World Allergy Organization Journal最新文献

Eosinophilic esophagitis and allergic susceptibility: A systematic review and meta-analysis 嗜酸性粒细胞性食管炎和过敏易感性：一项系统回顾和荟萃分析

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2025-04-25 DOI: 10.1016/j.waojou.2025.101054

Ruoyu Ji MD (Doctor of Medicine) , Xiangyi Cui MM (Master of Medicine) , Yuxiang Zhi MD (Doctor of Medicine)

Background

Eosinophilic esophagitis (EoE) is a type 2 helper T (Th2) cell immune-mediated gastrointestinal disease. Accumulating evidence has supported allergic etiology as an underlying mechanism for EoE, but the magnitude of the correlation between EoE and atopy remains ambiguous. Hence, we performed a meta-analysis to evaluate and compare the rate of co-existing common atopic diseases between EoE and non-EoE patients.

Methods

We searched through electronic databases and reference lists of review articles for studies describing co-existing rates of atopic diseases in EoE and non-EoE patients. EoE was diagnosed based on clinical and pathological evaluations. Risk of bias was assessed using the modified Newcastle-Ottawa Scale. Random-effects models were used for analyses. Quantitative results were presented as odds ratio (OR) and 95% confidence interval (CI). Subgroup analyses and sensitivity analyses were performed to explore and to identify heterogeneity across studies. Publication bias was examined by Egger's test and visualized by funnel plots.

Results

Altogether, 27 studies containing 1831 cases and 2982 controls were enrolled. 57.2% of EoE patients had co-existing atopic disease. Patients with EoE were more likely to comorbid with atopic diseases (OR = 3.56, 95% CI: 2.27 to 5.59, I² = 78%), including asthma (OR = 2.43, 95% CI: 1.94 to 3.06, I² = 29%), allergic rhinitis (OR = 5.39, 95% CI: 3.29 to 8.84, I² = 78%), atopic dermatitis (OR = 2.46, 95% CI: 1.89 to 2.30, I² = 12%) and food allergy (OR = 4.93, 95% CI: 3.96 to 6.14, I² = 0%) than non-EoE controls. Heterogeneity sources were explored and identified via subgroup and sensitivity analyses, with the majority of subgroup estimates aligning with the primary findings. No significant publication bias was detected.

Conclusions

Our findings suggest that EoE patients are more likely to comorbid atopic diseases, favoring the allergic diathesis of EoE. Clinicians should be alert for EoE in allergic patients having upper gastrointestinal symptoms. However, the causality between EoE and atopic diseases was not revealed and remains to be explored.

嗜酸性粒细胞性食管炎（EoE）是一种2型辅助性T （Th2）细胞免疫介导的胃肠道疾病。越来越多的证据支持过敏病因是EoE的潜在机制，但EoE与特应性之间的相关性程度仍不明确。因此，我们进行了一项荟萃分析，以评估和比较EoE和非EoE患者之间共存的常见特应性疾病的发生率。方法通过电子数据库和文献综述检索描述EoE和非EoE患者特应性疾病共存率的研究。根据临床和病理评价诊断为EoE。偏倚风险采用改良的纽卡斯尔-渥太华量表进行评估。随机效应模型用于分析。定量结果以比值比（OR）和95%置信区间（CI）表示。进行亚组分析和敏感性分析以探索和确定研究之间的异质性。发表偏倚采用Egger检验，并采用漏斗图可视化。结果共纳入27项研究，纳入病例1831例，对照组2982例。57.2%的EoE患者并发特应性疾病。与非EoE对照相比，EoE患者更容易合并特应性疾病（OR = 3.56, 95% CI: 2.27 ~ 5.59, I2 = 78%），包括哮喘（OR = 2.43, 95% CI: 1.94 ~ 3.06, I2 = 29%）、变应性鼻炎（OR = 5.39, 95% CI: 3.29 ~ 8.84, I2 = 78%）、特应性皮炎（OR = 2.46, 95% CI: 1.89 ~ 2.30, I2 = 12%）和食物过敏（OR = 4.93, 95% CI: 3.96 ~ 6.14, I2 = 0%）。通过亚组和敏感性分析探索和确定异质性来源，大多数亚组估计与主要发现一致。未发现显著的发表偏倚。结论EoE患者更易并发特应性疾病，有利于EoE患者的过敏素质。临床医生应警惕有上消化道症状的过敏患者的EoE。然而，EoE与特应性疾病之间的因果关系尚未揭示，仍有待探索。

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引用次数: 0

ARIA–Italy managing allergic rhinitis and asthma in a changing world: The role of the Pharmacist 意大利管理过敏性鼻炎和哮喘在一个不断变化的世界：药剂师的作用

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2025-04-25 DOI: 10.1016/j.waojou.2025.101055

Giovanni Paoletti Dr. M.D. , Corrado Giua Prof. Pharm.D. , Alessandro Marti Dr. M.D. , Matteo Alberto Baio Dr. Pharm. , Nicolò Valli Dr. M.D. , Erminia Ridolo Prof. M.D. , Maria Teresa Ventura Prof. M.D. , Giovanni Passalacqua Prof. M.D. , Francesca Puggioni Dr. M.D. , Olga Lourenço Dr. Pharm. , Jean Bousquet Prof. M.D., Ph.D. , Giorgio Walter Canonica Prof. M.D. , Enrico Heffler Prof. M.D., Ph.D. , Carlo Lombardi Dr. M.D.

Allergic rhinitis (AR) and asthma are common respiratory disorders that often occur together, affecting quality of life and increasing healthcare expenses of patients.

These chronic illnesses are often managed without medical supervision, creating distinct challenges. A lack of resources can limit regular follow-up, which in turn promotes disease mismanagement and an increased reliance on self-medication, including the inappropriate use of corticosteroids and nasal decongestants. Community pharmacies could serve as critical primary healthcare providers, facilitating AR and asthma management by promoting therapy adherence, minimizing drug misuse, and improving symptom monitoring using digital tools.

The evolving role of pharmacists as vital healthcare team members is highlighted by their involvement in screening, prevention, and patient education, particularly in underserved communities. Strengthening the partnerships between pharmacists, physicians, and patients may lead to more tailored and effective management strategies. This collaborative approach has demonstrated promise in enhancing disease outcomes and reducing healthcare costs.

变应性鼻炎（Allergic rhinitis， AR）和哮喘是常见的呼吸系统疾病，常同时发生，影响患者的生活质量，增加患者的医疗费用。这些慢性疾病通常在没有医疗监督的情况下进行管理，造成了明显的挑战。缺乏资源可能会限制定期随访，这反过来又会导致疾病管理不善，并增加对自我用药的依赖，包括不适当使用皮质类固醇和鼻减充血剂。社区药房可以作为关键的初级卫生保健提供者，通过促进治疗依从性、最大限度地减少药物滥用和改善使用数字工具的症状监测，促进AR和哮喘管理。药剂师作为重要的医疗团队成员的作用不断发展，他们参与筛查，预防和患者教育，特别是在服务不足的社区。加强药剂师、医生和患者之间的伙伴关系可能会导致更有针对性和更有效的管理策略。这种协作方法在改善疾病结果和降低医疗保健成本方面表现出了希望。

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引用次数: 0

Impact of 2018 Japan floods on allergic rhinitis prescriptions 2018年日本洪水对过敏性鼻炎处方的影响

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2025-04-23 DOI: 10.1016/j.waojou.2025.101051

Hanae Konishi MD , Hiroshi Iwamoto MD, PhD , Shuhei Yoshida MD, PhD , Yasushi Horimasu MD, PhD , Shinichiro Ohshimo MD, PhD , Kota Takemoto MD, PhD , Noboru Hattori MD, PhD , Sachio Takeno MD, PhD , Masatoshi Matsumoto MD, PhD

Background

Climate change and natural disasters can impact allergic conditions. The 2018 Japan floods, which occurred in July 2018, were among the largest water-related disasters in Japan's history. We aimed to investigate the impact of flooding on prescription rates for allergic rhinitis.

Methods

This retrospective cohort study utilized data from the National Database of Health Insurance Claims from 1 year before and after the flood in the most severely affected region. Individuals with a victim code certified by local authorities were categorized into the victim group, whereas the others were classified into the non-victim group. A difference-in-differences analysis with a logistic regression model was employed to evaluate the impact of the disaster on prescription rates of corticosteroids or antihistamine nasal sprays. Cedar and cypress pollen (the major allergens causing seasonal rhinitis during spring in Japan) counts were measured using a rotary-type pollen collector.

Results

Among 6,176,299 individuals included, 36,076 were identified as flood victims. An upward trend in prescriptions was observed during the cedar and cypress pollen season from February to April, and the pattern of higher prescriptions among disaster victims relative to non-victims continued throughout both the pollen and non-pollen seasons after the disaster. The difference-in-differences analysis indicated a significant increase in nasal spray prescription in disaster victims compared with non-victims, with adjusted odds ratios of 1.40 (95% confidence interval: 1.24–1.58) 3 months after the disaster and 1.72 (95% confidence interval: 1.56–1.95) 1 year after. Subgroup analyses showed that the prescription rates of nasal spray significantly increased across all age groups and in both males and females among disaster victims compared to non-victims.

Conclusions

This study demonstrated a long-term increase in prescriptions for allergic rhinitis among flood victims, underscoring the need to recognize natural disasters as potential contributors to the incidence of allergic rhinitis.

气候变化和自然灾害会影响过敏状况。2018年7月发生的2018年日本洪水是日本历史上最大的水灾之一。我们旨在调查洪水对变应性鼻炎处方率的影响。方法回顾性队列研究利用受灾最严重地区洪水前后一年的国家健康保险索赔数据库数据。拥有地方当局认证的受害者代码的个人被归类为受害者组，而其他个人则被归类为非受害者组。采用logistic回归模型的差异分析来评估灾难对皮质类固醇或抗组胺鼻喷雾剂处方率的影响。雪松和柏树花粉（日本春季引起季节性鼻炎的主要过敏原）计数使用旋转式花粉收集器进行测量。结果在6176299人中，有36076人被确定为洪水受害者。2 ~ 4月雪松和柏树花粉季节处方量呈上升趋势，灾后花粉季节和非花粉季节受灾者处方量均高于非受灾者。差异中异数分析显示，灾害受害者与非受害者相比，鼻喷雾剂处方显著增加，灾后3个月调整优势比为1.40(95%置信区间：1.24-1.58)，灾后1年调整优势比为1.72（95%置信区间：1.56-1.95）。亚组分析显示，与非受害者相比，所有年龄组以及受灾男女的鼻喷雾剂处方率都显著增加。结论：本研究表明，洪水灾民的变应性鼻炎处方长期增加，强调有必要认识到自然灾害是变应性鼻炎发病率的潜在因素。

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引用次数: 0

Monitoring, distribution and clinical relevance of airborne pollen and fern spores in Southeast Asia – A systematic review 东南亚空气中花粉和蕨类孢子的监测、分布和临床相关性——系统综述

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2025-04-23 DOI: 10.1016/j.waojou.2025.101053

Ngoc Thi Pham MSc , Asad Siddiquee MSc , Maureen Sabit PhD , Łukasz Grewling PhD

Southeast Asia is witnessing a rapid increase in the prevalence of allergic diseases, including asthma and allergic rhinitis. Pollen grains stand out as one of the primary triggers for allergy, and monitoring aeroallergens plays a pivotal role in allergy prevention. However, our understanding of the diversity and abundance of allergenic pollen in tropical regions, as well as their clinical significance, remains limited. This review aims to address this issue by identifying the most potentially allergenic plants in Southeast Asia, examining sensitization rates to their pollen allergens, describing the dynamics of pollen seasons, and discussing the current state of aerobiological monitoring in the region. The selection of plants was conducted through a systematic review process (following PRISMA guidelines), by screening the Scopus and PubMed databases, and focusing on studies that provided clinical and aerobiological data. As a result, 73 studies related to pollen allergy in Southeast Asia were identified and reviewed. The list of potentially allergenic plants posing the highest risk in Southeast Asia has been narrowed down to 10, including 5 woody species, 2 primarily weed families, grasses, palms, and ferns. The descriptions of these plants are supplemented with information on their ecology, pollen seasons dynamics, and clinical significance.

在东南亚，包括哮喘和过敏性鼻炎在内的过敏性疾病的发病率正在迅速上升。花粉粒是过敏的主要诱因之一，监测空气过敏原在预防过敏中起着至关重要的作用。然而，我们对热带地区致敏花粉的多样性和丰度及其临床意义的了解仍然有限。本文旨在通过识别东南亚最具潜在致敏性的植物，研究其花粉过敏原的致敏率，描述花粉季节的动态，并讨论该地区当前的有氧生物监测状况，来解决这一问题。植物的选择是通过系统的审查过程（遵循PRISMA指南）进行的，通过筛选Scopus和PubMed数据库，并重点关注提供临床和空气生物学数据的研究。结果，在东南亚地区发现并回顾了73项与花粉过敏相关的研究。在东南亚造成最高风险的潜在过敏植物名单已经缩小到10个，包括5个木本物种，2个主要的杂草科，草，棕榈和蕨类植物。对这些植物的描述补充了它们的生态学、花粉季节动态和临床意义的信息。

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引用次数: 0

Surveys on the prevalence of pediatric asthma in Japan: A comparison between the 1982, 1992, 2002, 2012, and 2022 surveys conducted in the same region using the same methodology (WJSAAC PhaseⅠ∼Ⅴ) 日本儿童哮喘患病率调查：1982年、1992年、2002年、2012年和2022年在同一地区使用相同方法进行的调查的比较（WJSAAC阶段Ⅰ~Ⅴ）

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2025-04-23 DOI: 10.1016/j.waojou.2025.101052

Sankei Nishima MD, PhD , Junichiro Tezuka MD, PhD , Hiroshi Odajima MD, PhD , Hiroshi Matsuzaki MD , Satoshi Honjo MD, PhD, MSc , Kunitaka Ota MD, PhD , Yuji Gohda MD , Kazuyoshi Koga MD , Keijiro Tsuda MD , Yoshiaki Kanaya MD, PhD , Shuich Yamamoto MD, PhD , Shinji Aratake MD , Tatsuo Koga MD, PhD , Ayako Sakamoto MD , Yasushi Shimada MD, PhD , Kasumi Tashiro MD , Kazunari Fukahori MD , Shinpei Sunagawa MD, PhD , Hiroki Yamamoto MD , Hiroyuki Matsuzaki MD , Zenji Miyazato MD

Objectives

To investigate the trends in the prevalence of pediatric asthma in the western part of Japan over 40 years, using data from surveys conducted every 10 years from 1982 to 2022.

Design

A series of school-based epidemiological surveys conducted every 10 years.

Setting

Elementary schools in 11 prefectures in the western part of Japan.

Participants

Children aged 6–12 years. Surveys included 55,388 children in 1982, 46,718 in 1992, 36,228 in 2002, 33,902 in 2012, and 30,024 in 2022.

Main outcome measures

Prevalence of asthma, wheeze, and other allergic diseases such as allergic rhinitis, atopic dermatitis, and food allergies.

Results

The prevalence of asthma increased from 1982 to 2002 (boys: 3.8%–8.1%; girls: 2.5%–5.0%) and then decreased in 2012 and 2022 (boys: 6.0%–3.2%; girls: 3.5%–2.1%). The prevalence of wheeze followed a similar trend. Allergic rhinitis was the most common comorbidity, affecting 53–58% of children from 1992 onwards. Other comorbidities included atopic dermatitis, allergic conjunctivitis, and pollinosis. The prevalence of asthma was higher in urban areas than in rural areas in the early surveys, but this difference disappeared in later surveys.

Conclusions

The prevalence of pediatric asthma in western Japan increased until 2002 and then decreased in subsequent surveys. Changes in environmental factors and public health measures, including those related to the COVID-19 pandemic, may have influenced these trends. Further research is needed to understand the long-term effects of these factors on asthma prevalence.

目的利用1982年至2022年每10年进行一次的调查数据，调查日本西部地区40年来儿童哮喘患病率的变化趋势。每10年进行一次以学校为本的流行病学调查。在日本西部的11个县设置小学。参与者：6-12岁的儿童。调查对象为：1982年55388名、1992年46718名、2002年36228名、2012年33902名、2022年3024名。主要结局指标哮喘、喘息和其他过敏性疾病（如过敏性鼻炎、特应性皮炎和食物过敏）的复发率。结果1982 ~ 2002年哮喘患病率呈上升趋势(男童：3.8% ~ 8.1%；女孩：2.5%-5.0%)，然后在2012年和2022年下降(男孩：6.0%-3.2%；女孩:3.5% - -2.1%)。喘息的流行也有类似的趋势。过敏性鼻炎是最常见的合并症，从1992年起影响了53-58%的儿童。其他合并症包括特应性皮炎、过敏性结膜炎和花粉症。在早期的调查中，城市地区的哮喘患病率高于农村地区，但这种差异在后来的调查中消失了。结论日本西部儿童哮喘患病率在2002年之前呈上升趋势，随后在调查中有所下降。环境因素和公共卫生措施（包括与COVID-19大流行有关的措施）的变化可能影响了这些趋势。需要进一步的研究来了解这些因素对哮喘患病率的长期影响。

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引用次数: 0

Total IgE levels in patients with hematologic malignancies 血液恶性肿瘤患者的总IgE水平

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2025-04-22 DOI: 10.1016/j.waojou.2025.101050

Parisa Amjadi Ph.D , Fatemehsadat Hosseini M.D , Ehsan Zaboli M.D , Mohammad Eslami-Jouybari M.D , Hossein Asgarian-Omran Ph.D , Akbar Hedayatizadeh-Omran M.D, Ph.D , Versa Omrani-Nava M.Sc , Reza Alizadeh-Navaei M.D, Ph.D

Background

Immune system compartments have a crucial role in the progression or suppression of cancer. Hematologic malignancies are among the most common cancers, and there is conflicting research regarding the role of their relationship with allergies and IgE levels. This study aimed to compare total IgE levels in patients with hematologic malignancies to those in non-cancer controls.

Methods

In this cross-sectional study in 2023, sixty patients with hematological malignancies and 90 non-cancer patients attending Sari Imam Hospital were evaluated for total IgE levels along with demographic data. The convenience sampling method was used for the selection of both patients and controls. IgE levels were measured in both groups ELISA method. The analysis was performed using SPSS 20.

Results

The most common types of malignancy were ALL (23.3%) and multiple myeloma (23.3%). The median IgE level in patients (7.08, IQR:2.07–19.07) was significantly lower than the control group (42.41, IQR:11.99–145.57). The odds ratio for hematological malignancy associated with low total IgE was 6.79 (CI 95%: 2.90–15.92). After adjusting for age and sex, the adjusted odds ratio increased to 15.89 (CI 95%: 4.14–60.95).

Conclusion

Patients with hematological cancers have significantly lower IgE levels compared with individuals with no cancer.

背景免疫系统在癌症的发展或抑制过程中起着至关重要的作用。血液系统恶性肿瘤是最常见的癌症之一，而关于它们与过敏和 IgE 水平之间关系的研究却相互矛盾。本研究旨在比较血液恶性肿瘤患者与非癌症对照组的总 IgE 水平。方法在这项横断面研究中，2023 年，萨里伊玛目医院的 60 名血液恶性肿瘤患者和 90 名非癌症患者接受了总 IgE 水平评估和人口统计学数据。选择患者和对照组时采用了方便抽样法。两组患者的 IgE 水平均采用 ELISA 方法进行测量。结果最常见的恶性肿瘤类型是 ALL（23.3%）和多发性骨髓瘤（23.3%）。患者的 IgE 水平中位数（7.08，IQR:2.07-19.07）明显低于对照组（42.41，IQR:11.99-145.57）。血液恶性肿瘤与低总 IgE 相关的几率比为 6.79（CI 95%：2.90-15.92）。调整年龄和性别后，调整后的几率比上升至 15.89（CI 95%：4.14-60.95）。

{"title":"Total IgE levels in patients with hematologic malignancies","authors":"Parisa Amjadi Ph.D , Fatemehsadat Hosseini M.D , Ehsan Zaboli M.D , Mohammad Eslami-Jouybari M.D , Hossein Asgarian-Omran Ph.D , Akbar Hedayatizadeh-Omran M.D, Ph.D , Versa Omrani-Nava M.Sc , Reza Alizadeh-Navaei M.D, Ph.D","doi":"10.1016/j.waojou.2025.101050","DOIUrl":"10.1016/j.waojou.2025.101050","url":null,"abstract":"<div><h3>Background</h3><div>Immune system compartments have a crucial role in the progression or suppression of cancer. Hematologic malignancies are among the most common cancers, and there is conflicting research regarding the role of their relationship with allergies and IgE levels. This study aimed to compare total IgE levels in patients with hematologic malignancies to those in non-cancer controls.</div></div><div><h3>Methods</h3><div>In this cross-sectional study in 2023, sixty patients with hematological malignancies and 90 non-cancer patients attending Sari Imam Hospital were evaluated for total IgE levels along with demographic data. The convenience sampling method was used for the selection of both patients and controls. IgE levels were measured in both groups ELISA method. The analysis was performed using SPSS 20.</div></div><div><h3>Results</h3><div>The most common types of malignancy were ALL (23.3%) and multiple myeloma (23.3%). The median IgE level in patients (7.08, IQR:2.07–19.07) was significantly lower than the control group (42.41, IQR:11.99–145.57). The odds ratio for hematological malignancy associated with low total IgE was 6.79 (CI 95%: 2.90–15.92). After adjusting for age and sex, the adjusted odds ratio increased to 15.89 (CI 95%: 4.14–60.95).</div></div><div><h3>Conclusion</h3><div>Patients with hematological cancers have significantly lower IgE levels compared with individuals with no cancer.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 5","pages":"Article 101050"},"PeriodicalIF":3.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860257","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

Refining cytokine-based diagnostics in DRESS: A two-color IFN-γ/IL-4 ELISpot approach 改进基于细胞因子的DRESS诊断：双色IFN-γ/IL-4 ELISpot方法

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2025-04-01 DOI: 10.1016/j.waojou.2025.101049

Edouard Massip MD, Emeline Delaunay, Jacques Trauet, Arnaud Dendooven, Stéphane Esnault PhD, Delphine Staumont-Sallé MD, PhD, Guillaume Lefevre MD, PhD, Frédéric Dezoteux MD, PhD

引用次数: 0

Differential expression of eicosanoid pathways after whole blood stimulation in asthma patients 哮喘患者全血刺激后类二十烷酸途径的差异表达

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2025-04-01 DOI: 10.1016/j.waojou.2025.101047

Chrysanthi Skevaki MD , Pavel Tafo PhD , Thomas Bahmer MD , Mustafa Abdo PD, MD , Henrik Watz MD , Frauke Pedersen PhD , Christian Herzmann PD, MD , Klaus F. Rabe PhD, MD, FERS , Harald Renz MD , Wolfgang Andreas Nockher PD, PhD

Objectives

Asthma is a heterogeneous disease regarding its pathophysiology, clinical symptoms, and response to treatment. Eicosanoids are important inflammatory mediators, able to either promote or attenuate the underlying chronic airway inflammation. We compared eicosanoid expression patterns in the blood circulation and in stimulated blood leukocytes of asthma patients to identify differences in eicosanoid release which may be related to airway inflammation.

Methods

Blood was collected from 198 adult asthmatic patients and 63 healthy controls, participating in the German Center for Lung Research (DZL) ALLIANCE cohort. Eicosanoid release from leukocytes was analyzed using heparinized whole blood after in vitro stimulation with zymosan. Additionally, circulating eicosanoids were measured directly from ethylenediaminetetraacetic acid (EDTA) plasma. Eicosanoids were extracted via solid phase extraction and quantified by high-performance-liquid-chromatography-tandem-mass-spectrometry (HPLC-MS²).

Results

Eicosanoid levels were low in blood circulation with no significant differences between asthmatics and controls, except for leukotriene E₄ (LTE₄) which was slightly elevated in asthmatics. After in vitro stimulation we observed an inhibition of prostaglandin and thromboxane biosynthesis only in patients with severe asthma which was related to the regular use of systemic corticosteroids. In contrast, a significant increase was shown for formation of the 5-Lipoxygenase (5-LOX) product LTE₄ in steroid-naïve asthmatics with moderate as well as severe disease severity but not in subjects with systemic steroid treatment. Furthermore 15-Hydorxyeicosatetraenoic acid (15-HETE) production was elevated in asthmatic patients with mild-to-moderate disease activity but dropped down in severe asthmatics.

Conclusions

Profiling of eicosanoid production in stimulated whole blood samples showed a specific biosynthesis pattern of asthmatic patients, which is influenced by the use of systemic corticosteroids.

目的哮喘在病理生理、临床症状和治疗反应方面是一种异质性疾病。类二十烷酸是重要的炎症介质，能够促进或减轻潜在的慢性气道炎症。我们比较了哮喘患者血液循环和受刺激的血液白细胞中类二十烷酸的表达模式，以确定可能与气道炎症有关的类二十烷酸释放的差异。方法收集198例成年哮喘患者和63例健康对照者的血液，参与德国肺研究中心（DZL）联盟队列研究。用肝素化全血对体外刺激后白细胞的类二十烷酸释放量进行了分析。此外，循环二十烷酸直接从乙二胺四乙酸（EDTA）血浆中测量。采用固相萃取法提取二十烷类化合物，采用高效液相色谱-串联质谱法（HPLC-MS2）定量。结果除白三烯E4 （LTE4）在哮喘组略有升高外，哮喘组血循环中类二十烷含量较低，与对照组无显著差异。体外刺激后，我们观察到只有在严重哮喘患者中前列腺素和凝血素的生物合成受到抑制，这与经常使用全身皮质类固醇有关。相反，5-脂氧合酶（5-LOX）产物LTE4的形成在steroid-naïve中度和重度哮喘患者中有显著增加，但在接受全身类固醇治疗的受试者中没有。此外，15-羟基二十碳四烯酸（15-HETE）在轻度至中度疾病活动度的哮喘患者中升高，而在重度哮喘患者中下降。结论受刺激的全血样本中类二十烷酸的生成谱显示哮喘患者具有一种特定的生物合成模式，这种模式受全身使用皮质类固醇的影响。

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引用次数: 0

Efficacy of omalizumab in food allergic adults - A retrospective analysis omalizumab治疗成人食物过敏的疗效回顾性分析

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2025-04-01 DOI: 10.1016/j.waojou.2025.101048

Aikaterina Alexiou MSc , Sofia Carreras-Kàtcheff MD , Karin Hartmann MD, PhD , Regina Treudler MD, PhD , Paolo Tassinari MSc , Victoria Cardona MD, PhD , Margitta Worm MD, PhD

Background

IgE-mediated food allergy poses a significant public health concern, currently with no approved therapies for adults in Europe. Omalizumab (OMA) used as monotherapy or in conjunction with oral immunotherapy (OIT) has been suggested as an efficacious treatment for severe food allergy. The aim of this study was to analyze real-world data from food-allergic patients treated with OMA.

Methods

We included food-allergic patients treated with OMA between 2002 and 2022 throughout Europe. Treatment responders (TR) were identified based on the unresponsiveness to related food allergens (determined by food challenge), reduction in the severity of food allergy and absence of anaphylactic reactions.

Results

Sixty-two patients (female n = 39/62, 62.9%; mean age 30.6 years) were included into this analysis, most of whom were polysensitized to more than 2 food allergens (n = 40/62, 64.5%); 45/62 patients (72.6%) received OMA in conjunction with OIT, while the remaining patients underwent OMA monotherapy. The eliciting food allergens were tree nuts (n = 27/62, 43.5%), cow's milk (n = 26/62, 41.9%), and vegetables (n = 25/62, 40.3%). In most cases, OMA was initiated with 300 mg q4w (n = 51/62, 82.3%) dosing. Treatment was tolerated exceptionally well.

Fifty-two (52/62) patients (83.9%) were classified as treatment responders. Six (6/62) patients (9.7%) developed unresponsiveness, 6/62 (9.7%) had a reduction of the severity of food allergy, and 40/62 (64.5%) had no further anaphylactic reactions during treatment. One (1/62) patient (1.6%) undergoing monotherapy was a non-responder, exhibiting repeated anaphylactic reactions to accidental exposures, and 10/62 patients (16.1%) reported anaphylactic reactions during treatment. In most of these cases, cofactors (n = 5/10, 50%) were present.

Conclusion

Our real-world evidence data indicate efficacy and tolerability of OMA for the treatment of IgE-mediated food allergy with and without OIT. As the onset of food related reactions upon treatment was frequently linked to the presence of cofactors, these should be identified and considered in patients with food allergy—not only for diagnosis, but also in treatment settings.

dige介导的食物过敏引起了重大的公共卫生问题，目前在欧洲没有批准的成人治疗方法。Omalizumab （OMA）作为单一疗法或与口服免疫疗法（OIT）联合使用已被认为是严重食物过敏的有效治疗方法。本研究的目的是分析OMA治疗的食物过敏患者的真实数据。方法我们纳入了2002年至2022年间全欧洲接受OMA治疗的食物过敏患者。治疗应答者（TR）是根据对相关食物过敏原的无反应（由食物刺激确定）、食物过敏严重程度的减轻和没有过敏反应来确定的。结果62例患者中，女性39/62例，占62.9%；平均年龄30.6岁)，其中大多数对2种以上的食物过敏原多致敏（n = 40/62, 64.5%）；62例患者中有45例（72.6%）接受OMA联合OIT治疗，其余患者接受OMA单药治疗。引起过敏原的食物为坚果（n = 27/62, 43.5%）、牛奶（n = 26/62, 41.9%）和蔬菜（n = 25/62, 40.3%）。在大多数病例中，OMA的起始剂量为300mg / 4w （n = 51/ 62,82.3%）。治疗的耐受性非常好。52例（52/62）患者（83.9%）被分类为治疗应答者。6例（6/62）患者（9.7%）出现无反应性，6/62（9.7%）患者的食物过敏严重程度减轻，40/62（64.5%）患者在治疗期间没有进一步的过敏反应。1例（1/62）接受单一治疗的患者（1.6%）无反应，对意外暴露表现出反复的过敏反应，10/62（16.1%）患者在治疗期间报告了过敏反应。在大多数病例中，存在辅助因子（n = 5/ 10,50 %）。结论：我们的真实世界证据数据表明，OMA治疗ige介导的食物过敏有或没有OIT的有效性和耐受性。由于治疗后食物相关反应的发生经常与辅助因子的存在有关，因此在食物过敏患者中应识别和考虑这些因素-不仅用于诊断，而且在治疗环境中也是如此。

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引用次数: 0

Latin American guidelines for the diagnosis and treatment of Stevens-Johnson syndrome and toxic epidermal necrolysis 史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症的拉丁美洲诊断和治疗指南

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2025-03-26 DOI: 10.1016/j.waojou.2025.101046

Andrea Dionelly Murillo-Casas MD , Ricardo Zwiener MD , Pedro Giavina-Bianchi MD, PhD , Verónica Pardo-Manrique MD , Rosalaura Villarreal-González MD, PhD , Olga Patricia Monge-Ortega MD , Margarita María Velásquez-Lopera MD, PhD , Diana Lucia Silva-Espinosa MD , Silvana Marcela Castillo-Loaiza MD , Liliana Eugenia Muñoz-García MD , Maria Camila Garzón-Portilla MD , Yury Juliana León-Hernández , Carlos Daniel Serrano-Reyes MD

Background

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous reactions induced by delayed drug hypersensitivity, characterized by their complexity and multisystemic nature. Their diagnosis and management are challenging and require a multidisciplinary approach. Identifying the culprit drug is crucial to ensure that the patient has access to safe therapeutic options in the future. To date, there are no specific Latin American guideline or consensus documents on SJS/TEN.

Objective

To develop a Latin American guideline on the clinical diagnosis, management, and treatment of SJS/TEN, based on available scientific evidence and the experience of experts from various medical specialties.

Methods

This guideline was developed by a group of Latin American allergists and dermatologists involved in the management of SJS/TEN. A search of scientific publications was conducted, and the expert group evaluated the available evidence in the literature, providing grades of recommendation. In cases where there was insufficient evidence, consensus was reached among the experts.

Results

The Latin American guidelines on SJS/TEN were developed, addressing relevant practical aspects of clinical diagnosis, and the identification of culprit drugs using the ALDEN (Algorithm of Drug Causality for Epidermal Necrolysis). It also offers recommendations on management, treatment, and prevention of complications, along with a specific algorithm for disease management. This guideline includes a therapeutic strategy, developed and agreed upon by expert specialists involved in the treatment of SJS/TEN.

史蒂文斯-约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）是由迟发性药物超敏反应引起的严重皮肤反应，具有复杂性和多系统的特点。他们的诊断和管理是具有挑战性的，需要多学科的方法。确定罪魁祸首药物对于确保患者在未来获得安全的治疗选择至关重要。迄今为止，没有关于SJS/TEN的具体拉丁美洲指南或共识文件。目的根据现有的科学证据和各医学专业专家的经验，制定拉丁美洲SJS/TEN的临床诊断、管理和治疗指南。方法本指南由一组参与SJS/TEN管理的拉丁美洲过敏症专家和皮肤科医生制定。对科学出版物进行了检索，专家组评估了文献中的现有证据，并提供了推荐等级。在证据不足的情况下，专家之间达成共识。结果制定了SJS/TEN拉丁美洲指南，解决了临床诊断的相关实际问题，并使用ALDEN（表皮坏死松解药物因果关系算法）识别罪魁祸首药物。它还提供管理、治疗和预防并发症的建议，以及疾病管理的特定算法。本指南包括由参与SJS/TEN治疗的专家制定和商定的治疗策略。

{"title":"Latin American guidelines for the diagnosis and treatment of Stevens-Johnson syndrome and toxic epidermal necrolysis","authors":"Andrea Dionelly Murillo-Casas MD , Ricardo Zwiener MD , Pedro Giavina-Bianchi MD, PhD , Verónica Pardo-Manrique MD , Rosalaura Villarreal-González MD, PhD , Olga Patricia Monge-Ortega MD , Margarita María Velásquez-Lopera MD, PhD , Diana Lucia Silva-Espinosa MD , Silvana Marcela Castillo-Loaiza MD , Liliana Eugenia Muñoz-García MD , Maria Camila Garzón-Portilla MD , Yury Juliana León-Hernández , Carlos Daniel Serrano-Reyes MD","doi":"10.1016/j.waojou.2025.101046","DOIUrl":"10.1016/j.waojou.2025.101046","url":null,"abstract":"<div><h3>Background</h3><div>Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous reactions induced by delayed drug hypersensitivity, characterized by their complexity and multisystemic nature. Their diagnosis and management are challenging and require a multidisciplinary approach. Identifying the culprit drug is crucial to ensure that the patient has access to safe therapeutic options in the future. To date, there are no specific Latin American guideline or consensus documents on SJS/TEN.</div></div><div><h3>Objective</h3><div>To develop a Latin American guideline on the clinical diagnosis, management, and treatment of SJS/TEN, based on available scientific evidence and the experience of experts from various medical specialties.</div></div><div><h3>Methods</h3><div>This guideline was developed by a group of Latin American allergists and dermatologists involved in the management of SJS/TEN. A search of scientific publications was conducted, and the expert group evaluated the available evidence in the literature, providing grades of recommendation. In cases where there was insufficient evidence, consensus was reached among the experts.</div></div><div><h3>Results</h3><div>The Latin American guidelines on SJS/TEN were developed, addressing relevant practical aspects of clinical diagnosis, and the identification of culprit drugs using the ALDEN (Algorithm of Drug Causality for Epidermal Necrolysis). It also offers recommendations on management, treatment, and prevention of complications, along with a specific algorithm for disease management. This guideline includes a therapeutic strategy, developed and agreed upon by expert specialists involved in the treatment of SJS/TEN.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 4","pages":"Article 101046"},"PeriodicalIF":3.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704019","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}

引用次数: 0