Allergy, Asthma & Immunology Research最新文献

Purpose: Shrimp is a predominant allergic food in adults and adolescents. This study aims to evaluate the clinical efficacy of immunologic diagnosis in differentiating the clinical phenotypes of shrimp allergy.

Methods: We enrolled 85 adults diagnosed with shrimp allergy based on clinical symptoms that occurred at least twice after shrimp ingestion and who had specific immunoglobulin E (IgE) results for shrimp extract, were enrolled in the study. Patients were classified into 2 groups: anaphylaxis (ANA) and non-ANA. Serum-specific IgEs to shrimp and recombinant tropomyosin from both house dust mite (HDM) and shrimp were measured using ImmunoCAP.

Results: Among the patients (mean age 38 years; 51.8% female), 32 were diagnosed with shrimp-induced ANA. The remaining 53 were classified into the non-ANA group, including 46 acute urticaria/angioedema and 7 isolated oropharyngeal manifestations. There were no significant differences in shrimp-specific IgE positivity (78.1% vs. 60.4%) or skin prick test (SPT) positivity (16.7% vs. 25.9%) between groups. However, specific IgE to shrimp extract was significantly higher in the ANA group. Receiver operating characteristic analysis indicated that a shrimp-specific IgE level > 0.7 kU/L was an appropriate cutoff for identifying ANA among patients with shrimp allergy (area under the curve 0.643, P = 0.028). No significant differences were observed in specific IgEs to recombinant shrimp and the HDM tropomyosin between the groups. The ANA group had a greater prevalence of nonsteroidal anti-inflammatory drug hypersensitivity (31.3% vs. 7.5%, P = 0.006) and chronic urticaria (35.5% vs. 15.4%, P = 0.035).

Conclusions: Patients with shrimp-induced ANA presented higher levels of specific IgE to shrimp extract compared to those with acute urticaria or localized oropharyngeal symptoms. Neither SPTs nor specific IgE tests for recombinant tropomyosin effectively differentiate ANA among shrimp allergy patients.

Purpose: Safety thresholds for air quality levels have been proposed to protect people from the harmful effects of air pollutants. However, the impacts of air pollutants on asthma, particularly at levels below these safe thresholds, remain unclear.

Methods: We analyzed the associations between air pollutants (particulate matter of 10 μm or less in diameter [PM₁₀], particulate matter of 2.5 μm or less in diameter, sulfur dioxide [SO₂], carbon monoxide, ozone [O₃], and nitrogen dioxide) and healthcare utilization in 23,498 individuals with asthma in Seoul during the 2015-2017 season. The relative risk for healthcare utilization was assessed based on quantitative comparison (upper quartile vs. lower quartile) and non-linear concentration-response curves. Safety thresholds for air quality levels were determined according to the World Health Organization and Korean standards.

Results: In quantitative analysis, healthcare utilization risk decreased for PM₁₀ and SO₂ but increased for O₃ on lag day 0, with no significant associations observed for other air pollutants. Non-linear analyses revealed significant concentration-response associations for all air pollutants, indicating increased risks of healthcare utilization on lag day 0. Notably, these increased risks occurred below proposed safety thresholds, with a steeper rise observed for asthma-related healthcare utilization within these ranges.

Conclusions: Exposure to 6 air pollutants was associated with an increased risk of healthcare utilization among individuals with asthma, with no safe exposure levels identified. The impact was more pronounced below current safety thresholds.

Purpose: Gliadins are the primary triggers in wheat-dependent exercise-induced anaphylaxis. Currently, there are no officially approved immune-modulating treatments for gliadin allergy. Recent in vivo studies have shown that hyaluronic acid based dissolving microarray patch (dMAP) could deliver house dust mite allergens through transdermal pathway and protect allergic asthma and atopic dermatitis in vivo. In this study, we explored the potential of dMAP for the transdermal delivery of gliadin proteins as a strategy to mitigate gliadin allergy.

Methods: C3H/HeJ mice were sensitized to gliadin with cholera toxin via oral administration, followed by oral or intraperitoneal gliadin challenge. To evaluate the protective effects of transdermal immunotherapy (TDIT), gliadin-loaded dMAPs were applied twice a week to gliadin-sensitized mice for 4 weeks. Afterward, the mice were challenged with gliadin.

Results: The manufacturing process of dMAP did not alter the allergenicity of gliadin. TDIT significantly improved the anaphylaxis clinical score and stabilized core body temperature in the gliadin anaphylaxis model. It reduced mast cell protease-1 and gliadin-specific immunoglobulin E (IgE), and increased specific IgG₁, IgG_2a and IgG_2b levels. Ex vivo splenocyte study revealed that TDIT enhanced T helper type 1 (Th₁) cell population, interferon-γ expression, regulatory T cell population, and interleukin (IL)-10 expression, as well as suppressed Th₂ cell population and associated cytokines (IL-4, IL-5, and IL-13). Furthermore, this TDIT preserved the structural integrity of small intestinal villi and reduced eosinophil and mast cell infiltration.

Conclusions: Gliadin TDIT using dMAP mitigates gliadin-induced anaphylaxis in a murine model, offering a promising novel immune modulating treatment for gliadin-induced anaphylaxis.

Purpose: We investigated the prevalence of asthma and its risk factors in Korean children in 2022, comparing the prevalence with previous data to identify trends in the prevalence of childhood asthma over time.

Methods: This nationwide cross-sectional study enrolled 4,038 children aged 6-7 years and 4,269 children aged 12-13 years from 213 randomly selected elementary schools in 2022. The prevalence of asthma in 2022 was compared with those in 1995, 2000, and 2010, with subgroup comparisons classified by gender. A modified International Study of Asthma and Allergies in Childhood questionnaire assessed asthma prevalence with environmental factors.

Results: The prevalence of ''asthma diagnosis ever' in children aged 6-7 years was 9.1%, 9.4%, and 10.4% in 1995, 2000, and 2010, respectively, which was decreased in 2022 (2.1%, P < 0.001). The prevalence of 'current asthma' in children aged 6-7 years showed fluctuations (3.5%, 2.0%, 4.2%, and 0.6% in 1995, 2000, 2010, and 2022, respectively) without showing a significant trend. The prevalence of 'asthma diagnosis ever' and 'current asthma' in children aged 6-7 years was significantly higher in males than in females. The prevalence of 'asthma diagnosis ever' in children aged 12-13 years was 3.1% in 1995, with a significant increasing trend in 2000 (5.8%) and 2010 (7.5%), followed by a decrease in 2022 (3.4%). Male sex, a history of bronchiolitis in early life, allergic rhinitis diagnosis ever, and atopic dermatitis diagnosis ever were associated with 'asthma diagnosis ever' in children aged 6-7 years. For children aged 12-13 years, male sex and history of bronchiolitis in early life were independently associated with 'asthma diagnosis ever.'

Conclusions: Childhood asthma prevalence has decreased, varying by asthma definition. The study's findings provide important information for establishing prevention and management strategies of childhood asthma.

Exposure to pets can trigger symptoms in asthmatic children sensitized to pets. However, little is known about the association between pet ownership and asthma morbidity in children who are not sensitized to pets. We aimed to investigate the effect of pets on lung function, airway inflammation, and morbidity in children with asthma, and to determine whether the effect of exposure to pets vary based on pet sensitization status. A total of 975 asthmatic children, aged 5-15 years, were enrolled in the Korean Childhood Asthma Study. Pet ownership and asthma morbidity were evaluated by questionnaires or pediatrician evaluations. Pulmonary function, fractional exhaled nitric oxide (FeNO), and atopic status were assessed. FeNO levels were significantly higher in children with pets than in those without pets. Pet ownership significantly increased FeNO levels in atopic asthmatic children, irrespective of pet sensitization status. In children sensitized to pets, the geometric mean was 46.6 (range of 1 standard deviation, 26.9-81.5) for those with pets vs. 27.2 (13.8-53.6) for those without pets (P < 0.001). In children without sensitization to pets, the geometric mean was 37.3 (15.0-53.6) for pet owners vs. 25.2 (12.9-49.2) for non-owners (P = 0.014). The multiple regression analysis also revealed that pet ownership was significantly associated with increased FeNO levels and asthma severity in atopic asthmatic children. Pet ownership increased the FeNO levels and asthma severity, regardless of pet sensitization status, in children with atopic asthma. Exposure to pets could increase airway inflammation and disease severity even in atopic asthmatic children who are not sensitized to pets.

Mepolizumab, an interleukin-5 antagonist, is globally recognized for its efficacy in randomized controlled trials for the treatment of severe eosinophilic asthma. The present study explored its real-world effectiveness and safety in a Korean cohort, filling a critical gap in current research. This multi-center retrospective study used data from the Korean Severe Asthma Registry, involving 67 patients treated with mepolizumab for uncontrolled severe asthma between September 2017 and July 2022. We assessed the effects of treatment on acute exacerbations, oral corticosteroid (OCS) maintenance dose, lung function, and quality of life. The notable findings included a marked reduction in the proportion of patients experiencing acute exacerbations, with 73.0% of patients reporting no exacerbations during the 6-month treatment period. At baseline, 31.8% of patients had reported no exacerbations over the prior 12 months. The OCS maintenance doses also decreased substantially, with only 3.2% of patients requiring OCS after 6 months. Additionally, there was an improvement in lung function. No severe adverse reactions were reported in this study, highlighting the safety of mepolizumab. This study confirmed that mepolizumab reduced exacerbations and OCS use, with additional improvements seen in asthma control, lung function, and patient-reported quality of life. These real-world findings support broader applications and reinforce the need for further research to optimize treatment strategies. Despite certain limitations, such as the small sample size and retrospective design, this study significantly contributes to the understanding of the real-world efficacy and safety of mepolizumab.

The prevention of allergic reactions relies on avoiding allergenic foods making it crucial to accurately label products and provide clear information to customers. The "Big Eight" allergenic foods (milk, eggs, peanuts, tree nuts, shellfish, fish, soybeans, and wheat) recommended by the Codex Alimentarius form the basis of the global allergy labeling system. Nevertheless, countries worldwide have developed their own labeling systems tailored to their unique dietary habits and allergy prevalence. With the increase in global food trade and allergy rates, inconsistent international food allergy labeling can jeopardize consumer safety and confuse manufacturers. This review provides a comprehensive overview of the Big Eight allergenic foods and a comparative analysis of allergen labeling regulations across various global regions. It highlights the need for internationally consistent labeling standards, and harmonized approaches for precautionary allergen labeling as well as emphasizes global efforts to enhance the identification of allergenic foods. Furthermore, this review aims to enhance global food safety management, promote international cooperation, and help consumers make informed food choices.