Asian Pacific journal of allergy and immunology最新文献

Background: Corticosteroids added to high volume saline nasal irrigation have been introduced as a more effective method of delivering corticosteroids to the sinuses than nasal sprays. However, information regarding the effect of this intervention on the hypothalamic-pituitary-adrenal (HPA) axis is still limited.

Objective: To evaluate the safety of long-term corticosteroid (6 months) nasal irrigation in patients with chronic rhinosinusitis (CRS) post endoscopic sinus surgery.

Methods: Seventeen patients with CRS were included. After undergoing endoscopic sinus surgery, the patients were prescribed budesonide nasal irrigations (250 ml via squeeze bottle) twice daily (1 mg/day) for six months. The serum morning cortisol levels of these patients were then evaluated at 3 and 6 months post-operatively.

Results: Median serum morning cortisol levels were 10.5 mcg% at pre-operative baseline; 10.3 mcg% at 3 months; and 11.2 mcg% at 6 months on post-operative follow-up. There were no significant changes in the serum morning cortisol levels (P value = 0.71 and 0.63 respectively). Three of 17 patients (17.65%) had mildly abnormal serum morning cortisol levels (4, 4.3 and 4.9 mcg%) at 3 months. However, these levels were within a normal range at 6 months.

Conclusions: Serum morning cortisol levels were not significantly changed after usage of budesonide nasal irrigation for 6 months.

Background: The global COVID-19 pandemic, caused by SARS-CoV-2, has highlighted the importance of understanding immune responses elicited by vaccines.

Objective: This study evaluated antibody and T cell responses to the inactivated CoronaVac vaccine, as well as the role of pre-existing immunity to common human coronaviruses (HCoVs) in shaping vaccine-induced immunity.

Methods: We enrolled 64 participants (17 males and 47 females) and measured IgG levels against HCoVs before and after vaccination. T cell responses were analysed by stimulating peripheral blood mononuclear cells (PBMCs) with wild-type, Delta, and Omicron spike peptides.

Results: We found pre-existing antibodies against HCoV-229E, HCoV-HKU1, HCoV-NL63, and HCoV-OC43 were present before vaccination. Notably, a positive correlation was observed between pre-existing antibodies to HCoV-229E and HCoV-HKU1 and anti-RBD IgG levels post-vaccination. Pre-existing CD4+ T cell responses were observed for the wild-type strain before vaccination, with a significant reduction in IFN-γ secretion after Delta re-stimulation and partial restoration after Omicron re-stimulation. IL-4 production by CD4+ T cells was significantly reduced upon re-stimulation with Delta and Omicron compared to wild-type. CD8+ T cells again showed a reduction of IL-4 production after Delta re-stimulation compared to the original strain.

Conclusions: This work demonstrate that CoronaVac induces robust humoral and cellular immune responses, though variant-specific responses vary. Pre-existing immunity to certain HCoVs may influence vaccine-induced antibody responses, underscoring the importance of monitoring immunity to emerging SARS-CoV-2 variants and informing future vaccine design.

Background: Denatonium benzoate (DB), one of the most bitter compounds known to man, is used for alcohol denaturation. Some reports have demonstrated that asthmatic symptoms are associated with DB exposure, but the possible links between DB and immunoglobulin E (IgE)-mediated allergy susceptibility have not yet been examined.

Objective: This study investigated the effects of DB on in vitro IgE-mediated mast cell degranulation and food allergy in BALB/c mice.

Methods: IgE-sensitized rat RBL-2H3 cells (a basophilic leukemia mast cell line) and human KU812 cells (a basophilic cell line) and mice with ovalbumin (OVA)-induced allergy were treated with DB. Histamine release, calcium ion (Ca²⁺) influx, phosphorylated spleen tyrosine kinase (p-Lyn) and phosphorylated phospholipase C-γ (p-PLCγ) levels, OVA-specific IgE, anaphylactic symptoms, and the cell-surface expression of the high-affinity IgE receptor α-subunit (FcεRIα) on mast cells were evaluated.

Results: DB increased histamine release, Ca²⁺ mobilization, and p-Lyn and p-PLCγ levels in IgE-mediated activated RBL-2H3 and KU812 cells, and enhanced the cell-surface expression of FcεRIα messenger RNA (mRNA). In mice, DB increased the severity of OVA-induced anaphylactic and diarrheic symptoms, the mucus thickness in the jejunum, histamine and OVA-specific IgE levels, and FcεRIα mRNA in isolated mucosal mast cells.

Conclusions: Our work indicates that DB promotes IgE-mediated mast cell degranulation and OVA-induced allergic diarrhea in BALB/c mice, providing evidence that exposure to DB promotes allergy susceptibility.

Background: Previous studies reported positive associations between exposure to air volatile organic compounds (VOCs) and daily visits for atopic dermatitis (AD).

Objective: This population-based study investigated associations between air VOCs exposure and daily hospitals visits for AD, severity subgroup (mild and severe), and lag-day effect in central-southern Taiwan.

Methods: The dependent variable was AD with diagnostic codes (ICD-9-CM 691.8 and ICD-10-CM L20) retrieved from the Taiwan National Health Insurance Research Database from 2008/01/01 to 2018/12/31. Independent variables included one-day 75th-percentile value of each VOC (benzene, ethylbenzene, toluene, m-/p-xylene, o-xylene, 1,3,5-trimethylbenzene, 1,2,4-trimethylbenzene, isopentane, n-pentane, n-hexane, methylcyclohexane, and cyclohexane) and four meteorological conditions from the Taiwan Air Quality Monitoring Network Database. This was a case-crossover design with multivariable conditional logistic regression, and the adjusted odds ratios (AORs) were reported.

Results: Concentrations of the 12 air VOCs significantly positively affected the total number of daily visits for AD (AOR = 1.02~1.69, P < 0.001) and subgroups of mild (AOR = 1.001~1.049, P < 0.001) and severe (AOR = 1.002~1.077, P < 0.001). The effect of air VOCs on the severe AD group was higher than that on the mild group. Values of the six VOCs on the 1st lag day (benzene: AOR = 1.16, 1,3,5-trimethylbenzene: AOR = 1.5, 1,2,4-trimethylbenzene: AOR = 1.13, isopentane: AOR = 1.07, n-pentane: AOR = 1.08, methylcyclohexane: AOR = 1.5, all P < 0.05) were significantly positively associated with the number of daily visits for AD.

Conclusions: Exposure to the 12 air VOCs on the visit days increased the risks of daily visits for AD in total and severity subgroup. The effects of six certain VOCs on the 1st lag day were significant positive.

Background: Nonsteroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (N-ERD) is a clinical syndrome characterized by chronic rhinosinusitis with nasal polyposis (CRSwNP), adult-onset asthma and hypersensitivity to NSAIDs. Long-term aspirin treatment after desensitization (ATAD) is used for clinical improvement in N-ERD patients. However, information on the potential effect of ATAD on the platelet-neutrophil aggregates (PNA) level in N-ERD patients is highly limited.

Objective: This study aimed to explore the impact of PNA on the pathogenesis of N-ERD and the potential effect of ATAD on N-ERD patient profiles from a platelet point-of-view.

Methods: Sixty-one individuals were enrolled, including 16 N-ERD patients with ATAD (ATAD+), 15 N-ERD patients without ATAD (ATAD-), 15 aspirin-tolerant asthma (ATA) patients, and 15 healthy controls (HCs). Lipid mediators classical in N-ERD, including urinary-LTE4 (uLTE4), prostaglandin-D2 (PGD2), and prostaglandin-E2 (PGE2) were assessed by ELISA. Platelet activation was estimated based on expression levels of sP-selectin, CD40L, Platelet Factor-4 (PF4), RANTES, Thromboxane-A2 (TXA2), PAF, 12-HETE in plasma levels by ELISA; and PNA percentage by flow cytometry.

Results: ATAD+; 12-HETE, and PF4 levels were remarkably low, while higher levels were determined in ATAD- and ATA groups. ATAD+; uLTE4 levels were positively correlated with 12-HETE. Another positive correlation was detected between sP-selectin and 12-HETE in ATAD-. Compared to HCs, it was found that among all N-ERD patients, significant increase in PNA.

Conclusions: Plasma levels of PGE2, PF4, and 12-HETE appear to be affected by aspirin treatment. We believe that 12-HETE could play a significant role in the N-ERD pathogenesis by contributing to platelet activation.

Background: The role of anti-elastin antibody (Ab) in the lung is unclear, although they may be involved in chronic obstructive pulmonary disease (COPD). Recently, increased anti-elastin Ab levels were reported in asthma.

Objective: To elucidate the role of anti-elastin Ab in asthma, we created a murine asthma model. Anti-elastin Ab in the airway was neutralized by intratracheal administration of elastin peptide, and the inhibitory effects of anti-elastin Ab on airway remodeling were evaluated.

Methods: BALB/c mice were immunized with ovalbumin (OVA) on days 0 and 14. After immunization, the mice received booster OVA via inhalation twice per week for 9 weeks, and bronchoalveolar lavage fluid (BALF) and lung tissues were evaluated.

Results: In lung tissues, airway remodeling occurred after 9 weeks of OVA sensitization. Peak levels of anti-elastin Ab and eosinophils in BALF were detected after 3 weeks of OVA sensitization. Anti-elastin Ab and eosinophil levels in BALF were significantly reduced after 3 weeks by the neutralization of anti-elastin Ab. Peak transforming growth factor-β1 levels in BALF were detected at 3 weeks after OVA sensitization and were significantly reduced by the neutralization of anti-elastin Ab. Airway remodeling in lung tissues was also significantly inhibited by the neutralization of anti-elastin Ab.

Conclusions: In our murine asthma model, anti-elastin Ab was recruited to the airway by OVA-induced allergic inflammation. Airway remodeling was inhibited by the neutralization of anti-elastin Ab. Anti-elastin Ab may contribute to the progression of airway remodeling.

Background: Wheat allergy is one of the most prevalent allergens in Korea, decreasing quality of life and causing nutritional repercussions.

Objective: We aimed to investigate the efficacy and safety of the home-based wheat oral immunotherapy (OIT) using wheat noodles in children with a wheat allergy.

Methods: We conducted a retrospective study involving 72 children aged 3 to 17 years diagnosed with a wheat allergy. Patients received wheat OIT using wheat noodles (n = 50) and were compared with a historical control group (n = 22). Baseline characteristics, adverse events, and immunological changes were assessed. Predictors of successful desensitization were identified using logistic regression analysis.

Results: Among 50 patients completing the up-dosing phase, 82.0% achieved desensitization to 2,400 mg of wheat protein, compared to 4.5% in the control group (p < 0.001). During the up-dosing period, the median number of adverse reactions per person was 2, and anaphylaxis occurred in 30.0% (15/50). However, there were no life-threatening adverse events. In multivariable analysis, the presence of asthma (adjusted odds ratio [aOR], 8.88; 95% confidence interval [CI], 1.10-71.97; p = 0.041) and a higher ratio of specific IgE (sIgE) to ω-5-gliadin and total IgE (aOR 19.09, 95%CI 1.21-300.80, p = 0.036) were significantly associated with treatment outcomes of wheat OIT.

Conclusion: Our study showed the safety and efficacy of home-based wheat OIT using boiled noodles in Korean children with wheat allergies. Careful consideration is warranted for patients with elevated baseline sIgE to ω-5-gliadin to total IgE ratio and a history of asthma.

Background: It is often difficult to differentiate between asthma and chronic obstructive pulmonary disease (COPD), and useful biomarkers are needed for accurate diagnosis.

Objective: We evaluated anti-elastin antibody to identify useful biomarkers for differentiating between a diagnosis of asthma and COPD.

Methods: Patients with asthma (male to female ratio = 10/13; mean age, 67.3 years), COPD (16/0; 74.8 years) and controls (8/4; 72.3 years) were enrolled. Samples from sputum and serum were collected and levels of anti-elastin Ab were measured.

Results: The levels of anti-elastin Ab in sputum were significantly higher in asthma (11.4 ± 7.16 μg/mL) than in COPD (5.82 ± 5.16 μg/mL; P < 0.01), and serum levels in asthma (67.4 ± 29.7 μg/mL) were also significantly higher than in COPD or controls (45.0 ± 12.8 μg/mL; P < 0.05, 38.6 ± 10.4 μg/mL; P < 0.01, respectively). Anti-elastin Ab in sputum showed a positive correlation with smoking in asthma (r2 = 0.218, P < 0.05). However, no significant differences were observed in the levels of anti-elastin Ab and eosinophils, asthma phenotypes, inhaled corticosteroids, or severity in patients with asthma. Elastin was strongly expressed under the airway basement membrane in asthma compared with COPD or the healthy control.

Conclusions: Anti-elastin Ab in sputum could be a useful biomarker for COPD and asthma in ever-smokers. In asthma, anti-elastin Ab was recruited to the airways by both airway allergic inflammation and smoking, and it may contribute to the progression of airway remodeling via autoimmune inflammation, but not emphysema, in COPD.

Background: Fire ant, honey bee, and wasp allergen extracts are useful in the diagnosis and treatment of severe Hymenoptera allergic patients.

Objective: To evaluate the result of skin prick test (SPT) and intradermal test (ID) compared between local and commercial insect allergen extracts in patients with severe Hymenoptera sting allergy.

Methods: SPT and ID using local and commercial insect allergen extracts were performed. Specific IgE (sIgE) to honey bee, wasp, and fire ant; component-resolved diagnosis (CRD); (rApi m1, rApi m2, rApi m3, rApi m5, rApi m10, rVes v5, rPol d5, and rVes v1); and, cross-reactive carbohydrate determinant (CCD) were performed.

Results: Twenty-seven patients were included. Twenty-five had anaphylaxis, and 2 had severe systemic skin reaction. Positive skin test (SPT and/or ID) result from local and commercial allergen extracts was 74% vs. 67% for fire ant, 48% vs. 59% for honey bee, and 52% vs. 74% for yellowjacket. Local and commercial allergen extracts showed substantial agreement for fire ant (k = 0.647, p = 0.001) and honey bee (k = 0.632, p = 0.001), and moderate agreement for wasp (k = 0.547, p = 0.001). When compared with sIgE subtracted with CCD and/or CRD, skin test results of local fire ant allergen extract showed higher sensitivity (87% vs. 67%), specificity (42% vs. 33%), and accuracy (67% vs. 52%) than commercial extract. Commercial honey bee and wasp showed higher sensitivity (62% vs. 50%, 85% vs. 65%) and accuracy (63% vs. 52%, 78% vs. 70%), respectively.

Conclusions: SPT and ID with local or commercial insect venoms could help in confirming and/or identifying the causative insects.

Background: Renal tubulointerstitial fibrosis is known to occur as a result of epithelial cell transformation into myofibroblasts via the epithelial-to-mesenchymal transition (EMT) process. It has been reported that macrophages, regulatory T (Treg) cells, and gamma delta T (γδ T) cells can promote fibrosis via EMT in vivo.

Objective: Our study intended to detect whether thymocytes can induce renal tubular cells to undergo the EMT.

Methods: Rat thymocytes were activated by phytohemagglutinin and concanavalin A. The rat renal tubular epithelial cells (NRK-52E) were incubated in a conditioned medium harvested from activated thymocytes or co-cultured with freshly isolated thymocytes for 48 hours. Real-time reverse transcription-polymerase chain reaction, immunofluorescence, and western blotting analysis were used to test the expression of the epithelial and mesenchymal markers in NRK-52E cells. Scratch assay was designed to test the cell migration abilities of NRK-52E cells. Student's t test and oneway analysis of variance test were used for statistical analysis.

Results: The combined stimulation with phytohemagglutinin and concanavalin A activated the primary isolated rat thymocytes. After treatment with conditioned medium or freshly isolated thymocytes, the expression levels of cytokeratin 19 and E-cadherin were downregulated in NRK-52E cells, while the mRNA and protein expression levels of alpha-smooth muscle actin, desmin, and vimentin were upregulated (P < 0.05). We found that the cell migration abilities of the induced NRK-52E cells were significantly improved.

Conclusions: Both activated rat thymocytes (more percentage of CD8+ T cells) and freshly isolated thymocytes have promoting effects on the EMT of NRK-52E cells.