Asian Pacific journal of allergy and immunology最新文献

Background: Meteorological changes can influence the type and concentration of allergenic pollen in the atmosphere.

Objective: This study aimed to investigate the relationship between the diversity of pollen sensitivity based on skin prick test (SPT) reactions and meteorological changes over the past 10 years in Konya, Türkiye.

Methods: A total of 23,111 patients who underwent skin prick testing (SPT) between January 2015 and December 2024 were included in the study. Meteorological data, including temperature, sunlight exposure, relative humidity, rainfall, and wind speed, were obtained from the 8th Regional Directorate of Meteorology.

Results: Our analysis revealed significant relationships between meteorological parameters and pollen sensitivity. Sunlight duration was positively correlated with sensitivity to tree pollen (r = 0.608, p < 0.001). Wind speed was positively correlated with sensitivity to tree pollen (r = 0.433, p = 0.002) but negatively correlated with sensitivity to Chenopodium (r = -0.353, p = 0.013). Humidity was positively correlated with sensitivity to weed and grass pollen (r = 0.367, p = 0.022; r = 0.305, p = 0.033) and negatively correlated with sensitivity to tree pollen (r = -0.605, p < 0.001). Temperature was positively correlated with sensitivity to Artemisia vulgaris (r = 0.317, p = 0.034) and negatively correlated with sensitivity to weed pollen (r = -0.734, p < 0.001). Rainfall was negatively correlated with sensitivity to grass pollen (r = -0.296, p = 0.039), tree pollen (r = -0.850, p < 0.001), and Chenopodium (r = -0.408, p = 0.004).

Conclusions: Our results revealed intricate interactions between pollen sensitivity and meteorological parameters. Notably, rainfall consistently exhibited a negative correlation with specific pollen types, suggesting a potential mitigating effect on pollen-related sensitization. These findings underscore the importance of considering meteorological variability in the management and prediction of allergic diseases.

Background: Exposure to environmental pollutants has been associated with an increased risk of respiratory and allergic diseases.

Objective: To describe the interactions between common pollutants and the immune system and their association with allergic diseases.

Methods: A systematic literature review was conducted using PubMed, Clinical Key, Redalyc, MEDLINE, and SciELO for studies published between 2018 and 2024.

Results: Evidence shows that pollutants such as PM2.5 , PM10 , NO2 , CO, and ozone trigger oxidative stress, inflammatory responses, and epithelial damage, facilitating allergic sensitization, asthma, rhinitis, and dermatitis.

Conclusions: Exposure to environmental pollutants plays a key role in the development and exacerbation of allergic diseases, highlighting the need for preventive measures.

Background: Inflammation of the nasal lining, resulting in rhinorrhea and sneezing, leads to productivity losses.

Objective: We aimed to clarify which corticosteroid nasal spray, dexamethasone cipecilate, fluticasone furoate, fluticasone propionate, or mometasone furoate hydrate, is more cost-effective in treating allergic rhinitis in Japan from the perspective of healthcare payers.

Methods: A decision tree was generated using data on transition probabilities of effectiveness and side effects retrieved from post-marketing surveillance data. Direct medical costs were sourced from Medical Fee Index 2022. The drug prices were determined using the Drug Price Index 2021. Utilities were determined using the EQ-5D-5L scale. Deterministic and probabilistic sensitivity analyses were conducted to examine the robustness of the results. Prescription data for the fiscal year 2020 were also examined.

Results: The incremental cost of mometasone furoate hydrate, dexamethasone cipecilate, and fluticasone furoate compared with that of fluticasone propionate was 200 JPY (1.99 USD), 440 JPY (4.37 USD), and 760 JPY (7.54 USD), respectively. The incremental effectiveness of mometasone furoate hydrate, dexamethasone cipecilate, and fluticasone furoate compared with that of fluticasone propionate was -0.0004, -0.0004, and -0.0002, respectively. Thus, mometasone furoate hydrate, dexamethasone cipecilate, and fluticasone furoate were dominated by fluticasone propionate. The sensitivity analyses showed that the result was robust. Prescription data showed that fluticasone furoate was prescribed most often, followed by mometasone furoate hydrate.

Conclusions: Fluticasone propionate is the most cost-effective agent. As it was not often prescribed in the fiscal year 2020, physicians should understand our results to sustain the reduction of healthcare expenditures.

Background: Asthma is a heterogeneous disease influenced by genetic and environmental factors. Type 2 (T2)-high asthma has been extensively studied; however, the pathophysiological mechanisms of T2-low asthma remain unclear.

Objective: The present study aimed to determine the clinical indices contributing to asthma exacerbation and identify the phenotypes of T2-low asthma.

Methods: We used data from the NHOM Asthma Study (N = 1925), a nationwide asthma cohort study conducted in Japan. T2-low asthma was defined by eosinophils < 150/μL and fractional exhaled nitric oxide levels < 25 ppb. The clinical indices associated with asthma exacerbation were identified using univariate and multivariate analyses. Hierarchical cluster analysis was performed to classify the phenotypes of T2-low asthma.

Results: Multivariate analysis revealed that younger age and comorbid allergic diseases contributed to the exacerbation of T2-low asthma. Four phenotypes were identified: Cluster 1 (n = 19, 7.8%, smoking-related T2-low asthma with preserved pulmonary function), Cluster 2 (n = 18, 7.4%, smoking-related T2-low asthma with low pulmonary function), Cluster 3 (n = 99, 40.7%, elderly, female-dominant, late-onset T2-low asthma), and Cluster 4 (n = 107, 44.0%, younger, female-dominant, comorbid with allergic disease T2-low asthma). Clusters 2 and 4 were prone to asthma exacerbation, indicating distinct allergen sensitization.

Conclusions: These findings indicate that antigen-specific IgE profiles may reflect the phenotypic heterogeneity of T2-low asthma and could serve as potential biomarkers for identifying subgroups at increased risk of exacerbations.

Background: Ambrosia (ragweed) pollen is a major allergenic source, but Ambrosia trifida allergens remain understudied. Triosephosphate isomerase, a conserved pan-allergen in plants, has not been reported in weed pollen.

Objective: To identify and characterize the novel allergen (Amb t 18) and evaluated its clinical relevance.

Methods: Amb t 18 cDNA was cloned and expressed in E. coli. Natural (nAmb t 18) and recombinant (rAmb t 18) proteins were purified for structural analyses (CD spectra) and IgE-reactivity testing (ELISA/basophil activation). Cross-reactivity with homologs Pla a 7 and Tri a 31 was assessed through inhibition ELISA. Structural analyses included 3D modeling, sequence alignment, and phylogenetics.

Results: Natural and recombinant Amb t 18 exhibited similar CD spectra. Amb t 18 reacted with 35.1% (13/37) of serum samples, inhibited 17.56% of IgE-binding to pollen extracts, and activated basophils. In some sera, its IgE-binding activity exceeded that of ragweed pollen extracts. It shared 82% sequence identity with Pla a 7 and Tri a 31, grouped together in the phylogenetic tree. The recombinant Amb t 18 reacted with Pla a 7 or Tri a 31 IgE-positive sera from Platanus acerifolia or Triticum aestivum-allergic patients, rAmb t 18, rPla a 7, and rTri a 31 inhibited IgE binding to rAmb t 18 by 76.70%, 5.80%, and 21.94%, respectively.

Conclusions: Amb t 18 was identified as a novel Ambrosia trifida pollen allergen, the first of its type in ragweed pollen. These findings may aid in developing new diagnostic and therapeutic approaches for ragweed allergy.

Background: The health benefits of breastfeeding are partly contributed by human milk oligosaccharides (HMOs), but there is limited data on breast milk (BM) HMO composition in Chinese.

Objective: This study investigated the association between early-life HMO intake and allergy occurrence in Chinese children.

Methods: 103 healthy Chinese pregnant women regardless of allergy history were recruited into this birth cohort. Their babies were followed until 24 months old. Concentrations of 2'-fucosyllactose (2'-FL), lacto-N-neotetraose (LNnT), -sialyllactose (3'-SL) and 6'-sialyllactose (6'-SL) in BM collected at 1-month postpartum were measured by liquid chromatography-mass spectrometry. The associations between these HMOs and allergy occurrence by 24 months were analyzed by multivariate regression analyses.

Results: Twenty-nine percent and 19% of participants had eczema at 12 and 24 months old respectively. Eighty BM samples were analyzed, with 2'-FL being the most abundant HMO (median 1447 ppm, interquartile range [IQR] 291-1906 ppm), and median (IQR) levels of LNnT, 6'-SL and 3'-SL in ppm were 738 (580-950), 20.5 (12.7-38.8) and 23.0 (17.8-27.6) respectively. Participants with eczema by 24 months consumed BM with higher 2'-FL concentration at 1-month (P = 0.008), and also lower 6'-SL concentration in exclusively breastfed infants (P = 0.012) but higher 6'-SL concentration for those with mixed feeding at 1 month (P = 0.043). Food allergic children at 12 months consumed BM with higher 2'-FL concentrations at 1 month (P = 0.048).

Conclusions: BM 2'-FL concentration is higher in children who develops eczema by 24 months and food allergy during infancy. The relationship for 6'-SL is divergent depending on mode of feeding in infants.

Background: In Taiwan, nonionic iodinated contrast media (ICMs) are commonly used but can occasionally cause severe side effects. The infrequency of these adverse events, coupled with the complexities in establishing direct causality, poses significant challenges for genetic research.

Objective: : To investigate the genetic factors associated with skin reactions mediated by nonionic ICMs on a genome-wide scale.

Methods: A hospital-based cohort from the China Medical University Hospital biobank was utilized to conduct a comprehensive genome-wide association study (GWAS) using PLINK v1.9. The study incorporated two distinct cohorts: one based on adverse drug reaction (ADR) reports, capturing immediate reactions, and the other based on self-reports, which primarily reflected delayed reactions. Known loci were determined by the GWAS catalog. Fine mapping was conducted by FINEMAP to predict causal variants. Pathway enrichment analysis was performed by clusterProfiler to reveal the biological function of the identified genetic signatures.

Results: The ADR-based cohort included 120 cases and 3640 controls. GWAS identified 6 candidate risk loci, namely rs150515068, rs6847491, rs192044153, rs191908641, rs376660317, and rs368821335. The self-report-based cohort, consisting of 275 cases and 8338 controls, revealed 36 additional candidate risk loci. Fine mapping further identified 4 causal variants within each cohort. Pathway analysis showed that immediate HSR-related genes are linked to growth hormone response and signaling, while non-immediate HSR genes are involved in neurotransmission.

Conclusion: This study offers new perspectives on the genetic foundation of nonionic ICM-induced skin reactions within the Taiwanese population, suggesting that the genes contributing to immediate and non-immediate HSRs might have different functional roles.

Background: Toll-like receptor 9 (TLR9), located in the endosomal compartment, is known to play a role in inflammation by recognizing oligonucleotides that contain CpG motive (CpG-ODN). Signaling by TLR9 leads to the production of proinflammatory cytokines and can trigger cell death.

Objective: This study aims to investigate the molecular mechanism of pyroptosis induced by ODN1826 in the mouse macrophage cell line (Raw264.7).

Methods: The protein expression and the amount of lactate dehydrogenase (LDH) of ODN1826-treated cells were determined by immunoblotting and LDH assay, respectively. In addition, the level of cytokine production was observed by ELISA assay and the ROS production was determined by flow cytometry.

Results: Our results showed that ODN1826 induced pyroptosis as judged by LDH releases. Furthermore, caspase-11 and gasdermin D activation, which are the key molecules in pyroptosis, were also observed in ODN1826-activated cells. Moreover, we also demonstrated that Reactive Oxygen Species (ROS) production by ODN1826 is essential for caspase-11 activation and gasdermin D release, which leads to pyroptosis.

Conclusions: ODN1826 induces pyroptosis in Raw264.7 cells via caspase-11 and GSDMD activation. Moreover, the production of ROS by this ligand plays an essential role in the regulation of caspase-11 and GSDMD activation, which then controls pyroptosis in TLR9 activation.

Background: Conventional and cluster subcutaneous immunotherapy (SCIT) are effective but may be time-consuming. Rush SCIT may offer a more convenient treatment option to patients and be of shorter duration; however, it is also associated with a higher incidence of systemic adverse reactions. Therefore, a combination of protocols between rush and cluster SCIT could have a superior risk-benefit ratio.

Objective: To determine the safety of the combination of rush and cluster HDM-SCIT and to identify the risk factors for local and systemic adverse reactions.

Methods: We retrospectively reviewed the charts of patients who received HDM-SCIT, with rush and cluster combination protocols, at a tertiary care hospital between January 2009 and December 2020. Data were collected at the initial visit (demographic data; underlying allergic disease; current medication; and laboratory investigation results including skin prick test, serum specific IgE (sIgE) levels to aeroallergen, total IgE, and eosinophil count) and follow-up visits (rate and severity of local and systemic adverse reactions).

Results: In total, 698 injections (28 patients) were reviewed. Overall, 13 patients developed systemic adverse reactions, at 3% (21/698) per injection visit. All reactions occurred within 60 minutes. In total, 6 patients experienced large local reactions, at 1.1% (8/698) per injection visit. A high level of sIgE to D. pteronyssinus was significantly associated with systemic adverse reactions (HR = 1.02; P = 0.009).

Conclusions: HDM-SCIT with a combination of rush and cluster schedules in the build-up phase could be used as an alternative protocol, given its acceptable systemic adverse reaction rate and shortened duration.

Background: Perioperative immediate hypersensitivity reaction (POH) is an immediate hypersensitivity reaction during an anesthesiologist monitored procedure. We report data of clinically-suspected POH (csPOH) patients undergoing an allergist-performed unified diagnostic workup algorithm for POH.

Objective: To describe the characteristics of patients with csPOH, POH events, and the POH outcomes of procedures after the unified diagnostic workup algorithm for POH.

Methods: A prospective cohort was conducted in adult patients with csPOH at Siriraj Hospital, a tertiary hospital, in Thailand from January 2018 to August 2022. Diagnostic workup for POH by the allergist included an initial assessment, followed by comprehensive allergological evaluation. Patients were then follow-up for POH outcomes during subsequent anesthesia procedures.

Results: Of 68 patients were csPOH, only 52 patients were diagnosed with POH by allergists. The incidence was 1:4,304 anesthetic procedures for POH, and 1:11,900 anesthetic procedures for at least grade III POH. Most patients had a grade III (51.2%) or II (46.4%) reaction. The leading identified causative agents were antibiotics (36.8%), antiseptics (21%), latex (13.1%), and morphine (13.1%). Cefazolin and chlorhexidine were the most common antibiotic and antiseptic, respectively. During a median follow-up time of 2.1 years, all 14 patients completing comprehensive allergological evaluation underwent subsequent anesthesia without recurrence of POH.

Conclusions: The incidence of POH at our hospital was comparable to the global incidence. Antibiotics were the most common causative agent. Complete records, collaboration among the multidisciplinary team, and comprehensive evaluation of POH allow for safe subsequent procedures.