Hugo Neffen, Arzu Yorgancıoğlu, Hamdan Al-Jahdali, Steve McLachlan, Julie Myers, Christopher Bly, Pamela Martin, Saeed Noibi
Background: Several studies suggest that patients often under-estimate their asthma symptoms and over-estimate their level of asthma control, potentially putting them at risk of undertreatment with inhaled corticosteroids.
Objective: To determine the association and correlation between patient symptom perception and asthma control.
Methods: A rapid literature review comprising searches in MEDLINE, Embase and Cochrane Library identified English language articles published between 2011-2021 that included a statistical measure of the association or correlation between perceptions of symptoms and asthma control in patients with asthma (adults and/or children). [PROSPERO CRD42021230152]. The Joanna Briggs Institute (JBI) instrument was used for study quality appraisal.
Results: Of 22 identified studies, nine presented association data and 13 reported correlation analyses. Eight of nine association studies showed a discordance between patients perceived symptoms and level of asthma control or lung function; among these, patients more frequently overestimated their asthma control than they underestimated their asthma control. Of 10 studies reporting correlation coefficients, all reported a statistically significant correlation between increased symptoms and worse asthma control; however, the strength of the correlation was shown to be only weak or moderate in most studies (coefficients numerically ranged from 0.12 to 0.74).
Conclusion: Many patients with asthma tend to overestimate their level of asthma control. Although more frequent or worse symptoms were shown to be statistically significantly correlated with worsening asthma control, there was wide variation in correlation strengths, most showing weak or moderate correlations. Research to further understand the reasons for patient symptom misperceptions are warranted.
{"title":"Association and correlation of patient symptom perception and asthma control - a rapid literature review.","authors":"Hugo Neffen, Arzu Yorgancıoğlu, Hamdan Al-Jahdali, Steve McLachlan, Julie Myers, Christopher Bly, Pamela Martin, Saeed Noibi","doi":"10.12932/AP-181023-1710","DOIUrl":"10.12932/AP-181023-1710","url":null,"abstract":"<p><strong>Background: </strong>Several studies suggest that patients often under-estimate their asthma symptoms and over-estimate their level of asthma control, potentially putting them at risk of undertreatment with inhaled corticosteroids.</p><p><strong>Objective: </strong>To determine the association and correlation between patient symptom perception and asthma control.</p><p><strong>Methods: </strong>A rapid literature review comprising searches in MEDLINE, Embase and Cochrane Library identified English language articles published between 2011-2021 that included a statistical measure of the association or correlation between perceptions of symptoms and asthma control in patients with asthma (adults and/or children). [PROSPERO CRD42021230152]. The Joanna Briggs Institute (JBI) instrument was used for study quality appraisal.</p><p><strong>Results: </strong>Of 22 identified studies, nine presented association data and 13 reported correlation analyses. Eight of nine association studies showed a discordance between patients perceived symptoms and level of asthma control or lung function; among these, patients more frequently overestimated their asthma control than they underestimated their asthma control. Of 10 studies reporting correlation coefficients, all reported a statistically significant correlation between increased symptoms and worse asthma control; however, the strength of the correlation was shown to be only weak or moderate in most studies (coefficients numerically ranged from 0.12 to 0.74).</p><p><strong>Conclusion: </strong>Many patients with asthma tend to overestimate their level of asthma control. Although more frequent or worse symptoms were shown to be statistically significantly correlated with worsening asthma control, there was wide variation in correlation strengths, most showing weak or moderate correlations. Research to further understand the reasons for patient symptom misperceptions are warranted.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"207-221"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Previous house dust mite subcutaneous immunotherapy (HDM SCIT) placebo-controlled trials have small sample sizes and lack a consensus on baseline treatment.
Objective: To determine the efficacy of HDM SCIT in moderate-to-severe allergic rhinitis (AR) patients treated with an intranasal corticosteroid at baseline.
Methods: We conducted a randomized, placebo-controlled trial comparing HDM SCIT against placebo in Dermatophagoides pteronyssinus (Der p) sensitized. All patients received standard of care according to Allergic Rhinitis and its Impact on Asthma (ARIA) guideline, including an intranasal steroid (INCS) at baseline. The primary endpoint was the comparison of a composite score, combining the total nasal symptom score and medication score, assessed at the twelfth month post-treatment.
Results: Of the 144 subjects, 108 received HDM-SCIT and 36 received a placebo. The median age was 30 years (range 11-61), with 60% being female. The mean Der p wheal diameter was 9.4 mm (SD 4.4). After one year of treatment, the composite score median (IQR) in the HDM SCIT group and the placebo group was 0.75 (0.50-1.13) and 0.63 (0.50-1.25), respectively (p > 0.05). Both groups exhibited a significant mean change in the composite score from baseline (p < 0.001), but there was no significant difference between the groups. The median (IQR) serum Der p-specific immunoglobulin G4 level significantly increased only in the HDM SCIT arm (p ≤ 0.001).
Conclusion: One-year HDM SCIT significantly reduced both symptoms and medication use in HDM-allergic rhinitis patients. However, the changes were not significantly different from those in the placebo group, who also received an INCS at baseline. A longer-term study is warranted to assess disease modification factors.
背景:以往的屋尘螨皮下免疫疗法(HDM SCIT)安慰剂对照试验样本较少,且对基线治疗缺乏共识:以往的屋尘螨皮下免疫疗法(HDM SCIT)安慰剂对照试验的样本量较小,而且对基线治疗缺乏共识:目的:确定家尘螨皮下免疫疗法对中重度过敏性鼻炎(AR)患者的疗效:我们进行了一项随机安慰剂对照试验,比较了HDM SCIT与安慰剂对Dermatophagoides pteronyssinus (Der p)致敏患者的疗效。所有患者均按照过敏性鼻炎及其对哮喘的影响(ARIA)指南接受标准治疗,包括在基线时使用鼻内类固醇(INCS)。主要终点是在治疗后第十二个月评估鼻部症状总分和药物治疗得分的综合得分比较:144名受试者中,108人接受了HDM-SCIT治疗,36人接受了安慰剂治疗。中位年龄为 30 岁(11-61 岁不等),60% 为女性。平均 Der p 乳泡直径为 9.4 毫米(标准偏差为 4.4)。治疗一年后,HDM SCIT 组和安慰剂组的综合评分中位数(IQR)分别为 0.75(0.50-1.13)和 0.63(0.50-1.25)(P > 0.05)。两组的综合评分平均值与基线相比均有显著变化(P < 0.001),但组间无明显差异。只有 HDM SCIT 组的血清 Der p 特异性免疫球蛋白 G4 的中位数(IQR)水平显著升高(p ≤ 0.001):结论:为期一年的HDM SCIT明显减轻了HDM过敏性鼻炎患者的症状和用药量。结论:为期一年的HDM SCIT能明显减轻HDM过敏性鼻炎患者的症状和用药量,但这些变化与安慰剂组没有明显差异,安慰剂组在基线时也接受了INCS。有必要进行更长期的研究,以评估疾病改变因素。
{"title":"A large scale multicentre randomized, placebo-controlled subcutaneous house dust mite allergen immunotherapy (HDM SCIT) in allergic rhinitis: MITAR Study.","authors":"Narissara Suratannon, Ticha Limsuwan, Pongsakorn Tantilipikorn, Pantipa Chatchatee, Atik Saengapaswiriya, Tadech Boonpiyathad, Torpong Thongngarm, Boonsam Roongpuvapaht, Hiroshi Chantaphakul, Prapasri Kulalert, Sanguansak Thanaviratananich, Pasuree Sangsupawanich, Supranee Fooanant, Wiparat Manuyakorn, Supinda Chusakul, Orathai Piboonpochanun, Tanakorn Apornpong, Jongkonnee Wongpiyabovorn, Kiat Ruxrungtham","doi":"10.12932/AP-221123-1735","DOIUrl":"10.12932/AP-221123-1735","url":null,"abstract":"<p><strong>Background: </strong>Previous house dust mite subcutaneous immunotherapy (HDM SCIT) placebo-controlled trials have small sample sizes and lack a consensus on baseline treatment.</p><p><strong>Objective: </strong>To determine the efficacy of HDM SCIT in moderate-to-severe allergic rhinitis (AR) patients treated with an intranasal corticosteroid at baseline.</p><p><strong>Methods: </strong>We conducted a randomized, placebo-controlled trial comparing HDM SCIT against placebo in Dermatophagoides pteronyssinus (Der p) sensitized. All patients received standard of care according to Allergic Rhinitis and its Impact on Asthma (ARIA) guideline, including an intranasal steroid (INCS) at baseline. The primary endpoint was the comparison of a composite score, combining the total nasal symptom score and medication score, assessed at the twelfth month post-treatment.</p><p><strong>Results: </strong>Of the 144 subjects, 108 received HDM-SCIT and 36 received a placebo. The median age was 30 years (range 11-61), with 60% being female. The mean Der p wheal diameter was 9.4 mm (SD 4.4). After one year of treatment, the composite score median (IQR) in the HDM SCIT group and the placebo group was 0.75 (0.50-1.13) and 0.63 (0.50-1.25), respectively (p > 0.05). Both groups exhibited a significant mean change in the composite score from baseline (p < 0.001), but there was no significant difference between the groups. The median (IQR) serum Der p-specific immunoglobulin G4 level significantly increased only in the HDM SCIT arm (p ≤ 0.001).</p><p><strong>Conclusion: </strong>One-year HDM SCIT significantly reduced both symptoms and medication use in HDM-allergic rhinitis patients. However, the changes were not significantly different from those in the placebo group, who also received an INCS at baseline. A longer-term study is warranted to assess disease modification factors.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":"42 3","pages":"233-245"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Cow's milk protein allergy (CMPA) is a common food allergy in children. The impact of various feeding regimens on growth in infants with CMPA is not sufficiently well understood.
Objective: To investigate 12-month growth and accession of tolerance in infants with CMPA compared among those fed with breast milk or alternative formulae.
Methods: This retrospective study included CMPA infants with treatment adherence for at least six months. Infants were categorized into the following feeding regimen groups: soy-based formula (SF), extensively hydrolyzed protein formula (EHF), commercial amino acid-based formula (cAAF), new amino acid-based formula (nAAF), chicken-based formula, and breast milk. Weight-for-age z-score (WAZ), length-for-age z-score (LAZ), and weight-for-length z-score (WLZ) were evaluated at diagnosis and at follow-ups. Clinical manifestations, other allergenic foods, and time to tolerance of CMP were assessed.
Results: One hundred and sixteen infants were enrolled. Infants consuming EHF had markedly improved WAZ. Infants with one symptom at diagnosis, those who had gastrointestinal symptom, and those with allergy to only CMP had more pronounced growth improvement. Compared to breast milk, SF and EHF were significantly associated with lower probability of tolerance to CMP (HR: 0.14, 95%CI: 0.03-0.62; and, HR: 0.21, 95%CI: 0.07-0.64, respectively). Those allergic to only CMP were more likely to develop tolerance to CMP than those allergic to CMP and other foods.
Conclusions: Improvement in growth was significantly more pronounced in CMP-allergic infants fed with EHF. Accession of tolerance to CMP was associated with breast milk as the therapeutic diet.
{"title":"Twelve-month growth and accession of tolerance in infants with cow's milk protein allergy compared among those fed with breast milk or alternative formulae.","authors":"Chonlada Trakulpark, Narumon Densupsoontorn","doi":"10.12932/AP-300720-0933","DOIUrl":"10.12932/AP-300720-0933","url":null,"abstract":"<p><strong>Background: </strong>Cow's milk protein allergy (CMPA) is a common food allergy in children. The impact of various feeding regimens on growth in infants with CMPA is not sufficiently well understood.</p><p><strong>Objective: </strong>To investigate 12-month growth and accession of tolerance in infants with CMPA compared among those fed with breast milk or alternative formulae.</p><p><strong>Methods: </strong>This retrospective study included CMPA infants with treatment adherence for at least six months. Infants were categorized into the following feeding regimen groups: soy-based formula (SF), extensively hydrolyzed protein formula (EHF), commercial amino acid-based formula (cAAF), new amino acid-based formula (nAAF), chicken-based formula, and breast milk. Weight-for-age z-score (WAZ), length-for-age z-score (LAZ), and weight-for-length z-score (WLZ) were evaluated at diagnosis and at follow-ups. Clinical manifestations, other allergenic foods, and time to tolerance of CMP were assessed.</p><p><strong>Results: </strong>One hundred and sixteen infants were enrolled. Infants consuming EHF had markedly improved WAZ. Infants with one symptom at diagnosis, those who had gastrointestinal symptom, and those with allergy to only CMP had more pronounced growth improvement. Compared to breast milk, SF and EHF were significantly associated with lower probability of tolerance to CMP (HR: 0.14, 95%CI: 0.03-0.62; and, HR: 0.21, 95%CI: 0.07-0.64, respectively). Those allergic to only CMP were more likely to develop tolerance to CMP than those allergic to CMP and other foods.</p><p><strong>Conclusions: </strong>Improvement in growth was significantly more pronounced in CMP-allergic infants fed with EHF. Accession of tolerance to CMP was associated with breast milk as the therapeutic diet.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"258-269"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25411051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hiroyuki Kawai, Fumiko Yagyu, Aki Terada, Tsukasa Matsunaga, Manabu Inobe
Background: Cyclosporin A (CSA) and tacrolimus (TAC) suppress T-cell activation and subsequent proliferation by inhibiting calcineurin. Though they have the same target, CSA and TAC have quite different molecular structures, indicating quantitative and/or qualitative differences in their effects.
Objective: CD28 is a costimulatory molecule that enhances T-cell activation. It has also been shown to attenuate calcineurin inhibitors. In this study, we compared the CD28-mediated resistance of CD4+ T cells to those calcineurin inhibitors and tried to predict CD28's impact on infectious diseases.
Methods: CD4+ T-cell proliferation was induced with anti-CD3 mAb in the presence or absence of anti-CD28 mAb in vitro. CSA or TAC was added at various concentrations, and the half-maximal inhibitory concentration on CD4+ T-cell proliferation was determined. Effects of lipopolysaccharide (LPS) on dendritic cells (DCs) and CD4+ T-cell proliferation were also evaluated in vitro.
Results: Anti-CD28 mAb conferred CD4+ T cells with resistance to both CSA and TAC, and CD28's effect on the latter was approximately twice that on the former. LPS induced expression of CD28 ligands CD80/86 on DCs. The addition of LPS to culture containing DCs seemed to make CD4+ T cells slightly resistant to TAC but not to CSA. However, its effect on the former was very weak under our experimental conditions.
Conclusions: CD28 attenuated TAC more strongly than CSA. Although LPS did not demonstrate strong enough resistance in our in vitro model, TAC might maintain a better antibacterial immune response than CSA in clinical use.
背景:环孢素 A(CSA)和他克莫司(TAC)通过抑制钙调蛋白来抑制 T 细胞的活化和随后的增殖。虽然它们的作用靶点相同,但 CSA 和 TAC 的分子结构却截然不同,这表明它们的作用在数量和/或质量上存在差异:目的:CD28 是一种成本刺激分子,可增强 T 细胞的活化。目的:CD28 是一种成本调控分子,能增强 T 细胞的活化,也被证明能减弱钙调蛋白抑制剂的作用。在这项研究中,我们比较了 CD28 介导的 CD4+ T 细胞对这些钙调素抑制剂的抗性,并试图预测 CD28 对传染性疾病的影响:方法:在有或没有抗 CD28 mAb 的情况下,用抗 CD3 mAb 在体外诱导 CD4+ T 细胞增殖。加入不同浓度的 CSA 或 TAC,测定对 CD4+ T 细胞增殖的半数最大抑制浓度。脂多糖(LPS)对树突状细胞(DCs)和CD4+ T细胞增殖的影响也在体外进行了评估:结果:抗 CD28 mAb 使 CD4+ T 细胞对 CSA 和 TAC 都具有抵抗力,CD28 对后者的影响大约是对前者的影响的两倍。LPS 可诱导 DCs 上 CD28 配体 CD80/86 的表达。在含有 DCs 的培养液中加入 LPS 似乎能使 CD4+ T 细胞对 TAC 稍有抵抗力,但对 CSA 却没有。然而,在我们的实验条件下,LPS对前者的影响非常微弱:结论:CD28对TAC的抑制作用比CSA更强。虽然 LPS 在我们的体外模型中没有表现出足够强的抵抗力,但在临床应用中,TAC 可能会比 CSA 保持更好的抗菌免疫反应。
{"title":"CD28 confers CD4+ T cells with resistance to cyclosporin A and tacrolimus but to different degrees.","authors":"Hiroyuki Kawai, Fumiko Yagyu, Aki Terada, Tsukasa Matsunaga, Manabu Inobe","doi":"10.12932/AP-270820-0949","DOIUrl":"10.12932/AP-270820-0949","url":null,"abstract":"<p><strong>Background: </strong>Cyclosporin A (CSA) and tacrolimus (TAC) suppress T-cell activation and subsequent proliferation by inhibiting calcineurin. Though they have the same target, CSA and TAC have quite different molecular structures, indicating quantitative and/or qualitative differences in their effects.</p><p><strong>Objective: </strong>CD28 is a costimulatory molecule that enhances T-cell activation. It has also been shown to attenuate calcineurin inhibitors. In this study, we compared the CD28-mediated resistance of CD4+ T cells to those calcineurin inhibitors and tried to predict CD28's impact on infectious diseases.</p><p><strong>Methods: </strong>CD4+ T-cell proliferation was induced with anti-CD3 mAb in the presence or absence of anti-CD28 mAb in vitro. CSA or TAC was added at various concentrations, and the half-maximal inhibitory concentration on CD4+ T-cell proliferation was determined. Effects of lipopolysaccharide (LPS) on dendritic cells (DCs) and CD4+ T-cell proliferation were also evaluated in vitro.</p><p><strong>Results: </strong>Anti-CD28 mAb conferred CD4+ T cells with resistance to both CSA and TAC, and CD28's effect on the latter was approximately twice that on the former. LPS induced expression of CD28 ligands CD80/86 on DCs. The addition of LPS to culture containing DCs seemed to make CD4+ T cells slightly resistant to TAC but not to CSA. However, its effect on the former was very weak under our experimental conditions.</p><p><strong>Conclusions: </strong>CD28 attenuated TAC more strongly than CSA. Although LPS did not demonstrate strong enough resistance in our in vitro model, TAC might maintain a better antibacterial immune response than CSA in clinical use.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"298-304"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25411050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ploykarn Kiatiwat, Wat Mitthamsiri, Tadech Boonpiyathad, Panitan Pradubpongsa, Atik Sangasapaviliya
Background: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. Allergen-specific immunotherapy is a treatment option for selected patients with severe AD sensitization to house dust mites (HDM).
Objective: To report the first case of successful treatment with HDM sublingual immunotherapy (SLIT) tablets in patients with severe AD.
Methods: A Thai male patient with HDM sensitization and severe AD who had not responded to topical corticosteroids and calcineurin inhibitors underwent 1 month of HDM subcutaneous immunotherapy (SCIT), after which his skin symptoms were minimally improved. He lost follow-up SCIT and the symptoms worsened, with large wheal lesions appearing at the SCIT injection site, so we decided to switch from SCIT to HDM SLIT tablets.
Results: After the SLIT treatment, the AD and skin lesions improved and the medication could be stopped.
Conclusions: HDM SLIT might be an alternative treatment in patients with HDM sensitization and severe AD who are refractory to conventional treatment.
{"title":"Successful treatment of atopic dermatitis with house dust mite sublingual immunotherapy tablets.","authors":"Ploykarn Kiatiwat, Wat Mitthamsiri, Tadech Boonpiyathad, Panitan Pradubpongsa, Atik Sangasapaviliya","doi":"10.12932/AP-231120-1004","DOIUrl":"10.12932/AP-231120-1004","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. Allergen-specific immunotherapy is a treatment option for selected patients with severe AD sensitization to house dust mites (HDM).</p><p><strong>Objective: </strong>To report the first case of successful treatment with HDM sublingual immunotherapy (SLIT) tablets in patients with severe AD.</p><p><strong>Methods: </strong>A Thai male patient with HDM sensitization and severe AD who had not responded to topical corticosteroids and calcineurin inhibitors underwent 1 month of HDM subcutaneous immunotherapy (SCIT), after which his skin symptoms were minimally improved. He lost follow-up SCIT and the symptoms worsened, with large wheal lesions appearing at the SCIT injection site, so we decided to switch from SCIT to HDM SLIT tablets.</p><p><strong>Results: </strong>After the SLIT treatment, the AD and skin lesions improved and the medication could be stopped.</p><p><strong>Conclusions: </strong>HDM SLIT might be an alternative treatment in patients with HDM sensitization and severe AD who are refractory to conventional treatment.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"253-257"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39171751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Influenza vaccine has rarely been associated with the occurrence of systemic inflammatory diseases.
Objective: To present a case of adult-onset Still's disease (AOSD) following influenza vaccination, and subsequently explore the possible association between AOSD and influenza vaccination, as well as implications for clinical practice.
Methods: Case report.
Results: We report a case of 20-year-old woman who developed typical AOSD, characterized by spiking fever, arthritis and salmon-pink rash, one week after influenza vaccination. She responded well to systemic corticosteroids therapy. This is the first case report of influenza vaccination-associated AOSD from Thailand.
Conclusions: Influenza vaccination may be a trigger of AOSD but more data are needed to confirm the association. History of recent vaccination should be explored in patients suspected of having systemic inflammatory diseases including AOSD.
{"title":"Adult-onset Still's disease preceded by influenza vaccination: Coincidence or true association?","authors":"Kanon Jatuworapruk","doi":"10.12932/AP-100121-1033","DOIUrl":"10.12932/AP-100121-1033","url":null,"abstract":"<p><strong>Background: </strong>Influenza vaccine has rarely been associated with the occurrence of systemic inflammatory diseases.</p><p><strong>Objective: </strong>To present a case of adult-onset Still's disease (AOSD) following influenza vaccination, and subsequently explore the possible association between AOSD and influenza vaccination, as well as implications for clinical practice.</p><p><strong>Methods: </strong>Case report.</p><p><strong>Results: </strong>We report a case of 20-year-old woman who developed typical AOSD, characterized by spiking fever, arthritis and salmon-pink rash, one week after influenza vaccination. She responded well to systemic corticosteroids therapy. This is the first case report of influenza vaccination-associated AOSD from Thailand.</p><p><strong>Conclusions: </strong>Influenza vaccination may be a trigger of AOSD but more data are needed to confirm the association. History of recent vaccination should be explored in patients suspected of having systemic inflammatory diseases including AOSD.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"294-297"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39432379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mpox is currently a global health emergency. This review (Part II) aims to provide insights into Mpox vaccines and their advancements, offering easily digestible information for healthcare workers and researchers. Current Mpox vaccines are all live-attenuated, previously approved for smallpox, and are classified into non-replicating (Modified Vaccinia Ankara-Bavarian Nordic or MVA-BN) and replicating vaccines (Lister clone16m8 KM Biologic or LC16m8KMB and Acambis2000 or ACAM2000). Replicating vaccines offer long-lasting immunity but are contraindicated for immunocompromised individuals and those with extensive dermatitis. Replicating vaccines are administered as a single dose via epicutaneous scarification, while the non-replicating vaccine is given as two subcutaneous doses. Regulatory approvals in various countries are based on animal challenge studies, with limited effectiveness data available. Only LC16m8 is approved for children in Japan, while the others are approved for individuals aged 18 and older. Clinical trials are currently investigating the efficacy and safety of MVA-BN, particularly in children and for post-exposure prophylaxis (PEP). Novel Mpox vaccines that provide cross-protection against orthopoxviruses are needed, with DNA, subunit, and mRNA platforms under development. MPXV-neutralizing antibody-inducing target antigens for vaccine development include the outer envelope antigens of extracellular enveloped virus (EEV): A35R and B6R, and the inner membrane antigens of intracellular mature virus (IMV): M1R, A29L, H3L, and E8L. Two mRNA vaccines are currently in early clinical stages. Importantly, the COVID-19 pandemic underscored the importance of addressing vaccine disparities and improving global access. Transformative approaches are being explored to overcome this challenge and to enhance access in low- and middle-income countries.
{"title":"Mpox global health emergency: Insights into the virus, immune responses, and advancements in vaccines PART II: Insights into the advancements in vaccines.","authors":"Eakachai Prompetchara, Chutitorn Ketloy, Chirayus Khawsang, Tanapat Palaga, Kiat Ruxrungtham","doi":"10.12932/AP-111024-1946","DOIUrl":"10.12932/AP-111024-1946","url":null,"abstract":"<p><p>Mpox is currently a global health emergency. This review (Part II) aims to provide insights into Mpox vaccines and their advancements, offering easily digestible information for healthcare workers and researchers. Current Mpox vaccines are all live-attenuated, previously approved for smallpox, and are classified into non-replicating (Modified Vaccinia Ankara-Bavarian Nordic or MVA-BN) and replicating vaccines (Lister clone16m8 KM Biologic or LC16m8KMB and Acambis2000 or ACAM2000). Replicating vaccines offer long-lasting immunity but are contraindicated for immunocompromised individuals and those with extensive dermatitis. Replicating vaccines are administered as a single dose via epicutaneous scarification, while the non-replicating vaccine is given as two subcutaneous doses. Regulatory approvals in various countries are based on animal challenge studies, with limited effectiveness data available. Only LC16m8 is approved for children in Japan, while the others are approved for individuals aged 18 and older. Clinical trials are currently investigating the efficacy and safety of MVA-BN, particularly in children and for post-exposure prophylaxis (PEP). Novel Mpox vaccines that provide cross-protection against orthopoxviruses are needed, with DNA, subunit, and mRNA platforms under development. MPXV-neutralizing antibody-inducing target antigens for vaccine development include the outer envelope antigens of extracellular enveloped virus (EEV): A35R and B6R, and the inner membrane antigens of intracellular mature virus (IMV): M1R, A29L, H3L, and E8L. Two mRNA vaccines are currently in early clinical stages. Importantly, the COVID-19 pandemic underscored the importance of addressing vaccine disparities and improving global access. Transformative approaches are being explored to overcome this challenge and to enhance access in low- and middle-income countries.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":"42 3","pages":"191-206"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Minhyung Lee, Young-Kyung Ko, Sehun Jang, Chan Hee Gil, Kyoung Mi Eun, Yu-Lian Zhang, Sung-Woo Cho, Dae Woo Kim, Hyun Jik Kim, Chae-Seo Rhee
Background: Recent human and animal studies have demonstrated that Nod-like receptor family, pyrin domain-containing 3 (NLRP3) inflammasome is closely involved in the development of allergic diseases.
Objective: To identify the mechanism underlying the activation of NLRP3 inflammasome signaling pathway in an ovalbumin (OVA)-induced allergic rhinitis (AR) mice model and to validate the effect of a specific inhibitor of the NLRP3, MCC950.
Methods: Mice were divided into three groups and each group consisted of ten mice (saline group, the negative control group; OVA group, the OVA-induced AR model group; and OVA+MCC group, treated with 10 mg/kg MCC950). MCC950 was administered intraperitoneally every second day. Multiple parameters of AR, including NLRP3, caspase-1, interleukin (IL)-1β, and IL-18 were evaluated by using ELISA, RT-qPCR, histopathology, and immunohistochemistry.
Results: The mRNA and protein levels of NLRP3, caspase-1, IL-1β and IL-18 were upregulated in the OVA group compared with those of the saline group. MCC950 significantly inhibited the mRNA and protein levels of NLRP3, caspase-1, IL-1β and IL-18 in nasal tissue. Further, AR symptoms and eosinophil count were normalized after MCC950 treatment. However, OVA-specific IgE was not restored in the OVA+MCC group.
Conclusion: NLRP3 inflammasome signaling pathway may be an alternative pathway to induce AR symptoms in OVA-induced AR model. MCC950 is a specific inhibitor of NLRP3 cascade, which attenuates AR symptoms regardless of IgE.
{"title":"NLRP3 inhibition attenuates the allergic rhinitis symptoms in a mouse model.","authors":"Minhyung Lee, Young-Kyung Ko, Sehun Jang, Chan Hee Gil, Kyoung Mi Eun, Yu-Lian Zhang, Sung-Woo Cho, Dae Woo Kim, Hyun Jik Kim, Chae-Seo Rhee","doi":"10.12932/AP-301223-1756","DOIUrl":"https://doi.org/10.12932/AP-301223-1756","url":null,"abstract":"<p><strong>Background: </strong>Recent human and animal studies have demonstrated that Nod-like receptor family, pyrin domain-containing 3 (NLRP3) inflammasome is closely involved in the development of allergic diseases.</p><p><strong>Objective: </strong>To identify the mechanism underlying the activation of NLRP3 inflammasome signaling pathway in an ovalbumin (OVA)-induced allergic rhinitis (AR) mice model and to validate the effect of a specific inhibitor of the NLRP3, MCC950.</p><p><strong>Methods: </strong>Mice were divided into three groups and each group consisted of ten mice (saline group, the negative control group; OVA group, the OVA-induced AR model group; and OVA+MCC group, treated with 10 mg/kg MCC950). MCC950 was administered intraperitoneally every second day. Multiple parameters of AR, including NLRP3, caspase-1, interleukin (IL)-1β, and IL-18 were evaluated by using ELISA, RT-qPCR, histopathology, and immunohistochemistry.</p><p><strong>Results: </strong>The mRNA and protein levels of NLRP3, caspase-1, IL-1β and IL-18 were upregulated in the OVA group compared with those of the saline group. MCC950 significantly inhibited the mRNA and protein levels of NLRP3, caspase-1, IL-1β and IL-18 in nasal tissue. Further, AR symptoms and eosinophil count were normalized after MCC950 treatment. However, OVA-specific IgE was not restored in the OVA+MCC group.</p><p><strong>Conclusion: </strong>NLRP3 inflammasome signaling pathway may be an alternative pathway to induce AR symptoms in OVA-induced AR model. MCC950 is a specific inhibitor of NLRP3 cascade, which attenuates AR symptoms regardless of IgE.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ji Hee Kwak, Ju Hee Kim, Eun Kyo Ha, Hye Mi Jee, Youn Ho Shin, Hey Sung Baek, Man Yong Han
Background: The ISAAC phase III study in Korea found a higher incidence of wheezing illnesses among residents in basements or semi-basements.
Objective: This study investigates the link between living in banjihas (semi-basements) and airway resistance and Th2 airway inflammation in Korean children, compared to those on higher floors.
Methods: We assessed 575 fifth- and sixth-grade students (aged 10-12) in an inner-city area of South Korea. The study utilized impulse oscillometry to measure small and total airway resistance (Rrs20-5 and Rrs0, respectively) and Fractional Exhaled Nitric Oxide (FeNO) measurements to evaluate airway inflammation. We also considered a range of biological and environmental factors, including allergen sensitization, serum 25-hydroxyvitamin D levels, and urinary metabolites like VOCs, bisphenol, and triclosan. Participants were categorized by living floors: banjihas, first-fifth floors, and sixth floors or higher.
Results: Twenty-five children (4.3%) lived in banjihas, 311 (54.1%) on the first to fifth floor, and 239 (41.6%) on the sixth floor or above. Despite similar levels of allergen sensitization and urinary pollutant metabolite levels across all groups, banjiha dwellers showed significantly higher total airway resistance (adjusted &1: 0.633, 95%CI: 0.156, 1.109; P = 0.009) and a greater prevalence of elevated FeNO levels (> 35 ppb) (P = 0.033). These findings persisted after adjusting for critical factors like height, gender, BMI z-score, and birth conditions.
Conclusion: Children in banjihas exhibit elevated airway resistance and FeNO levels independently of allergen sensitization or pollution exposure, underscoring the necessity for enhanced focus on their respiratory health in such living conditions.
背景:韩国的 ISAAC III 期研究发现,地下室或半地下室居民的喘息病发病率更高:韩国的 ISAAC III 期研究发现,地下室或半地下室居民的喘息病发病率较高:本研究调查了与较高楼层相比,居住在banjihas(半地下室)与韩国儿童气道阻力和Th2气道炎症之间的联系:我们对韩国市内地区的 575 名五、六年级学生(10-12 岁)进行了评估。研究采用脉冲振荡测量法测量小气道阻力和总气道阻力(分别为 Rrs20-5 和 Rrs0),并采用分量呼出一氧化氮(FeNO)测量法评估气道炎症。我们还考虑了一系列生物和环境因素,包括过敏原致敏、血清 25- 羟维生素 D 水平以及尿液代谢物,如挥发性有机化合物、双酚和三氯生。参与者按居住楼层分类:班吉哈斯、一至五楼、六楼或六楼以上:25名儿童(4.3%)住在班吉哈斯,311名儿童(54.1%)住在一至五楼,239名儿童(41.6%)住在六楼或六楼以上。尽管各组的过敏原致敏水平和尿液污染物代谢物水平相似,但班吉哈居民的总气道阻力明显更高(调整后&1:0.633,95%CI:0.156,1.109;P = 0.009),FeNO 水平升高(> 35 ppb)的发生率更高(P = 0.033)。在对身高、性别、体重指数 z 分数和出生条件等关键因素进行调整后,这些结果依然存在:结论:班吉哈儿童表现出较高的气道阻力和 FeNO 水平,与过敏原致敏或污染暴露无关。
{"title":"Total airway mechanics and fractional exhaled nitric oxide levels of children living in banjihas (semi-basements).","authors":"Ji Hee Kwak, Ju Hee Kim, Eun Kyo Ha, Hye Mi Jee, Youn Ho Shin, Hey Sung Baek, Man Yong Han","doi":"10.12932/AP-050224-1780","DOIUrl":"https://doi.org/10.12932/AP-050224-1780","url":null,"abstract":"<p><strong>Background: </strong>The ISAAC phase III study in Korea found a higher incidence of wheezing illnesses among residents in basements or semi-basements.</p><p><strong>Objective: </strong>This study investigates the link between living in banjihas (semi-basements) and airway resistance and Th2 airway inflammation in Korean children, compared to those on higher floors.</p><p><strong>Methods: </strong>We assessed 575 fifth- and sixth-grade students (aged 10-12) in an inner-city area of South Korea. The study utilized impulse oscillometry to measure small and total airway resistance (Rrs20-5 and Rrs0, respectively) and Fractional Exhaled Nitric Oxide (FeNO) measurements to evaluate airway inflammation. We also considered a range of biological and environmental factors, including allergen sensitization, serum 25-hydroxyvitamin D levels, and urinary metabolites like VOCs, bisphenol, and triclosan. Participants were categorized by living floors: banjihas, first-fifth floors, and sixth floors or higher.</p><p><strong>Results: </strong>Twenty-five children (4.3%) lived in banjihas, 311 (54.1%) on the first to fifth floor, and 239 (41.6%) on the sixth floor or above. Despite similar levels of allergen sensitization and urinary pollutant metabolite levels across all groups, banjiha dwellers showed significantly higher total airway resistance (adjusted &1: 0.633, 95%CI: 0.156, 1.109; P = 0.009) and a greater prevalence of elevated FeNO levels (> 35 ppb) (P = 0.033). These findings persisted after adjusting for critical factors like height, gender, BMI z-score, and birth conditions.</p><p><strong>Conclusion: </strong>Children in banjihas exhibit elevated airway resistance and FeNO levels independently of allergen sensitization or pollution exposure, underscoring the necessity for enhanced focus on their respiratory health in such living conditions.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jiwon Kim, Minyoung Jung, Sehun Jang, Sanghee Shin, Jeongmin Song, Sukyung Kim, Ji Young Lee, Hyun Mi Kim, Yeonghee Kim, Min Hee Lee, Su Jin Lee, Minji Kim, Jihyun Kim, Kangmo Ahn
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.
{"title":"Home-based up-dosing of wheat oral immunotherapy: Real-world effectiveness and predictive factor analysis.","authors":"Jiwon Kim, Minyoung Jung, Sehun Jang, Sanghee Shin, Jeongmin Song, Sukyung Kim, Ji Young Lee, Hyun Mi Kim, Yeonghee Kim, Min Hee Lee, Su Jin Lee, Minji Kim, Jihyun Kim, Kangmo Ahn","doi":"10.12932/AP-130224-1783","DOIUrl":"10.12932/AP-130224-1783","url":null,"abstract":"<p><strong>Background: </strong>Wheat allergy is one of the most prevalent allergens in Korea, decreasing quality of life and causing nutritional repercussions.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}