Asian Pacific journal of allergy and immunology最新文献

Background: Encountering individuals sensitized to both inhalant and food allergens is challenging in clinical practice. Despite its rarity, studies have documented cross-sensitization between these allergens. However, the extent, diversity, and age-related variations of this phenomenon remain unclear.

Objective: Hence, our objective was to investigate a substantial quantity of allergy sensitivity test results in which both inhalant and food allergens were concurrently examined. The primary goal of our study is to calculate the cross-sensitization ratio, with a secondary objective of analyzing this phenomenon across four age groups.

Methods: A retrospective analysis was conducted on a multiple-antigen simultaneous test (MAST) obtained from a domestic laboratory medicine facility and comprising 55 food allergens and 49 inhalant allergens from 368,156 individuals aged 1 to 89. By calculating the cross-sensitization ratio, the degree of cross-sensitization between each food allergen and inhalant allergen was determined. Further subgroup analysis was conducted to ascertain the cross-sensitization ratio between the four subgroups categorized by age.

Results: The median cross-sensitization ratio between food and inhalant allergens was 5.14, indicating a significant level of cross-sensitization. The cross-sensitization ratio was greatest among pollen allergens and plant-derived food allergens, followed by between some animal aeroallergens and meat/fish/dairy/poultry food allergens. The degree of overall cross-sensitization was least prominent in adolescents, greater in adults and children, and most pronounced in the elderly.

Conclusion: Our findings reveal that various inhalant and dietary allergens have considerable cross-sensitivity, with the elderly having the highest degree of cross-sensitivity and adolescents the lowest.

Background: During the COVID-19 pandemic, national lockdowns were implemented worldwide. Asthma control was reported to have improved. However, some patients lost follow-up from the clinic because they intended to avoid crowds at the hospital.

Objective: To evaluate the level of asthma control during the COVID-19 pandemic and explore factors influencing asthma outcomes.

Methods: Subjects 8-18 years old from our previous study in 2019 were recruited. The data during the pandemic period were collected between June 2021 - May 2023. The level of asthma control was compared before and during the pandemic. We also evaluated inhaled corticosteroid (ICS) adherence and factors related to poor asthma control during the COVID-19 pandemic.

Results: One hundred and three subjects were enrolled. Asthma control levels remained relatively stable during the pandemic. However, an asthma exacerbation was significantly decreased from 36 (36.3%) in 2019 to 19 (19.2%)and 15 (15.1%) in 2021 and 2022 (p = 0.012, p < 0.001), respectively. Spirometry results demonstrated improved pre-bronchodilator FEV1 (89.91 ± 11.02 vs. 101.91 ± 14.11, p < 0.001). The factors related to the poor asthma outcome were not wearing a face mask (aOR = 8.52, 95%CI 1.26-57.79) and previously poor-controlled by the ACT score (aOR = 2.55, 95%CI 1.41-4.63). The median adherence rate during the pandemic was 85%. The main reasons for poor adherence were hectic lifestyle and misunderstandings of disease.

Conclusion: Asthma exacerbation was significantly decreased during the lockdown. Not wearing a face mask and previously poorly controlled by the ACT score are related to poor asthma outcomes.

Background: The prevalence and etiology of anaphylaxis vary based on geographic regions, study design, and definition used. Anaphylaxis leading to emergency department visits and hospitalizations has increased worldwide.

Objective: The prevalence and etiology of anaphylaxis vary based on geographic regions, study design, and definition used. Anaphylaxis leading to emergency department visits and hospitalizations has increased worldwide.

Methods: A cross-sectional retrospective analysis of medical records from patients with ICD-10 confirmed anaphylaxis was performed at Naresuan University Hospital between March 2011 and February 2021.

Results: We identified 439 anaphylaxis episodes in 381 patients within 10 years. The average annual occurrence rates of anaphylactic episodes were 25.0 per 100,000 outpatient and emergency department visits and 11.2 per 100,000 inpatient visits. Both pediatric and adult anaphylaxis events increased annually, from 13.3 (children: 20.5, adults: 12.4) in 2012 to 46.6 (children: 52.6, adults: 46.1) episodes per 100,000 visits in 2021. Peak incidence was observed in adolescents and young adults. Food was the most common trigger, with shrimp and fried insects being predominant. Risk factors for severe anaphylaxis were underlying cardiovascular diseases, drug triggers, and wheezing. Epinephrine was administered in 98.4% of all episodes. Although, there were no fatalities, only 11.4% of patients received prescriptions for self-injectable epinephrine.

Conclusion: The study underscores an increasing trend of anaphylaxis affecting both children and adults in lower northern Thailand, with shrimp and fried insects as common triggers.

Background: Allergic rhinitis (AR) represents a significant global health concern that can give rise to numerous diseases and result in labor productivity. T regulatory (Treg) cells are pivotal players in the pathogenesis of AR, and their deficiencies are closely related to Prostaglandin E2 (PGE2). However, the downstream mechanisms of this relationship remain poorly understood.

Objective: This study aims to investigate the inhibitory mechanisms through which PGE2 impacts the differentiation of Treg cells.

Methods: We compared the differentiation of Treg cells from naïve CD4+ T cells of AR patients and healthy controls, with or without the presence of PGE2 by flow cytometry. Intracellular cAMP concentration, mRNA and protein levels of cyclic-AMP dependent protein kinase A (PKA), as well as their downstream target, Peroxisome Proliferator-Activated Receptor-γ (PPAR-γ) were examined in Treg cells from AR and healthy donors. AR mouse model was established by pollen administration.

Results: PGE2 suppressed the differentiation of Treg cells from human naïve CD4+ T cells through the EP4 receptor. Furthermore, in AR patients and AR mouse, the expression of EP4 receptor were observed enhanced. The PGE2-EP4 signal was carried out by activating cAMP-PKA signaling pathway. Subsequently, phospholated PKA would suppress PPAR-γ expression. Treatment of Pioglitazone, a PPAR-γ agonist, was demonstrated to rescue the differentiation of Treg and help alleviate inflammation in the AR mouse model.

Conclusion: In AR disease, the PGE2-EP4 signaling exerts an inhibitory effect on Treg differentiation by influencing the cAMP-PKA pathway and its downstream target PPAR-γ.

Background: Serum allergen-specific IgE (sIgE) detection is an important tool in the diagnosis of allergic diseases. However, the absence of international standards for sIgE detection systems raises questions about the comparability of different systems.

Objective: This study aims to evaluate three common allergen sIgE detection systems, with a primary focus on detecting dust mite allergens.

Methods: We recruited 85 children with rhinitis and 15 healthy control children. The subjects underwent testing with three different sIgE detection systems, including magnetic particle flow fluorescence, magnetic particle chemiluminescence, and protein chip, to detect sIgE levels to HDM extracts. In addition, skin prick testing (SPT) was conducted, and protein chip technology was performed to measure sIgE levels to component proteins.

Results: Our findings reveal strong consistency between SPT and the three in vitro detection systems, with consistency exceeding 71.76% for dust mite allergens. Moreover, there was excellent consistency and RAST class consistency among the three in vitro detection systems, with scores exceeding 94.12% and 89.00%, respectively. And for the 13 additional allergens crude extracts sIgE simultaneously detected by systems 1 and 2, the results showed that the consistency of both systems was above 87.00%, and the RAST class consistency was above 82.00%.

Conclusion: The three serum sIgE detection systems exhibited an approximate 80% concordance rate with SPT in identifying dust mite allergens. Furthermore, these systems demonstrated excellent consistency and RAST class consistency among themselves. These findings suggest that the three assays introduced in this study are interchangeable in allergen diagnosis.

Signal Transducer and Activator of Transcription (STAT) proteins play pivotal roles in immune regulation. The dysregulation of these proteins, attributed to both gain-of-function (GOF) and loss-of-function (LOF) variants, has emerged as a substantial and intricate area of research. This comprehensive review delves into the intricate details of the diverse clinical spectrum associated with STAT variants and the immunological findings linked to these genetic alterations. Although this review does not encompass the treatment of each individual disease, we discuss investigative approaches ranging from immunophenotyping assessment to evaluation of STAT protein activity. These investigations play a crucial role in identifying affected patients and understanding the complexities of STAT.

Background: A fexofenadine/pseudoephedrine combination tablet (F/P) is an optimal product for nasal obstruction. It contains fexofenadine hydrochloride, a histamine H1-receptor antagonist for sneezing and rhinorrhea and pseudoephedrine hydrochloride, an α-adrenergic agonist. The effect of an antihistamine-decongestant on nasal obstruction has been demonstrated in previous studies, but onset of action and efficacy data on nasal obstruction are limited.

Objective: We estimated the efficacy of F/P on nasal obstruction in patients with house dust mite-induced allergic rhinitis (AR) versus fexofenadine (F) using objective methods.

Methods: In this single-center, single-dose, prospective, randomized, parallel-group study, 24 adult patients with a history of at least 2 years of AR and nasal obstruction were randomized to receive F/P or F. The effect on nasal obstruction was evaluated using nasal airflow and visual analog scale (VAS) score measured at 30-minute intervals before and for 8 hours after dosing. The primary end point was onset of action, based on a comparison of absolute change from baseline in nasal airflow between F/P and F. The protocol was registered in a clinical trial registry as UMIN 000041845.

Results: The onset of action for F/P was 30 minutes based on nasal airflow and 60 minutes based on VAS. F/P maintained a significant beneficial effect after onset of effect, while F showed no significant change during the test period.

Conclusions: We found F/P had a clear effect on nasal obstruction associated with perennial AR when compared with F. There was a time lag in nasal airflow improvement and nasal obstruction relief.

Background: Type 1 autoimmune pancreatitis (AIP) is a pancreatic manifestation of IgG4-related disease (IgG4-RD). Although AIP and IgG4-RD are characterized by multiple organ involvement including salivary glands, lung, and kidney, co-occurrence of chronic rhinosinusitis (CRS) and AIP/IgG4-RD has been poorly defined.

Objective: We explored molecular mechanism accounting for the co-occurrence of CRS and AIP/IgG4-RD.

Methods: Serum concentrations of IFN-α and IL-33 were measured by enzyme-linked immune-sorbent assay.

Results: We encountered a patient with concurrent type 1 AIP/IgG4-RD and CRS. Induction of remission by prednisolone (PSL) for type 1 AIP/IgG4-RD led to a marked improvement of CRS. Serum cytokine analysis after PSL treatment revealed a marked reduction in serum concentrations of IFN-α and IL-33, both of which are candidate pathogenic cytokines for AIP/IgG4-RD.

Conclusions: Given that IL-33 is shared as one of pathogenic cytokines by type 1 AIP/IgG4-RD and CRS, enhanced IL33 responses may cause concurrent type 1 AIP/IgG4-RD and CRS.

Background: Thiocolchicoside is a muscle relaxant, anti-inflammatory, and analgesic. Administered orally, intramuscularly, or topically, this drug is used in the symptomatic treatment of muscular spasms and rheumatologic disorders. Despite its extensive use, thiocolchicoside is a very rare sensitizer.

Objective: To evaluate IgE-mediated reaction to thiocolchicoside by basophil activation test.

Methods: Allergological work-up with skin prick tests, intradermal tests and basophil activation test with thiocolchicoside.

Results: We report the first case of immediate reaction to thiocolchicoside confirmed by basophil activation test in addition to positive skin tests.

Conclusions: BAT can be considered a complementary diagnostic tool to demonstrate an IgE-mediated reaction also for muscle relaxant drugs.

Background: Toll-like receptor 4 (TLR4) is an important receptor for lipopolysaccharide and lipid A, components of gram-negative bacteria. At present, a variant in TLR4 has been shown to be associated with asthma, but it has not been reported whether variants in TLR4 are associated with bronchial asthma in children.

Objective: The objective is to determine the relationship between the rs4986791 (+1196C/T) variants of TLR4 and bronchial asthma in Chinese children.

Methods: DNA extracted from peripheral blood samples was amplified and the Bi-PASA technique was carried out to identify the genotypes in 600 patients.

Results: The result showed no difference between the 1196 C/T variant of TLR4 and hemoglobin level, proportion of neutrophils and lymphocytes, leukocyte, basophil and eosinophil counts, log10IgE and hsCRP in the peripheral blood of bronchial asthmatic patients. However, the eosinophil ratio, FEV1% and FEV1/FVC level of asthma patients with the CT genotype was lower than those of patients with the CC genotype, which were 1.19 ± 0.10 and 1.67 ± 0.18 (P = 0.01), 81.25 ± 0.50 and 84.99 ± 0.65 (P < 0.0001), 81.72 ± 0.568 and 5.55 ± 0.78 (P < 0.0001), respectively. The incidence of bronchial asthma in patients with the CT genotype is higher than that in patients with the CC genotype. We analysed the influence of the two genotypes on the current medical history by multiple logistic regression, performing a comparative analysis between the two genotypes and bronchial asthma (P < 0.05). Patients with moderately persistent asthma with the CT genotype are more likely to develop severely persistent asthma compared to those with the CC genotype (P < 0.01).

Conclusions: This comparative analysis between rs4986791 and bronchial asthma in children indicates that this variant is associated with bronchial asthma risk in Chinese children.