Asian Pacific journal of allergy and immunology最新文献

Background: Intranasal corticosteroid (INCS) remains the primary treatment for allergic rhinitis (AR). Understanding adherence, safety concerns and sensory preferences is crucial for optimal care.

Objective: This review aims to determine medication adherence, sensory attributes and adverse effects of INCS in AR patients.

Methods: A systematic search of PubMed, Web of Science, Scopus, and Cochrane database was conducted for English articles published from 2004 to 2023. Eligibility includes clinical trials and observational studies with adult patients (18 years old or older) receiving INCS for AR (both intermittent and persistent).

Results: Thirty-one studies with 10,582 patients, comprising 10 cross-sectional studies and 21 randomized controlled trials (RCT) were included. Adherence rates ranged from 28% to 87%, with an average of 55.8%. Forgetfulness was the primary reason for non-adherence (63.1-77.8%), followed by adverse events (26.4-61.5%) and fear of adverse events (3.8-31.5%). Scent (38%), taste (28.5%), or aftertaste (24.3%) were the main differentiators for sensory attribute, with varying levels of intensity and preferences for each INCS. Common adverse events encompass epistaxis, nasal dryness/irritation, headache and nasopharyngitis. A meta-analysis of eight RCT detected no significant difference in adverse events between the INCS and control groups (risk ratio 1.05; 95% confidence interval, 0.88-1.24; p = 0.61).

Conclusions: The findings of this review indicate that medication adherence to INCS is not optimal, with non-adherence mostly attributed to forgetfulness, preferences for sensory attributes, and unpleasant effects associated with INCS. The underlying factors should be addressed as part of a multimodal strategy to improve adherence.

Background: Inhaled corticosteroids (ICS) are the first-line therapy for pediatric asthma. However, very few studies have developed simple tools for predicting treatment outcomes in pediatric asthma.

Objective: This study aimed to construct a predictive model for poor asthma control in children after 6 months of ICS therapy.

Methods: This retrospective study included children with asthma, aged 6-15 years, who received ICS with complete follow-up for 6 months. The potential factors associated with poor asthma control were also assessed. Poor control was considered if the child had partial or uncontrolled symptoms according to the Global Initiative for Asthma guidelines.

Results: Among the 165 eligible children, 33 (20%) had poor symptom control. The factors associated with poor control were a history of more than four exacerbations in the 12 months before ICS treatment (odds ratio [OR], 3.39 [1.06, 10.83]), the presence of moderate to severe allergic rhinitis symptoms at the 6-month follow-up visit (OR, 21.93 [2.97, 162.05]), and poor adherence to asthma medications (OR, 4.16 [1.32, 13.12]). By incorporating these factors, a model for predicting poorly controlled asthma was constructed and converted into a nomogram with a total score of 200, with prediction risk ranging from 0 to 100%. The area under the receiver operating characteristic curve of the developed model was 0.737, indicating a moderate performance level.

Conclusions: We developed a predictive tool for poor asthma control. The model has a good discriminatory ability and is simple to use, which could facilitate the individualized management of children with asthma.

Background: Asthma are associated with the vitamin D axis. Genetic variations of VDBP, notably rs7041 and rs4588, influence circulating vitamin D levels. However, data on their link to asthma are inconsistent, and ethnic differences remain unclear.

Objective: We explored how genetic variations in VDBP affect vitamin D levels and susceptibility to asthma across diverse ethnic populations.

Methods: In our cross-ethnic study, we analyzed vitamin D levels and VDBP polymorphisms (rs7041 and rs4588) in Taiwanese, Mongolian, Lithuanian, and Latvian populations. Our study included 363 asthmatic subjects and 481 non-asthma controls. We performed genotyping for rs7041 and rs4588 and assessed serum concentrations of 25-hydroxyvitamin D [25(OH)D], examining the associations between VDBP polymorphisms, vitamin D levels, and asthma.

Results: The study found significant differences in vitamin D levels among ethnic groups. Non-asthmatic individuals from Taiwan had higher concentrations, while asthma subjects in both Taiwanese and Lithuanian populations showed lower levels compared to their non-asthma counterparts (both p-value < 0.001). VDBP polymorphisms were associated with asthma in the Latvian population, with the rs7041 GG vs. GT+TT showing an odds ratio (OR) of 1.72 (95% confidence interval (CI): 1.10-2.69, p = 0.016) and the rs4588 CC vs. CA+AA showing an OR of 1.88 (95%CI: 1.24-2.84, p = 0.003). However, this association was not observed in other populations.

Conclusions: Our cross-ethnic study underscores the intricate relationship between VDBP genetic variations, vitamin D levels, and asthma vulnerability. The association of VDBP polymorphisms with asthma seems to differ among populations, emphasizing the importance of a nuanced comprehension of these connections.

Background: Chronic obstructive pulmonary disease (COPD) exerts a notable impact on the quality of life of individuals, precipitating substantial economic burdens. A probable association exists between chronic obstructive pulmonary disease (COPD) and chronic rhinitis (CR).

Objective: This study aims to explore the impact of CR in COPD.

Methods: A scoping literature review framework was used for this study. Relevant publications published between January 2003 to December 2023, were captured from Embase, MEDLINE, and Scopus. The outcomes included prevalence, quality of life, exacerbation and hospitalization, lung function, COPD symptom score, and psychological impact.

Results: The scoping review included six eligible studies that focused on CR in COPD. The prevalence of chronic nasal symptoms was found in up to 88% of COPD with nasal discharge found to be the most common symptom in COPD. Chronic rhinitis impacted the QoL, causing a significant increase in the risk of exacerbation & hospitalization, associated with lower lung function and higher COPD symptom scores. CR was not found to impact mood disorder in terms of psychological aspects.

Conclusions: CR, including Allergic and Non-allergic rhinitis, may influences the outcomes of COPD. Assessing chronic nasal symptoms in COPD patients is suggested to understand their role in disease progression. A comprehensive approach targeting both upper and lower airway conditions could improve COPD treatment outcomes.

Background: Cholangiocarcinoma (CCA) is a very aggressive cancer of the bile ducts. Recent advances in immunotherapy, particularly with human single-chain variable fragments (HuScFv), have shown promise in the treatment of solid tumors by targeting cancer cells or improving the immune response.

Objective: This study aimed to select and produce human single-chain antibody fragments (HuScFv) specific to CCA cells (HubCCA1, RMCCA) from phage display HuScFv libraries with minimum or no binding to cholangiocytes (MMNK1).

Methods: Phages that displayed HuScFv to CCA cells were selected by bio-panning and each phagemid was transduced to HB2151 E. coli. The presence of huscfv was determined by direct colony PCR. HuScFv was produced in the E. coli and detected by Western blot analysis and confirmed their specificity and binding capacity to CCA by flow cytometry.

Results: From biopanning, 196 of 350 colonies (56%) of HB2151 E. coli harboring the huscfv gene, and 106 of these (30%) produced the protein. Flow cytometry testing with 14 clones confirmed the presence of the HuScFv protein. The result showed that five HuScFv clones (25, 33, 61, 68, and 80) exhibited stronger binding to CCA cell lines (HubCCA1, RMCCA) compared to cholangiocytes. Furthermore, each clone possessed a distinct amino acid sequence, suggesting unique binding specificities.

Conclusions: HuScFv specific to CCA cells were successfully selected from phage display HuScFv libraries which offer new revenues to develop a pan-CCA immunotherapy and diagnosis of CCA.

Background: The receptor-binding domain (RBD) of the SARS-CoV-2 spike (S) protein is pivotal in facilitating viral entry and serves as a major target for vaccine development and therapeutics. Despite undergoing mutations aimed at evading host immunity, certain regions within the RBD remain conserved.

Objective: This study aimed to identify peptides capable of interacting with these conserved regions of the RBD across various variants and assess their neutralization potential.

Methods: The PhD-12 phage display library underwent screening to identify phages binding to the RBD. Selected phage clones were examined for binding to the RBD of multiple variants, including 2019-nCoV, Delta (B.1.617.2), Omicron (B.1.1.529), and XBB. Peptides, expressed as chimeric constructs, were tested for their binding to the RBD, the Omicron trimeric S, inactivated SARS-CoV-2 virus, and neutralizing activity. The binding sites were analyzed using Molecular Docking.

Results: Two selected phage clones displayed peptides binding to the RBD of multiple variants. Chimeric T hioredoxin-peptides (Trx-RB9 and Trx-RB10) exhibited binding to both inactivated SARS-CoV-2 and the Omicron trimeric S, with half-maximum effective concentrations (EC50 ) values of 111.9 and 360.2 nM, respectively. Molecular docking revealed distinct binding sites within the RBD of the Omicron trimeric S for both Trx-RB9 and Trx-RB10. A mixture of Trx-RB9 and Trx-RB10 inhibited 78% of the binding of recombinant human ACE2 to the Omicron trimeric S.

Conclusions: The chimeric Trx-RB9 and Trx-RB10 peptides bind to the RBD of SARS-CoV-2 variants and inhibit the binding of ACE2 to the RBD of the Omicron trimeric S.

Background: The allergenic relevance of the living environment changes over the last decades is largely unknown.

Objective: We aimed to compare the factors associated with asthma and/or rhinitis between 2008 and 2018.

Methods: We assessed two nationally representative cross-sectional datasets in 2008 and 2018. Within the rigorous protocol, questionnaire and serum IgE measurement were conducted in 2322 and 2353 patients with allergic asthma (A) and/or rhinitis (R) respectively. Multivariate logistic regression analysis was used to examine the effect of different factors on sensitization.

Results: The prevalence of sensitization increased in rhinitis alone (A-R+, 63% in 2008 vs. 67.7% in 2018, P = 0.039) and asthma with rhinitis (A+R+, 70.6% vs. 75.1%, P = 0.014). The common factors for sensitization were male sex, using mattress and air conditioner, family history of rhinitis, building age > 30 years, and meat consumption. Compared with 2008, secondhand smoke was an additional risk factor for A+R- (odds ratio [OR] 2.17, 95% confidence interval [CI] 1.18-7.01) and A+R+ (OR 1.72, 95%CI 1.03-3.14), and the odds of farmland or forest for pollen and mold sensitization were higher in 2018 (OR 3.61, 95%CI 2.79-4.66, and OR 1.86, 95%CI 1.34-2.58). Eating fish was inversely associated with A-R+ (OR 0.68, 95%CI 0.52-0.91, P < 0.01), while older age also showed an inverse relationship with sensitization. The OR of age 25-44 years was higher in 2018.

Conclusions: Repeated surveys showed variations in the factors affecting allergic asthma and/or rhinitis. The variable factors included age of 25-44 years, secondhand smoke, farmland, forest, and fish consumption.

Background: Barrier disruption in the airway mucosae has been implicated in allergic type 2 inflammatory diseases such as allergic rhinitis and asthma. Zingiber cassumunar Roxb. has long been used in traditional medicine to treat allergic diseases. The active compound, namely compound D, has proven anti-inflammatory benefits. However, the effect of compound D on allergic inflammation remains unclear.

Objective: This study aimed to investigate the protective effects of compound D on allergic inflammation-induced barrier disruption.

Methods: Type 2 cytokine (IL-4 and IL-13)-exposed 16HBE human bronchial epithelial cells were treated with compound D. After 24, 48, and 72 h, cytotoxicity, epithelial integrity, and tight junction (TJ) disruption were determined by viability assays, transepithelial electrical resistance measurement, and immunofluorescence staining, respectively. Moreover, the mechanism of action of compound D was investigated by western blotting.

Results: Compound D (100 and 200 µM) prevented IL-4/IL-13-induced barrier disruption at 24 and 48 h with no effect on cell viability. Compound D rescued the localization of ZO-1 to pericellular areas, and the barrier-protective effect of compound D was mediated by inhibiting STAT6 signaling.

Conclusions: Compound D can suppress IL-4/IL-13-induced epithelial inflammation and TJ disruption through STAT6 inhibition. The agent is a promising candidate for therapeutic or adjunctive treatment of type 2 inflammation-associated diseases, including asthma.

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: The inconsistency between serum total IgE (tIgE) and allergen-specific IgE (sIgE) results is often encountered in clinical practice, but the distribution and influencing factors of the inconsistent results have not been fully understood.

Objective: The aim of this study was to analyze the distribution and inconsistency between tIgE and sIgE test results.

Methods: A retrospective study, from the electronic medical records of 2139 patients who underwent both tIgE and sIgE tests, from January to December 2023 was reviewed. The tIgE and sIgE results and their distribution, as well as their inconsistency, were analyzed based on sex, age, and disease subgroups.

Results: 36.2% of the patients had a positive sIgE, and 43.7% had an elevated tIgE level. sIgE and tIgE results were discordant in nearly 30% of patients, with no difference between genders, while individuals aged over 60 exhibited a significantly higher inconsistency rate than the other age groups, and the inconsistency rate between tIgE and sIgE results was significantly different among different tIgE levels, sIgE grades, positive allergen count and positive allergen types. In addition, patients with chronic urticaria (CU) had a higher inconsistency rate than those with other allergic diseases, but the difference was not statistically significant.

Conclusion: The overall inconsistency rate between tIgE and sIgE results was about 30%. The elderly group older than 60 years old is more likely to have inconsistent results, and tIgE level, sIgE level, the number and type of positive allergens also affected the consistency of tIgE and sIgE results.