花生成分特异性（Ara h 1、Ara h 2、Ara h 3、Ara h 6、Ara h 8 和 Ara h 9）IgE 和 IgG4 水平与临床结果之间的潜在关系。 结果 共分析了 269 名参与者（PTAH，n = 202；安慰剂，n = 67）。筛查时的特异性 IgE 和 IgG4 水平与筛查时的最大耐受花生蛋白剂量或退出双盲安慰剂对照食物挑战（DBPCFC）时的反应状态之间未发现任何关系。在接受过 PTAH 治疗的参与者中，筛查时的 IgE 和 IgG4 水平与退出 DBPCFC 时的最大症状严重程度之间未发现任何关系。PTAH 组的筛查后比率（即筛查后/筛查）在更新治疗结束时和退出访问时对大多数成分都有显著影响。就大多数成分而言，PTAH 组比安慰剂组特异性 IgE 水平的筛查后变化更明显。 结论 筛查时的特异性 IgE 和 IgG4 水平与筛查或出院时的 DBPCFC 结果无关，也不能预测对 PTAH 的临床反应。花生（Arachis hypogaea）过敏原粉末-dnfp含有相关的免疫优势过敏原，可通过治疗诱导免疫学变化。 临床试验注册 ClinicalTrials.gov identifier：NCT02635776。
{"title":"Exploratory immunogenicity outcomes of peanut oral immunotherapy: Findings from the PALISADE trial","authors":"Caroline Nilsson, Andrea Vereda, Magnus P. Borres, Mats Andersson, Eva Södergren, Magnus Rudengren, Alex Smith, Reyna J. Simon, Robert Ryan, Montserrat Fernández-Rivas, Daniel Adelman, Brian P. Vickery","doi":"10.1002/clt2.12326","DOIUrl":"https://doi.org/10.1002/clt2.12326","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Immunoglobulin E (IgE) and immunoglobulin G4 (IgG4) to peanut and its components may influence the clinical reactivity to peanut. Allergen-specific immunotherapy is known for modifying both IgE and IgG4. Peanut oral immunotherapy may influence these serological parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Exploratory analyses of serological data from participants receiving peanut (<i>Arachis hypogaea</i>) allergen powder-dnfp (PTAH) and placebo in the double-blind, randomized, phase 3 PALISADE trial were conducted to evaluate potential relationships between peanut-specific and peanut component–specific (Ara h 1, Ara h 2, Ara h 3, Ara h 6, Ara h 8, and Ara h 9) IgE and IgG4 levels and clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 269 participants (PTAH, <i>n</i> = 202; placebo, <i>n</i> = 67) were analyzed. No relationship was observed between specific IgE and IgG4 levels at screening and maximum tolerated peanut protein dose during screening or response status during exit double-blind placebo-controlled food challenge (DBPCFC). In PTAH-treated participants, no relationship was observed between IgE and IgG4 levels at screening and maximum symptom severity during exit DBPCFC. Postscreening ratios (ie, postscreening/screening) in the PTAH group were significant at the end of updosing and exit visit for most components. Postscreening changes in specific IgE levels were more pronounced with PTAH versus placebo for most components.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Specific IgE and IgG4 levels at screening are not correlated with screening or exit DBPCFC results, and are not predictive of clinical response to PTAH. Peanut (<i>Arachis hypogaea</i>) allergen powder-dnfp contains the relevant and immunodominant allergens, inducing immunological changes with the treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT02635776.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12326","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139488370","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}
Ewelina Harcęko-Zielińska, Marek Niedoszytko, Aleksandra Górska, Sylwia Małgorzewicz, Marta Gruchała-Niedoszytko, Marek Bronk, Slawomir Dąbrowski, Marta Chełminska, Ewa Jassem
Background
Mastocytosis is a rare neoplastic disease of the bone marrow associated with the proliferation and accumulation of mast cells in various internal organs, including the gastrointestinal tract. There are few studies describing the gut microbiome of patients with mastocytosis using next generation sequencing supported using traditional culture methods. The aims of the study were, firstly, the determination of nutrition habits, composition of the intestinal microflora and BMI in mastocytosis, and secondly, analysis of mastocytosis severity and symptoms depending on the composition of the intestinal microflora.
Methods
The study included 47 patients with indolent systemic mastocytosis and 18 healthy controls. All participants gave their informed consent to participate in the study. The study consisted of 3 parts: I-clinical assessment, II - examination of the intestinal microflora using the biochemical method, III - 16S rRNA sequencing.
Results
The nutrition habits and BMI of mastocytosis patients were similar to controls; however, most patients with mastocytosis had a low dietary vitamin and mineral content. As many as 94.5% of patients had too little fiber intake and mineral content. The most common cause of the abnormal stool test result with traditional culture was a titer of E. coli <106. The low richness of microbiota species indicated by the Simpson index was observed in mastocytosis, p = 0.04. There were no significant differences in the composition of the intestinal microflora depending on the type of mastocytosis; however, the tryptase level correlated with the amount of Suterella, Barnesiellaceae, Eubacterium, Odoribacter, and Anaerostipes.
Conclusions
The nutritional habits and BMI of mastocytosis patients are similar to the general population, except for too little fiber intake and mineral content. The gastrointestinal symptoms of mastocytosis patients may be related to the low richness of microbiota species and the amount of Suterella, Barnesiellaceae, Eubacterium, Odoribacter, Anaerostipes, which correlated with tryptase levels.
{"title":"The influence of nutritional habits, body mass index and intestinal microbiota in mastocytosis on clinical symptoms using conventional culture and next generation sequencing","authors":"Ewelina Harcęko-Zielińska, Marek Niedoszytko, Aleksandra Górska, Sylwia Małgorzewicz, Marta Gruchała-Niedoszytko, Marek Bronk, Slawomir Dąbrowski, Marta Chełminska, Ewa Jassem","doi":"10.1002/clt2.12310","DOIUrl":"https://doi.org/10.1002/clt2.12310","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mastocytosis is a rare neoplastic disease of the bone marrow associated with the proliferation and accumulation of mast cells in various internal organs, including the gastrointestinal tract. There are few studies describing the gut microbiome of patients with mastocytosis using next generation sequencing supported using traditional culture methods. The aims of the study were, firstly, the determination of nutrition habits, composition of the intestinal microflora and BMI in mastocytosis, and secondly, analysis of mastocytosis severity and symptoms depending on the composition of the intestinal microflora.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 47 patients with indolent systemic mastocytosis and 18 healthy controls. All participants gave their informed consent to participate in the study. The study consisted of 3 parts: I-clinical assessment, II - examination of the intestinal microflora using the biochemical method, III - 16S rRNA sequencing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The nutrition habits and BMI of mastocytosis patients were similar to controls; however, most patients with mastocytosis had a low dietary vitamin and mineral content. As many as 94.5% of patients had too little fiber intake and mineral content. The most common cause of the abnormal stool test result with traditional culture was a titer of <i>E</i>. <i>coli</i> <10<sup>6</sup>. The low richness of microbiota species indicated by the Simpson index was observed in mastocytosis, <i>p</i> = 0.04. There were no significant differences in the composition of the intestinal microflora depending on the type of mastocytosis; however, the tryptase level correlated with the amount of Suterella, Barnesiellaceae, Eubacterium, Odoribacter, and Anaerostipes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The nutritional habits and BMI of mastocytosis patients are similar to the general population, except for too little fiber intake and mineral content. The gastrointestinal symptoms of mastocytosis patients may be related to the low richness of microbiota species and the amount of Suterella, Barnesiellaceae, Eubacterium, Odoribacter, Anaerostipes, which correlated with tryptase levels.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12310","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139436656","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}
Despite the high prevalence of co-existing bronchiectasis and asthma (asthma-bronchiectasis overlap syndrome [ABOS]), little is known regarding the dominant pathogens and clinical correlates.
Objective
To investigate the bacteria and viruses which differentially dominate in ABOS (including its subtypes) compared with bronchiectasis alone, and determine their relevance with bronchiectasis severity and exacerbations.
Methods
This was a prospective observational cohort study conducted between March 2017 and August 2023. We included 81 patients with ABOS and 107 patients with bronchiectasis alone. At steady-state baseline, patients underwent comprehensive assessments and sputum collection for bacterial culture and viral detection (quantitative polymerase-chain-reaction). Patients were followed-up to record exacerbation and spirometry.
Results
Patients with ABOS had significantly higher symptom burden and exacerbation frequency than those with bronchiectasis alone. Despite similar pathogen spectrum, the rate of bacteria–virus co-detection increased less substantially at acute exacerbations (AE) onset than at steady-state compared with bronchiectasis alone. Pathogenic bacteria (particularly Pseudomonas aeruginosa) were detected fairly common (exceeding 50%) in ABOS and were associated with greater severity of bronchiectasis when stable and conferred greater exacerbation risks at follow-up. Viral but not bacterial compositions changed substantially at AE onset compared with clinical stability. Higher blood eosinophil count, moderate-to-severe bronchiectasis and non-atopy were associated with higher odds of bacterial, but not viral, detection (all p < 0.05).
Conclusion
Detection of bacteria or virus is associated with bronchiectasis severity or clinical outcomes in ABOS. This highlights the importance of integrating sputum microbial assessment for ascertaining the dominant pathophysiology (atopy vs. infection) and longitudinal trajectory prediction in ABOS.
背景 尽管支气管扩张和哮喘（哮喘-支气管扩张重叠综合征 [ABOS]）并存的发病率很高，但人们对主要病原体和临床相关性知之甚少。 目的 研究与单纯支气管扩张相比，在 ABOS（包括其亚型）中占主导地位的细菌和病毒，并确定它们与支气管扩张严重程度和病情加重的相关性。 方法 这是一项前瞻性观察性队列研究，研究时间为 2017 年 3 月至 2023 年 8 月。我们纳入了 81 名 ABOS 患者和 107 名单纯支气管扩张症患者。在稳态基线时，患者接受综合评估，并采集痰液进行细菌培养和病毒检测（定量聚合酶链式反应）。对患者进行随访，记录病情加重情况和肺活量。 结果 ABOS 患者的症状负担和恶化频率明显高于单纯支气管扩张症患者。尽管病原体谱相似，但与单纯性支气管扩张症相比，细菌-病毒共同检测率在急性加重（AE）开始时的增加幅度小于稳定期。在 ABOS 中，病原菌（尤其是铜绿假单胞菌）的检出率相当高（超过 50%），在病情稳定时与支气管扩张的严重程度相关，在随访时会带来更大的病情加重风险。与临床稳定期相比，AE 发病时病毒（而非细菌）成分发生了重大变化。较高的血液嗜酸性粒细胞计数、中度至重度支气管扩张和无炎症与较高的细菌检测几率相关，但与病毒检测几率无关（所有 p < 0.05）。 结论 细菌或病毒的检测与 ABOS 的支气管扩张严重程度或临床结果有关。这凸显了综合痰微生物评估对确定主要病理生理学（特异性与感染）和纵向预测 ABOS 病变轨迹的重要性。
{"title":"Bacteria and viruses and clinical outcomes of asthma-bronchiectasis overlap syndrome: A cohort study","authors":"Xiao-xian Zhang, Jia-hui He, Cui-xia Pan, Zhen-feng He, Hui-min Li, Zhen-hong Lin, Xiao-fen Zhang, Lai-jian Cen, Ri-lan Zhang, Ming-xin Shi, Wei-jie Guan","doi":"10.1002/clt2.12331","DOIUrl":"https://doi.org/10.1002/clt2.12331","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite the high prevalence of co-existing bronchiectasis and asthma (asthma-bronchiectasis overlap syndrome [ABOS]), little is known regarding the dominant pathogens and clinical correlates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the bacteria and viruses which differentially dominate in ABOS (including its subtypes) compared with bronchiectasis alone, and determine their relevance with bronchiectasis severity and exacerbations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective observational cohort study conducted between March 2017 and August 2023. We included 81 patients with ABOS and 107 patients with bronchiectasis alone. At steady-state baseline, patients underwent comprehensive assessments and sputum collection for bacterial culture and viral detection (quantitative polymerase-chain-reaction). Patients were followed-up to record exacerbation and spirometry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with ABOS had significantly higher symptom burden and exacerbation frequency than those with bronchiectasis alone. Despite similar pathogen spectrum, the rate of bacteria–virus co-detection increased less substantially at acute exacerbations (AE) onset than at steady-state compared with bronchiectasis alone. Pathogenic bacteria (particularly <i>Pseudomonas aeruginosa</i>) were detected fairly common (exceeding 50%) in ABOS and were associated with greater severity of bronchiectasis when stable and conferred greater exacerbation risks at follow-up. Viral but not bacterial compositions changed substantially at AE onset compared with clinical stability. Higher blood eosinophil count, moderate-to-severe bronchiectasis and non-atopy were associated with higher odds of bacterial, but not viral, detection (all <i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Detection of bacteria or virus is associated with bronchiectasis severity or clinical outcomes in ABOS. This highlights the importance of integrating sputum microbial assessment for ascertaining the dominant pathophysiology (atopy vs. infection) and longitudinal trajectory prediction in ABOS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12331","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139435122","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}
Sophia Neisinger, Bernardo Sousa Pinto, Aiste Ramanauskaite, Jean Bousquet, Karsten Weller, Martin Metz, Markus Magerl, Emek Kocatürk, Ivan Cherrez-Ojeda, Ana M. Gimenez-Arnau, Claudio Alberto S. Parisi, Sabine Altrichter, Luis Felipe Ensina, Laurence Bouillet, Riccardo Asero, Margarida Gonçalo, Carole Guillet, Krzysztof Rutkowski, Jonathan A. Bernstein, Hannah Hardin, Kiran Godse, Zenon Brzoza, Jose Ignacio Larco Sousa, Simon Francis Thomsen, Martijn van Doorn, Michihiro Hide, Young-Min Ye, Staffan Vanderse, Lāsma Lapiņa, Jonny Peter, Zuotao Zhao, Lianyi Han, Iman Nasr, Heike Rockmann-Helmbach, Jennifer Astrup Sørensen, Rabia Öztaş Kara, Natalja Kurjāne, Andrii I. Kurchenko, Igor Kaidashev, Vladyslav Tsaryk, Roman Stepanenko, Marcus Maurer
Background
Chronic spontaneous urticaria (CSU) is unpredictable and can severely impair patients' quality of life. Patients with CSU need a convenient, user-friendly platform to complete patient-reported outcome measures (PROMs) on their mobile devices. CRUSE®, the Chronic Urticaria Self Evaluation app, aims to address this unmet need.
Methods
CRUSE® was developed by an international steering committee of urticaria specialists. Priorities for the app based on recent findings in CSU were defined to allow patients to track and record their symptoms and medication use over time and send photographs. The CRUSE® app collects patient data such as age, sex, disease onset, triggers, medication, and CSU characteristics that can be sent securely to physicians, providing real-time insights. Additionally, CRUSE® contains PROMs to assess disease activity and control, which are individualised to patient profiles and clinical manifestations.
Results
CRUSE® was launched in Germany in March 2022 and is now available for free in 17 countries. It is adapted to the local language and displays a country-specific list of available urticaria medications. English and Ukrainian versions are available worldwide. From July 2022 to June 2023, 25,710 observations were documented by 2540 users; 72.7% were females, with a mean age of 39.6 years. At baseline, 93.7% and 51.3% of users had wheals and angioedema, respectively. Second-generation antihistamines were used in 74.0% of days.
Conclusions
The initial data from CRUSE® show the wide use and utility of effectively tracking patients' disease activity and control, paving the way for personalised CSU management.
{"title":"CRUSE®—An innovative mobile application for patient monitoring and management in chronic spontaneous urticaria","authors":"Sophia Neisinger, Bernardo Sousa Pinto, Aiste Ramanauskaite, Jean Bousquet, Karsten Weller, Martin Metz, Markus Magerl, Emek Kocatürk, Ivan Cherrez-Ojeda, Ana M. Gimenez-Arnau, Claudio Alberto S. Parisi, Sabine Altrichter, Luis Felipe Ensina, Laurence Bouillet, Riccardo Asero, Margarida Gonçalo, Carole Guillet, Krzysztof Rutkowski, Jonathan A. Bernstein, Hannah Hardin, Kiran Godse, Zenon Brzoza, Jose Ignacio Larco Sousa, Simon Francis Thomsen, Martijn van Doorn, Michihiro Hide, Young-Min Ye, Staffan Vanderse, Lāsma Lapiņa, Jonny Peter, Zuotao Zhao, Lianyi Han, Iman Nasr, Heike Rockmann-Helmbach, Jennifer Astrup Sørensen, Rabia Öztaş Kara, Natalja Kurjāne, Andrii I. Kurchenko, Igor Kaidashev, Vladyslav Tsaryk, Roman Stepanenko, Marcus Maurer","doi":"10.1002/clt2.12328","DOIUrl":"https://doi.org/10.1002/clt2.12328","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic spontaneous urticaria (CSU) is unpredictable and can severely impair patients' quality of life. Patients with CSU need a convenient, user-friendly platform to complete patient-reported outcome measures (PROMs) on their mobile devices. CRUSE<sup>®</sup>, the Chronic Urticaria Self Evaluation app, aims to address this unmet need.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>CRUSE<sup>®</sup> was developed by an international steering committee of urticaria specialists. Priorities for the app based on recent findings in CSU were defined to allow patients to track and record their symptoms and medication use over time and send photographs. The CRUSE<sup>®</sup> app collects patient data such as age, sex, disease onset, triggers, medication, and CSU characteristics that can be sent securely to physicians, providing real-time insights. Additionally, CRUSE<sup>®</sup> contains PROMs to assess disease activity and control, which are individualised to patient profiles and clinical manifestations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CRUSE<sup>®</sup> was launched in Germany in March 2022 and is now available for free in 17 countries. It is adapted to the local language and displays a country-specific list of available urticaria medications. English and Ukrainian versions are available worldwide. From July 2022 to June 2023, 25,710 observations were documented by 2540 users; 72.7% were females, with a mean age of 39.6 years. At baseline, 93.7% and 51.3% of users had wheals and angioedema, respectively. Second-generation antihistamines were used in 74.0% of days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The initial data from CRUSE<sup>®</sup> show the wide use and utility of effectively tracking patients' disease activity and control, paving the way for personalised CSU management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12328","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139090754","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}
Allergic bronchopulmonary mycosis (ABPM) is an allergic disease caused by type I and type III hypersensitivity to environmental fungi. Schizophyllum commune, a basidiomycete fungus, is one of the most common fungi that causes non-Aspergillus ABPM.
Objective
Herein, we attempted to clarify the clinical characteristics of ABPM caused by S. commune (ABPM-Sc) compared with those of allergic bronchopulmonary aspergillosis (ABPA).
Methods
Patients with ABPM-Sc or ABPA were recruited from a nationwide survey in Japan, a multicenter cohort, and a fungal database at the Medical Mycology Research Center of Chiba University. The definition of culture-positive ABPM-Sc/ABPA is as follows: (1) fulfills five or more of the 10 diagnostic criteria for ABPM proposed by Asano et al., and (2) positive culture of S. commune/Aspergillus spp. in sputum, bronchial lavage fluid, or mucus plugs in the bronchi.
Results
Thirty patients with ABPM-Sc and 46 with ABPA were recruited. Patients with ABPM-Sc exhibited less severe asthma and presented with better pulmonary function than those with ABPA (p = 0.008–0.03). Central bronchiectasis was more common in ABPM-Sc than that in ABPA, whereas peripheral lung lesions, including infiltrates/ground-glass opacities or fibrotic/cystic changes, were less frequent in ABPM-Sc. Aspergillus fumigatus-specific immunoglobulin (Ig)E was negative in 10 patients (34%) with ABPM-Sc, who demonstrated a lower prevalence of asthma and levels of total serum IgE than those with ABPM-Sc positive for A. fumigatus-specific IgE or ABPA.
Conclusions
Clinical characteristics of ABPM-Sc, especially those negative for A. fumigatus-specific IgE, differed from those of ABPA.
过敏性支气管肺霉菌病（ABPM）是一种由对环境真菌的 I 型和 III 型过敏引起的过敏性疾病。基生真菌 Schizophyllum commune 是引起非曲霉性支气管肺霉病的最常见真菌之一。
{"title":"Clinical characteristics of allergic bronchopulmonary mycosis caused by Schizophyllum commune","authors":"Tsuyoshi Oguma, Takashi Ishiguro, Katsuhiko Kamei, Jun Tanaka, Junko Suzuki, Akira Hebisawa, Yasushi Obase, Hiroshi Mukae, Takae Tanosaki, Shiho Furusho, Koji Kurokawa, Kentaro Watai, Hiroto Matsuse, Norihiro Harada, Ai Nakamura, Takuo Shibayama, Rie Baba, Kentaro Fukunaga, Hisako Matsumoto, Hisano Ohba, Susumu Sakamoto, Shinko Suzuki, Shintetsu Tanaka, Takahiro Yamada, Akira Yamasaki, Yuma Fukutomi, Yoshiki Shiraishi, Takahito Toyotome, Koichi Fukunaga, Terufumi Shimoda, Satoshi Konno, Masami Taniguchi, Katsuyoshi Tomomatsu, Naoki Okada, Koichiro Asano, Japan ABPM Research Program","doi":"10.1002/clt2.12327","DOIUrl":"10.1002/clt2.12327","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Allergic bronchopulmonary mycosis (ABPM) is an allergic disease caused by type I and type III hypersensitivity to environmental fungi. <i>Schizophyllum commune</i>, a basidiomycete fungus, is one of the most common fungi that causes non-<i>Aspergillus</i> ABPM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Herein, we attempted to clarify the clinical characteristics of ABPM caused by <i>S. commune</i> (ABPM-Sc) compared with those of allergic bronchopulmonary aspergillosis (ABPA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with ABPM-Sc or ABPA were recruited from a nationwide survey in Japan, a multicenter cohort, and a fungal database at the Medical Mycology Research Center of Chiba University. The definition of culture-positive ABPM-Sc/ABPA is as follows: (1) fulfills five or more of the 10 diagnostic criteria for ABPM proposed by Asano et al., and (2) positive culture of <i>S. commune/Aspergillus</i> spp. in sputum, bronchial lavage fluid, or mucus plugs in the bronchi.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty patients with ABPM-Sc and 46 with ABPA were recruited. Patients with ABPM-Sc exhibited less severe asthma and presented with better pulmonary function than those with ABPA (<i>p</i> = 0.008–0.03). Central bronchiectasis was more common in ABPM-Sc than that in ABPA, whereas peripheral lung lesions, including infiltrates/ground-glass opacities or fibrotic/cystic changes, were less frequent in ABPM-Sc. <i>Aspergillus fumigatus</i>-specific immunoglobulin (Ig)E was negative in 10 patients (34%) with ABPM-Sc, who demonstrated a lower prevalence of asthma and levels of total serum IgE than those with ABPM-Sc positive for <i>A. fumigatus</i>-specific IgE or ABPA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Clinical characteristics of ABPM-Sc, especially those negative for <i>A. fumigatus</i>-specific IgE, differed from those of ABPA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12327","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139063256","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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