The journal of allergy and clinical immunology. Global最新文献

{"title":"Global differences and risk factors influencing drug hypersensitivity quality of life: A multicenter, multiethnic study of drug allergy across 3 continents","authors":"Ana M. Copaescu MD, FRCP ,&nbsp;Hugo W.F. Mak MBBS ,&nbsp;Sara Vogrin MBiostat ,&nbsp;Natasha E. Holmes PhD ,&nbsp;Jason A. Trubiano PhD ,&nbsp;Philip H. Li MD","doi":"10.1016/j.jacig.2024.100354","DOIUrl":"10.1016/j.jacig.2024.100354","url":null,"abstract":"<div><h3>Background</h3><div>Penicillin allergy labels are associated with many adverse outcomes. Fear and restriction of future medication use also have an impact on health-related quality of life (HR-QoL). However, the impact of a drug allergy on HR-QoL and its associated factors remains unknown.</div></div><div><h3>Objective</h3><div>We sought to investigate the impact of penicillin allergy labels and compare the factors associated with HR-QoL impairment among patients in an international multicenter, multiethnic cohort.</div></div><div><h3>Methods</h3><div>HR-QoL was measured using the 6-item Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q) and compared among patients labeled with penicillin allergy, before their allergy evaluation, from 8 adult allergy/immunology clinics across Asia, Australia, and North America.</div></div><div><h3>Results</h3><div>We recruited 643 patients labeled with penicillin allergy (median age, 56 years [interquartile range, 39-67]; male:female ratio, 1:2.2), with 273 (42.5%), 186 (28.9%), and 184 (28.6%) from Asia, North America, and Australia, respectively. The median DrHy-Q score was 8.3 (interquartile range, 0.0-29.2). All patients underwent penicillin allergy evaluation, and 96% (617 of 643) were delabeled following negative provocation test results. Female patients (8.3 vs 4.2; <em>P</em> = .003), those with other concomitant antimicrobial allergy labels (20.8 vs 4.2; <em>P</em> = .004), and patients from Asia (33.3 vs 4.2 [North America] vs 0 [Australia]; <em>P</em> &lt; .001) had significantly higher DrHy-Q scores, reflecting a reduced HR-QoL. Ethnicity as well as other allergy variables were not significant in the multivariate analysis.</div></div><div><h3>Conclusions</h3><div>Regional differences, ethnicity, and other risk factors influence HR-QoL impairment among patients labeled with penicillin allergy. Future studies are needed to understand the contributions of regional sociodemographic factors and identify interventions to improve HR-QoL.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100354"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omics analysis reveals galectin-3 to be a potential key regulator of allergic inflammation in hereditary angioedema","authors":"Supriya D. Mahajan PhD, MPH ,&nbsp;Ravikumar Aalinkeel PhD ,&nbsp;Jessica L. Reynolds PhD ,&nbsp;Janvhi S. Machhar MS ,&nbsp;Berhane Ghebrehiwet DVM, DSc ,&nbsp;Stanley A. Schwartz MD, PhD","doi":"10.1016/j.jacig.2024.100353","DOIUrl":"10.1016/j.jacig.2024.100353","url":null,"abstract":"<div><h3>Background</h3><div>Hereditary angioedema (HAE) is a rare inherited disorder that predisposes an individual to develop vasogenic edema. Bradykinin release, which increases vascular permeability, results in angioedema. C1 esterase inhibitor (C1-INH) is a major regulator of critical enzymes involved in bradykinin generation and mutations in genes that encode the C1 inhibitor of complement factor 1, which prevent its synthesis (type I HAE), form a dysfunctional protein (type II HAE), or have normal functioning C1-INH (type III HAE, aka HAE-III).</div></div><div><h3>Objectives</h3><div>The goals of this study were to use a systems biology analysis to identify novel biomarkers to aid in the diagnosis of HAE-III and to elucidate its underlying pathogenic mechanisms.</div></div><div><h3>Methods</h3><div>Blood samples were obtained from HAE-III subjects and age- and sex-matched healthy controls. DNA, RNA, and protein purified from the samples were subjected to multiomics analysis using a 1-shot liquid chromatography–mass spectrometry–based multiomics platform (Omni-MS, Dalton Bioanalytics) to profile proteins, lipids, electrolytes, and metabolites enabling concurrent analysis of diverse analyte classes.</div></div><div><h3>Results</h3><div>A total of 1647 novel identifications that included genes, proteins, and metabolites were made when comparing HAE-III samples to control samples. Our identification library included MSFragger for protein identification, LipiDex for lipid identification, and Compound Discoverer for metabolite identification, enabling differential expression analysis. Key findings included a significant increase in the expression levels of galectin-3, lysosomal α-glucosidase, platelet factor 4, and platelet-derived growth factor subunit A in HAE-III subjects compared to controls, all of which generate an immunomodulatory response.</div></div><div><h3>Conclusion</h3><div>Galectin-3 plays a critical role in eosinophil recruitment and airway allergic inflammation. It may contribute to chronic inflammation and fibrosis resulting in leaky vasculature, and it could be a potential therapeutic target in HAE-III.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100353"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Questionnaire-based real-world survey of diagnosing food allergy in children: Utilization of oral food challenge tests and other diagnostic methods","authors":"Chisa Kumagai MD ,&nbsp;Norio Kawamoto MD, PhD ,&nbsp;Yuki Miwa MD ,&nbsp;Tomoko Kaneyama MD ,&nbsp;Saori Kadowaki MD, PhD ,&nbsp;Minako Kawamoto MD, PhD ,&nbsp;Hidenori Ohnishi MD, PhD","doi":"10.1016/j.jacig.2024.100356","DOIUrl":"10.1016/j.jacig.2024.100356","url":null,"abstract":"<div><h3>Background</h3><div>Oral food challenge tests are considered the reference standard for diagnosing food allergies; however, studies on their real-world implementation rates are limited.</div></div><div><h3>Objective</h3><div>The study aimed to investigate the proportion of school-age children who underwent the oral food challenge test and to understand the motivations behind food elimination and utilization of various health care services.</div></div><div><h3>Methods</h3><div>The questionnaire-based survey for the parents of the students who submitted the “Certificate for School Life Management (For Allergic Diseases)” was conducted across public elementary and junior high schools in Gifu prefecture, Japan.</div></div><div><h3>Results</h3><div>The study encompassed parents of 3457 children with food allergies who submitted the certificate. Approximately one third of those eliminating the 3 major allergens—eggs (32.5%), milk (27.6%), and wheat (33.5%)—were diagnosed via oral food challenge tests, and approximately two thirds were diagnosed using a combination of symptoms and blood tests, suggesting most children were diagnosed appropriately. However, many children were diagnosed and eliminated foods based solely on blood tests without any symptoms of other allergens, such as buckwheat (55.8%), peanuts (29.2%), and tree nuts (21.2%), suggesting that it was likely that these children unnecessarily eliminated foods. Elimination of buckwheat because of anxiety was associated with eliminating other foods for the same reason and with eliminating 2 or more foods.</div></div><div><h3>Conclusion</h3><div>Examination of the real-world application of the proposed recommendations for the accurate diagnosis of food allergies suggests that closely monitoring their practical application should be conducted in each case to avoid unnecessary food elimination from children’s diets.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100356"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NFATc1 in CD4+ T cells and CD11c+ dendritic cells drives TH2-mediated eosinophilic inflammation in allergic asthma","authors":"Zuqin Yang MSc ,&nbsp;Susanne Krammer RPh ,&nbsp;Hannah Mitländer ,&nbsp;Janina C. Grund ,&nbsp;Sabine Zirlik MD ,&nbsp;Stefan Wirtz PhD ,&nbsp;Manfred Rauh PhD ,&nbsp;Atefeh Sadeghi Shermeh MSc ,&nbsp;Susetta Finotto PhD","doi":"10.1016/j.jacig.2024.100355","DOIUrl":"10.1016/j.jacig.2024.100355","url":null,"abstract":"<div><h3>Background</h3><div>Asthma, a chronic lung disease, is a significant public health problem worldwide. It is marked by increased T_H2 response resulting in eosinophil accumulation. The pathophysiology of asthma involves various cell types, including epithelial cells, dendritic cells (DCs), innate lymphoid cells, B cells, and effector cells. Nuclear factor of activated T cells, cytoplasmic 1 (NFATc1), a critical transcription factor for immune regulation, is known for its role in T cells and, more recently, in myeloid cells. However, the specific contributions of NFATc1 in T cells and DCs in the context of asthma are not well understood.</div></div><div><h3>Objective</h3><div>We explored NFATc1’s role in T cells and DCs in modulating T_H2 immune responses within the pathophysiology of allergic asthma.</div></div><div><h3>Methods</h3><div>We induced asthma in mice lacking <em>Nfatc1</em> in CD4⁺ T cells or CD11c⁺ DCs using house dust mite, thereby enabling investigation into NFATc1’s role in both cell types in experimental allergic asthma. Additionally, we examined NFATc1 expression in these cell types and its correlation with blood eosinophil levels in an adult asthma cohort.</div></div><div><h3>Results</h3><div>In a house dust mite–induced asthma model, we found that <em>Nfatc1</em> deficiency either in CD4⁺ T cells or CD11c⁺ DCs resulted in reduced T_H2-driven eosinophilic inflammation, IgE levels, and mast cell presence in the lung of asthmatic mice. <em>Nfatc1</em>’s absence in CD4⁺ T cells directly hampered T_H2 cell polarization and functionality, whereas in CD11c⁺ DCs, it affected DC differentiation and maturation, thereby weakening T-cell priming, proliferation, and subsequent T_H2 differentiation. Correspondingly, translational research indicated significant correlations between CD4⁺NFATc1⁺ and CD11c⁺NFATc1⁺ cell populations and eosinophil levels in asthmatic patients, but not in healthy controls.</div></div><div><h3>Conclusion</h3><div>NFATc1 in T cells and DCs modulates T_H2-mediated eosinophilic inflammation in allergic asthma, thus offering insight into asthma pathogenesis and identifying NFATc1 as a potential target for therapeutic intervention.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100355"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of aeroallergen testing with reduced oral corticosteroid bursts among adults with asthma","authors":"Patrick K. Gleeson MD, MSCE ,&nbsp;Knashawn H. Morales ScD ,&nbsp;Timothy M. Buckey MD, MBE ,&nbsp;Olajumoke O. Fadugba MD ,&nbsp;Andrea J. Apter MD, MSc, MA ,&nbsp;Jason D. Christie MD, MSCE ,&nbsp;Blanca E. Himes PhD","doi":"10.1016/j.jacig.2024.100348","DOIUrl":"10.1016/j.jacig.2024.100348","url":null,"abstract":"<div><h3>Background</h3><div>Aeroallergen testing can improve precision care for persistent asthma. How testing benefits diverse populations of adults with asthma and the importance of the aeroallergen sensitization and test modality used remain poorly understood.</div></div><div><h3>Objective</h3><div>We evaluated whether aeroallergen testing was associated with a reduction in oral corticosteroid (OCS) bursts.</div></div><div><h3>Methods</h3><div>We used electronic health record data to conduct a retrospective cohort study of adults with asthma who were prescribed an inhaled corticosteroid and had an allergy/immunology visit in a large health system between January 1, 2017, and June 30, 2022. We used negative binomial regression models to evaluate whether testing was associated with fewer OCS bursts in the 12-month period after an initial visit among all patients and those without chronic obstructive pulmonary disease (COPD) and smoking histories. We then repeated these analyses while considering effects of sensitization to aeroallergen categories and whether the testing was via skin prick or serum-specific IgE.</div></div><div><h3>Results</h3><div>A total of 684 (48.4%) of 1,412 patients underwent testing. Testing was not associated with fewer bursts overall (incidence rate ratio [IRR] = 0.84 vs no testing, <em>P</em> = .08), but it was among never smokers without COPD (461 of 927 tested, IRR = 0.69, <em>P</em> = .005). Among never smokers without COPD, sensitization to 5-7 aeroallergen categories (IRR = 0.57 vs no test, <em>P</em> = .003) and receipt of skin prick tests (IRR = 0.58 vs no test, <em>P</em> &lt; .0005) were associated with fewer bursts.</div></div><div><h3>Conclusion</h3><div>Aeroallergen testing was associated with reduced OCS bursts among adults with asthma who were never smokers without COPD. This association varied according to aeroallergen sensitization and test modality used.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100348"},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of immediate vancomycin-induced hypersensitivity reaction to severe perioperative anaphylaxis","authors":"Emily Gansert BS ,&nbsp;Ricardo J. Estrada-Mendizabal MD ,&nbsp;Santiago Alvarez-Arango MD ,&nbsp;Alexei Gonzalez-Estrada MD","doi":"10.1016/j.jacig.2024.100352","DOIUrl":"10.1016/j.jacig.2024.100352","url":null,"abstract":"<div><div>The evaluation of vancomycin hypersensitivity reactions is challenging, as skin testing is not validated. Intradermal testing with vancomycin in human serum albumin–based sterile saline could be a new approach to the evaluation of IgE-independent hypersensitivity reactions.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100352"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of cephalosporin allergy: Survey of drug allergy experts","authors":"Anna Brameli MD ,&nbsp;Cosby A. Stone Jr. MD, MPH ,&nbsp;Elizabeth J. Phillips MD","doi":"10.1016/j.jacig.2024.100351","DOIUrl":"10.1016/j.jacig.2024.100351","url":null,"abstract":"<div><h3>Background</h3><div>Since the publication of the 2022 Drug Allergy Practice Parameters (DAPP) of the American Academy of Allergy, Asthma &amp; Immunology (AAAAI) and American College of Allergy, Asthma &amp; Immunology (ACAAI), it is unclear the extent to which the simplified and risk-stratified evaluation of cephalosporin allergy has been incorporated into allergy practice.</div></div><div><h3>Objective</h3><div>We aimed to assess current cephalosporin allergy testing practices using real case examples.</div></div><div><h3>Methods</h3><div>An 18-question REDCap survey was sent to the 136 members of the Adverse Reactions to Drugs, Biologics and Latex (ARDBL) Committee of the AAAAI between February and April 2023.</div></div><div><h3>Results</h3><div>Forty-six (33.8%) ARDBL members completed the survey after 3 email attempts. Most practiced in the United States (32, 69.6%), 6 (13.0%) in Canada, and the rest in Europe and Asia. Almost half (47.7%) reported that the 2022 DAPP had increased their use of direct oral challenge, and 91% would prescribe cephalosporins in the setting of low-risk penicillin allergy history without testing. For low-risk cephalosporin reactions, 68% would perform a direct oral challenge with the culprit drug. In severe immediate penicillin reactions, 23% would evaluate with penicillin skin test before assessing cephalosporin allergy. For cephalosporin-related anaphylaxis, 48% would perform cephalosporin-based tests. For perioperative anaphylaxis with cefazolin, 57% would perform cephalosporin-based tests. For positive skin test result to cefazolin, 79% chose to avoid the culprit drug with follow-up oral challenge to a structurally dissimilar cephalosporin.</div></div><div><h3>Conclusion</h3><div>Increased uptake of direct oral challenge represents the initial impact of the 2022 DAPP. However, there is significant variation in testing practices of cephalosporin allergy even among drug allergy experts, reflecting a need for a firmer evidence base to guide consensus around testing for higher-risk reactions.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100351"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health disparities in the Middle East: Representative analysis of the region","authors":"Amal Assa’ad MD ,&nbsp;Alon Y. Hershko MD, PhD ,&nbsp;Carla Irani MD ,&nbsp;Mahboobeh Mahdavinia MD, PhD ,&nbsp;David A. Khan MD ,&nbsp;Jonathan A. Bernstein MD","doi":"10.1016/j.jacig.2024.100350","DOIUrl":"10.1016/j.jacig.2024.100350","url":null,"abstract":"<div><div>Health care disparities refer to differences in health and health care between groups that are closely associated with governmental, social, economic, and/or environmental policies. To address this gap in knowledge, a forum to address health disparities in different regions of the world was developed as an American Academy of Allergy, Asthma &amp; Immunology (AAAAI) presidential initiative (under Dr Jonathan Bernstein) in partnership with the World Allergy Organization to better understand political and socioeconomic issues within different countries and how they affect their health care systems. The first region selected was the Middle East. Representatives from Egypt, Israel, Lebanon, and Iran were invited to speak at this forum. Although we were not able to be inclusive of all countries in this region, it is apparent that the health care systems for those that participated are heterogeneous as a result of socioeconomic, educational, and governmental infrastructures. However, all regions noted health disparities that appeared to be linked to social determinants of health. Unfortunately, conflict in this region has had an additional adverse effect on these health care systems, making solutions even more challenging. However, recognition of the problems that loom large for allergy/immunology in particular can provide an opportunity for international collaboration that focuses on providing patient and physician education and identifying strategies to improve access to specialized health care.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100350"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142594044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resident memory B cells are enriched in chronic rhinosinusitis with nasal polyps","authors":"Yohei Sato MD, PhD ,&nbsp;Natsuki Inoue MD, PhD ,&nbsp;Erika Osada BS ,&nbsp;Yasuhiro Tsunemi MD ,&nbsp;Daiki Nakashima MD ,&nbsp;Tomomitsu Hirota DDS, PhD ,&nbsp;Nobuyoshi Otori MD, PhD ,&nbsp;Mamoru Yoshikawa MD, PhD ,&nbsp;Shin-ichi Haruna MD, PhD ,&nbsp;Tsuguhisa Nakayama MD, PhD","doi":"10.1016/j.jacig.2024.100349","DOIUrl":"10.1016/j.jacig.2024.100349","url":null,"abstract":"<div><h3>Background</h3><div>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic nasal and sinonasal inflammatory disease. Recently, resident memory B (BRM) cells have been identified in the lungs, although not in the sinonasal mucosa.</div></div><div><h3>Objective</h3><div>Our aim was to characterize memory B-cell phenotypes with regard to patients with CRSwNP and identify BRM cells in both normal sinonosal mucosa and samples from patients with CRSwNP.</div></div><div><h3>Methods</h3><div>CD19⁺ B cells were isolated from patients with CRSwNP and analyzed using flow cytometry and immunohistochemistry.</div></div><div><h3>Results</h3><div>Although BRM cells were found in the normal sinonasal mucosa, their numbers and frequencies tended to be limited. These findings were confirmed on the basis of immunohistochemical analyses indicating an upregulation of CD69/CD45RB in tissue sections from patients with CRSwNP, although not in normal sinonasal mucosa. Accordingly, BRM cells were established to be enriched in the nasal polyps isolated from patients with CRSwNP.</div></div><div><h3>Conclusion</h3><div>Our findings in this study reveal that BRM cells can be detected in normal sinonasal mucosa, although they are significantly enriched in nasal polyps derived from patients with CRSwNP. These findings can contribute to gaining a more comprehensive understanding of the immune reactions associated with CRSwNP and facilitate the identification of potential therapeutic targets, such as anti–B-cell therapy.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100349"},"PeriodicalIF":0.0,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of prednisone on woodsmoke-induced sputum inflammation in healthy volunteers: A randomized, placebo-controlled pilot study","authors":"Terry L. Noah MD ,&nbsp;Neil E. Alexis PhD ,&nbsp;William D. Bennett PhD ,&nbsp;Michelle L. Hernandez MD ,&nbsp;Allison J. Burbank MD ,&nbsp;Haolin Li PhD ,&nbsp;Haibo Zhou PhD ,&nbsp;Ilona Jaspers PhD ,&nbsp;David B. Peden MD, MS","doi":"10.1016/j.jacig.2024.100347","DOIUrl":"10.1016/j.jacig.2024.100347","url":null,"abstract":"<div><h3>Background</h3><div>Inhalation of biomass smoke is associated with adverse respiratory effects in those with chronic pulmonary conditions. There are few published data regarding the effects of anti-inflammatory interventions on these outcomes.</div></div><div><h3>Objective</h3><div>Our aim was to assess the effects of postexposure prednisone on woodsmoke (WS)-induced sputum neutrophilia.</div></div><div><h3>Methods</h3><div>We carried out a randomized, placebo-controlled, crossover pilot study assessing the effect of a postexposure dose of 60 mg prednisone on induced sputum inflammation after controlled exposure to WS (500 μg/m³ for 2 hours) in healthy adults who had been identified in a separate screening protocol as being “PMN responsive” to WS. Secondary end points were sputum cytokine level and mucociliary clearance as measured by γ-scintigraphy.</div></div><div><h3>Results</h3><div>A total of 11 subjects yielded complete data for the primary analysis. At 24 hours after WS exposure, there was a significant increase in sputum percentage of PMNs (%PMN) versus at baseline after placebo (median = 42% [IQR = 31%-53%]) (<em>P</em> = .02) but not after prednisone (median = 32% [IQR = 18%-40%]) (<em>P</em> = .09). Prednisone reduced Δ%PMN at 24 hours, but this difference did not reach statistical significance. However, for the 8 of 11 subjects who were PMN responsive after placebo, prednisone reduced Δ%PMN significantly (<em>P</em> = .05). Prednisone had no significant effects on sputum levels of IL-1β, IL-6, IL-8, or TNF-α. WS exposure tended to reduce mucociliary clearance in the placebo arm but not in the prednisone arm.</div></div><div><h3>Conclusions</h3><div>Prednisone taken immediately after exposure to WS mitigated short-term increase in sputum %PMN among healthy volunteers selected for their underlying inflammatory responsiveness to WS. Our data support future studies assessing anti-inflammatory interventions and the role of mucus clearance in WS-induced respiratory health effects.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100347"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}