Clinical and Translational Allergy最新文献

{"title":"Sensitization patterns to cat molecular allergens in subjects with allergic sensitization to cat dander","authors":"Saliha Selin Özuygur Ermis,&nbsp;Aram Norouzi,&nbsp;Magnus P. Borres,&nbsp;Rani Basna,&nbsp;Linda Ekerljung,&nbsp;Carina Malmhäll,&nbsp;Emma Goksör,&nbsp;Göran Wennergren,&nbsp;Madeleine Rådinger,&nbsp;Jan Lötvall,&nbsp;Hannu Kankaanranta,&nbsp;Bright I. Nwaru","doi":"10.1002/clt2.12294","DOIUrl":"10.1002/clt2.12294","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The use of molecular allergology has increasingly become common in the diagnosis and management of allergic diseases. However, there is still a lack of data on cat molecular allergens in adults. Therefore, we aimed to uncover the sensitization patterns to cat molecular allergens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were recruited from the West Asthma Sweden Study, a population-based study enriched with asthma subjects aged 16–75 years. Of 1872, 361 individuals were positive for cat dander immunoglobulin E and were further analysed for cat molecular allergens (Fel d 1/2/4/7). Sensitization patterns were classified as monosensitization, polysensitization, and concomitant sensitization, and were related to demographic and clinical measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among cat-sensitized subjects, 84.2% were sensitized to secretoglobin, while 42.4% were sensitized to lipocalins. Nearly half of the subjects were monosensitized to Fel d 1. Polysensitization was observed in 20.2%, and concomitant sensitization to protein families was seen in 7.2%. Asthma prevalence, cat exposure, and rural living were associated with poly- and concomitant sensitization to protein families. Concomitant sensitization to single allergens was more common in those with asthma than in those without, while concomitant sensitization to both Fel d 1 and Fel d 4 was the most common pattern in individuals with asthma. Sensitization patterns also differed according to cat ownership and the degree of urbanization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Sensitization to molecular allergens was observed in 90.9% of cat-sensitized subjects and showed variations across participants' background characteristics and the presence of asthma. Identification of sensitization patterns to cat allergens might provide better characterization of cat-allergic subjects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2023-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12294","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10439094","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":"Effect of infant viral respiratory disease on childhood asthma in a non-industrialized setting","authors":"Jessica Atwell,&nbsp;Martha Chico,&nbsp;Maritza Vaca,&nbsp;Andrea Arévalo-Cortes,&nbsp;Ruth Karron,&nbsp;Philip J. Cooper","doi":"10.1002/clt2.12291","DOIUrl":"10.1002/clt2.12291","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There are limited data from non-industrialized settings on the effects of early life viral respiratory disease on childhood respiratory illness. We followed a birth cohort in tropical Ecuador to understand how early viral respiratory disease, in the context of exposures affecting airway inflammation including ascariasis, affect wheezing illness, asthma, and rhinoconjunctivitis in later childhood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A surveillance cohort nested within a birth cohort was monitored for respiratory infections during the first 2 years in rural Ecuador and followed for 8 years for the development of wheeze and rhinoconjunctivitis. Nasal swabs were examined for viruses by polymerase chain reaction and respiratory symptom data on recent wheeze and rhinoconjunctivitis were collected by periodic questionnaires at 3, 5, and 8 years. Stools from pregnant mothers and periodically from children aged 2 years were examined microscopically for soil-transmitted helminths. Atopy was measured by allergen skin prick testing at 2 years. Spirometry, fractional exhaled nitric oxide measurement, and nasal washes were performed at 8 years. Associations between clinically significant respiratory disease (CSRD) and wheezing or rhinoconjunctivitis at 3, 5, and 8 years were estimated using multivariable logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four hundred and twenty six children were followed of which 67.7% had at least one CSRD episode; 12% had respiratory syncytial virus (RSV)+CSRD and 36% had rhinovirus (RHV)+CSRD. All-cause CSRD was associated with increased wheeze at 3 (OR 2.33 [95% confidence intervals (CI) 1.23–4.40]) and 5 (OR: 2.12 [95% CI 1.12–4.01]) years. RHV+CSRD was more strongly associated with wheeze at 3 years in STH-infected (STH-infected [OR 13.41, 95% CI 1.56–115.64] vs. uninfected [OR 1.68, 95% CI 0.73–3.84]) and SPT+ (SPT+ [OR 9.42, 95% CI 1.88–47.15] versus SPT- [OR 1.92, 95% CI 0.84–4.38]) children. No associations were observed between CSRD and rhinoconjunctivitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>CSRD was significantly associated with childhood wheeze with stronger associations observed for RHV+CSRD in SPT+ and STH-infected children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10439098","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":"Sensitization patterns to Poaceae pollen indicates a hierarchy in allergens and a lead of tropical grasses","authors":"Victoria Rodinkova,&nbsp;Serhii Yuriev,&nbsp;Vitalii Mokin,&nbsp;Olena Sharikadze,&nbsp;Yevhenii Kryzhanovskyi,&nbsp;Lilia Kremenska,&nbsp;Olha Kaminska,&nbsp;Andrii Kurchenko","doi":"10.1002/clt2.12287","DOIUrl":"10.1002/clt2.12287","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The allergenicity of pollen of Poaceae family members is a well-known and confirmed fact. Using the data of component-resolved molecular diagnostics of allergy, we set a goal to establish the population and individual characteristics of sensitization to grass pollen and assess the patterns of its development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Multiplex allergy Alex² test results of 20,033 patients were used. In addition to descriptive statistics to uncover traits of the sensitized population, statistical inference was utilized to establish the conditional probability of sensitisation, the nature of links between allergens, and the most frequent combinations of allergens in individual patient profiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sensitivity to grass pollen comprised 30.79% of the studied sample. Children accounted for 62.21%, adults—37.79%. Sensitisation to Phl p 1, Lol p 1, and Cyn d 1 was the most frequent in all age groups. Among them, Phl p 1 and Lol p 1 were the major ones. Phl p 2, Phl p 5.0101, and Phl p 6 were also responsible for primary sensitization; Phl p 5.0101 promoted the highest sIgE levels. A combination “Lol p 1—Phl p 1”, where Lol p 1 might play a leading role, was most frequent in individual profiles. Monosensitization to Phl p 2 was the second most frequent and Bayesian Network suggested its independent development. Monosensitization to Cyn d 1, especially among children, may indicate the impact of climate change, promoting the spread of the subtropical grasses to the temperate region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Descriptive statistics and known clinical data coincide well with statistical inference results and can provide for new clinical insights.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10439095","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":"In chronic spontaneous urticaria, IgE and C-reactive protein are linked to distinct microRNAs and interleukin-31","authors":"Ozge Sevil Karstarli Bakay,&nbsp;Betül Demir,&nbsp;Demet Cicek,&nbsp;Deniz Erol,&nbsp;Zulal Aşçı Toraman,&nbsp;Yunus Gural,&nbsp;Marcus Maurer","doi":"10.1002/clt2.12290","DOIUrl":"10.1002/clt2.12290","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic spontaneous urticaria (CSU) is a common and disabling disease. Assessments of IgE and C-reactive protein (CRP) are recommended in the diagnostic work-up, but the role and clinical relevance of these biomarkers are not well characterized. Moreover, it remains unknown if elevated levels of IgE or CRP are linked to CSU microRNA (miRNA) signatures or interleukin 31 (IL-31).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We measured IgE and CRP serum levels in 47 CSU patients (and 45 healthy controls) and determined CSU disease activity using the urticaria activity score (UAS7). Expression levels of miR-155 and miR-221 were assessed by RT-PCR, and IL-31 levels were determined by ELISA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Total IgE and CRP levels were independently increased in CSU patients. IgE and CRP levels were highest and lowest in patients with high and mild disease activity. IgE levels correlated with miR-155 levels, whereas CRP levels correlated with miR-221 levels. miR-155 and miR-221 were significantly overexpressed in CSU patients. ROC analyses linked miRNA-155 and CSU with a sensitivity of 79% and specificity of 87%, and miRNA-221 and CSU with a sensitivity of 75% and specificity of 91%. High CRP and miR-221 expression levels were linked to elevated levels of IgG anti-TPO and IL-31.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>IgE and CRP are useful biomarkers for disease activity in CSU, with distinct miRNA profiles. High CRP and miR-221 levels may point to autoimmune CSU and a role for IL-31.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12290","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10439100","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":"Anaphylaxis management in a French pediatric emergency department: Lessons from the ANA-PED study","authors":"Evangéline Clark,&nbsp;Luciana Kase Tanno,&nbsp;Tram Vo,&nbsp;Brigitte Blanc,&nbsp;Pascal Demoly,&nbsp;Davide Caimmi","doi":"10.1002/clt2.12289","DOIUrl":"10.1002/clt2.12289","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Anaphylaxis is a serious systemic hypersensitivity reaction that requires immediate recognition and prompt administration of epinephrine/adrenaline. The present study aimed to assess the appropriateness of epinephrine/adrenaline use in children identified as allergic by physicians in the emergency department (ED) at the time of the reaction, and to identify factors that are possibly associated with epinephrine/adrenaline administration, auto-injector prescription, and further referral to an allergist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective cross-sectional study at the pediatric ED of the University Hospital of Montpellier, France. We included all consecutive children who attended the ED between 2016 and 2020 with an allergy-related diagnosis at discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 1056 allergy-related visits, including 224 (21.2%) with a diagnosis of anaphylaxis at discharge; only 17.0% of them received an epinephrine/adrenaline injection, and 57.1% consulted an allergist after the acute episode. An auto-injector was prescribed to 63 (28.1%) patients at discharge from the ED. Besides the severity of the clinical presentation, factors associated with a guidelines-based management of the anaphylactic reaction and with an increased administration rate of epinephrine/adrenaline included presence of asthma symptoms and presence of extended skin reactions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study underlines persistent gaps in the management of pediatric anaphylaxis in ED, focusing on hereby identified levers. By disseminating current knowledge and guidelines on anaphylaxis and allergies, specialists could work together with emergency physicians to establish effective management algorithms and improve anaphylaxis management and care pathways for children experiencing allergic reactions, especially anaphylaxis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trail Registration</h3>\u0000 \u0000 <p>Clinical Trials, number NCT05112367.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12289","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10439096","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":"The association between the level of specific IgE to molecular components of mites and the expression of CD23 molecule on B lymphocytes in atopic dermatitis patients treated or not treated with dupilumab—Pilot study","authors":"Jarmila Čelakovská,&nbsp;Eva Čermáková,&nbsp;Petra Boudková,&nbsp;Ctirad Andrýs,&nbsp;Jan Krejsek","doi":"10.1002/clt2.12278","DOIUrl":"10.1002/clt2.12278","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The CD23 molecule has an effect on the regulation of IgE synthesis, either by stimulation or inhibition. It is not yet known whether the expression of CD23 on B lymphocytes is related to the level of allergen-specific IgE antibodies in patients with atopic dermatitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this pilot study was to evaluate the association between the expression of CD23 molecule on B cells and on their subsets (memory, naive, switched, non-switched, and total B lymphocytes) and the level of specific IgE to molecular components of mites in atopic dermatitis patients (with and without dupilumab therapy).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-five patients suffering from atopic dermatitis were included: 32 patients without dupilumab treatment (10 men, 22 women, average age 35 years), 13 patients with dupilumab treatment (7 men, 6 women, average age 43.4 years) and 30 subjects as a control group (10 men, 20 women, average age 44.7 years). The serum level of the specific IgE was measured using the components resolved diagnostic microarray-based specific IgE detection assay ALEX2 Allergy Xplorer. In all included patients, the expression of CD23 molecule on B lymphocytes was evaluated with flow cytometry using monoclonal antibodies. For the statistical analysis of the association between expression of CD23 molecule on B lymphocytes and the level of specific IgE to molecular components of mites, we used non-parametric Kruskal-Wallis one-factor analysis of variance with post-hoc by Dunn's test with Bonferroni modification and the Spearman's rank correlation coefficient; for coefficients higher than 0.41, we report R2 (%, percent of Variation Explained).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The association between the expression of CD23 molecule on B cells and the level of specific IgE to molecular components of mites was confirmed only in patients with dupilumab therapy. In these patients, the highest association was confirmed between the level of specific IgE to Der p 20 and expression of CD23 on switched B lymphocytes (in 48.9%). In patients without dupilumab, the association between the level of specific IgE to molecular components of mites and the expression of CD23 on B cells and on their subsets is low.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Further research is needed to fully understand the underlying mechanism of this phenomenon and its implications","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2023-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10251549","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":"Enhanced thrombin generation potential and endothelial dysfunction in chronic spontaneous urticaria","authors":"Katie Ridge,&nbsp;Helen Fogarty,&nbsp;Dearbhla Doherty,&nbsp;Mary Byrne,&nbsp;Cliona O’Farrelly,&nbsp;James S. O’Donnell,&nbsp;Niall Conlon","doi":"10.1002/clt2.12285","DOIUrl":"10.1002/clt2.12285","url":null,"abstract":"<p>Chronic spontaneous urticaria (CSU) is characterized by recurrent hives that last longer than 6 weeks. The relationship between the coagulation cascade, endothelial cell (EC) activation and urticaria pathogenesis is acknowledged but remains poorly understood.<span>^{1, 2}</span> Examination of these pathways may offer opportunities for improved disease endotyping, prognostication and novel therapeutic avenues.</p><p>Mast cells and eosinophils are known to be important in CSU pathogenesis.<span>^{3, 4}</span> Mast cell degranulation results in the generation of leukotrienes and mast cell-derived mediators. Resulting EC activation promotes vascular permeability. Activated eosinophils express tissue factor, which initiates coagulation via Factor VII.<span>³</span> Despite our understanding of these pathways, the distinct profiles of coagulation and fibrinolysis in CSU remain obscure. Furthermore, products of fibrinolysis, such as D-Dimer, are increasingly proposed as potential markers of severe disease.<span>⁴</span> This study sought to examine markers of EC activation as well as the dynamics of thrombin generation (TG) in patients with CSU.</p><p>Adult patients with a diagnosis of CSU attending an urticaria clinic at a tertiary Irish teaching Hospital were invited to participate. The study received ethical approval and informed written consent was obtained. Patients (<i>N</i> = 26) with CSU completed the urticaria control test, a measure of disease control assessing hives and swellings over the past 4 weeks.<span>⁵</span> In this four item questionnaire with scores of 0–16, lower scores indicate higher symptom burden. A healthy control group without a diagnosis of CSU was recruited (<i>N</i> = 18). Markers of EC activation included plasma von Willebrand Factor (VWF) antigen (VWF:Ag) and procoagulant Factor VIII (FVIII:C) levels. These assays, in conjunction with a thrombin generation assay (TGA), were performed on participant plasma as previously described.<span>⁶</span> Statistical analyses were performed using <i>t</i> tests in GraphPad Prism 9.0 (GraphPad Software) with a <i>p</i> value of &lt; 0.05 considered statistically significant.</p><p>We assessed levels of TG, plasma FVIII:C and plasma VWF:Ag and compared them with levels found in the control group. We also compared patients with CSU who were in receipt of anti-IgE therapy and high dose antihistamines with CSU patients on high dose antihistamines only.</p><p>Baseline characteristics are outlined in Table 1. CSU patients had a distinct TG profile relative to controls with an increased peak thrombin (<i>p</i> ≤ 0.0001) shortened time to peak thrombin (<i>p</i> = 0.004) and an enhanced velocity index (<i>p</i> = 0.0001) (see Figure 1). There was a trend towards elevated endogenous thrombin potential (ETP) in patients with CSU although this was not statistically significant (<i>p</i> = 0.07). Neither age and gender nor the prese","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12285","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10232965","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":"Primary care as a setting for introducing milk using the milk ladder in children with IgE-mediated cow's milk protein allergy","authors":"Caoimhe Cronin,&nbsp;Anne Marie McGinley,&nbsp;Laura Flores,&nbsp;Anne McKiernan,&nbsp;Roberto Velasco,&nbsp;Jonathan O’B Hourihane,&nbsp;Juan Trujillo","doi":"10.1002/clt2.12286","DOIUrl":"10.1002/clt2.12286","url":null,"abstract":"<p>Cow's milk protein allergy (CMPA) is one of the most common food allergies in infancy and childhood.<span>¹</span> IgE-mediated CMPA is managed in tertiary care (TC) centres in Ireland using the iMAP milk ladder.<span>²</span> However, in primary care (PC) settings in Ireland, the use of the milk ladder is recommended only in the management of non-IgE mediated CMPA.<span>³</span></p><p>In a recent review, the milk ladder was shown to be a safe and effective method of gradual introduction to milk in children with IgE-mediated CMPA.<span>⁴</span> Two recent studies demonstrated the effectiveness of the iMAP milk ladder in tertiary allergy centres in Ireland and the UK<span>²</span>^,\u0000 <span>⁵</span>; however, the employment of the milk ladder in children with IgE-mediated CMPA in non-hospital clinical settings by general practitioners has not yet been evaluated. We reviewed the safety and effectiveness of the use of the milk ladder for children with IgE-mediated CMPA in a PC setting.</p><p>This retrospective analysis is part of a larger study comparing the management strategies of IgE-mediated CMPA in two countries (Ireland and Spain). Patients diagnosed with IgE-mediated CMPA between 2015 and 2021 who were treated with the iMAP milk ladder in a tertiary paediatric allergy clinic and in a local PC clinic in Ireland were included. Parents were trained in the use of the milk ladder by clinical staff. An adapted Milk Allergy in Primary care (MAP) Guideline,<span>⁶</span> known as the milk ladder was used. This ladder uses a 12-step guideline for the reintroduction of foods containing different amounts of milk protein.</p><p>The main outcome was reaching step 12 on the iMAP milk ladder, the introduction of unrestricted liquid cow's milk, which was defined as the uneventful intake of more than 150 mL of cow's milk or the equivalent intake of 4.5 g of milk protein daily. Failure to complete the ladder was defined as the failure to introduce liquid cow's milk after 36 months of follow-up. Data were analysed with SPSS Version 28.</p><p>A total of 13 patients in the primary care (PC) cohort and 69 patients in the TC cohort were included for analysis. Demographic features are shown in Table 1. Eleven (85%) patients in the PC cohort completed the reintroduction of milk to their diet compared to 57 (83%) in the TC cohort (<i>p</i> = 0.86). These results are similar to previous studies of the use of the milk ladder in IgE-mediated CMPA.<span>²</span>^,\u0000 <span>⁵</span></p><p>The mean time to completion of step 12 of the ladder was 12.7 months (95% CI 6.1–19.3 months) in the PC cohort and 15.5 months (95% CI 12.2–18.8 months) in the TC cohort (<i>p</i> = 0.472). Children in the PC group achieved tolerance at 25 months (95% CI 15.4–34.6 months) compared to 30.4 months (95% CI 24.87–35.98 months) in the TC cohort (<i>p</i> ","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12286","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9874986","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":"Efficacy of probiotics in pediatric atopic dermatitis: A systematic review and meta-analysis","authors":"Xiali Xue,&nbsp;Xinwei Yang,&nbsp;Xiubo Shi,&nbsp;Zhongyi Deng","doi":"10.1002/clt2.12283","DOIUrl":"10.1002/clt2.12283","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atopic dermatitis (AD) is a prevailing skin disease in childhood. Several studies have appraised probiotics as a strategy for treating AD. We aimed to assess the validity of probiotics in the treatment of AD in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically searched the PubMed/MEDLINE, Embase, Scopus, EBSCO, Web of Science and Cochrane library databases for randomized controlled trials (RCTs) that assessed the effect of probiotic treatment on SCORAD value in pediatric patients with AD compared with a placebo group between 1 January 2010 and 1 January 2023. The risk of bias and the certainty of evidence were assessed using Cochrane ROB 2.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 10 outcomes from 9 RCTs involving 1000 patients were included. Three of these outcomes were analyzed as dichotomous variables in 373 patients. The other seven were analyzed for continuous variables in 627 patients. A meta-analysis of the random-effect model of the dichotomous variables demonstrated no significant difference between the probiotic and control groups [OR = 1.75, 95% confidence interval (CI) (0.70, 4.35), <i>p</i> = 0.23, <i>I</i>² = 68%]. A meta-analysis of the random-effect model of continuous variables demonstrated significant differences between the probiotic and control groups [MD = −4.24, 95% CI (−7.78, −0.71), <i>p</i> = 0.002, <i>I</i>² = 71%]. Subgroup analysis of continuous variables showed that the effects of children's age, treatment duration and probiotic species on the SCORAD value were not statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Evidence on the improvement effect of probiotics on pediatric patients with AD is limited. This study showed that single-strain probiotic treatment exerts a positive effect on AD. Restricted to the quantity and quality of incorporated studies, these conclusions have yet to be validated by high-quality studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12283","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10232960","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":"Genetic differences according to onset age and lung function in asthma: A cluster analysis","authors":"Han-Kyul Kim,&nbsp;Ji-One Kang,&nbsp;Ji Eun Lim,&nbsp;Tae-Woong Ha,&nbsp;Hae Un Jung,&nbsp;Won Jun Lee,&nbsp;Dong Jun Kim,&nbsp;Eun Ju Baek,&nbsp;Ian M. Adcock,&nbsp;Kian Fan Chung,&nbsp;Tae-Bum Kim,&nbsp;Bermseok Oh","doi":"10.1002/clt2.12282","DOIUrl":"10.1002/clt2.12282","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The extent of differences between genetic risks associated with various asthma subtypes is still unknown. To better understand the heterogeneity of asthma, we employed an unsupervised method to identify genetic variants specifically associated with asthma subtypes. Our goal was to gain insight into the genetic basis of asthma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this study, we utilized the UK Biobank dataset to select asthma patients (All asthma, <i>n</i> = 50,517) and controls (<i>n</i> = 283,410). We excluded 14,431 individuals who had no information on predicted values of forced expiratory volume in one second percent (FEV1%) and onset age, resulting in a final total of 36,086 asthma cases. We conducted k-means clustering based on asthma onset age and predicted FEV1% using these samples (<i>n</i> = 36,086). Cluster-specific genome-wide association studies were then performed, and heritability was estimated via linkage disequilibrium score regression. To further investigate the pathophysiology, we conducted eQTL analysis with GTEx and gene-set enrichment analysis with FUMA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Clustering resulted in four distinct clusters: early onset asthma^normalLF (early onset with normal lung function, <i>n</i> = 8172), early onset asthma^reducedLF (early onset with reduced lung function, <i>n</i> = 8925), late-onset asthma^normalLF (late-onset with normal lung function, <i>n</i> = 12,481), and late-onset asthma^reducedLF (late-onset with reduced lung function, <i>n</i> = 6508). Our GWASs in four clusters and in All asthma sample identified 5 novel loci, 14 novel signals, and 51 cluster-specific signals. Among clusters, early onset asthma^normalLF and late-onset asthma^reducedLF were the least correlated (<i>r</i>_<i>g</i> = 0.37). Early onset asthma^reducedLF showed the highest heritability explained by common variants (<i>h</i>^<i>2</i> = 0.212) and was associated with the largest number of variants (71 single nucleotide polymorphisms). Further, the pathway analysis conducted through eQTL and gene-set enrichment analysis showed that the worsening of symptoms in early onset asthma correlated with lymphocyte activation, pathogen recognition, cytokine receptor activation, and lymphocyte differentiation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest that early onset asthma^reducedLF was the most genetically predisposed cluster, and that asthma ","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12282","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10232963","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}