The health-related quality of life (HRQL) of people with food allergies should be evaluated to provide high-quality medical care. Currently, there is no available easy-to-use and reliable instrument for assessing HRQL clinically in Japan.
Methods
The Food Allergy Quality of Life Questionnaire 10 (FAQLQ10) in English was translated into Japanese, and this was referred to as the Japanese version of the Food Allergy Quality of Life Questionnaire 10 (FAQLQ10-J). Participants aged up to 18 years, who had food allergy, and their parents were instructed to complete the FAQLQ10-J and the Food Allergy Independent Measure, a self-report instrument. For comparison, participants without food allergies were also included in the survey.
Results
The FAQLQ10-J, which included forms for individuals aged 8–12 years, teenagers, and caregivers was developed. The responders completed each form within approximately 3 min. An analysis of responses showed that each form had a good internal consistency, test–retest reliability, construct validity, and discriminant validity. Moreover, based on an examination of the relationship between demographic data and FAQLQ10-J scores, items such as possession of an adrenaline auto-injector, participant age, and number of eliminated foods might influence HRQL.
Conclusions
We developed the FAQLQ10-J, which is a simple, reliable, and effective tool for assessing HRQL among Japanese individuals with food allergy. Its use may provide a more detailed understanding of HRQL among individuals with food allergy in clinical settings and may facilitate the development of more individual-oriented treatments.
{"title":"Japanese version of the food allergy quality of life questionnaire 10: An easy-to-use instrument","authors":"Shigenori Kabashima MD, PhD , Kiwako Hanada Yamamoto MD, PhD , Yumiko Miyaji MD , Yuri Endo Kram MD , Mami Shimada MD , Seiko Hirai MD , Hiroya Ogita MD , Tomoyuki Kiguchi MD , Yusuke Inuzuka MD, PhD , Kenji Toyokuni MD, PhD , Makoto Irahara MD, PhD , Fumi Ishikawa MD , Miori Sato MD , Mayako Saito-Abe MD, PhD , Hiroki Yasudo MD, PhD , Tatsuki Fukuie MD, PhD , Ichiro Nomura MD, PhD , Audrey DunnGalvin PhD , Yukihiro Ohya MD, PhD","doi":"10.1016/j.waojou.2024.100979","DOIUrl":"10.1016/j.waojou.2024.100979","url":null,"abstract":"<div><h3>Background</h3><div>The health-related quality of life (HRQL) of people with food allergies should be evaluated to provide high-quality medical care. Currently, there is no available easy-to-use and reliable instrument for assessing HRQL clinically in Japan.</div></div><div><h3>Methods</h3><div>The Food Allergy Quality of Life Questionnaire 10 (FAQLQ10) in English was translated into Japanese, and this was referred to as the Japanese version of the Food Allergy Quality of Life Questionnaire 10 (FAQLQ10-J). Participants aged up to 18 years, who had food allergy, and their parents were instructed to complete the FAQLQ10-J and the Food Allergy Independent Measure, a self-report instrument. For comparison, participants without food allergies were also included in the survey.</div></div><div><h3>Results</h3><div>The FAQLQ10-J, which included forms for individuals aged 8–12 years, teenagers, and caregivers was developed. The responders completed each form within approximately 3 min. An analysis of responses showed that each form had a good internal consistency, test–retest reliability, construct validity, and discriminant validity. Moreover, based on an examination of the relationship between demographic data and FAQLQ10-J scores, items such as possession of an adrenaline auto-injector, participant age, and number of eliminated foods might influence HRQL.</div></div><div><h3>Conclusions</h3><div>We developed the FAQLQ10-J, which is a simple, reliable, and effective tool for assessing HRQL among Japanese individuals with food allergy. Its use may provide a more detailed understanding of HRQL among individuals with food allergy in clinical settings and may facilitate the development of more individual-oriented treatments.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 11","pages":"Article 100979"},"PeriodicalIF":3.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528766","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}
Limited investigations have focused on the association between the Mediterranean dietary (MeD) and asthma among children and adolescents. We aimed to study the associations between a modified Mediterranean dietary pattern and asthma symptoms in children living in Iran.
Method
This cross-sectional study was conducted among 7667 children and adolescence. Data on dietary intakes, asthma symptoms and other possible confounders, were collected using a questionnaire completed by parents. The relationship between Mediterranean diet (MeD) and asthma was assessed using logistic regression.
Results
We found that participants in the highest quartile of MeD score had 32% lower odds of wheezing in the past 12 months in the whole population when compared with those in the lowest quartile (OR: 0.68; 95% CI: 0.51–0.90; Ptrend < 0.001). Regarding the wheezing, a linear reducing trend was observed in girls (OR: 0.88; 95% CI: 0.62–1.25; Ptrend = 0.04); and a significant protective association was seen among boys (OR: 0.45; 95% CI: 0.28–0.73; Ptrend < 0.001). Analyses by gender showed, girls and boys in the highest quartile had 68% and 51% lower odds of current asthma in comparison with the first quartile.
Conclusion
Mediterranean-style diet emphasizing high in fruits, vegetables, and cereals and low in fast foods is associated with reduced wheezing as an asthma-related symptom. On the other hand, meat intake has adverse correlation with asthma prevalence. No association was found between this dietary pattern and asthma. Further prospective investigations should be conducted to confirm these findings.
{"title":"Adherence to a modified Mediterranean diet and in association with asthma and wheezing in schoolchildren: A cross-sectional study","authors":"Faezeh Poursoleiman PhD , Bahareh Sasanfar PhD , Nasrin Behniafard MD , Zahra Nafei MD , Elahe Akbarian MS , Abbas Khalili MD , Amin Salehi-Abargouei PhD","doi":"10.1016/j.waojou.2024.100948","DOIUrl":"10.1016/j.waojou.2024.100948","url":null,"abstract":"<div><h3>Background</h3><div>Limited investigations have focused on the association between the Mediterranean dietary (MeD) and asthma among children and adolescents. We aimed to study the associations between a modified Mediterranean dietary pattern and asthma symptoms in children living in Iran.</div></div><div><h3>Method</h3><div>This cross-sectional study was conducted among 7667 children and adolescence. Data on dietary intakes, asthma symptoms and other possible confounders, were collected using a questionnaire completed by parents. The relationship between Mediterranean diet (MeD) and asthma was assessed using logistic regression.</div></div><div><h3>Results</h3><div>We found that participants in the highest quartile of MeD score had 32% lower odds of wheezing in the past 12 months in the whole population when compared with those in the lowest quartile (OR: 0.68; 95% CI: 0.51–0.90; P<sub>trend</sub> < 0.001). Regarding the wheezing, a linear reducing trend was observed in girls (OR: 0.88; 95% CI: 0.62–1.25; P<sub>trend</sub> = 0.04); and a significant protective association was seen among boys (OR: 0.45; 95% CI: 0.28–0.73; P<sub>trend</sub> < 0.001). Analyses by gender showed, girls and boys in the highest quartile had 68% and 51% lower odds of current asthma in comparison with the first quartile.</div></div><div><h3>Conclusion</h3><div>Mediterranean-style diet emphasizing high in fruits, vegetables, and cereals and low in fast foods is associated with reduced wheezing as an asthma-related symptom. On the other hand, meat intake has adverse correlation with asthma prevalence. No association was found between this dietary pattern and asthma. Further prospective investigations should be conducted to confirm these findings.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 11","pages":"Article 100948"},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446571","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}
In recent years, there has been a notable surge in interest in gender medicine, with a growing focus on exploring gender and sex differences in skin diseases.
Although it is noticeable in clinical practice that more women than men present with chronic spontaneous urticaria (CSU) in the outpatient setting, there is currently no systematic review available which addresses gender differences in CSU. PubMed Medline, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched until July 2023. English and German randomized controlled trials, prospective and retrospective cohorts, and case-control studies that examined gender and sex differences in CSU were included. Two authors independently screened the reports for eligibility. One extracted all data, the second double-checked and critically appraised the quality and risk of bias of the studies. Twenty-six reports were included. The article reviewed differences in epidemiology, diagnostics, clinical characteristics, treatment, and quality of life in female and male patients. The findings provide limited data for the substantial impact of gender and sex in CSU patients and reveal major gaps in gender-specific care in dermatology which should be narrowed in the upcoming years to optimize patient-centered, individualized, gender-equal healthcare.
PROSPERO registration
CRD42023442958.
近年来，人们对性别医学的兴趣明显增加，越来越多的人开始关注皮肤病的性别差异。虽然在临床实践中，门诊慢性自发性荨麻疹（CSU）患者中女性明显多于男性，但目前还没有针对CSU性别差异的系统综述。我们检索了 PubMed Medline、Web of Science 和 Cochrane Central Register of Controlled Trials (CENTRAL)，直至 2023 年 7 月。纳入了研究 CSU 性别差异的英语和德语随机对照试验、前瞻性和回顾性队列研究以及病例对照研究。两位作者独立筛选了报告的合格性。其中一位作者提取了所有数据，另一位作者对研究的质量和偏倚风险进行了双重检查和严格评估。共纳入 26 篇报告。文章回顾了女性和男性患者在流行病学、诊断、临床特征、治疗和生活质量方面的差异。研究结果提供了有限的数据，说明了性别和性别对 CSU 患者的实质性影响，并揭示了皮肤病学在性别护理方面存在的主要差距，这些差距应在未来几年内缩小，以优化以患者为中心的、个性化的、性别平等的医疗服务。
{"title":"Is there a difference between women and men in chronic spontaneous urticaria? A systematic review on gender and sex differences in CSU patients","authors":"Sarah Preis MD , Carla Claussen MD , Stefanie Ziehfreund , Tilo Biedermann MD , Sophia Horster MD , Alexander Zink MD, PhD","doi":"10.1016/j.waojou.2024.100974","DOIUrl":"10.1016/j.waojou.2024.100974","url":null,"abstract":"<div><div>In recent years, there has been a notable surge in interest in gender medicine, with a growing focus on exploring gender and sex differences in skin diseases.</div><div>Although it is noticeable in clinical practice that more women than men present with chronic spontaneous urticaria (CSU) in the outpatient setting, there is currently no systematic review available which addresses gender differences in CSU. PubMed Medline, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched until July 2023. English and German randomized controlled trials, prospective and retrospective cohorts, and case-control studies that examined gender and sex differences in CSU were included. Two authors independently screened the reports for eligibility. One extracted all data, the second double-checked and critically appraised the quality and risk of bias of the studies. Twenty-six reports were included. The article reviewed differences in epidemiology, diagnostics, clinical characteristics, treatment, and quality of life in female and male patients. The findings provide limited data for the substantial impact of gender and sex in CSU patients and reveal major gaps in gender-specific care in dermatology which should be narrowed in the upcoming years to optimize patient-centered, individualized, gender-equal healthcare.</div></div><div><h3>PROSPERO registration</h3><div>CRD42023442958.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 11","pages":"Article 100974"},"PeriodicalIF":3.9,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418144","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 : 2024-10-01DOI: 10.1016/j.waojou.2024.100953
Jorge Sánchez MD, MSc, EAC, PhD , Leidy Álvarez MD, MSc , Juan Bedoya MD , Daniel Peñaranda MD, MSc , Gustavo Vanegas MD , Carlos Celis MD , Edison Morales MD , Elizabeth García MD, EAC , Augusto Peñaranda MD, MSc
Background
Guidelines for chronic rhinosinusitis (CRS) propose total IgE and eosinophils as important biomarkers to identify type-2 inflammation. Despite the fact that specific IgE (sIgE) have been identified as a clinical predictor in some type-2 diseases for different clinical outcomes, its role in CRS has yet to be explored in detail.
Objetive
To describe systemic and local sIgE in CRS and explore its possible association with clinical outcomes using nasal challenge tests (NCT).
Methods
In CRS patients, we measure total IgE, serum sIgE (SsIgE) and nasosinusal sIgE (NsIgE) against 9 allergenic sources; Der p, Der f, Blo t, Can f, Fel d, Per a, grasses, Staphylococcus enterotoxin A, and B. NCT was done using the allergen with the higher sIgE prevalence (Der p).
Results
A total of 174 patients were included. Prevalence of SsIgE was 52.8% and NsIgE 46.5%; Der p was the principal allergen for SsIgE and NsIgE. The presence of nasal polyps, asthma comorbidity, NSAID hypersensitivity, and hyposmia, were significantly associated with the presence of SsIgE and NsIgE but not with total IgE. NCT-Der p was performed in 73 CRS patients, being positive in 33 (45.2%). SsIgE have the best diagnostic accuracy (79.4%) to predict NCT results (NsIgE 67.5% total IgE 52%).
Conclusion
Specific IgE is a better biomarker in CRS than total IgE. Patients with clinically relevant SsIgE have a pheno-endotype associated with different clinical outcomes. Considering the clinical relevance of SsIgE demonstrated by NCT, interventions like allergen immunotherapy in CRS must be study.
{"title":"Role of specific immunoglobulin-E in chronic rhinosinusitis: Its clinical relevance according to nasal challenge test","authors":"Jorge Sánchez MD, MSc, EAC, PhD , Leidy Álvarez MD, MSc , Juan Bedoya MD , Daniel Peñaranda MD, MSc , Gustavo Vanegas MD , Carlos Celis MD , Edison Morales MD , Elizabeth García MD, EAC , Augusto Peñaranda MD, MSc","doi":"10.1016/j.waojou.2024.100953","DOIUrl":"10.1016/j.waojou.2024.100953","url":null,"abstract":"<div><h3>Background</h3><div>Guidelines for chronic rhinosinusitis (CRS) propose total IgE and eosinophils as important biomarkers to identify type-2 inflammation. Despite the fact that specific IgE (sIgE) have been identified as a clinical predictor in some type-2 diseases for different clinical outcomes, its role in CRS has yet to be explored in detail.</div></div><div><h3>Objetive</h3><div>To describe systemic and local sIgE in CRS and explore its possible association with clinical outcomes using nasal challenge tests (NCT).</div></div><div><h3>Methods</h3><div>In CRS patients, we measure total IgE, serum sIgE (SsIgE) and nasosinusal sIgE (NsIgE) against 9 allergenic sources; Der p, Der f, Blo t, Can f, Fel d, Per a, grasses, Staphylococcus enterotoxin A, and B. NCT was done using the allergen with the higher sIgE prevalence (Der p).</div></div><div><h3>Results</h3><div>A total of 174 patients were included. Prevalence of SsIgE was 52.8% and NsIgE 46.5%; Der p was the principal allergen for SsIgE and NsIgE. The presence of nasal polyps, asthma comorbidity, NSAID hypersensitivity, and hyposmia, were significantly associated with the presence of SsIgE and NsIgE but not with total IgE. NCT-Der p was performed in 73 CRS patients, being positive in 33 (45.2%). SsIgE have the best diagnostic accuracy (79.4%) to predict NCT results (NsIgE 67.5% total IgE 52%).</div></div><div><h3>Conclusion</h3><div>Specific IgE is a better biomarker in CRS than total IgE. Patients with clinically relevant SsIgE have a pheno-endotype associated with different clinical outcomes. Considering the clinical relevance of SsIgE demonstrated by NCT, interventions like allergen immunotherapy in CRS must be study.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 10","pages":"Article 100953"},"PeriodicalIF":3.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418670","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 : 2024-10-01DOI: 10.1016/j.waojou.2024.100976
Rajesh Melaram , James Adefisoye , Donald E. Warden , Stephen Potter , Hasan Arshad , Hongmei Zhang
Background
Pollen exposure is an environmental risk factor for asthma symptoms and allergic reactions in children. The extent to which pollen exposure in pregnancy and the first year of life influences the development of childhood asthma and rhinitis is not fully understood.
Objective
We aimed to investigate early life exposures to pollen with childhood asthma and rhinitis at age 6 in a longitudinal birth cohort of the United Kingdom.
Methods
In this retrospective cohort study, via logistic regressions, we analyzed the associations between pollen exposures in pregnancy and the first year of life with childhood asthma and rhinitis.
Results
Higher pollen exposure accumulated during pregnancy and during the first year of life both associated with an increased odds of asthma at age 6 (OR = 1.14, 95% CI 1.03–1.26, p = 0.01; OR = 1.15, 95% CI 1.03–1.29, p = 0.02, respectively). We did not observe statistically significant associations between early life pollen exposures and the odds of rhinitis at the same age.
Conclusion
High pollen exposure during early life (prenatal and postnatal) associated with an increased risk of asthma incidence at age 6. Further studies are desired to validate these findings and to elucidate the mechanisms of early life exposures to pollen on asthma etiology.
背景花粉暴露是导致儿童出现哮喘症状和过敏反应的一个环境风险因素。我们的目的是在英国的一个纵向出生队列中调查早期花粉暴露与 6 岁儿童哮喘和鼻炎的关系。方法在这项回顾性队列研究中，我们通过逻辑回归分析了孕期和出生后第一年的花粉暴露与儿童哮喘和鼻炎之间的关系。结果孕期和出生后第一年的花粉暴露累积越高，6 岁时患哮喘的几率越大（OR = 1.14，95% CI 1.03-1.26，p = 0.01；OR = 1.15，95% CI 1.03-1.29，p = 0.02）。我们没有观察到早期花粉暴露与同龄人患鼻炎几率之间存在统计学意义上的显著关联。需要进一步的研究来验证这些发现，并阐明生命早期接触花粉对哮喘病因的影响机制。
{"title":"Pollen exposures in pregnancy and early life are associated with childhood asthma incidence","authors":"Rajesh Melaram , James Adefisoye , Donald E. Warden , Stephen Potter , Hasan Arshad , Hongmei Zhang","doi":"10.1016/j.waojou.2024.100976","DOIUrl":"10.1016/j.waojou.2024.100976","url":null,"abstract":"<div><h3>Background</h3><div>Pollen exposure is an environmental risk factor for asthma symptoms and allergic reactions in children. The extent to which pollen exposure in pregnancy and the first year of life influences the development of childhood asthma and rhinitis is not fully understood.</div></div><div><h3>Objective</h3><div>We aimed to investigate early life exposures to pollen with childhood asthma and rhinitis at age 6 in a longitudinal birth cohort of the United Kingdom.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, via logistic regressions, we analyzed the associations between pollen exposures in pregnancy and the first year of life with childhood asthma and rhinitis.</div></div><div><h3>Results</h3><div>Higher pollen exposure accumulated during pregnancy and during the first year of life both associated with an increased odds of asthma at age 6 (OR = 1.14, 95% CI 1.03–1.26, p = 0.01; OR = 1.15, 95% CI 1.03–1.29, p = 0.02, respectively). We did not observe statistically significant associations between early life pollen exposures and the odds of rhinitis at the same age.</div></div><div><h3>Conclusion</h3><div>High pollen exposure during early life (prenatal and postnatal) associated with an increased risk of asthma incidence at age 6. Further studies are desired to validate these findings and to elucidate the mechanisms of early life exposures to pollen on asthma etiology.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 10","pages":"Article 100976"},"PeriodicalIF":3.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418671","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 : 2024-10-01DOI: 10.1016/j.waojou.2024.100969
Jinli Huang MD , Xingzhi Wang MD , Juan Zhang MD , Qiuhong Li MD , Panpan Zhang MD , Cheng Wu MD , Yuanyuan Jia MD , Hui Su PhD , Xin Sun PhD
Background
Food allergy (FA) is a common disorder in children and affects the health of children worldwide. The gut microbiota is closely related to the occurrence and development of FA. Fecal microbiota transplantation (FMT) is a way to treat diseases by reconstituting the microbiota; however, the role and mechanisms of FA have not been validated.
Methods
In this study, we established an ovalbumin (OVA)-induced juvenile mouse model and used 16S RNA sequencing, pathological histological staining, molecular biology, and flow-through techniques to evaluate the protective effects of FMT treatment on FA and to explore the mechanisms.
Results
OVA-induced dysregulation of the gut microbiota led to impaired intestinal function and immune dysregulation in FA mice. FMT treatment improved the structure, diversity, and composition of the gut microbiota and restored it to a near-donor state. FMT treatment reduced levels of Th2-associated inflammatory factors, decreased intestinal tissue inflammation, and reduced IgE production. In addition, FMT reduced the number of mast cells and eosinophils and suppressed OVA-specific antibodies. Further mechanistic studies revealed that FMT treatment induced immune tolerance by inducing the expression of CD103+DCs and programmed cell death ligand 1 (PD-L1) in mesenteric lymph nodes and promoting the production of Treg through the programmed cell death protein 1 (PD-1)/PD-L1 pathway. Meanwhile, Th2 cytokines, OVA-specific antibodies, and PD-1/PD-L1 showed a significant correlation with the gut microbiota.
Conclusions
FMT could regulate the gut microbiota and Th1/Th2 immune balance and might inhibit FA through the PD-1/PD-L1 pathway, which would provide a new idea for the treatment of FA.
背景食物过敏（FA）是一种常见的儿童疾病，影响着全世界儿童的健康。肠道微生物群与食物过敏的发生和发展密切相关。粪便微生物群移植（FMT）是一种通过重建微生物群来治疗疾病的方法；然而，FA 的作用和机制尚未得到验证。方法在这项研究中，我们建立了一个卵清蛋白（OVA）诱导的幼鼠模型，并使用 16S RNA 测序、病理组织学染色、分子生物学和流式细胞技术来评估 FMT 治疗对 FA 的保护作用并探索其机制。结果OVA 诱导的肠道微生物群失调导致 FA 小鼠肠道功能受损和免疫失调。FMT治疗改善了肠道微生物群的结构、多样性和组成，并使其恢复到接近供体状态。FMT治疗降低了Th2相关炎症因子的水平，减少了肠道组织炎症，并减少了IgE的产生。此外，FMT 还能减少肥大细胞和嗜酸性粒细胞的数量，抑制 OVA 特异性抗体。进一步的机理研究发现，FMT治疗通过诱导肠系膜淋巴结中CD103+DCs和程序性细胞死亡配体1（PD-L1）的表达，并通过程序性细胞死亡蛋白1（PD-1）/PD-L1途径促进Treg的产生，从而诱导免疫耐受。结论FMT可调节肠道微生物群和Th1/Th2免疫平衡，并可能通过PD-1/PD-L1途径抑制FA，这将为FA的治疗提供新思路。
{"title":"Fecal microbiota transplantation alleviates food allergy in neonatal mice via the PD-1/PD-L1 pathway and change of the microbiota composition","authors":"Jinli Huang MD , Xingzhi Wang MD , Juan Zhang MD , Qiuhong Li MD , Panpan Zhang MD , Cheng Wu MD , Yuanyuan Jia MD , Hui Su PhD , Xin Sun PhD","doi":"10.1016/j.waojou.2024.100969","DOIUrl":"10.1016/j.waojou.2024.100969","url":null,"abstract":"<div><h3>Background</h3><div>Food allergy (FA) is a common disorder in children and affects the health of children worldwide. The gut microbiota is closely related to the occurrence and development of FA. Fecal microbiota transplantation (FMT) is a way to treat diseases by reconstituting the microbiota; however, the role and mechanisms of FA have not been validated.</div></div><div><h3>Methods</h3><div>In this study, we established an ovalbumin (OVA)-induced juvenile mouse model and used 16S RNA sequencing, pathological histological staining, molecular biology, and flow-through techniques to evaluate the protective effects of FMT treatment on FA and to explore the mechanisms.</div></div><div><h3>Results</h3><div>OVA-induced dysregulation of the gut microbiota led to impaired intestinal function and immune dysregulation in FA mice. FMT treatment improved the structure, diversity, and composition of the gut microbiota and restored it to a near-donor state. FMT treatment reduced levels of Th2-associated inflammatory factors, decreased intestinal tissue inflammation, and reduced IgE production. In addition, FMT reduced the number of mast cells and eosinophils and suppressed OVA-specific antibodies. Further mechanistic studies revealed that FMT treatment induced immune tolerance by inducing the expression of CD103<sup>+</sup>DCs and programmed cell death ligand 1 (PD-L1) in mesenteric lymph nodes and promoting the production of Treg through the programmed cell death protein 1 (PD-1)/PD-L1 pathway. Meanwhile, Th2 cytokines, OVA-specific antibodies, and PD-1/PD-L1 showed a significant correlation with the gut microbiota.</div></div><div><h3>Conclusions</h3><div>FMT could regulate the gut microbiota and Th1/Th2 immune balance and might inhibit FA through the PD-1/PD-L1 pathway, which would provide a new idea for the treatment of FA.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 10","pages":"Article 100969"},"PeriodicalIF":3.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418689","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 : 2024-09-25DOI: 10.1016/j.waojou.2024.100972
Paul J. Turner , Antonio Bognanni , Stefania Arasi , Ignacio J. Ansotegui , Sabine Schnadt , Sébastien La Vieille , Jonathan O’B. Hourihane , Torsten Zuberbier , Philippe Eigenmann , Motohiro Ebisawa , Mario Morais-Almeida , Julie Barnett , Bryan Martin , Linda Monaci , Graham Roberts , Gary Wong , Ruchi Gupta , Sophia Tsabouri , Clare Mills , Simon Brooke-Taylor , Alessandro Fiocchi
Background
Precautionary Allergen (“may contain”) Labelling (PAL) is used by industry to communicate potential risk to food-allergic individuals posed by unintended allergen presence (UAP). In 2014, the World Allergy Organization (WAO) highlighted that PAL use was increasing, but often applied inconsistently and without regulation — which reduces its usefulness to consumers with food allergy and those purchasing food for them. WAO proposed the need for a regulated, international framework to underpin application of PAL. In 2019, the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) of the United Nations convened an expert consultation to address the issue of PAL, the outputs of which are now being considered by the Codex Committee on Food Labelling (CCFL).
Objectives
To summarise the latest data to inform the application of PAL in a more systematic way, for implementation into global food standards.
Methods
A non-systematic review of issues surrounding precautionary labelling and food allergens in pre-packaged products.
Results
Approximately, 100 countries around the world have legislation on the declaration of allergenic ingredients. Just a few have legislation on UAP. Given the risks that UAP entails, non-regulated PAL creates inconvenience in real life due to its unequal, difficult interpretation by patients. The attempts made so far to rationalize PAL present lights and shadows.
Conclusions
At a time when CCFL is considering the results of the FAO/WHO Expert Consultation 2020–2023, we summarise the prospects to develop an effective and homogeneous legislation at a global level, and the areas of uncertainty that might hinder international agreement on a regulated framework for PAL of food allergens.
背景预防性过敏原（"可能含有"）标签（PAL）被工业界用来向食物过敏者传达无意过敏原存在（UAP）所带来的潜在风险。2014 年，世界过敏组织（WAO）强调，PAL 的使用在不断增加，但其应用往往不一致且缺乏监管，这降低了其对食物过敏消费者和为其购买食品的消费者的实用性。WAO 建议需要一个规范的国际框架来支持 PAL 的应用。2019 年，世界卫生组织 (WHO) 和联合国粮食及农业组织 (FAO) 召开了一次专家磋商会，讨论 PAL 问题，食品标签法典委员会 (CCFL) 目前正在审议磋商会的成果。方法 对预包装产品中的预防性标签和食品过敏原相关问题进行非系统性审查。结果 全球约有 100 个国家制定了有关过敏原成分声明的法律。只有少数几个国家制定了有关 UAP 的法律。鉴于 UAP 所带来的风险，不规范的 PAL 在现实生活中造成了不便，因为患者很难对其做出不平等的解释。结论当食品标签委员会正在审议粮农组织/世卫组织 2020-2023 年专家磋商会的结果时，我们总结了在全球范围内制定有效和统一立法的前景，以及可能阻碍就食品过敏原 PAL 的规范框架达成国际协议的不确定领域。
{"title":"Time to ACT-UP: Update on precautionary allergen labelling (PAL)","authors":"Paul J. Turner , Antonio Bognanni , Stefania Arasi , Ignacio J. Ansotegui , Sabine Schnadt , Sébastien La Vieille , Jonathan O’B. Hourihane , Torsten Zuberbier , Philippe Eigenmann , Motohiro Ebisawa , Mario Morais-Almeida , Julie Barnett , Bryan Martin , Linda Monaci , Graham Roberts , Gary Wong , Ruchi Gupta , Sophia Tsabouri , Clare Mills , Simon Brooke-Taylor , Alessandro Fiocchi","doi":"10.1016/j.waojou.2024.100972","DOIUrl":"10.1016/j.waojou.2024.100972","url":null,"abstract":"<div><h3>Background</h3><div>Precautionary Allergen (“may contain”) Labelling (PAL) is used by industry to communicate potential risk to food-allergic individuals posed by unintended allergen presence (UAP). In 2014, the World Allergy Organization (WAO) highlighted that PAL use was increasing, but often applied inconsistently and without regulation — which reduces its usefulness to consumers with food allergy and those purchasing food for them. WAO proposed the need for a regulated, international framework to underpin application of PAL. In 2019, the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) of the United Nations convened an expert consultation to address the issue of PAL, the outputs of which are now being considered by the Codex Committee on Food Labelling (CCFL).</div></div><div><h3>Objectives</h3><div>To summarise the latest data to inform the application of PAL in a more systematic way, for implementation into global food standards.</div></div><div><h3>Methods</h3><div>A non-systematic review of issues surrounding precautionary labelling and food allergens in pre-packaged products.</div></div><div><h3>Results</h3><div>Approximately, 100 countries around the world have legislation on the declaration of allergenic ingredients. Just a few have legislation on UAP. Given the risks that UAP entails, non-regulated PAL creates inconvenience in real life due to its unequal, difficult interpretation by patients. The attempts made so far to rationalize PAL present lights and shadows.</div></div><div><h3>Conclusions</h3><div>At a time when CCFL is considering the results of the FAO/WHO Expert Consultation 2020–2023, we summarise the prospects to develop an effective and homogeneous legislation at a global level, and the areas of uncertainty that might hinder international agreement on a regulated framework for PAL of food allergens.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 10","pages":"Article 100972"},"PeriodicalIF":3.9,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319758","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 : 2024-09-23DOI: 10.1016/j.waojou.2024.100968
Erminia Ridolo MD, PhD , Francesca Nicoletta MD , Carlo Lombardi MD , Giovanni Passalacqua MD , Gianenrico Senna MD , Giorgio Walter Canonica MD
Eosinophilic esophagitis (EoE) and allergic rhinitis (AR) usually represent the latest manifestations of the atopic march, sharing a common type 2 inflammation response. A relevant prevalence of AR in EoE cohorts has been widely confirmed. An increasing literature assessed the involvement of aeroantigens in EoE pathogenesis, focusing foremost on the seasonality of new diagnoses, symptoms, and response to therapy. Unfortunately, no diriment direction has been achieved, probably due to the retrospective design of the studies so far available, which chose surrogate markers of EoE activity (mostly the date of new diagnosis) which may be affected by geographical, logistic and personal factors, probably not dependent by the disease itself. EoE exacerbations reported in the context of the pollen levels (preferably pollen counts) may represent a more reliable marker. AR might promote the onset and the re-exacerbation of EoE through mechanisms that are both local (ie, massive exposure to airborne antigens mediated by post-nasal drip) and systemic (type 2 inflammation). Furthermore, AR may facilitate EoE onset by predisposing to pollen food allergic syndrome (PFAS), and EoE patients with PFAS reported higher rate of AR, thus suggesting a bond among these 3 conditions whose causative relationship have still to be ascertained. In addition, because of its shifting activity from Th2 to Th1 inflammation, several case reports focused on the effect of allergen immunotherapy (AIT) employed to treat AR in EoE patients. Also in this instance, no certainties could be guaranteed, although sublingual immunotherapy (SLIT) is more frequently reported to exacerbate EoE, while SCIT is mostly described as a remission adjuvant. The real life experience reported from our allergy service appears to confirm such hypothesis. Finally, a watchful eye should be reserved to monoclonal antibodies as a potential future option for concomitant EoE and AR. In light of all this, an attentive evaluation of allergic history of EoE patients should be relevant. Future perspectives should be addressed on prospective studies targeted to shed light on causative relations among airborne antigens, AR and EoE, and to viable comprehensive treatments.
嗜酸性粒细胞食管炎（EoE）和过敏性鼻炎（AR）通常是特应性进展的最新表现，具有共同的 2 型炎症反应。嗜酸性粒细胞性食管炎队列中 AR 的相关患病率已得到广泛证实。越来越多的文献评估了航空抗原在特应性鼻炎发病机制中的作用，主要关注新诊断、症状和治疗反应的季节性。遗憾的是，迄今为止的研究还没有确定方向，这可能是由于这些研究采用了回顾性设计，选择了肠易激综合征活动的代用指标（主要是新诊断的日期），而这些指标可能会受到地理、物流和个人因素的影响，很可能与疾病本身无关。根据花粉水平（最好是花粉计数）报告的肠易激综合征加重可能是更可靠的标志物。AR 可能会通过局部机制（即通过鼻后滴流大量接触空气中的抗原）和全身机制（2 型炎症）促进咽喉炎的发病和再次恶化。此外，AR 可能会导致花粉食物过敏综合征（PFAS），从而促进 EoE 的发生，而患有 PFAS 的 EoE 患者报告的 AR 发生率较高，这表明这三种疾病之间存在联系，其因果关系仍有待确定。此外，由于过敏原的活性从 Th2 炎症转变为 Th1 炎症，一些病例报告重点探讨了过敏原免疫疗法（AIT）治疗咽喉炎患者 AR 的效果。同样，虽然舌下免疫疗法（SLIT）经常被报道会加重咽喉炎，而 SCIT 则大多被描述为缓解病情的辅助疗法，但在这种情况下，并不能保证一定会产生效果。我们过敏服务部门的实际经验似乎证实了这一假设。最后，单克隆抗体作为一种潜在的治疗同时伴有肠易激综合征和 AR 的未来选择，应保持警惕。有鉴于此，应该对呃逆患者的过敏史进行仔细评估。未来应着眼于前瞻性研究，以阐明空气传播的抗原、AR 和咽喉炎之间的致病关系，并找到可行的综合治疗方法。
{"title":"Eosinophilic esophagitis and inhalant antigens: Pointing out the roles of allergic rhinitis, immunotherapy and biologic treatment","authors":"Erminia Ridolo MD, PhD , Francesca Nicoletta MD , Carlo Lombardi MD , Giovanni Passalacqua MD , Gianenrico Senna MD , Giorgio Walter Canonica MD","doi":"10.1016/j.waojou.2024.100968","DOIUrl":"10.1016/j.waojou.2024.100968","url":null,"abstract":"<div><div>Eosinophilic esophagitis (EoE) and allergic rhinitis (AR) usually represent the latest manifestations of the atopic march, sharing a common type 2 inflammation response. A relevant prevalence of AR in EoE cohorts has been widely confirmed. An increasing literature assessed the involvement of aeroantigens in EoE pathogenesis, focusing foremost on the seasonality of new diagnoses, symptoms, and response to therapy. Unfortunately, no diriment direction has been achieved, probably due to the retrospective design of the studies so far available, which chose surrogate markers of EoE activity (mostly the date of new diagnosis) which may be affected by geographical, logistic and personal factors, probably not dependent by the disease itself. EoE exacerbations reported in the context of the pollen levels (preferably pollen counts) may represent a more reliable marker. AR might promote the onset and the re-exacerbation of EoE through mechanisms that are both local (ie, massive exposure to airborne antigens mediated by post-nasal drip) and systemic (type 2 inflammation). Furthermore, AR may facilitate EoE onset by predisposing to pollen food allergic syndrome (PFAS), and EoE patients with PFAS reported higher rate of AR, thus suggesting a bond among these 3 conditions whose causative relationship have still to be ascertained. In addition, because of its shifting activity from Th2 to Th1 inflammation, several case reports focused on the effect of allergen immunotherapy (AIT) employed to treat AR in EoE patients. Also in this instance, no certainties could be guaranteed, although sublingual immunotherapy (SLIT) is more frequently reported to exacerbate EoE, while SCIT is mostly described as a remission adjuvant. The real life experience reported from our allergy service appears to confirm such hypothesis. Finally, a watchful eye should be reserved to monoclonal antibodies as a potential future option for concomitant EoE and AR. In light of all this, an attentive evaluation of allergic history of EoE patients should be relevant. Future perspectives should be addressed on prospective studies targeted to shed light on causative relations among airborne antigens, AR and EoE, and to viable comprehensive treatments.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 10","pages":"Article 100968"},"PeriodicalIF":3.9,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1939455124001005/pdfft?md5=72cc13f072286d806a69f7ae8954a726&pid=1-s2.0-S1939455124001005-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312085","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}
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