Washing with water is not inferior to washing with soaps and detergents in children with atopic dermatitis (AD) in remission during the fall-winter seasons. We investigated whether this finding varies during summer based on the type of cleanser (soaps and detergents).
Methods
This evaluator-blinded, pragmatic, randomized, and non-inferiority study enrolled patients with AD whose eczema was controlled following regular steroid ointment application 2 days/week. For 8 ± 4 weeks, participants washed their upper and lower limbs with a cleanser on one side and with water alone on the other. Each participant chose either a weakly alkaline soap or an acidic detergent. The primary outcome was the Eczema Area and Severity Index (EASI) score at week 8 ± 4.
Results
The data of 43 of the 47 registered participants were analyzed. The median patient age was 44 (23–99) months; 28 and 15 participants chose weakly alkaline and acidic cleansers, respectively. At week 8 ± 4, EASI scores of the water and cleanser sides were 0.00 (0.00–0.40) and 0.15 (0.00–0.40), respectively (p = 0.74). The difference between both sides was 0.00 (−0.07 to 0.14); the limits of the 95 % confidence interval did not reach the pre-specified non-inferiority margin. No difference was observed in the median Patient-Oriented Eczema Measure score, number of additional steroid ointment applications, and occurrences of skin infections. There were no differences between the cleanser types in any of the results.
Conclusions
We demonstrated that washing with water was not inferior to that with a cleanser in patients with AD in the maintenance phase during summer, regardless of the type of cleanser.
{"title":"Skin care by washing with water is not inferior to washing with a cleanser in children with atopic dermatitis in remission in summer: WASH study","authors":"Yukiko Katoh , Osamu Natsume , Ryuhei Yasuoka , Satoshi Hayano , Eisaku Okada , Yutaka Ito , Akira Sakai , Yoko Monna , Fumitaka Takayanagi , Yusuke Inuzuka , Yuji Sakakura","doi":"10.1016/j.alit.2024.01.007","DOIUrl":"10.1016/j.alit.2024.01.007","url":null,"abstract":"<div><h3>Background</h3><p>Washing with water is not inferior to washing with soaps and detergents in children with atopic dermatitis (AD) in remission during the fall-winter seasons. We investigated whether this finding varies during summer based on the type of cleanser (soaps and detergents).</p></div><div><h3>Methods</h3><p>This evaluator-blinded, pragmatic, randomized, and non-inferiority study enrolled patients with AD whose eczema was controlled following regular steroid ointment application 2 days/week. For 8 ± 4 weeks, participants washed their upper and lower limbs with a cleanser on one side and with water alone on the other. Each participant chose either a weakly alkaline soap or an acidic detergent. The primary outcome was the Eczema Area and Severity Index (EASI) score at week 8 ± 4.</p></div><div><h3>Results</h3><p>The data of 43 of the 47 registered participants were analyzed. The median patient age was 44 (23–99) months; 28 and 15 participants chose weakly alkaline and acidic cleansers, respectively. At week 8 ± 4, EASI scores of the water and cleanser sides were 0.00 (0.00–0.40) and 0.15 (0.00–0.40), respectively (<em>p</em> = 0.74). The difference between both sides was 0.00 (−0.07 to 0.14); the limits of the 95 % confidence interval did not reach the pre-specified non-inferiority margin. No difference was observed in the median Patient-Oriented Eczema Measure score, number of additional steroid ointment applications, and occurrences of skin infections. There were no differences between the cleanser types in any of the results.</p></div><div><h3>Conclusions</h3><p>We demonstrated that washing with water was not inferior to that with a cleanser in patients with AD in the maintenance phase during summer, regardless of the type of cleanser.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 3","pages":"Pages 428-435"},"PeriodicalIF":6.8,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S132389302400008X/pdfft?md5=bbbac75fdd1f53e3708e6efa4ff40775&pid=1-s2.0-S132389302400008X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139679674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-02DOI: 10.1016/j.alit.2024.01.008
Yutaka Omatsu, Yumiko Shimizu, Tomoko Haruki, Yoshitsugu Inoue, Dai Miyazaki
Background
Atopic conditions are known to be associated with viral and bacterial infections. The purpose of this study was to determine the relationship between the effects of atopic conditions on the severity and recurrence of ocular infections including herpes simplex virus (HSV).
Methods
This study was performed on 474 consecutive patients with infectious keratitis caused by bacteria, fungus, acanthamoeba, HSV, or varicella-zoster virus. The relationships between the atopic condition and specific infectious pathogens and HSV were determined using real-time PCR.
Results
Our findings showed that atopic dermatitis (AD) was significantly associated with the incidence of HSV keratitis (odds ratio (OR), 10.2; P = 0.000). Other associations with AD were observed only with bacteria in an adverse manner. HSV proliferation in the lesions of patients with HSV keratitis whose AD was associated with non-infectious atopic blepharitis were significantly greater by 145-folds (P = 0.000). The presence of asthma or allergic rhinitis also increased the HSV DNA copy numbers.
A recurrence of HSV keratitis was observed in 70 patients (43.2 %), and mean time to recurrence was 1647 days. Cox proportional hazard model indicated that the epithelial type of HSV recurrence but not the stromal type was associated with atopic conditions especially with AD. The factors significantly associated with a recurrence was AD associated with non-infectious atopic blepharitis (HR: 6.11, P = 0.000) and asthma (HR: 3.03, P = 0.025).
Conclusions
Atopic conditions, especially AD with atopic blepharitis, are significantly associated with the development, increased proliferation, and shorter time to a recurrence on HSV keratitis.
{"title":"Effect of atopic conditions on development and recurrences of infectious keratitis","authors":"Yutaka Omatsu, Yumiko Shimizu, Tomoko Haruki, Yoshitsugu Inoue, Dai Miyazaki","doi":"10.1016/j.alit.2024.01.008","DOIUrl":"10.1016/j.alit.2024.01.008","url":null,"abstract":"<div><h3>Background</h3><p>Atopic conditions are known to be associated with viral and bacterial infections. The purpose of this study was to determine the relationship between the effects of atopic conditions on the severity and recurrence of ocular infections including herpes simplex virus (HSV).</p></div><div><h3>Methods</h3><p>This study was performed on 474 consecutive patients with infectious keratitis caused by bacteria, fungus, acanthamoeba, HSV, or varicella-zoster virus. The relationships between the atopic condition and specific infectious pathogens and HSV were determined using real-time PCR.</p></div><div><h3>Results</h3><p>Our findings showed that atopic dermatitis (AD) was significantly associated with the incidence of HSV keratitis (odds ratio (OR), 10.2; <em>P</em> = 0.000). Other associations with AD were observed only with bacteria in an adverse manner. HSV proliferation in the lesions of patients with HSV keratitis whose AD was associated with non-infectious atopic blepharitis were significantly greater by 145-folds (<em>P</em> = 0.000). The presence of asthma or allergic rhinitis also increased the HSV DNA copy numbers.</p><p>A recurrence of HSV keratitis was observed in 70 patients (43.2 %), and mean time to recurrence was 1647 days. Cox proportional hazard model indicated that the epithelial type of HSV recurrence but not the stromal type was associated with atopic conditions especially with AD. The factors significantly associated with a recurrence was AD associated with non-infectious atopic blepharitis (HR: 6.11, <em>P</em> = 0.000) and asthma (HR: 3.03, <em>P</em> = 0.025).</p></div><div><h3>Conclusions</h3><p>Atopic conditions, especially AD with atopic blepharitis, are significantly associated with the development, increased proliferation, and shorter time to a recurrence on HSV keratitis.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 3","pages":"Pages 445-452"},"PeriodicalIF":6.8,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893024000091/pdfft?md5=d84db142059e31636e8d5270112ecd33&pid=1-s2.0-S1323893024000091-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139679455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The association between pet exposure in infancy, early childhood eczema, and FLG mutations remains unclear.
Methods
This was a birth cohort study performed in Tokyo, Japan. The primary outcome was current eczema based on questionnaire responses collected repeatedly from birth to 5 years of age. Generalized estimating equations and generalized linear modeling were used to evaluate the association.
Results
Data from 1448 participants were used for analyses. Household dog ownership during gestation, early infancy, and 18 months of age significantly reduced the risk of current eczema. Household cat ownership also reduced the risk of current eczema, albeit without statistical significance. The combined evaluation of children from households with pets, be it cats, dogs or both, the risk of current eczema at 1–5 years of age was lower in those with household pet exposure ownership during gestation (RR = 0.59, 95 % CI 0.45–0.77) and at 6 months (RR = 0.49, 95 % CI 0.36–0.68). , Reduced risks of eczema were also observed at 2–5 (RR = 0.52, 95 % CI 0.37–0.73) and 3–5 years of age (RR = 0.50 95 % CI 0.35–0.74) when the respective household pet ownership were evaluated at 18 months and 3 years of age. These protective associations of reduced risk of eczema were only observed in children without FLG mutations.
Conclusions
Household dog and pet (dog, cat, or both) ownership was protective against early childhood eczema in a birth cohort dataset. This protective association was observed only in children without FLG mutations, which should be confirmed in studies with larger cohorts.
背景婴儿期接触宠物、儿童早期湿疹和FLG突变之间的关系仍不清楚。方法这是在日本东京进行的一项出生队列研究。主要结果是根据从出生到5岁期间反复收集的问卷调查结果得出的当前湿疹情况。结果对 1448 名参与者的数据进行了分析。在妊娠期、婴儿早期和 18 个月大时家中养狗可显著降低目前患湿疹的风险。养猫的家庭也能降低目前患湿疹的风险,尽管没有统计学意义。对有宠物(猫、狗或两者)家庭的儿童进行综合评估后发现,在妊娠期(RR = 0.59,95 % CI 0.45-0.77)和 6 个月大时(RR = 0.49,95 % CI 0.36-0.68)拥有家庭宠物的儿童在 1-5 岁时患湿疹的风险较低。在 2-5 岁(RR = 0.52,95 % CI 0.37-0.73)和 3-5 岁(RR = 0.50,95 % CI 0.35-0.74)时,如果分别在 18 个月和 3 岁时对家庭宠物拥有情况进行评估,也会发现湿疹风险降低。结论在一个出生队列数据集中,家庭养狗和宠物(狗、猫或两者)对儿童早期湿疹具有保护作用。只有在没有FLG基因突变的儿童中才能观察到这种保护作用,这一点应在更大规模的队列研究中得到证实。
{"title":"Influence of household pet ownership and filaggrin loss-of-function mutations on eczema prevalence in children: A birth cohort study","authors":"Kenji Toyokuni , Kiwako Yamamoto-Hanada , Limin Yang , Kouhei Hagino , Daisuke Harama , Marei Omori , Yasuaki Matsumoto , Daichi Suzuki , Kotaro Umezawa , Kazuma Takada , Mami Shimada , Seiko Hirai , Fumi Ishikawa , Sayaka Hamaguchi , Mayako Saito-Abe , Miori Sato , Yumiko Miyaji , Shigenori Kabashima , Tatsuki Fukuie , Emiko Noguchi , Yukihiro Ohya","doi":"10.1016/j.alit.2024.01.003","DOIUrl":"10.1016/j.alit.2024.01.003","url":null,"abstract":"<div><h3>Background</h3><p>The association between pet exposure in infancy, early childhood eczema, and <em>FLG</em> mutations remains unclear.</p></div><div><h3>Methods</h3><p>This was a birth cohort study performed in Tokyo, Japan. The primary outcome was current eczema based on questionnaire responses collected repeatedly from birth to 5 years of age. Generalized estimating equations and generalized linear modeling were used to evaluate the association.</p></div><div><h3>Results</h3><p>Data from 1448 participants were used for analyses. Household dog ownership during gestation, early infancy, and 18 months of age significantly reduced the risk of current eczema. Household cat ownership also reduced the risk of current eczema, albeit without statistical significance. The combined evaluation of children from households with pets, be it cats, dogs or both, the risk of current eczema at 1–5 years of age was lower in those with household pet exposure ownership during gestation (RR = 0.59, 95 % CI 0.45–0.77) and at 6 months (RR = 0.49, 95 % CI 0.36–0.68). , Reduced risks of eczema were also observed at 2–5 (RR = 0.52, 95 % CI 0.37–0.73) and 3–5 years of age (RR = 0.50 95 % CI 0.35–0.74) when the respective household pet ownership were evaluated at 18 months and 3 years of age. These protective associations of reduced risk of eczema were only observed in children without <em>FLG</em> mutations.</p></div><div><h3>Conclusions</h3><p>Household dog and pet (dog, cat, or both) ownership was protective against early childhood eczema in a birth cohort dataset. This protective association was observed only in children without <em>FLG</em> mutations, which should be confirmed in studies with larger cohorts.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 3","pages":"Pages 422-427"},"PeriodicalIF":6.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893024000042/pdfft?md5=202c0a6ec3a7cfef59bd87cde6b87e60&pid=1-s2.0-S1323893024000042-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139657030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Low-dose oral food challenge (LD-OFC) is an approach to avoid complete elimination in high-risk patients with wheat allergy (WA). We examined the 3-year prognosis after LD-OFC among patients who passed and failed LD-OFC.
Methods
Children with immediate-type WA aged ≤6 years with a history of reaction to ≤390 mg of wheat protein underwent their first LD-OFC with 52 mg (baseline LD-OFC). After passing the LD-OFC, children stepped up to 390, 1300, and 5200 mg step-by-step every 3–6 months. After failing LD-OFC, children repeated LD-OFC every 6–12 months. We assessed wheat tolerance defined as consuming 5200 mg without symptoms for 3 years after baseline LD-OFC.
Results
The median age of 124 children was 2.4 years, and the wheat- and ω-5-gliadin-specific immunoglobulin E (IgE) levels (kUA/L) were 23.6 and 2.1, respectively. Upon baseline LD-OFC, 57% passed (LD-tolerant), whereas 43% failed (LD-reactive). Within 3 years, 38% of the LD-reactive group passed re-administered LD-OFC, and 70% of all participants avoided complete elimination. The percentage of the participants who became capable of consuming 390 mg (87% vs. 18%), 1300 mg (78% vs. 13%), and acquired tolerance (70% vs. 13%) was significantly higher in the LD-tolerant group than in the LD-reactive group (p < 0.001). Predictors of persistent WA in the LD-tolerant group were older age (adjusted odds ratio, 1.63), ω-5-gliadin-specific IgE level (1.62 per 10-fold increase), and other food allergies (1.94).
Conclusions
LD-tolerant patients frequently acquired wheat tolerance within 3 years. Even if once positive, one-third could pass the re-administered LD-OFC within 3 years.
{"title":"Three-year prognosis after low-dose oral food challenge for children with wheat allergy","authors":"Takaaki Itonaga , Noriyuki Yanagida , Ken-ichi Nagakura , Tomoyuki Asaumi , Mai Tokunaga , Makoto Nishino , Kyohei Takahashi , Kiyotake Ogura , Sakura Sato , Motohiro Ebisawa","doi":"10.1016/j.alit.2024.01.004","DOIUrl":"10.1016/j.alit.2024.01.004","url":null,"abstract":"<div><h3>Background</h3><p>Low-dose oral food challenge (LD-OFC) is an approach to avoid complete elimination in high-risk patients with wheat allergy (WA). We examined the 3-year prognosis after LD-OFC among patients who passed and failed LD-OFC.</p></div><div><h3>Methods</h3><p>Children with immediate-type WA aged ≤6 years with a history of reaction to ≤390 mg of wheat protein underwent their first LD-OFC with 52 mg (baseline LD-OFC). After passing the LD-OFC, children stepped up to 390, 1300, and 5200 mg step-by-step every 3–6 months. After failing LD-OFC, children repeated LD-OFC every 6–12 months. We assessed wheat tolerance defined as consuming 5200 mg without symptoms for 3 years after baseline LD-OFC.</p></div><div><h3>Results</h3><p>The median age of 124 children was 2.4 years, and the wheat- and ω-5-gliadin-specific immunoglobulin E (IgE) levels (kU<sub>A</sub>/L) were 23.6 and 2.1, respectively. Upon baseline LD-OFC, 57% passed (LD-tolerant), whereas 43% failed (LD-reactive). Within 3 years, 38% of the LD-reactive group passed re-administered LD-OFC, and 70% of all participants avoided complete elimination. The percentage of the participants who became capable of consuming 390 mg (87% vs. 18%), 1300 mg (78% vs. 13%), and acquired tolerance (70% vs. 13%) was significantly higher in the LD-tolerant group than in the LD-reactive group (<em>p</em> < 0.001). Predictors of persistent WA in the LD-tolerant group were older age (adjusted odds ratio, 1.63), ω-5-gliadin-specific IgE level (1.62 per 10-fold increase), and other food allergies (1.94).</p></div><div><h3>Conclusions</h3><p>LD-tolerant patients frequently acquired wheat tolerance within 3 years. Even if once positive, one-third could pass the re-administered LD-OFC within 3 years.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 3","pages":"Pages 416-421"},"PeriodicalIF":6.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893024000054/pdfft?md5=0621f6990616f6bcdc79301e95b7e6a5&pid=1-s2.0-S1323893024000054-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The efficacy of macrolides in the management of asthma has been studied but remains controversial. We conducted a systematic review and meta-analysis of macrolides in the management of adult patients with asthma.
Methods
Randomized controlled trials of macrolides used in adult patients with asthma were searched for in MEDLINE, EMBASE, PsycINFO, Cochrane Library, CINAHL, and Igaku Chuo Zasshi databases to evaluate the efficacy and safety of macrolides.
Results
Seventeen reports with macrolide treatment durations ranging from 6 to 48 weeks were included. Macrolides did not reduce exacerbations requiring hospitalization, severe exacerbations, or rescue use of short-acting beta-2 agonist inhalers; improve lung function; decrease peripheral blood or sputum neutrophil counts; or decrease fractional exhaled nitric oxide compared to placebo. Macrolides statistically improved asthma control and quality of life but by less than the minimal clinically important difference. Peripheral blood eosinophil counts as well as serum and sputum eosinophilic cationic protein concentrations were significantly decreased with macrolides compared to placebo. The improvement of asthma symptoms and airway hyperresponsiveness varied by study. The safety profile of macrolides was comparable to that of placebo.
Conclusions
Although macrolides have some useful clinical aspects, there is not sufficient evidence to recommend their use in the management of adult patients with asthma.
背景对大环内酯类药物治疗哮喘的疗效进行了研究,但仍存在争议。方法在 MEDLINE、EMBASE、PsycINFO、Cochrane Library、CINAHL 和 Igaku Chuo Zasshi 等数据库中检索大环内酯类药物用于成人哮喘患者的随机对照试验,以评估大环内酯类药物的疗效和安全性。与安慰剂相比,大环内酯类药物不能减少需要住院治疗的病情加重、严重病情加重或短效β2受体激动剂吸入剂的抢救使用;不能改善肺功能;不能降低外周血或痰中中性粒细胞计数;也不能降低呼出一氧化氮的分数。据统计,大环内酯类药物可改善哮喘控制和生活质量,但改善幅度小于最小临床重要性差异。与安慰剂相比,大环内酯类药物能显著降低外周血嗜酸性粒细胞计数以及血清和痰中嗜酸性粒细胞阳离子蛋白浓度。不同研究对哮喘症状和气道高反应性的改善程度各不相同。大环内酯类药物的安全性与安慰剂相当。结论虽然大环内酯类药物在临床方面有一些作用,但没有足够的证据建议将其用于成年哮喘患者的治疗。
{"title":"A systematic review and meta-analysis of macrolides in the management of adult patients with asthma","authors":"Hiroshi Ohnishi , Toshihito Otani , Yoshihiro Kanemitsu , Tatsuya Nagano , Johsuke Hara , Masamitsu Eitoku","doi":"10.1016/j.alit.2024.01.002","DOIUrl":"10.1016/j.alit.2024.01.002","url":null,"abstract":"<div><h3>Background</h3><p>The efficacy of macrolides in the management of asthma has been studied but remains controversial. We conducted a systematic review and meta-analysis of macrolides in the management of adult patients with asthma.</p></div><div><h3>Methods</h3><p>Randomized controlled trials of macrolides used in adult patients with asthma were searched for in MEDLINE, EMBASE, PsycINFO, Cochrane Library, CINAHL, and Igaku Chuo Zasshi databases to evaluate the efficacy and safety of macrolides.</p></div><div><h3>Results</h3><p>Seventeen reports with macrolide treatment durations ranging from 6 to 48 weeks were included. Macrolides did not reduce exacerbations requiring hospitalization, severe exacerbations, or rescue use of short-acting beta-2 agonist inhalers; improve lung function; decrease peripheral blood or sputum neutrophil counts; or decrease fractional exhaled nitric oxide compared to placebo. Macrolides statistically improved asthma control and quality of life but by less than the minimal clinically important difference. Peripheral blood eosinophil counts as well as serum and sputum eosinophilic cationic protein concentrations were significantly decreased with macrolides compared to placebo. The improvement of asthma symptoms and airway hyperresponsiveness varied by study. The safety profile of macrolides was comparable to that of placebo.</p></div><div><h3>Conclusions</h3><p>Although macrolides have some useful clinical aspects, there is not sufficient evidence to recommend their use in the management of adult patients with asthma.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 3","pages":"Pages 382-389"},"PeriodicalIF":6.8,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893024000030/pdfft?md5=a7301f6e2f48b386084da43a70b70cbe&pid=1-s2.0-S1323893024000030-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139649337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.1016/j.alit.2024.01.001
Yung-Chi Chuang , Hsin-Hua Tsai , Meng-Chih Lin , Chao-Chien Wu , Yuan-Chung Lin , Tsu-Nai Wang
Background
Asthma has been identified as different phenotypes due to various risk factors. Age differences may have potential effects on asthma phenotypes. Our study aimed to identify potential asthma phenotypes among adults divided by age as either younger or older than 65 years. We also compared differences in blood granulocyte patterns, occupational asthmagens, and asthma control-related outcomes among patient phenotype clusters.
Methods
We recruited nonelderly (<65 years old) (n = 726) and elderly adults (≥65 years old) (n = 201) with mild-to-severe asthma. We conducted a factor analysis to select 17 variables. A two-step cluster analysis was used to classify subjects with asthma phenotypes, and a discriminant analysis was used to verify the classification of cluster results.
Results
There were three clusters with different characteristics identified in both the nonelderly and elderly asthmatic adults. In the nonelderly patient group, cluster 2 (obese, neutrophilic phenotypes) had a 1.85-fold significantly increased risk of asthma exacerbations. Cluster 3 (early-onset, atopy, and smoker with an eosinophil-predominant pattern) had a 2.37-fold risk of asthma exacerbations and higher oral corticosteroid (OCS) use than cluster 1 (late-onset and LMW exposure with paucigranulocytic blood pattern). Among elderly patients, cluster 2 had poor lung function and more ex-smokers. Cluster 3 (early-onset, long asthma duration) had the lowest paucigranulocytic blood pattern percentages in the elderly group.
Conclusions
The novelty of the clusters was found in age-dependent clusters. We identified three distinct phenotypes with heterogeneous characteristics, asthma exacerbations and medicine use in nonelderly and elderly asthmatic patients, respectively. Classification of age-stratified asthma phenotypes may lead to precise identification of patients, which provides personalized disease management.
{"title":"Cluster analysis of phenotypes, job exposure, and inflammatory patterns in elderly and nonelderly asthma patients","authors":"Yung-Chi Chuang , Hsin-Hua Tsai , Meng-Chih Lin , Chao-Chien Wu , Yuan-Chung Lin , Tsu-Nai Wang","doi":"10.1016/j.alit.2024.01.001","DOIUrl":"10.1016/j.alit.2024.01.001","url":null,"abstract":"<div><h3>Background</h3><p>Asthma has been identified as different phenotypes due to various risk factors. Age differences may have potential effects on asthma phenotypes. Our study aimed to identify potential asthma phenotypes among adults divided by age as either younger or older than 65 years. We also compared differences in blood granulocyte patterns, occupational asthmagens, and asthma control-related outcomes among patient phenotype clusters.</p></div><div><h3>Methods</h3><p>We recruited nonelderly (<65 years old) (n = 726) and elderly adults (≥65 years old) (n = 201) with mild-to-severe asthma. We conducted a factor analysis to select 17 variables. A two-step cluster analysis was used to classify subjects with asthma phenotypes, and a discriminant analysis was used to verify the classification of cluster results.</p></div><div><h3>Results</h3><p>There were three clusters with different characteristics identified in both the nonelderly and elderly asthmatic adults. In the nonelderly patient group, cluster 2 (obese, neutrophilic phenotypes) had a 1.85-fold significantly increased risk of asthma exacerbations. Cluster 3 (early-onset, atopy, and smoker with an eosinophil-predominant pattern) had a 2.37-fold risk of asthma exacerbations and higher oral corticosteroid (OCS) use than cluster 1 (late-onset and LMW exposure with paucigranulocytic blood pattern). Among elderly patients, cluster 2 had poor lung function and more ex-smokers. Cluster 3 (early-onset, long asthma duration) had the lowest paucigranulocytic blood pattern percentages in the elderly group.</p></div><div><h3>Conclusions</h3><p>The novelty of the clusters was found in age-dependent clusters. We identified three distinct phenotypes with heterogeneous characteristics, asthma exacerbations and medicine use in nonelderly and elderly asthmatic patients, respectively. Classification of age-stratified asthma phenotypes may lead to precise identification of patients, which provides personalized disease management.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 2","pages":"Pages 214-223"},"PeriodicalIF":6.8,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893024000017/pdfft?md5=398fe5a8aa343aacaee3ce4bfcaff518&pid=1-s2.0-S1323893024000017-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139586082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nasal congestion in allergic rhinitis (AR) is caused by vascular hyperpermeability and vascular relaxation of the nasal mucosa. We previously detected high levels of a lipoxygenation metabolite of dihomogammalinolenic acid, 15-hydroxy-8Z,11Z,13E-eicosatrienoic acid (15-HETrE) in the nasal lavage fluid of AR model mice. Here, we investigated the effects of 15-HETrE on vascular functions associated with nasal congestion.
Methods
We measured 15-HETrE levels in the nasal lavage fluid of ovalbumin-induced AR model mice and nasal discharge of patients with AR. We also assessed nasal congestion and vascular relaxation in mice. Vascular contractility was investigated using isolated mouse aortas.
Results
Five ovalbumin challenges increased 15-HETrE levels in AR model mice. 15-HETrE was also detected in patients who exhibiting AR-related symptoms. Intranasal administration of 15-HETrE elicited dyspnea-related behavior and decreased the nasal cavity volume in mice. Miles assay and whole-mount immunostaining revealed that 15-HETrE administration caused vascular hyperpermeability and relaxation of the nasal mucosa. Intravital imaging demonstrated that 15-HETrE relaxed the ear vessels that were precontracted via thromboxane receptor stimulation. Moreover, 15-HETrE dilated the isolated mouse aortas, and this effect was attenuated by K+ channel inhibitors and prostaglandin D2 (DP) and prostacyclin (IP) receptor antagonists. Additionally, vasodilatory effects of 15-HETrE were accompanied by an increase in intracellular cAMP levels.
Conclusions
Our results indicate that 15-HETrE, whose levels are elevated in the nasal cavity upon AR, can be a novel lipid mediator that exacerbates nasal congestion. Moreover, it can stimulate DP and IP receptors and downstream K+ channels to dilate the nasal mucosal vasculature.
背景:过敏性鼻炎(AR)的鼻塞是由鼻粘膜血管高渗透性和血管松弛引起的。我们以前曾在 AR 模型小鼠的鼻腔灌洗液中检测到高浓度的二氢骆驼蓬烯酸脂氧代谢产物--15-羟基-8Z,11Z,13E-二十碳三烯酸(15-HETrE)。在此,我们研究了 15-HETrE 对与鼻塞相关的血管功能的影响:方法:我们测量了卵清蛋白诱导的 AR 模型小鼠鼻腔灌洗液和 AR 患者鼻腔分泌物中的 15-HETrE 水平。我们还评估了小鼠的鼻塞和血管松弛情况。使用离体小鼠主动脉对血管收缩性进行了研究:结果:五次卵清蛋白挑战增加了 AR 模型小鼠的 15-HETrE 水平。在出现 AR 相关症状的患者体内也检测到了 15-HETrE。鼻内注射 15-HETrE 会引起小鼠呼吸困难相关行为,并减少鼻腔容积。迈尔斯测定和全图免疫染色显示,15-HETrE 会导致血管高渗透性和鼻黏膜松弛。肉眼成像显示,15-HETrE 使预先收缩的耳血管在血栓素受体的刺激下松弛。此外,15-HETrE 还能扩张离体小鼠主动脉,K+ 通道抑制剂、前列腺素 D2(DP)和前列环素(IP)受体拮抗剂可减轻这种效应。此外,15-HETrE 的血管扩张作用还伴随着细胞内 cAMP 水平的增加:我们的研究结果表明,15-HETrE 是一种新型脂质介质,可加剧鼻塞。此外,它还能刺激 DP 和 IP 受体及下游 K+ 通道,从而扩张鼻粘膜血管。
{"title":"15-Hydroxyeicosatrienoic acid induces nasal congestion by changing vascular functions in mice","authors":"Noriko Ozaki , Naoaki Sakamoto , Daiki Horikami , Yuri Tachibana , Nanae Nagata , Koji Kobayashi , Yoshino Taira Arai , Masayoshi Sone , Kazuhiro Hirayama , Takahisa Murata","doi":"10.1016/j.alit.2023.12.007","DOIUrl":"10.1016/j.alit.2023.12.007","url":null,"abstract":"<div><h3>Background</h3><p>Nasal congestion in allergic rhinitis (AR) is caused by vascular hyperpermeability and vascular relaxation of the nasal mucosa. We previously detected high levels of a lipoxygenation metabolite of dihomogammalinolenic acid, 15-hydroxy-8Z,11Z,13E-eicosatrienoic acid (15-HETrE) in the nasal lavage fluid of AR model mice. Here, we investigated the effects of 15-HETrE on vascular functions associated with nasal congestion.</p></div><div><h3>Methods</h3><p>We measured 15-HETrE levels in the nasal lavage fluid of ovalbumin-induced AR model mice and nasal discharge of patients with AR. We also assessed nasal congestion and vascular relaxation in mice. Vascular contractility was investigated using isolated mouse aortas.</p></div><div><h3>Results</h3><p>Five ovalbumin challenges increased 15-HETrE levels in AR model mice. 15-HETrE was also detected in patients who exhibiting AR-related symptoms. Intranasal administration of 15-HETrE elicited dyspnea-related behavior and decreased the nasal cavity volume in mice. Miles assay and whole-mount immunostaining revealed that 15-HETrE administration caused vascular hyperpermeability and relaxation of the nasal mucosa. Intravital imaging demonstrated that 15-HETrE relaxed the ear vessels that were precontracted via thromboxane receptor stimulation. Moreover, 15-HETrE dilated the isolated mouse aortas, and this effect was attenuated by K<sup>+</sup> channel inhibitors and prostaglandin D<sub>2</sub> (DP) and prostacyclin (IP) receptor antagonists. Additionally, vasodilatory effects of 15-HETrE were accompanied by an increase in intracellular cAMP levels.</p></div><div><h3>Conclusions</h3><p>Our results indicate that 15-HETrE, whose levels are elevated in the nasal cavity upon AR, can be a novel lipid mediator that exacerbates nasal congestion. Moreover, it can stimulate DP and IP receptors and downstream K<sup>+</sup> channels to dilate the nasal mucosal vasculature.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 3","pages":"Pages 464-472"},"PeriodicalIF":6.8,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893024000029/pdfft?md5=383aded651e40fe9aefb4d9b4ba09302&pid=1-s2.0-S1323893024000029-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-17DOI: 10.1016/j.alit.2023.12.005
Jungho Ahn , Seungyong Shin , Gi Chun Lee , Bo Eun Han , Eun Lee , Eun Kyo Ha , Jeewon Shin , Won Seok Lee , Ju Hee Kim , Man Yong Han
Background
Atopic dermatitis and autoimmune diseases are highly heritable conditions that may co-occur from an early age.
Methods
The primary study is a national administrative cohort study involving 499,428 children born in 2002, tracked until 2017. Atopic dermatitis was defined as five or more principal diagnoses of atopic dermatitis and two or more topical steroid prescriptions. We estimated the risks for the occurrence of 41 autoimmune diseases, controlling for risk factors. In addition, we sourced a gene library from the National Library of Medicine to conduct a comprehensive gene ontology. We used Gene Weaver to identify gene set similarity and clustering, and used GeneMania to generate a network for shared genes.
Results
Exposed and unexposed groups included 39,832 and 159,328 children, respectively. During a mean follow-up of 12 years, the exposed group had an increased risk of autoimmune disease (hazard ratio, 1.27 [95 % confidence interval, 1.23–1.32]) compared to the unexposed group. The hazard ratios of autoimmune illnesses consistently increased with two- and five years lag times and alternative atopic dermatitis definitions. Shared genes between atopic dermatitis and autoimmune diseases were associated with comorbidities such as asthma, bronchiolitis, and specific infections. Genetic interactions of these shared genes revealed clustering in Th1, Th2, Th17, and non-classifiable pathways.
Conclusions
Atopic dermatitis was significantly associated with an increased risk of subsequent autoimmune disease. we identified the genetically associated disease in atopic dermatitis patients comorbid with autoimmune disease and demonstrated a genetic network between atopic dermatitis and autoimmune diseases.
{"title":"Unraveling the link between atopic dermatitis and autoimmune diseases in children: Insights from a large-scale cohort study with 15-year follow-up and shared gene ontology analysis","authors":"Jungho Ahn , Seungyong Shin , Gi Chun Lee , Bo Eun Han , Eun Lee , Eun Kyo Ha , Jeewon Shin , Won Seok Lee , Ju Hee Kim , Man Yong Han","doi":"10.1016/j.alit.2023.12.005","DOIUrl":"10.1016/j.alit.2023.12.005","url":null,"abstract":"<div><h3>Background</h3><p>Atopic dermatitis and autoimmune diseases are highly heritable conditions that may co-occur from an early age.</p></div><div><h3>Methods</h3><p>The primary study is a national administrative cohort study involving 499,428 children born in 2002, tracked until 2017. Atopic dermatitis was defined as five or more principal diagnoses of atopic dermatitis and two or more topical steroid prescriptions. We estimated the risks for the occurrence of 41 autoimmune diseases, controlling for risk factors. In addition, we sourced a gene library from the National Library of Medicine to conduct a comprehensive gene ontology. We used Gene Weaver to identify gene set similarity and clustering, and used GeneMania to generate a network for shared genes.</p></div><div><h3>Results</h3><p>Exposed and unexposed groups included 39,832 and 159,328 children, respectively. During a mean follow-up of 12 years, the exposed group had an increased risk of autoimmune disease (hazard ratio, 1.27 [95 % confidence interval, 1.23–1.32]) compared to the unexposed group. The hazard ratios of autoimmune illnesses consistently increased with two- and five years lag times and alternative atopic dermatitis definitions. Shared genes between atopic dermatitis and autoimmune diseases were associated with comorbidities such as asthma, bronchiolitis, and specific infections. Genetic interactions of these shared genes revealed clustering in Th1, Th2, Th17, and non-classifiable pathways.</p></div><div><h3>Conclusions</h3><p>Atopic dermatitis was significantly associated with an increased risk of subsequent autoimmune disease. we identified the genetically associated disease in atopic dermatitis patients comorbid with autoimmune disease and demonstrated a genetic network between atopic dermatitis and autoimmune diseases.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 2","pages":"Pages 243-254"},"PeriodicalIF":6.8,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893023001405/pdfft?md5=93065ae56f068b77c7bede44f12e2397&pid=1-s2.0-S1323893023001405-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N-3 polyunsaturated fatty acids (PUFAs) have anti-inflammatory properties and are expected to prevent the onset of allergies. However, epidemiological studies investigating the relationship between child allergies and maternal intake of n-3 PUFAs or fish have yielded inconsistent results.
Methods
Following exclusions from a dataset comprising 103,057 records from the Japan Environment and Children's Study, 72,105 participants were divided into five groups according to mothers' intake of n-3 PUFAs or fish during pregnancy to assess the risk of their children being diagnosed with allergy by 3 years old. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for child allergies were calculated using multivariable logistic regression analyses with reference to the lowest intake group.
Results
Levels of maternal intake of n-3 PUFAs or fish showed inverted associations (i.e., reduced risk) with the incidence of physician-diagnosed allergic rhinoconjunctivitis or parent-reported symptoms of current rhinitis with eye symptoms at different time points and the cumulative incidence from birth to 3 years of age. Inverted associations were also found for current wheeze at 1-<2 years of age and current eczema at 1-<2 and 0-<3 years of age. However, for food allergies, no significant associations were observed in the incidence in each group compared with the lowest intake group at any age.
Conclusions
The findings suggest that n-3 PUFA intake during pregnancy may reduce the risk of developing allergic diseases and symptoms in children. In addition, consumption of n-3 PUFAs or fish is very unlikely to increase the risk of allergy given that the results are from a country with high fish consumption. Trial registration: UMIN000030786 https://rctportal.niph.go.jp/detail/um?trial_id=UMIN000030786.
{"title":"Association of allergies in children younger than 3 years with levels of maternal intake of n-3 polyunsaturated fatty acids or fish during pregnancy: A nationwide birth cohort study, the Japan Environment and Children's Study","authors":"Sayaka Tsuji , Yuichi Adachi , Akiko Tsuchida , Kei Hamazaki , Kenta Matsumura , Hidekuni Inadera","doi":"10.1016/j.alit.2023.12.004","DOIUrl":"10.1016/j.alit.2023.12.004","url":null,"abstract":"<div><h3>Background</h3><p>N-3 polyunsaturated fatty acids (PUFAs) have anti-inflammatory properties and are expected to prevent the onset of allergies. However, epidemiological studies investigating the relationship between child allergies and maternal intake of n-3 PUFAs or fish have yielded inconsistent results.</p></div><div><h3>Methods</h3><p>Following exclusions from a dataset comprising 103,057 records from the Japan Environment and Children's Study, 72,105 participants were divided into five groups according to mothers' intake of n-3 PUFAs or fish during pregnancy to assess the risk of their children being diagnosed with allergy by 3 years old. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for child allergies were calculated using multivariable logistic regression analyses with reference to the lowest intake group.</p></div><div><h3>Results</h3><p>Levels of maternal intake of n-3 PUFAs or fish showed inverted associations (i.e., reduced risk) with the incidence of physician-diagnosed allergic rhinoconjunctivitis or parent-reported symptoms of current rhinitis with eye symptoms at different time points and the cumulative incidence from birth to 3 years of age. Inverted associations were also found for current wheeze at 1-<2 years of age and current eczema at 1-<2 and 0-<3 years of age. However, for food allergies, no significant associations were observed in the incidence in each group compared with the lowest intake group at any age.</p></div><div><h3>Conclusions</h3><p>The findings suggest that n-3 PUFA intake during pregnancy may reduce the risk of developing allergic diseases and symptoms in children. In addition, consumption of n-3 PUFAs or fish is very unlikely to increase the risk of allergy given that the results are from a country with high fish consumption. <em>Trial registration</em>: UMIN000030786 <span>https://rctportal.niph.go.jp/detail/um?trial_id=UMIN000030786</span><svg><path></path></svg>.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 2","pages":"Pages 282-289"},"PeriodicalIF":6.8,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893023001399/pdfft?md5=a8dfb91dcfe73f986ecbddd82c6cd71d&pid=1-s2.0-S1323893023001399-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139464561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}