Clinical and Experimental Allergy最新文献

{"title":"Psychology Provision for People With Food Allergy: A Survey of UK Healthcare Professionals and Psychologists","authors":"Rebecca C. Knibb, Eva L. Wooding, Heather Padley, Constantinos Petrides, Rosalynd Gourgey, Antony Aston, Louise J. Michaelis, Siân Ludman","doi":"10.1111/cea.14545","DOIUrl":"10.1111/cea.14545","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"54 11","pages":"933-935"},"PeriodicalIF":6.3,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway Exposure to House Dust Mite Promotes the Development of Allergy to Egg White in Mice","authors":"Sara Benedé, Leticia Pérez-Rodríguez, David Menchén-Martínez, Elena Molina, Rosina López-Fandiño","doi":"10.1111/cea.14543","DOIUrl":"10.1111/cea.14543","url":null,"abstract":"<p>Cases of adverse reactions to food in young children at their first known exposure have raised intriguing questions about food allergy development, leading to the hypothesis that sensitisation, at least to certain allergens such as peanut, may occur by contact through non-oral pathways like airway inhalation [<span>1</span>]. Interestingly, the biological activity of house dust mite (HDM) allergens stimulates bystander responses to other proteins, which implies that respiratory exposure to food allergens present in domestic dust, such as egg proteins could potentially lead to systemic sensitisation [<span>2</span>]. These findings suggest the possibility that prior sensitisation to egg proteins through the respiratory tract, facilitated by the adjuvant activity of accompanying HDM components, could lead to food allergies when egg is later ingested, in a way similar to that described for peanuts [<span>3, 4</span>]. To test this hypothesis, we used a murine model of sensitisation, without exogenous adjuvants, to investigate the immunostimulant properties of the proteolytically active and inactive forms of HDM in the development of allergy to egg white (EW) when administered either through inhalation or orally. Six-week-old female BALB/c mice received intranasally six doses of HDM, proteolytically inactive HDM (hereafter iHDM), or combinations of EW + HDM and EW + iHDM, followed by eight intragastric gavages with EW, before being intranasally challenged with EW. Materials and methods are provided in the open access repository OSF (https://doi.org/10.17605/OSF.IO/YCNPF).</p><p>Mice that received intranasally EW and its combinations with HDM or iHDM developed EW-specific IgE and IgG1 antibodies, while prior exposure to HDM or iHDM alone did not induce antibodies specific to EW after repeated oral EW administrations over 2 weeks (Figure 1a). Repeated oral administrations of EW did not elicit clinical signs or temperature changes, but, on Day 39, the jejunal concentration of MCP-1 was significantly elevated in mice that had received EW, EW + HDM and EW + iHDM intranasally (Figure 1b), indicating mast cell activation and degranulation in the intestinal mucosa of mice that had produced specific antibodies towards EW. Conversely, intranasal challenge with EW caused anaphylaxis symptoms in the mice that had previously received EW through the airways, particularly in the groups administered EW + HDM and EW + iHDM, which also experienced significant temperature drops, showing that both extracts had adjuvant activity that facilitated airway sensitisation to EW and anaphylaxis following intranasal challenge. Consistently, the concentration of MCP-1 in lung homogenates was significantly elevated in mice exposed to EW + HDM and EW + iHDM (Figure 1b). Mice receiving EW, EW + HDM and EW + iHDM exhibited significantly higher lung levels of IL-6 and IL-4, while the level of TNF-α was significantly higher in the mice exposed to EW + iHDM (Figure 1b). Analyses in t","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"54 10","pages":"777-780"},"PeriodicalIF":6.3,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.14543","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal BCG Vaccination for Prevention of Allergy in Infants: The MIS BAIR Randomised Controlled Trial","authors":"Nicole L. Messina,&nbsp;Kaya Gardiner,&nbsp;Laure F. Pittet,&nbsp;Emily K. Forbes,&nbsp;Kate L. Francis,&nbsp;Bridget Freyne,&nbsp;Christel Zufferey,&nbsp;Veronica Abruzzo,&nbsp;Clare Morison,&nbsp;Hannah Turner,&nbsp;Katrina J. Allen,&nbsp;Katie L. Flanagan,&nbsp;Anne-Louise Ponsonby,&nbsp;Roy Robins-Browne,&nbsp;Frank Shann,&nbsp;Peter Vuillermin,&nbsp;Susan Donath,&nbsp;Dan Casalaz,&nbsp;Nigel Curtis,&nbsp;the Melbourne Infant Study: BCG for Allergy and Infection Reduction (MIS BAIR) Group","doi":"10.1111/cea.14537","DOIUrl":"10.1111/cea.14537","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The beneficial off-target effects of Bacille Calmette–Guérin (BCG) vaccination potentially include protection against allergy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>In the MIS BAIR trial, we aimed to determine whether neonatal BCG vaccination reduces atopic sensitisation and clinical food allergy in infants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this randomised controlled trial, 1272 neonates were allocated to BCG-Denmark vaccine (0.05 mL intradermal dose) or no BCG at birth. Randomisation was stratified by recruitment site, mode of delivery and plurality of birth. The primary outcome was the incidence of atopic sensitisation determined by skin prick test at 1 year of age. Food allergy was determined by 3-monthly online questionnaires and oral food challenges. Data were analysed by intention-to-treat using binary regression. Clinicaltrials.gov (NCT01906853).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Atopic sensitisation during the first year of life was 22.9% among infants in the BCG group and 18.9% in the control group (adjusted risk difference (aRD) 3.8% (95% CI −1.5 to 9.1) after multiple imputation). Clinical food allergy was similar between infants in the BCG and control groups (9.8% vs. 9.6%; aRD 0.2, 95% CI −3.4 to 3.8). An interaction was observed between the primary outcome and maternal history of BCG vaccination. No interaction was observed for the additional prespecified potential effect modifiers tested (sex, delivery mode, family history of any allergy, season of birth, hepatitis B vaccination at randomisation, BCG scar and age at BCG administration).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Clinical Relevance</h3>\u0000 \u0000 <p>Neonatal BCG-Denmark vaccination does not protect against atopic sensitisation or clinical food allergy in the first year of life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"54 9","pages":"682-693"},"PeriodicalIF":6.3,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.14537","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141615966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Basophil Activating Factors in the Serum May Underlie the ‘Nonreleaser’ Basophil Status in the Basophil Activation Test","authors":"Jiakai Wu,&nbsp;Chiara Tontini,&nbsp;Ran Wang,&nbsp;Silvia Bulfone-Paus,&nbsp;Clare S. Murray,&nbsp;Angela Simpson","doi":"10.1111/cea.14542","DOIUrl":"10.1111/cea.14542","url":null,"abstract":"&lt;p&gt;Basophil activation test (BAT) has been increasingly used in allergy diagnosis. For certain food allergies, such as nut allergy, BAT has demonstrated high specificity and sensitivity in distinguishing allergic and tolerant subjects, which helps reduce the need for oral food challenges [&lt;span&gt;1&lt;/span&gt;]. However, it has been reported that 10%–20% of subjects display ‘nonreleaser’ basophils due to spleen tyrosine kinase (Syk) deficiency [&lt;span&gt;2, 3&lt;/span&gt;]. Although one study showed that ‘nonreleasers’ had a reduction in the incidence of allergic rhinitis [&lt;span&gt;3&lt;/span&gt;], the status of ‘nonreleaser’ can change over time [&lt;span&gt;4&lt;/span&gt;], and therefore, the clinical implications remain unknown.&lt;/p&gt;&lt;p&gt;The underlying cause of a ‘nonreleaser’ state remains unclear. The nonreleaser state is characterised as no response to IgE-mediated stimulation, via anti-FcεRI or anti-IgE engagement. In contrast, degranulation mediated by IgE-independent mechanisms remains intact, such as stimulation via G-protein–coupled fMLP receptors using fMLP [&lt;span&gt;5&lt;/span&gt;]. The nonreleaser state is not a result of a genetic defect, as Syk is expressed normally in other granulocytes, such as eosinophils and neutrophils, and B cells, suggesting a separate regulation in basophils via mechanisms that remain largely unknown [&lt;span&gt;4&lt;/span&gt;]. Although some researchers have speculated that it could be a protective mechanism for some individuals [&lt;span&gt;3&lt;/span&gt;], a better explanation is needed as to why only basophils seem to be affected.&lt;/p&gt;&lt;p&gt;We hypothesise that a basophil-specific self-activating mechanism from the patient's own serum might be responsible for the observed ‘nonreleaser’ state. Loss of Syk in human basophils through IgE or non–IgE-dependent stimulation was reported previously [&lt;span&gt;6, 7&lt;/span&gt;]. However, a clear link between nonreleaser basophils and basophil-specific self-activation mechanism was not established.&lt;/p&gt;&lt;p&gt;To investigate this hypothesis, we identified subjects most likely to carry basophils with impaired IgE-mediated degranulation function. To do this, we performed BAT using whole blood of subjects sensitised to at least one allergen (&lt;i&gt;n&lt;/i&gt; = 30) and were not taking oral corticosteroids (Path 1 of Figure 1A). In parallel, subjects' sera were frozen, and batch tested using the progenitor cell derived basophils (PCB) [&lt;span&gt;8&lt;/span&gt;]. This includes progenitor cell derived basophil activation test (PCBAT, Path 2 of Figure 1A) and serum-induced PCB activation test (Paths 3–4 of Figure 1A). Informed consent was obtained for all subjects (Rec reference: 20/NW/0302). Both BAT and PCBAT used 1 μg/mL anti-IgE as stimulant, and the percentage of degranulation was measured via CD63 expression compared with unstimulated control using flow cytometry.&lt;/p&gt;&lt;p&gt;While BAT results combine subject-dependent humoral and cellular factors, PCBAT only reflects the subjects' humoral responses via passive sensitisation of donor basophils using subjects' own sera (Figure 1A","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"54 10","pages":"774-776"},"PeriodicalIF":6.3,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.14542","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141589762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life in Hymenoptera Venom Allergy: Minimal Clinically Important Difference for the Vespid Quality of Life Questionnaire.","authors":"Matteo Martini, Marina Mauro, Donatella Bignardi, Patrizia Bonadonna, Maria Chiara Braschi, Francesca Emiliani, Laura Guerra, Serena Liberati, Francesco Olivieri, Valerio Pravettoni, Donatella Preziosi, Erminia Ridolo, Federica Rivolta, Ilaria Baiardini, Maria Beatrice Bilò","doi":"10.1111/cea.14540","DOIUrl":"https://doi.org/10.1111/cea.14540","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IgE-Mediated Mast Cell Responses to Rocuronium: A Matter of Protonation Status","authors":"Didier G. Ebo,&nbsp;Michel Van Houdt,&nbsp;Michiel Beyens,&nbsp;Alessandro Toscano,&nbsp;Christel Mertens,&nbsp;Athina L. Van Gasse,&nbsp;Pierre Bruhns,&nbsp;Vito Sabato,&nbsp;Jessy Elst","doi":"10.1111/cea.14536","DOIUrl":"10.1111/cea.14536","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"54 10","pages":"760-762"},"PeriodicalIF":6.3,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Farm Dust Exposure Reduces Cytokine- and Rhinovirus-Induced IL-33 Expression in Bronchial Epithelial Cells","authors":"Jasmijn A. Schrumpf,&nbsp;Dennis K. Ninaber,&nbsp;Christoph Müller,&nbsp;Bettina Rankl,&nbsp;Mikaela Tham,&nbsp;Erika von Mutius,&nbsp;Hermelijn H. Smits,&nbsp;Pieter S. Hiemstra","doi":"10.1111/cea.14535","DOIUrl":"10.1111/cea.14535","url":null,"abstract":"&lt;p&gt;Pre-school wheeze, attributed to respiratory viral infections, with rhinovirus (RV) being the most important risk factor, may contribute to early-onset asthma development [&lt;span&gt;1, 2&lt;/span&gt;]. In asthmatic children, the alarmin IL-33 is elevated in the airways and is involved in the development of T helper (Th)2 immunity and in Th2-driven immune responses to RV [&lt;span&gt;3, 4&lt;/span&gt;]. Although IL-33 is constitutively expressed, IL-33 is also increased in response to pro-inflammatory cytokines like TNF-α and IFN-γ and after RV infections in airway epithelial cells [&lt;span&gt;5, 6&lt;/span&gt;]. Children that grow up on traditional farms develop less wheezing, allergies and asthma [&lt;span&gt;7&lt;/span&gt;]. This is partly caused by dust exposure from cow stables [&lt;span&gt;7&lt;/span&gt;]. Furthermore, exposure to farm dust (FD) extract or its components protects against house dust mite (HDM)–induced allergic airway inflammation in mice [&lt;span&gt;7&lt;/span&gt;] and enhances epithelial barrier function and RV clearance in primary bronchial epithelial cells (PBEC) [&lt;span&gt;7&lt;/span&gt;]. Currently, the effects of FD on the alarmin IL-33 in human airway epithelial cells have not been investigated. The present study aims to investigate how exposure to FD affects the expression of IL-33 in PBEC. This article's Online Repository at Zenodo (https://zenodo.org/records/10417793) contains an extended version of this letter, including supporting data and a full description of methods.&lt;/p&gt;&lt;p&gt;To achieve our objective, submerged (S-) cultures of PBEC were pre-treated with FD for 24 h before being infected with RV-A1B for 48 h. Alternatively, cells were stimulated with TNF-α and INF-γ in the presence or absence of FD for 6 and 8 h. Changes in gene expression and protein levels were assessed using qPCR and HEK-Blue IL-33 reporter cells. We observed that FD pretreatment inhibited RV-mediated increase of &lt;i&gt;IL33&lt;/i&gt; mRNA, without affecting viral RNA (vRNA) levels (Figure 1A). We furthermore showed that FD decreased the TNF-α-/IFN-γ-induced expression of &lt;i&gt;IL33&lt;/i&gt; mRNA and protein in S-PBEC (Figure 1B). We further observed that FD reduced the TNF-α-/IFN-γ-induced expression levels of both IL-33 mRNA and protein in differentiated (ALI-)PBEC. However, effects of both TNF-α/IFN-γ-exposure and FD treatment were less prominent in ALI-PBEC, compared to S-PBEC (Online Repository).&lt;/p&gt;&lt;p&gt;We next explored the mechanism underlying the reduction of TNF-α-/IFN-γ-induced IL-33 by FD. We therefore pre-treated S-PBEC for 1 h with inhibitors of downstream IFN-γ signalling pathways or FD and stimulated with IFN-γ (a key driver of TNF-α-/IFN-γ-mediated IL-33 expression [&lt;span&gt;8&lt;/span&gt;]) for 6 h to assess &lt;i&gt;IL33&lt;/i&gt; mRNA expression and for 30 min for the analysis of phosphorylated (p-)STAT1, p-p38, p-EGFR and GAPDH. In addition to FD, inhibition of JAK–STAT, p38 MAPK and EGFR also decreased &lt;i&gt;IL33&lt;/i&gt; expression in S-PBEC (Figure 1C). Western blot analysis showed that FD partially inhibited p-STAT1 (with a trend towards sign","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"54 10","pages":"766-769"},"PeriodicalIF":6.3,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.14535","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosing Paediatric Mild Acute Food Protein-Induced Enterocolitis Syndrome: Proposal of New Criteria","authors":"Stefano Miceli Sopo,&nbsp;Francesco Mastellone,&nbsp;Giulia Bersani,&nbsp;Marta Barbato,&nbsp;Bruno Miceli Sopo,&nbsp;Mariannita Gelsomino","doi":"10.1111/cea.14512","DOIUrl":"10.1111/cea.14512","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"54 7","pages":"512-514"},"PeriodicalIF":6.3,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Allergy as a Chronic Inflammatory Condition From a Systems Biology Perspective","authors":"M. I. Delgado Dolset,&nbsp;C. Pablo-Torres,&nbsp;N. Contreras,&nbsp;A. Couto-Rodríguez,&nbsp;A. Escolar-Peña,&nbsp;O. Graña-Castro,&nbsp;E. Izquierdo,&nbsp;J. C. López-Rodríguez,&nbsp;A. Macías-Camero,&nbsp;M. Pérez-Gordo,&nbsp;A. Villaseñor,&nbsp;E. Zubeldia-Varela,&nbsp;D. Barber,&nbsp;M. M. Escribese","doi":"10.1111/cea.14517","DOIUrl":"10.1111/cea.14517","url":null,"abstract":"<p>Persistent and unresolved inflammation is a common underlying factor observed in several and seemingly unrelated human diseases, including cardiovascular and neurodegenerative diseases. Particularly, in atopic conditions, acute inflammatory responses such as those triggered by insect venom, food or drug allergies possess also a life-threatening potential. However, respiratory allergies predominantly exhibit late immune responses associated with chronic inflammation, that can eventually progress into a severe phenotype displaying similar features as those observed in other chronic inflammatory diseases, as is the case of uncontrolled severe asthma. This review aims to explore the different facets and systems involved in chronic allergic inflammation, including processes such as tissue remodelling and immune cell dysregulation, as well as genetic, metabolic and microbiota alterations, which are common to other inflammatory conditions. Our goal here was to deepen on the understanding of an entangled disease as is chronic allergic inflammation and expose potential avenues for the development of better diagnostic and intervention strategies.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"54 8","pages":"550-584"},"PeriodicalIF":6.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.14517","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity and Asthma: Implementing a Treatable Trait Care Model","authors":"Francisca Castro Mendes,&nbsp;Vanessa Garcia-Larsen,&nbsp;André Moreira","doi":"10.1111/cea.14520","DOIUrl":"10.1111/cea.14520","url":null,"abstract":"<div>\u0000 \u0000 <p>Recognition of obesity as a treatable trait of asthma, impacting its development, clinical presentation and management, is gaining widespread acceptance. Obesity is a significant risk factor and disease modifier for asthma, complicating treatment. Epidemiological evidence highlights that obese asthma correlates with poorer disease control, increased severity and persistence, compromised lung function and reduced quality of life. Various mechanisms contribute to the physiological and clinical complexities observed in individuals with obesity and asthma. These encompass different immune responses, including Type IVb, where T helper 2 cells are pivotal and driven by cytokines like interleukins 4, 5, 9 and 13, and Type IVc, characterised by T helper 17 cells and Type 3 innate lymphoid cells producing interleukin 17, which recruits neutrophils. Additionally, Type V involves immune response dysregulation with significant activation of T helper 1, 2 and 17 responses. Finally, Type VI is recognised as metabolic-induced immune dysregulation associated with obesity. Body mass index (BMI) stands out as a biomarker of a treatable trait in asthma, readily identifiable and targetable, with significant implications for disease management. There exists a notable gap in treatment options for individuals with obese asthma, where asthma management guidelines lack specificity. For example, there is currently no evidence supporting the use of incretin mimetics to improve asthma outcomes in asthmatic individuals without Type 2 diabetes mellitus (T2DM). In this review, we advocate for integrating BMI into asthma care models by establishing clear target BMI goals, promoting sustainable weight loss via healthy dietary choices and physical activity and implementing regular reassessment and referral as necessary.</p>\u0000 </div>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"54 11","pages":"881-894"},"PeriodicalIF":6.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}