Journal of Investigational Allergology and Clinical Immunology最新文献

Background and objectives: Pollen-food allergy syndrome (PFAS) is a frequent comorbidity in individuals with hay fever. Identifying risk factors and allergen clusters can aid targeted interventions and management strategies. Objective: This study characterizes PFAS in patients with hay fever and identifies associated risk factors using the mobile health platform, AllerSearch.

Methods: A digital cross-sectional cohort study was conducted in Japan from August 2020 to September 2024. Participants provided demographic, medical, lifestyle, and environmental data via AllerSearch. PFAS was identified based on self-reported allergic reactions to specific fruits and vegetables. Allergen patterns were analyzed using Uniform Manifold Approximation and Projection clustering, and risk factors were assessed via multivariable logistic regression.

Results: Among 2874 participants, 2352 had hay fever, and 1788 (23.9%) reported PFAS. The most common triggers were melon (22.9%), kiwi (18.3%), and tomato (11.7%). Significant risk factors included a history of allergic disease (OR, 1.58), asthma (1.44), atopic dermatitis (1.90), urticaria (2.73), contact lens discontinuation during hay fever season (1.50), sensitivity to yellow sand or particulate matter 2.5 (3.42), and drug allergy (3.04). Seven allergen clusters were identified, with Cluster 6 exhibiting broad allergen sensitivity and the remaining clusters each associated with a single food. Onset of hay fever was earlier in Clusters 1, 4, and 6 than in non-PFAS individuals (P=.002, P=.002, and P=.002, respectively).

Conclusions: This study highlights key factors and allergen clusters associated with PFAS using a mobile health approach. Our findings may facilitate tailored interventions and improve quality of life for affected individuals.

Background: Dynamic hyperinflation (DH), characterized by an abnormal increase in operative lung volumes during exercise, is associated with breathlessness and exercise intolerance. This study aimed to evaluate the relationship between DH and control of symptoms in patients with moderate-severe asthma.

Methods: A cross-sectional, multicenter, observational study was conducted in patients with moderate-severe asthma. DH was defined as a decrease in inspiratory capacity after a 6-minute walk test (6MWT), and asthma control was measured using the Asthma Control Test (ACT) and Spanish Guidelines for the Management of Asthma (GEMA). Secondary variables included sensitization to aeroallergens (prick test), quality of life (miniAQLQ), anxiety or depression, dyspnea (mMRC), fatigue (Borg scale), and small airway dysfunction (oscillometry).

Results: Among the 154 patients analyzed, 97 (63%) had DH. ACT scores did not differ significantly between patients with and without DH (20.8 [4.4] vs 21.7 [3.6]; P=.411). However, the percentage of patients with partially and poorly controlled asthma according to GEMA was significantly higher in the DH group than in those without DH (40.2% vs 24.6%; P=.048). Compared with patients without DH, patients with DH had higher dyspnea scores (0.9 [0.9] vs 0.5 [0.6]; P=.009), greater fatigue before the 6MWT (1.3 [1.9] vs 0.5 [1.1]; P=.004), higher respiratory reactance (0.7 [1.2] vs 0.4 [1.2] cmH2O/L/s; P=.032), higher depression scores (4.2 [3.7] vs 2.1 [2.1], P=.002), and lower sensitization to aeroallergens (45.4% vs 68.4%; P=.014).

Conclusions: Although no relationship was found between DH and uncontrolled asthma via the ACT, the proportion of patients with uncontrolled asthma according to GEMA was significantly higher in the DH group.

Background: Bilastine is a second-generation antihistamine for the symptomatic treatment of allergic rhinoconjunctivitis (ARC) and urticaria in adults, adolescents, and children. The pharmacokinetics and safety of oral bilastine 10 mg/d in children aged 2 to 5 years were evaluated.

Methods: This was a multicenter, open-label clinical trial in children aged 2 to 5 years with seasonal or perennial ARC or urticaria treated once daily with bilastine 10 mg orodispersible tablets. The safety evaluation included treatment-emergent adverse events (TEAEs), vital signs, and physical examination. Pharmacokinetic data were pooled with data from a prior pediatric study, and pharmacokinetic modeling was performed to assess consistency.

Results: A total of 37 children with ARC (81.1%), urticaria (8.1%), or both (10.8%) were included in the study, with a mean (SD) age of 3.7 (1.2) years. The highest plasma concentrations of bilastine were observed 1 hour after administration (634.91 ng/mL). Eight patients (21.6%) experienced 1 TEAE each, none of which was severe. Body weight and age were not covariates of variation in either systemic clearance or the volume of distribution in children aged 2 to 5 years and did not affect the pharmacokinetic parameters of bilastine.

Conclusions: The pharmacokinetics of bilastine was linear and consistent with data from a previous trial, suggesting that a 10-mg dose may be used in children (2 to <12 years). No dose adjustments are deemed necessary. Oral once-daily bilastine 10 mg presented a good safety profile in children aged 2 to 5.

Allergic diseases affect up to 40% of adults worldwide, a percentage that is increasing with environmental changes related to global warming. A systematic review of the literature was performed to identify and evaluate current evidence of the effect of climate change-related environmental factors on the prevalence, incidence, and severity of allergic diseases in terms of the impact on patients with allergy. PECO criteria for 2 research questions were established and guided the literature searches of the PubMed and Cochrane databases (January 1, 2016 to December 31, 2021). Study outcomes were categorized and grouped to facilitate data synthesis. Outcomes were classified as significant (P<.05), nonsignificant (P>.05), or undetermined (P value not reported). Assessment of the 2 questions enabled us to identify 609 publications. Of these, 96 were assessed for eligibility and 42 provided data. Environmental factors, including the presence of pollutants, influenced patients' conditions in terms of effects on allergy, exposure to allergen(s), and the immune system. The pollutants most frequently reported to have an impact were nitrogen dioxide (NO2) and particles <2.5 μm in diameter. The allergic diseases most frequently reported to be affected by environmental factors were respiratory disease (asthma and rhinitis) and atopic dermatitis, with an impact on epidemiology and health care burden. Environmental pollution increased the frequency and health care burden of allergic diseases. The effect of environmental pollution was predominantly caused by pollutants such as NO2 and particles <2.5 μm in diameter and was observed across allergic diseases, including respiratory disease (asthma and rhinitis) and atopic dermatitis.