International Archives of Allergy and Immunology最新文献

Introduction: NLRP3 is involved in Th2 cell differentiation and the pathogenesis of allergic rhinitis. The purpose of this study was to explore the significance of NLRP3 polymorphisms in the susceptibility to allergic rhinitis.

Methods: From March 2023 to November 2024, children with allergic rhinitis (n = 200) and healthy children (n = 200) were collected. Tag single nucleotide polymorphisms (SNPs) were screened by Haploview 4.2 software. Multiplex PCR and sequencing were used to analyze genotypes of SNPs. HaploReg (version 4.2) was used to predict the impact of SNPs on regulatory motifs.

Results: Five tag SNPs were obtained, which were rs10925025, rs72553860, rs870381, rs10925018, and rs10802502. The relationship between genotypes of different polymorphic loci and polymorphism was analyzed. There were significant differences in the distribution frequency of the CC, CT, and TT genotypes of NLRP3 rs10925018 between allergic rhinitis and healthy children. The rs10925018 T allele was associated with an increased risk of allergic rhinitis (OR = 1.349, 95% CI: 1.012-1.798, p = 0.041). The genotype frequency distribution of NLRP3 rs10925018 was statistically different in the serum IgE levels subgroup (p = 0.036). The rs10925018 T allele was associated with an increased risk of serum IgE levels (OR = 1.660, 95% CI: 1.105-2.493, p = 0.014). Through HaploReg prediction, the rs10925018 polymorphism may affect regulatory motifs, thereby affecting the binding of YY1 and NLRP3.

Conclusions: NLRP3 rs10925018 polymorphism may be associated with susceptibility to allergic rhinitis and high IgE phenotype in children with allergic rhinitis.

Background: Airway cilia are essential for maintaining respiratory health by facilitating the removal of inhaled pathogens and toxicants through mucociliary clearance. However, daily exposure to environmental factors such as cigarette smoke, PM2.5, allergens, and microplastics can impair cilia structure and function, leading to compromised mucociliary clearance and the progression of respiratory diseases.

Summary: This review synthesizes recent research on the impact of common environmental exposures on airway cilia, focusing on structural and functional alterations, as well as associated signaling pathways. Emerging therapeutic strategies, including gene therapy, anti-inflammatory agents, and antioxidants, show promise in restoring ciliary function and improving mucociliary clearance.

Key messages: Environmental exposures impair airway cilia through multiple mechanisms, including oxidative stress, inflammation, and dysregulation of signaling pathways. Future research should focus on identifying novel therapeutic targets and developing personalized interventions to mitigate ciliary damage.

Introduction: Chronic urticaria (CU) negatively impacts children's quality of life (QoL), yet data on pediatric CU remain limited. This study assessed CU's impact on QoL using the Children's Dermatology Life Quality Index (CDLQI).

Methods: Children (4-16 years) with CU were recruited and completed standardized questionnaires on demographics, CU type, management, and comorbidities. Chart review assessed laboratory data. Patients also completed the Urticaria Control Test (UCT), Urticaria Activity Score over 7 days (UAS7), and CDLQI at study entry. Multivariable logistic regression identified factors associated with clinically poor QoL.

Results: Seventy-four children (median age = 10) were recruited: 39 (52.7%) had chronic spontaneous urticaria, 21 (27.0%) had chronic inducible urticaria, and 14 (16.2%) had both. Most children (n = 54; 72.9%) reported a clinically satisfactory (CDLQI ≤5), while 20 (27.0%) reported a clinically poor QoL (CDLQI >5). Factors associated with clinically poor QoL included older age at symptom onset (aOR = 1.04; 95% CI = 1.01-1.05), elevated C-reactive protein (CRP >5 mg/L) (aOR = 1.49; 95% CI = 1.04-2.13), and history of atopic dermatitis (aOR = 1.59; 95% CI = 1.18-2.13). In younger children (aged 4-10), cold urticaria was associated with clinically poor QoL (aOR = 1.44; 95% CI = 1.07, 2.00).

Conclusion: Older age at symptom onset, elevated CRP, atopic dermatitis, and cold urticaria are associated with clinically poor QoL in children with CU. These findings highlight the need for targeted interventions, such as psychosocial support and education, to improve patient outcomes.

Introduction: Biological agents are essential treatment options for severe asthma, particularly in cases with type 2 (T2) inflammation, due to their ability to improve symptoms, prevent exacerbations, and reduce the use of oral corticosteroids. However, limited data exist regarding their long-term effects on lung function, particularly on forced expiratory volume in 1 s (FEV₁). This study aimed to analyze the longitudinal changes in FEV₁ before and after the initiation of biological agents by following cases over an extended period.

Methods: This study included patients with at least three spirometric measurements before and after the initiation of biological agents, and a follow-up period of at least 2 years. The primary outcome was the annual change in FEV₁ (ΔFEV₁). Secondary outcomes included comparisons between patients with improved and deteriorated ΔFEV₁, differences based on the type of biological agent used, and comparisons between patients who achieved clinical remission and those who did not.

Results: A total of 41 patients with severe asthma were analyzed. The overall ΔFEV₁ significantly improved after the introduction of biological agents (p < 0.001). Patients with greater declines in FEV₁ prior to treatment showed more pronounced improvements, especially among those treated with anti-IL-5 biologics (mepolizumab and benralizumab) or anti-IL-4 receptor antibodies (p = 0.016 and p = 0.026, respectively). Furthermore, patients with elevated T2 inflammation biomarkers, such as fractional exhaled nitric oxide and peripheral blood eosinophil count, exhibited greater improvements in FEV₁.

Conclusion: This study indicates that biological agents may help prevent the progressive decline in lung function in severe asthma, particularly among patients with significantly declined lung function or elevated T2 inflammation biomarkers before treatment. Further research is needed to explore differences in efficacy across various biological agents.

Introduction: Hereditary angioedema (HAE) is a rare genetic disorder characterized by unpredictable, painful swelling attacks that significantly impair patients' quality of life (QoL). Clinical trials of lanadelumab led to its approval for long-term prophylaxis in patients with HAE; however, real-world data on long-term lanadelumab use in patients with HAE are limited. This analysis describes real-world outcomes of patients with HAE who have received lanadelumab as long-term prophylaxis for ≥3 years.

Methods: From January 2023 to January 2024, investigators collected data from the Adelphi Wave II Disease Specific Programme™, a real-world, cross-sectional survey of physicians and their patients with HAE in the USA. Physicians retrospectively reported attack frequency, attack severity, and QoL before lanadelumab initiation, at 12, 24, and 36 months post initiation, and at the time of the survey.

Results: Physicians reported data on 51 patients who had received lanadelumab for ≥3 years. Before lanadelumab initiation, physicians reported attack severity as mild in 49.0% of patients and very severe in 8.2%; at 36 months post lanadelumab initiation, 62.5% of patients experienced mild attacks and none experienced very severe attacks in the preceding year. The proportion of patients experiencing ≥1 attack per month on average decreased from 54.0% before lanadelumab initiation to 9.8% at the time of the survey. The proportion of patients with good or excellent QoL increased from 68.6% before lanadelumab initiation to 88.2% at the time of the survey.

Conclusion: In this real-world HAE study, patients treated with lanadelumab for ≥3 years experienced improvements in attack frequency, disease severity, and QoL.

Introduction: Allergic rhinitis (AR) is characterized by sensitization to various allergens, with polysensitization being a common phenomenon. This study investigated demographic and clinical characteristics, allergic sensitization profiles, and the association between sensitization and AR phenotypes in Vietnam.

Methods: A multicenter, cross-sectional study was conducted from June 2022 to December 2024 at three hospitals in Ho Chi Minh City, Vietnam (Cho Ray Hospital, Thu Duc Hospital, and University Medical Center). Patients with AR were recruited and assessed in terms of their AR status and visual analogue scale (VAS) scores. All patients underwent a skin prick test (SPT) for common aeroallergens, including house dust mites, pet dander, cockroaches, molds, and grass pollen. Blood samples were collected to measure the total immunoglobulin E (IgE) levels, eosinophil count, and allergen-specific IgE (sIgE) levels. Patients were classified as polysensitized if they demonstrated positive IgE responses (either positive SPT, sIgE, or both) to two or more aeroallergen classes.

Results: One hundred forty-six participants were recruited, comprising 61 (41.78%) monosensitized AR, 62 (42.47%) polysensitized AR, and 23 (15.75%) non-allergic rhinitis (NAR) patients. Sensitized patients had a significantly younger age at onset, longer duration of illness, more frequent use of oral corticosteroids, and higher VAS scores (all p < 0.05) than NAR patients. The frequency of polysensitization was highest in moderate-severe AR groups, while NAR was highest in mild intermittent group. Sensitization to house dust mites was the most prevalent in all patients.

Conclusion: This study highlighted the clinical and immunological differences between NAR, monosensitized, and polysensitized patients with AR, emphasizing the need for tailored management strategies for diverse patient populations.

Introduction: This study employs bibliometric methods to reveal research trends, hot topics, and development trajectories in the field of cow milk protein allergy (CMPA) in children.

Methods: We retrieved and downloaded literature on CMPA in children from the Web of Science Core Collection database on the basis of specific search strategies and screening criteria. Using VOSviewer software, we analyzed the collaboration networks among countries, institutions, and authors, as well as the co-occurrence of keywords. We utilized Biblioshiny software to analyze highly cited papers and research trend topics and to construct thematic maps.

Results: We included 1,128 articles related to pediatric CMPA for analysis. The results show that since 2014, the number of research papers on CMPA has increased. The USA, Italy, and China are the countries with the greatest number of publications, with the USA occupying a central position in the collaboration network. The Icahn School of Medicine at Mount Sinai ranks first in terms of research output. Professor Hugh A. Sampson is the most influential author in this field. The main research areas include clinical manifestations, molecular mechanisms, immune regulation, and immunotherapy for CMPA. Emerging research hotspots in recent years include the gut microbiome, the development of dairy substitutes, and the application of sandwich enzyme-linked immunosorbent assay (sELISA) technology in milk protein detection.

Conclusion: Through bibliometric analysis, this study revealed the research trends and hotspots in the field of CMPA in children. Future research should further strengthen international cooperation to promote in-depth research and effective management of CMPA.

In the article "Silencing of FSTL1 Alleviated LPS-Induced Inflammatory Damage and Oxidative Damage in Human Bronchial Epithelial Cells via BMP4/KLF4 Axis" [Int Arch Allergy Immunol. 2022;183(7):785-795. https://doi.org/10.1159/000521852] by Yi Zhang, Liping Yan, Jiao Yang and Xiangni Li, after publication, the authors identified an error in Figure 5a of their article.Fig. 5.Silencing FSTL1 promoted BMP4 and KLF4 expression. a Co-IP was used to study whether FSTL1 interacts directly with KLF4. b The expression levels of KLF4 and BMP4 were detected by Western blotting. c Quantitative value of BMP4 expression level. d Quantitative value of KLF4 expression level. ##p < 0.01 versus LPS + si-NC group. $p < 0.05 versus LPS + si-FSTL1 group. Co-IP, co-immunoprecipitation.Figure 5a was erroneously submitted by the authors as a draft sketch. The correct complete Figure 5 is shown here.The original article has been updated to reflect this.

Introduction: Polycyclic aromatic hydrocarbons (PAHs) are environmental pollutants with widespread human exposure and have been associated with adverse health outcomes. However, their potential relationship with psoriasis remains insufficiently explored. The aim of this study was to investigate the association between PAH exposure and psoriasis.

Methods: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) for the periods 2005-2006, 2009-2010, and 2011-2012. Weighted multivariate logistic regression analysis was performed to assess the association between individual PAH metabolites and psoriasis. Bayesian kernel machine regression, quantile g-computation (qgcomp), and weighted quantile sum regression were used to evaluate the relationship between mixed PAH exposure and psoriasis, as well as to determine the relative contributions of specific PAH metabolites. Stratified and sensitivity analyses were conducted to assess result stability.

Results: A total of 4,912 participants (mean age, 43.52 years; 95% confidence interval, 42.65-44.39 years) were included, of whom 2,514 (51.18%) were female, and 141 (2.87%) were diagnosed with psoriasis. Multivariate logistic regression analysis identified significant positive associations between psoriasis and seven urinary PAH metabolites: 2-hydroxynaphthalene, 3-hydroxyfluorene, 2-hydroxyfluorene, 3-hydroxyphenanthrene, 1-hydroxyphenanthrene, 2-hydroxyphenanthrene, and 1-hydroxypyrene. Analysis of mixed exposure PAH across all three models demonstrated significant positive associations between urinary PAH metabolites and psoriasis, with 2-hydroxyphenanthrene and 2-hydroxynaphthalene identified as primary contributors. Stratified and sensitivity analyses confirmed the robustness of these results, and the observed associations persisted among nonsmokers.

Conclusion: Both single and mixed exposure analyses demonstrated a positive association between PAH exposure and psoriasis. These findings suggest that reducing PAH exposure may help mitigate psoriasis risk.

Introduction: Although various biomarkers exist for chronic spontaneous urticaria (CSU), their use is limited, particularly in children. Periostin is produced during skin damage and inflammation.

Methods: This cross-sectional study aimed to compare serum periostin levels (SPLs) between children with CSU and age- and sex-matched healthy controls (HCs). The secondary objective was to investigate the association between SPL and disease severity using the urticaria activity score-7 questionnaire and urticaria control test.

Results: Overall, 84 participants (CSU, 45; HC, 39) were included in the study. There was no significant correlation between SPL and disease activity scores. Patients receiving leukotriene receptor antagonist plus antihistamines had significantly lower SPL than those receiving antihistamines only (44.32 ± 20.18 vs. 61.33 ± 18.50; p = 0.009). The mean SPL was significantly lower in the patient group than in the control group (56.41 ± 20.32 ng/mL vs. 71.68 ± 20.36 ng/mL; p = 0.001; Cohen's d = 0.750) (aOR: 0.964, 95% CI: 0.942-0.987, p = 0.002). The receiver operating characteristic (ROC) curve of the SPL was determined to be significant (p = 0.001), and the area under the curve of the ROC curve was 0.705 (95% CI: 0.593-0.817).

Conclusion: Our study is the first to measure SPL in children with CSU. The results indicated that children with CSU had significantly lower SPL than the HCs. Those on more advanced treatments showed significantly lower SPL. Hence, SPL may reflect immunological activity associated with CSU in children and warrants further investigation in future studies.