Allergologia et immunopathologia最新文献

Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a subtype of immunoglobulin E (IgE)-mediated wheat allergy characterized by symptoms from wheat intake followed by physical exercise. Although omega-5 gliadin-specific IgE (sIgE) is widely used for diagnosing WDEIA, its sensitivity is lower in children than in adults. This report describes a 13-year-old male with suspected wheat allergy who experienced anaphylaxis following wheat ingestion and exercise. ImmunoCAP results revealed positive sIgE for wheat and gluten but negative results for omega-5 gliadin. An open-label oral food challenge combined with exercise confirmed the diagnosis of WDEIA. Notably, alpha/beta gliadin sIgE was detected using an enzyme-linked immunosorbent assay with the patient's serum, suggesting that alpha/beta gliadin can serve as an alternative marker in pediatric cases where omega-5 gliadin sIgE is undetectable. This suggests that omega-5 gliadin sIgE alone may not be appropriate for diagnosing WDEIA in children. Instead, utilizing a combination of other wheat protein components may enhance both sensitivity and specificity in diagnosis.

Purpose: Research has indicated that individuals with allergic rhinitis exhibit elevated levels of CXCL16 expression in their serum. This study aims to illustrate the role of CXCL16 and its associated mechanisms in mice suffering from allergic rhinitis.

Methods: An allergic rhinitis model was established by injecting ovalbumin (OVA) into mice, and the expression of CXCL16 mRNA and protein in nasal mucosal tissue was measured. The frequency of nose rubbing and sneezing in each group of mice was recorded. Serum levels of IgE and IgG1 were also assessed. Th2 cell-related factors in the bronchoalveolar lavage fluid (NALF) were analyzed. Histological staining was used to examine pathological changes in the nasal and lung tissues. The expression levels of p-p65, p65, p-IκBα, and IκBα proteins in nasal tissues were evaluated using western blot.

Results: CXCL16 expression was elevated in OVA-induced allergic rhinitis mice. CXCL16 knockout reduced the frequency of nose wiping and sneezing in OVA-induced mice and suppressed the levels of IgE and IgG1. Furthermore, CXCL16 knockout led to a decrease in both the number of inflammatory cells and the levels of inflammatory factors in NALF. Histological staining revealed that CXCL16 knockout alleviated pathological tissue changes and goblet cell hyperplasia. Additionally, CXCL16 knockout suppressed the expression of p-p65/p65 and p-IκBα in nasal tissues, while increasing the expression of IκBα.

Conclusion: CXCL16 deficiency alleviates allergic rhinitis.

Egg allergy is one of the most common food allergies in the pediatric population. It significantly impacts the quality of life of patients and their families. Egg allergy is an adverse reaction mediated by an immune mechanism. There are different mechanisms involved. This review refers to immunoglobulin E (IgE)-mediated egg allergy. The prevalence of egg sensitization and allergy is higher in children with cow's milk allergy and in those with atopic dermatitis. The prognosis for egg allergy in young children is generally good, although in some cases it tends to persist at adult age. The main allergens in egg white are ovomucoid and ovalbumin. Diagnosis is based on the suggestive clinical history and the study of specific positive egg allergy. Oral food challenge test is the gold standard test to confirm diagnosis. Egg allergy, like other food allergies, is primarily managed with the avoidance diet and symptomatic treatment in case of an allergic reaction. The current approach emphasizes minimizing restrictive diets, if possible. Therefore, obtaining an accurate diagnosis through component-resolved diagnostics is essential, and whenever necessary, confirming tolerance through oral challenge tests. Food immunotherapy can be potentially curative and can be regarded as a therapeutic option for IgE-mediated egg allergy. It increases the amount of food tolerated and reduces the risk of a life-threatening anaphylactic reaction. There are different approaches: orally, sublingually, subcutaneous, or via epicutaneous. Among these, oral immunotherapy is the most extensively studied and widely used approach in clinical practice.

Background: All chemotherapy agents have the potential risk of developing hypersensitivity reactions (HSRs). In patients who develop HSRs, rapid drug desensitization (RDD) enables the use of a treatment option that prevents disease progression. If RDD fails to elicit the desired results or in patients with baseline HSRs Brown grades 2-3, omalizumab may also be a treatment option. Our primary aim is to share the demographic and clinical characteristics of our patients who underwent RDD. Our secondary aim is to share our experience with omalizumab during RDD in difficult cases.

Methods: This was a retrospective study of patients with immediate-HSRs to chemotherapeutic (CHT) agents. Initial HSRs were classified as grades 1, 2, or 3 based on severity. Prick/intradermal skin tests were performed with implicated agents. In grade 3 reactions and skin prick test (SPT)-positive patients, a 16-step desensitization was applied. A 12-step desensitization was applied in other patients. In 10 patients, omalizumab was administered for premedication.

Results: The study analyzed data from 80 patients (F/M: 60/20). The number of patients who received different medictions was as follows: carboplatin-23, paclitaxel-22, oxaliplatin-21, dasotaxel-9, etoposide-1, docorubicin-1, pertuzimab-1, paclitaxel+herceptin-1, and bevacizumab+oxaliplatin-1. Inıtıal HSRs were grade 1: 27(%33,7) , grade 2: 30 (%37,5), and grade 3: 23(% 28,7). A total of 22 patients (27.5 %) had atopy based on SPT. Skin tests with implicated agents were done on 78 patients. For the inıtial HSR grades 1, 2, and 3, the number of positive skin test responses was 25/27, 27/29, and 17/22, respectively. A total of 377 RDDs were performed completely, but 22 patients developed 3 reactions during RDD (grade 1: 77.2%, grade 2: 13.6%, and grade 3 9%). All patients received a mean of 4.7 (minimum: 1, maximum: 23) RDDs. There was no statistical difference in the severity of reaction, system involvement, and distribution of symptoms between platinum and taxanes groups. The rate of reaction during RDD was higher in patients receiving platinum compared with taxan. Ten patients received omalizumab before RDD. Initial HSRs were grade 3 in 8 patients; the responsible agent was platinum in 5 patients; and 1 patient developed grade 3 HSR during RDD. In four patients, ınıtıal HSRs were grades 2 and 3, and desensitization was not continued when HSR developed during RDD. A total of 373 successful RDDs were performed.

Conclusions: RDD is a very important treatment applied to patients with immediate-HSRs to CHT agents. Omalizumab facilitated the continuation of chemotherapy in patients with index reaction grades 2-3. It provided an opportunity for 8 of 10 patients with Grade 2-3 severe reactions to continue treatment. In our population, 98.9% (373/377) successful completion of RDDs in all chemotherapy groups demonstrates the safety of thi

The anergic period is defined as a period of around 3-6 weeks following a systemic allergic reaction when skin test results are negative. Therefore, most guidelines recommend that physicians should conduct skin test 6 weeks after an immediate hypersensitivity reaction. However, in vitro tests, including serum-specific immunoglobulin E (IgE) measurement, are generally deemed unaffected by the anergic period. Here, we present a case of a patient with initial cefaclor-specific IgE negativity, but when tested immediately after confirmed anaphylaxis to cefaclor, the results converted to positive after the resolution of the anergic period, 8 weeks post reaction. In patients with a strong clinical suspicion of drug-induced anaphylaxis, repeating in vitro tests after the anergic period may be warranted, even if the initial results are negative. Further investigation is needed to assess whether ImmunoCAP values, similar to skin test reactivity, exhibit significant short-term variability.

Introduction: Early diagnosis of childhood asthma is a challenge; so we questioned whether metabolomic analysis could differentiate persistent recurrent wheezing from transient wheezing in preschoolers.

Methods: Case-control study with individuals aged 4-6 years and 11 months with three or more episodes of wheezing due to bronchospasm was carried out in an allergy outpatient clinic and metabolomics laboratory from July 2021 to February 2023. Two groups were formed: persistent wheezers with multiple trigger attacks after the fourth year of life; and transient wheezers without wheezing for at least 12 months after the third year of life. Those with other wheezing disorders were excluded.

Results: This study was carried out on 29 children with a mean age of 4.9 (±0.6) years-19 (65%) persistent wheezers and 10 (35%) transient wheezers. Sensitization to aeroallergens and the positive asthma predictive index were significantly higher among persistent wheezers. From the plasma hydrogen-1 NMR (¹H NMR) spectra, five best subsets were selected to discriminate between the two groups with an accuracy rate of 93.1%. Among the metabolites, valine and citrate showed higher signals and lipids and lipoproteins were higher in persistent wheezers.

Background: Pediatric pneumonia is a severe inflammatory condition frequently precipitated by bacterial endotoxins, such as lipopolysaccharide (LPS), which can elicit oxidative stress, endoplasmic reticulum (ER) stress, and apoptotic cell death. DEP domain-containing mTOR-interacting protein (DEPTOR), an endogenous inhibitor of mTOR signaling, has been implicated in the regulation of inflammation and ER homeostasis. However, its specific function in the pathogenesis of pneumonia remains poorly defined.

Methods: WI-38 human fetal lung fibroblast cells were employed to establish an in vitro model of LPS-induced inflammation. DEPTOR was overexpressed via plasmid transfection to examine its functional role. The impact of DEPTOR on pro-inflammatory cytokine release, oxidative and ER stress responses, apoptosis, and nuclear factor kappa B signaling was comprehensively evaluated using quantitative real-time polymerase chain reaction, Western blot analysis, enzyme-linked-immunosorbent serologic assay, flow cytometry, and biochemical assays.

Results: DEPTOR expression is significantly downregulated in LPS-stimulated WI-38 cells (P < 0.01). DEPTOR overexpression markedly suppresses LPS-induced pro-inflammatory cytokine production (P < 0.01), ameliorates oxidative and ER stress-as indicated by decreased lipid peroxidation and restoration of superoxide dismutase and glutathione levels (P < 0.01)-and inhibits apoptosis, reducing apoptotic cell percentages by over 10% (P < 0.01).

Conclusion: These results suggest that DEPTOR confers a protective role against LPS-induced cellular injury, supporting its potential as a promising therapeutic target for mitigating.

Objective: To evaluate the role of systemic inflammation response index (SIRI) and systemic immune-inflammation index (SII) biomarkers in predicting the response to omalizumab (OMA) treatment in patients with severe allergic asthma.

Methods: A retrospective analysis was conducted to examine the correlation between the fourth-month treatment responses of patients undergoing OMA therapy for severe allergic asthma and their baseline neutrophil, lymphocyte, monocyte, and platelet values, as well as SIRI and SII scores.

Results: Posttreatment asthma control scores had a positive correlation with baseline SIRI (p = 0.03, r = 0.358), SII (p = 0.04, r = 0.345), and serum neutrophil values (p = 0.01, r = 0.308), and a negative correlation with lymphocyte values (p = 0.00, r = -0.398). Baseline SII showed a negative correlation with posttreatment systemic steroid usage (mg) (p = 0.04, r = -0.247) and the number of exacerbations (p = 0.02, r = -0.269).

Conclusion: SIRI and SII scores hold promise for predicting the success of OMA therapy; however, their utility needs to be validated in larger patient cohorts and further studies.

Allergic reactions caused by local anesthetics are quite rare and these reactions often manifest as Type I (immediate-type) hypersensitivity; however, Type IV (delayed-type) hypersensitivity reactions also hold clinical significance. Type IV reactions are generally T-lymphocyte mediated and symptoms appear hours or days after antigen exposure. In this case report, a rare Type IV hypersensitivity reaction to prilocaine, an amide-type local anesthetic, is described. The patient presented to our center due to the delayed-onset skin lesions that developed after previous surgical procedures and was evaluated through comprehensive allergy testing. A positive delayed-type reaction to prilocaine was observed in the intradermal and patch tests; however, no reaction was detected in the provocation test performed with mepivacaine. This highlights the importance of careful selection of local anesthetics and consideration of Type IV hypersensitivity. Sharing such cases contributes to increased clinical awareness.

This systematic review investigates the connections between ABO blood groups and allergic diseases by analyzing the existing literature to uncover underlying immunological mechanisms. Our search of PubMed, Google Scholar, and the Cochrane Database identified 35 relevant studies, with 10 articles meeting our inclusion criteria. Results suggest that blood group antigens significantly influence immune responses through interactions with immunoglobulin E (IgE) and variations in cytokine profiles. This review highlights the impact of blood group antigens on IgE and cytokine profiles, the relationship between blood group types and allergic disease susceptibility, and the role of gut microbiota in allergy development. The evidence indicates that immunological mechanisms involving IgE antibodies and cytokine signaling play a crucial role in mediating the relationship between blood groups and allergies. Our findings underscore the importance of further research into the immunological pathways linking blood groups to allergic diseases, potentially informing the development of personalized treatments and preventative measures.