Journal of Asthma and Allergy最新文献

{"title":"IL-Mediated Macrophage Polarization Axis: From Inflammatory Positive Feedback Loop to Precision Biomarkers and Therapeutic Targets for Allergic Rhinitis-A Narrative Review.","authors":"Wanying Peng, Liangzhen Xie, Yuanchun Liu, Yan Li","doi":"10.2147/JAA.S631200","DOIUrl":"https://doi.org/10.2147/JAA.S631200","url":null,"abstract":"<p><p>This narrative review comprehensively elaborates the complicated interleukin (IL)-macrophage polarization axis as the core pathogenesis of allergic rhinitis (AR), focusing on layered molecular regulatory mechanisms covering inflammatory signaling, metabolic reprogramming and epigenetic modulation. Pro-inflammatory IL-1β, IL-6, IL-17 and TNF-α bind to TLR receptors to activate NF-κB, NLRP3 inflammasome and PI3K/Akt cascades, triggering M1 macrophage overactivation and acute nasal congestion, rhinorrhea via robust inflammatory mediator release. By contrast, anti-inflammatory IL-4 and IL-10 predominantly activate STAT6 signaling to drive abnormal M2 macrophage accumulation, sustaining persistent type 2 inflammation and irreversible nasal tissue remodeling; notably, IL-17 presents concentration-dependent bidirectional regulation on macrophage phenotypes. Metabolic reprogramming featured with glycolysis-oxidative phosphorylation switch, together with DNA methylation, histone modification and non-cRNA-mediated epigenetic regulation, serve as vital downstream executors linking IL signals to macrophage polarization imbalance. Conventional glucocorticoids, antihistamines and monoclonal antibodies including omalizumab and dupilumab (targeting IL-4Rα) exert therapeutic efficacy via intervening this axis, while multiple natural herbal constituents and classic TCM formulas also modulate relevant inflammatory pathways to alleviate AR symptoms. For translational application, the CD206/CD86 macrophage polarization ratio is highlighted as a representative candidate biomarker for disease severity assessment. Collectively, this review integrates multi-layered regulatory evidence and lays theoretical support for developing novel precision-targeted anti-allergic therapies.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"631200"},"PeriodicalIF":3.3,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of IL-5 Pathway Inhibition on Circulating Eosinophil- and Remodeling-Related Biomarkers in Severe Eosinophilic Asthma.","authors":"Piotr Damiański, Anna Kumor-Kisielewska, Adam J Białas, Piotr Kuna, Maciej Kupczyk","doi":"10.2147/JAA.S619744","DOIUrl":"https://doi.org/10.2147/JAA.S619744","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the effects of IL-5 pathway inhibition with mepolizumab or benralizumab on circulating eosinophil-related and selected remodeling-associated biomarkers in severe eosinophilic asthma (SEA), and to determine whether these profiles differ according to four-component study-defined early clinical remission (ECR) status.</p><p><strong>Patients and methods: </strong>This prospective, observational, single-center cohort study included 30 adults with SEA treated with mepolizumab or benralizumab. Clinical assessment, spirometry, and blood sampling were performed at baseline and after 6 months. The primary endpoint was change in circulating biomarker concentrations; secondary endpoints included clinical improvement and ECR rate.</p><p><strong>Results: </strong>IL-5 pathway inhibition improved asthma control and lung function, with OCS-treated exacerbations occurring in 4 of 30 patients during follow-up. These changes were accompanied by marked reductions in eosinophil-related biomarkers, with median decreases of 95.3% in blood eosinophils, 79.5% in eosinophil-derived neurotoxin, and 32.9% in galectin-10, respectively; false discovery rate (FDR)-adjusted p≤0.003. Significant but smaller decreases were observed in MMP-10, TGF-β1, and TGF-β2, with median reductions of 5.0%, 21.2%, and 10.9%, respectively; FDR-adjusted p≤0.002. No significant group-level changes were observed for eotaxin-1, MMP-9, TIMP-1, fibulin-1, tenascin-C, or periostin. ECR was achieved in 16 of 30 patients (53.3%). Compared with non-ECR patients, those achieving ECR had lower baseline OCS burden and fewer relevant comorbidities, whereas neither baseline biomarker concentrations nor 6-month biomarker changes differed significantly between groups. Exploratory comparisons did not show consistent differences in clinical outcomes or biomarker changes between mepolizumab and benralizumab.</p><p><strong>Conclusion: </strong>IL-5 pathway inhibition in SEA was associated with marked suppression of eosinophil-related biomarkers, more selective changes in remodeling-associated mediators, and meaningful clinical benefit after 6 months. Similar biomarker responses in patients with and without ECR should be interpreted cautiously, but suggest that incomplete clinical response may reflect broader disease burden, particularly comorbidities, rather than insufficient suppression of eosinophilic inflammation alone.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"619744"},"PeriodicalIF":3.3,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Easier Biologic Access with Remission and Other Clinical Outcomes in Severe Asthma: A Global Real-World Study.","authors":"Susanne Hansen, Ming-Ju Tsai, Trung N Tran, John D Blakey, Benjamin Emmanuel, Shawn D Aaron, Yahya Habis, Valeria Perugini, Alan Altraja, Rohit K Katial, Luis Perez-de-Llano, Paul E Pfeffer, Nikolaos G Papadopoulos, John Townend, Ghislaine Scelo, Aaron Beastall, Lakmini Bulathsinhala, John Busby, Andrew W Lindsley, Wendy C Moore, Reynold A Panettieri, Giorgio Walter Canonica, Enrico Heffler, Cristina Cardini, Giuseppe Guida, Celeste M Porsbjerg, Anne-Sofie Bjerrum, Anna Von Bülow, Ole Hilberg, Kjell Erik Julius Håkansson, Marianne Baastrup Soendergaard, Charlotte Suppli Ulrik, Eileen Wang, Michael E Wechsler, Nicholas Chapman, Flavia C L Hoyte, Kanao Otsu, Liam G Heaney, David J Jackson, Pujan H Patel, Dermot Ryan, Celine Bergeron, Shelley Abercromby, Mohit Bhutani, Kenneth R Chapman, Andréanne Côté, Beth E Davis, Delbert R Dorscheid, Leiana Hoshyari, Brianne Philipenko, Hana Serajeddini, Florence Schleich, Renaud Louis, Piotr Kuna, Borja G Cosio, Désirée Larenas-Linnemann, Carlos A Torres-Duque, María José Fernández-Sánchez, Elizabeth Garcia, Fabio Bolívar-Grimaldos, Libardo Jiménez-Maldonado, Diana Jimena Cano-Rosales, Ivan Solarte, Riyad Al-Lehebi, Adeeb A Bulkhi, Mona Al-Ahmad, Takashi Iwanaga, Soichiro Hozawa, Hisako Matsumoto, Tatsuya Nagano, Tomoko Tajiri, Bernt Bøgvald Aarli, Diahn-Warng Perng, Yi-Han Hsiao, Pin-Kuei Fu, Chau-Chyun Sheu, Konstantinos Kostikas, Mina Gaga, Athena Gogali, Maria Kallieri, Stelios Loukides, Michael Makris, Maria Dimosthenis Ntakoula, Andriana I Papaioannou, Giannis Paraskevopoulos, Fotios Psarros, Bassam Mahboub, Laila Salameh, Mariko Siyue Koh, Mei Fong Liew, Pee Hwee Pang, Tze Lee Tan, Tunn Ren Tay, Paulo Márcio Pitrez, Chin Kook Rhee, Njira Lugogo, Arjun Mohan, João A Fonseca, Ana Alves da Silva, Cláudia Chaves Loureiro, Hadassa Cristhina de Azevedo Soares Dos Santos, Jorge Fernando Máspero, Ledit R F Ardusso, María Eugenia Franchi, Martin Sivori, Ana María Stok, Anahí Yañez, George Christoff, Todor A Popov, Patrick D Mitchell, Sundeep Santosh Salvi, Richard W Costello, Eve Denton, Mark Hew, Christine R Jenkins, David Langton, Peter G Middleton, Matthew J Peters, Lauri Lehtimäki, Arnaud Bourdin, Camille Taillé, Christian Taube, Zsuzsanna Csoma, Dóra Lúdvíksdóttir, Job F M van Boven, James Fingleton, Leif Bjermer, Helena Emery, Graham Lough, Roy Alton Pleasants, Diego J Maselli, Christopher S Ambrose, Cathy Emmas, Andrew N Menzies-Gow, Victoria Carter, Nevaashni Eleangovan, Ruth B Murray, Chris A Price, Mohsen Sadatsafavi, David B Price","doi":"10.2147/JAA.S597657","DOIUrl":"10.2147/JAA.S597657","url":null,"abstract":"<p><strong>Purpose: </strong>Time to biologic initiation for the treatment of severe asthma (SA) is affected by many factors, including ease of access to biologics, which is often subject to approval by regulatory authorities and reimbursement criteria by relevant agencies. We investigated the association between ease of biologic access (using the biologic accessibility score [BACS] as a proxy) and post-biologic asthma outcomes, including remission.</p><p><strong>Methods: </strong>This ecological study, using data from CHRONICLE (a US severe asthma registry), the International Severe Asthma Registry (ISAR), and the Optimum Patient Care Research Database (OPCRD), included patients with SA from 21 countries. Associations at the country level, between BACS, a composite score of prescription criteria for biologics in SA, and the proportion of patients with a favorable asthma outcome 1-year post-biologic in each setting (ie ISAR country or in the CHRONICLE or OPCRD datasets) were tested. Several definitions of favorable outcome were used, including proportion of patients who achieved clinical remission (defined using 2, 3 and 4 domains), experienced no exacerbations, had well- or partly controlled asthma, a percent predicted forced expiratory volume in 1 second (ppFEV₁) or percent predicted peak expiratory flow rate (ppPEFR) ≥80%, and no long-term oral corticosteroid (LTOCS) use.</p><p><strong>Results: </strong>A total of 9,183 patients were included. A higher BACS (as a proxy of easier access to biologics) was associated with a higher likelihood of achieving clinical remission (p≤0.001), no exacerbations (p<0.001), well- or partly controlled asthma (p=0.047), a ppFEV₁ or ppPEFR ≥80% (p=0.004), and no need for LTOCS (p=0.045) 1 year post-biologic initiation.</p><p><strong>Conclusion: </strong>Easier access to biologics for patients with SA, a prerequisite for shorter time-to-initiation, was associated with a greater probability of achieving clinical remission and other favorable asthma outcomes. Initiating biologics earlier in the asthma disease course may help unlock greater therapeutic potential in SA. These findings warrant confirmation in additional studies to further establish the causal relationship between biologic accessibility, timing of initiation, and clinical outcomes in SA.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"597657"},"PeriodicalIF":3.3,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating TFH2 Cell Expansion and GZMK⁺ TFH1 Cells are Associated with Allergic Rhinitis.","authors":"Jiejun He, Yueqi Sun, Yang Chen, Yinyan Lai, Han Lei, Jianbo Shi, Wenxiang Gao","doi":"10.2147/JAA.S614763","DOIUrl":"10.2147/JAA.S614763","url":null,"abstract":"<p><strong>Background: </strong>Allergic rhinitis (AR) is a prevalent condition characterized by an immunoglobulin E (IgE)-mediated immune response. T follicular helper (TFH) cells regulate B-cell differentiation and antibody production, and circulating TFH2 cells are closely associated with type 2 humoral immunity and IgE-related responses in AR. However, whether AR is marked by isolated TFH2 expansion or broader remodeling of circulating TFH (cTFH) subsets, including TFH1-related heterogeneity, remains unclear.</p><p><strong>Methods: </strong>A total of 56 participants were enrolled, including 39 patients with AR and 17 healthy controls (HC). Flow cytometry was performed in 36 patients with AR and 14 HC to quantify cTFH subsets and activation states. Single-cell RNA sequencing (scRNA-seq) was conducted in an independent exploratory cohort comprising 3 patients with AR and 3 HC to characterize TFH transcriptional heterogeneity, based on canonical transcriptional programs.</p><p><strong>Results: </strong>Flow cytometry demonstrated that cTFH2 cell frequencies were significantly increased in patients with AR and positively correlated with disease severity. Activated CCR7^low PD-1^high cTFH cells were also elevated, indicating enhanced TFH activation. Further scRNA-seq analysis identified six transcriptionally distinct TFH clusters, with TFH2-like transcriptional signatures enriched in patients with AR, consistent with flow cytometric findings. Notably, a GZMK⁺ TFH1 subset, enriched in cytotoxic genes, including GZMK, CCL5, and GZMA, was more abundant in patients with AR, a result corroborated by flow cytometry.</p><p><strong>Conclusion: </strong>This study demonstrates the expansion of cTFH2 and GZMK⁺ TFH1 subsets in patients with AR and highlights the phenotypic and transcriptional heterogeneity of cTFH cells. These findings suggest that peripheral TFH profiling may aid in characterizing systemic immune alterations in allergic inflammation. The scRNA-seq results should be interpreted as exploratory due to the limited sample size.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"614763"},"PeriodicalIF":3.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Functional Variant of <i>CYP4V2</i> Contributes to Asthma Susceptibility Through Methylation-Mediated Regulation of the Arachidonic Acid Pathway.","authors":"Xiangran Chen, Terence Yin Weng Lam, Yang Yie Sio, Yee-How Say, Kavita Reginald, Fook Tim Chew","doi":"10.2147/JAA.S598881","DOIUrl":"10.2147/JAA.S598881","url":null,"abstract":"<p><strong>Background: </strong><i>CYP4V2</i> is involved in lipid metabolism, but its contribution to asthma is poorly understood. This study aimed to investigate genetic polymorphisms and regulatory features of <i>CYP4V2</i> in asthma development.</p><p><strong>Methods: </strong>We performed an integrative multi-omics analysis combining transcriptomic, genetic, and epigenetic data from peripheral blood mononuclear cells (PBMCs) of individuals in the Singapore/Malaysia Cross-Sectional Genetics and Epidemiological Study (SMCSGES) cohort. The influence of <i>CYP4V2</i> expression on asthma risk and expression of genes involved in arachidonic acid (AA) pathway were evaluated, followed by expression quantitative trait locus (eQTL) analysis to identify regulatory variants. DNA methylation analyses were conducted to assess epigenetic regulation of <i>CYP4V2</i>, and promoter reporter assays were used to functionally validate candidate regulatory CpG sites.</p><p><strong>Results: </strong>The upregulation of <i>CYP4V2</i> in PBMCs was associated with an increased risk of asthma and inversely associated with <i>PTGER2</i> and <i>ALOX5AP</i> in the AA pathway. The SNP rs2276921 was identified as the only expression quantitative trait locus (eQTL) associated with both increased <i>CYP4V2</i> expression and asthma risk (FDR-adjusted <i>p</i> < 0.05; OR = 1.24, 95% CI = 1.10-1.40). The minor allele G of rs2276921 was associated with low methylation at cg23232844 (<i>p</i> = 3.94 × 10^-3) and cg11969330 (<i>p</i> = 4.25 × 10^-2), located in the promoters of the protein-coding and non-coding <i>CYP4V2</i> isoforms respectively. Promoter assays indicated that these two CpG sites inhibited <i>CYP4V2</i> expression, supporting the regulatory effect of rs2276921 on <i>CYP4V2</i> expression may be mediated through methylation.</p><p><strong>Conclusion: </strong>This study identified rs2276921 and CpG sites cg23232844 and cg11969330 that regulate <i>CYP4V2</i> expression. <i>CYP4V2</i> potentially modulates the AA metabolism and contributes to asthma susceptibility. These findings suggest <i>CYP4V2</i> as a potential biomarker and therapeutic target in asthma.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"598881"},"PeriodicalIF":3.3,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13426356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-Like Peptide-1 Receptor Agonists vs Dipeptidyl Peptidase-4 Inhibitor Use on Risk of Asthma Exacerbation Among Diabetic Patients with Co-Morbid Asthma in Hong Kong.","authors":"Wang Chun Kwok, Lu Zhou, Ting Fung Ma, Raymond Yau Hang Leung, Terence Chi Chun Tam, James C M Ho","doi":"10.2147/JAA.S622748","DOIUrl":"10.2147/JAA.S622748","url":null,"abstract":"<p><strong>Background: </strong>Co-existing asthma and diabetes mellitus (DM) are common, and there has been a debate on whether glucagon-like peptide-1 (GLP-1)-based therapies, such as GLP-1 receptor agonists (GLP-1RA) and inhibitors of dipeptidyl peptidase-4 (DPP-4i), confer benefits in these patients due to their anti-inflammatory effects in chronic inflammatory diseases.</p><p><strong>Methods: </strong>A territory-wide retrospective cohort study was conducted in Hong Kong among adult patients with co-existing asthma and DM to examine the impact of add-on GLP-1RA or DPP-4i on asthma exacerbations, ranging from mild exacerbations managed in outpatient settings to severe exacerbations requiring hospitalization. Adult patients were prescribed DPP-4i or GLP-1RA in year 2018 and for at least 6 months in Hospital Authority of Hong Kong were included. These patients were followed till 31st December 31, 2023. Propensity score matching was performed using optimal full matching, which is a sub-classification-based approach in which treated and control subjects are assigned to matched subclasses.</p><p><strong>Results: </strong>A total of 3295 patients with both asthma and DM, 3193 treated with DPP-4i and 102 treated with GLP-1RA, were included in the study. There were 1191 (36.1%) male patients with a mean age of 68.0 ± 14.2 years. There were 2531 (76.8%) patients with moderate-to-severe asthma according to Global Initiative for Asthma (GINA) Steps 3 to 5. GLP-1RA-treated patients had significantly lower risks of hospitalized asthma exacerbation (Average Treatment Effect on the Treated (ATT) Mean Ratio of 0.513, p < 0.001), ad hoc outpatient visits with OCS (ATT Mean Ratio of 0.343, p = 0.005), emergency visits (ATT Mean Ratio of 0.378, p = 0.009), and all asthma exacerbations (ATT Mean Ratio of 0.419, p < 0.001) compared with the DPP-4i group.</p><p><strong>Conclusion: </strong>GLP-1RA, compared with DPP-4i, as an add-on treatment for patients with co-existing DM and asthma was associated with a lower risk of asthma exacerbation. The use of GLP-1RA among diabetic patients with comorbid asthma may be considered though validation in clinical trials is needed.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"622748"},"PeriodicalIF":3.3,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration of the Potential Mechanisms of Yinqiao Powder in Treating Atopic Dermatitis: Integrating Network Pharmacology, Single-Cell, and Bulk RNA Sequencing.","authors":"Lila Luo","doi":"10.2147/JAA.S592593","DOIUrl":"10.2147/JAA.S592593","url":null,"abstract":"<p><strong>Purpose: </strong>Yinqiao powder (YQP) is a traditional Chinese medicine formula that has been widely used clinically to treat infectious diseases such as respiratory tract infections, influenza, and pneumonia, exhibiting anti-inflammatory and antiviral properties. This study aimed to investigate its therapeutic potential for atopic dermatitis (AD) and to identify its key target genes and active components.</p><p><strong>Methods: </strong>We performed mRNA transcriptome sequencing on blood samples collected from 15 adult patients with AD and 15 adult healthy controls. Potential targets were identified by intersecting differentially expressed genes (DEGs) with known YQP target genes. Key genes were pinpointed using protein-protein interaction networks and receiver operating characteristic (ROC) curve analysis. We estimated immune cell proportions, constructed regulatory networks, and used molecular docking to predict active ingredients. Single-cell RNA sequencing data (GSE180885) was also analyzed to identify key cell types and track gene expression.</p><p><strong>Results: </strong>Fifty-two potential target genes were identified. From these, four key genes-CTNNB1, ERBB2, TP53, and HIF1A-were highlighted, potentially involved in carbon metabolism and organelle biosynthesis. A nomogram model based on these genes showed strong predictive power for AD. Immune analysis linked resting CD4+ memory T cells with TP53 and HIF1A. Molecular docking suggested beta-carotene, aloe-emodin, and quercetin as potential active ingredients binding to these key targets. Single-cell analysis identified keratinocytes as a key population, with key gene expression varying during their differentiation.</p><p><strong>Conclusion: </strong>This study indicates that CTNNB1, ERBB2, TP53, and HIF1A are key targets of YQP in AD treatment, with beta-carotene, aloe-emodin, and quercetin as likely active components. These findings provide a theoretical basis for using YQP in AD therapy.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"592593"},"PeriodicalIF":3.3,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asthma with Preserved Ratio Impaired Spirometry: A Distinct Phenotype Associated with Increased Exacerbation Burden.","authors":"Yoshihito Arimoto, Natsue Honda, Kosuke Haruki, Yasuo To, Masako To","doi":"10.2147/JAA.S618426","DOIUrl":"10.2147/JAA.S618426","url":null,"abstract":"<p><strong>Purpose: </strong>Asthma is a heterogeneous disease, and identifying phenotypes associated with an increased exacerbation burden is clinically important. Preserved ratio impaired spirometry (PRISm) has been linked to adverse health outcomes; however, its clinical impact on asthma remains incompletely defined. The aim of this study was to determine whether asthma with PRISm represents a distinct clinical phenotype characterised by an increased exacerbation burden.</p><p><strong>Patients and methods: </strong>We retrospectively analysed data from 1,411 adult patients with asthma. The patients were categorised into three groups according to %FEV₁ and FEV₁/FVC: control (n=1102), PRISm (n=133), and airflow obstruction groups (n=176). Clinical characteristics and asthma exacerbation profiles were compared among the groups.</p><p><strong>Results: </strong>Age, sex, smoking status, and body mas index (BMI) significantly differed among the groups. The PRISm group had a significantly higher frequency of severe acute exacerbations than the control group, whereas no significant difference was observed between the PRISm and airflow obstruction groups. Severe asthma was more frequent in the PRISm group than in the control group, but its frequency was comparable between the PRISm and airflow obstruction groups. In multinomial logistic regression analysis, relative to the control group, the PRISm group was characterised by higher BMI (1.08 (1.03-1.13), adjusted odds ratio (95% confidence interval)), longer asthma duration (1.02 (1.00-1.03)), and higher severe acute exacerbation (2.31 (1.46-3.64)). Relative to the airflow obstruction group, the PRISm group was characterised by higher BMI (1.15 (1.07-1.24)) and shorter asthma duration (0.97 (0.96-0.99)), while the frequency of severe acute exacerbations (1.39 (0.78-2.48)) did not differ significantly between them.</p><p><strong>Conclusion: </strong>Asthma with PRISm may represent a distinct and clinically relevant phenotype associated with a substantial exacerbation burden. Its clinical importance lies not merely in its spirometric profile, but in the identification of a subgroup of patients who may require closer surveillance and earlier optimisation of management.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"618426"},"PeriodicalIF":3.3,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Patterns of Allergen Sensitization in Southern China: A Retrospective Analysis of 18,777 Routine Checkup Participants in Shenzhen.","authors":"Linlin Xu, Changmeng Wu, Juan He, Wenhan Du, Yu Li","doi":"10.2147/JAA.S610904","DOIUrl":"10.2147/JAA.S610904","url":null,"abstract":"<p><strong>Purpose: </strong>The distribution of allergens exhibits significant geographic variation. Local epidemiological studies are essential for understanding allergic sensitization patterns, which may inform regional epidemiological reference. This study aimed to investigate the sensitization patterns among a routinely screened population in Shenzhen, a coastal metropolis in southeastern China.</p><p><strong>Patients and methods: </strong>A total of 18,777 participants undergoing routine health examinations were included. Serum-specific IgE (sIgE) levels against 19 allergens (10 inhalant and 9 food allergens) were measured using an immunoblot assay. The prevalence of sensitization was analyzed across gender, age groups, and seasons.</p><p><strong>Results: </strong>Among 18,777 participants, overall sIgE positivity was 24.4%. Inhalant allergens (21.7%) were more common than food allergens (6.7%). House dust mite (17.7%), crab (3.5%), cat dander (2.9%) and cockroach (2.7%) were the most prevalent. An 12-allergen panel was able to detected 99% of sensitized individuals in this population. Males showed significantly higher sensitization rates than females (<i>P</i> < 0.05). Inhalant sensitization decreased with age, whereas food sensitization remained relatively stable Seasonal variations were significant for tree, common ragweed, mutton, and house dust (all <i>P</i> < 0.05). Poly-sensitization was observed in 32.5% of sensitized individuals. Strong positive correlations formed four distinct allergen modules.</p><p><strong>Conclusion: </strong>House dust mite, crab, and cat dander are major allergens in Shenzhen. Sensitization patterns vary significantly by gender, age, and season. Seafood sensitization is more common in younger adults, while peanut sensitization increases in older adults.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"610904"},"PeriodicalIF":3.3,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Overweight and Obesity in Severe Asthma Patients and Its Influence on Achieving Clinical Remission.","authors":"Mona Al-Ahmad, Asmaa Ali, Wafaa Talat","doi":"10.2147/JAA.S613179","DOIUrl":"10.2147/JAA.S613179","url":null,"abstract":"<p><strong>Background and objectives: </strong>Obesity exacerbates asthma, resulting in more severe symptoms, poor disease control, and a reduced quality of life. With the increasing use of biologic therapies, achieving clinical remission (CR) has become an important treatment goal. This study evaluated the prevalence and impact of obesity on biologic response and CR in severe asthma patients.</p><p><strong>Methods: </strong>This prospective observational study included 525 patients enrolled in the Kuwait Severe Asthma Registry (KSAR). This prospective observational study included 525 patients enrolled in the Kuwait Severe Asthma Registry (KSAR). Patients were categorized according to body mass index (BMI) into normal weight, overweight, mild-to-moderate obesity, and morbid obesity groups. Demographic, clinical, and biomarker data, including blood eosinophil count (BEC), total immunoglobulin E (IgE), fractional exhaled nitric oxide (FeNO), and IL4 and IL6 gene polymorphisms, were collected. Patients treated with biologics for at least 12 months were followed. CR was defined as absence of exacerbations, no oral corticosteroid (OCS) use, Asthma Control Test (ACT) score ≥20, Asthma Control Questionnaire (ACQ-6) score ≤0.75, and predicted forced expiratory volume in one second (FEV1) ≥80%.</p><p><strong>Results: </strong>Overweight and obesity were highly prevalent, with only 15.4% of patients having normal weight. Morbidly obese patients were older, had longer disease duration, worse asthma control, lower lung function, and higher rates of diabetes and allergic rhinitis. Biologic therapy significantly improved ACT, ACQ-6, exacerbation frequency, OCS use, and lung function across all BMI groups (p<0.001). However, morbidly obese patients continued to demonstrate poorer asthma control, lower FEV1 and FVC, and higher exacerbation and OCS rates. No significant changes were observed in BEC, total IgE, or FeNO. CR was achieved in 17.3% of patients overall, with higher rates in normal-weight individuals (25%) and lower rates in morbid obesity (11%). Younger age and the IL4 CC genotype were associated with greater likelihood of CR.</p><p><strong>Conclusion: </strong>Obesity was highly prevalent among severe asthma patients and was associated with poorer disease outcomes and lower CR rates despite biologic therapy. These findings highlight the importance of weight management and personalized treatment strategies in severe asthma.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"613179"},"PeriodicalIF":3.3,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13381607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}