Allergology International最新文献_第3页

Sputum symptoms and microbiome in type 2 airway diseases with mucus plugs on computed tomography 2型气道疾病的痰症状和微生物组与粘液塞的计算机断层扫描

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.10.002

Naoya Tanabe , Hisako Matsumoto , Chie Morimoto , Yusuke Hayashi , Hironobu Sunadome , Atsuyasu Sato , Susumu Sato , Toyohiro Hirai

引用次数: 0

Clinical utility of YKL-40 for understanding pathophysiology of obstructive airway disorders YKL-40在了解阻塞性气道疾病病理生理方面的临床应用。

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.05.004

Yasuhito Suzuki, Junpei Saito , Masami Kikuchi, Suguru Sato, Atsuro Fukuhara, Mami Rikimaru, Hikaru Tomita, Kentaro Kazama, Koshi Saito, Rina Harigane, Riko Sato, Ryuki Yamada, Natsumi Watanabe, Takashi Umeda, Ryuichi Togawa, Yuki Sato, Hiroyuki Minemura, Takefumi Nikaido, Kenya Kanazawa, Xintao Wang, Yoko Shibata

Background

Chitinase-3-like protein 1 (YKL-40) has been reported as a biomarker of neutrophilic airway inflammation in obstructive airway disorders. However, the pathophysiological features of YKL-40 remain unclear. The aim of the study is to evaluate the associations between YKL-40 and clinical features in patients with asthma, chronic obstructive pulmonary disease (COPD), or asthma-COPD overlap (ACO).

Methods

Serum and sputum YKL-40 levels were measured in 46 asthmatics, 35 COPD, and 32 ACO patients.

Results

Serum YKL-40 levels were elevated in the COPD and ACO patients, and sputum YKL-40 levels were higher in the COPD patients compared to the asthmatics. Both serum and sputum YKL-40 levels positively correlated with sputum neutrophils. Only serum YKL-40 levels negatively correlated with FEV₁ (%predicted), FEV₁/FVC, and annual decline in FEV₁. In 15 patients whose paired serum samples were obtained within 6 months, changes in serum YKL-40 levels showed a significant positive correlation with those in FEV₁. Furthermore, patients who had experienced exacerbations either in the past year or the following year showed significantly greater serum, but not sputum, YKL-40 levels. Sputum YKL-40 levels showed significant correlations with scores on the COPD assessment test and modified Medical Research Council dyspnea scale.

Conclusions

Serum and sputum YKL-40 may reflect distinct clinical features in obstructive airway disorders. Serum YKL-40 may provide beneficial information on predicting obstructive neutrophilic inflammation and exacerbations, whilst sputum YKL-40 may offer valuable insights for evaluating ongoing symptoms. Concomitant measurement of YKL-40 in serum and sputum might be more useful than individual measurement.

背景：几丁质酶-3样蛋白1 （YKL-40）已被报道为阻塞性气道疾病中性粒细胞气道炎症的生物标志物。然而，YKL-40的病理生理特征尚不清楚。该研究的目的是评估哮喘、慢性阻塞性肺疾病（COPD）或哮喘-COPD重叠（ACO）患者的YKL-40与临床特征之间的关系。方法：对46例哮喘、35例COPD、32例ACO患者进行血清及痰中YKL-40水平测定。结果：COPD和ACO患者血清YKL-40水平均升高，且COPD患者痰中YKL-40水平高于哮喘患者。血清和痰中YKL-40水平与痰中中性粒细胞呈正相关。只有血清YKL-40水平与FEV1（预测百分比）、FEV1/FVC和FEV1年下降呈负相关。在6个月内获得配对血清样本的15例患者中，血清YKL-40水平的变化与FEV1的变化呈显著正相关。此外，在过去一年或接下来一年经历加重的患者血清中YKL-40水平明显升高，但痰中没有。痰液中YKL-40水平与COPD评估测试和改良的医学研究委员会呼吸困难量表得分有显著相关性。结论：血清和痰液中YKL-40可反映阻塞性气道疾病的不同临床特征。血清YKL-40可能为预测阻塞性中性粒细胞炎症和恶化提供有益信息，而痰液YKL-40可能为评估持续症状提供有价值的见解。同时测定血清和痰中YKL-40可能比单独测定更有用。

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引用次数: 0

Association of allergen signatures with individualized allergic phenotypes 过敏原特征与个体化过敏表型的关联。

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.09.003

Dachan Kim , Hyung-Ju Cho , Chang-Hoon Kim , Min-Seok Rha

Background

Allergen sensitization patterns are heterogeneous, and their clinical relevance is often obscured by extensive cross-reactivity. We applied non-negative matrix factorization (NMF) to disentangle overlapping immunoglobulin E (IgE) signals and define clinically meaningful allergen signatures in a large Korean cohort.

Methods

We analyzed 45,065 patients who underwent multiplex allergen testing (35 inhalants and food components) between 2010 and 2025. Class-scaled specific IgE values (0–6) were factorized by NMF (k = 4). Signature weights were related to asthma, allergic rhinitis, and atopic dermatitis using multivariable logistic regression and to peripheral eosinophil counts and total IgE using age- and sex-adjusted linear models.

Results

Four signatures—mite, grass/weed, pet, and tree—explained 77.7 % of the variance in sensitization. The mite signature predominated (57.6 % of patients) and was strongly associated with allergic rhinitis (adjusted OR: 7.21, 95 % CI: 5.66–9.16), as well as marked increases in eosinophils and total IgE. The pet signature was the strongest predictor of asthma (OR: 8.90, 6.48–12.24). The tree signature showed the strongest association with atopic dermatitis (OR: 6.27, 3.81–10.32) and broader multisystem allergic morbidity. The grass/weed signature exhibited a biphasic age trajectory with a late-adult resurgence but had modest clinical impact. All signatures were significant and graded as determinants of blood eosinophil counts and IgE levels.

Conclusions

Data-driven factorization of multiplex IgE panels yields portable allergen signatures that refine attribution of asthma, allergic rhinitis, and atopic dermatitis and link serologic patterns to systemic inflammation.

背景：过敏原致敏模式是异质的，它们的临床相关性常常被广泛的交叉反应性所掩盖。我们应用非负矩阵分解（NMF）来解开重叠的免疫球蛋白E （IgE）信号，并在一个大型韩国队列中定义有临床意义的过敏原特征。方法：我们分析了2010年至2025年间接受多重过敏原检测（35种吸入剂和食物成分）的45,065例患者。分类特异性IgE值（0-6）由NMF因子分解（k = 4）。特征权重与哮喘、变应性鼻炎和特应性皮炎相关，与外周嗜酸性粒细胞计数和总IgE相关，采用年龄和性别调整线性模型。结果：螨、草/杂草、宠物和树这四个特征解释了77.7%的致敏差异。螨特征占主导地位（57.6%的患者），与变应性鼻炎密切相关（调整后的OR: 7.21, 95% CI: 5.66-9.16），嗜酸性粒细胞和总IgE显著增加。宠物特征是哮喘的最强预测因子（OR: 8.90, 6.48-12.24）。树特征显示与特应性皮炎（OR: 6.27, 3.81-10.32）和更广泛的多系统过敏性发病率的最强关联。草/杂草特征表现出双相年龄轨迹，成年后期复苏，但临床影响不大。所有的特征都是显著的，并被分级为血液嗜酸性粒细胞计数和IgE水平的决定因素。结论：多重IgE面板的数据驱动因子分解产生便携式过敏原特征，可细化哮喘，过敏性鼻炎和特应性皮炎的归因，并将血清学模式与全身性炎症联系起来。

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引用次数: 0

Corrigendum to “Black-box optimization in immunology and beyond: A practical guide to algorithms and future directions” [Allergol Int 74 (2025) 549–62] “免疫学及其他领域的黑箱优化：算法和未来方向的实用指南”[Allergol Int 74(2025) 549-62]的勘误表。

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.11.001

Takanori Kawabata , Taku Tsuzuki , Tsuyoshi Tatsukawa , Kota Matsui , Eiryo Kawakami

引用次数: 0

Consensus definition of clinical remission in asthma for the Japanese asthma prevention and management guidelines (JGL 2024): A modified delphi survey and comprehensive review 日本哮喘预防和管理指南（JGL 2024）中哮喘临床缓解的共识定义：一项修改的德尔菲调查和综合评价

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.11.004

Hiroyuki Nagase , Norihiro Harada , Junichiro Tezuka , Masaki Futamura , Mizuho Nagao , Takumi Takizawa , Shigemi Yoshihara , Makoto Nagata , Akio Niimi , Masao Yamaguchi

Clinical remission in asthma has gained prominence as both a therapeutic goal and a research endpoint, although its operational definitions have varied. To harmonize Japanese practice with emerging global frameworks, the Japanese Society of Allergology (JSA) conducted a two-round modified Delphi survey to establish a consensus definition for inclusion in the 2024 Asthma Prevention and Management Guidelines (JGL 2024).

In Round 1 (January 2024), 81 JGL 2024 guideline committee members representing adult and pediatric specialties were invited. Seventy-four percent agreed that clinical remission should be defined, and 50 % supported including both on- and off-treatment remission. Four core components emerged: absence of exacerbations, well-controlled symptoms, no continuous oral corticosteroid use, and optimization of pulmonary function.

Round 2 refined operational thresholds for symptom control, adopting ACT ≥23 (C-ACT ≥23 for children) and ACQ ≤0.75, consistent with JGL's long-standing goal of achieving a truly symptom-free state without reliever use. Pulmonary function was defined as “optimization,” encompassing normalization where achievable and stabilization when normalization is unlikely (e.g., airway remodeling), which received strong agreement.

Collaboration between adult and pediatric experts affirmed clinical remission as a milestone toward off-treatment remission and potential cure, broadening its applicability across severities and age groups. This review further summarizes evidence supporting remission as an outcome of biologic therapy, its key predictors (e.g., smoking, obesity, disease duration), pediatric perspectives, and future directions. JGL 2024 formally adopts these criteria, providing a rigorous and pragmatic framework to advance patient-centered asthma care and reframe management toward disease modification and eventual cure.

临床缓解在哮喘已经获得突出作为治疗目标和研究终点，尽管其操作定义有所不同。为了使日本的实践与新兴的全球框架保持一致，日本过敏症学会（JSA）进行了两轮修正德尔菲调查，以建立共识定义，纳入2024年哮喘预防和管理指南（JGL 2024）。第1轮（2024年1月）邀请了81名代表成人和儿科专业的JGL 2024指南委员会成员。74%的人同意应该定义临床缓解，50%的人支持包括治疗期间和非治疗期间的缓解。出现了四个核心组成部分：没有恶化，症状控制良好，不持续口服皮质类固醇，肺功能优化。第2轮细化了症状控制的操作阈值，采用ACT≥23（儿童C-ACT≥23）和ACQ≤0.75，符合JGL长期以来的目标，即在不使用缓解剂的情况下实现真正的无症状状态。肺功能被定义为“优化”，包括可实现的正常化和不可能正常化时的稳定（例如气道重塑），这得到了强烈的认同。成人和儿科专家之间的合作肯定了临床缓解是治疗缓解和潜在治愈的里程碑，扩大了其在严重程度和年龄组中的适用性。这篇综述进一步总结了支持缓解作为生物治疗结果的证据、其关键预测因素（如吸烟、肥胖、疾病持续时间）、儿科观点和未来方向。JGL 2024正式采用这些标准，提供严格和务实的框架，以推进以患者为中心的哮喘护理，并重新构建疾病改变和最终治愈的管理。

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引用次数: 0

Clinical remission in severe asthma treated with biologics and macrolides: Definition, prevalence, associated factors, and future perspectives 用生物制剂和大环内酯类药物治疗严重哮喘的临床缓解：定义、患病率、相关因素和未来展望

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.10.001

Yuto Hamada , Dennis Thomas , Vanessa M. McDonald , Michael Fricker , Liam G. Heaney , Peter G. Gibson

Severe asthma is associated with persistent symptoms, frequent exacerbations, oral corticosteroid dependence, and reduced lung function. The emergence of biologic therapies targeting type 2 (T2) cytokines, including IL-5, IL-4, IL-13, thymic stromal lymphopoietin, and circulating IgE, has changed disease management and led to substantial improvement. This approach has also introduced the concept of clinical remission (defined as controlled symptoms, no maintenance corticosteroid use, no exacerbations, and optimized/stabilized lung function) as a potential treatment target.

Although some guidelines propose remission criteria, no universally accepted definition exists, and reported prevalence varies depending on definitions, and therapies, and patient groups. Clinical remission has been achieved in approximately one-third of patients receiving T2-targeted biologics. Factors associated with achieving clinical remission include less severe disease (less symptoms, fewer exacerbations, and better lung function), fewer comorbidities (e.g. obesity, anxiety/depression), greater T2-disease activity (the presence of nasal polyps and higher T2 biomarkers), and early treatment response. Azithromycin therapy can also contribute to achieving remission in both T2-high and T2-low moderate to severe asthma phenotypes.

Future perspectives on asthma remission include integrating a treatable traits approach, establishing and validating the definition of complete remission, and assessing the long-term benefits of achieving remission. Complete remission may encompass clinical remission, inflammatory remission (normalization of T2 biomarkers), and structural/functional remission (resolution of bronchial hyperresponsiveness, mucus plugging, and airway remodeling). Standardizing remission criteria will enable the identification of predictive factors and facilitate personalized, treat-to-target strategies. Early induction of clinical remission may be a promising strategy for optimizing outcomes in severe asthma.

严重哮喘与持续症状、频繁恶化、口服皮质类固醇依赖和肺功能降低相关。针对2型（T2）细胞因子的生物疗法的出现，包括IL-5、IL-4、IL-13、胸腺基质淋巴生成素和循环IgE，已经改变了疾病的管理并导致了实质性的改善。该方法还引入了临床缓解的概念（定义为症状控制，不使用维持性皮质类固醇，无恶化，优化/稳定肺功能）作为潜在的治疗目标。尽管一些指南提出了缓解标准，但没有普遍接受的定义，报告的患病率因定义、治疗和患者群体而异。大约三分之一接受t2靶向生物制剂治疗的患者达到了临床缓解。与实现临床缓解相关的因素包括疾病较轻（症状较少，恶化较少，肺功能较好），合共病较少（例如肥胖，焦虑/抑郁），T2疾病活动性较大（鼻息肉和较高T2生物标志物的存在），以及早期治疗反应。阿奇霉素治疗也有助于实现t2高和t2低的中度至重度哮喘表型的缓解。哮喘缓解的未来前景包括整合可治疗的特征方法，建立和验证完全缓解的定义，以及评估实现缓解的长期益处。完全缓解可能包括临床缓解、炎症缓解（T2生物标志物的正常化）和结构/功能缓解（支气管高反应性、粘液堵塞和气道重塑的消退）。标准化缓解标准将使预测因素的识别和促进个性化，治疗到目标的策略。早期诱导临床缓解可能是优化重症哮喘预后的一种有希望的策略。

{"title":"Clinical remission in severe asthma treated with biologics and macrolides: Definition, prevalence, associated factors, and future perspectives","authors":"Yuto Hamada , Dennis Thomas , Vanessa M. McDonald , Michael Fricker , Liam G. Heaney , Peter G. Gibson","doi":"10.1016/j.alit.2025.10.001","DOIUrl":"10.1016/j.alit.2025.10.001","url":null,"abstract":"<div><div>Severe asthma is associated with persistent symptoms, frequent exacerbations, oral corticosteroid dependence, and reduced lung function. The emergence of biologic therapies targeting type 2 (T2) cytokines, including IL-5, IL-4, IL-13, thymic stromal lymphopoietin, and circulating IgE, has changed disease management and led to substantial improvement. This approach has also introduced the concept of clinical remission (defined as controlled symptoms, no maintenance corticosteroid use, no exacerbations, and optimized/stabilized lung function) as a potential treatment target.</div><div>Although some guidelines propose remission criteria, no universally accepted definition exists, and reported prevalence varies depending on definitions, and therapies, and patient groups. Clinical remission has been achieved in approximately one-third of patients receiving T2-targeted biologics. Factors associated with achieving clinical remission include less severe disease (less symptoms, fewer exacerbations, and better lung function), fewer comorbidities (e.g. obesity, anxiety/depression), greater T2-disease activity (the presence of nasal polyps and higher T2 biomarkers), and early treatment response. Azithromycin therapy can also contribute to achieving remission in both T2-high and T2-low moderate to severe asthma phenotypes.</div><div>Future perspectives on asthma remission include integrating a treatable traits approach, establishing and validating the definition of complete remission, and assessing the long-term benefits of achieving remission. Complete remission may encompass clinical remission, inflammatory remission (normalization of T2 biomarkers), and structural/functional remission (resolution of bronchial hyperresponsiveness, mucus plugging, and airway remodeling). Standardizing remission criteria will enable the identification of predictive factors and facilitate personalized, treat-to-target strategies. Early induction of clinical remission may be a promising strategy for optimizing outcomes in severe asthma.</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"75 1","pages":"Pages 15-25"},"PeriodicalIF":6.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical efficacy of mepolizumab and dupilumab for eosinophilic otitis media: Analysis of patient clinical characteristic 美泊珠单抗和杜匹单抗治疗嗜酸性中耳炎的临床疗效：患者临床特征分析。

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.07.002

Saori Kikuchi , Tomonori Sugiyama , Saemi Suzuki , Yukiko Iino

Background

Eosinophilic otitis media (EOM) is characterized by eosinophilic infiltration of the middle ear; it is frequently associated with bronchial asthma and chronic rhinosinusitis with nasal polyposis. Although biologics have been used to treat EOM, their efficacy based on clinical characteristics remains unclear. In this study, we evaluated the effectiveness of biologics and analyzed the clinical factors that influenced outcomes.

Methods

We retrospectively studied 29 patients with EOM treated with either mepolizumab or dupilumab as an adjunct to standard therapy, which included intratympanic instillation of triamcinolone. Clinical efficacy was assessed by severity scores, temporal bone computed tomography scores, and pure-tone audiometry. The control group comprised 15 patients with EOM who did not receive biologics. We also analyzed the correlations between changes in severity score from baseline and clinical factors for each patient.

Results

Both biologics groups had significantly lower severity scores at 6 months, with sustained effects until 12 months. The patients with severe middle ear mucosal changes and high baseline severity scores experienced significant improvement with the use of dupilumab; mepolizumab was more effective in elderly patients. Temporal bone computed tomography scores improved in both biologics groups, indicating inflammation resolution in the whole temporal bone. No deterioration of bone-conduction hearing levels was observed in any group.

Conclusions

Mepolizumab and dupilumab showed efficacy for EOM, with therapeutic effects evident within 6 months. Dupilumab is preferable for patients with severe mucosal changes, whereas mepolizumab may benefit elderly patients. Further studies are needed to refine treatment strategies.

背景：嗜酸性中耳炎（EOM）以中耳嗜酸性浸润为特征；它常与支气管哮喘和慢性鼻窦炎合并鼻息肉病有关。虽然生物制剂已被用于治疗EOM，但其基于临床特征的疗效尚不清楚。在这项研究中，我们评估了生物制剂的有效性，并分析了影响结果的临床因素。方法：我们回顾性研究了29例EOM患者，使用美波珠单抗或杜匹单抗作为标准治疗的辅助治疗，其中包括鼓室内滴注曲安奈德。临床疗效通过严重程度评分、颞骨计算机断层扫描评分和纯音听力学来评估。对照组为15例EOM患者，未接受生物制剂治疗。我们还分析了每位患者从基线开始的严重程度评分变化与临床因素之间的相关性。结果：两个生物制剂组在6个月时的严重程度评分均显著降低，并持续到12个月。使用杜匹单抗后，中耳黏膜严重改变和基线严重程度评分较高的患者有显著改善；Mepolizumab对老年患者更有效。两个生物制剂组的颞骨计算机断层扫描评分均有所改善，表明整个颞骨的炎症消退。在任何组中均未观察到骨传导听力水平的恶化。结论：美泊珠单抗和杜匹单抗对EOM均有疗效，且6个月内疗效明显。Dupilumab适用于严重粘膜改变的患者，而mepolizumab可能有利于老年患者。需要进一步的研究来完善治疗策略。

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引用次数: 0

Elevated Kocuria rhizophila contributing to repair of skin barrier function in patients with atopic dermatitis 特应性皮炎患者皮肤屏障功能修复中嗜根瘤菌升高的作用。

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.06.006

Hyunjoon Park , Chaewon Lee , Chul Sung Huh , Myongsoon Sung

Background

Recent findings suggest skin microbiota is closely linked to the aggravation of atopic dermatitis (AD) and skin barrier dysfunction.

Methods

This prospective cross-sectional study included 52 children: 35 with AD flare (F) and non-flare (NF), and 17 without AD (non-AD). Microbes in the skin samples from the three groups were analyzed using 16S rRNA amplicon sequencing. We estimated the anti-virulence of Kocuria rhizophila in the skin microbiome of children. The effects of K. rhizophila were evaluated in human skin cell models with AD-like damage caused by Staphylococcus aureus secretory toxins, including protein A (PA), lipoteichoic acid, and protease V8.

Results

Taxonomic classification revealed significant phylum-level differences among the three groups. Alpha-diversity indices tended to decrease in the AD-F group compared with the non-AD group but were higher in the AD-NF group. The AD group had a high relative abundance of S. aureus, but S. aureus was almost absent in the non-AD group and exhibited a marked decrease in the AD-NF group; K. rhizophila was negatively correlated with AD severity. Heat-killed K. rhizophila (HKKR) treatment upregulated gene expression of the tight junction protein zonula occludens-1 and critical components of the cornified cell envelope, involucrin and filaggrin, while downregulating the expression of the pro-inflammatory cytokines interleukin (IL)-1b and IL-6. Transcriptomic analysis revealed that HKKR treatment was associated with skin barrier functions, cell–cell junctions, and immune responses.

Conclusions

K. rhizophila may be associated with the mitigation of skin barrier dysfunction and inflammation in S. aureus infection, highlighting its potential for AD treatment.

背景：最近的研究结果表明，皮肤微生物群与特应性皮炎（AD）和皮肤屏障功能障碍的恶化密切相关。方法：这项前瞻性横断面研究包括52名儿童：35名患有AD (F)和非AD (NF)， 17名无AD （non-AD）。使用16S rRNA扩增子测序对三组皮肤样本中的微生物进行分析。我们估计了儿童皮肤微生物群中嗜根古菌的抗毒力。在金黄色葡萄球菌分泌毒素（包括蛋白A （PA）、脂磷胆酸和蛋白酶V8）引起ad样损伤的人皮肤细胞模型中，评估了嗜根K. .的作用。结果：三组间的分类学有显著的门水平差异。与非ad组相比，AD-F组α -多样性指数有降低的趋势，而AD-NF组α -多样性指数较高。AD组金黄色葡萄球菌相对丰度较高，而非AD组金黄色葡萄球菌几乎不存在，AD- nf组金黄色葡萄球菌明显减少；嗜根霉与AD严重程度呈负相关。热杀K. rhizophila （HKKR）处理上调紧密连接蛋白zonula occluden -1和凝固细胞包膜关键成分、天花素和聚丝蛋白的基因表达，下调促炎细胞因子白介素(IL)-1b和IL-6的表达。转录组学分析显示HKKR治疗与皮肤屏障功能、细胞-细胞连接和免疫反应有关。结论：嗜根K.菌可能与减轻金黄色葡萄球菌感染的皮肤屏障功能障碍和炎症有关，突出了其治疗AD的潜力。

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引用次数: 0

Identification of an immunodominant IgE epitope on Mal d 1 and its role for treatment of birch pollen-related apple allergy Mal - 1免疫显性IgE表位的鉴定及其对桦树花粉相关苹果过敏的治疗作用。

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.11.006

Hilal Demir , Jana Unterhauser , Maria R. Strobl , Ute Vollmann , Katarína Repiská , Gordana Wozniak-Knopp , Martin Tollinger , Barbara Bohle

引用次数: 0

Perioperative anaphylaxis in Japan: Epidemiology, diagnosis, and challenges. 日本围手术期过敏反应：流行病学、诊断和挑战。

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2025-12-26 DOI: 10.1016/j.alit.2025.12.003

Tomonori Takazawa

Perioperative anaphylaxis (POA) is one of the most critical acute complications in anesthesia practice, characterized by rapid onset, diagnostic complexity, and potentially fatal outcomes. Despite global improvements in anesthesia safety, the unpredictable nature of anaphylaxis continues to challenge clinicians. The Japanese Epidemiologic Study for Perioperative Anaphylaxis (JESPA) established the first nationwide, prospective surveillance system for POA, providing valuable insights into the epidemiology and mechanisms of POA in Japan. Large-scale studies from multiple countries, including the United Kingdom's National Audit Project 6 (NAP6) and France's Groupe d'Étude des Réactions Anaphylactiques Périopératoires (GERAP), have reported similar incidence rates, at approximately 1 in 5000 to 10,000 general anesthesia cases, indicating that POA is a rare but consistently serious global event. In Japan, JESPA confirmed a comparable frequency, identifying neuromuscular blocking agents (NMBAs), antibiotics, and sugammadex as major culprits causing anaphylaxis. Notably, the frequency of sugammadex-induced anaphylaxis is higher in Japan, likely reflecting its extensive clinical use. POA involves both immunologic and non-immunologic pathways, culminating in mast cell activation and mediator release. Its presentation, primarily hypotension and bronchospasm, is often masked under anesthesia, complicating its recognition. Diagnosis requires integrating clinical findings, measuring tryptase using the European Academy of Allergy and Clinical Immunology (EAACI) consensus formula (1.2 × baseline + 2 ng/mL), and identifying causative drugs via skin testing, basophil activation tests (BATs), or drug provocation tests (DPTs). Future priorities include expanding access to tryptase testing, strengthening multidisciplinary collaboration, and promoting anesthesiologist-led allergy investigations to enhance diagnostic precision and patient safety in perioperative care.

围手术期过敏反应（POA）是麻醉实践中最关键的急性并发症之一，其特点是发病迅速，诊断复杂，结局可能致命。尽管麻醉安全性在全球范围内有所改善，但过敏反应的不可预测性继续挑战着临床医生。日本围手术期过敏反应流行病学研究（JESPA）建立了第一个全国性的POA前瞻性监测系统，为日本POA的流行病学和机制提供了有价值的见解。来自多个国家的大规模研究，包括英国的国家审计项目6 （NAP6）和法国的Étude研究小组报告了类似的发病率，大约为5000至10000例全身麻醉病例中有1例，表明POA是一种罕见但一贯严重的全球事件。在日本，JESPA证实了类似的频率，确定神经肌肉阻滞剂（NMBAs）、抗生素和糖madex是引起过敏反应的主要罪魁祸首。值得注意的是，在日本，糖madex引起的过敏反应的频率较高，可能反映了其广泛的临床应用。POA涉及免疫和非免疫途径，最终导致肥大细胞活化和介质释放。其主要表现为低血压和支气管痉挛，常在麻醉下被掩盖，使其识别复杂化。诊断需要综合临床表现，使用欧洲过敏和临床免疫学学会（EAACI）共识公式（1.2 ×基线+ 2 ng/mL）测量胰蛋白酶，并通过皮肤试验、嗜碱性粒细胞激活试验（BATs）或药物激发试验（DPTs）确定致病药物。未来的重点包括扩大胰蛋白酶检测的可及性，加强多学科合作，促进麻醉师主导的过敏调查，以提高诊断的准确性和围手术期护理的患者安全性。

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引用次数: 0