Asian Pacific journal of allergy and immunology最新文献

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.

Thailand has achieved remarkable success in preventing and reducing hepatitis B virus (HBV) incidence through its nationwide newborn vaccination program, introduced in 1992 as part of the Expanded Program on Immunization (EPI). Before the vaccination era, HBV endemicity in Thailand was high, with a carrier rate of 6-8%, and mother-to-child transmission was a major route of infection. Early trials demonstrated the efficacy of hepatitis B vaccines, especially when administered within 12 hours of birth, followed by scheduled doses. The national vaccination program was initially piloted in two provinces in 1988 and expanded to full coverage by 1992. By 2024, carrier rates among children under 10 years dropped to less than 0.1%, meeting the WHO goal of zero mother-to-child transmission. Studies confirmed the vaccine's long-term protection, with no cases of chronic infection in vaccinated individuals with detectable anti-HBs over 20 years. Moreover, literature indicates that hepatitis B vaccination provides long-lasting protection more than 35 years. Additional measures, including antiviral use for high-risk mothers and expanded screening and treatment programs, have further supported HBV elimination. The program's impact has significantly reduced liver-related diseases and positioned Thailand as a model for HBV control. As the nation moves toward the 2030 hepatitis elimination goal, ongoing efforts focus on screening older populations with a high prevalence of infection and ensuring treatment access to achieve lasting eradication.

Background: Atopic dermatitis (AD) and food allergy (FA) often originate early in life. Gut microbiota interactions with the host immune system influence allergy development, yet the distinct gut microbiome and functional profiles in individuals with AD, FA, or both AD+FA remain underexplored.

Objective: We investigated microbial colonization and proteomic profiles in infants with AD, FA, and AD+FA compared to age- and sex-matched controls from the Allergy Development in Early Life and Associated Factors in the Thai Birth Cohort (ALICE).

Methods: Gut microbiomes from stool samples were analyzed using 16S sequencing, and proteomic analysis was conducted by liquid chromatography-tandem mass spectrometry.

Results: The study included 16 AD, 5 FA, 5 AD+FA subjects, and 26 controls. AD+FA group exhibited the most severe dysbiosis. Enrichment of proteins involved in methionine biosynthesis in Bifidobacterium scardovii and high Erysipelotrichaceae colonization suggest a link to high-fat diets, known to reduce intestinal short-chain fatty acid and serotonin levels, contributing to allergies. Erysipelotrichaceae in AD+FA groups also expressed proteins related to histidine degradation. Low Bifidobacteriaceae levels were noted in FA and AD+FA, with more pathogenic strains colonized. Increased Bacteroidaceae in FA and AD+FA and Enterobacteriaceae in FA were detected. Pathways involving vitamin B1, a ligand for proliferator-activated receptor-γ (PPAR-γ) from Enterobacteriaceae could promote TH2 cells, type 2 innate lymphoid cells, and M2 macrophages, likely contribute to allergic inflammation.

Conclusions: AD+FA phenotype exhibited the most distinctive gut microbiome alterations, highlighting unique dysbiosis patterns. Microbiome biosynthesis pathways involving metabolism of methionine, histidine, serotonin, and vitamin B1 point to new targets for modifying or treating AD and FA.

Background: Despite concerns on the major neuropsychiatric side effects for long-term use of H1-receptor antagonist (anti-histamine, AH), one of the major therapeutic tools for allergic diseases, their association has not been investigated well.

Objective: This study aimed to assess the association between AH usage and neuropsychiatric disorder (NPD) incidence using the National Health Insurance Service Database.

Methods: This study was conducted using data from the National Health Insurance Service Database from January 1st 2002 through December 31th 2017. To enroll the participants who may have history of long-term use of AH, participants having common allergic diseases were enrolled. We defined NPD as diagnosed by a psychiatrist occurring during and after antihistamine use to 6 months thereafter.

Results: A total of 1,488,075 participants were enrolled. No significant association was found between increased AH usage and NPD incidence after adjusting for potential confounding factors in the health screening data. Notably, the 30-89 day AH usage group showed a significantly lower NPD risk in the subgroup analysis in participants aged over 60 years. No other groups within this age category showed a significant increase in risk.

Conclusions: This study suggests that long-term AH use does not significantly increase NPD risk. While this study lacked evaluation of mild neuropsychiatric side effects not requiring psychiatric visits, this study may contribute real-world evidence to the understanding of AHs' long-term neuropsychiatric side effects.

Background: Premorbid allergic diseases are linked with the development of age-related macular degeneration (AMD), however, the risk of allergic diseases among patients with AMD is largely unknown.

Objective: To evaluate the association between AMD with or without visual disability (VD) and the risk of allergic diseases.

Methods: A total of 2,744,372 Individuals 50 years or older participated in the Korean National Health Screening Program in 2009 were categorized by presence of AMD and VD. Patients were followed until December 2019, and the prospective association of AMD and related VD with incident allergic diseases cases identified during the study period was investigated using the multivariable-adjusted Cox proportional hazard model.

Results: During an average follow-up period of 5.87 years, 1,783,370 individuals were diagnosed with allergic diseases. Moreover, an increased risk of allergic diseases was observed in the group of individuals with AMD as compared to the control group (adjusted HR [aHR], 1.13; 95%CI, 1.11-1.14). The risk of atopic dermatitis or allergic rhinitis was more profound than that of asthma (aHR 1.12 [95%CI 1.07-1.18], aHR 1.13 [95%CI 1.11-1.14], and aHR 1.06 [95%CI 1.04-1.09], respectively). Furthermore, patients affected by AMD with VD were at an increased risk of atopic dermatitis (aHR 1.32, 95%CI 1.12-1.56) than those without VD (aHR 1.11, 95%CI 1.05-1.16) when compared with those in the control group.

Conclusions: AMD is associated with an increased risk of developing allergic diseases. Further investigations are required to elucidate the underlying mechanisms.

Background: Thymoma-associated immunodeficiency (TAI) is a rare, acquired adult-onset immunodeficiency. It includes the classic form of Good syndrome (GS), characterized by thymoma and hypogammaglobulinemia, as well as a non-classic form of GS. This condition leads to specific or combined deficiencies in both B- and T-cells, causing considerable morbidity and mortality, although the underlying immunopathology is still not well understood.

Objective: In this study, we examine the clinical features, laboratory investigations, immunological analysis and treatment outcomes of 21 patients with TAI in our institution, and its associated comorbidities and complications.

Methods: Patients with thymoma and recurrent infections who were followed up in our immunodeficiency clinic between 1 January 1999 and 1 December 2023 were identified. Clinical information, laboratory, treatment and outcome data were extracted from the medical records. Seven patients agreed to provide additional blood samples for anti-cytokine antibodies profiling.

Results: Of the 21 TAI patients, 12 (57.1%) were females and the mean age at diagnosis of TAI was 61.3 ± 9.2 years. 19 patients had classic GS. 12 (57.1%) had underlying bronchiectasis, 5 (23.8%) had sinusitis and 5 (23.8%) developed malignancy other than thymic carcinoma after diagnosis of thymoma. 10 patients (47.6%) developed autoimmune conditions including myasthenia gravis, polymyositis, lichen planus, vasculitis and ulcerative colitis. One patient was found to have high titre of neutralizing anti-interferon alpha antibodies as well as medium titre of neutralizing anti-interleukin 17 antibodies. 9 patients died at a median of 4.2 (IQR 1.98 - 4.9) years after diagnosis of TAI.

Conclusions: TAI is associated with significant morbidity and mortality. The syndrome leads to a plethora of opportunistic infections, autoimmune complications and malignancy.

Background: Previous studies have demonstrated that salbutamol administration via metered-dose inhaler with spacer (MDI-S) is as effective as using a jet nebulizer (NEB) for treating children experiencing asthma exacerbation. However, a paucity of research focuses on the direct medical costs associated with each mode of salbutamol administration for asthma exacerbation.

Objective: This study aims to compare the effectiveness and direct medical costs of salbutamol administration via MDI-S versus NEB.

Methods: A retrospective cohort study was conducted on the medical records of children under 18 years old presenting with mild to moderate asthma exacerbation. Clinical responses to salbutamol administration were assessed using the Ramathibodi Pediatrics Asthma Scores. The costs and clinical outcomes (i.e., Asthma score and hospitalization averted) were compared using the Incremental Cost-Effectiveness Ratio (ICER) from a hospital perspective.

Results: The study included 95 medical records from 72 children, with 33 records of MDI-S and 62 records of NEB. Both the MDI-S and NEB groups showed significant reductions in asthma scores post-treatment. Children with moderate asthma exacerbation treated with MDI-S had a lower hospitalization rate than those treated with NEB (20% vs 57.5%, p = 0.034). The cost-effectiveness analysis indicated that the MDI-S group incurred lower costs and was considered cost-saving compared to the NEB group, with an ICER of -4.60 US dollars per one-point improvement in asthma score and -20.07 US dollars per hospitalization averted.

Conclusions: Salbutamol administration via MDI-S offers clinical effectiveness comparable to NEB and is more cost-effective.

Background: Granulomatosis with polyangiitis (GPA) is characterized by granulomatous inflammation, vasculitis, and elevated levels of serum proteinase 3 (PR3)-anti-neutrophil cytoplasmic antibody (PR3-ANCA).

Objective: We tried to characterize immune cells accumulated into the lung lesions of a GPA patient exhibiting spontaneous regression.

Methods: Transbronchial lung biopsy (TBLB) samples were subjected to immunohistochemical analyses.

Results: Multiple lung nodules were detected by CT. TBLB showed granulomatous inflammation and small vessel vasculitis. This case was diagnosed as GPA based on pathological findings and elevation of PR-3 ANCA levels. Spontaneous disappearance of multiple lung nodules was observed in CT. CD3+ T cells and CD20+ B cells accumulated in the inflammatory lesions surrounding the vessels whereas granulomatous inflammation was mainly comprised of CD3+ T cells and CD68+ macrophages, but not B cells or myeloperoxidase+ neutrophils.

Conclusions: We characterized immune cell compositions of the lung lesions of a patient with GPA exhibiting spontaneous regression.

Background: Recent treatment for food allergies involves the intake of allergy-causing foods at doses lower than the threshold dose determined by the oral food challenge (OFC). For a more successful treatment, it is necessary to identify a biomarker to establish safer doses of allergens in foods consumed at home.

Objective: In this study, we aim to investigate whether the pattern of sensitization to cow's milk (CM) is related to the threshold dose of CM.

Methods: Fifty patients with sensitization to casein (casein-specific IgE titer ≥ 0.7 UA/ml) and who have undergone the CM OFC test from July 2013 to July 2015 were enrolled. They were examined for the presence or absence of sensitization to β-lactoglobulin (BLG) (BLG-specific IgE ≥ 0.7 UA/ml). They were divided into two groups, namely, the only-casein-specific IgE-positive (C) group, and both casein- and BLG-specific IgE-positive (C + B) group.

Results: The C group had 26 patients and the C + B group had 24. Both the CM- and casein-specific IgE titers were higher in the C + B group than in the C group. The positivity rates determined from OFC test results were 53.8 and 87.5%, and the threshold doses of CM were 88.7 and 31.1 ml in the C and C + B groups, respectively. In patients with low casein-specific IgE titers (≤ 10 UA/ml), the C + B group showed a significantly lower threshold dose of CM than the C group.

Conclusions: Our results suggest that children with CM allergy sensitized to casein alone have a higher threshold dose than those sensitized to both casein and BLG.

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.