Asian Pacific journal of allergy and immunology最新文献

Background: Sensitization to cat and/or dog allergens during childhood represents a risk factor for the development of allergic diseases later in life.

Objective: The study investigated the association of patterns of sensitization to cat and dog allergen components with clinical symptoms of allergy to these furry animals among cat-sensitized children.

Methods: The children were evaluated for the presence of bronchial asthma, atopic dermatitis and allergic rhinitis. Their mothers completed a questionnaire on pet exposure at home. Levels of serum IgE cat epitopes Fel d (1, 2, 4), as well as dog components Can f (1, 2, 3, 5) were measured in all the studied children.

Results: Respiratory symptoms following exposure to the cat allergen were most common in children with Fel d 2 epitope (p = 0.041). After contact with a dog, respiratory symptoms were most common in children with Can f 1 epitope (p = 0.042), atopic dermatitis in children with sensitization to both Can f 1 (p = 0.009) and Can f 2 (p = 0.002), whereas eye symptoms occurred mostly in children with Can f 3 (p = 0.039).

Conclusions: Molecular diagnosis in patients with pet allergy may help clinicians to predict clinical symptoms and their severity.

Background: Neurocysticercosis is a growing public health problem in the United States. Albendazole is a mainstay of medical therapy for neurocysticercosis, and here we present a case of hypersensitivity to albendazole leading to life-threatening disease progression.

Objective: To report the first successful albendazole desensitization protocol.

Methods: An oral albendazole 12-step desensitization protocol was developed, starting with 0.001 mg and progressing at 15 minutes intervals. Dosage for each subsequent step was as follows: 0.003 mg, 0.01 mg, 0.03 mg, 0.1 mg, 0.3 mg, 1 mg, 3 mg, 10 mg, 30 mg, 100 mg, 300mg.

Results: The patient rapidly improved from a symptomatic standpoint, and repeat MRI showed a dramatic improvement in lesions.

Conclusions: This successful desensitization protocol to albendazole can be of value to other patients with history suggestive of IgE-mediated allergy needing treatment for parasitic infections.

COA number for ethical approval should be included in Methods part as follows: Methods Patients The study was approved by the Institutional Review Board, Siriraj Hospital (SiEc 100/2012, COA no. Si 315/2012). Forty patients with history of AR were recruited. All patients signed an informed consent before SPT. Thirty-one of them were excluded due to mono -sensitization to grass allergen. Nine patients, aged 9-47 years old (mean 26.3 ± 4 years), were included in this study based on positive SPT (mean wheal diameter, MWD ≥ 3 mm) to protein extract from at least 2 of 3 BGP, JGP, and PGP. The SPT extracts were prepared as described previously.4 Determination of level of serum sIgE against extract of BGP and JGP was carried out by ImmunoCAP (Phadia, Uppsala, Sweden). However, there is no available test for PGP.

Similar to many other viruses, SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) causes various symptoms in individuals who have been exposed to the virus. Individuals exposed to the virus can be asymptomatic, mild, severe, and critical for mortality. Most hypotheses explaining the uncertainty of symptoms are based on innate immunity, which is unclear in explaining some issues. For example, 1. uncertain symptoms of SARS-CoV-2 infection, 2. failure to induce immunity for prevention by vaccines in some individuals, and 3. repeated infections in some individuals. With the ambition of explaining this clearly, this article proposed another perspective to explain the cause of uncertain symptoms in SARS-CoV-2-positive individuals. This could be influenced by host factors with a variety of cellular molecules (viral receptors/co-receptors) and major histocompatibility complex (MHC) polymorphisms, which are crucial factors in explaining this question. Hopefully, this perspective could encourage further research and pave the way for developing new public health policies to deal with COVID-19 and emergent viral epidemics in the future.

Background: Chronic spontaneous urticaria (CSU) is frequently associated with psychiatric comorbidities.

Objective: We aimed to determine if depressive symptoms were present in CSU patients who received omalizumab and if depression scores got better with omalizumab treatment and whether the presence of depressive symptoms impaired treatment responses.

Methods: CSU patients who received at least three injections of omalizumab were included in the study. Changes in Urticaria Activity Score (UAS), Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL), Beck Depression Inventory (Beck-D) and Urticaria Control Test (UCT) scores were compared before and after treatment.

Results: From 49 patients, 20 (40.8%) had depressive symptoms at baseline. After treatment, UAS7, CU-Q2oL, Beck-D scores decreased and UCT-scores increased significantly (p < 0.001, for all). UCT scores were lower at baseline and at 3rd month following treatment in patients with depressive symptoms compared to patients without (baseline median (interquartile range-IQR) 2.5 (1-5) vs 5 (2.5-6.5); p = 0.04 and 3rd month 12 (9-13) vs 14 (12-16); p = 0.006, respectively). Omalizumab non-responders had higher baseline Beck-D-scores [18.5 (15.2-22) vs 12 (6-22.5); p = 0.031]. The number of omalizumab non-responders were significantly higher among patients with depressive symptoms compared to patients without. (40% vs 13.8%; p = 0.048). Only 6 patients scored as having depressive symptoms after treatment; of these 6 patients only one was an omalizumab responder.

Conclusions: Omalizumab not only provides symptom control for urticaria but also improves psychological conditions of the patients. Coexistent psychiatric comorbidities should be taken into account in CSU patients since these conditions might impair treatment response.

Background: Omalizumab is a safe and effective treatment for antihistamine-refractory chronic spontaneous urticaria (CSU) but is insufficient in one-third of patients. For serious cases in which omalizumab is ineffective, cyclosporine or methotrexate may be preferred. Most drug trials in CSU have focused on omalizumab or cyclosporine monotherapy.

Objective: This retrospective study evaluated responses to monotherapy or combined therapy and real-life data on the effectiveness and safety of omalizumab in antihistamine-refractory CSU.

Methods: A total of 133 patients who received omalizumab due to antihistamine-refractory CSU were evaluated in terms of 7-day urticaria activity score, total IgE, anti-thyroid peroxidase, C-reactive protein, skin prick test with aeroallergens and disease duration. Partial or nonresponders to omalizumab monotherapy were given antihistamine, omalizumab, cyclosporine, and methotrexate as combined or monotherapy.

Results: Ninety-eight (73.7%) of the 133 patients were female and the mean age was 40.7 ± 14.4 years; 70.6% of the patients received omalizumab monotherapy and the others received combined or non-omalizumab monotherapy. Omalizumab monotherapy was effective in 66.9% of the patients. Of those with complete response to omalizumab monotherapy, 65.4% had early recurrence after discontinuing treatment. Treatment response was significantly better in patients who had high total IgE (p = 0.001). Patients with longer disease duration had significantly higher likelihood of early recurrence (p = 0.035).

Conclusions: Omalizumab monotherapy was as effective in real life as in placebo-controlled trials. Omalizumab was well tolerated by all patients. Treatment responses were comparable in patients treated with combined therapy and those who received monotherapy.

Background: Asian carps, a popular freshwater fish globally, are valued for their flavor and serve as a crucial protein source, especially for infants. However, grass carp parvalbumin is highly allergenic, surpassing the allergenicity of fish like salmon and cod. The allergenic potential of parvalbumin in other Asian carps remains unknown, underscoring the need for allergen identification to improve the precision of fish allergy diagnosis and treatment.

Objective: To identify all parvalbumin homologs in Asian carps and investigate the role of gene divergence in allergenic homolog formation.

Methods: Three annotated genomes of Asian carp, including grass carp, black carp and bighead carp, were constructed using a hybrid assembly approach. Through sequence homology at the genomic level, all the homologs of major fish allergens were identified. Bioinformatics tools were then employed to reveal the gene structures, expression levels, and protein conformations of parvalbumin.

Results: Grass carp genome analysis showed nine parvalbumin homologs, with Cid_PV2 most similar to Cten i 1. Bighead and black carp genomes had ten homologs, including potentially allergenic Mpi_PV7 and Hno_PV7. Tissue-specific expression patterns revealed alternative usage of parvalbumin homologs. Gene duplication events expanded parvalbumin copies in bony fish, with two gene clusters identified in Asian carp genomes.

Conclusion: All the homologs of Asian carps' parvalbumin were accurately identified and gene divergence contributed to the formation of allergenic homologs. Together with a comprehensive gene sequence profile of carps' parvalbumin, those could be applied to achieve a more precise clinical diagnostic test.

Background: The basophil activation test (BAT) has high sensitivity and specificity for diagnosing Hymenoptera venom allergy and is useful for predicting the clinical sensitivity of bee venom-allergic patients after venom immunotherapy. Patients sensitized to Hymenoptera venom are at risk for systemic reactions (SRs) to subsequent stings. Therefore, a tool that can predict the occurrence of SRs and the severity of Hymenoptera stings is needed.

Objective: We performed BATs on Japanese beekeepers naturally sensitized to honey bee venom (HBV) and analyzed the positive threshold concentration for the occurrence of SRs following honey bee stings (HBS).

Methods: Sixty-one beekeepers were interviewed and blood samples were taken. Data including history of HBS and the occurrence and severity of SRs to HBS were recorded. Blood samples were exposed to HBV-specific IgE antibodies (sIgE) and BAT was performed. Participants with HBV-sIgE ≥ class 1 were considered sensitized to HBV. The positive threshold for BAT scored as 0.0001, 0.001, 0.01, 0.1, and 1 μg/ml was classified as classes 5, 4, 3, 2, and 1, respectively. Samples negative at 1 μg/ml were classified as class 0.

Results: About 40% of beekeepers with a positive BAT threshold ≤ 0.1 μg/ml had SRs after HBS. The mean score of the BAT positivity threshold for beekeepers who developed SRs was significantly lower than that for beekeepers with no history of SRs (2.6 ± 0.8 vs 1.4 ± 1.1, P < 0.01).

Conclusion: Analysis of the positive threshold of BAT in Japanese beekeepers naturally sensitized to HBV may be a useful tool for predicting the occurrence of SRs.

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disorder affecting up to 20% of children in developed countries. Although probiotics have shown promise as adjuvant treatments for AD, their mechanisms are not well understood.

Objective: Building upon our previous studies, we investigated whether Lactobacillus gasseri and its moonlighting glyceraldehyde 3-phosphate dehydrogenase (GAPDH), namely LGp40, could be beneficial in AD management.

Methods: In AD mouse models (SKH and C57BL/6J mice) with ovalbumin (OVA) and Dermatophagoides pteronyssinus (Der p) allergens, aligning with the "outside-in" and "inside-out" hypotheses, we administered L. gasseri orally and LGp40 intraperitoneally to investigate their protective effects. The evaluation involved measuring physiological, pathological, and immune function parameters. To delve deeper into the detailed mechanism of LGp40 protection in AD, additional assays were conducted using human skin keratinocytes (HaCaT) and monocytes (THP1) cell lines.

Results: L. gasseri and LGp40 enhanced skin barrier function and increased skin moisture retention. They also led to reduced infiltration of Langerhans cells in the dermis and mitigated skewed Th2 and Th17 immune responses. Moreover, LGp40 inhibited allergen-induced keratinocyte apoptosis through the blockade of the caspase-3 cascade and reduced the NLR family pyrin domain containing 3 (NLRP3) inflammasome in macrophages. These inhibitions were achieved through the activation of the peroxisome proliferator-activated receptor gamma (PPARγ) pathway.

Conclusion: The results of this study provide a novel insight into the mechanism of action of probiotics in the prevention and treatment for allergic disorders through the moonlighting GAPDH protein.

Background: Lactic acid bacteria may be used as probiotics to prevent or treat various diseases, and Lactobacillus delbrueckii has an inhibitory effect on the development of atopic diseases.

Objective: This study explored the effects of L. delbrueckii subsp. lactis strain LDL557 administration on a mouse asthma model resulting from Dermatophoides pteronyssinus (Der p) sensitization and investigated the associated gut microbiota.

Methods: Der p-sensitized and challenged BALB/c mice were orally administered with three different doses of live (low, 10⁷ colony-forming units (CFU); medium, 10⁸ CFU; high, 10⁹ CFU) and heat-killed (10⁹ cells) LDL557 in 200 μL of PBS daily, starting 2 weeks before Der p sensitization and lasting 4 weeks. After the allergen challenge, airway responsiveness to methacholine and the influx of inflammatory cells to the lungs were assessed. The gut microbiome was obtained by sequencing the V3-V4 region of the 16S rRNA gene from mice stool samples.

Results: LDL557 in the live (10⁹ CFU) and heat-killed (10⁹ cells) conditions reduced the airway hyper-responsiveness after stimulation with methacholine, inflammatory cell infiltration, and mucus production. These effects were similar to those in groups treated with dexamethasone. No significant change in the gut microbiota was observed after LDL557 treatment, except for the tendency of heat-killed LDL557 to change the gut microbial profile to a greater extent than live LDL557.

Conclusion: In summary, we found that live and heat-killed LDL557 had the beneficial effect of preventing Der p-induced allergic inflammation in a mouse model of asthma.