International Archives of Allergy and Immunology最新文献

Introduction: Chronic obstructive pulmonary disease (COPD) and allergic diseases share epithelial barrier dysfunction and immune imbalance, yet the shared genetic basis across the full allergy spectrum remains unclear.

Methods: We integrated large-scale genome-wide association study (GWAS) summary statistics from European populations for COPD and four allergic diseases - allergic asthma (AA), allergic rhinitis, atopic dermatitis, and allergic conjunctivitis (AC). Genome-wide genetic correlations were estimated using linkage disequilibrium score regression (LDSC) and high-definition likelihood (HDL). Cross-trait pleiotropy was tested with Pleiotropic Analysis under Composite Null Hypotheses (PLACO; p < 5 × 10-8). Functional Mapping and Annotation (FUMA), Bayesian colocalization, and Multi-Marker Analysis of GenoMic Annotation (MAGMA) were applied for locus annotation, causal inference, and gene-level prioritization, followed by pathway and tissue enrichment analyses.

Results: LDSC and HDL consistently revealed positive genetic correlations between COPD and allergic diseases (LDSC rg = 0.144-0.497; HDL rg = 0.141-0.605; all p < 1 × 10-3), exhibiting a gradient, with the strongest correlation for AA and the weakest for AC. We detected 70 pleiotropic loci, 24 with strong colocalization (PP.H4 ≥0.75), including recurrent hotspots at 2q12.1, 2q37.3, and 11q13.5. Gene-level analysis highlighted 172 pleiotropic genes (e.g., BACH2, IL18R1/IL1RL1/IL18RAP, IL1R1, ZGPAT) enriched for cytokine and inflammatory signaling, converging on the IL-1/IL-18/IL-33 axis and showing specificity in lung and immune tissues.

Conclusion: This study provides the first systematic evidence, in individuals of European ancestry, of shared genetic architecture between COPD and multiple allergic diseases, supported by concordant LDSC/HDL genetic correlations and colocalized loci. Newly identified hotspots at 2q12.1 and 2q37.3 implicate the IL-1/IL-18/IL-33 pathway as a common mechanism in European populations, indicating pleiotropic variants affecting epithelial-immune interactions and nominating cytokine-related targets for translational investigation.

Introduction: Rapid urbanization in China has reshaped urban spatial form with potential consequences for respiratory health. We examined the association between the Urban Sprawl Index (USI) - where higher values indicate a more dispersed, less compact urban form - and asthma and quantified mediation via ambient air pollution and park green space.

Methods: We analyzed 11,043 respondents from the 2015 wave of the nationally representative China Health and Retirement Longitudinal Study (CHARLS). Asthma was based on a self-reported physician diagnosis. Multivariable logistic regression estimated the association between USI and asthma using quartiles and restricted cubic splines; models adjusted for sociodemographic, behavioral, and health covariates. We conducted subgroup analyses and performed causal mediation with nonparametric bootstrapping (5,000 resamples) to estimate the average causal mediation effect (ACME), average direct effect (ADE), and proportion mediated for particulate matter ≤2.5 µm (PM_2.5), particulate matter ≤10 µm (PM₁₀), and per-capita park green space. In fully adjusted multi-pollutant models, we additionally evaluated sulfur dioxide (SO₂), carbon monoxide (CO), nitrogen dioxide (NO₂), and ozone (O₃).

Results: Higher USI was associated with greater odds of asthma. An interquartile-range increase in USI was associated with a 15.1% increase in the odds of asthma (OR = 1.151; 95% CI: 1.034-1.282; p = 0.010), with a clear dose-response across USI quartiles and a monotonic pattern in spline analyses. Associations varied by marital status and education (p for interaction < 0.05). In mediation analyses, ∼7-12% of the total effect was mediated - ∼11.7% via park green space and ∼7.5% via PM_2.5 (ACME and 95% CIs significant), while the remaining effect was attributable to pathways not captured by these mediators. In multi-pollutant models, PM_2.5 remained independently associated with asthma; SO₂, CO, NO₂, and O₃ did not show independent associations after adjustment.

Conclusion: More dispersed, sprawling urban form is associated with higher asthma, partly mediated by reduced park green space and increased PM_2.5 exposure. Urban planning strategies that promote compact development, expand accessible green space, and reduce fine particulate pollution may yield meaningful respiratory health benefits.

Introduction: The risk of allergic reactions due to airborne exposure to peanuts remains uncertain. Although a few small studies indicate that this risk is low, further evidence is needed. We aimed to assess the risk of allergic reactions during a standardized, open peanut inhalation challenge in a large cohort of peanut-allergic children and adolescents.

Methods: Patients aged 5-18 years with probable peanut allergy were recruited to undergo a standardized inhalation challenge. Inclusion criteria were either having a history of allergic reaction involving more than one organ system and having Ara h 2 >2.0 kU/L or having no known exposure and Ara h 2 >5.0 kU/L. Participants were exposed to an open bag of peanuts positioned 30 cm from the nose for 10 min, followed by a 20-min observation period. Spirometry and physical examination were performed before and after the challenge. Data were collected on age at index allergic reaction to peanuts when available, atopic comorbidities, specific IgE levels for peanut and Ara h 2, and family history. Allergic responses were classified as subjective or objective. Objective reactions were defined as visible or measurable signs, including urticaria, erythema, rhinitis, conjunctivitis, angioedema, or respiratory symptoms (e.g., stridor, wheezing, or ≥12% reduction in forced expiratory volume in 1 s from baseline). Subjective reactions were defined as symptoms other than those defined as objective.

Results: A total of 323 children and adolescents with probable peanut allergy completed the inhalation challenge. Fifty participants (15.5%) showed possible allergic reactions during or after exposure, of whom 10 (3.1%) exhibited objective reactions. Only four (1.2%) participants received medical treatment. No severe adverse events occurred, and no participants required hospitalization.

Conclusion: The findings indicate that the risk of significant allergic reactions from airborne peanut exposure is low. These results may offer reassurance to patients, caregivers, and healthcare professionals regarding the safety of being in proximity to others consuming peanuts.

Introduction: Egg allergy is one of the most common food allergies in early childhood and often coexists with atopic conditions such as atopic dermatitis (AD) and urticaria. Skin-barrier dysfunction plays a critical role in the pathophysiology of allergic diseases. This study aimed to examine the relationship between egg allergy and skin-barrier health by evaluating hydration, sebum, and softness using a noninvasive bioimpedance method.

Methods: In this prospective case-control study, 49 children aged 0-2 years with egg allergy and 50 age-matched healthy controls were enrolled between December 2024 and February 2025. In the case group, total and egg-specific IgE levels, eosinophil counts, and skin prick test results were recorded. Skin parameters were measured from the antecubital region using a portable bioimpedance device. Intergroup comparisons were performed using the Mann-Whitney U test. Additionally, an exploratory subgroup analysis compared skin parameters between egg-allergic children with and without AD exacerbation after allergic reaction.

Results: Children with egg allergy had significantly lower skin hydration, sebum, and softness compared to controls (p < 0.001 for all). Total IgE levels were higher in egg-specific IgE-positive patients (p = 0.001), although skin parameters did not differ significantly by IgE status. Among 20 egg-allergic children with follow-up after allergic reactions, those with AD exacerbation had markedly lower moisture, oil, and softness scores than those without exacerbation (p < 0.01 for all comparisons).

Conclusion: Children with egg allergy exhibit both elevated immunologic activity and impaired skin-barrier function. Bioimpedance analysis offers a practical and noninvasive tool for evaluating skin health in allergic infants. Integrating skin-barrier assessment into allergy management may facilitate early intervention and more comprehensive care.

Introduction: This study aimed to investigate the distribution characteristics, sensitization patterns, and potential correlation of airborne pollen allergens of physician-diagnosed pollen-induced allergic rhinitis (PiAR) patients in Ordos city in grasslands region.

Methods: This retrospective study enrolled 234 patients with confirmed PiAR. Skin prick tests (SPT) of 12 common pollen allergens were used to detect and analyze the correlation of pollen allergens. Kendall's tau-b correlation was performed. The LASSO regression model was used to select the most important variables. Multi-adjusted logistic regression was performed to predict the risk of Artemisia sensitization.

Results: Artemisia, sunflower, and lambsquarters were the top three sensitizing pollen allergens, and the highest sensitization rate was for Artemisia (72.22%). The sensitization rate of weed pollen was higher than that of tree pollen. Kendall's tau-b correlation results showed a moderate (0.4 < r < 0.6) to strong (0.6 < r < 0.8) correlation between tree- and grass-pollen allergens. Age-, sex-adjusted logistic regression showed tree (birch, green ash), weed (Japanese hop, lambsquarters, sunflower), and grass (corn) pollen allergies were risk factors for Artemisia sensitization while age was a protective factor (all p < 0.05). Multivariate logistic regression showed that sunflower (OR = 28.34 [95% CI: 6.166-130.263], p < 0.0001) and lambsquarters (OR = 3.596 [95% CI: 1.06-12.204], p = 0.0401) were risk factors for Artemisia sensitization, especially in female PiAR.

Conclusion: The positive correlation of SPT results indicated the co-sensitization among common pollen allergens. Sunflower was the most significant independent risk factor for Artemisia sensitization, and co-sensitization with lambsquarters would greatly increase the risk of sensitization to Artemisia.

Introduction: Airborne pollen has become an important environmental driver of allergic respiratory diseases, especially under accelerating climate change. Lanzhou, a representative arid city in northwestern China, experiences distinct seasonal pollen peaks that may influence the incidence of allergic rhinitis (AR) and bronchial asthma (BA). This study aimed to investigate the short-term associations between daily airborne pollen concentrations and outpatient visits for AR and BA.

Methods: We collected daily outpatient visit data from a class A tertiary hospital in Lanzhou between April and October 2024, along with daily airborne pollen concentrations, meteorological indicators, and air pollutant levels. A distributed lag nonlinear model was applied to evaluate the nonlinear and lagged effects of pollen exposure on AR and BA. Stratified analyses were conducted by sex and age-group.

Results: Elevated pollen concentrations were significantly associated with increased risks of both AR and BA, with the strongest effects observed within 1-3 days after exposure. Females and individuals aged 0-19 years showed higher susceptibility. Health impacts were more pronounced during the late summer to autumn pollen season, likely due to the predominance of highly allergenic taxa such as Artemisia and Chenopodiaceae. Thunderstorm events coincided with sharp increases in pollen concentrations and outpatient visits, indicating potential thunderstorm-related allergic exacerbations.

Conclusion: Daily airborne pollen exposure contributes to acute increases in AR and BA incidence in Lanzhou, particularly among children, adolescents, and females. These findings underscore the need for region-specific pollen monitoring, early warning systems, and targeted public health interventions to reduce the burden of allergic respiratory diseases under increasingly variable climatic conditions.

Introduction: Asthma is a complex chronic illness with significant morbidity and costs, but effective management can prevent these outcomes. The COVID-19 pandemic led to a shift from in-person to virtual healthcare, presenting an opportunity to explore telemedicine in asthma management.

Methods: We performed a scoping review guided by the Arksey and O'Malley framework. We used search terms including: asthma, telehealth, telemedicine, and virtual care, searching four databases (OVID Medline, CINAHL, Web of Science, Embase) from May to July 2023 for publications from 2010 onward, managed in Covidence. Inclusion criteria focused on articles addressing telemedicine accessibility for underserved or vulnerable groups. The selected articles were stratified into mutually exclusive categories: rural communities; lower income populations; lower income rural communities; black, indigenous, people of colour (BIPOC); and English as an additional language (EAL).

Results: Out of 811 articles identified in our searches, 171 remained following de-duplication and title/abstract screening. After full-text review, 11 articles remained, stratified into main categories: rural communities (n = 3), lower income (n = 1), lower income rural (n = 2), BIPOC (n = 4), and EAL (n = 1). Most articles (n = 9, 69%) reported a positive association with telehealth use, although barriers like the digital divide (n = 3, 21%) were also noted.

Conclusion: While telemedicine has a positive effect on asthma care, barriers like inaccessibility remain, thereby limiting full benefits.

Introduction: Atopic dermatitis (AD) is a common chronic inflammatory skin disorder associated with psychological burdens, including sadness and suicidality. Yet, little is known about long-term trends in these mental health outcomes among adolescents with AD. This study examined temporal trends in suicidal ideation and sadness in South Korean adolescents with and without AD.

Methods: Nationwide data from the Korean Youth Risk Behavior Web-based Survey, comprising middle and high school adolescents, were utilized, covering the period from 2007 to 2024. Weighted prevalence estimates were calculated to evaluate trends of questionnaire-based suicidal ideation and sadness by AD status. To examine the impacts of the COVID-19 pandemic, the study period was categorized into three periods, including pre-pandemic (2007-2019), intra-pandemic (2020-2022), and post-pandemic (2023-2024). For analyzing the β coefficients and β differences (β_diff) between three periods, binary logistic regression and linear regression were used. In addition, we utilized logistic regression models for calculating weighted odds ratio (wOR) with 95% confidence intervals (CIs).

Results: Among 1,140,402 adolescents (553,213 [48.51%] female), those with AD reported a higher prevalence of suicidal ideation (17.51% [95% CI: 17.32-17.70]) and sadness (33.11% [32.88-33.34]) compared to those without AD. Weighted prevalence rates showed an increase during the intra-pandemic period, both in suicidal ideation (β_diff, 3.67 [3.32-4.03]) and sadness (β_diff, 4.88 [4.45-5.32]). Statistically significant sex-specific differences were observed, with females displaying a higher risk of suicidal ideation (wOR, 1.69 [1.65-1.73]) and sadness (wOR, 1.61 [1.57-1.64]). Other risk factors associated with heightened prevalence included high levels of stress, smoking and drinking status, lower levels of education and economic status, and in-facility residential environments.

Conclusion: This is the first comprehensive study to display the association of AD with suicidal ideation and sadness in Korean adolescents. Our findings can provide insights into identifying vulnerable populations and seek to guide the public health strategies for minimizing disparities in the mental health burdens of AD.

Introduction: This study aimed to characterize the alterations in mitochondrial DNA (mtDNA) damage and inflammatory markers in bronchoalveolar lavage fluid (BALF) from patients with bronchiectasis during acute exacerbations (AEs) and to investigate their potential contribution to airway inflammation and disease mechanisms.

Methods: A retrospective case-control study was conducted, enrolling 45 patients with AEs and 84 patients with stable bronchiectasis (stable control [SC] group). BALF samples were collected via bronchoscopy. mtDNA damage was assessed using quantitative PCR, and inflammatory markers, including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), and interleukin-8 (IL-8), were quantified via enzyme-linked immunosorbent assay. Multivariate logistic regression was performed to identify independent predictors of AEs, and Spearman correlation analysis was used to evaluate the relationships between mtDNA damage and inflammatory markers.

Results: The AE group exhibited significantly lower mtDNA copy numbers and higher mtDNA deletion rates compared to the SC group (p < 0.001). Inflammatory markers, including IL-6, TNF-α, CRP, and IL-8, were markedly elevated in the AE group (p < 0.001). Spearman correlation analysis demonstrated a significant negative correlation between mtDNA copy number and all inflammatory markers, while mtDNA deletion rate was positively associated with inflammatory markers (p < 0.001). Moreover, multivariate logistic regression identified mtDNA copy number (odds ratio [OR] = 0.289, p = 0.026) and IL-6 (OR = 2.182, p = 0.038) as independent predictors of AEs.

Conclusion: mtDNA damage and elevated inflammatory marker levels in BALF are closely associated with AEs of bronchiectasis. These findings highlight their potential as biomarkers and therapeutic targets for future clinical application. Further studies are warranted to validate these observations and explore their role in the clinical management of bronchiectasis.

Introduction: Allergic rhinitis (AR) is an inflammatory disorder of the nasal mucosa in allergen-sensitized individuals. Beyond local inflammation, AR also promotes systemic inflammatory responses. This study aimed to evaluate biomarkers reflecting systemic inflammation like neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), and serum SCUBE levels in the diagnosis and treatment monitoring of AR.

Methods: In this prospective, controlled study, 88 patients with AR and 50 healthy controls were enrolled. All AR patients received nasal corticosteroid (NCS) therapy; however, only 42 patients returned for follow-up. Symptom severity was assessed using the Visual Analogue Scale (VAS) and the Control of Allergic Rhinitis and Asthma Test (CARAT). Laboratory measurements included NLR, PLR, SII, PIV, and serum SCUBE1 and SCUBE2 levels. Intergroup and pre-posttreatment comparisons were performed.

Results: Compared with controls, AR patients exhibited significantly higher PLR, SII, and PIV values (p < 0.05 for all), whereas SCUBE1 or SCUBE2 levels showed no difference. Following treatment, significant clinical improvement was observed in VAS and CARAT scores (p < 0.001). In addition, NLR, PLR, and SII values significantly decreased compared with baseline (p < 0.05 for all). The area under the curve values were 0.655 (95% CI: 0.562-0.747) for PIV, 0.611 (95% CI: 0.512-0.711) for SII, and 0.607 (95% CI: 0.512-0.702) for PLR.

Conclusion: PLR, SII, and PIV were significantly elevated in patients with AR, while NLR, PLR, and SII improved following 1 month of NCS therapy. These findings highlight that the systemic inflammatory burden of AR should not be underestimated and suggest that novel, easily accessible biomarkers such as SII and PIV may provide additional value in the assessment and monitoring of inflammation in AR.