Allergologia et immunopathologia最新文献

This study investigates the effect of electronic fibrobronchoscope alveolar lavage combined with local administration of budesonide on the efficacy of treating Mycoplasma pneumoniae pneumonia (MPP) in children. A retrospective analysis was conducted on the clinical data of 100 children with MPP treated at our hospital from April 2022 to April 2024. The patients were divided into an experimental group (50 cases) and a control group (50 cases) based to the treatment method. Both groups received routine treatment, however, the control group was treated with electronic fibrobronchoscope alveolar lavage alone, while the experimental group received electronic fibrobronchoscope alveolar lavage combined with local administration of budesonide. The efficacy of the two treatments was compared. The experimental group showed a significantly higher overall effective rate than the control group (p<0.05). After treatment, the time for cough relief, lung rales resolution, fever reduction, and hospital stay were significantly shorter in the experimental group compared to the control group (p<0.05). One week after treatment, the levels of tidal volume, vital capacity, and peak expiratory flow in the experimental group were higher than those in the control group (p<0.05). Post-treatment levels of WBC and CRP were lower in the experimental group than in the control group (p<0.05). Additionally, the incidence of complications in the experimental group was lower than in the control group (p<0.05). Electronic fibrobronchoscope alveolar lavage combined with local administration of budesonide improves the efficacy of treatment for children with MPP, enhances clinical indicators, reduces inflammation levels, and has high safety, making it worthy of clinical promotion.

Background: The epidemiology of atopic eczema in adolescents in Kosovo is virtually unknown, and the risk factors for the condition in very low-prevalence areas (as it was the case) are not well studied. The objective of the present study was to better know those factors and whether the presence of comorbid wheezing symptoms modifies the factors.

Methods: The cross-sectional survey, Global Asthma Network-validated questionnaire, which includes questions on eczema symptoms and environmental factors (such as smoking, pet ownership, paracetamol usage, truck traffic, siblings, time spent using screens or watching television, and physical exercise), was administered to adolescents in the following main cities of Kosovo: Ferizaj, Gjakova, Gjilan, Peja, Prishtina, and Prizren. Additionally, height and weight were measured at school.

Results: Prevalence of eczema symptoms ranged from 2.2% in Ferizaj to 5.5% in Gjakova. Severe symptoms were <1% in all cities. Eczema ever ranged from 3.0% in Ferizaj to 6.4% in Prizren. Factors significantly associated with the prevalence of current eczema symptoms in the meta-analysis were males (pooled adjusted odds ratio [aOR] 0.50, 95% Confidence Interval [95% CI] 0.37-0.66); physical exercise (pooled aOR 2.79, 95% CI 1.89-4.10); and paracetamol intake (pooled 1.86, 95% CI 1.32-2.64). The corresponding figures for eczema ever were as follows: pooled aOR: 0.68, 95% CI 0.44-1.06; pooled aOR 2.07, 95% CI 1.48-2.90; and pooled aOR 1.19, 95% CI 0.88-1.60. The associations tended to be higher in the subpopulation with eczema and wheezing comorbidity.

Conclusions: The prevalence of atopic eczema is very low in Kosovo and is associated with females, physical exercise, and paracetamol intake. These associations are higher when eczema and wheezing are comorbid conditions.

Respiratory diseases in children are common health problems that significantly impact their quality of life and health status, and this has its own unique challenges compared to adults. A growing body of research has focused on epigenetic mechanisms that relate with the development of various diseases, such as pediatric respiratory diseases. Noncoding RNAs (ncRNAs), especially long noncoding RNAs, microRNA, and circular RNA, are reported to play a regulatory role in pediatric respiratory diseases whose mutations or aberrant expressions are strongly associated with the development of these diseases. In this review, we mainly discussed the functions of these three ncRNAs in pediatric respiratory diseases.

Background: The role of immunoglobulin G (IgG) responses to food as potential triggering factors in allergic disorders continues to be debatable, and is not endorsed by most allergy societies.

Objective: To explore the prevalence of specific IgG immune responses to common foods in pediatric allergic disorders and any potential relationship between them.

Methods: A retrospective study was conducted on children and adolescents diagnosed with allergic disorders at the Ekthar Clinic in Jeddah City. Food-specific IgG (FS-IgG) antibody test results were collected from their medical records.

Results: Seventy-five children with a mean age of 8.5 years (SD = 5.3) were included. The overall allergic diagnosis determined atopic dermatitis as the most common (57.3%, 43 participants), followed by food allergy and allergic rhinitis (each 40%, 30 participants), and bronchial asthma (29.3%, 22 participants). Food-specific IgG levels were elevated in all participants. The foods with the highest levels of FS-IgG were dairy products (88%: cow's milk [86.6%], sour milk [81.3%], sheep's milk [74.7%], cheese [72%], and goat's milk [70.7%]), followed by gluten-containing products (81.3%: wheat [70.7%], gluten [69.3%], and spelt [66.6%]), and eggs (66.6%). Significant correlations (P < 0.05) were found between atopic dermatitis and several foods; chronic urticaria and chicken and lamb; asthma and ocean perch; allergic rhinitis and rennet cheese; and allergic conjunctivitis and potato, pollock, and lamb.

Conclusion: Among pediatric allergic disorders, dairy, gluten, and eggs were the most detected foods in FS-IgG tests, with some notable correlations with other foods. FS-IgG testing may help identify potential triggers in refractory allergic disorders.

Background: Local allergic rhinitis (LAR) is a well-defined phenotype in adults, but still there is little data available on children. This scarcity of data can be partly attributed to the lack of standardized protocols for Nasal Allergen Challenges (NAC) in this demographic.

Methods: 20 controls (control group) and 24 patients (rhinitis group) with allergic rhinitis diagnosis sensitized to Blomia tropicalis (Bt) underwent the NAC with Bt. The acoustic rhinometry was performed after instillation of increasing concentrations of Bt (5,000 BU/mL).

Results: The median reduction in the volume of the nasal cavity in its first five centimeters (V5) by the conclusion of the NAC in the rhinitis group was markedly higher than that observed in the control group, at -22.9% (range: -21.1% to -26.2%) compared to -7.7% (ranging: -4.8% to +12.8%).

Conclusions: Our research demonstrates the efficacy and safety of the NAC protocol utilizing Bt in distinguishing allergic from non-allergic children.

Background: Hypersensitivity to chlorhexidine is rare in children. The usefulness of different diagnostic tests for allergic contact dermatitis (ACD) is unknown.

Objective: We aim to describe a case series of children with hypersensitivity to chlorhexidine and to compare the results of different diagnostic tests.

Patients: Nine children with hypersensitivity to chlorhexidine were included. Only six of these children and their parents consented to a comprehensive allergy assessment, which included the prick test, intradermal test, patch test, and repeated open application test (ROAT).

Results: Seven children (78%) presented symptoms of chlorhexidine hypersensitivity within the first 5 years of life; two of them before the age of 1 year. In four children, the dermatitis lesions were suggestive of wound superinfection. All six children who participated in the comprehensive diagnostic evaluation had negative results on the prick test. The immediate-reading intradermal test was positive in one case and uncertain in two cases. The patch test was positive in five cases, and the ROAT was positive in all six cases when using 2% chlorhexidine alcohol solution.

Conclusion: ACD to chlorhexidine in children appears to be rare and can be difficult to detect. Clinicians should consider this diagnosis when wounds worsen with chlorhexidine. Although the patch test is the most standardized method for detecting ACD, the ROAT with 2% chlorhexidine alcohol solution was the most sensitive test in our patients.

To evaluate the response to Tezepelumab in real clinical practice, we performed an analysis of the clinical, functional, and inflammatory characteristics of 13 patients with severe asthma after completing four doses of Tezepelumab was performed. When comparing clinical parameters such as asthma control test (ACT), FENO value, exacerbations in the last 4 months, blood eosinophils and FEV1%, before receiving Tezepelumab and after four doses of Tezepelumab, statistically significant differences were found in ACT levels (p=0.0072), exacerbations (p=0.018) and FEV1% (p=0.012) before and after four doses of Tezepelumab. No statistically significant differences were found in blood eosinophils or FeNO levels, however, a mean reduction of 102.5±231 cells/mm³ and 14.67±30 ppb, respectively, was observed. Patients with a high T2 profile had significantly higher baseline FeNO (p<0.05), but no significant improvement in lung function or asthma control was observed in this group. Patients with Aspirin-exacerbated respiratory disease (AERD) were evaluated separately. There was no difference in ACT, FeNO, or lung function changes after tezepelumab use compared to patients without AERD (all p>0.05). We demonstrated, in a multicenter study, the clinical improvement associated with tezepelumab treatment in severe uncontrolled asthma, independent of inflammatory biomarkers, eosinophilic profile, or previous biological failure.

Background: Psoriasis is an autoimmune skin condition characterized by hyperproliferation of keratinocytes and chronic immune responses. Gypenosides (Gyp) exhibits anti-proliferative and anti-inflammatory effects on different diseases. However, its functioning and mechanism of Gyp on psoriasis remains unknown.

Objective: To explore the effect and mechanism of Gyp on psoriasis.

Material and methods: The impact and mechanism of Gyp on psoriasis in vitro and in vivo were probed through cell counting kit-8 (CCK-8), 5-ethynyl-2'-deoxyuridine (EdU) incorporation assay, reverse transcription quantitative polymerase chain reaction, hematoxylin and eosin staining, enzyme-linked immunosorbent serologic assay, immunofluorescence, and Western Blotting assays.

Results: Gyp inhibited cell proliferation and the release of inflammatory cytokinesin interleukin (IL-22)-induced spontaneously transformed human aneuploid immortal keratinocyte cell line (HaCaT). In addition, Gyp demonstrated enhancement in erythema and scaling as well as reductions in the thickness of epidermal layers, release of inflammatory factors, and Ki-67 (a nuclear protein) level in imiquimod (IMQ)-induced mice. Mechanistically, Gyp upregulated nuclear factor erythroid 2-related factor 2 (Nrf-2) expression and diminished the level of p-p65/p65 and p-STAT3/STAT3 in skin tissues from IMQ-induced mice and IL-22-induced HaCaT cells, which were reversed with the application of ML385, an inhibitor of Nrf2. In addition, the administration of ML385 reversed decrease in cell viability and reduced the expressions of IL-1β, IL-6, and tumor necrosis factor-α (TNF-α) in IL-22-induced HaCaT cells caused by Gyp.

Conclusion: In summary, Gyp reduced excessive cell growth and inflammation in psoriasis by suppressing nuclear factor kappa B (NF-κB) and signal transducer and activator of transcription 3 (STAT3) through activation of Nrf2.

Allergic diseases are becoming increasingly common, and they are a threat to people's health. Exploring the distribution characteristics of allergen-specific immunoglobulin E (sIgE) in people from Sichuan province, southwest China, can provide clinical epidemiological data. This study enrolled 12,204 consecutive patients with suspected allergies from May 2018 to May 2021. Among the patients, 4206 were diagnosed with allergic rhinitis or asthma. The Rayto Lumiray 1600 detection system and sIgE and total IgE (tIgE) detection kits were used to measure the levels of nine common sIgE and tIgE. sIgE ≥ 0.35 IU/mL was considered positive. The sensitization rate of D1 (Dermatophagoides pteronyssinus) is the highest (22.97%), followed by D2 (Dermatophagoides farinae) (23.33%); M3 (Aspergillus fumigatus) has the lowest positive rate (1.5%). E5 (Canis familiaris) and I6 (Blatella germanica) exhibited relatively high sensitization rates (8.64% and 12.35%, respectively). Allergen sensitization was significantly higher in men than in women. Moreover, 90.3% of sensitization samples from D1 were combined with at least one of the other eight allergens. Similarly, a positive correlation was demonstrated between D1, D2, and E1 (Felis domesticus). In addition, patients with allergic rhinitis (91.88% and 91.54%, respectively), allergic asthma (72.44% and 74.01%, respectively), and allergic rhinitis with asthma (92.12% and 93.22%, respectively) were mainly sensitized to D1 and D2. D1, D2, I6, and E5 are the main allergens. Moreover, D1 and D2 are the main allergens in patients with respiratory allergic diseases. Research focusing on the distribution of allergens and the characteristics of hypersensitivity in different people helps prevent, diagnose, and treat allergic diseases.