Allergologia et immunopathologia最新文献

Introduction: Allergy to lipid transfer proteins (LTP) is one of the leading causes of anaphylaxis in the Mediterranean region. Oral immunotherapy, sublingual immunotherapy (SLIT), with peach extract has emerged as a strategy to induce tolerance.

Objective: This study aimed to evaluate the efficacy of SLIT with peach extract and the usefulness of serological biomarkers as predictors of clinical response in patients with LTP-related anaphylaxis.

Methods: Observational study involving 80 patients diagnosed with LTP syndrome. Total IgE levels, specific IgE, and IgG4 specific to Pru p 3 were measured before and after 1 year of treatment. Patients were classified based on tolerance at the end of therapy.

Results: Sixty-one patients (76.3%) tolerated the final oral challenge. Baseline levels of total IgE, specific IgE, and IgG4 specific to Pru p 3 were significantly higher in the tolerance group. IgG4 levels increased significantly in both groups after treatment. Specific IgE levels increased only in the nontolerance group.

Conclusions: SLIT with peach extract may induce tolerance in the majority of patients with LTP allergy. Elevated baseline levels of total IgE, specific IgE, and IgG4 specific to Pru p 3 could serve as markers of clinical response.

Acne vulgaris is a chronic inflammatory skin disorder predominantly caused by Cutibacterium acnes and its virulence-associated CAMP (Christie-Atkins-Munch-Petersen) factors, particularly CAMP1 and CAMP2, which contribute to inflammation and bacterial survival. With increasing antibiotic resistance and concerns over microbiome disruption from conventional treatments, probiotic-derived postbiotics present a promising alternative. This study aimed to investigate the anti-acne potential of fatty acids produced by Pediococcus acidilactici BCBH1, targeting CAMP1 and CAMP2 proteins of C. acnes using a network pharmacology-guided approach. Metabolite profiling via GC-MS identified vaccenic acid as a major fatty acid metabolite (4.88 mg/L at 48 h under 10% linoleic acid stress). Virulence prediction confirmed high pathogenicity of CAMP1 (score 0.9055) and CAMP2 (score 0.9927). Molecular docking revealed strong binding affinities of vaccenic acid to CAMP1 and CAMP2 with binding energies of -9.6 kJ/mol and -9.3 kJ/mol, respectively, outperforming traditional anti-acne compound 4-terpineol (-9.0 kJ/mol and -8.7 kJ/mol). Molecular dynamics simulations further validated the stable interaction of vaccenic acid with CAMP proteins over 100 ns. Pharmacokinetic analyses indicated vaccenic acid's favorable absorption and safety profiles with no blood-brain barrier permeability. These findings highlight vaccenic acid as a potent, microbiome-friendly therapeutic candidate for acne management. Future work should focus on experimental validation, formulation development, and combinatorial strategies to enhance clinical efficacy and safety.

This retrospective study was conducted to identify clinical, demographic, and biochemical factors associated with prolonged disease duration in chronic spontaneous urticaria (CSU) by including adults diagnosed with CSU between October 2023 and October 2024. Laboratory data examined included complete blood counts, C-reactive protein, hemoglobin, and serum iron, as well as specific measurements such as anti-thyroperoxidase antibodies and antinuclear antibody (ANA) positivity and total IgE. Age (at initial visit), sex, disease duration, presence of angioedema were retrieved from electronic records. Disease duration was calculated as the time from symptom onset to the most recent episode based on local hospital records and the Turkish Ministry of Health's National Health System (e-nabız) records. The population size was 203 (~70% females), with a mean age of 40.27 ± 15.03 years. Disease duration was unassociated with age (p = 0.794) and sex (p = 0.366). Angioedema and ANA positivity were respectively detected in 43.35% and 52.26% of patients, but were not associated with disease duration (p = 0.301 and p = 0.824). Notably, patients with a disease duration of >12 months had significantly lower total IgE (p = 0.042) and higher basophils (p = 0.019) compared to those with shorter disease duration. No significant relationships were found when disease duration was classified with thresholds of 24, 36, or 60 months. Basophil count was the only parameter with a very weak but significant correlation with disease duration (r = 0.142, p = 0.044). These results suggest that prolonged CSU duration may be associated with basophil counts and IgE levels; however, it appears that these relationships are weak and likely non-linear. Further research is needed to better understand whether quantifiable parameters might have use in predicting CSU-related characteristics.

Food Allergies (FA) presents an increasing global challenge, influenced by factors such as genetic predisposition, ethnicity, age, and cultural dietary practices. Patients diagnosed with IgE-mediated FA must adhere to strict dietary restrictions to avoid potential life-threatening anaphylactic reactions. Such restrictions are crucial but come with significant consequences as increased nutritional risks, higher costs for special meal preparations and medical care with potential social and psychological impacts on both the individual and their family The impact of FA on quality of life is frequently surrounded by persistent fear of adverse reactions after consuming certain foods. To better understand the behavior of patients with FA this study aims to explore whether patients with confirmed IgE-mediated FA tend to exclude other foods and to identify possible reasons for such exclusions.

Objective: To systematically evaluate the efficacy of Yupingfeng powder combined with acupuncture and moxibustion on allergic rhinitis (AR) and to provide evidence-based basis for combined treatment of AR patients.

Methods: The randomized controlled trials of Yupingfeng powder combined with acupuncture in the treatment of AR were searched in Chinese and English databases (China National Knowledge Infrastructure, Wanfang Database, VIP, PubMed, Embase, and Cochrane). The search time was from the establishment of the database to May 2025. Stata15.0 software was used to perform a meta-analysis of the included literature that met the requirements.

Results: A total of nine studies were included, with a total sample size of 686 cases-350 cases in the control group and 336 cases in the study group. A meta-analysis showed that compared with other treatment methods, Yupingfeng powder combined with acupuncture was more effective in the treatment of AR [RR = 2.52,95% CI (1.80,3.54), P < 0.001]. In addition, the effective rate of follow-up after treatment was higher than that of the control group [RR = 2.03,95% CI (1.32,3.13), P = 0.01], and the recurrence rate of the treatment group was also lower than that of the control group [RR = 0.28,95% CI (0.09,0.87), P = 0.028]; the differences were statistically significant.

Conclusion: Yupingfeng powder and acupuncture therapy have certain clinical efficacy and maintenance effects in the treatment of AR. It can be promoted and applied on a larger scale after further clinical practice.

Asthma is a widespread allergic condition that has impacted around 300 million people globally. There are various classifications of asthma, one of which is based on T-helper2 (Th2) cells, and in this review, we have focused on Th2 high type and how it is caused. In the following sections, we have explored various treatment approaches for asthma, with a particular emphasis on mesenchymal stem cells (MSCs) as a more effective alternative to conventional treatments. MSCs contribute to asthma management through multiple mechanisms, including the secretion of secretomes, soluble factors, and even interactions with other cells, such as dendritic cells and macrophages. However, as explained later in this review, there are challenges associated with MSCs. In response to these limitations, the development of engineered MSCs offers a novel approach. These engineered MSCs are tailored to improve therapeutic efficacy by boosting their homing efficiency, survival rates, and capacity to modulate immune responses. Engineered MSCs are designed with a variety of genes, each enabling distinct mechanisms that contribute to the effective control of asthma. By specifically targeting Th2 cells, these genetically modified MSCs can modulate immune responses, reduce inflammation, and improve airway function, offering a promising therapeutic strategy for management of asthma.

Von Willebrand Disease (VWD) Type 3 is a rare and severe bleeding disorder characterized by an almost complete deficiency of Von Willebrand Factor (VWF). Plasma-derived Factor VIII (FVIII)/VWF concentrates are used both on demand and for prophylactic treatment. However, allergic reactions to these products pose significant challenges in clinical management. A 40-year-old female patient with VWD Type 3 presented to our clinic with symptoms including jaw numbness and tightness, chills, fatigue, nausea, and dyspnea following administration of a FVIII/VWF concentrate (Haemate^® P). Skin prick tests and intradermal tests were performed for diagnostic evaluation and were found to be negative. The hypersensitivity reaction was assessed as an immediate type and non-IgE-mediated reaction. As there were no alternative treatment options, we decided to perform desensitization. A 14-step desensitization protocol was successfully administered. The patient is now able to self-administer Haemate^® P at home three times a week. This case highlights the importance of desensitization and multidisciplinary approach in the case of drug hypersensitivity in patients with VWD Type 3. Our desensitization protocol with FVIII/VWF concentrate is highly effective and safe.

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.

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.