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Allergen immunotherapy in China 中国的过敏原免疫疗法
Q2 ALLERGY Pub Date : 2024-01-08 DOI: 10.3389/falgy.2023.1324844
Yaqi Yang, Wen-jing Li, R. Zhu
Allergen immunotherapy (AIT) is an etiological treatment strategy that involves administering escalating doses of clinically relevant allergens to desensitize the immune system. It has shown encouraging results in reducing allergy symptoms and enhancing patients' quality of life. In this review, we offer a thorough overview of AIT in China, examining its efficacy, safety, current practices, and prospects. We further underscore the progress made in AIT research and clinical applications, as well as the distinct challenges and opportunities that China faces in this area.
过敏原免疫疗法(AIT)是一种病因学治疗策略,它是指给患者注射逐渐增加剂量的临床相关过敏原,使免疫系统脱敏。它在减轻过敏症状和提高患者生活质量方面取得了令人鼓舞的效果。在这篇综述中,我们全面概述了 AIT 在中国的发展情况,探讨了其疗效、安全性、当前实践和前景。我们进一步强调了 AIT 研究和临床应用所取得的进展,以及中国在这一领域所面临的独特挑战和机遇。
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引用次数: 0
Navigating formula shortages: associations of parental perspectives on transitioning to alternative infant formulas for cow's milk protein allergy during the 2022 national formula shortage 驾驭配方奶粉短缺:在 2022 年全国配方奶粉短缺期间,父母对改用替代婴儿配方奶粉治疗牛乳蛋白过敏症的看法的联系
Q2 ALLERGY Pub Date : 2024-01-08 DOI: 10.3389/falgy.2023.1333570
Abigail L. Fabbrini, Andrew A. Farrar, Jerry M. Brown, Lea Oliveros, J. Florio, Jesse Beacker, Luke Lamos, Jessica V Baran, Michael J Wilsey
The COVID-19 pandemic led to supply chain disruptions causing a severe shortage of infant formula. The shortage impacted parents of infants with cow's milk protein allergy (CMPA) who rely on specialized formulas. However, research on parent perspectives during formula shortages is limited. We aimed to understand the factors guiding parents' decisions when transitioning to alternative amino acid formula (AAF) or extensively hydrolyzed formula (eHF) during the national formula shortage. We conducted a survey using the ZSMoments platform and found that before the shortage, parents valued safety (83%), tolerability (78%), and reputability (78%) as primary factors in selecting eHFs and AAFs. Post-shortage, formula tolerability (86%), assurance (84%), and safety (80%) gained more importance. Among those switching eHF (n = 54), health care provider recommendations (81%), reputability (78%), taste (78%), and tolerability (78%) were rated as “extremely important.” Among those switching AAF (n = 26), top factors included tolerability (77%), assurance (73%), safety (73%), cost-effectiveness (73%), and formula trustworthiness (73%). These data suggest that parents carefully weigh various factors when managing their child's CMPA and transitioning to different AAF or eHF options.
COVID-19 大流行导致供应链中断,造成婴儿配方奶粉严重短缺。配方奶粉短缺影响了那些依赖专用配方奶粉的牛奶蛋白过敏(CMPA)婴儿的父母。然而,有关配方奶粉短缺期间家长观点的研究十分有限。我们的目的是了解在全国配方奶粉短缺期间,指导家长决定过渡到替代氨基酸配方奶粉(AAF)或广泛水解配方奶粉(eHF)的因素。我们使用 ZSMoments 平台进行了一项调查,结果发现,在配方奶粉短缺之前,父母在选择 eHF 和 AAF 时,主要看重安全性(83%)、耐受性(78%)和声誉(78%)。奶粉短缺后,配方奶粉的耐受性(86%)、保证性(84%)和安全性(80%)变得更加重要。在更换易合奶粉的人群中(n = 54),医疗保健提供者的建议(81%)、信誉(78%)、口味(78%)和耐受性(78%)被评为 "极其重要"。在更换 AAF 的人群中(n = 26),最重要的因素包括耐受性(77%)、保证(73%)、安全性(73%)、成本效益(73%)和配方奶粉的可信度(73%)。这些数据表明,家长在管理孩子的 CMPA 和过渡到不同的 AAF 或 eHF 选择时,应仔细权衡各种因素。
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引用次数: 0
Evaluation of peripheral basophil activation during exercise provocation test for desensitized patients 评估脱敏患者运动诱发试验期间外周嗜碱性粒细胞的激活情况
Q2 ALLERGY Pub Date : 2023-12-22 DOI: 10.3389/falgy.2023.1298137
Jun Kunizaki, Shiro Sugiura, Akira Sakai, Miyuki Teshigawara, Atsushi Makino, Y. Takasato, T. Matsui, Yasuto Kondo, K. Ito
Some food allergic patients who have undergone oral immunotherapy develop exercise-induced allergic reactions on desensitization (EIARDs). This study investigated basophil activation status during the exercise provocation test (EPT) performed to diagnose EIARD. EPT was performed on 20 participants, and in vivo basophil activation status was analyzed using activation markers CD203c and CD63. The results showed that there was no significant difference between EPT-positive and negative subjects for basophil activation status throughout EPT. Consequently, in vivo basophil activation after ingestion of the causative food may not be associated with EIARDs. New tests are desired for predicting EIARDs.
一些接受过口服免疫疗法的食物过敏患者会出现运动诱发的脱敏过敏反应(EIARDs)。本研究调查了为诊断 EIARD 而进行的运动诱发试验(EPT)期间嗜碱性粒细胞的活化状态。对 20 名参与者进行了 EPT,并使用活化标记 CD203c 和 CD63 分析了体内嗜碱性粒细胞的活化状态。结果显示,在整个 EPT 过程中,EPT 阳性和阴性受试者的嗜碱性粒细胞活化状态没有明显差异。因此,摄入致病食物后体内嗜碱性粒细胞的活化可能与 EIARDs 无关。我们需要新的检测方法来预测 EIARDs。
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引用次数: 0
Potential and limitations of epitope mapping and molecular targeting in Hymenoptera venom allergy 表位图谱和分子靶向在膜翅目昆虫毒液过敏中的潜力和局限性
Q2 ALLERGY Pub Date : 2023-12-14 DOI: 10.3389/falgy.2023.1327391
Luís Gustavo Romani Fernandes, E. Spillner, Thilo Jakob
Hymenoptera venom (HV) allergy can lead to life threatening conditions by specific IgE (sIgE)-mediated anaphylactic reactions. The knowledge about major allergens from venom of different clinically relevant species increased in the last decades, allowing the development of component-resolved diagnostics in which sIgE to single allergens is analysed. Despite these advances, the precise regions of the allergens that bind to IgE are only known for few HV allergens. The detailed characterization of IgE epitopes may provide valuable information to improve immunodiagnostic tests and to develop new therapeutic strategies using allergen-derived peptides or other targeted approaches. Epitope-resolved analysis is challenging, since the identification of conformational epitopes present in many allergens demands complex technologies for molecular analyses. Furthermore, functional analysis of the epitopeś interaction with their respective ligands is needed to distinguish epitopes that can activate the allergic immune response, from those that are recognized by irrelevant antibodies or T cell receptors from non-effector cells. In this review, we focus on the use of mapping and molecular targeting approaches for characterization of the epitopes of the major venom allergens of clinically relevant Hymenoptera species. The screening of the most relevant allergen peptides by epitope mapping could be helpful for the development of molecules that target major and immunodominant epitopes blocking the allergen induced cellular reactions as novel approach for the treatment of HV allergy.
膜翅目昆虫毒液(HV)过敏可通过特异性 IgE(sIgE)介导的过敏反应导致生命危险。在过去几十年中,人们对不同临床相关物种毒液中主要过敏原的了解不断增加,从而能够开发出成分分辨诊断方法,对单一过敏原的 sIgE 进行分析。尽管取得了这些进展,但与 IgE 结合的过敏原的精确区域只有少数 HV 过敏原是已知的。IgE 表位的详细特征描述可为改进免疫诊断测试和利用过敏原衍生肽或其他靶向方法开发新的治疗策略提供有价值的信息。表位解析分析具有挑战性,因为识别许多过敏原中的构象表位需要复杂的分子分析技术。此外,还需要对表位与各自配体的相互作用进行功能分析,以区分可激活过敏性免疫反应的表位与那些被无关抗体或非效应细胞的 T 细胞受体识别的表位。在这篇综述中,我们将重点介绍利用制图和分子靶向方法鉴定临床相关膜翅目物种主要毒液过敏原表位的情况。通过表位图谱筛选最相关的过敏原肽有助于开发靶向主要和免疫显性表位的分子,阻断过敏原诱导的细胞反应,作为治疗 HV 过敏的新方法。
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引用次数: 0
Population-based incidence of all-cause anaphylaxis and its development over time: a systematic review and meta-analysis. 基于人群的全因过敏性休克发病率及其随时间的发展:系统回顾和荟萃分析。
Q2 ALLERGY Pub Date : 2023-12-12 eCollection Date: 2023-01-01 DOI: 10.3389/falgy.2023.1249280
Vanessa Pühringer, Bernd Jilma, Harald Herkner

Introduction: It is extremely difficult to compare studies investigating the frequency of anaphylaxis making it challenging to satisfactorily assess the worldwide incidence rate. Using a systematic review and meta-analysis, this publication aims to determine the current incidence of all-cause anaphylaxis worldwide. Additionally, we investigated whether the incidence of anaphylaxis has changed over time and which factors influence the rates determined by individual studies.

Methods: A literature search was performed in four databases. All articles that reported relevant information on population-based incidence rates of all-cause anaphylaxis were included. The protocol was published on INPLASY, the International Platform of Registered Systematic Review and Meta-analysis Protocols.

Results: The database query and screening process resulted in 46 eligible articles on anaphylaxis. The current incidence worldwide was found to be approximately 46 cases per 100,000 population per year (95% CI 21-103). Evaluating confounding factors showed that studies using allergy clinics and hospitalizations as data source result in comparably low rates. Moreover, children are less prone to develop anaphylaxis compared to the general population. Using a random effects Poisson model we calculated a yearly increase of anaphylaxis incidence by 7.4% (95% CI 7.3-7.6, p < 0.05).

Discussion: This seems to be the first approach to analyze every reported all-cause anaphylaxis incidence rate until 2017 for an at most accurate determination of its epidemiology. Based on these results, future research could investigate the underlying causes for the rising incidence in order find ways to decrease the condition's frequency.

Systematic review registration: inplasy.com, identifier [INPLASY202330047].

导言:对过敏性休克发生频率的调查研究进行比较非常困难,因此很难令人满意地评估全球发病率。通过系统回顾和荟萃分析,本出版物旨在确定目前全球各种原因过敏性休克的发病率。此外,我们还调查了过敏性休克的发病率是否随着时间的推移而变化,以及哪些因素会影响个别研究确定的发病率:方法:我们在四个数据库中进行了文献检索。方法:我们在四个数据库中进行了文献检索,纳入了所有报道基于人群的全因过敏性休克发病率相关信息的文章。研究方案发布在 INPLASY(注册系统综述和荟萃分析方案国际平台)上:通过数据库查询和筛选,共有 46 篇符合条件的关于过敏性休克的文章。发现目前全球的发病率约为每年每 10 万人 46 例(95% CI 21-103)。对混杂因素的评估显示,使用过敏诊所和住院治疗作为数据来源的研究结果显示,过敏性休克的发病率相对较低。此外,与普通人群相比,儿童更不容易发生过敏性休克。利用随机效应泊松模型,我们计算出过敏性休克发病率每年增加 7.4%(95% CI 7.3-7.6,p 讨论):这似乎是第一种分析 2017 年之前报告的所有原因过敏性休克发病率的方法,以便最准确地确定其流行病学。基于这些结果,未来的研究可以调查发病率上升的根本原因,从而找到降低该病发病率的方法。系统综述注册:inplasy.com,标识符[INPLASY202330047]。
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引用次数: 0
Facial mask for prevention of allergic rhinitis symptoms 预防过敏性鼻炎症状的面膜
Q2 ALLERGY Pub Date : 2023-12-06 DOI: 10.3389/falgy.2023.1265394
Oğuzhan Oğuz, F. Manole, N. Bayar Muluk, C. Cingi
We reviewed the role of facial masks in preventing allergic rhinitis (AR) symptoms.The literature survey was performed in PubMed, EBSCO, UpToDate, and Proquest Central databases of Kırıkkale University and Google and Google Scholar databases.Aeroallergens are microscopic airborne particles that trigger AR symptoms. In sensitive people, the type 1 hypersensitivity reaction against these allergens occurs when these microparticles enter the nasal mucosa via inhalation. Pollens, molds, dust mites, and animal dander are only some of the allergens suspected of contributing to AR symptoms. The treatment guidelines for AR extensively encompass allergy avoidance and environmental management as the first-line treatment. It is recommended that those who experience seasonal symptoms try to avoid their triggers whenever possible. While medical masks filter out particles larger than 3 μm, FFP2 masks are effective against particles as small as 0.004 μm. Since both mask types are effective in filtering pollen larger than 5 μm in size, they can be used to prevent pollen exposure. The “antiviral protection” provided by medical and FFP2 masks to hospital employees is roughly equivalent. Thus, both should be effective against direct local (eye) or indirect inhaled (nose, bronchial) pollen exposure. For the masks to do their job, they need to fit correctly.Face mask affects AR patients' quality of life and reduces AR symptoms' severity.
本文综述了口罩在预防变应性鼻炎(AR)症状中的作用。文献调查在Kırıkkale大学的PubMed、EBSCO、UpToDate和Proquest Central数据库以及Google和Google Scholar数据库中进行。空气过敏原是引起AR症状的微小空气颗粒。在敏感人群中,当这些微粒通过吸入进入鼻黏膜时,就会发生针对这些过敏原的1型超敏反应。花粉、霉菌、尘螨和动物皮屑只是被怀疑导致过敏性鼻炎症状的部分过敏原。过敏性过敏症的治疗指南广泛包括过敏避免和环境管理作为一线治疗。建议那些有季节性症状的人尽可能地避免他们的诱因。医用口罩可以过滤3 μm以上的颗粒物,而FFP2口罩可以过滤0.004 μm以下的颗粒物。由于两种口罩都能有效过滤直径大于5 μm的花粉,因此可以用于防止花粉暴露。医用口罩和FFP2口罩对医院员工提供的“抗病毒保护”大致相当。因此,两者都应有效防止直接局部(眼睛)或间接吸入(鼻子,支气管)花粉暴露。为了让口罩发挥作用,它们需要正确适配。口罩影响AR患者的生活质量,减轻AR症状的严重程度。
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引用次数: 0
Hong Kong–Macau Severe Hives and Angioedema Referral Pathway 香港-澳门严重荨麻疹和血管性水肿转介路径
Q2 ALLERGY Pub Date : 2023-12-06 DOI: 10.3389/falgy.2023.1290021
P. H. Li, Elaine Y. L. Au, S. Cheong, Ling Chung, Ka I. Fan, Marco H. K. Ho, Agnes S. Y. Leung, Martin M. H. Chung, J. C. Wong, Ricardo Coelho
Urticaria (defined as the presence of hives, angioedema, or both) can be caused by a variety of etiologies ranging from more common conditions such as chronic spontaneous urticaria (CSU) to rarer conditions such as hereditary angioedema (HAE). Specialist referral may be necessary in cases of severe urticaria or HAE, but access to specialist services remains limited in certain regions, such as the Greater Bay Area (GBA) of China. To address this, the Hong Kong–Macau Severe Hives and Angioedema Referral Pathway (SHARP) was initiated by the Hong Kong Institute of Allergy and Macau Society of Dermatology to promote multidisciplinary collaboration and regional exchange of expertise in the diagnosis and management of severe urticaria.A nominated task force of dermatologists and immunologists who manage patients with severe urticaria formulated the consensus statements (CS) using the Delphi method. The consensus was defined a priori as an agreement of ≥80%.A total of 24 CS were formulated, including four statements on classifications and definitions, seven statements on diagnosis, and 13 statements on management and referral. The definitions for acute/chronic urticaria and severe CSU were stated. Unnecessary investigations and inappropriate medications were discouraged. The characteristics and recommended approach to suspected bradykinergic angioedema were specified. Stepwise treatment options using second-generation antihistamines, omalizumab, or cyclosporin for patients with CSU were addressed, and the importance of access to HAE-specific medications was emphasized. Furthermore, an integrated referral pathway for patients with severe hives and angioedema was constructed.The SHARP provides guidance for the management and specialist referral of patients with severe hives and angioedema in Hong Kong and Macau.
荨麻疹(定义为荨麻疹、血管性水肿或两者兼有)可由多种病因引起,从较常见的慢性自发性荨麻疹(CSU)到较罕见的遗传性血管性水肿(HAE)。在严重荨麻疹或HAE病例中,可能需要专家转诊,但在某些地区(如中国大湾区),获得专家服务的机会仍然有限。为了解决这个问题,香港过敏研究所和澳门皮肤科学会发起了“香港-澳门严重荨麻疹及血管性水肿转诊通道”(SHARP),以促进多学科合作和区域间在严重荨麻疹诊断和治疗方面的专业知识交流。由管理严重荨麻疹患者的皮肤科医生和免疫学家组成的指定工作组使用德尔菲法制定了共识声明(CS)。共识被先验地定义为≥80%的一致性。共制定了24条CS,其中分类定义4条,诊断7条,管理转诊13条。说明了急性/慢性荨麻疹和严重CSU的定义。不鼓励不必要的调查和不适当的药物。并详细说明了疑似缓动性血管性水肿的特点和推荐的治疗方法。针对CSU患者采用第二代抗组胺药、omalizumab或环孢素的逐步治疗方案进行了讨论,并强调了获得hae特异性药物的重要性。此外,构建了严重荨麻疹合并血管性水肿患者的综合转诊途径。该计划为香港及澳门严重荨麻疹及血管性水肿病人的管理及专科转介提供指引。
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引用次数: 0
Viruses in chronic rhinosinusitis: a systematic review 慢性鼻炎中的病毒:系统综述
Q2 ALLERGY Pub Date : 2023-12-05 DOI: 10.3389/falgy.2023.1237068
Nitish Kumar, Tripti Brar, Hirohito Kita, Lisa A. Marks, A. Miglani, Michael J. Marino, D. Lal
Unlike acute rhinosinusitis (ARS) which is mostly viral in etiology, the role of viruses in chronic rhinosinusitis (CRS) remains unclear. Viruses may play a role in initiation, exacerbations or perpetuate chronic inflammatory responses in the sinonasal mucosa. Research needs to characterize whether viruses are part of the normal sinonasal microbiome, colonizers or pathogenic.Systematic review of the English literature was conducted. Following databases were searched with an initial search conducted in November 2021 and then updated through June 2023: Ovid Medline (1946 to present), Ovid Embase (1988 to present), Scopus (2004 to present) and Web of Science (1975 to present). MeSH (Medical Subject Headings) terms included: viruses, virus diseases, sinusitis, and rhinovirus. Keywords: virus, viral infection*, sinusitis, rhinovirus, chronic rhinosinusitis, CRS, respiratory virus, respiratory infection*, and exacerbat*. A supplementary search was conducted through September 2023: Ovid Medline (1946 to present), Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R) Daily. Keywords used were: virus, viral infection*, sinusitis, chronic rhinosinusitis, CRS, respiratory virus, respiratory infection*, and exacerbat*.Thirty studies on viruses in CRS met inclusion criteria for full review. These included 17 studies on prevalence of virus in CRS, 5 examining probable causes of host susceptibility to viral infections in CRS, and 8 studies examining pathological pathways in viral association of CRS. The prevalence of viruses in nasal specimens of CRS subjects was higher as compared to controls in most studies, though a few studies showed otherwise. Rhinovirus was the most common virus detected. Studies showed that viruses may be associated with persistent hyper-responsiveness in the sinonasal mucosa, susceptibility to bacterial infections, upregulation of genes involved in the immune response and airway remodeling as well as CRS exacerbations. Presence of viruses was also associated with worse symptom severity scores in CRS subjects.Most data show higher presence of viruses in nasal and serum samples of CRS subjects as compared to controls but their exact role in CRS pathophysiology in unclear. Large studies with longitudinal sampling at all disease phases (i.e., prior to disease initiation, during disease initiation, during disease persistence, and during exacerbations) using standardized sampling techniques are needed to definitively elucidate the role of virus in CRS.
不同于急性鼻窦炎(ARS)的病因主要是病毒,病毒在慢性鼻窦炎(CRS)中的作用尚不清楚。病毒可能在鼻窦黏膜慢性炎症反应的起始、加重或延续中起作用。研究需要确定病毒是正常鼻腔微生物群的一部分,是定植者还是致病性的。对英国文献进行了系统的综述。以下数据库在2021年11月进行了首次搜索,然后更新到2023年6月:Ovid Medline(1946年至今),Ovid Embase(1988年至今),Scopus(2004年至今)和Web of Science(1975年至今)。MeSH(医学主题标题)术语包括:病毒、病毒性疾病、鼻窦炎和鼻病毒。关键词:病毒、病毒感染*、鼻窦炎、鼻病毒、慢性鼻窦炎、CRS、呼吸道病毒、呼吸道感染*、加重*补充检索进行到2023年9月:Ovid Medline(1946年至今),Epub Ahead of Print, In-Process & Other非索引引文和Ovid Medline (R) Daily。关键词:病毒、病毒感染*、鼻窦炎、慢性鼻窦炎、CRS、呼吸道病毒、呼吸道感染*、加重*。有30项关于CRS病毒的研究符合完整综述的纳入标准。这些研究包括17项关于CRS病毒流行的研究,5项关于CRS宿主对病毒感染易感性的可能原因的研究,8项关于CRS病毒相关病理途径的研究。在大多数研究中,CRS受试者鼻标本中的病毒流行率高于对照组,尽管少数研究显示相反情况。鼻病毒是检测到的最常见病毒。研究表明,病毒可能与鼻黏膜持续的高反应性、对细菌感染的易感性、参与免疫反应和气道重塑的基因上调以及CRS加重有关。在CRS受试者中,病毒的存在也与较差的症状严重程度评分相关。大多数数据显示,与对照组相比,CRS受试者鼻腔和血清样本中病毒的存在率较高,但其在CRS病理生理中的确切作用尚不清楚。为了明确阐明病毒在CRS中的作用,需要使用标准化采样技术在所有疾病阶段(即疾病开始之前、疾病开始期间、疾病持续期间和恶化期间)进行纵向采样的大型研究。
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引用次数: 0
Oligomerization and tyrosine nitration enhance the allergenic potential of the birch and grass pollen allergens Bet v 1 and Phl p 5 寡聚化和酪氨酸硝化增强了桦树和草花粉过敏原 Bet v 1 和 Phl p 5 的致敏潜力
Q2 ALLERGY Pub Date : 2023-12-05 DOI: 10.3389/falgy.2023.1303943
J. Fröhlich-Nowoisky, Nadine Bothen, A. Backes, M. Weller, Ulrich Pöschl
Protein modifications such as oligomerization and tyrosine nitration alter the immune response to allergens and may contribute to the increasing prevalence of allergic diseases. In this mini-review, we summarize and discuss relevant findings for the major birch and grass pollen allergens Bet v 1 and Phl p 5 modified with tetranitromethane (laboratory studies), peroxynitrite (physiological processes), and ozone and nitrogen dioxide (environmental conditions). We focus on tyrosine nitration and the formation of protein dimers and higher oligomers via dityrosine cross-linking and the immunological effects studied.
蛋白质修饰如寡聚化和酪氨酸硝化改变了对过敏原的免疫反应,并可能导致过敏性疾病的患病率增加。在这篇综述中,我们总结和讨论了四硝基甲烷(实验室研究)、过氧亚硝酸盐(生理过程)、臭氧和二氧化氮(环境条件)修饰的主要桦木和草花粉过敏原betv1和php5的相关发现。我们重点研究了酪氨酸硝化和通过二酪氨酸交联形成蛋白质二聚体和高级低聚物及其免疫效应。
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引用次数: 0
Editorial: Allergic sensitization in infants 社论:婴儿过敏反应
Q2 ALLERGY Pub Date : 2023-12-04 DOI: 10.3389/falgy.2023.1339678
Kirsi M. Järvinen, Nitya Jain, Daniel Munblit, R. J. J. van Neerven
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引用次数: 0
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Frontiers in allergy
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