Journal of Asthma and Allergy最新文献

Purpose: Pediatric allergic conjunctivitis (PAC) is a prevalent inflammatory eye condition caused by hypersensitivity to allergens. This study performs a scientometric assessment to uncover global research patterns, collaboration networks, and thematic evolution in PAC literature.

Methods: Publications related to PAC from 1963 to 2025 were retrieved from the Web of Science Core Collection database. Data were analyzed and visualized using VOSviewer (version 1.6.20), CiteSpace (version 6.3.R1), and the "bibliometrix" package in R (version 4.3.3).

Results: A total of 378 documents were analyzed, revealing a significant increase in publications over the years, especially after 2010. China led with 99 publications, followed by the USA and Japan. Notable international collaboration was observed, particularly between China and Germany. China Medical University Taiwan, Sun Yat Sen University, and China Medical University Hospital Taiwan were identified as the leading institutions. The journal Pediatric Allergy and Immunology was the most prolific, followed by Allergy. The most cited authors included Wei CC and Lin CL, with key research themes encompassing asthma, rhinitis, and pediatric allergic diseases. Keyword analysis indicated a growing interest in environmental factors such as air pollution and the comorbidity of PAC with other allergic conditions.

Conclusion: This bibliometric analysis offer valuable insights for future research directions and clinical strategies aimed at enhancing PAC diagnosis and treatment. Future research should evaluate the long-term efficacy of immunotherapy and investigate environmental determinants in PAC pathogenesis. Special emphasis is needed on multicenter studies incorporating regional diversity and standardized methodologies. Diverse regional data was incorporated to enhance global applicability and reduce public health burdens.

Background: Tissue remodeling is a key feature of allergic rhinitis (AR), but its underlying molecular mechanisms remain unclear. Lysyl oxidase-like 2 (LOXL2), a regulator of tissue remodeling, has not been studied in AR.

Methods: Proteomic analysis was performed on nasal mucosal tissues from 8 AR patients and 8 healthy controls (HCs) to identify differentially expressed proteins (DEPs). The top three upregulated DEPs and their association with tissue remodeling markers were validated by immunofluorescence, Western blot, and RT-qPCR in an independent cohort of 30 AR patients and 30 HCs. In vitro, human nasal epithelial cells (HNECs) were treated with IL-4, and the effects of candidate protein inhibitors on remodeling were assessed. An AR mouse model was used to evaluate the impact of these inhibitors on nasal inflammation and remodeling.

Results: Proteomic analysis revealed a disease-specific protein expression profile in the nasal mucosa of AR patients, with the top three upregulated proteins being LOXL2, TGF-β1, and TIRAP. Tissue validation showed that LOXL2 was significantly upregulated in the nasal mucosa of AR patients compared to HCs and was significantly correlated with EMT markers (TGF-β1, α-SMA, and E-cadherin). In vitro, IL-4 stimulation significantly upregulated LOXL2, TGF-β1, and α-SMA, while downregulating E-cadherin in a dose-dependent manner in human nasal epithelial cells. These effects were reversed by inhibition of LOXL2. Further investigations demonstrated that LOXL2 promotes tissue remodeling through activation of the TGF-β1/Smad signaling pathway. In the AR mouse model, LOXL2 inhibitors significantly reduced nasal mucosal inflammation and tissue remodeling.

Conclusion: Our proteomic analysis suggests that LOXL2 may be involved in the pathological remodeling processes of AR, potentially through modulation of the TGF-β1/Smad signaling pathway. These findings provide preliminary evidence that LOXL2 could serve as a candidate biomarker and a possible therapeutic target in AR, warranting further investigation.

Purpose: To investigate the morphological characteristics of the meibomian glands (MGs) in children with allergic conjunctivitis (AC)-related dry eye (DE).

Methods: Children with a clinical diagnosis of seasonal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC) were recruited. Age- and sex-matched children without a history of allergy or dry eye were recruited as controls. All participants completed the 5-item Dry Eye Questionnaire (DEQ-5) and ocular surface examination, including assessment of the tear meniscus height (TMH), noninvasive tear breakup time (NIBUT), and morphology of the upper lower MGs by noncontact infrared meibography (Oculus Keratograph 5M). Receiver operating characteristic (ROC) curve analysis was performed to determine the predictive value of the morphological characteristics of the MGs for AC-related DE.

Results: Sixty-two children with AC (31 with DE and 31 without DE) and 33 healthy children were enrolled in the study. The mean age was 7.67 (ranging from 5-13.5) years. More morphological changes were observed in the upper eyelids of AC children with DE than in healthy children. No morphological feature difference was found between AC children without DE and healthy children. ROC curve analysis showed that the morphological characteristics with good predictive value for DE were shortened upper eyelid MGs (AUC=0.72, P<0.001) and hooked upper eyelid MGs (AUC=0.71, P<0.001).

Conclusion: The grading of MG morphology according to the DREAM Study may be a valuable predictor for AC-related DE in children.

Objective: Magnetic particle chemiluminescence is a novel allergen detection technology recently introduced in clinical practice in China. This study analyzed the application of the ALLEOS assay using real-world clinical data from Guangzhou to identify regional allergen sensitization patterns.

Methods: A retrospective review of 20,406 suspected allergy patients, tested for 28 specific allergens using the ALLEOS 2000 system at the First Affiliated Hospital of Guangzhou Medical University from June 2021 to January 2024.

Results: The highest positive rate was observed for Dermatophagoides farinae (53.4%), followed by D. pteronyssinus (43.2%) and tropical mites (20.4%). Children showed significantly higher positivity rates for most allergens compared to adults, except for dog dander and German cockroach (P < 0.05). Among allergic diseases, children predominated in rhinitis (84.9%), while adults predominated in asthma (56.5%). In terms of severity, asthma and rhinitis patients exhibited higher sensitization levels (Class 3-6) to D. pteronyssinus (81.6% and 86.3%) and D. farinae (86.7% and 87.3%), while dermatitis patients were more sensitized to egg (19.7%) and milk (17.9%) allergens. Allergen positivity rates varied by season, with children showing significantly higher sensitization to both daisy and dandelion in autumn (11.1% and 8.8%) and winter (11.8% and 16.7%). In childhood (ages 0-4), egg (31.4%) and milk (27.1%) sensitization rates peaked and declined with age, whereas animal dander showed lower rates (<10.0%). Multiple sensitizations were observed in 22.2% of patients. Analysis of sensitization patterns revealed three main categories for inhalation allergens: mite-dominant, animal dander-dominant, and pollen-dominant sensitizations, with a Cronbach's α of 0.889. Similarly, food allergies were categorized into egg and milk-dominant, nut-dominant, and seafood-dominant patterns, with a Cronbach's α of 0.932.

Conclusion: This real-world study revealed age-, disease-, and season-specific allergen sensitization patterns in southern China. Inhalant and food allergens formed three major sensitization clusters each. These findings support region- and population-specific testing strategies and may inform clinical decision-making.

[This corrects the article DOI: 10.2147/JAA.S516225.].

Purpose: Allergic rhinitis (AR) is a global health concern caused by allergen exposure. This Indian study utilized the Score for Allergic Rhinitis (SFAR) questionnaire to estimate the prevalence of AR among patients with nasal symptoms visiting doctors' clinics/hospitals.

Patients and methods: This multicenter, cross-sectional study assessed AR using the SFAR questionnaire in patients with nasal symptoms visiting doctors' clinics/hospitals. It included patients aged ≥11 years across 19 states/union territories of India from September 2022 to April 2023. The score was digitally calculated using the Kribado^TM device, with a score of ≥7 indicating the presence of AR. Patient-reported data covered demographics, seasonal patterns, symptoms, allergens/triggers, and prevalence. Associations among various risk factors were analyzed.

Results: This study involved 3358 doctors, including ENT surgeons and chest physicians, and 40,001 patients across India. Among all patients, 53.7% (n=21,480) had SFAR scores ≥7. Sneezing was the most common symptom, reported by 69.1% of patients overall and 86.8% in the AR+ subgroup. House dust mites were the most prevalent allergens, affecting 73.8% of patients. Nose-related issues peaked from October to January. Half of the patients had a family history of asthma, eczema, or AR. In the AR+ subgroup, only 46% were diagnosed with allergies by a doctor, and 31.5% underwent allergy testing. After adjusting for variables, AR was significantly linked to nasal symptoms, including itchy and watery eyes, and a history of doctor-diagnosed allergies.

Conclusion: The in-clinic prevalence of AR in patients with nasal symptoms, as indicated by the SFAR questionnaire, is substantially high in India. A positive family history, indoor dust exposure, nasal symptoms, the months of October to January, and females were strongly linked to AR in Indian patients. The SFAR score is an effective in-clinic screening tool to support early AR diagnosis and management in India.

Background and purpose: Biologics are crucial for severe asthma treatment, but their high costs pose challenges. Omalizumab (OML) is dosed on the basis of patient-specific factors. The purpose of this study is to clarify the clinical characteristics of severe asthmatics who maintain long-term control on omalizumab including healthcare cost considerations.

Patients and methods: A retrospective, multicenter cohort study was conducted. Patients receiving OML at three institutions were enrolled. Patients continuing OML (C-OML) were compared with those switching to other biologics (S-OML) in terms of clinical background, cost-effectiveness, and type-2 inflammation levels.

Results: Forty-seven patients were enrolled. The C-OML group achieved exacerbation control comparable to that of the S-OML group, with a median OML dose of 300 mg/month, resulting in significantly lower personal payments (p < 0.01). Compared with the S-OML group, the C-OML group had a greater prevalence of overweight (p = 0.04), a lower prevalence of eosinophilic chronic rhinosinusitis (p < 0.01), and a trend toward a higher prevalence of allergic rhinitis (p = 0.06). Effective asthma control with OML was associated with nonsevere type-2 inflammation (eosinophils < 300/μL and FeNO < 50 ppb).

Conclusion: Patients with nonsevere type-2 inflammation and a high BMI can achieve effective asthma control with OML, reducing treatment costs. Identifying this phenotype can improve the cost-effectiveness of biologic therapies for patients with severe asthma.

Allergic bronchopulmonary aspergillosis is characterized by hypersensitivity to Aspergillus spp. and often causes intractable asthma. Studies have been conducted on biologics administered to patients with allergic bronchopulmonary aspergillosis; however, treatment may not always be successful. This may be due to the limitations of the current biologics that selectively target a single cytokine. Tezepelumab, a human monoclonal antibody that blocks the activity of thymic stromal lymphopoietin, broadly suppresses type 2 inflammation by regulating the upstream cascade of airway inflammation. Therefore, it is expected to have favorable effects in patients with allergic bronchopulmonary aspergillosis. We report three cases of allergic bronchopulmonary aspergillosis with uncontrolled symptoms despite the maximal use of conventional anti-asthmatic drugs such as inhalative agents, anti-leukotriene receptor antagonists, and antifungal drugs. None of the patients had previously received biologics. The addition of tezepelumab produced a marked clinical response in all three patients, which included fewer exacerbations and a reduced dosage of oral systemic corticosteroids and/or reduced as-needed short-acting beta-2 agonists. The patients' pulmonary symptoms were better controlled, peripheral blood eosinophil counts and immunoglobulin E levels decreased, and quality of life scores and respiratory function parameters improved. Mucous plugs accompanied by atelectasis and infiltrative shadows observed on chest computed tomography also improved. Tezepelumab may be a promising treatment option for allergic bronchopulmonary aspergillosis in patients with severe asthma, offering effective symptom control and enabling reduction in systemic corticosteroid use.

Introduction: Discoordination between inhalation and pressurized metered-dose inhaler (pMDI) actuation when delivering inhaled corticosteroids (ICS) is a common technique error that can lead to worsened treatment outcomes. Valved holding chambers (VHCs) are thought to improve the delivered dose if inhalation is delayed, but this effect has not been sufficiently quantified.

Methods: The aerodynamic particle size distribution of fluticasone propionate (FP) and ciclesonide (CIC) was studied under three conditions: inhalation initiated before actuation without a VHC, inhalation started at actuation without a VHC, and inhalation started at actuation with a VHC. We used a Next Generation Impactor connected to an anatomical adult throat model and a breathing simulator that produced a single, adult-type inhalation.

Results: We found that when inhalation was initiated simultaneously with actuation, the effective dose delivered decreased markedly for both FP and CIC compared to when inhalation was begun correctly, ie, before actuation. However, when a VHC was used and inhalation was started at actuation, delivered dose improved substantially for both medications. This protective effect of the VHC was especially pronounced for CIC, with both the fraction of particles in the 1-5 µm range and those under 1 µm returning to the same levels as when inhalation was initiated correctly.

Discussion: Although our study was conducted in vitro and did not involve patients, the findings likely have relevance for clinical practice. Therefore, promoting the use of VHCs in both children and adults may be beneficial, but this should be confirmed in clinical studies.

Background: Allergic rhinitis (AR) triggered by pollen is a growing global public health concern. This study aimed to: 1) analyze IgE reactivity to grass and weed pollen in Thai AR patients; 2) assess the prevalence and intensity of IgE-reactive protein bands; and 3) investigate cross-reactivity among pollen species.

Methods: Sera were collected from Thai adult AR patients in Bangkok, Thailand, and skin prick test (SPT) data were obtained. ELISA assessed IgE reactivity to pollen extracts from four grasses (Bermuda grass, para grass, Johnson grass, Manila grass) and two weeds (nutsedge, careless weed) using 119 patient sera. Immunoblot identified IgE-reactive protein bands using 65 patient sera with positive SPT. Cross-reactivity was confirmed by immunoblot and ELISA inhibition assays.

Results: Johnson grass showed the highest ELISA optical density (OD) values. Significant positive correlations (r_s = 0.740 to 0.935, p < 0.0001) in IgE reactivity were observed among pollen species, with stronger correlations among grasses. Immunoblot identified 30 kDa and 63 kDa proteins as major IgE-reactive proteins in grasses, and 25 kDa and 75 kDa proteins in nutsedge. Strong positive correlations were found within grass species for number of bands, ELISA OD, and SPT wheal size. A positive correlation existed between ELISA and SPT results (r_s = 0.27, p = 0.030). Inhibition assays confirmed cross-reactivity among grass and weed species.

Conclusion: This study highlights variability in pollen sensitization, cross-reactivity, and potential novel allergens in Thai AR patients. These findings are crucial for enhancing pollen allergy understanding and improving diagnostic and treatment, particularly in tropical/subtropical regions.