Asia Pacific Allergy最新文献

Background: Real-life clinical research on biomarkers that predict therapy outcomes of severe chronic spontaneous urticaria patients receiving omalizumab (OMA) therapy is still limited. For this reason, we aimed to identify biomarkers that predict the response to OMA treatment.

Methods: A single-center, observational, retrospective review of patients with severe chronic urticaria treated with OMA from January 2015 to January 2023 in a Portuguese Immunology and Allergy Department. One-way ANOVA and linear regression were used.

Results: Data on 56 OMA-treated chronic spontaneous urticaria patients shows patients can be divided into 3 groups according to their response to OMA. The first group of 26 patients (46.4%) successfully reduced their IMA dose without experiencing any rebound effects. The second group of 19 (33.9%) patients achieved disease control but could not tolerate a progressive dose reduction, and the third group of 11 (19.6%) patients, required a higher dose to achieve disease control. In group 1, patient age and a favorable clinical response had a positive correlation (P = 0.008). The patient's age was also correlated to the time interval until a dose reduction was tolerated (r = 0.69; P = 0.005). There was also a negative correlation between the ratio: thyroid peroxidase antibodies/total-IgE and a favorable clinical response (r = -0.74; P = 0.021). In group 2, thyroid peroxidase antibodies were negatively correlated with a favorable clinical response (r = -0.55; P = 0.027). In group 3, anti-double-stranded DNA was negatively correlated with a favorable clinical response (r = -0,97; P = 0,007).

Conclusion: Our study suggests that older patients experience higher success rates with OMA compared to younger individuals, but increasing age is also associated with a longer interval before achieving successful dose reduction. Potential markers of resistance to OMA identified in our cohort included elevated levels of IgG-antithyroid peroxidase antibodies, positive anti-dsDNA antibodies, and a higher IgG-antithyroid peroxidase/total-IgE ratio.

Hypersensitivity reactions (HSRs) to taxanes, such as paclitaxel, occur in 5% to 10% of patients and can involve immunoglobulin E (IgE) or non-IgE mechanisms. We report a 65-year-old male with lung cancer who developed anaphylactic shock during his second paclitaxel treatment. Positive intradermal tests raised the suspicion of an IgE-mediated reaction and, consequently, the possibility of prior sensitization through environmental exposure to Taxus baccata (European yew) pollen. The patient underwent a 17-step desensitization protocol with nab-paclitaxel, a formulation with a lower risk of HSRs, and successfully completed 6 additional treatment cycles without recurrence. This case highlights the role of skin testing, potential environmental factors in taxane allergies, and desensitization protocols as effective strategies to ensure safe and uninterrupted therapy.

Background: Dermatophagoides pteronyssinus (Dp), with its major allergen Der p 2, triggers allergy symptoms in various populations worldwide, but their IgE-binding properties among Filipinos remain limited.

Objectives: This study investigated the IgE reactivity of Dp and its major allergen rDer p 2 in a cohort of allergic and nonallergic Filipinos from Ilocos Norte, Philippines.

Methods: Using enzyme-linked immunosorbent assay, total IgE (n = 960), Dp-specific IgE (n = 247), and rDer p 2-specific IgE (n = 90) levels were determined. The odds ratio was used to determine the association between Dp and rDer p 2 specific IgE among selected demographic variables. An inhibition enzyme-linked immunosorbent assay was used to measure the inhibition of rDer p 2 against Dp allergen extract.

Results: Among 171 allergic cases, mean IgE levels were significantly higher (P < 0.01) than in 76 nonallergic controls. Of the allergic cases, 85 individuals (49.71%) were sensitized to Dp allergens, with 68.89% of these also displaying sensitization to rDer p 2. On average, rDer p 2 inhibited IgE binding to Dp allergens by approximately 36%. Significant associations were found between Dp sensitization and age (P < 0.01), male gender (P = 0.01), and between rDer p 2-sensitization and atopy (P = 0.01).

Conclusion: This study has shown the importance of Dp extract and its major allergen rDer p 2 as a source of allergen that sensitizes atopic Filipino individuals. Consequently, the inclusion of Dp and rDer p 2 in the panel of reagents utilized in immunodiagnostic and immunotherapeutic strategies and interventions for the local Filipino population sensitized to house dust mites is highly recommended.

Background: Anaphylaxis is a life-threatening condition with significant global health implications. Understanding its risk factors in children across diverse populations is crucial for effective prevention and management strategies.

Objective: The aim is to identify risk factors for severe anaphylaxis in children, using data from a Southeast Asian population.

Methods: A retrospective study was conducted at a tertiary care hospital, Thailand, from 2015 to 2023. Data from 335 pediatric patients with anaphylaxis, classified into severe and nonsevere groups, were analyzed. Risk factors were identified using multivariable logistic regression.

Results: Severe anaphylaxis occurred in 24 patients (7.2%). Males (58%) and food allergens, particularly shellfish and wheat, were the predominant factors. Severe cases were associated with an age greater than 12 years (adjusted odds ratio [aOR]: 5.67, P < 0.05), cardiovascular manifestations (aOR: 129.94, P < 0.01), and an early onset of symptoms (aOR: 0.96, P < 0.05).

Conclusion: Age >12 years, cardiovascular symptoms, and early symptom onset were significant risk factors for severe anaphylaxis in children. These findings highlight the need for heightened vigilance and tailored management strategies in older children and those with cardiovascular involvement. Future studies in diverse populations are needed to confirm the generalizability of these risk factors.

Influenza remains a significant public health concern globally, including in Southeast Asia, where unique epidemiological patterns and year-round virus circulation necessitate tailored vaccination strategies. This article briefly explores the historical milestones of influenza vaccine development, tracing its evolution from early inactivated vaccines to modern formulations. It also examines the annual inclusion of specific virus strains in vaccines, detailing the codename system for strain identification. In tropical regions like Southeast Asia, the need for influenza vaccination is debated due to continuous exposure; however, evidence supports its efficacy in reducing disease burden. It also discusses World Health Organization guidelines for optimal vaccination timing based on regional influenza activity and identifies target populations, including high-risk groups, and considerations for broader immunization efforts. Addressing these factors can enhance vaccination strategies and reduce influenza's impact in Southeast Asia.

Primary eosinophilic gastrointestinal diseases (EGIDs) are defined by recurring or persistent gastrointestinal symptoms with histopathological eosinophilic inflammation, after excluding secondary causes. Food elimination diets (FEDs) are one of the main treatment options for primary EGIDs. Sensitization and immunoglobulin E (IgE)-mediated hypersensitivity reactions to eliminated foods after dietary restriction were reported in only a small number of patients with EGIDs. Here, a pediatric EGID patient was described who experienced anaphylaxis after the reintroduction of cow's milk post-FED. In addition, cases of primary EGID patients developing IgE-mediated hypersensitivity reactions to once-tolerated foods after elimination diets were reviewed.

Background: Multicomponent interventions have been reported as effective strategies for improving allergen reduction and asthma control. However, few studies have evaluated the integration of an indoor air quality (IAQ) system and e-health as part of multicomponent interventions.

Objective: To evaluate the effects of multicomponent interventions on house dust mite allergens, indoor particulate matter, and knowledge and trigger reduction behaviors (TRBs) of caregivers.

Methods: Twelve pediatric asthmatic patients with dust mite sensitization were randomly assigned to either a multicomponent intervention group or a control group. In the multicomponent intervention group, IAQ systems were installed in participants' bedrooms, bedding covers were provided, and asthma education was delivered through the LINE application, while the control group received conventional treatment. House dust mite allergen levels were analyzed using the enzyme-linked immunosorbent assay technique, and particulate matter <2.5 micrometer diameter (PM2.5) concentrations were measured at baseline, 4 weeks, and 8 weeks postenrollment. Questionnaires were used to evaluate TRBs and asthma knowledge among caregivers before and after the intervention.

Results: There were decreased Dermatophagoides pteronyssinus allergen group 1 and Dermatophagoides farinae allergen group 1 levels in the multicomponent intervention group compared to the control group; however, the reduction was not statistically significant. Indoor PM2.5 concentrations were significantly lower in the multicomponent intervention group compared to the control group after 4 and 8 weeks (P = 0.005). Statistically significant improvement in overall TRBs (P = 0.04) and a trend in improving asthma knowledge among caregivers were observed in the multicomponent intervention group compared to the control group, although the difference did not reach statistical significance (P = 0.06).

Conclusion: Implementation of an IAQ system and asthma education through the LINE application, as part of multicomponent interventions, resulted in a significant reduction in indoor PM2.5 concentrations and improved TRBs among caregivers.

The treatment for acute food protein-induced enterocolitis syndrome (FPIES) has not been fully resolved. We investigated the efficacy of 5-HT₃ receptor inhibitors and steroids in patients with recurrent vomiting during the oral food challenge test (OFC) for acute FPIES. Patients who met the diagnostic criteria of the international guidelines of acute FPIES and developed recurrent vomiting with the OFC were enrolled. Patients who had a single vomiting underwent infusion with normal saline. A 5-HT₃ receptor inhibitor was administered intravenously when recurrent vomiting appeared with lethargy and/or pallor. If the patient continued to develop persistent symptoms, additional steroids were administered intravenously. This study examined the rate of OFCs in which the administration of a single 5HT₃ inhibitor was insufficient to improve gastrointestinal symptoms, requiring the additional administration of steroids. A total of 20 OFCs were included; 2 treated with infusion therapy, 9 OFCs treated with 5-HT₃ receptor inhibitor, and 9 OFCs treated with 5-HT₃ receptor inhibitors and steroids. Nine OFCs treated with a single 5-HT₃ receptor inhibitor were effective, with only 2 episodes of vomiting observed before administration, and none after treatment. In the remaining 9 OFCs, steroids were additionally administered due to persistent symptoms. Five of 7 OFCs with persistent vomiting improved, and all 7 OFCs with persistent lethargy improved. This study revealed that in OFCs performed due to acute FPIES leading to recurrent vomiting, monotherapy with 5-HT₃ receptor inhibitors was insufficient in half of the OFCs, suggesting that combination therapy with 5-HT₃ receptor inhibitors and steroids should be considered for severe OFCs.

Background: Some regions of the world have experienced increases in the prevalence of diseases such as asthma, allergic rhinitis, and atopic dermatitis; however, little is known about whether the same has occurred with the prevalence of adverse food reactions.

Objective: To determine the temporal trend in the prevalence of adverse food reactions among adults in western Mexico.

Methods: The results of 2 cross-sectional studies conducted 11 years apart (2012-2013 and 2023-2024) are compared. Data were obtained through a standardized survey administered to adults participating in physical activities in the "vía recreactiva" of Guadalajara and were included through stratified sampling based on sex and age.

Results: The first and second studies included 471 and 485 adults, respectively. Comparatively, the prevalence of adverse food reactions was 19.5% and 19.4% (P = 0.953). For oral allergy syndrome, urticaria, and self-reported anaphylaxis, the prevalence was 6.8% and 9.7% (P = 0.104), 5.9% and 4.3% (P = 0.258), and 2.3% and 0.6% (P = 0.032), respectively. Multivariate analyses identified female sex (adjusted odds ratio: 1.52, P = 0.013), age between 25 and 50 years (adjusted odds ratio: 0.59, P = 0.002), personal history of allergic rhinitis (adjusted odds ratio: 2.10, P = 0.004), and atopic dermatitis (adjusted odds ratio: 4.99, P < 0.001) as factors associated with adverse food reaction.

Conclusion: Overall, the prevalence of adverse food reactions, their clinical manifestations, and the most implicated foods did not change during the analysis period. Sex, age, and atopic comorbidities were associated with adverse food reactions.