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Tumors in the setting of dupilumab use: A review of the literature 肿瘤在杜匹单抗的使用:文献综述。
IF 3.9 2区 医学 Q2 ALLERGY Pub Date : 2025-01-01 DOI: 10.1016/j.waojou.2024.101006
Shumeng Guo , Liangchun Wang MD, PhD , Dingfang Bu MD, PhD , Fengjie Liu MD, PhD
Dupilumab is the first monoclonal antibody approved for treating moderate-to-severe atopic dermatitis (AD) and has significantly improved the quality of life of AD patients. However, the safety of dupilumab is yet unclear in the context of cancer. Therefore, we aimed to investigate the safety of dupilumab and its relationship with the progression and occurrence of tumors. By reviewing relevant medical records of 90 patients who had pre-existing tumors before dupilumab treatment or presented new tumors after dupilumab treatment, we found that dupilumab probably had no significant negative effects on most tumors, but several patients with Cutaneous T-cell lymphomas (CTCLs) had relatively unfavorable outcomes during dupilumab treatment. Besides, CTCLs and lymphomas accounted for the majority of patients who presented new tumors after dupilumab treatment. Several patients were first diagnosed with presumed AD and probably were the presentations of CTCL at an early stage, and they developed typical CTCL symptoms after dupilumab treatment. Finally we came to the conclusion that dupilumab is safe for most patients with cancer. However, the effect of dupilumab on CTCLs is disputable. The use of dupilumab requires individual evaluation and closely monitored. When the efficacy is poor, re-evaluation of the diagnosis, especially of CTCLs and related diseases, is necessary.
Dupilumab是首个被批准用于治疗中重度特应性皮炎(AD)的单克隆抗体,并显著改善了AD患者的生活质量。然而,dupilumab在癌症治疗中的安全性尚不清楚。因此,我们旨在探讨dupilumab的安全性及其与肿瘤进展和发生的关系。通过回顾90例在dupilumab治疗前已存在肿瘤或在dupilumab治疗后出现新肿瘤的患者的相关医疗记录,我们发现dupilumab可能对大多数肿瘤没有明显的负面作用,但一些皮肤t细胞淋巴瘤(CTCLs)患者在dupilumab治疗期间预后相对不利。此外,在dupilumab治疗后出现新肿瘤的患者中,ctcl和淋巴瘤占大多数。一些患者最初被诊断为AD,可能是早期CTCL的表现,在dupilumab治疗后,他们出现了典型的CTCL症状。最后我们得出结论,dupilumab对大多数癌症患者是安全的。然而,dupilumab对ctcl的影响是有争议的。dupilumab的使用需要个体评估和密切监测。当疗效不佳时,需要重新评估诊断,特别是ctcl及相关疾病。
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引用次数: 0
The baked side: Cow's milk and egg protein threshold dose distributions in children reacting to baked milk and baked egg 烘焙侧:对烘焙牛奶和烘焙鸡蛋有反应的儿童的牛奶和鸡蛋蛋白质阈值剂量分布。
IF 3.9 2区 医学 Q2 ALLERGY Pub Date : 2025-01-01 DOI: 10.1016/j.waojou.2024.101012
Rocco Luigi Valluzzi MD , Carla Riccardi MD , Sara Urbani MD , Davide Ursi MD , Deborah Zavettieri MD , Francesco Di Girolamo PhD , Lamia Dahdah MD , Veronica Calandrelli PharmD , Vincenzo Fierro MD , Alessandro Fiocchi MD

Background

Children allergic to milk and egg, but tolerant to baked products, display higher reactivity thresholds than the general population of children allergic to milk and egg. We sought to verify the reactivity thresholds of milk- and egg-allergic children who also react to baked milk and baked egg, respectively.

Methods

We retrospectively assessed consecutive oral food challenge (OFC) for baked milk and egg between January 2018 and March 2022 in a population of baked milk- and baked-egg allergic children.

Results

Among 407 children included (median age 56 - IQR 31.1–103.7 months, 67.1% male), 93 (23.6%) returned positive OFC results, 41 with baked milk, and 52 with baked egg. The most conservative ED01 was 0.4 mg total protein (IQR 0.1–2.7) for milk and 2.2 mg total protein (IQR 0.6–7.3) for egg. The respective ED05 was 3.9 (IQR 1.1–14) mg for milk and 11.7 (IQR 5–27.2) mg for egg. Such thresholds are consistent to those found for fresh milk (0.8 times for ED01, 1.1 times for ED05). For egg, they are 6.5 (egg ED01), and 7.5 (egg ED05) times lower than for native form.Compared to the currently used thresholds, they are 1.3 (milk ED01), 1.3 (milk ED05), 11 (egg ED01), and 4.9 (egg ED05) times higher.

Conclusions

Milk thresholds are similar to those already observed in baked allergic versus baked tolerant children, while EDs for egg are at least 1.6 times higher than those currently indicated.Egg-allergic patients could be exempt from the recommendations of absolute avoidance of foods when present in infinitesimal quantities, represented by precautionary allergen labelling based on current EDs.
背景:对牛奶和鸡蛋过敏但对烘焙食品耐受的儿童,其反应阈值高于对牛奶和鸡蛋过敏的一般儿童。我们试图验证对牛奶和鸡蛋过敏的儿童的反应阈值,他们也分别对烤牛奶和烤鸡蛋有反应。方法:我们回顾性评估了2018年1月至2022年3月期间烘焙牛奶和烘焙鸡蛋过敏儿童对烘焙牛奶和烘焙鸡蛋的连续口服食物挑战(OFC)。结果:在纳入的407例患儿中(中位年龄56 - IQR 31.1-103.7个月,67.1%为男性),93例(23.6%)OFC阳性,41例食用烤牛奶,52例食用烤鸡蛋。牛奶和鸡蛋的最保守ED01分别为0.4 mg和2.2 mg总蛋白(IQR分别为0.1 ~ 2.7和0.6 ~ 7.3)。牛奶和鸡蛋的ED05分别为3.9 (IQR 1.1 ~ 14) mg和11.7 (IQR 5 ~ 27.2) mg。这些阈值与鲜奶的阈值一致(ED01为0.8倍,ED05为1.1倍)。对鸡蛋而言,它们分别比原生品种低6.5倍(鸡蛋ED01)和7.5倍(鸡蛋ED05)。与目前使用的阈值相比,分别提高了1.3倍(牛奶ED01)、1.3倍(牛奶ED05)、11倍(鸡蛋ED01)和4.9倍(鸡蛋ED05)。结论:牛奶的阈值与已经观察到的烘焙过敏儿童和烘焙耐受儿童相似,而鸡蛋的ed至少比目前所指出的高1.6倍。鸡蛋过敏患者可以免除绝对避免食物的建议,当存在无限小的量时,以基于当前EDs的预防性过敏原标签为代表。
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引用次数: 0
Gradient disparities in allergy and the gut microbiome among rural, migrant, and urban populations across China
IF 3.9 2区 医学 Q2 ALLERGY Pub Date : 2025-01-01 DOI: 10.1016/j.waojou.2024.101018
Wanjun Wang , Mo Xian , Ruchong Chen , Jing Li , Lulu Wu

Background

While much of the evidence linking the rapid urbanization and the increasing prevalence of allergen sensitization, but little is known regarding rural-to-urban migrants. The aim of this study was to identify the disparities in allergy, the gut microbiome and factors among native urban, migrating, and native rural Chinese.

Methods

We redesigned the dataset of the China Alliance of Research on Respiratory Allergic Disease secondary survey, and after stratified sampling, a subsample of 2422 subjects were enrolled for the analysis of a questionnaire, skin prick tests (SPT), and specific immunoglobulin E (sIgE) titer measurements against 8 common allergens. Fecal microbiotal composition was also sequenced by 16S rRNA and regression-based analyses with covariate adjustment applied.

Results

From urban to migrant and rural populations, IgE sensitization was predominantly directed against Dermatophagoides pteronyssinus (Der p). The titers of Der p-sIgE decreased sequentially across the 3 respective populations and co-sensitization to other allergens also showed a sequential decrease. Rural-to-urban migrants showed a low prevalence of Der p-SPT and Der p-sIgE initially, but developed substantial IgE titers and their gut microbiotal diversity, as well as species richness, appeared to change along with residential time spent in the urban area. High-fat diet, using a mattress, an SPT wheal size from Der p ≥ 6 mm, and duration of immigration >5 years were significantly associated with sIgE positivity in the migrants.

Conclusion

The Der p-sIgE responses and the composition of gut microbiota differs synchronously with extended living time in an urban area. Studies in immigrants provide a unique opportunities to evaluate the effects of environmental factors in the pathogenesis of allergic disorders.
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引用次数: 0
Advancing allergic rhinitis research through phenome-wide association studies: Insights from known genetic loci 通过全现象关联研究推进变应性鼻炎研究:来自已知遗传位点的见解。
IF 3.9 2区 医学 Q2 ALLERGY Pub Date : 2025-01-01 DOI: 10.1016/j.waojou.2024.101014
Xingling Tan MD , Zhouyouyou Xiao MB , Yao Wen MD , Han Liu MD , Wei Yu MD

Background

Allergic rhinitis (AR) is a common chronic respiratory disease that can lead to the development of various other conditions. Although genetic risk loci associated with AR have been reported, the connections between these loci and AR comorbidities or other diseases remain unclear.

Methods

This study conducted a phenome-wide association study (PheWAS) using known AR risk loci to explore the impact of known AR risk variants on a broad spectrum of phenotypes. Subsequently, linkage disequilibrium score regression (LDSC) and bidirectional two-sample mendelian randomization (TSMR) analyses were used to further analyze the genetic correlation and causal relationships between significant and potentially related phenotypes and AR.

Results

The PheWAS analysis indicated significant associations between asthma, eczema, nasal polyps, hypothyroidism, and AR risk variants. Additionally, potential associations were observed with ulcerative colitis, psoriasis, chalazion, pernicious anemia, glaucoma, multiple sclerosis, arthritis, prostate cancer, varicose veins of lower extremities, and heart attack. LDSC analysis showed that only asthma, eczema, and nasal polyps have significant positive genetic correlations with AR. Furthermore, TSMR analysis revealed causal relationships between AR and asthma, eczema, and nasal polyps.

Conclusion

This study highlights the impact of AR risk loci on a variety of diseases. By revealing new associations and shared genetic pathways, our findings provide valuable insights into the pathophysiology of AR and pave the way for more effective targeted interventions to manage AR and its related diseases.
背景:变应性鼻炎(AR)是一种常见的慢性呼吸道疾病,可导致各种其他疾病的发展。虽然已经报道了与AR相关的遗传风险位点,但这些位点与AR合并症或其他疾病之间的联系尚不清楚。方法:本研究利用已知AR风险位点进行全表型关联研究(PheWAS),探讨已知AR风险变异对广泛表型的影响。随后,采用连锁不平衡评分回归(LDSC)和双向双样本孟德尔随机化(TSMR)分析进一步分析显著和潜在相关表型与AR之间的遗传相关性和因果关系。结果:PheWAS分析显示哮喘、湿疹、鼻息肉、甲状腺功能减退和AR风险变异之间存在显著相关性。此外,还观察到溃疡性结肠炎、牛皮癣、湿疹、恶性贫血、青光眼、多发性硬化症、关节炎、前列腺癌、下肢静脉曲张和心脏病发作的潜在关联。LDSC分析显示,只有哮喘、湿疹和鼻息肉与AR存在显著的正相关遗传关系。此外,TSMR分析显示AR与哮喘、湿疹和鼻息肉存在因果关系。结论:本研究强调了AR风险位点对多种疾病的影响。通过揭示新的关联和共享的遗传途径,我们的研究结果为AR的病理生理学提供了有价值的见解,并为更有效地靶向干预AR及其相关疾病铺平了道路。
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引用次数: 0
In perennial allergic rhinitis, RQLQ is improved similarly by Azelastine 0.15 and mometasone furoate
IF 3.9 2区 医学 Q2 ALLERGY Pub Date : 2025-01-01 DOI: 10.1016/j.waojou.2024.101021
Jean Bousquet MD , Ludger Klimek MD , Hans-Christian Kuhl PhD , Duc Tung Nguyen MD , Rajesh Kumar Ramalingam MD , G. Walter Canonica MD , William E. Berger MD
Some double-blind, placebo-controlled trials have shown that Azelastine (Aze) high dose (0.15%) was effective in seasonal (SAR) and perennial allergic rhinitis (PAR). However, there was no long-term comparison between Aze 0.15% and intranasal corticosteroids (INCS) on safety and quality of life in perennial allergic rhinitis.
An open-label, active-controlled, parallel-group one-year study comparing mometasone furoate and Aze 0.15% in adults assessed safety over 1 year. Efficacy using the 28-item rhino-conjunctivitis quality of life questionnaire (RQLQ) was a secondary end point.
A total of 703 patients were randomized and 687 (97.7%) were included in the intent-to-treat (ITT) population. The present formulation was shown to be safe with long-term use over 12 months, with a mean duration of exposure of 270.7 days.
Over the one-year period, there was no significant difference for any RQLQ domains between Aze and mometasone furoate (MF) for all evaluations (baseline, 6, 9, and 12 months). This study suggests that Aze 0.15% and MF display a similar improvement of RQLQ ( 2.80 [2.78] for Aze 0.15% vs 2.81 [2.75] for MF).

Clinical trial registry number

NCT00720382.
{"title":"In perennial allergic rhinitis, RQLQ is improved similarly by Azelastine 0.15 and mometasone furoate","authors":"Jean Bousquet MD ,&nbsp;Ludger Klimek MD ,&nbsp;Hans-Christian Kuhl PhD ,&nbsp;Duc Tung Nguyen MD ,&nbsp;Rajesh Kumar Ramalingam MD ,&nbsp;G. Walter Canonica MD ,&nbsp;William E. Berger MD","doi":"10.1016/j.waojou.2024.101021","DOIUrl":"10.1016/j.waojou.2024.101021","url":null,"abstract":"<div><div>Some double-blind, placebo-controlled trials have shown that Azelastine (Aze) high dose (0.15%) was effective in seasonal (SAR) and perennial allergic rhinitis (PAR). However, there was no long-term comparison between Aze 0.15% and intranasal corticosteroids (INCS) on safety and quality of life in perennial allergic rhinitis.</div><div>An open-label, active-controlled, parallel-group one-year study comparing mometasone furoate and Aze 0.15% in adults assessed safety over 1 year. Efficacy using the 28-item rhino-conjunctivitis quality of life questionnaire (RQLQ) was a secondary end point.</div><div>A total of 703 patients were randomized and 687 (97.7%) were included in the intent-to-treat (ITT) population. The present formulation was shown to be safe with long-term use over 12 months, with a mean duration of exposure of 270.7 days.</div><div>Over the one-year period, there was no significant difference for any RQLQ domains between Aze and mometasone furoate (MF) for all evaluations (baseline, 6, 9, and 12 months). This study suggests that Aze 0.15% and MF display a similar improvement of RQLQ ( 2.80 [2.78] for Aze 0.15% vs 2.81 [2.75] for MF).</div></div><div><h3>Clinical trial registry number</h3><div>NCT00720382.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101021"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069730","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
Ambrosia (ragweed) pollen — A growing aeroallergen of concern in South Africa 豚草花粉——在南非引起关注的一种日益增长的空气过敏原
IF 3.9 2区 医学 Q2 ALLERGY Pub Date : 2024-12-01 DOI: 10.1016/j.waojou.2024.101011
Dorra Gharbi PhD , Dilys Berman PhD , Frank H. Neumann PhD , Trevor Hill PhD , Siyavuya Sidla BSc , Sarel S. Cillers PhD , Jurgens Staats MD , Nanike Esterhuizen PhD , Linus Ajikah PhD , Moteng E. Moseri MSc , Lynne J. Quick PhD , Erin Hilmer BSc , Andri Van Aardt PhD , Juanette John PhD , Rebecca Garland PhD , Jemma Finch PhD , Werner Hoek MD , Marion Bamford PhD , Riaz Y. Seedat MD , Ahmed I. Manjra MD , Jonny Peter MD, PhD

Background

Ragweed is an invasive, highly allergenic weed predicted to expand its habitat with warming global temperatures. Several Ambrosia species have been identified in South Africa for well over a century; however, its presence remained undetected by allergists and aerobiologists until the development of an extensive aerospora monitoring system across South African urban areas since 2019. This paper presents the inventory of preliminary investigation of the Ambrosia airborne pollen and the taxonomic identification of ragweed species.

Methods

Burkard volumetric spore traps for collecting pollen samples are set up in 9 South African cities (Johannesburg, Cape Town, Pretoria, Kimberley, Durban, Potchefstroom, Ermelo, Bloemfontein, and Gqeberha). Light microscopic identification was combined with environmental DNA metabarcoding analysis to confirm the species level of airborne Ambrosia at selected monitoring stations. Ragweed sensitisation was examined in Cape Town between February 2019 and February 2024, using Allergy Xplorer (ALEX2) multicomponent allergen array.

Results

Ambrosia pollen was detected in 5 aerobiological monitoring stations over the sampling period (Durban, Kimberley, Pretoria, Potchefstroom, Johannesburg). Periods of 4 consistent pollination years were observed in Kimberley (min: 1; max: 16 p.g/m3) and Durban (min: 26; max: 66 p.g/m3). In Pretoria, ragweed pollen was detected for 2 years (2020–2021; 2022–2023) with average total annuals (5-17 p.g/m3). A peak flowering period between March and April was observed in Potchefstroom, and several ragweed pollen peaks were present between the end of December and the beginning of May in Durban. The highest number of Ambrosia pollen grains was recorded in Potchefstroom, with 308 grains, and a maximum peak of 47 p.g/m3. eDNA metabarcoding confirmed the presence of Ambrosia artemisiifolia and A.trifida species. The overall prevalence of Ambrosia-sensitisation amongst 673 tests (age range 7–72 years) was 8.2% (55/673), with no significant difference in sensitisation patterns between age groups.

Conclusion

Our study confirms the need to monitor the spread of ragweed, and an increasing awareness of Ambrosia as an allergen of concern in Southern Africa. Extension of aerobiological networks and testing for Ambrosia sensitisation across urban and rural sites will be required.
豚草是一种具有高度过敏性的入侵杂草,预计随着全球变暖,其栖息地将扩大。一个多世纪以来,南非已经发现了几种安氏菌;然而,自2019年以来,在南非城市地区建立了广泛的空气孢子虫监测系统之前,过敏症专家和空气生物学家一直没有发现它的存在。本文介绍了豚草空气花粉的初步调查和豚草种类的分类鉴定。方法在南非9个城市(约翰内斯堡、开普敦、比勒陀利亚、金伯利、德班、Potchefstroom、Ermelo、Bloemfontein和Gqeberha)设置burkard体积孢子诱捕器采集花粉样本。采用光镜鉴定与环境DNA元条形码分析相结合的方法,确定了选定监测站空气中安氏菌的种类水平。2019年2月至2024年2月,在开普敦使用Allergy Xplorer (ALEX2)多组分过敏原阵列检测豚草致敏性。结果5个监测站(德班、金伯利、比勒陀利亚、波切夫斯特鲁姆、约翰内斯堡)在采样期内检测到sambrosia花粉。在金伯利观察到4个一致的授粉年(min: 1;最大:16磅/立方米)和德班(最小:26;最大:66磅/立方米)。在比勒陀利亚,检测到豚草花粉的时间为2年(2020-2021;(2022-2023),年平均总量为5-17 p.g/m3。Potchefstroom的花粉高峰期为3 ~ 4月,德班的花粉高峰期为12月底~ 5月初。在Potchefstroom中,Ambrosia花粉粒数最多,为308粒,最高峰值为47 p.g/m3。eDNA元条形码证实了蒿属和三叶草属的存在。在673例试验(年龄范围7-72岁)中,ambrosia致敏的总体患病率为8.2%(55/673),年龄组之间的致敏模式无显著差异。结论我们的研究证实有必要监测豚草的传播,并且越来越多的人意识到豚草是一种令人担忧的过敏原。将需要在城市和农村地区扩展空气生物学网络和测试安氏菌的致敏性。
{"title":"Ambrosia (ragweed) pollen — A growing aeroallergen of concern in South Africa","authors":"Dorra Gharbi PhD ,&nbsp;Dilys Berman PhD ,&nbsp;Frank H. Neumann PhD ,&nbsp;Trevor Hill PhD ,&nbsp;Siyavuya Sidla BSc ,&nbsp;Sarel S. Cillers PhD ,&nbsp;Jurgens Staats MD ,&nbsp;Nanike Esterhuizen PhD ,&nbsp;Linus Ajikah PhD ,&nbsp;Moteng E. Moseri MSc ,&nbsp;Lynne J. Quick PhD ,&nbsp;Erin Hilmer BSc ,&nbsp;Andri Van Aardt PhD ,&nbsp;Juanette John PhD ,&nbsp;Rebecca Garland PhD ,&nbsp;Jemma Finch PhD ,&nbsp;Werner Hoek MD ,&nbsp;Marion Bamford PhD ,&nbsp;Riaz Y. Seedat MD ,&nbsp;Ahmed I. Manjra MD ,&nbsp;Jonny Peter MD, PhD","doi":"10.1016/j.waojou.2024.101011","DOIUrl":"10.1016/j.waojou.2024.101011","url":null,"abstract":"<div><h3>Background</h3><div>Ragweed is an invasive, highly allergenic weed predicted to expand its habitat with warming global temperatures. Several <em>Ambrosia</em> species have been identified in South Africa for well over a century; however, its presence remained undetected by allergists and aerobiologists until the development of an extensive aerospora monitoring system across South African urban areas since 2019. This paper presents the inventory of preliminary investigation of the <em>Ambrosia</em> airborne pollen and the taxonomic identification of ragweed species.</div></div><div><h3>Methods</h3><div>Burkard volumetric spore traps for collecting pollen samples are set up in 9 South African cities (Johannesburg, Cape Town, Pretoria, Kimberley, Durban, Potchefstroom, Ermelo, Bloemfontein, and Gqeberha). Light microscopic identification was combined with environmental DNA metabarcoding analysis to confirm the species level of airborne <em>Ambrosia</em> at selected monitoring stations. Ragweed sensitisation was examined in Cape Town between February 2019 and February 2024, using Allergy Xplorer (ALEX<sup>2</sup>) multicomponent allergen array.</div></div><div><h3>Results</h3><div><em>Ambrosia</em> pollen was detected in 5 aerobiological monitoring stations over the sampling period (Durban, Kimberley, Pretoria, Potchefstroom, Johannesburg). Periods of 4 consistent pollination years were observed in Kimberley (min: 1; max: 16 p.g/m<sup>3</sup>) and Durban (min: 26; max: 66 p.g/m<sup>3</sup>). In Pretoria, ragweed pollen was detected for 2 years (2020–2021; 2022–2023) with average total annuals (5-17 p.g/m<sup>3</sup>). A peak flowering period between March and April was observed in Potchefstroom, and several ragweed pollen peaks were present between the end of December and the beginning of May in Durban. The highest number of <em>Ambrosia</em> pollen grains was recorded in Potchefstroom, with 308 grains, and a maximum peak of 47 p.g/m<sup>3</sup>. eDNA metabarcoding confirmed the presence of <em>Ambrosia artemisiifolia</em> and <em>A.trifida</em> species. The overall prevalence of <em>Ambrosia</em>-sensitisation amongst 673 tests (age range 7–72 years) was 8.2% (55/673), with no significant difference in sensitisation patterns between age groups.</div></div><div><h3>Conclusion</h3><div>Our study confirms the need to monitor the spread of ragweed, and an increasing awareness of Ambrosia as an allergen of concern in Southern Africa. Extension of aerobiological networks and testing for <em>Ambrosia</em> sensitisation across urban and rural sites will be required.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 12","pages":"Article 101011"},"PeriodicalIF":3.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758811","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
A multidimensional grading system for ABPA treatment escalation within the first year: The HEID score 一年内ABPA治疗升级的多维分级系统:HEID评分
IF 3.9 2区 医学 Q2 ALLERGY Pub Date : 2024-12-01 DOI: 10.1016/j.waojou.2024.100996
Zhang Ping'an MD, Ma Yanliang MD, Chen Xi MD, Ma Yifan MD, Yang Luyang MM, Zhang Moqin MD, Gao Zhancheng PhD

Background

Susceptibility to relapse is an important feature of allergic bronchopulmonary aspergillosis (ABPA); early identification of patients at high risk of relapse is urgently needed. A practical score that classifies the severity of ABPA according to its prognosis is not available.

Methods

We retrospectively reviewed patients with a diagnosis of ABPA at our hospital between January 2010 and December 2022. Logistic regression analysis was used to investigate independent risk factors for ABPA treatment escalation and select the variables included in the final score.

Results

One hundred and three patients with ABPA were enrolled in this study. An eosinophil count >1000/μL, Aspergillus fumigatus–specific IgE (Sp-IgE) >3.5 kUA/L, expectoration of brownish-black mucus plugs, high-attenuation mucus (HAM) and a percentage of the predicted diffusing capacity of carbon monoxide (DLCO/pred) < 60% were independent risk factors for ABPA treatment escalation. Initial treatment with antifungals was an independent protective factor. The final scale, designated HEID, incorporated 4 dichotomized variables: HAM (H, 1 point); eosinophil count (E, cutoff 1000/μL, 1 point); Sp-IgE (I, cutoff 3.5 kUA/L, 1 point) and DLCO/pred (D, cutoff 60%, 1 point). A score of 0–1 point indicated a low relapse risk; 2–4 points indicated a high relapse risk.

Conclusion

This easy-to-use multidimensional grading system was capable of accurately classifying the risk of treatment escalation in ABPA.
易感性复发是变应性支气管肺曲霉病(ABPA)的一个重要特征;迫切需要早期识别复发风险高的患者。根据预后对ABPA的严重程度进行分类的实用评分是不可用的。方法回顾性分析2010年1月至2022年12月在我院诊断为ABPA的患者。采用Logistic回归分析探讨ABPA治疗升级的独立危险因素,并选择纳入最终评分的变量。结果103例ABPA患者入组。嗜酸性粒细胞计数>;1000/μL,烟曲霉特异性IgE (Sp-IgE) >3.5 kUA/L,棕黑色粘液塞、高衰减粘液(HAM)的咳痰量和预测一氧化碳扩散能力的百分比(DLCO/pred) <;60%是ABPA治疗升级的独立危险因素。初始抗真菌治疗是一个独立的保护因素。最终量表称为HEID,包含4个二分类变量:HAM (H, 1分);嗜酸性粒细胞计数(E,截止1000/μL, 1点);Sp-IgE (I,截止3.5 kUA/L, 1分)和DLCO/pred (D,截止60%,1分)。0-1分表示复发风险低;2-4分表示复发风险高。结论该多维度分级系统易于使用,能够准确地对ABPA治疗升级风险进行分级。
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引用次数: 0
National trends in the prevalence and recurrence of anaphylaxis across all ages: The role of neighborhood deprivation and comorbidity (2002–2019) 全国各年龄段过敏反应患病率和复发趋势:邻里剥夺和合并症的作用(2002-2019)
IF 3.9 2区 医学 Q2 ALLERGY Pub Date : 2024-12-01 DOI: 10.1016/j.waojou.2024.101005
Ju Hee Kim MD , Eun Kyo Ha MD , Jeewon Shin MD , Nahyun Lee BE , Bo Eun Han BE , Man Yong Han MD , Eun Lee MD, PhD

Background

Understanding the trends of anaphylaxis and risk factors associated with its recurrence is essential for the effective management and prevention of this condition.

Objective

This study aimed to analyze the prevalence trends of anaphylaxis and identify risk factors for recurrence, with a focus on the influence of neighborhood deprivation and comorbidities, across all age groups.

Methods

We conducted a retrospective administrative cohort study on anaphylaxis utilizing the National Health Insurance-National Sample Cohort (NHIS-NSC) database in Korea (2002–2019). Anaphylaxis was defined with ICD-10 codes for the diagnosis combined with prescription codes. The Neighborhood Deprivation Index was used to identify the risk of recurrent anaphylaxis. Trends in the annual prevalence and recurrence of anaphylaxis were assessed through joinpoint regression and Cox proportional hazard models.

Results

Out of the 1,137,861 individuals studied, 37,012 (3.25%) cases of anaphylaxis were identified. Among these, 5783 individuals (15.6%) experienced a recurrence, half of them experiencing it within the first year after the initial episode. The highest incidence of anaphylaxis was observed in children and adolescents, followed by middle-aged adults. A rapid increase in anaphylaxis cases was observed from 2002 to 2006 (Annual Percentage Change [APC], 33.2), followed by a more gradual increase until 2013 (APC, 12.8), and a stable trend from 2013 to 2019 (APC, 0.61). Males and adult age groups exhibited an increased risk of recurrence. Living in an area with neighborhood deprivation and the presence of comorbid conditions were associated with increased recurrence risk.

Conclusions

The increasing prevalence of anaphylaxis and its association with certain risk factors calls for targeted intervention. Addressing neighborhood deprivation and comorbid conditions may aid in reducing the recurrence and overall burden of anaphylaxis.
背景了解过敏反应的趋势及其复发相关的危险因素对于有效地管理和预防这种情况是必不可少的。目的本研究旨在分析过敏性反应的流行趋势,并确定复发的危险因素,重点关注邻里剥夺和合并症对所有年龄组的影响。方法利用韩国国民健康保险-国家样本队列(NHIS-NSC)数据库(2002-2019)对过敏反应进行回顾性行政队列研究。用ICD-10诊断代码结合处方代码定义过敏反应。邻里剥夺指数用于确定复发性过敏反应的风险。通过联结点回归和Cox比例风险模型评估过敏反应年患病率和复发率的趋势。结果在研究的1137861例个体中,有37012例(3.25%)被确诊为过敏反应。其中,5783人(15.6%)复发,其中一半在首次发作后的一年内复发。过敏反应发生率最高的是儿童和青少年,其次是中年人。从2002年到2006年,过敏反应病例快速增加(年度百分比变化[APC], 33.2),随后到2013年逐渐增加(APC, 12.8),并在2013年至2019年保持稳定趋势(APC, 0.61)。男性和成年年龄组的复发风险增加。居住在邻里剥夺和存在合并症的地区与复发风险增加有关。结论过敏性反应的患病率上升及其与某些危险因素的关系需要有针对性的干预。解决邻里剥夺和合并症条件可能有助于减少复发和过敏反应的总体负担。
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引用次数: 0
Applications of basophil activation test in paediatric allergic diseases 嗜碱性粒细胞活化试验在儿童变态反应性疾病中的应用。
IF 3.9 2区 医学 Q2 ALLERGY Pub Date : 2024-12-01 DOI: 10.1016/j.waojou.2024.100998
Dodi Giulia MD , Di Filippo Paola MD , Di Ludovico Armando MD , Simeone Pasquale PhD , De Bellis Domenico MSc , D'ascanio Francesca MSc , Di Pillo Sabrina MD , Chiarelli Francesco PhD , Lanuti Paola PhD , Attanasi Marina PhD
Basophilic granulocytes, containing and releasing histamine after a specific allergy stimulation, are directly involved in IgE-mediated allergic reactions. CD63 is a transmembrane protein of secretory lysosomes of basophils and its upregulation is related with the release of histamine to the extracellular space during IgE-mediated allergic reactions. Basophil activation test (BAT) measures the activation of circulating basophils upon the in vitro stimulation of living blood cells with specific allergens. Such a test is particularly safe and reproducible and has recently emerged as a new promising diagnostic tool for allergic diseases.
BAT can be used to diagnose food allergy and represents a promising alternative to oral food challenge tests, especially in children as it is less invasive, safer, and cheaper than the gold standard tests. As a biomarker of tolerance and reactivity, it is also useful to monitor natural resolution and clinical response to immune-modulatory treatments. Regarding drug allergies, BAT is even the only possible applicable diagnostic tool for allergy reactions to some drugs, because of the lack of alternative test, or given that those commonly used are unreliable, or equivocal. Additionally, BAT allows to screen patients with more active urticarial and identify Hymenoptera-allergic patients with negative venom-specific immunoglobulin (Ig)E. In respiratory allergic diseases, BAT can facilitate the diagnosis of local allergic rhinitis and evaluate basophil allergen sensitivity in allergic asthma. Although IgE-sensitization in allergic asthma is usually demonstrated by skin prick test and specific IgE, those tests do not predict the clinical allergy contribution to asthma pathogenesis. To date, the potential of BAT in the diagnostic work-up of allergic diseases is well established, but a better standardization of its use is needed. This narrative review summarizes the state-of-the-art BAT technology and applications in pediatric allergic diseases, focusing on immune-related mechanisms and the BAT real clinical utility.
嗜碱性粒细胞在特定的过敏刺激后含有并释放组胺,直接参与ige介导的过敏反应。CD63是嗜碱性细胞分泌溶酶体的跨膜蛋白,其上调与ige介导的过敏反应中组胺向细胞外释放有关。嗜碱性粒细胞活化试验(BAT)是在体外用特异性过敏原刺激活血细胞时,测量循环嗜碱性粒细胞的活化。这种测试特别安全且可重复,最近成为一种新的有前途的过敏性疾病诊断工具。BAT可用于诊断食物过敏,是替代口服食物激发试验的一种很有前景的方法,特别是在儿童中,因为它比金标准试验侵入性更小、更安全、更便宜。作为耐受性和反应性的生物标志物,它也可用于监测免疫调节治疗的自然消退和临床反应。对于药物过敏,由于缺乏替代测试,或者考虑到常用的测试不可靠或模棱两可,BAT甚至是对某些药物过敏反应的唯一可能适用的诊断工具。此外,BAT允许筛选更活跃的荨麻疹患者,并识别血清特异性免疫球蛋白(Ig)E阴性的膜翅类过敏患者。在呼吸道变应性疾病中,BAT可促进局部变应性鼻炎的诊断,评价过敏性哮喘中嗜碱性粒细胞变应原的敏感性。虽然过敏性哮喘的IgE致敏通常通过皮肤点刺试验和特异性IgE来证实,但这些试验并不能预测临床过敏对哮喘发病机制的贡献。迄今为止,BAT在变应性疾病诊断工作中的潜力已得到充分确立,但需要对其使用进行更好的标准化。本文综述了最新的BAT技术及其在儿童过敏性疾病中的应用,重点介绍了免疫相关机制和BAT的实际临床应用。
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引用次数: 0
Exploring cytokine outputs for ex vivo diagnostics in drug reaction with eosinophilia and systemic symptoms (DRESS) 探索细胞因子输出用于体外诊断与嗜酸性粒细胞增多和全身症状(DRESS)的药物反应。
IF 3.9 2区 医学 Q2 ALLERGY Pub Date : 2024-12-01 DOI: 10.1016/j.waojou.2024.101002
Ana M. Copaescu MD, FRCPC , Effie Mouhtouris BSc , Fiona James BBiomedSci , Michelle S.Y. Goh MBBS, FACD , Elizabeth J. Phillips MD, FRCPC, FRACP , Jason A. Trubiano MBBS, BBiomedSci, FRACP, PhD , for Australasian Registry of Severe Cutaneous Adverse Reactions (AUS-SCAR)

Background

In an exploratory study to assess the potential to individualize T-cell diagnostics in antibiotic-associated severe T-cell mediated hypersensitivity, we focused on drug reaction with eosinophilia and systemic symptoms (DRESS) and the related cytokine outputs IL-4 and IL-5.

Methods

Patients with well-phenotyped RegiSCAR ≥4 DRESS, positive intradermal skin testing, and a previous negative IFN-γ Enzyme-Linked ImmunoSpot (ELISpot) assay were prospectively recruited. We specifically performed an ELISpot assay with IL-4 and IL-5 cytokine outputs. As comparative controls, these cytokine outputs were performed simultaneously in patients with a positive ex vivo IFN-γ release ELISpot result.

Results

Four antibiotic-associated DRESS cases were included. The IL-4 and IL-5 output ELISpot assay demonstrated various results among these patients, with at least 1 cytokine present in all the cases. As for the 2 controls with known positive IFN-γ release, compared to the IFN-γ secretion, the cytokine output using IL-4 and IL-5 showed an increased positivity.

Conclusion

In patients where the early response has suggested a TH2 response such as DRESS, IL-4 and IL-5 cytokine outputs could present an investigational advantage, including when IFN-γ is negative. In the future, larger prospective studies are required to understand the role of varied cytokine outputs in T-cell-mediated hypersensitivities.
背景:在一项评估抗生素相关的严重t细胞介导的超敏反应个体化t细胞诊断潜力的探索性研究中,我们重点研究了嗜酸性粒细胞和全身症状(DRESS)的药物反应以及相关的细胞因子输出IL-4和IL-5。方法:前瞻性招募表型良好的RegiSCAR≥4 DRESS、皮内皮肤试验阳性、先前IFN-γ酶联免疫斑点(ELISpot)试验阴性的患者。我们专门对IL-4和IL-5细胞因子输出进行了ELISpot检测。作为对照,这些细胞因子输出在体外IFN-γ释放阳性ELISpot结果的患者中同时进行。结果:纳入4例抗生素相关DRESS病例。IL-4和IL-5输出ELISpot检测在这些患者中显示出不同的结果,所有病例中至少存在1种细胞因子。对于已知IFN-γ释放阳性的2个对照组,与IFN-γ分泌相比,使用IL-4和IL-5的细胞因子输出呈阳性增加。结论:在早期反应表明TH2反应如DRESS的患者中,IL-4和IL-5细胞因子输出可能呈现研究优势,包括当IFN-γ为阴性时。在未来,需要更大规模的前瞻性研究来了解不同细胞因子输出在t细胞介导的超敏反应中的作用。
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引用次数: 0
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World Allergy Organization Journal
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