{"title":"Gut microbiota and fecal metabolites in sustained unresponsiveness by oral immunotherapy in school-age children with cow's milk allergy","authors":"Ryohei Shibata , Naoka Itoh , Yumiko Nakanishi , Tamotsu Kato , Wataru Suda , Mizuho Nagao , J-OIT group , Tsutomu Iwata , Hideo Yoshida , Masahira Hattori , Takao Fujisawa , Naoki Shimojo , Hiroshi Ohno","doi":"10.1016/j.alit.2023.10.001","DOIUrl":"10.1016/j.alit.2023.10.001","url":null,"abstract":"<div><h3>Background</h3><p>Oral immunotherapy (OIT) can ameliorate cow's milk allergy (CMA); however, the achievement of sustained unresponsiveness (SU) is challenging. Regarding the pathogenesis of CMA, recent studies have shown the importance of gut microbiota (Mb) and fecal water-soluble metabolites (WSMs), which prompted us to determine the change in clinical and gut environmental factors important for acquiring SU after OIT for CMA.</p></div><div><h3>Methods</h3><p>We conducted an ancillary cohort study of a multicenter randomized, parallel-group, delayed-start design study on 32 school-age children with IgE-mediated CMA who underwent OIT for 13 months. We defined SU as the ability to consume cow's milk exceeding the target dose in a double-blind placebo-controlled food challenge after OIT followed by a 2-week-avoidance. We longitudinally collected 175 fecal specimens and clustered the microbiome and metabolome data into 29 Mb- and 12 WSM-modules.</p></div><div><h3>Results</h3><p>During OIT, immunological factors improved in all participants. However, of the 32 participants, 4 withdrew because of adverse events, and only 7 were judged SU. Gut environmental factors shifted during OIT, but only in the beginning, and returned to the baseline at the end. Of these factors, milk- and casein-specific IgE and the <em>Bifidobacterium</em>-dominant module were associated with SU (milk- and casein-specific IgE; OR for 10 kU<sub>A</sub>/L increments, 0.67 and 0.66; 95%CI, 0.41–0.93 and 0.42–0.90; <em>Bifidobacterium</em>-dominant module; OR for 0.01 increments, 1.40; 95%CI, 1.10–2.03), and these associations were observed until the end of OIT.</p></div><div><h3>Conclusions</h3><p>In this study, we identified the clinical and gut environmental factors associated with SU acquisition in CM-OIT.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 1","pages":"Pages 126-136"},"PeriodicalIF":6.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893023001053/pdfft?md5=356eee74a5c3380b1d6cecd2fb3bc1ae&pid=1-s2.0-S1323893023001053-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135221120","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}
Quang Luu Quoc , Thi Bich Tra Cao , Ji-Young Moon , Jae-Hyuk Jang , Yoo Seob Shin , Youngwoo Choi , Min Sook Ryu , Hae-Sim Park
{"title":"Contribution of monocyte and macrophage extracellular traps to neutrophilic airway inflammation in severe asthma","authors":"Quang Luu Quoc , Thi Bich Tra Cao , Ji-Young Moon , Jae-Hyuk Jang , Yoo Seob Shin , Youngwoo Choi , Min Sook Ryu , Hae-Sim Park","doi":"10.1016/j.alit.2023.06.004","DOIUrl":"10.1016/j.alit.2023.06.004","url":null,"abstract":"<div><h3>Background</h3><p>Increased blood/sputum neutrophil counts are related to poor clinical outcomes of severe asthma (SA), where we hypothesized that classical monocytes (CMs)/CM-derived macrophages (Mφ) are involved. We aimed to elucidate the mechanisms of how CMs/Mφ induce the activation of neutrophils/innate lymphoid cells (ILCs) in SA.</p></div><div><h3>Methods</h3><p>Serum levels of monocyte chemoattractant protein-1 (MCP-1) and soluble suppression of tumorigenicity 2 (sST2) were measured from 39 patients with SA and 98 those with nonsevere asthma (NSA). CMs/Mφ were isolated from patients with SA (n = 19) and those with NSA (n = 18) and treated with LPS/interferon-gamma. Monocyte/M1Mφ extracellular traps (MoETs/M1ETs) were evaluated by western blotting, immunofluorescence, and PicoGreen assay. The effects of MoETs/M1ETs on neutrophils, airway epithelial cells (AECs), ILC1, and ILC3 were assessed <em>in vitro</em> and <em>in vivo</em>.</p></div><div><h3>Results</h3><p>The SA group had significantly higher CM counts with increased migration as well as higher levels of serum MCP-1/sST2 than the NSA group. Moreover, the SA group had significantly greater production of MoETs/M1ETs (from CMs/M1Mφ) than the NSA group. The levels of MoETs/M1ETs were positively correlated with blood neutrophils and serum levels of MCP-1/sST2, but negatively correlated with FEV<sub>1</sub>%. <em>In vitro</em>/<em>in vivo</em> studies demonstrated that MoETs/M1ETs could activate AECs, neutrophils, ILC1, and ILC3 by increased migration as well as proinflammatory cytokine production.</p></div><div><h3>Conclusions</h3><p>CM/Mφ-derived MoETs/M1ETs could contribute to asthma severity by enhancing neutrophilic airway inflammation in SA, where modulating CMs/Mφ may be a potential therapeutic option.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 1","pages":"Pages 81-93"},"PeriodicalIF":6.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893023000680/pdfft?md5=5c5a9461356e2db012f589b18c7e4f88&pid=1-s2.0-S1323893023000680-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9692340","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":"A detailed intake-status profiling of seafoods in adult food–protein–induced enterocolitis syndrome patients","authors":"Sho Watanabe , Ayako Sato , Misugi Uga , Naoki Matsukawa , Rina Kusuda , Hiroko Suzuki , Saori Nagashima , Tsunehito Yauchi , Yukihiro Ohya , Ichiro Nomura","doi":"10.1016/j.alit.2023.12.003","DOIUrl":"10.1016/j.alit.2023.12.003","url":null,"abstract":"<div><h3>Background</h3><p>Adults with food-protein-induced enterocolitis syndrome (FPIES) often develop severe abdominal symptoms after eating seafood. However, no investigation of a food elimination strategy for adult FPIES patients has been performed to date.</p></div><div><h3>Methods</h3><p>We conducted a retrospective cohort study of seafood–avoidant adults by telephone interview, based on the diagnostic criteria for adult FPIES reported by González <em>et al.</em> We compared the clinical profiles, abdominal symptoms, and causative seafoods between FPIES and immediate-type food allergy (IgE-mediated FA) patients. We also profiled the detailed intake-status of seafoods in adult FPIES patients.</p></div><div><h3>Results</h3><p>Twenty-two (18.8 %) of 117 adults with seafood-allergy were diagnosed with FPIES. Compared with the IgE-mediated FA patients, FPIES patients had an older age of onset, more pre-existing gastrointestinal and atopic diseases, more episodes, longer latency and duration of symptoms, more nausea, abdominal distention, and severe abdominal pain, and more frequent vomiting and diarrhea. In particular, abdominal distention—reflecting intestinal edema and luminal fluid retention—may be the most distinctive characteristic symptom in adult FPIES (<em>p</em> < 0.001). Bivalves, especially oysters, were the most common cause of FPIES. Strikingly, intake-status profiling revealed that many FPIES patients can safely ingest an average of 92.6 % of seafood species other than the causative species.</p></div><div><h3>Conclusions</h3><p>There are many differentiators between FPIES and IgE-mediated FA, which may reflect differences in the underlying immunological mechanisms. Although seafood FPIES is unlikely to induce tolerance, many patients can ingest a wide variety of seafood species after a long period from onset.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 2","pages":"Pages 275-281"},"PeriodicalIF":6.8,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893023001235/pdfft?md5=edc1192622ab8f0cf295a66f4bf3f992&pid=1-s2.0-S1323893023001235-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049538","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":"Thymic stromal lymphopoietin contributes to ozone-induced exacerbations of eosinophilic airway inflammation via granulocyte colony-stimulating factor in mice","authors":"Yuki Kurihara , Hiroki Tashiro , Yoshie Konomi , Hironori Sadamatsu , Satoshi Ihara , Ayako Takamori , Shinya Kimura , Naoko Sueoka-Aragane , Koichiro Takahashi","doi":"10.1016/j.alit.2023.12.002","DOIUrl":"10.1016/j.alit.2023.12.002","url":null,"abstract":"<div><h3>Background</h3><p>Ozone is one of the triggers of asthma, but its impact on the pathophysiology of asthma, such as via airway inflammation and airway hyperresponsiveness (AHR), is not fully understood. Thymic stromal lymphopoietin (TSLP) is increasingly seen as a crucial molecule associated with asthma severity, such as corticosteroid resistance.</p></div><div><h3>Methods</h3><p>Female BALB/c mice sensitized and challenged with house dust mite (HDM) were exposed to ozone at 2 ppm for 3 h. Airway inflammation was assessed by the presence of inflammatory cells in bronchoalveolar lavage fluid and concentrations of cytokines including TSLP in lung. Anti-TSLP antibody was administered to mice to block the signal. Survival and adhesion of bone marrow-derived eosinophils in response to granulocyte colony-stimulating factor (G-CSF) were evaluated.</p></div><div><h3>Results</h3><p>Ozone exposure increased eosinophilic airway inflammation and AHR in mice sensitized and challenged with HDM. In addition, TSLP, but not IL-33 and IL-25, was increased in lung by ozone exposure. To confirm whether TSLP signaling is associated with airway responses to ozone, an anti-TSLP antibody was administered, and it significantly attenuated eosinophilic airway inflammation, but not AHR. Interestingly, G-CSF, but not type 2 cytokines such as IL-4, IL-5, and IL-13, was regulated by TSLP signaling associated with eosinophilic airway inflammation, and G-CSF prolonged survival and activated eosinophil adhesion.</p></div><div><h3>Conclusions</h3><p>The present data show that TSLP contributes to ozone-induced exacerbations of eosinophilic airway inflammation and provide greater understanding of ozone-induced severity mechanisms in the pathophysiology of asthma related to TSLP and G-CSF.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 2","pages":"Pages 313-322"},"PeriodicalIF":6.8,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893023001223/pdfft?md5=e399796eb2f4dee9fe7ddb4c26519e99&pid=1-s2.0-S1323893023001223-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139036509","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":"Best practices for multimodal clinical data management and integration: An atopic dermatitis research case","authors":"Tazro Ohta , Ayaka Hananoe , Ayano Fukushima-Nomura , Koichi Ashizaki , Aiko Sekita , Jun Seita , Eiryo Kawakami , Kazuhiro Sakurada , Masayuki Amagai , Haruhiko Koseki , Hiroshi Kawasaki","doi":"10.1016/j.alit.2023.11.006","DOIUrl":"10.1016/j.alit.2023.11.006","url":null,"abstract":"<div><h3>Background</h3><p>In clinical research on multifactorial diseases such as atopic dermatitis, data-driven medical research has become more widely used as means to clarify diverse pathological conditions and to realize precision medicine. However, modern clinical data, characterized as large-scale, multimodal, and multi-center, causes difficulties in data integration and management, which limits productivity in clinical data science.</p></div><div><h3>Methods</h3><p>We designed a generic data management flow to collect, cleanse, and integrate data to handle different types of data generated at multiple institutions by 10 types of clinical studies. We developed MeDIA (Medical Data Integration Assistant), a software to browse the data in an integrated manner and extract subsets for analysis.</p></div><div><h3>Results</h3><p>MeDIA integrates and visualizes data and information on research participants obtained from multiple studies. It then provides a sophisticated interface that supports data management and helps data scientists retrieve the data sets they need. Furthermore, the system promotes the use of unified terms such as identifiers or sampling dates to reduce the cost of pre-processing by data analysts. We also propose best practices in clinical data management flow, which we learned from the development and implementation of MeDIA.</p></div><div><h3>Conclusions</h3><p>The MeDIA system solves the problem of multimodal clinical data integration, from complex text data such as medical records to big data such as omics data from a large number of patients. The system and the proposed best practices can be applied not only to allergic diseases but also to other diseases to promote data-driven medical research.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 2","pages":"Pages 255-263"},"PeriodicalIF":6.8,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893023001181/pdfft?md5=f56d56da0a26883f820b82ed9109873d&pid=1-s2.0-S1323893023001181-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138685455","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":"Development and validation of a new asthma questionnaire to help achieve a high level of control in school-age children and adolescents","authors":"Mayumi Matsunaga , Yasunori Sato , Mizuho Nagao , Masanori Ikeda , Chikako Motomura , Makoto Kameda , Yukinori Yoshida , Akihiko Terada , Isao Miyairi , Takao Fujisawa , the LePAT investigators","doi":"10.1016/j.alit.2023.11.001","DOIUrl":"10.1016/j.alit.2023.11.001","url":null,"abstract":"<div><h3>Background</h3><p>Maintaining good asthma control minimizes the risk of exacerbations and lung function decline and is a primary goal of asthma management. The Japanese Pediatric Asthma Guidelines (JPGL) employs different classification criteria for control status from other guidelines, stressing a higher level of control. Based on JPGL, we previously developed a caregiver-completed questionnaire for assessing and achieving best asthma control in preschoolers. In this study, we aimed to develop a questionnaire for school-age children and adolescents.</p></div><div><h3>Methods</h3><p>A working questionnaire comprising 14 items for patients and 34 items for caregivers was administered to 362 asthma patients aged 6–15 years and their caregivers. Separately, physicians filled out a questionnaire to determine JPGL-defined control. Logistic regression analysis was performed to construct a model to predict control levels using data from a randomly selected set of completed questionnaires from two-thirds of the subjects. Validation was performed using the remaining questionnaires.</p></div><div><h3>Results</h3><p>A set of 7 questions, encompassing self-assessed control status at the time of the visit and in the past month, and nocturnal/early morning asthma symptoms for patients and frequency of asthma symptoms, dyspnea, rescue beta-agonist use, and asthma hospitalization for caregivers, were selected and the 7-item model showed a good statistical fit with AIC of 110.5. The model has been named the Best Asthma Control Test for School Children and Adolescents (Best ACT-S). Best ACT-S scores differed significantly in the hypothetical direction among the groups of different JPGL-defined control levels, step-up/down treatment decisions, and presence/non-presence of exacerbations in the previous year.</p></div><div><h3>Conclusions</h3><p>The Best ACT-S is a valid questionnaire for children/adolescents aiming for best asthma control.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 2","pages":"Pages 224-230"},"PeriodicalIF":6.8,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893023001132/pdfft?md5=df4edafabe57f5ff7f20add7a4b406ef&pid=1-s2.0-S1323893023001132-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138579737","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}