Allergologia et immunopathologia最新文献

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.

Background: Antituberculosis drugs can cause hypersensitivity reactions that interrupt treatment and increase morbidity. Early identification and management are essential to prevent complications and drug resistance.

Objective: To evaluate the clinical characteristics, risk factors, and outcomes of antituberculosis drug-induced hypersensitivity reactions over a 10-year period in a tertiary referral center.

Methods: We retrospectively analyzed 449 patients hospitalized for antituberculosis drug-induced hypersensitivity between 2015 and 2024. A control group of 478 tuberculosis patients without hypersensitivity was included. Demographic features, comorbidities, hypersensitivity types, causative drugs, and treatment outcomes were compared.

Results: The prevalence of hypersensitivity was 12.1%. Female gender, older age, Turkish nationality, and history of other drug allergies were significant risk factors. Type 1 reactions (77.7%) were more common and associated with shorter treatment interruption and higher cure rates. Pyrazinamide was the most frequently implicated drug. Desensitization was successful in the majority of patients.

Conclusion: This large cohort study highlights key risk factors and clinical outcomes in tuberculosis drug hypersensitivity. Close monitoring of high-risk patients in the early treatment phase may reduce delays and improve outcomes.

Purpose: We aimed to investigate allergic sensitization and associated factors in pediatric patients with selective immunoglobulin A deficiency (SIgAD) and to evaluate differences between allergic and nonallergic groups.

Methods: We analyzed 110 patients (aged 4-18 years) diagnosed with SIgAD at Çam and Sakura City Hospitals, Istanbul, between 2021 and 2024. Their demographic, clinical, and laboratory data were assessed.

Results: Allergic sensitization was detected in 62.7% of patients. Patients with allergic sensitization, family history of allergic diseases, eosinophilia, and elevated total immunoglobulin E (IgE) levels were significantly higher (P < 0.05). Immunglobulin M (IgM) levels were higher in the allergic group (P = 0.01), and they had lower neutrophil counts (P = 0.03). Allergic sensitization was lower in patients with autoimmune diseases (P = 0.03). In 60% of the patients, the main reason for presentation was recurrent infection.

Conclusion: Allergic sensitization with SIgAD is associated with genetic and immunological factors. A family history of allergic disease, eosinophilia, and elevated total IgE levels are important markers for the development of allergy. These findings highlight the need to closely monitor allergies in people with SIgAD.

Background: Asthma is a chronic respiratory disease with complex pathogenesis. Some studies suggest that certain trace metals may be associated with asthma. However, the relationship between serum copper (Cu) and childhood asthma remains unclear. This meta-analysis evaluates the association between Cu and childhood asthma.

Methods: Studies of multiple databases were searched from inception to 2024. We recorded the standardized mean difference (SMD), 95% confidence intervals (CIs), and other data. The analysis was performed using Stata 18.0 software. Two independent reviewers appraised methodological quality using the Newcastle-Ottawa Scale. Sensitivity analysis was used to test robustness. To evaluate publication bias, we used Begg's funnel plots and Egger's regression test.

Results: A total of 11 studies with a combined 1006 participants were included. There was no significant difference in the level of serum Cu between children with asthma cases and controls (SMD = -0.032, 95% CI: -0.291-0.228, P = 0.811). There was significant heterogeneity among the studies (I² = 73.5%, P < 0.0001). Subgroup analysis demonstrated that heterogeneity was not caused by the continent of origin, publication year, sample size, detection methods, and the mean age of participants. No publication bias was found.

Conclusion: There is no statistically significant association between serum Cu levels and childhood asthma. Further research, particularly large-scale prospective cohort studies, is needed to clarify this relationship.