Allergo Journal International最新文献

Obesity and allergies are among the most common diseases of our civilization. Given the simultaneous rise in the prevalence of these diseases in recent years, a potential causal link between the two has been proposed. In particular, obese patients are at an increased risk of developing bronchial asthma, likely due to mechanical restrictions but also to metabolic changes that adversely affect immune function. Neuroscience studies have also shown that obesity can lead to impaired brain function and mental health. In the following review, we will take a closer look at our studies that focus on the influence of obesity on allergic diseases and cognitive performance.

Both human studies and animal models (mice) have shown that obesity leads to increased allergic responses in the airways. Our studies in a mouse model of obesity confirm that an obese phenotype is associated with increased allergic sensitization and manifestation. These changes are associated with significant shifts in the composition of the gut microbial flora. The microbiome changes are further associated with allergic airway inflammation and an increased incidence of T helper 1 (Th1) type pulmonary macrophages. Interestingly, despite the changes in the microbiome, it is possible to effectively prevent allergy development by inducing oral tolerance. Furthermore, it was observed that obese mice show increased signs of anxiety and depression, as well as reduced cognitive performance.

Obesity is a complex metabolic disease that significantly impacts our body’s gut microbiome and immune system, resulting in an increased incidence of allergic asthma and neurological/psychological changes. Attention should be given to both the prophylactic and therapeutic measures to mitigate the impact of obesity, including oral tolerance for managing existing allergic diseases.

A variety of body surfaces, such as skin and mucosal membranes—from the nasopharyngeal area to the lungs, uterus, vaginal area, and digestive tract—contain complex microbial ecosystems that are tailored to the specifics of the respective niche [1].

The so-called dysbiosis—a disadvantageous change in the composition of the microbiome—is associated with the pathogenesis of a variety of diseases [2]. Gastrointestinal as well as cardiovascular, metabolic, neurodegenerative, psychological, oncological, and also allergic diseases have been linked to microbial dysbiosis. Susceptibility to allergies can be due to genetic predisposition; in addition, extrinsic factors from today’s lifestyle increasingly contribute to microbiome changes, but also to the disruption of the skin and mucosal barrier and thus to the development of allergies [3].

Gisela, a fictional farmer, guides us through this review. She is representative of adults and children of all genders in industrialized countries. During her daily routine, the skin and mucosal microbiome is influenced by a variety of exogenous factors. These include everyday personal hygiene products, detergents for laundry and dishes, food, medication, animal contact, and exposure to various outdoor environments. Gisela’s daily routine will illustrate how the human microbiome and the skin barrier are modified in positive or negative ways, and how this could influence the development of allergies. Furthermore, potential measures for the prevention and management of dysbiosis will be discussed in terms of examples of alternative products and behaviors.

This mini-review is an update on a previous review published in 2021 and aims to summarize recent findings on the influence of the microbiome on allergic diseases. We cover the topics of food allergy, airway allergies, and skin allergies with a particular focus on clinical implications. Articles published between January 2021 and March 2024 were screened to be included in this publication.

Novel technologies standardising the testing process of immediate hypersensitivities have been developed and validated in recent years. Meanwhile, challenges with regard to availability of testing agents and shortage of trained personnel have increased. Novel technologies could fight these challenges, but their distribution is at present not known. The current survey, conducted by the German Society for Allergology (AeDA), aimed to assess current practices of allergy diagnostics in Germany.

Members of AeDA were invited to complete an online questionnaire to obtain information on their perspectives on allergy testing and diagnostics.

A total of 150 allergologists from different disciplines treating patients with allergy completed the questionnaire. This survey revealed that twice as many skin prick tests (SPT; 21.2 tests/week) compared to serum specific immunoglobulin E tests (IgE; 10.4 tests/week) are being performed. Nasal allergen provocation tests are being performed in 56.0% of hospitals and physicians’ offices. An individual standard allergen panel for SPT is applied in 78.0% of testing cases. Methods used to perform a read out of SPT are variable with measurement of the longest wheal diameter being used most frequently (68.0%), followed by a qualitative evaluation (46.6%) or the longest wheal diameter including pseudopods (34.4%). In all, 66% of allergologists indicated that a device that automating the SPT process would be valuable for clinical practice.

Skin prick tests and serum IgE tests are still the cornerstones in the diagnostic work-up of immediate-type allergies. Variability in the execution of skin prick tests exists between different hospitals and physicians’ offices in Germany. Inconsistent availability of testing reagents was considered most problematic for maintaining allergy diagnostics in Germany. A majority of allergologists are open to evaluating tools that may contribute to standardize skin prick tests.

Studies suggest that children with immunoglobulin E (IgE)-mediated food allergies (FA) are at risk of impaired growth, especially those with cow’s milk or multiple FA. However, there is limited long-term data available on this topic. This analysis presents the growth of Swiss children for the first year after FA diagnosis.

This is a secondary analysis of data from a multicentered study following food allergic children (0–10 years) over 1 year post diagnosis, comparing those who received dietary counselling with those who did not. Growth z‑scores were calculated based on World Health Organization (WHO) standards, using data reported by caregivers. To analyze data, linear mixed models with between-subject factors related to dietary counselling, number of FA, and cow’s milk allergy were fitted to the data.

In the 48 children (median age 16 months) studied, we observed an increasing prevalence of wasting (weight-for-length/height z‑score < 2; 2–10%) and a lower prevalence of stunting (length/height-for-age < 2; 0–2%) over the 1‑year period. Twelve months after diagnosis, all median z‑scores showed an increase. Linear mixed model analysis did not find any significant within-subject and between-subject effects on growth.

Children with IgE-mediated FA can have normal growth if children with cow’s milk allergy or multiple food allergies receive dietary counselling. Routine length/height and weight measurements should be taken to identify individual malnutrition and to initiate tailored nutritional interventions. Larger studies with longer duration are needed to assess further growth development in children with IgE-mediated food allergies.