International Archives of Allergy and Immunology最新文献

Introduction: The aim of this study was to observe and assess the efficacy and safety of Artemisia annua (A. annua)-sublingual immunotherapy (SLIT) in patients with mild-moderate allergic asthma (AS).

Methods: In this retrospective study, the complete data of 60 patients with mild-moderate AS from October 2022 to October 2023 were included. Patients were stratified into two different groups based on treatment regimens: the SLIT group, 30 individuals who underwent standardized A. annua-SLIT for at least 6 months before pollen season, and the control group, the other 30 patients only received the symptomatic drug. During the 2022 and 2023 pollen season, asthma daytime symptom score (ADSS), asthma nighttime symptom score (ANSS), total medicine score (TMS), asthma control test score (ACT), forced expiratory volume in 1 s (FEV1), and FEV1/forced vital capacity were measured to evaluate the efficacy, and adverse events (AEs) were used to assess its safety.

Results: There were no significant differences in all clinical outcomes between the two groups during the 2022 pollen season (all p > 0.05). However, after SLIT treatment, the level of ADSS, ANSS, TMS, ACT, FEV1, and patients' number of well-controlled AS significantly improved compared with the control group (all p < 0.01). Notably, all the clinical outcomes significantly improved compared with the baseline only in the SLIT group (all p < 0.001). No severe AEs were reported, and all AEs were mild.

Conclusion: Pre-seasonal treatment of A. annua-SLIT for at least 6 months could relieve daytime and nighttime symptoms, reduce medication use, and improve asthma control and lung function in mono- and polysensitized patients with mild-moderate AS.

Introduction: The incidence of tree nut allergies, including walnut and cashew nut allergies, has increased significantly globally. In Japan, these allergies rank third after egg and milk allergies and are associated with high rates of anaphylaxis. Jug r 1 and Ana o 3 are effective biomarkers for diagnosing walnut and cashew nut allergies. However, sensitization rates and risk factors among preschool children remain underexplored. This study aimed to investigate the prevalence of Jug r 1-sIgE and Ana o 3-sIgE sensitization, as well as their associated risk factors, in this population.

Methods: This retrospective study was conducted at four hospitals in Chiba Prefecture and included preschool children under 7 years diagnosed with food allergies and without prior tree nut consumption. Sensitization was defined as a specific IgE level of ≥0.35 IU/mL. Clinical data, including allergic conditions, were analyzed, and logistic regression was used to identify the risk factors for sensitization.

Results: Among 248 children, Jug r 1-sIgE and Ana o 3-sIgE levels were measured in 198 and 215, respectively. Jug r 1 sensitization peaked at 34.0% in the 3-4-year group, while Ana o 3 sensitization peaked at 12.2% in the 5-6-year group. Cashew, peanut, and wheat allergies were identified as major risk factors for Jug r 1 sensitization, whereas peanut, walnut, and wheat allergies were associated with Ana o 3 sensitization.

Conclusion: Jug r 1-sIgE and Ana o 3-sIgE sensitization are prevalent in high-risk preschool children in Japan. Early screening and personalized management strategies are essential for managing tree nut allergies.

Introduction TXK is involved in the regulation of IFN-γ expression and T helper (Th)1 cell-mediated inflammation that underlies the development of neutrophilic asthma, however, its implication in asthma pathogenesis remains uncertain. This study aims to characterize the functional role of TXK single nucleotide polymorphism (SNP) contributing to asthma. Methods This study belongs to a part of an ongoing Singapore/Malaysia cross-sectional genetics and epidemiological study (SMCSGES). Associations of TXK transcript expression with asthma phenotype, the transcript expression of IFN-γ and IL23A, and SNP genotype were assessed in peripheral blood mononuclear cell (PBMC) samples from n=658 individuals of the SMCSGES sub-cohort. Genetic associations of TXK SNPs with asthma were assessed in a case-control cohort of n=2407 individuals from the SMCSGES population. Functional effects of asthma-associated SNPs on TXK promoter activity were evaluated by in vitro promoter luciferase assay in THP-1 cells. Results We identified significant associations of upregulated TXK transcript expression with increased asthma risk (p<0.05) and the increased transcript expressions of both IFN-γ (p<0.0001) and IL23A (p<0.0001) in PBMC. A significant association between tag-SNP rs2661532 and TXK transcript expression was detected in PBMC: the allele "T" was significantly associated with a higher TXK expression than allele "C" (false discovery rate-adjusted p<0.05). The major allele "T" of rs2661532 is also significantly associated with a higher risk of asthma (p=0.0346, odds ratio=1.171, 95% confidence interval=1.011-1.357). The in vitro promoter luciferase assay showed the major alleles of rs6819804 and rs74513879 (tagged by rs2661532) are significantly associated with higher TXK promoter activity (p<0.05). Conclusion This study identified multiple TXK functional variants associated with asthma by regulating the transcript expression of TXK and downstream Th1 and Th17 cell-mediated inflammatory pathways. Our findings indicated the potential involvement of TXK functional variants in the development of neutrophilic asthma.

Introduction Patients with asthma have a higher incidence of allergic or nonallergic persistent rhinitis, and chronic rhinosinusitis with or without nasal polyps. The nasal symptoms significantly reduce quality of life and substantially affect the asthma control among these patients. Because of no complete knowledge of the etiology of rhinological symptoms, in some patients the proposed therapeutic options are still ineffective. Recommended pharmacotherapy, immunotherapy and surgical treatment do not have the expected therapeutic effect in some patients. More recently, biological treatment based on phenotyping on has become a new alternative therapeutic option. Currently, omalizumab, a monoclonal antibody with an anti-IgE effect in patients with allergic phenotypes or mepolizumab, an anti-IL-5 biologic that reduces the number of eosinophils may be used. Methods In this single-center real-live study authors analyzed effects of biological treatment on rhinological symptoms in patients over the age of 18 with severe uncontrolled bronchial asthma with co-existing persistent allergic rhinitis treated with omalizumab or uncontrolled bronchial asthma with co-existing chronic rhinosinusitis with nasal polyps treated with mepolizumab. In all patients the otolaryngologist performed anterior rhinoscopy. Evaluation of rhinological symptoms and quality of life in patients treated with anti-IgE or anti-IL5 therapy before and six months after biological treatment was performed using the TNSS and SNOT-22 scales. The sub-analysis of changes in rhinological symptoms was also performed in a group of patients with N-ERD regardless of eosinophilic or allergic asthma phenotype. Results, 48 patients (9 male, 18%) with severe chronic bronchial asthma treated with biologics were included into the study. Among them there were 26 (54%) patients with allergic asthma and persistent allergic rhinitis treated with omalizumab, and 22 (46%) with eosinophilic asthma and chronic rhinosinusitis with nasal polyps treated with mepolizumab. In both groups six months of treatment with omalizumab or mepolizumab resulted in significant improvement in relation to all rhinological symptoms assessed with TNSS and SNOT-22 scales. There was a significant increase in the number of patients with smell improvement in the mepolizumab-treated group. Improvements in all rhinitis symptoms and quality of life assessed by TNSS and SNOT-22 scales after six months of treatment were comparable in NSAIDs sensitive vs NSAIDs tolerant patients regardless of type of monoclonal antibodies used. Conclusion. Six-month phenotyping-based biological therapy with omalizumab in patients with chronic allergic rhinitis accompanied by several bronchial asthma or with mepolizumab in patients with chronic sinusitis with nasal polyps accompanied by several bronchial asthma showed significant improvement in rhinological symptoms and quality of life.

Background Hereditary alpha tryptasemia (HαT) affects 4-6% of the general population. Inherited as a mendelian dominant, HαT has a variable phenotypic expression. Many patients have no obvious symptoms. There is a dearth of reports of possible co-inheritance of other genetic abnormalities. Methods We examined records of 69 Mayo Clinic patients with HαT for the results of any additional genetic studies obtained during routine or focused evaluations. Clinical records of patients evaluated for baseline tryptase values > 8 ng/mL testing positive for the TPSAB1 mutation were reviewed. Screening genetic tests obtained during standard care and/or for evaluation of clinical symptoms were recorded as well as inciting symptoms that led to tryptase determination, the serum tryptase level, alpha and beta tryptase gene copy numbers and the urinary mast cell mediator metabolites. Results Bone marrow biopsies for systemic mastocytosis and the presence of either a KIT Asp816Val, or Janus Kinase 2 Val617Phe mutation were negative. Genetic tests were diverse and included nearly 1000 suspect genes in one case and one to several hundred in others. There was no genetic testing in 19 patients and normal genetic test findings in 37 patients. A group of 8 patients showed at least one genetic abnormality, and in a group of 5 patients both normal and abnormal genetic findings were present. There was no clustering of genetic tests or relation to the inciting symptoms. Conclusion Genetic testing, often extensive, was obtained in 73% of these HαT patients. Most of these results were normal and did not suggest the presence of a concomitant genetic disorder.

Background: Sesame allergy has been seen with increasing frequency in recent years and is one of the important causes of food anaphylaxis.

Objective: The aim of our study was to examine the clinical and laboratory features of patients with sesame allergy and to evaluate the characteristics of sesame-related anaphylaxis.

Methods: Patients diagnosed with sesame allergy at Ankara Bilkent City Hospital between January 2017 and June 2024 were included in the study. Demographic, clinical and laboratory data of the patients were obtained from medical records.

Results: Sesame allergies were detected in 70 patients during the study period. Of these patients, 44 (62.9%) were male, and the median age at the onset of symptoms was 12 (IQR: 9-18) months.Thirty-two patients presented with anaphylaxis (45.7%), 31 with urticaria/angioedema (44.3%), and 7 with atopic dermatitis (10%). A total of 59 patients (84.3%) had other food allergies. The most common food allergy was tree nut allergy (54.3%). Sesame-specific IgE levels were higher in patients with anaphylaxis (median 2.8 kU/L IQR: 1.2-17.8) than in those who did not (median 1.6 kU/L IQR: 0.7-4.7). In the multivariate logistic regression model, the presence of a concomitant food allergy (OR: 18.7; CI 1.9-182.6) and being over one year of age at the time of the index reaction (OR: 4.1; CI 1.1-15.4) were identified as risk factors for anaphylaxis.

Conclusion: Sesame allergy is among the important causes of food allergy and anaphylaxis and generally presents with early-type reactions. It can be seen together with nut and other food allergies.

Background: Although previous studies have analyzed trends in asthma prevalence among adolescents before and during the COVID-19 pandemic, research specifically investigating asthma prevalence after the pandemic is lacking. Therefore, this study aims to analyze the long-term trends and the impact of the COVID-19 pandemic on the prevalence of asthma among Korean adolescents.

Methods: Data were collected from a nationwide representative study (Korean Youth Risk Behavior Web-based Survey), conducted among adolescents aged 12 to 18 years from 2007 to 2023. To assess the impact of the COVID-19 pandemic, data were divided into three periods: pre-pandemic (2007-2019), intra-pandemic (2020-2022), and post-pandemic (2023). The prevalence of current asthma and variations in asthma prevalence across the pre-, intra-, and post-pandemic periods were analyzed using weighted linear regression and logistic models with 95% confidence intervals (CIs).

Results: A total of 1,087,236 participants (559,840 males [51.49%]) were included in the analysis from 2007 to 2023. The weighted asthma prevalence exhibited slight fluctuations prior to the pandemic, with no notable overall changes. However, a substantial decline was observed during the intra-pandemic period compared to pre-pandemic (βdiff intra- versus pre-pandemic, -0.11 [95% CI, -0.12 to -0.09]), followed by a slight weakening in the post-pandemic period (βdiff post- versus intra-pandemic, 0.07 [95% CI, 0.03-0.10]). This trend persisted when analyzed by sex, with males exhibiting a higher prevalence than females throughout the entire period (versus females: weighted odds ratio, 1.31 [95% CI, 1.29-1.34]). Additionally, prior to the pandemic, the prevalence of asthma was higher among students in grades 7-9. However, after the pandemic began, students in grades 10-12 showed higher prevalence rates than their younger counterparts. The prevalence was also higher among adolescents who were overweight or obese, smoked, lived in facilities, had low household income, consumed fast food more than five times a week, experienced high stress levels, and reported low subjective recovery from fatigue.

Conclusions: This comprehensive study suggests that the prevalence of asthma among adolescents varies with age and may be affected by the COVID-19 pandemic. Additionally, it identifies key factors contributing to asthma vulnerability, highlighting the importance of developing age-specific policies and targeted interventions for these at-risk groups.

Introduction: This study aimed to explore the effect of Clostridia administration on ovalbumin (OVA)-induced allergy and the relevant underlying mechanism in BALB/c mice.

Methods: Female BALB/c mice were assigned to three groups: control (C), OVA sensitization (CO), and intervention (IG). All mice were treated with antibiotics to eliminate their intestinal flora. Then, the mice in the CO and IG groups were orally treated with phosphate-buffered saline (PBS) and Clostridia extract, respectively, followed by OVA sensitization, while the mice in the C group only received PBS during the experiment. Allergic reactions, intestinal barrier function, and composition of the gut flora were analyzed.

Results: The CO group demonstrated significant allergic reactions when compared to the C and IG groups. The serum levels of interleukin-5 (IL-5) were significantly lower in the IG group than in the CO group. The levels of interferon-γ, transforming growth factor-β1, and T-helper 1 subsets were significantly higher in the IG group than in the CO group. The serum D-lactate level was significantly reduced in the IG group, while IL-22 levels were reduced in the CO group relative to the C group. In addition, tight junction proteins and mucin in the ileal tissues were significantly elevated in the IG group than in the CO group. The relative abundance of Clostridia_UCG014 and Christensenellales was significantly enriched in the feces of mice in the IG group and negatively correlated with the serum sIgG1 level.

Conclusion: Clostridia alleviated food allergy symptoms in mice by regulating their intestinal immune function, improving the intestinal microbial composition, and enhancing the intestinal barrier.

Introduction: Current understanding of the immune landscape underlying allergic conjunctivitis (AC) remains rather limited. We investigated the potential association between circulating immunophenotypes and AC using Mendelian randomization (MR) methodology.

Methods: Based on genome-wide association study (GWAS) summary-level statistics, a 2-sample MR was employed to analyze the bidirectional causal relationships between 731 circulating immunophenotypes and AC risk.

Results: A total of 33 genetically predicted immunophenotypes were significantly associated with AC risk. A protective effect of 18 immunophenotypes against AC was found, such as CD3 on CD39+CD8br (inverse variance weighted [IVW] odds ratio [OR] = 0.936, 95% confidence interval [CI]: 0.925-0.985, p = 0.003) and CD25 on CD28+CD4+ (IVW OR = 0.921, 95% CI: 0.863-0.983, p = 0.013). Conversely, 15 immunophenotypes were found to be significantly associated with AC risk, such as CD25 on IgD-CD38dim (IVW OR = 1.042, 95% CI: 1.012-1.073, p = 0.006). Reverse MR based on these 33 genetically predicted immunophenotypes suggested that AC also had a significant influence on four circulating immune cells, including CD33-HLA DR-AC (IVW OR = 1.187, 95% CI: 1.034-1.362, p = 0.015), CD3 on CD39+CD8br (IVW OR = 0.876, 95% CI: 0.779-0.985, p = 0.027), HLA DR on CD14+monocyte (IVW OR = 0.831, 95% CI: 0.725-0.953, p = 0.008), and CD39 on CD39+secreting Treg (IVW OR = 1.123, 95% CI: 1.002-1.259, p = 0.046).

Conclusion: Our study highlights the intricate association between immune cells and AC, providing a valuable basis for future mechanistic and therapeutic studies from an immunological perspective.