Allergology International最新文献

英文中文

5-hydroxyeicosatetraenoic acid and 12-hydroxyeicosapentaenoic acid regulate basophil and mast cell activation and basophil recruitment in chronic spontaneous urticaria. 5-羟基二十碳四烯酸和12-羟基二十碳五烯酸调节慢性自发性荨麻疹中嗜碱性细胞和肥大细胞的活化和嗜碱性细胞的募集。

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-06 DOI: 10.1016/j.alit.2025.12.005

Mana Ito, Yoshimi Miki, Shota Toyoshima, Maho Tagui, Koremasa Hayama, Hideki Fujita, Yoshitaka Taketomi, Makoto Murakami, Yoshimichi Okayama

Background: The underlying pathomechanisms of wheal reaction enlargement in chronic spontaneous urticaria (CSU) remain largely unclear. We hypothesized that the activation of mast cells (MCs) and recruitment of basophils to locally inflamed skin would be enhanced by lipid mediators (LMs) following initial skin MC activation. This study aimed to identify the LMs responsible for enhancing the aggregation of IgE-mediated MC activation and basophil chemotaxis.

Methods: We enrolled 77 CSU patients and 36 non-atopic control (NC) subjects. Lipid profiling of plasma from these subjects was performed using liquid chromatography-tandem mass spectrometry/mass spectrometry. We compared LMs before and after omalizumab treatment between responders and non-responders.

Results: The concentration of 5-lipoxygenase-mediated LMs was significantly higher in the plasma obtained from patients than in the plasma obtained from NC subjects. The stepwise model demonstrated that 5-hydroxyeicosatetraenoic acid (HETE) (odds ratio, 3.34; 95 % confidence interval, 1.91-5.86; p = 0.0001) was the strongest independent marker of CSU. Here, 5-HETE significantly upregulated IgE-dependent basophil and MC activation. 12-hydroxyeicosapentaenoic acid (HEPE) demonstrated statistically significant correlations between changes in basophil counts and changes in the LM levels before and after omalizumab administration (p = 0.0146). Additionally, 12-HEPE significantly inhibits TNF-α/IFN-β-induced CCL2 mRNA expression in human keratinocytes. Furthermore, 12-HEPE showed a significant increase in concentration after omalizumab treatment in responders (p = 0.0095), but not in non-responders.

Conclusions: In conclusion, 5-HETE and 12-HEPE may regulate IgE-mediated activation of MCs and basophils and recruitment of basophils in the CSU, respectively, suggesting that these LMs may be involved in the enlargement of wheal reactions.

背景：慢性自发性荨麻疹（CSU）的轮状反应扩大的潜在病理机制仍不清楚。我们假设，在初始皮肤肥大细胞激活后，脂质介质（LMs）会增强肥大细胞（MCs）的激活和局部炎症皮肤的嗜碱性粒细胞的募集。本研究旨在确定负责增强ige介导的MC激活和嗜碱性粒细胞趋化性聚集的LMs。方法：我们招募了77例CSU患者和36例非特应性对照组（NC）。使用液相色谱-串联质谱/质谱法对这些受试者的血浆进行脂质谱分析。我们比较了有反应者和无反应者在奥玛珠单抗治疗前后的LMs。结果：患者血浆中5-脂氧合酶介导的LMs浓度明显高于NC组血浆。逐步模型显示，5-羟基二糖四烯酸（HETE）（优势比为3.34；95%可信区间为1.91 ~ 5.86;p = 0.0001）是CSU最强的独立标志物。在这里，5-HETE显著上调ige依赖性嗜碱性粒细胞和MC的激活。12-羟基二碳五烯酸（HEPE）在奥玛珠单抗前后嗜碱性粒细胞计数变化与LM水平变化之间具有统计学意义（p = 0.0146）。此外，12-HEPE显著抑制TNF-α/IFN-β诱导的人角质形成细胞CCL2 mRNA表达。此外，在奥玛珠单抗治疗后，12-HEPE浓度显著增加（p = 0.0095），但在无反应者中没有。结论：综上所述，5-HETE和12-HEPE可能分别调节ige介导的CSU中MCs和嗜碱性细胞的激活和嗜碱性细胞的募集，提示这些LMs可能参与了轮状反应的扩大。

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引用次数: 0

IgE reactivity to a walnut gibberellin-regulated protein in a patient with walnut anaphylaxis: A case report 核桃过敏反应患者对核桃赤霉素调节蛋白的IgE反应性：1例报告。

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.11.002

Yuji Mori , Keiko Momma , Hikaru Sugita , Toya Kono , Nobuaki Okumura , Hiroshi Narita , Yasuto Kondo

引用次数: 0

Clinical remission in asthma and related diseases: Current landscape and future perspectives 哮喘及相关疾病的临床缓解：现状和未来展望

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.12.002

Hiroyuki Nagase (Associate Editor, Allergology International)

引用次数: 0

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01

引用次数: 0

Uneven distribution of air trapping and its impact on physical activity in patients with asthma 哮喘患者空气捕获分布不均匀及其对身体活动的影响。

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.06.002

Ayumi Fukatsu-Chikumoto , Tsunahiko Hirano , Hiroshi Iwamoto , Taiga Kobayashi , Yoshie Kunihiro , Keiko Doi , Kazuki Hamada , Yoriyuki Murata , Toshiaki Utsunomiya , Keiji Oishi , Maki Asami-Noyama , Nobutaka Edakuni , Kazuma Kawamoto , Toshihito Otani , Naoko Higaki , Yoshihiro Amano , Mayuka Yamane , Naoya Tanabe , Akihito Yokoyama , Takeshi Isobe , Kazuto Matsunaga

Background

The underlying pathophysiology of varying physical activity levels in patients with asthma remains unclear. In this study, we investigated the association between physical activity and air trapping, identified via chest computed tomography, in patients with asthma.

Methods

The following computed tomography analyses were used to evaluate air trapping in two cohorts (Cohort 1: 27 patients with asthma, 12 healthy individuals; Cohort 2: 90 patients with asthma, 43 healthy individuals): density analysis, focusing on air trapping characteristics during expiration, and parametric response mapping (PRM), which integrates inspiratory and expiratory computed tomography scans to categorize air trapping into small airway disease (PRM^SAD) and low-attenuation areas. Mucus plug scores were also measured.

Results

Patients with asthma exhibited significantly reduced activity levels compared with healthy participants at intensities of ≥2, ≥3, and ≥4 metabolic equivalents (METs) in both cohorts. Among patients with asthma, air trapping was significantly associated with decreased physical activity of ≥4 METs, corresponding to moderate-to-vigorous exercise intensity. Among the air-trapping components, increased PRM^SAD significantly contributed to reduced physical activity at ≥4 METs. Regarding the relationship between PRM^SAD and physical activity for each lung lobe, elevated PRM^SAD in the left upper lobe played a significant role in decreasing physical activity. The presence of mucus plugs was associated with elevated PRM^SAD.

Conclusions

The uneven distribution of air trapping in the lungs of patients with asthma, particularly in the upper lobe, was linked to reduced moderate-to-vigorous-intensity physical activity and was partially attributable to small airway obstruction caused by mucus plugs.

背景：哮喘患者不同体力活动水平的潜在病理生理学尚不清楚。在这项研究中，我们调查了哮喘患者通过胸部计算机断层扫描确定的身体活动与空气捕获之间的关系。方法：采用以下计算机断层扫描分析来评估两个队列的空气捕获(队列1:27例哮喘患者，12例健康个体；队列2:90例哮喘患者，43例健康个体)：密度分析，关注呼气时的空气捕获特征，参数反应映射（PRM），整合吸气和呼气计算机断层扫描，将空气捕获分为小气道疾病（PRMSAD）和低衰减区。还测量了粘液堵塞评分。结果：与健康参与者相比，哮喘患者在≥2、≥3和≥4代谢当量（METs）强度下的活动水平显著降低。在哮喘患者中，空气滞留与≥4 METs的体力活动减少显著相关，对应于中等到剧烈的运动强度。在空气捕获成分中，PRMSAD的增加显著导致≥4 METs时身体活动的减少。关于各肺叶PRMSAD与身体活动的关系，左上肺叶PRMSAD升高对身体活动的降低有显著作用。黏液塞的存在与PRMSAD升高有关。结论：哮喘患者肺部（尤其是上肺叶）空气捕获分布不均匀，与中高强度体力活动减少有关，部分归因于粘液塞引起的小气道阻塞。

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引用次数: 0

Current definition of remission in eosinophilic granulomatosis with polyangiitis (EGPA) and future perspectives 嗜酸性肉芽肿病合并多血管炎（EGPA）缓解的当前定义和未来展望。

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.10.004

Hiromichi Tamaki

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis for which achieving remission is the primary therapeutic goal. Historically, remission in EGPA was defined by the absence of active vasculitis, typically a Birmingham Vasculitis Activity Score (BVAS) of 0. However, this definition is insufficient as it overlooks the significant morbidity associated with long-term glucocorticoid (GC) therapy. Recent evidence highlights that even low-dose GCs carry substantial risks, challenging the traditional acceptance of remission on GC. This review summarizes the evolution of the remission concept in EGPA, highlighting the paradigm shift seen in recent pivotal clinical trials for biologics, which have incorporated stringent GC dose thresholds (e.g., prednisone ≤4 mg/day) into their primary endpoints. This reflects a growing consensus that minimizing GC exposure is a crucial component of a successful treatment outcome. Further, this review explores potential future components for remission criteria, such as organ-specific activity measures and patient-reported outcomes.

嗜酸性肉芽肿病合并多血管炎（EGPA）是一种罕见的系统性血管炎，实现缓解是主要的治疗目标。从历史上看，EGPA的缓解是通过没有活动性血管炎来定义的，通常是伯明翰血管炎活动评分（BVAS）为0。然而，这一定义是不够的，因为它忽略了与长期糖皮质激素（GC）治疗相关的显著发病率。最近的证据强调，即使是低剂量的胃癌也有很大的风险，挑战了传统上对胃癌缓解的接受。本综述总结了EGPA缓解概念的演变，强调了近期生物制剂关键临床试验中的范式转变，这些试验将严格的GC剂量阈值（例如，泼尼松≤4mg /天）纳入其主要终点。这反映了越来越多的共识，即最小化GC暴露是成功治疗结果的关键组成部分。此外，本综述探讨了缓解标准的潜在未来组成部分，如器官特异性活动测量和患者报告的结果。

引用次数: 0

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01

引用次数: 0

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01

引用次数: 0

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01

引用次数: 0

Unsupervised identification of asthma symptom subtypes supports treatable traits approach 无监督的哮喘症状亚型鉴定支持可治疗特征方法。

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.06.004

Kazuki Hamada , Takeshi Abe , Keiji Oishi , Yoriyuki Murata , Tsunahiko Hirano , Takahide Hayano , Masahiko Nakatsui , Yoshiyuki Asai , Kazuto Matsunaga

Background

Heterogeneity of asthma requires a personalized therapeutic approach. However, objective measurements, such as spirometry and fraction of exhaled nitric oxide (FeNO) for implementing treatable traits approach, are limited in low- and middle-income countries and non-specialist settings. To implement precision medicine even with minimal resources, we developed an algorithm using unsupervised machine learning techniques that estimates key treatable traits (airflow limitation, type 2 [T2] inflammation, and frequent exacerbations) based on an asthma patient-reported outcome (PRO).

Methods

We applied hierarchical clustering and Uniform Manifold Approximation and Projection (UMAP) to Asthma Control Questionnaire (ACQ)-5 including five residual symptoms from two asthma cohorts (the discovery cohort with 1697 patients and validation cohort with 157 patients).

Results

We identified five symptom clusters, characterized by key treatable traits: Cluster 1, minimal asthma symptoms; Cluster 2, a little symptom, mild airflow limitation; Cluster 3, predominant shortness of breath and wheezes, airflow limitation; Cluster 4, predominant morning symptoms and nocturnal awakening, T2 inflammation; and Cluster 5, all symptoms severe, airflow limitation, T2 inflammation and frequent exacerbations. The UMAP projections of ACQ-5 (five-dimensional) to two-dimensions allowed to visualize datapoints and clusters, which visually revealed that patients with poorly-controlled asthma were divided into Clusters 3, 4 and 5. These results were externally validated in an independent cohort.

Conclusions

Based on asthma PRO data, the developed algorithm categorized asthma patients into five symptom-based subtypes that provide insights into key treatable traits. Our data-driven digital health approach will extend precision medicine of asthma to medical facilities even in resource-constrained settings.

背景：哮喘的异质性需要个性化的治疗方法。然而，用于实施可治疗特征方法的客观测量，如肺量测定法和呼出一氧化氮（FeNO）分数，在中低收入国家和非专业环境中是有限的。为了以最少的资源实现精准医疗，我们开发了一种使用无监督机器学习技术的算法，该算法基于哮喘患者报告的结果（PRO）来估计关键的可治疗特征（气流限制、2型[T2]炎症和频繁恶化）。方法：采用分层聚类和均匀流形逼近投影（UMAP）方法对哮喘控制问卷(ACQ)-5进行分析，其中包括来自两个哮喘队列（发现队列1697例患者和验证队列157例患者）的5种残留症状。结果：我们确定了五个症状集群，其特征是关键的可治疗特征：集群1，最小的哮喘症状；第二组，症状轻微，气流受限轻微；群集3，主要的呼吸短促和喘息，气流受限；第4组，以晨间症状和夜间觉醒为主，T2炎症；第5组，所有症状严重，气流受限，T2炎症和频繁恶化。ACQ-5（五维）到二维的UMAP投影允许可视化数据点和簇，直观地显示控制不良的哮喘患者分为簇3、4和5。这些结果在一个独立的队列中得到了外部验证。结论：基于哮喘PRO数据，开发的算法将哮喘患者分为五种基于症状的亚型，这些亚型提供了对关键可治疗特征的见解。我们的数据驱动的数字健康方法将把哮喘的精准医疗扩展到医疗机构，甚至在资源有限的环境中。

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