{"title":"Factors contributing to the diagnosis and onset prediction of perennial allergic rhinitis in high-risk children: A sub-analysis of the CHIBA study","authors":"Syuji Yonekura , Yoshitaka Okamoto , Fumiya Yamaide , Taiji Nakano , Kiyomi Hirano , Urara Funakoshi , Sawako Hamasaki , Tomohisa Iinuma , Toyoyuki Hanazawa , Naoki Shimojo","doi":"10.1016/j.alit.2024.01.012","DOIUrl":"10.1016/j.alit.2024.01.012","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to clarify the diagnostic and predictive factors for perennial allergic rhinitis (PAR) onset in children by analyzing the results of the Chiba High-risk Birth Cohort for Allergy study, which examined newborns with a family history of allergies.</p></div><div><h3>Methods</h3><p>Overall, 306 pregnant women were recruited. Their newborns were examined by otolaryngologists and pediatric allergists at 1, 2, and 5 years of age. Participants with clinical and laboratory data available at all consultation points were considered eligible.</p></div><div><h3>Results</h3><p>Among 187 eligible participants, the prevalence rates of PAR were 2.1%, 4.3%, and 24.1% at 1, 2, and 5 years of age, respectively. AR-specific nasal local findings and eosinophils in nasal smear were observed in a substantial number of patients with PAR at 1 and 2 years of age. Factors present up to 2 years of age that were associated with PAR onset at 5 years of age, in descending order, were as follows: sensitization to house dust mites (HDM), nasal eosinophilia, and sensitization to cat dander. In 44 cases with HDM sensitization, nasal eosinophilia up to 2 years of age achieved a sensitivity of 76.0% and a specificity of 73.7% for predicting PAR onset at 5 years.</p></div><div><h3>Conclusions</h3><p>Rhinitis findings and nasal eosinophilia are useful auxiliary diagnostic items for pediatric PAR. Sensitization to HDM and nasal eosinophilia were the most influential factors associated with future PAR onset. A combination of these factors may facilitate the prediction of PAR onset.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 3","pages":"Pages 436-444"},"PeriodicalIF":6.8,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893024000133/pdfft?md5=ca5cf1eb1c18e38ab69595b022695806&pid=1-s2.0-S1323893024000133-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730756","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":"Skin care by washing with water is not inferior to washing with a cleanser in children with atopic dermatitis in remission in summer: WASH study","authors":"Yukiko Katoh , Osamu Natsume , Ryuhei Yasuoka , Satoshi Hayano , Eisaku Okada , Yutaka Ito , Akira Sakai , Yoko Monna , Fumitaka Takayanagi , Yusuke Inuzuka , Yuji Sakakura","doi":"10.1016/j.alit.2024.01.007","DOIUrl":"10.1016/j.alit.2024.01.007","url":null,"abstract":"<div><h3>Background</h3><p>Washing with water is not inferior to washing with soaps and detergents in children with atopic dermatitis (AD) in remission during the fall-winter seasons. We investigated whether this finding varies during summer based on the type of cleanser (soaps and detergents).</p></div><div><h3>Methods</h3><p>This evaluator-blinded, pragmatic, randomized, and non-inferiority study enrolled patients with AD whose eczema was controlled following regular steroid ointment application 2 days/week. For 8 ± 4 weeks, participants washed their upper and lower limbs with a cleanser on one side and with water alone on the other. Each participant chose either a weakly alkaline soap or an acidic detergent. The primary outcome was the Eczema Area and Severity Index (EASI) score at week 8 ± 4.</p></div><div><h3>Results</h3><p>The data of 43 of the 47 registered participants were analyzed. The median patient age was 44 (23–99) months; 28 and 15 participants chose weakly alkaline and acidic cleansers, respectively. At week 8 ± 4, EASI scores of the water and cleanser sides were 0.00 (0.00–0.40) and 0.15 (0.00–0.40), respectively (<em>p</em> = 0.74). The difference between both sides was 0.00 (−0.07 to 0.14); the limits of the 95 % confidence interval did not reach the pre-specified non-inferiority margin. No difference was observed in the median Patient-Oriented Eczema Measure score, number of additional steroid ointment applications, and occurrences of skin infections. There were no differences between the cleanser types in any of the results.</p></div><div><h3>Conclusions</h3><p>We demonstrated that washing with water was not inferior to that with a cleanser in patients with AD in the maintenance phase during summer, regardless of the type of cleanser.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 3","pages":"Pages 428-435"},"PeriodicalIF":6.8,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S132389302400008X/pdfft?md5=bbbac75fdd1f53e3708e6efa4ff40775&pid=1-s2.0-S132389302400008X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139679674","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}
Yutaka Omatsu, Yumiko Shimizu, Tomoko Haruki, Yoshitsugu Inoue, Dai Miyazaki
{"title":"Effect of atopic conditions on development and recurrences of infectious keratitis","authors":"Yutaka Omatsu, Yumiko Shimizu, Tomoko Haruki, Yoshitsugu Inoue, Dai Miyazaki","doi":"10.1016/j.alit.2024.01.008","DOIUrl":"10.1016/j.alit.2024.01.008","url":null,"abstract":"<div><h3>Background</h3><p>Atopic conditions are known to be associated with viral and bacterial infections. The purpose of this study was to determine the relationship between the effects of atopic conditions on the severity and recurrence of ocular infections including herpes simplex virus (HSV).</p></div><div><h3>Methods</h3><p>This study was performed on 474 consecutive patients with infectious keratitis caused by bacteria, fungus, acanthamoeba, HSV, or varicella-zoster virus. The relationships between the atopic condition and specific infectious pathogens and HSV were determined using real-time PCR.</p></div><div><h3>Results</h3><p>Our findings showed that atopic dermatitis (AD) was significantly associated with the incidence of HSV keratitis (odds ratio (OR), 10.2; <em>P</em> = 0.000). Other associations with AD were observed only with bacteria in an adverse manner. HSV proliferation in the lesions of patients with HSV keratitis whose AD was associated with non-infectious atopic blepharitis were significantly greater by 145-folds (<em>P</em> = 0.000). The presence of asthma or allergic rhinitis also increased the HSV DNA copy numbers.</p><p>A recurrence of HSV keratitis was observed in 70 patients (43.2 %), and mean time to recurrence was 1647 days. Cox proportional hazard model indicated that the epithelial type of HSV recurrence but not the stromal type was associated with atopic conditions especially with AD. The factors significantly associated with a recurrence was AD associated with non-infectious atopic blepharitis (HR: 6.11, <em>P</em> = 0.000) and asthma (HR: 3.03, <em>P</em> = 0.025).</p></div><div><h3>Conclusions</h3><p>Atopic conditions, especially AD with atopic blepharitis, are significantly associated with the development, increased proliferation, and shorter time to a recurrence on HSV keratitis.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 3","pages":"Pages 445-452"},"PeriodicalIF":6.8,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893024000091/pdfft?md5=d84db142059e31636e8d5270112ecd33&pid=1-s2.0-S1323893024000091-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139679455","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":"Influence of household pet ownership and filaggrin loss-of-function mutations on eczema prevalence in children: A birth cohort study","authors":"Kenji Toyokuni , Kiwako Yamamoto-Hanada , Limin Yang , Kouhei Hagino , Daisuke Harama , Marei Omori , Yasuaki Matsumoto , Daichi Suzuki , Kotaro Umezawa , Kazuma Takada , Mami Shimada , Seiko Hirai , Fumi Ishikawa , Sayaka Hamaguchi , Mayako Saito-Abe , Miori Sato , Yumiko Miyaji , Shigenori Kabashima , Tatsuki Fukuie , Emiko Noguchi , Yukihiro Ohya","doi":"10.1016/j.alit.2024.01.003","DOIUrl":"10.1016/j.alit.2024.01.003","url":null,"abstract":"<div><h3>Background</h3><p>The association between pet exposure in infancy, early childhood eczema, and <em>FLG</em> mutations remains unclear.</p></div><div><h3>Methods</h3><p>This was a birth cohort study performed in Tokyo, Japan. The primary outcome was current eczema based on questionnaire responses collected repeatedly from birth to 5 years of age. Generalized estimating equations and generalized linear modeling were used to evaluate the association.</p></div><div><h3>Results</h3><p>Data from 1448 participants were used for analyses. Household dog ownership during gestation, early infancy, and 18 months of age significantly reduced the risk of current eczema. Household cat ownership also reduced the risk of current eczema, albeit without statistical significance. The combined evaluation of children from households with pets, be it cats, dogs or both, the risk of current eczema at 1–5 years of age was lower in those with household pet exposure ownership during gestation (RR = 0.59, 95 % CI 0.45–0.77) and at 6 months (RR = 0.49, 95 % CI 0.36–0.68). , Reduced risks of eczema were also observed at 2–5 (RR = 0.52, 95 % CI 0.37–0.73) and 3–5 years of age (RR = 0.50 95 % CI 0.35–0.74) when the respective household pet ownership were evaluated at 18 months and 3 years of age. These protective associations of reduced risk of eczema were only observed in children without <em>FLG</em> mutations.</p></div><div><h3>Conclusions</h3><p>Household dog and pet (dog, cat, or both) ownership was protective against early childhood eczema in a birth cohort dataset. This protective association was observed only in children without <em>FLG</em> mutations, which should be confirmed in studies with larger cohorts.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 3","pages":"Pages 422-427"},"PeriodicalIF":6.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893024000042/pdfft?md5=202c0a6ec3a7cfef59bd87cde6b87e60&pid=1-s2.0-S1323893024000042-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139657030","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 systematic review and meta-analysis of macrolides in the management of adult patients with asthma","authors":"Hiroshi Ohnishi , Toshihito Otani , Yoshihiro Kanemitsu , Tatsuya Nagano , Johsuke Hara , Masamitsu Eitoku","doi":"10.1016/j.alit.2024.01.002","DOIUrl":"10.1016/j.alit.2024.01.002","url":null,"abstract":"<div><h3>Background</h3><p>The efficacy of macrolides in the management of asthma has been studied but remains controversial. We conducted a systematic review and meta-analysis of macrolides in the management of adult patients with asthma.</p></div><div><h3>Methods</h3><p>Randomized controlled trials of macrolides used in adult patients with asthma were searched for in MEDLINE, EMBASE, PsycINFO, Cochrane Library, CINAHL, and Igaku Chuo Zasshi databases to evaluate the efficacy and safety of macrolides.</p></div><div><h3>Results</h3><p>Seventeen reports with macrolide treatment durations ranging from 6 to 48 weeks were included. Macrolides did not reduce exacerbations requiring hospitalization, severe exacerbations, or rescue use of short-acting beta-2 agonist inhalers; improve lung function; decrease peripheral blood or sputum neutrophil counts; or decrease fractional exhaled nitric oxide compared to placebo. Macrolides statistically improved asthma control and quality of life but by less than the minimal clinically important difference. Peripheral blood eosinophil counts as well as serum and sputum eosinophilic cationic protein concentrations were significantly decreased with macrolides compared to placebo. The improvement of asthma symptoms and airway hyperresponsiveness varied by study. The safety profile of macrolides was comparable to that of placebo.</p></div><div><h3>Conclusions</h3><p>Although macrolides have some useful clinical aspects, there is not sufficient evidence to recommend their use in the management of adult patients with asthma.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 3","pages":"Pages 382-389"},"PeriodicalIF":6.8,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893024000030/pdfft?md5=a7301f6e2f48b386084da43a70b70cbe&pid=1-s2.0-S1323893024000030-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139649337","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":"15-Hydroxyeicosatrienoic acid induces nasal congestion by changing vascular functions in mice","authors":"Noriko Ozaki , Naoaki Sakamoto , Daiki Horikami , Yuri Tachibana , Nanae Nagata , Koji Kobayashi , Yoshino Taira Arai , Masayoshi Sone , Kazuhiro Hirayama , Takahisa Murata","doi":"10.1016/j.alit.2023.12.007","DOIUrl":"10.1016/j.alit.2023.12.007","url":null,"abstract":"<div><h3>Background</h3><p>Nasal congestion in allergic rhinitis (AR) is caused by vascular hyperpermeability and vascular relaxation of the nasal mucosa. We previously detected high levels of a lipoxygenation metabolite of dihomogammalinolenic acid, 15-hydroxy-8Z,11Z,13E-eicosatrienoic acid (15-HETrE) in the nasal lavage fluid of AR model mice. Here, we investigated the effects of 15-HETrE on vascular functions associated with nasal congestion.</p></div><div><h3>Methods</h3><p>We measured 15-HETrE levels in the nasal lavage fluid of ovalbumin-induced AR model mice and nasal discharge of patients with AR. We also assessed nasal congestion and vascular relaxation in mice. Vascular contractility was investigated using isolated mouse aortas.</p></div><div><h3>Results</h3><p>Five ovalbumin challenges increased 15-HETrE levels in AR model mice. 15-HETrE was also detected in patients who exhibiting AR-related symptoms. Intranasal administration of 15-HETrE elicited dyspnea-related behavior and decreased the nasal cavity volume in mice. Miles assay and whole-mount immunostaining revealed that 15-HETrE administration caused vascular hyperpermeability and relaxation of the nasal mucosa. Intravital imaging demonstrated that 15-HETrE relaxed the ear vessels that were precontracted via thromboxane receptor stimulation. Moreover, 15-HETrE dilated the isolated mouse aortas, and this effect was attenuated by K<sup>+</sup> channel inhibitors and prostaglandin D<sub>2</sub> (DP) and prostacyclin (IP) receptor antagonists. Additionally, vasodilatory effects of 15-HETrE were accompanied by an increase in intracellular cAMP levels.</p></div><div><h3>Conclusions</h3><p>Our results indicate that 15-HETrE, whose levels are elevated in the nasal cavity upon AR, can be a novel lipid mediator that exacerbates nasal congestion. Moreover, it can stimulate DP and IP receptors and downstream K<sup>+</sup> channels to dilate the nasal mucosal vasculature.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 3","pages":"Pages 464-472"},"PeriodicalIF":6.8,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893024000029/pdfft?md5=383aded651e40fe9aefb4d9b4ba09302&pid=1-s2.0-S1323893024000029-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576657","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}
Jungho Ahn , Seungyong Shin , Gi Chun Lee , Bo Eun Han , Eun Lee , Eun Kyo Ha , Jeewon Shin , Won Seok Lee , Ju Hee Kim , Man Yong Han
{"title":"Unraveling the link between atopic dermatitis and autoimmune diseases in children: Insights from a large-scale cohort study with 15-year follow-up and shared gene ontology analysis","authors":"Jungho Ahn , Seungyong Shin , Gi Chun Lee , Bo Eun Han , Eun Lee , Eun Kyo Ha , Jeewon Shin , Won Seok Lee , Ju Hee Kim , Man Yong Han","doi":"10.1016/j.alit.2023.12.005","DOIUrl":"10.1016/j.alit.2023.12.005","url":null,"abstract":"<div><h3>Background</h3><p>Atopic dermatitis and autoimmune diseases are highly heritable conditions that may co-occur from an early age.</p></div><div><h3>Methods</h3><p>The primary study is a national administrative cohort study involving 499,428 children born in 2002, tracked until 2017. Atopic dermatitis was defined as five or more principal diagnoses of atopic dermatitis and two or more topical steroid prescriptions. We estimated the risks for the occurrence of 41 autoimmune diseases, controlling for risk factors. In addition, we sourced a gene library from the National Library of Medicine to conduct a comprehensive gene ontology. We used Gene Weaver to identify gene set similarity and clustering, and used GeneMania to generate a network for shared genes.</p></div><div><h3>Results</h3><p>Exposed and unexposed groups included 39,832 and 159,328 children, respectively. During a mean follow-up of 12 years, the exposed group had an increased risk of autoimmune disease (hazard ratio, 1.27 [95 % confidence interval, 1.23–1.32]) compared to the unexposed group. The hazard ratios of autoimmune illnesses consistently increased with two- and five years lag times and alternative atopic dermatitis definitions. Shared genes between atopic dermatitis and autoimmune diseases were associated with comorbidities such as asthma, bronchiolitis, and specific infections. Genetic interactions of these shared genes revealed clustering in Th1, Th2, Th17, and non-classifiable pathways.</p></div><div><h3>Conclusions</h3><p>Atopic dermatitis was significantly associated with an increased risk of subsequent autoimmune disease. we identified the genetically associated disease in atopic dermatitis patients comorbid with autoimmune disease and demonstrated a genetic network between atopic dermatitis and autoimmune diseases.</p></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"73 2","pages":"Pages 243-254"},"PeriodicalIF":6.8,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1323893023001405/pdfft?md5=93065ae56f068b77c7bede44f12e2397&pid=1-s2.0-S1323893023001405-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492604","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}