International Archives of Allergy and Immunology最新文献

Introduction: The Red Maple Trials Naturalistic Exposure Chamber™ (NEC™) is a fixed, live-cat exposure chamber wherein allergen shed from two resident cats is aerosolized using a modified robot vacuum. The EnviroMini™ is a portable allergen exposure tent, in which allergen (Fel d 1, primarily) from milled cat hair is aerosolized in a similar manner. This is a single-centre validation study designed to compare the allergic response to cat antigen provocation in the EnviroMini to the response in the previously validated NEC.

Methods: Eight cat allergic subjects were randomized to undergo sequential 2-hour allergen challenges in the EnviroMini and the NEC, 28 or more days apart. A modified robot vacuum aerosolized cat allergen in both chambers. Airborne Fel d 1 was measured using ELISA. Nasal, ocular and chest symptoms were recorded every 10 minutes and spirometry every 20 minutes. Challenges were stopped and not repeated if FEV1 fell >20% of baseline during the exposure.

Results: Fifteen subjects completed at least one challenge and eight completed both ("per-protocol"). Mean Total Nasal Symptom Score (TNSS) averaged over the last 30 minutes ("plateau") was not significantly different between the EnviroMini and NEC (paired t-test, p=0.16; mean (SE) 6.1 (1.2) and 4.5 (0.6), EnviroMini and NEC, respectively). There was no difference in FEV1 change between the two challenges (p= 0.90). The same results were found for all subjects as for the per-protocol group. TNSS plateau was not correlated with Fel d 1 exposure, and there was no difference in average Fel d 1 concentrations between the chambers (EnviroMini: 55; NEC: 54 ng/m3).

Conclusion: The EnviroMini offers comparable cat-allergen exposure and nasal and respiratory responses to the NEC. Its portability facilitates expansion to multi-site chamber studies for clinical validation of allergy therapies. Future work could expand its capabilities to other aeroallergens.

Introduction: This study aims to systematically review and summarize epidemiological evidence on the relationship between allergic diseases and migraine outcomes.

Methods: This meta-analysis, which was registered with PROSPERO (CRD420250656492), employed data from PubMed, Embase, the Cochrane Library, and references from the studies included in the review. The search encompassed literature from the inception of these databases through Feb 24, 2025. We included observational studies investigating the association between allergic diseases and migraine. The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Pooled odds ratio (OR) with 95% confidence interval (CI) were calculated using a random-effects model.

Results: A total of 10 studies encompassing 14,952,953 participants were included. The overall risk for migraine in patients with allergic diseases was 1.52 (95% CI: 1.40-1.65). Specifically, the meta-analysis revealed an OR for atopic dermatitis of 1.27(1.17-1.38), 1.49 (95% CI 1.32-1.68) for asthma, 2.16 (95% CI 1.43-3.24) for allergic rhinitis, and 1.74 (95% CI 1.43-2.10) for allergic conjunctivitis.

Conclusion: The current meta-analysis suggests that allergic diseases is associated with an increased risk of developing migraines. However, further large-scale prospective cohort studies are required to validate the proposed association, considering the considerable heterogeneity observed in our analyses.

Purpose: Atopic dermatitis (AD), allergic rhinitis (AR), and bronchial asthma (BA) are major allergic diseases in childhood. Pediatric allergic diseases are characterized by the 'atopic march,' where two or more allergic conditions can occur either simultaneously or sequentially. MicroRNAs (miRNAs) serve as fine regulators of gene expression, capable of modulating the clinical manifestations of allergic diseases post-transcriptionally. We investigated miRNAs commonly expressed in these three allergic diseases to enhance the understanding of their development and management.

Methods: We collected serum samples from subjects diagnosed with AD, AR, and BA as well as from healthy controls, at Korea University Anam Hospital. Their miRNA expression patterns were analyzed using microarray technology. Additionally, we examined the allergic inflammatory response of miRNA through an allergic animal model.

Results: A total of 68 subjects were enrolled in the allergy group, consisting of 42 with AD, 13 with AR, and 13 with BA, while 10 children participated as controls. Microarray analysis revealed that miR-4497 expression levels were consistently downregulated in these three allergic disease groups. Following mast cell activation and miR-4497 transfection, reduced levels of macrophage-derived chemokines (MDC) were observed. Furthermore, levels of IL-4, MDC and methacholine Penh were significantly decreased in a miR-4497 treated mouse model.

Conclusions: miR-4497 expressions were consistently downregulated in pediatric subjects with AD, AR and BA. Allergic inflammation was significantly reduced in HMC-1 cells transfected with miR-4497 and in the treated mouse model. Further research is needed to elucidate the epigenetic mechanisms by which miR-4497 modulates allergic diseases and to explore its potential as a non-invasive biomarker for diagnosis and treatment.

Objective: This study aimed to investigate the role of Raf kinase inhibitor protein (RKIP) in degranulation induced by echinococcal cyst fluid (EgCF) in bone marrow-derived mast cells (BMMCs).

Methods: Primary BMMCs were isolated and cultured from the femurs and tibias of RKIP gene knockout (KO) and wild-type (WT) C57BL/6 mice. EgCF-induced degranulation models were established for both groups. Samples of cells and supernatant were collected for analysis. Surface expression levels of CD117 and Fc-epsilon Receptor Ⅰ α (FcεRIα) were assessed. Supernatant concentrations of β-hexosaminidase, IL-4, IL-6, and tumor necrosis factor (TNF-α) were measured. Cellular mRNA levels of IL-4, IL-6, and TNF-α were quantified, and changes in RKIP protein expression during degranulation in WT BMMCs were monitored.

Results: After 4 weeks of induction culture, the double-positive rates for CD117 and FcεRIα exceeded 98% in both KO and WT BMMCs. Following sensitization, BMMCs from the KO group demonstrated significantly higher degranulation rates compared to the WT group (p < 0.05). In WT BMMCs, surface RKIP protein expression progressively decreased at 1 hour, 2 hours, and 3 hours post-sensitization, corresponding with degranulation progression (p < 0.05). The KO group exhibited elevated release of BMMC-related cytokines, including IL-4, IL-6, and TNF-α, compared to the WT group after sensitization (p < 0.05). Similarly, transcription levels of cytokines IL-4, IL-6, and TNF-α were higher in the KO group than in the WT group following sensitization (p < 0.05).

Conclusion: RKIP gene knockout resulted in an increased EgCF-induced release of cytokines and bioactive substances by BMMCs, indicating that RKIP may suppress EgCF-induced BMMC degranulation. These findings suggest that RKIP could serve as a potential therapeutic target for managing allergic reactions associated with cystic echinococcosis.

Background: The role of Blastocystis spp. subtypes (STs) in chronic spontaneous urticaria (CSU) and the impact of the eradication are unclear.

Objective: To investigate the role of Blastocystis spp. STs in CSU and the impact of the eradication on disease activity.

Methods: Stool samples from 295 CSU patients and 38 healthy controls (HCs) were searched for Blastocystis spp. by direct microscopy. Fifty-seven samples from patients and 12 samples from HCs were analyzed for ST distribution by DNA sequencing. DNA sequencing was only performed in samples detected by Real Time (RT)-polymerase chain reaction (PCR). The patients and HCs with Blastocystis spp. formed groups A and B, respectively. Anti-parasitic agents were used to eradicate the parasite in group A. Urticaria medication scores (MSs), urticaria activity score-7 (UAS7), blood eosinophil and basophil counts, total IgE values were compared between groups having different STs at the beginning and six months after the eradication. The subjects who were not taking any medication for the CSU such as antihistamine, montelukast, anti-IgE treatment or cyclosporin had no active urticarial lesions during a 6-month period were considered to be in remission.

Results: The parasite was detected in 45.7% (n=135) of the CSU patients and 34.2% (n=13) of the HCs. Fifty-seven samples (85.1%) in 67 CSU patients and 12 samples (92.3%) in 13 HCs revealed positive RT-PCR and formed groups A and B, respectively. ST3 was more frequent in group A (p<0.001) whereas ST1 was more common in group B (p<0.001). The patients having ST3 in group A formed subgroup A1 and other STs in group A formed subgroup A2. After the parasite eradication, the CSU remission rate was higher (p=0.031) and the control values of UAS7, MSs were lower (p=0.028, p=0.049) in subgroup A1 than A2.

Conclusion: Although the presence of Blastocystis spp. ST3 does not worsen CSU, its eradication improves the CSU symptoms.

Introduction: Nasal inverted papilloma (NIP) is a common nasal benign tumor, with a complex pathogenesis closely linked to inflammatory response. It can be classified into Grade-I and Grade-II phenotypes based on nasal epithelium abnormality. Our objective is to investigate potential inflammatory biomarkers in peripheral blood of NIP patients for preoperative assessment of disease severity.

Methods: We retrospectively analyzed inflammatory cells in the peripheral blood of 63 healthy controls and 82 NIP patients, while distinguishing different phenotypes of NIP through immunofluorescent and H&E staining. Using receiver operating characteristic curve analysis, we assessed the predictive value of monocytes%-to-lymphocytes% ratio (M%L%R) for peripheral blood abnormalities in NIP and explored its correlation with clinical data by Spearman r characteristic.

Results: We observed an increase in monocytes% and decrease in lymphocytes% proportion, while the level of M%L%R was upregulated in the peripheral blood of NIP patients (all p < 0.05). Immunofluorescent staining revealed basal cell proliferation and squamous metaplasia, along with inhibited differentiation of ciliated and goblet cells in nasal epithelium of NIP. Correlation analysis demonstrated a positive correlation between M%L%R and degree of nasal epithelial deterioration (r = 0.2999, p = 0.0062). Finally, M%L%R level was significantly increased in both Grade-I and Grade-II patients (all p < 0.05).

Conclusion: The expression level of M%L%R in the peripheral blood of patients with NIP can serve as a potential biomarker for preoperative evaluation of the severity of nasal epithelial lesions.

Introduction: Oral food challenges are the gold standard for diagnosis and reactivity thresholds but are resource-intensive and high-risk for reactions. Limited data on factors associated with increased risk of positive oral food challenges exist. We aimed to assess factors associated with positive oral food challenges and create a model to predict cow milk oral food challenge outcomes.

Methods: Children aged 5-18 being considered for cow's milk oral immunotherapy underwent a single-blind, placebo-controlled food challenge to cow's milk, with either positive (reaction) or negative (tolerance) outcomes. Initial factors recorded included sex, age, history of asthma, eczema, allergic rhinitis, prior epinephrine use for cow's milk-induced reactions, skin prick test size, serum levels of IgE antibodies to α-lactalbumin, β-lactoglobulin, and casein and log-transformed values. Stepwise backward multivariate Firth bias-reduced logistic regression was used to create the final model, and performance was assessed with ROC curves.

Results: 111 children underwent an oral food challenge, 103 patients reacted, and 8 tolerated the challenge. Univariate analysis showed skin prick test size, previous epinephrine use, history of asthma, and log-transformed α-lactalbumin, β-lactoglobulin, and casein were significantly associated with positive oral food challenge. The multivariate model included two factors: log-transformed casein (aOR 2.4; 95%CI 1.4-5.9; p<0.001) and previous epinephrine use (aOR 6.5; 95%CI 1.2-68.0; p=0.03). The final model showed good discriminatory performance (AUC 0.928 (95% CI 0.83 - 0.98). In comparison, a univariate model using only skin prick test (OR 1.44, 95%CI: 1.1-2.0; p=0.002) had worse discriminatory performance (AUC 0.83 (95% CI: 0.64-0.93).

Conclusion: The study suggests that logistic multivariate models, including log-transformed casein and previous epinephrine use, may help predict oral food challenge outcomes in pediatric patients. Future studies are needed to validate this with larger datasets.

Introduction: So far, there is no direct comparison between inhaled corticosteroid (ICS) monotherapy and ICS-long-acting beta-2 agonists (LABA) fixed-dose combination therapies in 6- to 11-year-old children with persistent asthma. The primary objective of this study was to compare ICS monotherapy and ICS-LABA fixed-dose combination therapies for the frequency of exacerbations requiring systemic corticosteroids (CS).

Methods: Patients aged 6-11 years diagnosed with persistent asthma during steps 2-4 of treatment, prescribed daily ICS-containing treatment (fluticasone propionate [FP], fluticasone propionate/salmeterol [FP/SAL], and budesonide/formoterol [BUD/F]), and followed for at least 1 year at our institution from January 2021 to January 2024 were included. The hospital's electronic database was used to retrospectively record asthma controller medication, frequency of asthma exacerbations (including those requiring systemic CS, emergency department [ED] visit and/or hospitalization) and pneumonia.

Results: The frequency of all exacerbations, exacerbations requiring systemic CS, and exacerbations requiring ED visit/hospitalization were significantly higher in the FP group compared to the FP/SAL and BUD/F groups (p < 0.001, p = 0.003, p < 0.001, respectively). There were no significant differences between the FP/SAL and BUD/F groups concerning all exacerbation parameters (p > 0.05). The incidence of pneumonia was very low in the fixed-dose combination groups, making a statistical comparison unfeasible.

Conclusion: ICS-LABA fixed-dose combination therapies have been found to be more effective than ICS monotherapy in preventing asthma exacerbations in 6-11-year-old children with persistent asthma and could be recommended as the preferred controllers.

Introduction: Surgical interventions can trigger angioedema attacks in hereditary angioedema (HAE). The aim of this study was to assess the incidence of perioperative angioedema and identify associated risk factors.

Methods: This retrospective study included HAE patients diagnosed between 1999 and 2024 at a tertiary adult allergy clinic. Data on surgical procedures and perioperative angioedema were analyzed.

Results: Of 102 HAE patients, 28 were excluded due to incomplete data, leaving 74 patients (46 female, 62.2%). Fifty-three patients underwent 94 surgeries, with the most common being gynecological (27, 28.7%), abdominal (27, 28.7%), and otorhinolaryngological (16, 17.0%). Of the 54 surgeries before HAE diagnosis, 23 (42.5%) were abdominal. Among 27 abdominal surgeries, 17 (62.9%) occurred in patients with gastrointestinal angioedema prior to diagnosis. Of the 40 surgeries after diagnosis, 31 (77.5%) received preoperative short-term prophylaxis (STP), mostly plasma-derived C1 esterase inhibitor concentrate (27, 87.1%). Perioperative angioedema occurred in 28 (29.8%) surgeries, with a median recovery of 48 h. In surgeries after diagnosis, attacks occurred in 7 out of 31 surgeries (22.6%) with STP and 2 out of 9 (22.2%) without. Among gynecological surgeries, 22 cesarean sections were performed. No significant difference in attack frequency was found between cesarean sections with STP (3, 27.3%) and without (2, 18.2%, p = 0.611).

Conclusion: Our study found that abdominal attacks before HAE diagnosis are consistent with the literature, underscoring their importance for early diagnosis. The angioedema rate was similar with or without STP before cesarean section, suggesting STP may not be necessary. Further research is needed to optimize HAE management in surgery.