Allergologia et immunopathologia最新文献

Objective: This study aimed to evaluate the demographic and clinical features of pediatric aeroallergen sensitization and seasonal symptom patterns, focusing on pollen.

Materials and methods: This retrospective single-center study included children aged 1-18 years who underwent standardized skin prick testing (SPT) between January 2020 and July 2021. Patients with chronic or immunological disorders other than asthma, allergic rhinitis (AR), and atopic dermatitis (AD) were excluded. Clinical and laboratory data, including symptom profiles, family atopy history, eosinophil counts, and total IgE, were extracted from records. Aeroallergen panels included pollens, house dust mites, molds, and animal dander. Comparisons were performed between monosensitized and polysensitized patients, and between those sensitized to pollen versus house dust mites.

Results: Of 2247 children tested, 2017 were eligible, and 500 (24.7%) with clinically relevant sensitization were analyzed (57% male; median age: 12 years, IQR: 8-15). Pollen was the most frequent sensitizer (78.6%), followed by house dust mites (36.6%). Within pollens, Poaceae predominated (98.1%), with Secale as the leading species (88.4%). Seasonal peaks of symptoms in pollen-sensitized patients occurred in May (31.8%), April (29.6%), and June (27%). Polysensitization was observed in 38.8%. AR was the most common diagnosis (83.2%), while asthma and AD were present in 36.4% and 34.0%, respectively. Pollen sensitization was significantly associated with AR (88% vs. 63%, p < 0.01) and sneezing (38% vs. 16%, p < 0.01), whereas house dust mite sensitization was more often linked with skin rashes (25.5% vs. 13%, p = 0.008). Patients with eosinophilia were younger, predominantly male, and more frequently diagnosed with AR (p < 0.001).

Conclusions: Pollen, particularly from the Poaceae family, was the predominant aeroallergen, and symptom timing matched seasonal pollen trends. Inclusion of region-specific pollens such as Secale in SPT panels is crucial for accurate sensitization detection and for guiding localized public health strategies.

Allergic diseases are prevalent immune disorders that have a considerable impact on public health. Although these cases are traditionally linked with younger individuals, older populations are increasingly affected due to immunological changes and a greater prevalence of comorbidities. The aim of this study was to evaluate the prevalence and triggers of allergic diseases across three age groups-under 50, 50-64, and 65 and older-to inform age-specific prevention and treatment strategies. In this retrospective study, data from 352 patients (270 females and 82 males) who presented to our allergy clinic between December 2022 and December 2023 were analyzed. Patients were grouped by age and data on allergic diseases, triggers, comorbidities, and skin prick test results were evaluated. Appropriate statistical analyses were performed, with statistical significance defined as p < 0.05. Allergic rhinitis (39.8%) was the most prevalent allergic disease, followed by chronic spontaneous urticaria (28.1%), and acute urticaria-angioedema (27.8%). Drug allergies were significantly more frequent in older adults (p = 0.016), with nonsteroidal anti-inflammatory drugs and beta-lactam antibiotics being common triggers. Allergic rhinitis was more prevalent in the < 50 age group (p = 0.013). Skin prick tests revealed sensitivities to pollen (9.4%), house dust mites (8.8%), and cat allergens (2.8%). Allergic diseases vary in frequency across age groups. Allergic rhinitis is more common in younger patients, while drug allergies are dominant in the elderly, likely due to polypharmacy. Raising awareness and tailoring diagnostic approaches for allergic diseases in older adults is essential. Further multicenter studies are needed to confirm these findings.

Introduction: Selective IgA deficiency (sIgAD) is the most common primary immunodeficiency, yet its clinical presentation ranges from asymptomatic cases to individuals suffering from recurrent infections, allergic manifestations, and autoimmune disorders. Limited data exist regarding the immunological and clinical profiles of pediatric patients with sIgAD in Türkiye.

Methods: We conducted a retrospective analysis of 45 pediatric patients (20 females and 25 males) diagnosed with sIgAD and followed at two tertiary care centers. Demographic features, allergic and autoimmune comorbidities, and immunological parameters were evaluated. Lymphocyte subset analyses and immunoglobulin subclass levels were recorded. Associations between IgG3/IgG4 subclass deficiencies and infection frequency were assessed using the Mann-Whitney U test.

Results: The median current age was 102 months (range: 48-204), with a median age of symptom onset at 24 months (range: 1-186), referral at 88 months (range: 6-199), and diagnosis at 87 months (range: 48-192). A history of at least one allergic disease, including asthma, allergic rhinitis, and/or atopic dermatitis, was present in 66.7% of patients. Autoimmune conditions were identified in 13.3%, including Hashimoto's thyroiditis, vitiligo, and immune thrombocytopenic purpura. No statistically significant differences in the frequencies of upper respiratory tract infections, pneumonia, otitis, or viral infections were observed between patients with low versus normal/high IgG3 or IgG4 levels (all P > 0.05).

Conclusion: Our findings highlight the high prevalence of allergic diseases and the clinical heterogeneity of sIgAD in children. Moreover, isolated IgG3 or IgG4 subclass deficiencies may not independently influence infection susceptibility. Longitudinal studies are warranted to better define the prognostic role of immunoglobulin subclasses in pediatric sIgAD.

Introduction: Legumes are a common source of allergic sensitization in many regions worldwide. Structural similarity among homologous proteins can lead to IgE-mediated cross--reactivity. In this context, in silico analysis offers a valuable approach to predict potential molecular interactions among related allergens and to support the interpretation of risk in patients with multiple sensitizations.

Methods: An in silico analysis was conducted to evaluate sequence homology, structural conservation, and surface exposure of IgE epitopes across five major protein families: 11S globulins, 7S globulins, 2S albumins, nsLTPs, and PR-10. Tools included multiple sequence alignment, A-RISC index calculation, and 3D visualization with ChimeraX.

Results: PR-10 proteins exhibited high homology (A-RISC >0.75), suggesting a high risk of cross-reactivity. Vicilins and glycinins showed intermediate similarity (A-RISC 0.45-0.57), while nsLTPs and 2S albumins displayed low A-RISC values (<0.50), although conserved structural motifs were identified in immunologically relevant regions.

Conclusion: This in silico approach enables early identification of cross-reactivity potential, reinforces the value of component-resolved molecular diagnostics, and contributes to improved food labeling, clinical decision-making, and nutritional safety in patients with -multiple sensitizations.

Introduction: Tezepelumab is a human monoclonal immunoglobulin G2λ antibody that targets the cytokine thymic stromal lymphopoietin (TSLP). In clinical trials, tezepelumab has been shown to reduce the annualized asthma exacerbation rate in patients with both high and low levels of T2 inflammation biomarkers.

Methods: This is a prospective, multicenter study of RE-ASGRAMUR (Register of Severe Asthma of the Region of Murcia) conducted under routine clinical practice conditions. We analyzed exacerbations, changes in lung function (pre-bronchodilator FEV1), asthma control (ACT), and quality of life (mini AQLQ). In addition, T2 biomarkers, including blood eosinophils and exhaled nitric oxide (FeNO), were analyzed.

Results: We present a series of 38 patients with severe allergic asthma who received treatment with tezepelumab. More than half of these patients had previously shown inadequate responses to other biologic therapies. Following treatment, the annualized rate of exacerbations decreased markedly from a baseline mean of 2.2 to 0.28, representing an 86.8% reduction. The Asthma Control Test (ACT) score improved by an average of 5.2 points, while the mini Asthma Quality of Life Questionnaire (miniAQLQ) score increased by 1 point. Pulmonary function also improved significantly, with a mean increase of 170 mL in FEV₁. Furthermore, type 2 inflammatory biomarkers, including blood eosinophil counts and fractional exhaled nitric oxide (FeNO), showed a significant reduction.

Conclusions: Tezepelumab is an effective treatment for severe allergic asthma, improving exacerbations, disease control, quality of life, and lung function.

Asthma, a respiratory tract disease, is characterized by inflammation and obstruction of airway. Inflammatory cells play a significant role in allergic asthma, and there is no complete cure for asthma. One of the new approaches in medicines is nanoparticle-base treatment. The aim of the current study is to introduce a new therapeutic approach in nano-medicine with neurotensin. Conjugated peptide nanoparticles were prepared and characterized, and then administrated to asthmatic mice. Airway hyperresponsiveness (AHR) test, broncho-alveolar lavage fluid (BALF) cells counting, cytokines level, and histopathology study were conducted. Treatment with peptide nanoparticles could control AHR, percentage of eosinophils in BALF, levels of interleukin 4 (IL-4), IL-5, and IL-33, peri-airways and perivascular eosinophilic inflammation. Producing and using of new peptide nano-drugs could introduce new therapeutic approach in controlling pathological-related mechanisms in allergic asthma.

Allergic asthma is an inflammatory airway disease influenced by genetic and environmental factors and orchestrated by imbalance between T helper 1 cell (Th1) and two immune responses. Inflammation contributes to pathological changes and remodeling in tissues such as the vascular, lung, heart, and beds. The purpose for this study was to evaluate the effects of allergic asthma on heart pathology and remodeling. In methodology, mice were allocated into two healthy and asthma groups, followed by the assessment of airway hyperresponsiveness (AHR), cell enumeration in bronchoalveolar lavage fluid (BALF), measurement of interleukin (IL)-4, IL-33, IL-5, interferon gamma (IFN-γ), and IL-13, total immunoglobulin E (IgE) levels, and analysis of remodeling factors. Also, gene expression analysis was performed for troponin, suppressor of mothers against decapentaplegic (SMAD)2, myocyte enhancer factor 2 (MEF-2), and SMAD3. Finally, histopathological study was conducted. The result revealed that asthma induction augmented AHR and elevated eosinophil percentage, elevated the levels of IL-13, IL-33, IL-5, IL-4, IgE, Helicobacter pylori (HP), and transforming growth factor beta (TGF-β), and the gene expression of SMAD3. Also, eosinophilic inflammation, goblet cell meta/hyperplasia, and mucus secretion were increased in asthmatic versus healthy mice. The level of IFN-γ was lower in the asthma compared to the control group; however, the expressions of troponin, SMAD2, and MEF-2 genes showed no significant differences. It was concluded that allergic asthma changed the balance between type 1 and 2 cytokines, which could possibly lead to profound effects on the cardiovascular system's structure and/or function.

Alternaria alternata is an ubiquitous mold commonly found in both outdoor and indoor environments. It is a common airborne mold recognized as a significant aeroallergen linked to pediatric allergic rhinitis and asthma. Although sensitization rates in children vary regionally, evidence suggests that A. alternata allergy significantly impacts pediatric respiratory health and as its exposure worsens, respiratory outcomes in susceptible pediatric populations Alternaria. Children are especially vulnerable due to their developing immune and respiratory systems and greater exposure to environmental allergens. This narrative review aims to summarize current knowledge on A. alternata as an allergenic source in children, including its biology, allergenic components (especially Alt a 1), interactions with immune system, airway epithelium interacting with other allergens, and clinical relevance. We also discuss the allergen-specific immunotherapy strategies with standardized extracts that are effective and safe in pediatric patients. Understanding the role of Alternaria in allergic disease is essential for early and accurate diagnosis (including component-resolved methods), effective intervention, and improving long-term outcomes in affected children. Future research should focus on novel vaccine technologies and standardized pediatric-specific treatment protocols.

Desensitization is an immunological process that creates temporary tolerance to a drug, which disappears once treatment is discontinued. Ciprofloxacin is a commonly used antibiotic, particularly for chronic lung diseases, yet there are very few desensitization protocols for it. Two ciprofloxacin desensitization schemes were developed a long time ago. However, these protocols are multistep, time-consuming processes, due to which a new protocol is required. We would like to present the practical oral desensitization protocol that we use. We included two patients with cystic fibrosis and bronchiectasis who required ciprofloxacin due to the presence of Pseudomonas aeruginosa in their sputum cultures. The desensitization process was successful and well-tolerated. This protocol is important because it addresses a significant gap in the literature.

Saline nasal irrigation provides symptom relief in allergic rhinitis (AR), but the optimal saline concentration remains uncertain. The comparative efficacy of 3% hypertonic saline nasal irrigation (HSNI) versus 0.9% isotonic saline is still debated. We conducted a meta-analysis to evaluate nasal symptom scores from studies comparing HSNI with control (isotonic saline or no saline) in patients with AR. Systematic search of PubMed, Scopus, and Cochrane Central was performed for randomized controlled trials (RCTs) comparing 3% HSNI with control from inception to May 8, 2024. Primary outcomes were total nasal symptom scores and antihistamine use. We pooled mean differences and odds ratios (OR) with 95% confidence intervals (CI) using a random effects model and assessed heterogeneity with I². Nine RCTs involving 645 patients met the inclusion criteria. Follow-up ranged from 4 weeks to 2 months. The mean age was 35.49 years in adults and 9.3 years in children. HSNI significantly reduced nasal symptom scores compared with control in adults (MD = -2.09; 95% CI: -3.86 to -0.33; P = 0.02; I² = 97%) and children (MD = -0.97; 95% CI: -1.51 to -0.44; P = 0.0004; I² = 42%). Antihistamine use was also lower with HSNI than control (OR = 0.39; 95% CI: 0.21-0.70; P = 0.002; I² = 14%), but no significant difference was found between HSNI and isotonic saline alone (OR = 0.69; 95% CI: 0.41-1.16; P = 0.16; I² = 0%). HSNI appears effective in reducing symptoms and medication use in allergic rhinitis across age groups.