International Archives of Allergy and Immunology最新文献

Introduction: COVID-19 has emerged as a significant worldwide health crisis in recent years, characterized by elevated morbidity and mortality rates. COVID-19 vaccinations can diminish transmission and safeguard people. The evaluation of immunogenicity and safety in high-risk populations, such as lung cancer patients, continues to provide a problem. This evaluation seeks to evaluate the safety and immunogenicity of COVID-19 vaccinations in patients with lung cancer.

Methods: A search was conducted in PubMed, EMBASE, and Web of Science from January 2021 to November 2022 utilizing the keywords: COVID-19 OR SARS-CoV-2 AND COVID-19 vaccination AND lung cancer OR lung carcinoma. The subsequent requirements must be satisfied for inclusion: (1) Research involving at least 30 lung cancer patients undergoing active anti-tumor therapy alongside healthy controls; (2) COVID-19 vaccination; (3) Observational studies (either prospective or retrospective) and clinical trials featuring healthy controls; (4) The primary outcome measured was anti-SARS-CoV-2 spike IgG titers following the second dose of the COVID-19 vaccine in lung cancer patients. Secondary results included local and systemic adverse responses following the first and second doses. Antibody titers (mean ± standard deviation) were assessed for each study individually. The occurrence of adverse events following the first and second dosages was recorded Results: Eight studies were included, comprising 1,220 lung cancer patients and 599 healthy persons. IgG titers against the SARS-CoV-2 spike protein were markedly reduced in lung cancer patients compared to healthy controls, with a statistically significant difference (p=0.002). The safety profiles of lung cancer patients and healthy individuals were comparable: local reaction after the first vaccine: RR=0.90, 95% CI: 0.68-1.19; systemic reaction after the first vaccine: RR=0.92, 95% CI: 0.51-1.66; local reaction after the second vaccine: RR=0.81, 95% CI: 0.54-1.19; systemic reaction after the second vaccine: RR=1.20, 95% CI: 0.65-2.21.

Conclusion: The antibody titer in lung cancer patients is markedly lower than that in the healthy group. Consequently, fatalities from COVID-19 may transpire in these people notwithstanding vaccination. Consequently, comprehensive protective measures must continue to be implemented to safeguard lung cancer patients who have received two doses of the COVID-19 vaccination against COVID-19.

Immunoglobulin E (IgE) plays a crucial role in the occurrence and development of allergic diseases. Since the discovery of IgE in 1967, the pathogenesis of allergic inflammatory diseases has been progressively revealed thereby providing a theoretical foundation for the development of therapeutic anti-IgE antibodies, which have emerged as a new method for the treatment of allergic diseases. In this paper, we aim to summarize and elaborate on the mechanism of biological effects and clinical application of anti-IgE antibodies by examining related global literature, particularly regarding Omalizumab in the past 5 years. We seek to establish theoretical foundations for the formation of new strategies for anti-allergic treatment.

Introduction: This study aimed to analyze the types and distribution characteristics of major inhalant allergens in patients with allergic rhinitis (AR) in Yinchuan, China.

Methods: In this cross-sectional study, 2,000 outpatients suspected of having AR were included from 2022 to 2023 at the Department of Otolaryngology-Head and Neck Surgery, General Hospital of Ningxia Medical University. Skin prick tests were performed on the included individuals using 13 common inhalant allergens: house dust mites, dust mites, tropical mites, Artemisia, dog hair, ragweed, cat hair, grass pollen, tree pollen, mold group I, mold group IV, German cockroach (Blattella germanica), and American cockroach (Periplaneta americana). The results of the skin prick tests were summarized, and patients with positive results were grouped by ethnicity, gender, and age to compare the differences in the positive rates of various inhalant allergens between the groups. The number of patients visiting each month was recorded to analyze the temporal variation in the incidence rate and compare the differences in the main inhalant sensitizers among patients in each quarter.

Results: Among the 2,000 included patients, there were 1,060 males and 940 females, with an average age of 18.7 years. Among the 2,000 outpatients who underwent allergen skin prick tests, 1,346 cases (67.30%) had positive results. The inhalant allergens were ranked in descending order of positive rates as follows: Artemisia (53.25%), dust mites (51.10%), house dust mites (49.10%), ragweed (45.70%), tropical mites (43.15%), dog hair (19.20%), cat hair (16.05%), American cockroach (12.10%), German cockroach (11.25%), grass pollen (9.15%), tree pollen (7.10%), mold group I (6.10%), and mold group IV (5.05%). There were no statistically significant differences in positive rates between different ethnicities or genders (all p > 0.05). Compared to patients aged 18 years and above, patients under 18 years old had statistically significant differences in positive rates for dust mites, Artemisia, ragweed, mold group I, and German cockroach (all p < 0.05). The seasonal distribution indicated that autumn had the highest number of patient visits in a year (579 cases, 58.95%).

Conclusion: Artemisia and dust mites were the major inhalant allergens in patients with suspected AR in Yinchuan, China. The positive rate of inhalant allergen skin prick tests was not correlated with the ethnicity or gender of the local population. Autumn was the season with the highest frequency of visits by patients with suspected AR.

Introduction: Anaphylaxis is an acute life-threatening allergy, most commonly provoked by food, venom, or drugs. There is limited data regarding differences in symptomatology between anaphylaxis provoked by different triggers. This study aimed to assess sociodemographic characteristics, clinical symptoms, and management of anaphylaxis, according to triggers in adults.

Methods: We conducted a cross-sectional study recruiting adult patients with anaphylactic reactions across 8 emergency departments (EDs) and 1 electronic medical service (EMS) in Canada. Univariate and multivariate regression models were used to evaluate symptoms involving all patients with the outcome of drug-induced anaphylaxis (DIA), venom-induced anaphylaxis (VIA), peanut-induced anaphylaxis (PIA), shellfish-induced anaphylaxis, tree-nut induced anaphylaxis (TIA) and nut-induced anaphylaxis (NIA). We assessed comorbidities associated with severe reactions, stratified by triggers listed above. Additionally, we evaluated the association of each trigger with treatment through regression models involving all patients with medications used as outcome and anaphylaxis triggers used as independent variables.

Results: From April 2011 to November 2023, 1,135 adults presenting with anaphylaxis to EDs were recruited. The median age was 35.5 (interquartile range 25.3-51.1). Most of the patients presented with FIA (50.3%). Regarding symptomatology, hypotension was more likely associated with DIA (aOR = 1.20, 95% CI = 1.11-1.30, p < 0.01). When adjusted for age at reaction and male sex, alcohol was more likely associated (aOR = 1.51, 95% CI = 1.04-2.19, p = 0.035) with NIA. Regarding management, TIA was more likely associated with inpatient epinephrine (aOR = 2.05, 95% CI = 1.16-3.64, p = 0.014). DIA was less likely associated with outpatient antihistamine (aOR = 0.68, 95% CI = 0.48-0.89, p < 0.01) whereas TIA was more likely associated with outpatient antihistamine (aOR = 1.81, 95% CI = 1.03-3.19, p = 0.040).

Conclusion: Our study underscores associations between specific triggers, clinical manifestations and managements, such as the potential link between TIA and throat tightness and hypotension and VIA. Identifying such associations can aid with the prompt diagnosis of anaphylaxis in patients presenting to the ED, leading to swifter treatment initiation and improving overall outcomes.

Introduction: Cat allergy is often difficult to avoid. Here, we evaluated the safety and effectiveness of a depigmented, polymerized cat epithelium extract (Dpg-pol-cat) for the treatment of allergic rhinoconjunctivitis and asthma.

Methods: Real-world, retrospective study of patients ≥12 years with cat allergy and moderate to severe allergic rhinitis/rhinoconjunctivitis, with or without asthma, who started allergen immunotherapy (AIT) with Dpg-pol-cat extract during routine visits to the Allergy Department. Safety and effectiveness (improvement in FEV1) of AIT were evaluated. The use of rescue medication and patient perceptions were also assessed.

Results: A total of 62 patients were included, of which 34 (54.8%) received at least 12 months of AIT. There were 15 adverse reactions, 8 local and 7 systemic, of which 3 led to AIT discontinuation. Patients with moderate to severe rhinitis decreased from 88.2% at baseline to 29.4% at 12 months (p <0.0001), and patients with moderate asthma decreased from 76.5% to 38.2% (p = 0.0004). FEV1 improved from a mean (SD) of 3188.9 (771.4) ml to 3419.6 (878.4) ml (p = 0.0023). The use of rescue medications for rhinitis decreased from 94.1% to 23.5% (p <0.0001), all patients requiring rescue medications for conjunctivitis (20.6%) were medication free at 12 months, and 97.1% and 92.6% of patients reported improvement in rhinitis and asthma symptoms, respectively.

Conclusion: AIT with Dpg-pol-cat extract shows a favorable safety and effectiveness profile in patients with allergic rhinitis/rhinoconjunctivitis, with or without allergic asthma, due to cat allergy, representing a valuable treatment option for these patients.

Introduction: An increasing number of studies have demonstrated that dynamic changes in lipid species can affect allergic diseases; however, the causal relationship and mediating role of immune cells remain unclear.

Methods: We conducted a bidirectional two-sample mendelian randomization (MR) analysis using genome-wide association study (GWAS) data on 179 lipid species (n = 7,174) and three types of allergic diseases including allergic rhinitis (AR) (n = 370,158), allergic asthma (n = 219,753), and allergic conjunctivitis (n = 377,277). The principal model used was the inverse variance-weighted approach, and a series of sensitivity analyses were conducted to ensure the robustness of the results. We used a two-step MR approach to assess whether the causal effect was mediated by immune cells (n = 3,757).

Results: Sterol ester and sphingomyelin played pathogenic roles in allergic asthma, AR, and allergic conjunctivitis; however, the effective subtypes differed. Among them, CD45RA- CD4+ mature T cells and CCR2 on CD14+ CD16+ monocytes affected the promoting impact of sterol ester's metabolism on allergic asthma and AR with different mediating proportions, while the role of sphingomyelin may not involve the immune cells. Moreover, we observed that HLA-DR on CD33- HLA DR+ myeloid cells, CD11b on CD66b++ myeloid cells, and IgD+ CD38- B cells played the most mediating effect of phosphatidylethanolamine (O-18:2_20:4) in allergic asthma, phosphatidylinositol (16:0_18:1) in AR, and phosphatidylethanolamine (18:0_18:2) in allergic conjunctivitis.

Conclusion: This MR study provides evidence for specific lipid species associated with the risk of allergic diseases, especially sterol esters, and identifies the immune cells that mediate this causal relationship.

Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by eczematous lesions and severe itching. However, its pathogenesis has not yet been fully elucidated. The aim of this study was to investigate the causal relationship between plasma proteins and AD, as well as to identify and quantify the potential roles of immune cell phenotypes as mediators.

Methods: We utilized summary-level data from genome-wide association studies and conducted a two-sample Mendelian randomization (MR) analysis involving 4907 circulating plasma proteins, 731 immune cell phenotypes, and AD. Initially, we conducted bidirectional univariate MR analyses to forecast causal effects linking circulating plasma proteins and AD. Subsequently, we employed a two-step MR analysis to scrutinize the immune cell phenotypes that could mediate these effects. The inverse variance weighted was the main method employed for MR analysis, while the Cochran's Q test and MR-Egger intercept test were used to assess the presence of heterogeneity and pleiotropy, respectively. We then determined whether our results could be influenced by individual single-nucleotide polymorphisms using the "leave-one-out" test.

Results: Positive correlations were observed between KRT1, IL18R1, and SEMA6A and the risk of AD, whereas BDH2, ADAMTS3, ANKRD1, TIAM1, MID2, and IFNA16 all showed negative correlations with the risk of AD. Mediation analysis indicated that CD8 on CM CD8br cells acted as a mediator between IFNA16 and AD, with a mediation effect proportion of 11.2%. In addition, sensitivity analyses did not reveal significant heterogeneity or level pleiotropy.

Conclusion: Our findings indicated the presence of a one-way causal relationship between the circulating plasma protein IFNA16 and AD. This study also explored immune cell phenotypes that may serve as mediators, offering novel insights into the etiology, pathogenesis, and potential clinical interventions in AD. Nevertheless, these findings need to be validated by clinical and laboratory studies.

Introduction: Cow's milk (CM) is one of the most common food allergens in Japan. The oral food challenge (OFC) of CM is important for the definite diagnosis of children with CM allergy and it is recommended to be actively and safely performed in individuals with low CM-sIgE levels. This study aimed to investigate the safety of low-dose CM-OFC in individuals with low CM-sIgE levels and discuss the prognostic factors and appropriate approaches for assessing the starting doses of CM-OFC in these individuals.

Methods: We retrospectively analyzed 6,929 OFC tests conducted between January 1, 2017 and December 31, 2021; of which, 1,390 were CM-OFC tests. The characteristics, OFC-positive rates, CM loading, and related factors were analyzed in 138 cases involving low CM-sIgE levels. Stepwise OFC tests were conducted according to the FA guidelines in Japan using an open and unblinded method.

Results: Among 138 individuals with low CM-sIgE levels, 110 (79.7%) passed the OFC test without any symptoms. Among the cases with OFC-positive status, 50.0% (14/28) cases showed symptoms with low-dose OFC (30-105 mg CM protein). Moreover, complete CM elimination was associated with a significantly high OFC-positive rate, and 60.0% (12/20) of the cases involving complete CM elimination showed symptoms with low-dose OFC.

Conclusion: Eighty percent of the patients with low CM-sIgE levels safely completed the OFC test. Nevertheless, careful observation is essential during low-dose OFC test in cases with low CM-sIgE levels, especially in the cases with complete elimination. The starting dose of the OFC test should be re-evaluated and modified using baked milk or a lower dose of CM to ensure safety and early outgrowth of CM allergy.

Introduction: So far, no definitive conclusions have been reached regarding the preventive effect of moisturizers on atopic dermatitis (AD). The variability in results may be due to differences in skin care methods, including bathing and washing, among studies and study design. In hot and humid Japan, bathing and gauze washing have been routinely practiced from the neonatal period, but this may impair the skin barrier function. To address this gap, we determined whether a combination of minimally invasive cleaning methods and moisturizing may prevent AD in infants in Japan.

Methods: Mothers of children born between January and September 2019 were instructed in traditional skin care methods (control group; 132 subjects), and mothers of children born between January and September 2020 were instructed in a new skin care method combining less invasive washing and moisturizing (intervention group; 140 subjects). Mothers and babies with and without a history of allergy were recruited, and the incidence of AD at 1 year of age was investigated by questionnaire.

Results: Skin care-related behaviors such as face washing, hand washing, and use of moisturizers were more frequent in the intervention group than in the control group. At 6 and 12 months of age, there was no difference in the incidence of AD between the two groups. However, for children born between January and March, the prevalence of AD at 12 months was significantly lower in the intervention group than in the control group (2.9% vs. 21.2%, p = 0.0253).

Conclusions: This study suggests that for children born during dry and cold seasons, strengthening the skin barrier function early in life through routine skin care with less invasive washing and moisturizing may prevent AD in Japan. Appropriate skin care practices for newborns and infants may vary in regions and environments.

Introduction: Hereditary alpha-tryptasemia (HT) is associated with postural orthostatic tachycardic syndrome (POTS), hypermobile Ehlers Danlos Syndrome (hEDS), and mast cell activation syndrome (MCAS). While POTS, hEDS and MCAS have all demonstrated increased prevalence of autoimmunity, this has not been investigated in HT populations. Our objective was to describe the prevalence of autoantibodies in individuals with HT.

Methods: We retrospectively studied a cohort of patients with positive genotyping for HT at a tertiary care allergy clinic. Demographic data including previous autoimmune history and autoantibody serologies were extracted on chart review. A literature search was conducted to determine the prevalence of specific autoimmune and autoantibody prevalences in the general population. We compared the proportions of autoantibody positivity and established autoimmune diseases in our cohort of HT individuals against those in general populations.

Results: We identified 101 patients with HT. Median age was 43 years (range 15-75) and most were female (87/101; 86.1%). Prevalence of self-reported drug hypersensitivity was 52/101 (52.5%) patients. The proportion of individuals with HT with positive tTG antibody (3/61, 4.9%) was significantly higher than that reported in the general population (133/16667, 0.8%) (p<0.001). The prevalence of SLE (1/101, 1%) and celiac disease (5/101, 5%) in our cohort were found to be significantly higher than the prevalence in the general population [194/96996, 0.2% (p=0.035) and 26/2845, 0.9% (p<0.001), respectively].

Conclusion: Patients with HT have increased prevalence of celiac disease, SLE and positive anti-tTG serology as well as self-reported drug hypersensitivity, relative to general populations.