World Allergy Organization Journal最新文献_第5页

Retrospective evaluation of pediatric anaphylaxis cases according to WAO and NIAID/FAAN/EAACI criteria: A single center experience 根据 WAO 和 NIAID/FAAN/EAACI 标准对儿科过敏性休克病例进行回顾性评估：单中心经验

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2024-10-24 DOI: 10.1016/j.waojou.2024.100982

Funda Aytekin Güvenir MD , Gökhan Yörüsün MD , Ragıp Dere MD , Ahmet Selmanoğlu MD , Zeynep Şengül Emeksiz MD , Emine Dibek Mısırlıoğlu MD

Background

Anaphylaxis is an emergency that must be correctly recognized and treated by every health care professional. With the update of the World Allergy Organization (WAO) criteria in 2020, differences between the European Academy of Allergy and Immunology (EAACI)/The National Institute of Allergy and Infectious Diseases (NIAID) and the Food Allergy and Anaphylaxis Network (FAAN) and WAO criteria have come to the fore.

Objective

The aim of our study is to compare the effectiveness of these 2 criteria in diagnosing anaphylaxis in pediatric patients.

Methods

Patients aged 0–18 years who applied to Ankara Bilkent City Hospital Pediatric Immunology and Allergy Clinic between September 1, 2020 and September 1, 2023 due to systemic allergic reaction and were diagnosed with anaphylaxis were evaluated retrospectively. The clinical findings of the patients were re-evaluated accordingto WAO 2020 and NIAID/FAAN/EAACI criteria.

Results

Included in the study were 492 patients who met the inclusion criteria. Median age was 3.8 years (IQR: 0.9–11.4). The majority of patients were male (59.6%). There were 466 patients (94.1%) diagnosed with anaphylaxis according to both NIAID/FAAN/EAACI and WAO criteria. Three patients (0.6%) with isolated laryngeal involvement and 23 (4.7%) patients with isolated respiratory findings (bronchospasm) were diagnosed only according to WAO Criterion 2, for a total of 26 patients (5.3%).

Conclusion

Although the majority of patients were diagnosed with both criteria, 5.3% were diagnosed only according to the WAO criteria. After contact with a suspected or known allergen, the presence of isolated respiratory or laryngeal findings without skin findings should be a warning before anaphylaxis progresses to more serious stages.

背景过敏性休克是一种急症，每位医护人员都必须正确认识和处理。随着世界过敏组织（WAO）标准在2020年的更新，欧洲过敏与免疫学学会（EAACI）/美国国家过敏与传染病研究所（NIAID）和食物过敏与过敏性休克网络（FAAN）与WAO标准之间的差异凸显出来。方法回顾性评估 2020 年 9 月 1 日至 2023 年 9 月 1 日期间因全身过敏反应前往安卡拉比尔肯特市医院儿科免疫和过敏门诊就诊并被诊断为过敏性休克的 0-18 岁患者。根据 WAO 2020 和 NIAID/FAAN/EAACI 标准重新评估了患者的临床结果。中位年龄为 3.8 岁（IQR：0.9-11.4）。大多数患者为男性（59.6%）。有 466 名患者（94.1%）根据 NIAID/FAAN/EAACI 和 WAO 标准被诊断为过敏性休克。有 3 名患者（0.6%）仅根据 WAO 标准 2 诊断出喉部受累，23 名患者（4.7%）仅根据 WAO 标准 2 诊断出呼吸道症状（支气管痉挛），共计 26 名患者（5.3%）。接触疑似或已知过敏原后，在过敏性休克发展到更严重的阶段之前，出现孤立的呼吸道或喉部症状而无皮肤症状应是一个警告。

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引用次数: 0

A 300 IR 5-grass pollen sublingual immunotherapy tablet-specific systematic review and meta-analysis confirms its clinical benefits for patients with allergic rhinoconjunctivitis with or without asthma 一项针对 300 IR 5-禾本科花粉舌下免疫疗法片剂的系统综述和荟萃分析证实了该疗法对伴有或不伴有哮喘的过敏性鼻结膜炎患者的临床疗效

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2024-10-24 DOI: 10.1016/j.waojou.2024.100985

Danilo Di Bona MD, PhD , Giovanni Paoletti MD , Michal Ordak PhD , Silvano Dragonieri MD, PhD , Josiane Cognet-Sice PharmD , Silvia Scurati PhD , Giorgio Walter Canonica MD

Background

In the realm of allergen immunotherapy (AIT), the quality of evidence varies across different products, making it unjustifiable to extend overall conclusions to all AIT products, as highlighted by WAO and EAACI.

Objective

To confirm the efficacy of the 300 IR 5-grass pollen sublingual AIT (SLIT)-tablet through a specific meta-analysis of randomized controlled trials (RCTs) involving patients with allergic rhino-conjunctivitis (ARC) with/without mild/intermittent asthma.

Methods

Data from published RCTs on the 300 IR 5-grass SLIT-tablet were gathered from electronic databases (MEDLINE, ISI Web of Science, LILACS, the Cochrane Library and ClinicalTrial.gov) and manual searches up to November 2023. Populations, treatments, and outcome data were combined. Efficacy was assessed based on symptom score (SS) and medication score (MS), measured as standardized mean difference (SMD) or mean difference (MD).

Results

Results from 5 RCTs comprising 1468 patients revealed a significant reduction in SS (SMD, −0.36; 95%confidence interval [CI], −0.52 to −0.19; P < 0.05) and MS (SMD, −0.29; 95%CI, −0.40 to −0.19; P < 0.05) compared to placebo. The difference of −0.36 SMD for SS corresponds to a MD of −1.26 SS points, greater than the minimal important difference. Subgroup analysis did not show differences in efficacy according to age, asthma status, and geographic location of the study (USA, Canada, Europe, Russia). No safety issues were reported.

Conclusion

This product-specific meta-analysis reinforces the evidence of clinical benefits associated with the 300 IR 5-grass SLIT-tablet, suggesting its appropriateness as a therapeutic choice for patients with ARC, irrespective of concurrent asthma, and exhibiting a favorable safety profile.

背景在过敏原免疫疗法（AIT）领域，不同产品的证据质量参差不齐，因此，正如 WAO 和 EAACI 所强调的那样，将总体结论推广到所有 AIT 产品是不合理的。目的通过对涉及过敏性鼻结膜炎（ARC）伴/不伴轻度/间歇性哮喘患者的随机对照试验（RCT）进行特定的荟萃分析，确认 300 IR 5-禾本科花粉舌下 AIT（SLIT）片剂的疗效。方法从电子数据库（MEDLINE、ISI Web of Science、LILACS、Cochrane 图书馆和 ClinicalTrial.gov）和截至 2023 年 11 月的人工搜索中收集已发表的有关 300 IR 5-grass SLIT 片剂的 RCT 数据。对人群、治疗方法和结果数据进行了合并。根据症状评分（SS）和用药评分（MS）评估疗效，以标准化均值差（SMD）或均值差（MD）衡量。结果5项RCT的结果显示，与安慰剂相比，1468名患者的SS（SMD，-0.36；95%置信区间[CI]，-0.52至-0.19；P< 0.05）和MS（SMD，-0.29；95%CI，-0.40至-0.19；P< 0.05）显著降低。SS的SMD为-0.36，相当于MD为-1.26 SS点，大于最小重要差异。分组分析显示，不同年龄、哮喘状况和研究地点（美国、加拿大、欧洲、俄罗斯）的疗效没有差异。结论这项针对特定产品的荟萃分析加强了与 300 IR 5-grass SLIT 片剂相关的临床疗效证据，表明该药物适合作为 ARC 患者的治疗选择，无论是否同时患有哮喘，并且具有良好的安全性。

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引用次数: 0

Japanese version of the food allergy quality of life questionnaire 10: An easy-to-use instrument 食物过敏生活质量问卷 10 日语版：简便易用的工具

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2024-10-24 DOI: 10.1016/j.waojou.2024.100979

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

Background

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.

背景为了提供高质量的医疗服务，应该对食物过敏患者的健康相关生活质量（HRQL）进行评估。方法将食物过敏生活质量问卷 10 (FAQLQ10) 的英文版翻译成日文，并将其称为食物过敏生活质量问卷 10 的日文版 (FAQLQ10-J)。患有食物过敏症的 18 岁以下参与者及其父母在指导下完成了 FAQLQ10-J 和食物过敏症独立测量（一种自我报告工具）。为了进行比较，调查还包括没有食物过敏的参与者。答卷者在大约 3 分钟内完成了每份表格。对回答进行的分析表明，每份表格都具有良好的内部一致性、重测可靠性、构建有效性和判别有效性。此外，根据人口统计学数据与 FAQLQ10-J 分数之间关系的研究，拥有肾上腺素自动注射器、参与者年龄和排除食物的数量等项目可能会影响 HRQL。使用该工具可以更详细地了解临床环境中食物过敏患者的 HRQL，并有助于开发更多面向个体的治疗方法。

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引用次数: 0

Adherence to a modified Mediterranean diet and in association with asthma and wheezing in schoolchildren: A cross-sectional study 坚持改良地中海饮食与学龄儿童哮喘和喘息的关系：横断面研究

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2024-10-18 DOI: 10.1016/j.waojou.2024.100948

Faezeh Poursoleiman PhD , Bahareh Sasanfar PhD , Nasrin Behniafard MD , Zahra Nafei MD , Elahe Akbarian MS , Abbas Khalili MD , Amin Salehi-Abargouei PhD

Background

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; P_trend < 0.001). Regarding the wheezing, a linear reducing trend was observed in girls (OR: 0.88; 95% CI: 0.62–1.25; P_trend = 0.04); and a significant protective association was seen among boys (OR: 0.45; 95% CI: 0.28–0.73; P_trend < 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.

背景对地中海饮食（MeD）与儿童和青少年哮喘之间关系的调查有限。我们旨在研究改良地中海饮食模式与伊朗儿童哮喘症状之间的关系。通过由家长填写的调查问卷收集了有关饮食摄入量、哮喘症状和其他可能的混杂因素的数据。结果我们发现，与最低四分位数的人相比，地中海饮食（MeD）得分最高的四分位数的参与者在过去 12 个月中出现喘息的几率要低 32%（OR：0.68；95% CI：0.51-0.90；Ptrend <；0.001）。关于喘息，在女孩中观察到线性降低趋势（OR：0.88；95% CI：0.62-1.25；Ptrend = 0.04）；在男孩中观察到显著的保护性关联（OR：0.45；95% CI：0.28-0.73；Ptrend <；0.001）。按性别进行的分析表明，与第一四分位数相比，最高四分位数的女孩和男孩目前患哮喘的几率分别降低了 68% 和 51%。另一方面，肉类摄入量与哮喘发病率呈负相关。这种饮食模式与哮喘之间没有关联。应开展进一步的前瞻性调查来证实这些发现。

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引用次数: 0

Vitamin D, allergen sensitization, and atopic dermatitis 维生素 D、过敏原致敏和特应性皮炎

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2024-10-15 DOI: 10.1016/j.waojou.2024.100978

Öner Özdemir MD

引用次数: 0

Blood and local eosinophil levels in chronic rhinitis: Comment 慢性鼻炎患者的血液和局部嗜酸性粒细胞水平评论

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2024-10-15 DOI: 10.1016/j.waojou.2024.100977

Hinpetch Daungsupawong PhD , Viroj Wiwanitkit MD

引用次数: 0

Is there a difference between women and men in chronic spontaneous urticaria? A systematic review on gender and sex differences in CSU patients 慢性自发性荨麻疹的男女患者有差异吗？关于慢性自发性荨麻疹患者性别差异的系统综述

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2024-10-12 DOI: 10.1016/j.waojou.2024.100974

Sarah Preis MD , Carla Claussen MD , Stefanie Ziehfreund , Tilo Biedermann MD , Sophia Horster MD , Alexander Zink MD, PhD

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。

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引用次数: 0

Role of specific immunoglobulin-E in chronic rhinosinusitis: Its clinical relevance according to nasal challenge test 特异性免疫球蛋白-E 在慢性鼻炎中的作用：鼻腔挑战试验的临床意义

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2024-10-01 DOI: 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.

背景慢性鼻炎（CRS）指南提出，总 IgE 和嗜酸性粒细胞是识别 2 型炎症的重要生物标志物。尽管特异性 IgE（sIgE）已被确定为某些 2 型疾病不同临床结果的临床预测指标，但其在 CRS 中的作用仍有待详细探讨。目的通过鼻腔挑战试验（NCT）描述 CRS 中的全身和局部 sIgE，并探讨其与临床结果之间可能存在的关联。方法在 CRS 患者中，我们测量了针对 9 种过敏源（Der p、Der f、Blo t、Can f、Fel d、Per a、草、葡萄球菌肠毒素 A 和 B）的总 IgE、血清 sIgE（SsIgE）和鼻腔 sIgE（NsIgE）。SsIgE 感染率为 52.8%，NsIgE 感染率为 46.5%；Der p 是 SsIgE 和 NsIgE 的主要过敏原。鼻息肉、哮喘合并症、对非甾体抗炎药过敏和嗅觉减退与 SsIgE 和 NsIgE 的存在显著相关，但与总 IgE 无关。对 73 例 CRS 患者进行了 NCT-Der p 检测，其中 33 例（45.2%）呈阳性。在预测 NCT 结果方面，特异性 IgE 的诊断准确率最高（79.4%）（NsIgE 67.5% 总 IgE 52%）。与临床相关的 SsIgE 患者的表观内型与不同的临床结果相关。考虑到 NCT 证实的 SsIgE 的临床相关性，必须对 CRS 的过敏原免疫疗法等干预措施进行研究。

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引用次数: 0

Pollen exposures in pregnancy and early life are associated with childhood asthma incidence 孕期和生命早期接触花粉与儿童哮喘发病率有关

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2024-10-01 DOI: 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。

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引用次数: 0

Fecal microbiota transplantation alleviates food allergy in neonatal mice via the PD-1/PD-L1 pathway and change of the microbiota composition 粪便微生物群移植通过 PD-1/PD-L1 途径和微生物群组成的改变缓解新生小鼠的食物过敏症

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2024-10-01 DOI: 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。

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引用次数: 0