Marynowski Mateusz, Karbownik Michał Seweryn, Szemraj Janusz, Kuna Piotr, Michał Gabriel Panek
Background
A key player in the fibrotic process is the transforming growth factor β (TGF-β) which enhances extracellular matrix production by increasing the transcription of matrix proteins. The cytokine TGF-β first binds to the TGFβRII receptor (dimer), resulting in the recruitment of the TGFβRI receptor (dimer). The complex thus formed leads to the phosphorylation of the kinase domain of TGFβRI, which in turn results in activation of the Smad pathway. This is therefore a targeted pathway for research into the application of peptide inhibitors in blocking the TGF-β-Smad signaling pathway. The aim of this study was to design a peptide inhibitor (homologous to the cytokine TGF-β) which, after binding to the TGFβRI/TGFβRII receptor, would block the cytokine binding and thus prevent the formation of an activating complex.
Methods
Preliminary work on the design and synthesis of inhibitors for TGFβRI/TGFβRII has allowed us to identify and describe five key regions of the TGF-β—TGFβRI/TGFβRII interface. The following five peptide inhibitors were synthesized for Region 1: 1.1 ALDAAYCFR, 1.2 LDAAYCFRN, 1.3 DAAYCFRNV, 1.4 AAYCFRNVQ, 1.5 AYCFRNVQD. The expression of the SEAP reporter gene, Smad2, Smad3, Smad4, and JNK1 gene was measured using quantitative real-time polymerase chain reaction.
Results
For Region 1 peptide inhibitors tested for TGFβRI/TGFβRII, reduced SEAP (reporter gene) expression was observed in cells of the MFB-F11 line, which suggests inhibited the formation of cytokine-receptor complexes.
Conclusions
For IP1_2, 1_3 and 1_5 Region 1 peptides tested for TGFβRI/TGFβRII, reduced cytokine-receptor signal by adding newly designed inhibitors. The study revealed an impact of these peptide inhibitors on the reduction of mRNA expression of Smad2, Smad3, Smad4 and JNK1 genes.
{"title":"Assessment of the effectiveness of the peptide inhibitor homologous to the transforming growth factor β cytokine blocking the TGFβRI/TGFβRII receptor complex—pilot study","authors":"Marynowski Mateusz, Karbownik Michał Seweryn, Szemraj Janusz, Kuna Piotr, Michał Gabriel Panek","doi":"10.1002/clt2.12320","DOIUrl":"10.1002/clt2.12320","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A key player in the fibrotic process is the transforming growth factor β (TGF-β) which enhances extracellular matrix production by increasing the transcription of matrix proteins. The cytokine TGF-β first binds to the TGFβRII receptor (dimer), resulting in the recruitment of the TGFβRI receptor (dimer). The complex thus formed leads to the phosphorylation of the kinase domain of TGFβRI, which in turn results in activation of the Smad pathway. This is therefore a targeted pathway for research into the application of peptide inhibitors in blocking the TGF-β-Smad signaling pathway. The aim of this study was to design a peptide inhibitor (homologous to the cytokine TGF-β) which, after binding to the TGFβRI/TGFβRII receptor, would block the cytokine binding and thus prevent the formation of an activating complex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Preliminary work on the design and synthesis of inhibitors for TGFβRI/TGFβRII has allowed us to identify and describe five key regions of the TGF-β—TGFβRI/TGFβRII interface. The following five peptide inhibitors were synthesized for Region 1: 1.1 ALDAAYCFR, 1.2 LDAAYCFRN, 1.3 DAAYCFRNV, 1.4 AAYCFRNVQ, 1.5 AYCFRNVQD. The expression of the SEAP reporter gene, Smad2, Smad3, Smad4, and JNK1 gene was measured using quantitative real-time polymerase chain reaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For Region 1 peptide inhibitors tested for TGFβRI/TGFβRII, reduced SEAP (reporter gene) expression was observed in cells of the MFB-F11 line, which suggests inhibited the formation of cytokine-receptor complexes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>For IP1_2, 1_3 and 1_5 Region 1 peptides tested for TGFβRI/TGFβRII, reduced cytokine-receptor signal by adding newly designed inhibitors. The study revealed an impact of these peptide inhibitors on the reduction of mRNA expression of Smad2, Smad3, Smad4 and JNK1 genes.</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/clt2.12320","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139062942","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}
Audrey Leau, Sandra Denery-Papini, Marie Bodinier, Wieneke Dijk
Hen's egg allergy is the second most frequent food allergy found in children. Allergic symptoms can be caused by raw or heated egg, but a majority of egg-allergic children can tolerate hard-boiled or baked egg. Understanding the reasons for the tolerance towards heated egg provides clues about the molecular mechanisms involved in egg allergy, and the differential allergenicity of heated and baked egg might be exploited to prevent or treat egg allergy. In this review, we therefore discuss (i) why some patients are able to tolerate heated egg; by highlighting the structural changes of egg white (EW) proteins upon heating and their impact on immunoreactivity, as well as patient characteristics, and (ii) to what extent heated or baked EW might be useful for primary prevention strategies or oral immunotherapy. We describe that the level of immunoreactivity towards EW helps to discriminate patients tolerant or reactive to heated or baked egg. Furthermore, the use of heated or baked egg seems effective in primary prevention strategies and might limit adverse reactions. Oral immunotherapy is a promising treatment strategy, but it can sometimes cause significant adverse events. The use of heated or baked egg might limit these, but current literature is insufficient to conclude about its efficacy.
摘要 母鸡蛋过敏是儿童中第二常见的食物过敏症。生鸡蛋或加热鸡蛋都可能引起过敏症状，但大多数鸡蛋过敏儿童都能耐受煮熟或烤熟的鸡蛋。了解对加热鸡蛋耐受的原因可为鸡蛋过敏的分子机制提供线索，加热鸡蛋和烤鸡蛋的不同过敏性可用于预防或治疗鸡蛋过敏。因此，在这篇综述中，我们将讨论：(i) 为什么有些患者能够耐受加热鸡蛋；通过强调蛋白 (EW) 蛋白在加热后的结构变化及其对免疫反应性的影响，以及患者的特征；(ii) 加热或烘焙 EW 在多大程度上可用于初级预防策略或口服免疫疗法。我们发现，对 EW 的免疫反应水平有助于区分患者对加热或烘烤鸡蛋的耐受性或反应性。此外，在一级预防策略中使用加热或烘烤的鸡蛋似乎很有效，并可限制不良反应。口服免疫疗法是一种很有前景的治疗策略，但有时会引起严重的不良反应。使用加热或烘烤的鸡蛋可能会限制这些不良反应，但目前的文献还不足以对其疗效做出结论。
{"title":"Tolerance to heated egg in egg allergy: Explanations and implications for prevention and treatment","authors":"Audrey Leau, Sandra Denery-Papini, Marie Bodinier, Wieneke Dijk","doi":"10.1002/clt2.12312","DOIUrl":"10.1002/clt2.12312","url":null,"abstract":"<p>Hen's egg allergy is the second most frequent food allergy found in children. Allergic symptoms can be caused by raw or heated egg, but a majority of egg-allergic children can tolerate hard-boiled or baked egg. Understanding the reasons for the tolerance towards heated egg provides clues about the molecular mechanisms involved in egg allergy, and the differential allergenicity of heated and baked egg might be exploited to prevent or treat egg allergy. In this review, we therefore discuss (i) why some patients are able to tolerate heated egg; by highlighting the structural changes of egg white (EW) proteins upon heating and their impact on immunoreactivity, as well as patient characteristics, and (ii) to what extent heated or baked EW might be useful for primary prevention strategies or oral immunotherapy. We describe that the level of immunoreactivity towards EW helps to discriminate patients tolerant or reactive to heated or baked egg. Furthermore, the use of heated or baked egg seems effective in primary prevention strategies and might limit adverse reactions. Oral immunotherapy is a promising treatment strategy, but it can sometimes cause significant adverse events. The use of heated or baked egg might limit these, but current literature is insufficient to conclude about its efficacy.</p>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"13 12","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12312","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139019193","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}
Karla Robles-Velasco, Matias Panchana-Lascano, Flavio Veintemilla-Burgos, Romina Hinostroza, Jonathan A. Bernstein, Ivan Cherrez-Ojeda
<p>Food allergy (FA), an immunoglobulin E (IgE) reaction, is rising steadily over time.<span><sup>1</sup></span> FA is present in 10% of the population, varying according to region.<span><sup>2</sup></span> Google's search engine has become a significant source of medical information; however, this information varies in quality. Google Trends (GTr) is a free online service that gives users access to current and historical data on Google searches from 2004 up to the present.<span><sup>3</sup></span></p><p>This study aims to assess the public interest and information-seeking behavior regarding food allergies over a specified period. We conducted several searches on GTr (http://trends.google.com) on April 1st, 2023. The data was downloaded and compiled at once across 10 countries from January 1, 2012, to December 31, 2022. Based on a literature review indicating high prevalence in various countries three different types of food were selected as the primary allergens.<span><sup>4</sup></span> These allergens were used as search topics in GTr, and include: “milk allergy,” “peanut allergy,” and “shellfish allergy.” The countries were selected using GTr performing a search for “Food allergy” as a topic with the "worldwide" category, we analyzed the countries with a relative search volume (RSV) score higher than 50. Ten countries were included: Australia, Canada, Finland, Hungary, Ireland, Netherlands, New Zealand, Philippines, Singapore, and the USA. Ten different searches were performed, one search for each of the 10 countries. Each search containing the three allergens, and done under the category “Health” in GTr. RSV is a value that expresses the relation between a specific search concerning the overall searches on Google at a specific time among other modifiable variables. RSV ranges between 100 and 0 in descending order, the former being a high popularity and the latter a low one. For this study, search volume trends and interest over time were developed using Statistical Package for Social Science (version 21.0; SPSS).</p><p>Over the years, there has been a noticeable growth in people's interest in searching about “food allergy” as a topic of search, as evidenced by increased Google search trends from 2012 to 2022 in the 10 countries examined. Although the interest in peanut allergy has been relatively low in the last decade, in the last 2 years there has been a prominent increase in searches in Australia, the USA, Finland, the Netherlands, and New Zealand. On the other hand, there was a decreasing interest in Canada, Hungary, Ireland, and the Philippines. Milk allergy was the most searched topic in 6 out of 10 countries of interest, with a sharp spike since 2021 in Canada, the USA, and Australia. In contrast, “shellfish allergy” showed the lowest RSV, being only searched mainly in the Philippines and Singapore (Figure 1).</p><p>The related queries with the most interest were different terms and definitions for allergy, such as “allergy,” “allergi
{"title":"Food allergy: What are people looking for? An infodemiology study","authors":"Karla Robles-Velasco, Matias Panchana-Lascano, Flavio Veintemilla-Burgos, Romina Hinostroza, Jonathan A. Bernstein, Ivan Cherrez-Ojeda","doi":"10.1002/clt2.12322","DOIUrl":"10.1002/clt2.12322","url":null,"abstract":"<p>Food allergy (FA), an immunoglobulin E (IgE) reaction, is rising steadily over time.<span><sup>1</sup></span> FA is present in 10% of the population, varying according to region.<span><sup>2</sup></span> Google's search engine has become a significant source of medical information; however, this information varies in quality. Google Trends (GTr) is a free online service that gives users access to current and historical data on Google searches from 2004 up to the present.<span><sup>3</sup></span></p><p>This study aims to assess the public interest and information-seeking behavior regarding food allergies over a specified period. We conducted several searches on GTr (http://trends.google.com) on April 1st, 2023. The data was downloaded and compiled at once across 10 countries from January 1, 2012, to December 31, 2022. Based on a literature review indicating high prevalence in various countries three different types of food were selected as the primary allergens.<span><sup>4</sup></span> These allergens were used as search topics in GTr, and include: “milk allergy,” “peanut allergy,” and “shellfish allergy.” The countries were selected using GTr performing a search for “Food allergy” as a topic with the \"worldwide\" category, we analyzed the countries with a relative search volume (RSV) score higher than 50. Ten countries were included: Australia, Canada, Finland, Hungary, Ireland, Netherlands, New Zealand, Philippines, Singapore, and the USA. Ten different searches were performed, one search for each of the 10 countries. Each search containing the three allergens, and done under the category “Health” in GTr. RSV is a value that expresses the relation between a specific search concerning the overall searches on Google at a specific time among other modifiable variables. RSV ranges between 100 and 0 in descending order, the former being a high popularity and the latter a low one. For this study, search volume trends and interest over time were developed using Statistical Package for Social Science (version 21.0; SPSS).</p><p>Over the years, there has been a noticeable growth in people's interest in searching about “food allergy” as a topic of search, as evidenced by increased Google search trends from 2012 to 2022 in the 10 countries examined. Although the interest in peanut allergy has been relatively low in the last decade, in the last 2 years there has been a prominent increase in searches in Australia, the USA, Finland, the Netherlands, and New Zealand. On the other hand, there was a decreasing interest in Canada, Hungary, Ireland, and the Philippines. Milk allergy was the most searched topic in 6 out of 10 countries of interest, with a sharp spike since 2021 in Canada, the USA, and Australia. In contrast, “shellfish allergy” showed the lowest RSV, being only searched mainly in the Philippines and Singapore (Figure 1).</p><p>The related queries with the most interest were different terms and definitions for allergy, such as “allergy,” “allergi","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"13 12","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12322","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138822573","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}
Oliver Pfaar, Ulrich Wahn, Giorgio Walter Canonica, Farah Bahbah, Philippe Devillier
Background
There is considerable interest in improving the scoring methods for evaluating the efficacy of allergen immunotherapy (AIT) and to show if this is associated with clinically meaningful results from the patient's perspective. We aimed to assess the efficacy and clinical relevance of a 300 index of reactivity (IR) 5-grass pollen sublingual immunotherapy (SLIT) tablet in children, adolescents and adults with moderate to severe grass-induced allergic rhinoconjunctivitis (ARC) with or without controlled asthma using the combined symptom and medication score CSMS0-36.
Methods
The data of the European population that participated in 3 Phase III, international, randomized double-blind placebo-controlled clinical trials were analyzed post hoc.
Results
A total of 864 patients randomized to 300 IR 5-grass tablet or placebo were analyzed. Over the primary evaluation period, the difference in CSMS0-36 between the 300 IR and placebo groups was statistically significant (point estimates: −2.51, CI95% [−3.88; −1.14], p < 0.0001 in clinical trial1; −2.31, CI95% [−3.39; −1.23], p < 0.0001 in CT2; and −2.31, CI95% [−3.58; −1.03], p = 0.0004 in CT3). The relative differences between the 300 IR 5-grass tablet and placebo were −29.7%, −33.8%, and −26.3%, respectively. The results based on CSMS0-36 were consistent with those obtained with the primary endpoints of the trials and support the consideration of the 2-point threshold of the CSMS0-36 for clinical relevance of AIT.
Conclusion
Post hoc analysis of 3 CTs with the 300 IR 5-grass SLIT tablet confirmed its significant and clinically relevant effect in the European population with grass pollen-induced ARC with or without controlled asthma.
背景 人们对改进过敏原免疫疗法（AIT）疗效评估的评分方法以及从患者的角度看这是否与有临床意义的结果相关联非常感兴趣。我们的目的是利用症状和药物综合评分 CSMS0-36，评估 300 反应指数（IR）5-禾本科花粉舌下免疫疗法（SLIT）片剂对患有中度至重度禾本科花粉引起的过敏性鼻结膜炎（ARC）并伴有或不伴有哮喘控制的儿童、青少年和成人的疗效和临床相关性。 方法 对参加 3 项 III 期国际随机双盲安慰剂对照临床试验的欧洲人群的数据进行了事后分析。 结果 共分析了 864 名随机服用 300 IR 5-草片或安慰剂的患者。在主要评估期间，300 IR 组和安慰剂组的 CSMS0-36 差异具有统计学意义（点估计值：-2.51，CI95：在临床试验1中为-2.51，CI95% [-3.88; -1.14], p < 0.0001；在临床试验2中为-2.31，CI95% [-3.39; -1.23], p < 0.0001；在临床试验3中为-2.31，CI95% [-3.58; -1.03], p = 0.0004）。300IR五味草片与安慰剂的相对差异分别为-29.7%、-33.8%和-26.3%。基于 CSMS0-36 的结果与试验主要终点的结果一致，并支持将 CSMS0-36 的 2 分阈值作为 AIT 临床相关性的考虑因素。 结论 对使用 300 IR 5-草酸 SLIT 片剂的 3 项 CT 进行的事后分析证实，该药物在欧洲草花粉诱发 ARC 并伴有或不伴有哮喘控制的人群中具有显著的临床相关性效果。
{"title":"Clinical relevance of pre- and coseasonal sublingual immunotherapy with a 300 index of reactivity 5-grass SLIT tablet in allergic rhinoconjunctivitis","authors":"Oliver Pfaar, Ulrich Wahn, Giorgio Walter Canonica, Farah Bahbah, Philippe Devillier","doi":"10.1002/clt2.12321","DOIUrl":"https://doi.org/10.1002/clt2.12321","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is considerable interest in improving the scoring methods for evaluating the efficacy of allergen immunotherapy (AIT) and to show if this is associated with clinically meaningful results from the patient's perspective. We aimed to assess the efficacy and clinical relevance of a 300 index of reactivity (IR) 5-grass pollen sublingual immunotherapy (SLIT) tablet in children, adolescents and adults with moderate to severe grass-induced allergic rhinoconjunctivitis (ARC) with or without controlled asthma using the combined symptom and medication score CSMS<sub>0-36</sub>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data of the European population that participated in 3 Phase III, international, randomized double-blind placebo-controlled clinical trials were analyzed post hoc.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 864 patients randomized to 300 IR 5-grass tablet or placebo were analyzed. Over the primary evaluation period, the difference in CSMS<sub>0-36</sub> between the 300 IR and placebo groups was statistically significant (point estimates: −2.51, CI<sub>95%</sub> [−3.88; −1.14], <i>p</i> < 0.0001 in clinical trial1; −2.31, CI<sub>95%</sub> [−3.39; −1.23], <i>p</i> < 0.0001 in CT2; and −2.31, CI<sub>95%</sub> [−3.58; −1.03], <i>p</i> = 0.0004 in CT3). The relative differences between the 300 IR 5-grass tablet and placebo were −29.7%, −33.8%, and −26.3%, respectively. The results based on CSMS<sub>0-36</sub> were consistent with those obtained with the primary endpoints of the trials and support the consideration of the 2-point threshold of the CSMS<sub>0-36</sub> for clinical relevance of AIT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Post hoc analysis of 3 CTs with the 300 IR 5-grass SLIT tablet confirmed its significant and clinically relevant effect in the European population with grass pollen-induced ARC with or without controlled asthma.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"13 12","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12321","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138739740","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}
Margitta Worm, Adam T. Fox, Magnus Wickman, Johannes Ring, Motohiro Ebisawa, Guillaume Pouessel, Pete Smith
Background
Anaphylaxis is a sudden multisystem allergic reaction which may result in a fatal outcome if not treated promptly. Guidelines worldwide suggest intramuscular adrenaline as the first-line treatment for anaphylaxis outside a perioperative reaction. Adrenaline autoinjectors (AAIs) are widely used self-administrable devices, especially in community settings. Different commercial AAIs have been authorized to be marketed in Europe. For an AAI to be efficacious, a rapid adrenaline delivery in patients, including those who are overweight or obese, resulting in an optimal cardiovascular (CV) response, is a key feature. AAIs are designed to achieve this requirement, which is reflected in their differing functional properties such as primary container selection, drug delivery mechanism (cartridge-or syringe-based), needle length, needle gauge, and adrenaline dose (150 μg, 300 μg, or 500 μg). However, the differences in functional properties across these devices may play a critical role in achieving these requirements as well as the differences in ergonomics in the handling of these devices.
The purpose of this review
Considering the dynamic pharmacokinetic/pharmacodynamic (PK/PD) profiles of different AAIs marketed in Europe and their effect on adrenaline delivery, the expert panel, also serving as author for this paper have carried out a detailed analysis of the PK/PD profiles of four AAIs, namely, Anapen, Emerade, EpiPen, and Jext, to delineate the adrenaline delivery and their subsequent physiological effects on the backdrop of device characteristics, dose strength, and the skin-to-muscle distances of the participants.
{"title":"Adrenaline auto injectors pharmacokinetic/pharmacodynamic studies and potential consequences for clinical practice","authors":"Margitta Worm, Adam T. Fox, Magnus Wickman, Johannes Ring, Motohiro Ebisawa, Guillaume Pouessel, Pete Smith","doi":"10.1002/clt2.12323","DOIUrl":"https://doi.org/10.1002/clt2.12323","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Anaphylaxis is a sudden multisystem allergic reaction which may result in a fatal outcome if not treated promptly. Guidelines worldwide suggest intramuscular adrenaline as the first-line treatment for anaphylaxis outside a perioperative reaction. Adrenaline autoinjectors (AAIs) are widely used self-administrable devices, especially in community settings. Different commercial AAIs have been authorized to be marketed in Europe. For an AAI to be efficacious, a rapid adrenaline delivery in patients, including those who are overweight or obese, resulting in an optimal cardiovascular (CV) response, is a key feature. AAIs are designed to achieve this requirement, which is reflected in their differing functional properties such as primary container selection, drug delivery mechanism (cartridge-or syringe-based), needle length, needle gauge, and adrenaline dose (150 μg, 300 μg, or 500 μg). However, the differences in functional properties across these devices may play a critical role in achieving these requirements as well as the differences in ergonomics in the handling of these devices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> The purpose of this review</h3>\u0000 \u0000 <p>Considering the dynamic pharmacokinetic/pharmacodynamic (PK/PD) profiles of different AAIs marketed in Europe and their effect on adrenaline delivery, the expert panel, also serving as author for this paper have carried out a detailed analysis of the PK/PD profiles of four AAIs, namely, Anapen, Emerade, EpiPen, and Jext, to delineate the adrenaline delivery and their subsequent physiological effects on the backdrop of device characteristics, dose strength, and the skin-to-muscle distances of the participants.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"13 12","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12323","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138739755","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}
Ling Shi, Qing Xiong, Fu Kiu Ao, Tsz Yau Wan, Xiaojun Xiao, Xiaoyu Liu, Baoqing Sun, Anchalee Tungtrongchitr, Ting Fan Leung, Stephen Kwok Wing Tsui
Background
Astigmatic mites contain potent allergens that can trigger IgE-mediated immune responses, leading to allergic diseases such as asthma, allergic rhinitis and atopic dermatitis. In house dust mites Dermatophagoides pteronyssinus and Dermatophagoides farinae, group 1 allergens (Der p 1 and Der f 1), characterized as papain-like cysteine proteases, have been defined as the major allergens that have high prevalence and potency. Previous studies of mite group 1 allergens mainly focused on identification, comparison of sequence and structure, as well as the investigation of cross-reactivity. To achieve a comprehensive view of mite group 1 allergens, we performed a comparative genomic analysis of all the cysteine proteases in six astigmatic mite species to elucidate the evolutionary relationships of group 1 allergens.
Methods
Based on the high-quality and annotated genomes, all the cysteine proteases in six astigmatic mite species were identified by sequence homology search. The phylogenetic relationships, gene synteny and expression levels were revealed by bioinformatic tools. The allergenicity of recombinant cysteine proteases was evaluated by enzyme-linked immunosorbent assay.
Results
Tandem duplication was revealed as the major feature of cysteine protease gene evolution in astigmatic mites. The high IgE-binding capacity and the significant expression level of the cysteine protease DP_007902.01 suggested its potential as a novel group 1 allergen of D. pteronyssinus. In addition, gene decay events were identified in the skin-burrowing parasitic mite Sarcoptes scabiei.
Conclusion
This comprehensive analysis provided insights into the evolution of cysteine proteases, as well as the component-resolved diagnosis of mite allergies.
{"title":"Comparative analysis of cysteine proteases reveals gene family evolution of the group 1 allergens in astigmatic mites","authors":"Ling Shi, Qing Xiong, Fu Kiu Ao, Tsz Yau Wan, Xiaojun Xiao, Xiaoyu Liu, Baoqing Sun, Anchalee Tungtrongchitr, Ting Fan Leung, Stephen Kwok Wing Tsui","doi":"10.1002/clt2.12324","DOIUrl":"https://doi.org/10.1002/clt2.12324","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Astigmatic mites contain potent allergens that can trigger IgE-mediated immune responses, leading to allergic diseases such as asthma, allergic rhinitis and atopic dermatitis. In house dust mites <i>Dermatophagoides pteronyssinus</i> and <i>Dermatophagoides farinae</i>, group 1 allergens (Der p 1 and Der f 1), characterized as papain-like cysteine proteases, have been defined as the major allergens that have high prevalence and potency. Previous studies of mite group 1 allergens mainly focused on identification, comparison of sequence and structure, as well as the investigation of cross-reactivity. To achieve a comprehensive view of mite group 1 allergens, we performed a comparative genomic analysis of all the cysteine proteases in six astigmatic mite species to elucidate the evolutionary relationships of group 1 allergens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Based on the high-quality and annotated genomes, all the cysteine proteases in six astigmatic mite species were identified by sequence homology search. The phylogenetic relationships, gene synteny and expression levels were revealed by bioinformatic tools. The allergenicity of recombinant cysteine proteases was evaluated by enzyme-linked immunosorbent assay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Tandem duplication was revealed as the major feature of cysteine protease gene evolution in astigmatic mites. The high IgE-binding capacity and the significant expression level of the cysteine protease DP_007902.01 suggested its potential as a novel group 1 allergen of <i>D. pteronyssinus</i>. In addition, gene decay events were identified in the skin-burrowing parasitic mite <i>Sarcoptes scabiei</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This comprehensive analysis provided insights into the evolution of cysteine proteases, as well as the component-resolved diagnosis of mite allergies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"13 12","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12324","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138634142","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}
Elena Sagües-Sesé, Natalia García-Casares, Ivan Álvarez-Twose
Background
Mastocytosis manifests with multisystemic symptoms, often involving the nervous system. Numerous cognitive, neuropsychiatric and neurological alterations have been reported in multiple observational studies.
Methods
We performed a qualitative systematic literature review of reported data consulting the electronic databases Medline, Scopus, Web of Science, Cochrane, and BASE until June 2023.
Results
We selected 24 studies in which the majority showed that a high proportion of mastocytosis patients suffer cognitive, neuropsychiatric and neurological alterations. The most common disorders and estimated ranges of frequency observed in adults were depression (68%–75%), anxiety, high stress or irritability (27%–54%), cognitive impairment (27%–39%, primarily affecting memory skills), and headaches (55%–69%). Attention challenges and learning difficulties were reported in children at a rate of 13%, while neurodevelopmental disorders occurred at rates of 8%–12%. Frequent white abnormalities in mastocytosis patients with concomitant psychocognitive symptoms have been reported although neuroimaging studies have been performed rarely in this population.
Conclusion
Further studies with more comprehensive and homogeneous evaluations and neuroimaging and histological analysis should be performed for a better understanding of these manifestations. An earlier detection and proper management of these symptoms could greatly improve the quality of life of these patients.
{"title":"Cognitive, neuropsychiatric and neurological alterations in mastocytosis: A systematic review","authors":"Elena Sagües-Sesé, Natalia García-Casares, Ivan Álvarez-Twose","doi":"10.1002/clt2.12319","DOIUrl":"10.1002/clt2.12319","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mastocytosis manifests with multisystemic symptoms, often involving the nervous system. Numerous cognitive, neuropsychiatric and neurological alterations have been reported in multiple observational studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a qualitative systematic literature review of reported data consulting the electronic databases Medline, Scopus, Web of Science, Cochrane, and BASE until June 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We selected 24 studies in which the majority showed that a high proportion of mastocytosis patients suffer cognitive, neuropsychiatric and neurological alterations. The most common disorders and estimated ranges of frequency observed in adults were depression (68%–75%), anxiety, high stress or irritability (27%–54%), cognitive impairment (27%–39%, primarily affecting memory skills), and headaches (55%–69%). Attention challenges and learning difficulties were reported in children at a rate of 13%, while neurodevelopmental disorders occurred at rates of 8%–12%. Frequent white abnormalities in mastocytosis patients with concomitant psychocognitive symptoms have been reported although neuroimaging studies have been performed rarely in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Further studies with more comprehensive and homogeneous evaluations and neuroimaging and histological analysis should be performed for a better understanding of these manifestations. An earlier detection and proper management of these symptoms could greatly improve the quality of life of these patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"13 12","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12319","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138629651","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}
<p>The incidence of anaphylaxis continues to rise globally based on hospital data from Europe (Sweden), United States, Australia, Brazil and some Asian (Japan) countries.<span><sup>1-4</sup></span> However, the incidence is likely to be higher due to misdiagnosis, misclassification, and underreporting<span><sup>1</sup></span> and because allergies and anaphylaxis are being neglected in developing countries due to other disease priorities.<span><sup>5</sup></span> In a large proportion of cases, after extensive evaluation, a trigger cannot be identified and are classified as ‘idiopathic anaphylaxis’ (IA). As food consumption patterns, genetic background, and environmental factors can lead to differences in allergen sensitization patterns in different geographical regions, we sought to identify possible triggers of IA in Sri Lankan patients presenting to a specialized allergy clinic.</p><p>All patients referred with a history of anaphylaxis were recruited following informed consent. The patients were evaluated for possible aetiological factors and contributing cofactors for the development of anaphylaxis. Relevant skin prick tests were conducted to identify the allergen. Those in whom a possible allergen could not be identified were classified as having idiopathic anaphylaxis. Accordingly, from January to December 2021, of 200 patients with anaphylaxis screened at the clinic, 65 patients were considered to have IA. In all patients, the events that led to the episode, the foods consumed, the severity of symptoms, and treatment received were recorded. Ethical approval was obtained from the Ethics Review Committee, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka. A blood sample was obtained from all patients on which an Immuno Solid-Phase Allergen Chip (ISAC) ImmunoCAP was performed. In patients whose ISAC was negative, a serum tryptase was done and results were within the normal range. Statistical analysis was done using GraphPad prism version 9.0.</p><p>Of the 65 patients, 42 (64.6%) were females and 49 (75.38%) were adults. Eight (12.3%) had grade 1 anaphylaxis, forty-six (70.8%) grade 2 anaphylaxis, and eleven (16.9%) grade 3 anaphylaxis. The allergen sensitization pattern is shown in (Table 1). Thirty-four (52.3%) patients were found to have specific IgE to alpha-gal. The other main allergens sensitized were house dust mites, twenty (30.8%), and grass pollen, sixteen (24.6%).</p><p>Allergy to Galactose-α-1,3-galactose (α-gal) has been shown as an important cause of anaphylaxis among those in whom a cause is unidentifiable.<span><sup>6</sup></span> Of the patients sensitized to alpha-gal, fourteen (41.2%) were male and twenty-two (64.7%) were adults. Sixteen (47.1%) did not have detectable IgE to other allergens included in the ISAC ImmunoCAP. Twelve (35.3%) had consumed mammalian meat prior to developing anaphylaxis, and therefore, alpha-gal allergy is most likely to be the trigger in these patients. Fourteen had consume
{"title":"Sensitization to alpha-gal as a cause of idiopathic anaphylaxis","authors":"Thushali Ranasinghe, Inoka Sepali Aberathna, Jeewantha Jayamali, Thashmi Nimasha, Harshani Chathurangika, Deneshan Peranantharajah, Hashini Colambage, Gathsaurie Neelika Malavige, Chandima Jeewandara","doi":"10.1002/clt2.12309","DOIUrl":"https://doi.org/10.1002/clt2.12309","url":null,"abstract":"<p>The incidence of anaphylaxis continues to rise globally based on hospital data from Europe (Sweden), United States, Australia, Brazil and some Asian (Japan) countries.<span><sup>1-4</sup></span> However, the incidence is likely to be higher due to misdiagnosis, misclassification, and underreporting<span><sup>1</sup></span> and because allergies and anaphylaxis are being neglected in developing countries due to other disease priorities.<span><sup>5</sup></span> In a large proportion of cases, after extensive evaluation, a trigger cannot be identified and are classified as ‘idiopathic anaphylaxis’ (IA). As food consumption patterns, genetic background, and environmental factors can lead to differences in allergen sensitization patterns in different geographical regions, we sought to identify possible triggers of IA in Sri Lankan patients presenting to a specialized allergy clinic.</p><p>All patients referred with a history of anaphylaxis were recruited following informed consent. The patients were evaluated for possible aetiological factors and contributing cofactors for the development of anaphylaxis. Relevant skin prick tests were conducted to identify the allergen. Those in whom a possible allergen could not be identified were classified as having idiopathic anaphylaxis. Accordingly, from January to December 2021, of 200 patients with anaphylaxis screened at the clinic, 65 patients were considered to have IA. In all patients, the events that led to the episode, the foods consumed, the severity of symptoms, and treatment received were recorded. Ethical approval was obtained from the Ethics Review Committee, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka. A blood sample was obtained from all patients on which an Immuno Solid-Phase Allergen Chip (ISAC) ImmunoCAP was performed. In patients whose ISAC was negative, a serum tryptase was done and results were within the normal range. Statistical analysis was done using GraphPad prism version 9.0.</p><p>Of the 65 patients, 42 (64.6%) were females and 49 (75.38%) were adults. Eight (12.3%) had grade 1 anaphylaxis, forty-six (70.8%) grade 2 anaphylaxis, and eleven (16.9%) grade 3 anaphylaxis. The allergen sensitization pattern is shown in (Table 1). Thirty-four (52.3%) patients were found to have specific IgE to alpha-gal. The other main allergens sensitized were house dust mites, twenty (30.8%), and grass pollen, sixteen (24.6%).</p><p>Allergy to Galactose-α-1,3-galactose (α-gal) has been shown as an important cause of anaphylaxis among those in whom a cause is unidentifiable.<span><sup>6</sup></span> Of the patients sensitized to alpha-gal, fourteen (41.2%) were male and twenty-two (64.7%) were adults. Sixteen (47.1%) did not have detectable IgE to other allergens included in the ISAC ImmunoCAP. Twelve (35.3%) had consumed mammalian meat prior to developing anaphylaxis, and therefore, alpha-gal allergy is most likely to be the trigger in these patients. Fourteen had consume","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"13 12","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138491420","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}
Peiwen Xue, Haiyan Qin, Di Qin, Huilin Liu, Juan Li, Rongjiang Jin, Xianjun Xiao
<div> <section> <h3> Background</h3> <p>Atopic dermatitis (AD) is a common skin disease that is hard to completely cure in a short time. Guidelines recommend the use of topical corticosteroids (TCS) as first-line anti-inflammatory therapy for AD, but long-term use has significant side effects. Microecological agents (MA), including probiotics, prebiotics and synbiotics, have been widely reported as a potential adjunctive therapy of AD, but whether MA can contribute to AD treatment is currently controversial. Therefore, we conducted a systematic review and meta-analysis to investigate whether MA as an add-on therapy for AD has synergistic and attenuated effects and to further understand the role of MA in clinical interventions for AD.</p> </section> <section> <h3> Methods</h3> <p>We systematically searched Medline, Embase, Web of Science, Cochrane Library and PsycINFO databases up to Apr 11, 2023, and bibliographies were also manually searched, for potentially relevant studies regarding MA as additional therapy of AD. The Cochrane Risk of Bias Tool for assessing risk of bias was used to assess the quality of randomized controlled trials (RCTs). Two reviewers screened studies, extracted data, and evaluated the risk of bias independently. The primary outcomes (SCORAD scores and the number of adverse events) and the secondary outcomes (pruritus scores, the quality of life and the frequency of TCS) were extracted from each article. The data were combined and analyzed to quantify the safety and efficacy of the treatment. R (V4.4.3) software was used for data synthesis. The certainty of the evidence was evaluated with the Grade of Recommendation, Assessment, Development and Evaluation (GRADE) system. We also performed a trial sequential analysis to assess the reliability of the evidence.</p> </section> <section> <h3> Results</h3> <p>A total of 21 studies, including 1230 individuals, were identified, 20 of which met the eligibility criteria for the meta-analysis. Our pooled meta-analyses showed that compared with controls, oral MA as an add-on therapy was associated with significantly lower SCORAD scores (MD = −5.30, 95% CI −8.50, −1.55, <i>p</i> < 0.01, <i>I</i><sup><i>2</i></sup> = 81%). However, adverse events, pruritus scores, quality of life, and frequency of TCS use showed no significant difference in this meta-analysis study (<i>p</i> > 0.05).</p> </section> <section> <h3> Conclusions</h3> <p>This meta-analysis showed that MA plus TCS could be an effective and safe treatment for patients with AD to relieve relevant symptoms, which might be use
特应性皮炎(AD)是一种常见病，短期内难以完全治愈。指南推荐使用局部皮质类固醇(TCS)作为AD的一线抗炎治疗，但长期使用有明显的副作用。微生态制剂(Microecological agents, MA)，包括益生菌、益生元和合成制剂，已被广泛报道为AD的潜在辅助治疗方法，但MA是否有助于AD的治疗目前存在争议。因此，我们进行了一项系统综述和荟萃分析，以研究MA作为AD的附加治疗是否具有协同和减毒作用，并进一步了解MA在AD临床干预中的作用。方法系统检索截至2023年4月11日的Medline、Embase、Web of Science、Cochrane Library和PsycINFO数据库，并人工检索文献，寻找MA作为AD附加治疗的潜在相关研究。使用Cochrane偏倚风险评估工具评估随机对照试验(rct)的质量。两位审稿人筛选研究、提取数据并独立评估偏倚风险。从每篇文章中提取主要结局(SCORAD评分和不良事件数量)和次要结局(瘙痒评分、生活质量和TCS频率)。这些数据被合并和分析，以量化治疗的安全性和有效性。采用R (V4.4.3)软件进行数据综合。采用推荐、评估、发展和评价等级(Grade)系统评价证据的确定性。我们还进行了试验序列分析，以评估证据的可靠性。结果共纳入21项研究，包括1230名个体，其中20项符合meta分析的资格标准。我们的汇总荟萃分析显示，与对照组相比，口服MA作为附加治疗与SCORAD评分显著降低相关(MD = - 5.30, 95% CI - 8.50， - 1.55, p <0.01, i2 = 81%)。然而，在这项荟萃分析研究中，不良事件、瘙痒评分、生活质量和TCS使用频率没有显着差异(p >0.05)。结论本荟萃分析显示，MA联合TCS可有效、安全地缓解AD患者的相关症状，可作为AD治疗的一种附加疗法。然而，由于研究数量有限，结果应谨慎解释。MA + TCS的最佳方案需要更大样本量的进一步研究。
{"title":"The efficacy and safety of oral microecological agents as add-on therapy for atopic dermatitis: A systematic review and meta-analysis of randomized clinical trials","authors":"Peiwen Xue, Haiyan Qin, Di Qin, Huilin Liu, Juan Li, Rongjiang Jin, Xianjun Xiao","doi":"10.1002/clt2.12318","DOIUrl":"https://doi.org/10.1002/clt2.12318","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atopic dermatitis (AD) is a common skin disease that is hard to completely cure in a short time. Guidelines recommend the use of topical corticosteroids (TCS) as first-line anti-inflammatory therapy for AD, but long-term use has significant side effects. Microecological agents (MA), including probiotics, prebiotics and synbiotics, have been widely reported as a potential adjunctive therapy of AD, but whether MA can contribute to AD treatment is currently controversial. Therefore, we conducted a systematic review and meta-analysis to investigate whether MA as an add-on therapy for AD has synergistic and attenuated effects and to further understand the role of MA in clinical interventions for AD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically searched Medline, Embase, Web of Science, Cochrane Library and PsycINFO databases up to Apr 11, 2023, and bibliographies were also manually searched, for potentially relevant studies regarding MA as additional therapy of AD. The Cochrane Risk of Bias Tool for assessing risk of bias was used to assess the quality of randomized controlled trials (RCTs). Two reviewers screened studies, extracted data, and evaluated the risk of bias independently. The primary outcomes (SCORAD scores and the number of adverse events) and the secondary outcomes (pruritus scores, the quality of life and the frequency of TCS) were extracted from each article. The data were combined and analyzed to quantify the safety and efficacy of the treatment. R (V4.4.3) software was used for data synthesis. The certainty of the evidence was evaluated with the Grade of Recommendation, Assessment, Development and Evaluation (GRADE) system. We also performed a trial sequential analysis to assess the reliability of the evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 21 studies, including 1230 individuals, were identified, 20 of which met the eligibility criteria for the meta-analysis. Our pooled meta-analyses showed that compared with controls, oral MA as an add-on therapy was associated with significantly lower SCORAD scores (MD = −5.30, 95% CI −8.50, −1.55, <i>p</i> < 0.01, <i>I</i><sup><i>2</i></sup> = 81%). However, adverse events, pruritus scores, quality of life, and frequency of TCS use showed no significant difference in this meta-analysis study (<i>p</i> > 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This meta-analysis showed that MA plus TCS could be an effective and safe treatment for patients with AD to relieve relevant symptoms, which might be use","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"13 12","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12318","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138480850","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}
Marine Savouré, Jean Bousquet, Bénédicte Leynaert, Céline Ribet, Marcel Goldberg, Marie Zins, Bénédicte Jacquemin, Rachel Nadif
Background
Few population-based studies have described allergic rhinitis (AR) according to the Allergic Rhinitis and its Impact on Asthma (ARIA) classification, and none have assessed the impact of asthma on this classification. Our aims were to 1) describe AR according to four ARIA classes and 2) within each of the four ARIA classes, compare participants with AR alone versus those with AR and asthma.
Methods
Cross-sectional analyses were performed using data from the 2014 annual follow-up questionnaire of the French adult population-based cohort Constances. Current AR was defined by the report of sneezing, runny, or blocked nose in the last 12 months and the report of nasal allergies. Following ARIA recommendations, rhinitis was classified according to its severity (mild or moderate-severe) and duration (intermittent or persistent). Ever asthma was also defined by a questionnaire.
Results
Among the 4675 participants with AR (57% women, mean age 50.2 ± 12.7 years), 44% were classified as mild/intermittent, 16% mild/persistent, 25% moderate-severe/intermittent, and 15% moderate-severe/persistent. Within each of the four ARIA classes, compared to participants with rhinitis alone, participants with rhinitis and asthma had significantly more severe symptoms, more conjunctivitis, a higher mean eosinophil count and more treatments with intra-nasal corticosteroids and oral antihistamines co-medication.
Conclusions
This is a paradigm shift study as for the first time this large population-based study in adults showed that asthma status has a profound effect on the ARIA classification. Rhinitis alone and rhinitis with asthma represent two distinct phenotypes. These results reinforce the need to include asthma status in the ARIA classification and guidelines.
{"title":"Asthma is associated with increased severity and duration of rhinitis: A study with the Allergic Rhinitis and its Impact on Asthma classes in the Constances cohort","authors":"Marine Savouré, Jean Bousquet, Bénédicte Leynaert, Céline Ribet, Marcel Goldberg, Marie Zins, Bénédicte Jacquemin, Rachel Nadif","doi":"10.1002/clt2.12316","DOIUrl":"https://doi.org/10.1002/clt2.12316","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Few population-based studies have described allergic rhinitis (AR) according to the Allergic Rhinitis and its Impact on Asthma (ARIA) classification, and none have assessed the impact of asthma on this classification. Our aims were to 1) describe AR according to four ARIA classes and 2) within each of the four ARIA classes, compare participants with AR alone versus those with AR and asthma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional analyses were performed using data from the 2014 annual follow-up questionnaire of the French adult population-based cohort Constances. Current AR was defined by the report of sneezing, runny, or blocked nose in the last 12 months and the report of nasal allergies. Following ARIA recommendations, rhinitis was classified according to its severity (mild or moderate-severe) and duration (intermittent or persistent). Ever asthma was also defined by a questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 4675 participants with AR (57% women, mean age 50.2 ± 12.7 years), 44% were classified as mild/intermittent, 16% mild/persistent, 25% moderate-severe/intermittent, and 15% moderate-severe/persistent. Within each of the four ARIA classes, compared to participants with rhinitis alone, participants with rhinitis and asthma had significantly more severe symptoms, more conjunctivitis, a higher mean eosinophil count and more treatments with intra-nasal corticosteroids and oral antihistamines co-medication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is a paradigm shift study as for the first time this large population-based study in adults showed that asthma status has a profound effect on the ARIA classification. Rhinitis alone and rhinitis with asthma represent two distinct phenotypes. These results reinforce the need to include asthma status in the ARIA classification and guidelines.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"13 11","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12316","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138432294","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号