Frontiers in allergy最新文献

Background: Research on the combination of biologics with rush immunotherapy (RIT) remains scarce, particularly regarding safety and efficacy data in pediatric and hypersensitive populations undergoing rapid desensitization or concurrent biologic therapy. Furthermore, regarding RIT, it remains unclear which patients can effectively reduce the occurrence of adverse reactions when combined with biologics, and which patients fail to achieve such a reduction with this combination therapy.

Methods: This retrospective study analyzed 202 patients with mite-induced allergic asthma (2018-2024) receiving RIT alone (n = 133) or omalizumab-pretreated RIT (RIT + Omb-pre, n = 69). Stratified analyses were conducted based on age, mite sIgE levels, total IgE(T-IgE) levels, and sIgE to T-IgE ratios. Outcomes included systemic adverse reaction (SR) rates, RIT completion rates, improvements in clinical parameters following omalizumab intervention, and 1-year follow-up efficacy across subgroups.

Results: Both regimens were well tolerated, with no grade ≥3 SRs observed. Compared to RIT alone, RIT + Omb-pre significantly reduced SR incidence (p < 0.05) and showed a trend toward higher target peak concentration completion rates (p = 0.054). Age-stratified analysis revealed higher SR risks in children/teenager patients vs. adults. Subgroup analyses further demonstrated that SR incidence correlated positively with mite sIgE levels and sIgE/T-IgE ratio (p < 0.05), but not with T-IgE. Patients with low-risk biomarkers (sIgE grades 1-2 and sIgE/T-IgE <10%) exhibited minimal SR incidence unaffected by omalizumab, whereas high-risk subgroups (sIgE grades 3-6 and sIgE/T-IgE ≥10%) showed significantly elevated SR incidence, which was markedly mitigated by omalizumab (p < 0.05).Subgroup with sIgE/T-IgE ratios >16% achieved substantially greater improvements in ACQ scores and daily medication burden compared to those with ratios <16% during the 12-month intervention. Furthermore, this study reaffirmed the age-dependent efficacy correlation, with pediatric patients demonstrating superior therapeutic outcomes to adult patients.

Conclusions: Regarding the safety of dust mite rush immunotherapy for allergic asthma, Omalizumab significantly reduces the incidence of SRs in high-risk populations (sIgE grades 3-6 and sIgE/T-IgE ≥10%), whereas it demonstrates limited efficacy in low-risk subgroups (sIgE grades 1-2 and sIgE/T-IgE <10%).

Objective: We hypothesized that intestinal barrier impairment is a key pathophysiological feature in AD and that the degree of baseline barrier dysfunction, reflected by serum D-lactate levels, predicts the clinical response to Washed Microbiota Transplantation (WMT). This study aimed to test these hypotheses by investigating the association between intestinal barrier biomarkers and AD severity, and their correlation with WMT outcomes.

Methods: We compared intestinal barrier biomarkers (D-lactate, endotoxin, and diamine oxidase) between 24 AD patients and 23 healthy donors. Additionally, we evaluated the clinical outcomes of 14 AD patients who underwent WMT therapy.

Results: AD patients exhibited significantly elevated intestinal barrier biomarkers compared to healthy donors (p < 0.01). Following WMT, significant improvements were observed in SCORAD, EASI, and NRS scores (p < 0.05). In exploratory, uncorrected analyses, baseline D-lactate levels showed a significant negative correlation with improvements in SCORAD (R = -0.738, p = 0.037) and NRS scores (R = -0.650, p = 0.012), suggesting that higher pre-treatment levels might predict greater symptom relief. Microbiota analysis revealed a increase in Acidaminococcus and decreases in Ruminococcus_gnavus_group, Flavonifractor, and Norank_f_Oscillospiraceae following WMT.

Conclusion: This study confirms significant intestinal barrier dysfunction in AD and demonstrates the potential clinical efficacy of WMT. The strong, uncorrected correlations suggest that pre-treatment D-lactate level warrants further investigation as a candidate biomarker for predicting WMT response. The clinical benefits occurred alongside a restructuring of the gut microbiota.

Rationale: Shrimp (Litopenaeus vannamei) allergies (SA) can result in allergic reactions ranging from life threatening severe anaphylaxis to oral allergy syndrome. SA may pose lifestyle restrictions on daily life and interfere with social relationships and school performance, but this has not been thoroughly investigated. We examined the QoL in SA adults and caregivers.

Methods: A QoL online questionnaire adapted from the validated Food Allergy Quality of Life Questionnaire (FAQLQ) was administered between September 30, 2023-July 15, 2024 to adults and caregivers of at least one SA child. Descriptive statistics, Wilcoxon rank sum test, and Fisher exact test were used to determine QoL and desire for treatment in SA subjects. Comparisons were made between SA adults with and without children with SA.

Results: Eighty-six participants completed the survey. Sixty-four (74%) SA adults did not have SA children, and 6 (7%) were SA adults with SA children. Eighty-one percent of SA adults found SA at least moderately to extremely troublesome, and 83% felt other people underestimated problems caused by SA. Seventy percent of SA adults were interested/very interested in a treatment and, of those interested, 47% wanted treatment to enable eating a serving size of shrimp. The small cohort of SA adults with a SA child may have been more likely to have concerns about allergic reaction compared to SA adults without a SA child. [OR, 4.4 (CI, 1-21)].

Conclusions: SA adults report impaired QoL and a desire for treatment to eat a serving size of shrimp. The majority of SA people have impaired QoL.

Background: Up to 30% of chronic spontaneous urticaria (CSU) patients and 24% of children with CSU may have an NSAIDs-exacerbated cutaneous disease (NECD). Some vegetables and fruits are rich in salicylate. Salicylates in food can exacerbate symptoms in CSU patients.

Aim: Our aim is to investigate the effect of a low salicylate diet on urticaria severity, quality of life, blood salicylate level and urine arachidonic acid pathway metabolites.

Methods: Patients followed a fourweek low salicylate diet. Chronic urticaria quality of life questionnaire (CU-Q2oL) and 4 Days-Urticaria Activity Scores (UAS4) were recorded and blood and urine samples were collected at baseline and after the low salicylate diet. Urine Leukotriene-E4, Prostaglandin-E2, Prostaglandin-F2α, Thromboxane-A2, and creatinine levels were measured via ELISA. Blood salicylate level was determined by LC-MS/MS.

Results: A total of 36 CSU patients were included in the study. The CU-Q2oL scores significantly decreased from 33.7 to 20.7 (p < 0.001) and the UAS4 significantly decreased from 14 to 8 (p < 0.001) after low salicylate diet when compared to baseline (low scores mean less complaints). The blood salicylate level was significantly lower after the low salicylate diet compared to the baseline (p = 0.042). However, there was no significant effect of the diet on urinary LTE4, PGDE2, PGDF2α and TXA2 levels.

Conclusion: Our findings suggest that a low salicylate diet may help to reduce the severity of urticaria and improve quality of life by lowering blood salicylate levels. However, the diet had no impact on urinary LTE4, PGDE2, PGDF2α, and TXA2 levels.

Background: Social phobia and asthma pose threats to the health of adolescents at the psychological and physical levels, respectively. The aim of this study was to explore the association between social phobia and asthma in this population.

Methods: A total of 337 adolescent asthma patients and 337 adolescent controls were included. Social phobia status was assessed using the Mini Social Phobia Inventory (Mini-SPIN) and the Social Anxiety Scale for Children (SASC). The ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC), the percentage of forced expiratory volume in 1 s to its predicted value (FEV1%pred), peak expiratory flow, and peripheral levels of plasma eosinophil, immunoglobulin E (IgE), leukotriene, and histamine were also measured. Multivariate logistic or linear regression analyses were used to evaluate the associations between social phobia-related variables and asthma-related variables.

Results: Elevated scores on the Mini-SPIN and SASC scales were associated with an increased risk of asthma in adolescents (both P < 0.001). This association remained consistent among adolescents with new-onset asthma (both P < 0.001) and those experiencing asthma recurrence in adolescence following a childhood asthma history (both P < 0.001). Meanwhile, higher scores on both scales correlated with decreased FEV1/FVC (both P < 0.001) and FEV1%pred (P = 0.001 and P = 0.002, respectively) and elevated leukotriene levels (P < 0.001 and P = 0.001, respectively). However, neither scale showed an association with plasma eosinophil, IgE, or histamine levels.

Conclusion: Among adolescents, there was a significant association between social phobia and asthma.

Allergic rhinitis (AR) is a complex, multifactorial condition that continues to pose significant clinical and public health challenges, despite the availability of established therapeutic strategies. It significantly contributes to a lower quality of life by causing sleep issues, mental fatigue, and a decline in productivity. A thorough grasp of AR is crucial to enhancing diagnosis and treatment results because of its pervasive effects and ongoing management gaps. This review covers a wide range of topics, such as classification schemes, historical perception, and physical consequences of AR. It talks about the etiological elements that influence the pathophysiology of the illness and sheds light on the immune systems at play. By critically examining current diagnostic limitations and barriers to early intervention, this review underscores the necessity for improved clinical awareness and patient education. Additionally, the paper assesses the variety of existing treatment options, ranging from allergy immunotherapy to pharmaceutical interventions, and investigates breakthroughs in the treatment of AR, including phytotherapy and innovative therapeutic techniques. Trends in patient preferences and clinical uptake are noted, along with the market's evolution for AR treatments. Furthermore, current clinical studies for possible pharmacotherapies are examined, highlighting the significance of continued innovation in the treatment of AR. The review's conclusion makes recommendations for enhancing clinical practice, public health initiatives, and patient outcomes as well as future research directions. By highlighting the necessity of improved clinical awareness and intervention techniques, this thorough analysis seeks to offer a comprehensive understanding of AR and its management.

Thymic stromal lymphopoietin (TSLP), IL-33, and IL-25 are epithelial-derived proinflammatory alarmin cytokines that drive inflammatory airway diseases such as asthma and chronic obstructive pulmonary disease (COPD). Targeted inhibition of these proteins has demonstrated varying degrees of efficacy in patients with asthma and COPD. As the biology of inflammatory respiratory disease is complex, combination approaches that directly inhibit multiple targets may provide deeper efficacy in a broader patient population. Here, we review the biology of alarmins and the development landscape for monotherapies and multispecific alarmin inhibitors.

Introduction: Allergic asthma affects over 300 million people globally, characterized by a type 2 immune response to allergens like house dust mite (HDM). This includes eosinophilia, IgE production, and symptoms such as bronchial hyperresponsiveness. Human milk oligosaccharides (HMOS), ingested by breastfed infants, have immunomodulatory effects and may help prevent allergic diseases, like asthma.

Methods: This study investigates the effects of two sialylated HMOS, 3'-sialyllactose (3'SL) and 6'-sialyllactose (6'SL), in a murine model of HDM-induced allergic asthma. Male BALB/c mice (6-7 weeks old) were fed an AIN93G diet with or without 0.1% or 0.5% 3'SL or 6'SL from 2 weeks before HDM sensitization until sacrifice. Airway hyperresponsiveness was measured after the final HDM challenge, and broncho-alveolar lavage fluid (BALF) and lung tissue were collected for analysis.

Results: Dietary 0.5% 3'SL, 0.1% 6'SL, or 0.5% 6'SL prevented methacholine-induced airway hyperresponsiveness in HDM-challenged mice compared to control diet. Mice fed the 0.5% 3'SL diet had elevated SCFA levels in cecum content. Both 3'SL and 6'SL groups showed reduced HDM-induced macrophage influx in BALF. Mice on 3'SL diets had lower total inflammatory cell influx, while those on 0.5% 6'SL had increased eosinophils in BALF, associated with higher IL33, TNFα, CCL5, IFNγ levels, and reduced regulatory T cells. The 3'SL diets also prevented increases in HDM-specific IgE and mMCP1 in serum.

Conclusion: Dietary 3'SL and 6'SL showed dose-dependent, differential clinical and immunological outcomes in HDM-sensitized mice. Both 0.5% 3'SL, 0.1% 6'SL, and 0.5% 6'SL reduced airway hyperresponsiveness. However, 0.5% 6'SL increased eosinophilic inflammation, while 3'SL protected against HDM-induced sensitization and asthma development.