Allergologia et immunopathologia最新文献

Introduction: Atopic Dermatitis (AD) is a chronic inflammatory skin disease that significantly impacts patients´ quality of life. Dupilumab was Brazil´s first biologic approved to treat moderate-to-severe AD. We aimed to assess the effectiveness and safety of dupilumab in a real-life setting for 16 weeks.

Methods: Fourteen patients were evaluated at weeks 0, 4, and 16 after the first dupilumab shot. At each visit, disease activity and severity, itching intensity, and impact on quality of life were measured using the EASI (Eczema Area and Severity Index), IGA (Investigator's Global Assessment), SCORAD (Scoring Atopic Dermatitis), NRS (Numeric Rating Scale for itching), and DLQI (Dermatology Life Quality Index).

Results: Clinical improvement observed was significant, with variation in all scores used in the study sample during the first 16 weeks of treatment (p < 0.0001).

Conclusion: Dupilumab was effective and safe in our patients with moderate-to-severe AD.

Background: Rheumatoid arthritis (RA) is one complex chronic autoimmune disease, resulting body pain and badly affect the health of RA patients. Zinc finger and BTB domain containing 16 (ZBTB16) has been reported to participate into many diseases including osteoarthritis and osteoporosis.

Objective: To verify the regulatory functions of ZBTB16 in RA progression keep dimness.

Methods: The mRNA expressions were tested through RT-qPCR. The protein expressions were evaluated through western blot. The pathological changes of synovial tissues were determined through HE staining. The erosion and destruction of bone tissues were examined through safranin-O/fast green staining. The levels of TNF-α, IL-1β, IL-6 and MMP-3 were testified through ELISA. The fluorescence intensity of proteins was assessed through IF assay.

Results: Firstly, it was uncovered that ZBTB16 expression was markedly reduced in the synovium tissues of RA patients through analyzing GSE55235 expression profile by GEO2R online tool. Next, ZBTB16 expression was down-regulated in synovial tissues of RA patients. Moreover, ZBTB16 can alleviate the degree of paw swelling in CIA mice. ZBTB16 improved the pathological changes of synovial tissues in CIA mice. The levels of inflammatory factors and matrix metalloproteinase were increased in CIA mice, but these impacts were reversed after ZBTB16 amplification. ZBTB16 can relieve pannus in CIA mice. Besides, the triggered GRK2/HIF-1α pathway in CIA mice can be retarded after ZBTB16 overexpression.

Conclusion: ZBTB16 exerted anti-angiogenic effects in RA by blocking GRK2/HIF-1α pathway. This work hinted that ZBTB16 may be one useful target for RA treatment.

Asthma is a debilitating lung disease characterized by airway inflammation and airflow obstruction. Immune cells, particularly T helper 2 (Th2) lymphocytes, are central players in the pathogenesis of asthma and mesenchymal stem cells (MSCs) have shown the capability of softening pathological inflammatory responses in asthma. Hence, we researched the immunopathologic effects MSCs cocultured with interferon (IFN)-γ, the main Th1 cytokine, in asthmatic mice. After isolation, MSCs were cocultured with IFN-γ and administered to asthmatic mice. Subsequent analyses included enumeration of broncho-alveolar lavage (BAL) fluid's inflammatory cells, determination of the levels of immunoglobulin E (IgE), leukotrienes (LTs), cytokines, chemokines, and histopathology assessment. The administration of IFN-γ-cocultured MSCs reduced the percentage of eosinophils in the BAL fluid and levels of IgE, LTs, cytokines, and chemokines. Also, there was a decrease in the eosinophilic infiltration of perivascular areas and periairways. IFN-γ cocultured MSCs could modulate immune responses and harness pathological events in allergic asthma.

Acute lung injury (ALI) is a pulmonary disorder characterized by severe lung tissue damage and inflammation. Morusin (a flavone, a type of flavonoid; C₂₅H₂₄O₆), a flavonoid isolated from mulberry root bark, possesses notable anti-inflammatory and antioxidant properties. However, its regulatory effects on ALI progression remain unclear. This study aimed to investigate whether morusin could mitigate the development of ALI. Morusin was shown to enhance cell viability and reduce apoptosis in lipopolysaccharide (LPS)-stimulated A549 cells. Furthermore, morusin alleviated inflammation by decreasing the levels of interleukin-1β (IL-1β), IL-6, and prostaglandin E2 (PGE2) in LPS-challenged A549 cells. In addition, morusin effectively reduced oxidative stress in these cells. Mechanistically, morusin was found to suppress the activation of NLRP3 (nucleotide-binding domain, leucine rich-containing family, pyrin domain containing 3) inflammasome in LPS-stimulated A549 cells. Finally, this study demonstrated for the first time that morusin ameliorates LPS-induced inflammation and oxidative stress in lung epithelial cells by inhibiting both nuclear factor kappa B signaling pathway and NLRP3 inflammasome activation. However, this project was limited to cell experiments, and no animal experiments or clinical verifications were conducted. Our findings suggest that morusin could serve as a promising therapeutic agent for the treatment of ALI.

Food protein-induced enterocolitis syndrome (FPIES) is a non-immunoglobulin E (IgE)-mediated food allergy characterized by gastrointestinal symptoms such as vomiting and diarrhea. Since 2018, hen's egg yolk has been the most common trigger for FPIES in Japan, whereas typical egg white (TEW) FPIES remains rare. Herein, we present two cases of acute TEW FPIES in young children. A 17-month-old girl experienced recurrent vomiting and lethargy following egg white ingestion, despite previously tolerating half an egg yolk and 5 g of egg white. Initial tests showed no sensitization markers (egg white-specific IgE < 0.1 kUA/L; ovomucoid [OVM]-specific IgE < 0.1 kUA/L; skin prick test [SPT] negative). Three oral food challenges (OFCs) at 6-month intervals at our hospital all triggered vomiting and lethargy. Procalcitonin and thymus- and activation-regulated chemokine levels remained elevated for 24 hours, and even after 31 months, the patient had not achieved egg white tolerance. A 14-month-old girl presented with vomiting and lethargy after egg white ingestion while on a strict egg yolk- and egg white-free diet. Blood tests again showed no sensitization markers (egg white-specific IgE < 0.1 kUA/L; OVM-specific IgE < 0.1 kUA/L; SPT negative). Two OFCs at 6-month intervals confirmed FPIES, and even after 2 years, the patient had not achieved egg white tolerance. These cases highlight that egg white can trigger FPIES. Thorough medical history taking and diagnostic evaluation, including OFCs, are essential to distinguish FPIES from immediate-type food allergies.

Introduction: Hereditary angioedema (HAE) is a rare but potentially life-threatening disorder characterized by recurrent swelling episodes. Adherence to clinical guidelines, such as the World Allergy Organization/European Academy of Allergy & Clinical Immunology (WAO/EAACI) guidelines, is crucial for effective management. With the increasing role of artificial intelligence in medicine, large language models (LLMs) offer potential for clinical decision support. This study evaluates the performance of ChatGPT, Gemini, Perplexity, and Copilot in providing guideline-adherent responses for HAE management.

Methods: Twenty-eight key recommendations from the WAO/EAACI HAE guidelines were reformulated into interrogative formats and posed to the selected LLMs. Two independent clinicians assessed responses based on accuracy, adequacy, clarity, and citation reliability using a five-point Likert scale. References were categorized as guideline-based, trustworthy, or untrustworthy. A reevaluation with explicit citation instructions was conducted, with discrepancies resolved by a third reviewer.

Results: ChatGPT and Gemini outperformed Perplexity and Copilot, achieving median accuracy and adequacy scores of 5.0 versus 3.0, respectively. ChatGPT had the lowest rate of unreliable references, whereas Gemini showed inconsistency in citation behavior. Significant differences in response quality were observed among models (p < 0.001). Providing explicit sourcing instructions improved performance consistency, particularly for Gemini.

Conclusion: ChatGPT and Gemini demonstrated superior adherence to WAO/EAACI guidelines, suggesting that LLMs can support clinical decision-making in rare diseases. However, inconsistencies in citation practices highlight the need for further validation and optimization to enhance reliability in medical applications.

Introduction and objectives: The degranulation and release of inflammatory mediators mediated by the high-affinity immunoglobulin E (IgE) receptor (FcεRI) on mast cells in response to allergen contact is the driving force of anaphylaxis. This study shows that P815 cells, which were previously thought not to express FcεRI, cause a reaction similar to FcεRI-mediated degranulation in the presence of antigen and IgE.

Materials and methods: The kinetics of degranulation were evaluated by comparing P815 cells with FcεRI-expressing a rat basophilic leukemia (RBL-2H3) (that typically indicates the specific clone or subline within that cell line) cell lines. Degranulation activity was measured using the release rate of β-hexosaminidase as an indicator. P815 cells showed significant degranulation when compound 48/80 or anti-dinitrophenyl (DNP)-IgE antibody and DNP-human serum albumin (HSA) antigen were added simultaneously. Gene expression analysis confirmed the expression of each FcεRI subunit-specifically, the γ subunit expressed markedly. Moreover, the expression of the phosphorylation enzymes Lyn, spleen tyrosine kinase (Syk), Fyn, and Bruton tyrosine kinase (Btk), which are involved in degranulation, was upregulated.

Results: FcεRI has three subunits: α, β, and γ. P815 cells do not express FcεRI because they have messenger ribonucleic acid (mRNA) for the γ subunit but not for the α and β subunits. However, P815 expressed each subunit protein (α, β, and γ), as detected in the western blotting analysis of cell extracts in the presence of DNP-HSA antigen and anti-DNP-IgE.

Conclusion: These results suggest that P815 may cause degranulation via FcεRI. Therefore, P815 is considered to be a cell model that can evaluate both FcεRI-mediated and FcεRI-independent degranulation reactions in response to allergens.

Background: Skin aging causes various immunological and structural changes and increases the risk of many skin diseases such as contact dermatitis.

Objective: Our aim was to share the allergen contact dermatitis sensitivities of the elderly population with the European baseline series (EBS) results.

Materials and methods: Patients aged 65 years and older who were patch tested with EBS in the immunology and allergy clinic between January 1, 2018, and March 1, 2025, were included in the study.

Results: The median age of the 62 patients included in the study was 69.5 years (25-75, 66.0-73.3 years); 54.8% of the patients were female; and 82.3% of the patients were under the age of 75. The rate of at least one positive patch test was 41.9%, and no positivity was observed in approximately half of the allergens included in the EBS. The rate of at least one positive test result was 37.3% in the 65-74 age group and 63.6% in the 75-84 age group (p = 0.177). The rate of at least one positive test result was 35.3% in women and 50% in men (p = 0.243). The most common allergen over the age of 65 was fragrance mix I (11.3%), followed by potassium dichromate (9.7%) and fragrance mix II (9.7%) in equal proportions.

Conclusion: It is also very necessary to create an "elderly baseline series" by avoiding unnecessary allergens that are not detected as positive in patch tests. In addition, increasing the number of studies in geriatric patients will help in understanding trends in contact allergy.

Background and objectives: Managing chronic spontaneous urticaria (CSU) resistant to anti-histamines remains challenging, and predictors of omalizumab efficacy are not fully understood. This study evaluated omalizumab's effectiveness, response patterns, and predictors in CSU patients.

Materials and methods: A retrospective analysis was conducted on 72 patients receiving omalizumab for at least six months. Factors influencing response to anti-IgE therapy were examined.

Results: Among the 72 patients with chronic spontaneous urticaria (CSU), 86.1% responded to omalizumab: 58.3% had a good response (UAS-7 <6), 27.8% showed a partial response, and 13.9% were non-responders. Baseline total IgE levels were significantly higher in responders compared to non-responders (good: 291.4 kUA/L vs. 60.2 kUA/L, p = 0.003; partial: 148 kUA/L vs. 60.2 kUA/L, p = 0.049). ROC analysis identified a total IgE cut-off of 64 kUA/L for predicting omalizumab response (AUC: 0.67, p = 0.019; sensitivity: 82%, specificity: 48%). Non-responders had significantly higher erythrocyte sedimentation rates (20.0 mm/h vs. 8.25 mm/h, p = 0.018). Patients with recurrence post-treatment had elevated thyroid-stimulating hormone (TSH) and C-reactive protein (CRP) levels (p = 0.006, p = 0.007). Among responders, 29% had an early response and 71% a late response. Early responders had significantly lower anti-thyroglobulin (anti-TG) and antinuclear antibody (ANA) positivity (p = 0.036, p = 0.035). Systemic inflammatory indices (SII, SIRI) did not predict response.

Conclusions: Baseline total IgE may predict omalizumab response, while ANA and anti-TG positivity correlate with delayed response. Elevated TSH and CRP levels may indicate a higher recurrence risk after treatment discontinuation.

Background: Most of the literature on aeroallergen sensitization have been generated in North America and Western Europe.

Objectives: To determine aeroallergen sensitization prevalences and patterns among patients with physician-diagnosed allergic rhinitis (AR) in Israel.

Methods: We conducted a retrospective, observational study of sensitization to 20 aeroallergen extracts in skin prick tests (SPTs) among consecutive pediatric and adult patients with AR attending the allergy clinic at Emek Medical Center (Afula, Israel) and an affiliated regional outpatient clinic (Nazareth, Israel) from 2021 to 2023.

Results: A total of 1993 patients (547 females, 27.4%) were included (median [range] age: 24 [6-82]). The five allergens or groups of allergens with the highest SPT positivity rates were house dust mite (HDM: Dermatophagoides pteronyssinus and D. farinae; 74.8%), tree pollens (44.3%), olive pollen (34.1%), grass pollens (25.6%), and cat dander (22.6%). Of the 1993 patients, 947 (47.5%) had a positive SPT for just one of the 20 tested extracts. Patients sensitized to cat dander were significantly (12-fold) more likely to be sensitized to dog dander and vice versa. Patients living in an urban environment were more likely to be sensitized to cypress pollen (19.3% vs. 12.0% in a nonurban environment; p = 0.002, chi-squared test) and pellitory pollen (21.6% vs. 15.1%, respectively; p = 0.010, chi-squared test). Our suggestion is that in the Middle East, patients with symptoms of AR can be effectively screened with a standard "European" panel of allergen extracts for SPTs (such as that suggested by the Global Allergy and Asthma European Network [GA2LEN] organization), plus Johnson grass, Bermuda grass, and oak and eucalyptus pollen extracts.