Allergology International最新文献

{"title":"T follicular helper and memory B cells in IgE recall responses","authors":"Joshua F.E. Koenig","doi":"10.1016/j.alit.2024.10.003","DOIUrl":"10.1016/j.alit.2024.10.003","url":null,"abstract":"<div><div>IgE antibodies raised against innocuous environmental antigens cause allergic diseases like allergic rhinitis, food allergy, and allergic asthma. While some allergies are often outgrown, others (peanut, shellfish, tree nut) are lifelong in the majority of individuals. Lifelong allergies are the result of persistent production of allergen-specific IgE. However, IgE antibodies and the plasma cells that secrete them tend to be short-lived. Persistent allergen-specific IgE titres are thought to be derived from the continued renewal of IgE plasma cells from memory B cells in response to allergen encounters. The initial generation of allergen-specific IgE is driven by B cell activation by IL-4 producing Tfh cells, but the cellular and molecular mechanisms of the long-term production of IgE are poorly characterized. This review investigates the mechanisms governing IgE production and Tfh activation in the primary and recall responses, towards the objective of identifying molecular targets for therapeutic intervention that durably inactivate the IgE recall response.</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 1","pages":"Pages 4-12"},"PeriodicalIF":6.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677515","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":"Dupilumab-related eosinophilia in patients with severe asthma: Post-marketing surveillance in Japan","authors":"Makoto Nagata ,&nbsp;Ryo Yamaguchi ,&nbsp;Makiko Usami ,&nbsp;Mami Orimo ,&nbsp;Masato Ishida","doi":"10.1016/j.alit.2024.08.003","DOIUrl":"10.1016/j.alit.2024.08.003","url":null,"abstract":"","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 1","pages":"Pages 169-171"},"PeriodicalIF":6.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142224734","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":"Three-year prognoses after low-dose oral food challenge for cow's milk","authors":"Mai Tokunaga ,&nbsp;Ken-ichi Nagakura ,&nbsp;Kyohei Takahashi ,&nbsp;Sakura Sato ,&nbsp;Motohiro Ebisawa ,&nbsp;Noriyuki Yanagida","doi":"10.1016/j.alit.2024.09.006","DOIUrl":"10.1016/j.alit.2024.09.006","url":null,"abstract":"<div><h3>Background</h3><div>Low-dose (LD) oral food challenge (OFC) with heated cow's milk (CM; 3 mL) effectively prevents CM elimination in children with CM allergy (CMA). We investigated the long-term prognoses after an LD-OFC for CMA.</div></div><div><h3>Methods</h3><div>Children with immediate CMA symptoms after consuming &lt;25 mL of CM within 2 years of a baseline LD-OFC were retrospectively analyzed. Children who successfully passed the baseline LD-OFC (LD-passing) continued consuming 3 mL of CM at home, whereas those who failed (LD-failing) continued to avoid CM. Dose escalation occurred through stepwise OFCs or gradually at home. CM tolerance was defined as the ability to repeatedly consume ≥100 mL CM without experiencing symptoms; the inability to do so indicated persistent CMA. The prognoses of the LD-passing and LD-failing groups within 3 years of LD-OFC were compared.</div></div><div><h3>Results</h3><div>Among 113 children, the median age at baseline LD-OFC was 2.8 years; 41 % had an anaphylaxis history, with equal distribution between the LD-passing and LD-failing groups. Three years later, 63 % and 5 % of children demonstrated CM tolerance in the LD-passing and LD-failing groups, respectively (<em>p</em> &lt; 0.001). In the LD-passing group, predictors of persistent CMA were older age (adjusted hazard ratio [95 % confidence interval], 1.37 [1.00–1.88]), higher CM-specific IgE level (2.95 [1.30–6.68]) and other food allergies (2.34 [1.12–4.90]).</div></div><div><h3>Conclusions</h3><div>Failure in LD-OFC is associated with persistent CMA, whereas successful LD-OFC outcomes are associated with a favorable prognosis thereafter, irrespective of a history of anaphylaxis.</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 2","pages":"Pages 240-245"},"PeriodicalIF":6.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911040","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":"Peach component-specific IgE measurement helps to differentiate between local and systemic reactions in peach-allergic Japanese patients","authors":"Yusuke Ando ,&nbsp;Sakura Sato ,&nbsp;Motohiro Ebisawa ,&nbsp;Shiro Sugiura ,&nbsp;Komei Ito ,&nbsp;Mizuho Nagao ,&nbsp;Takao Fujisawa ,&nbsp;Shigemi Yoshihara","doi":"10.1016/j.alit.2024.09.004","DOIUrl":"10.1016/j.alit.2024.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Component-resolved diagnostics are used to diagnose food allergies. Currently, reports on sensitization profiles using peach-allergen components in a multicenter setting are lacking. In this study, sensitization profiling of peach allergy was performed to evaluate the clinical utility of each component specific-immunoglobulin E antibody (sIgE ab) test.</div></div><div><h3>Methods</h3><div>Sixty-seven patients with peach allergy were enrolled at four Japanese centers and classified into a local reaction group (LR) with only oral or pharyngeal mucosal symptoms in 36 patients and a systemic reaction group (SR) without LR in 31 patients. Serum sIgE ab tests to peach crude, Pru p 1, Pru p 3, Pru p 4, Pru p 7, and tree pollen were conducted.</div></div><div><h3>Results</h3><div>In the receiver operating characteristic curve analysis, Pru p 1 had the highest area under the curve (AUC) for diagnosing LR, followed by Pru p 4, which outperformed peach crude allergen. Pru p 7 had the highest AUC for diagnosing SR, with the other peach allergen components and peach crude allergen showing lower values.</div></div><div><h3>Conclusions</h3><div>Sensitization to Pru p 1 was associated with LRs, while sensitization to Pru p 7 was associated with SRs; approximately one-third of patients in the SR group tested negative for the titer of peach crude sIgE ab, many of whom tested positive for the titer of Pru p 7 sIgE ab. We conclude that measuring Pru p 1, Pru p 4, and Pru p 7 sIgE ab titers is useful to differentiate LRs and SRs in peach-allergic Japanese patients.</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 2","pages":"Pages 233-239"},"PeriodicalIF":6.2,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911038","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":"Detection of anti-MGL_1304 IgE using the ImmunoCAP system for diagnosis of type I allergy to sweat","authors":"Shunsuke Takahagi ,&nbsp;Masaya Moriwaki ,&nbsp;Kaori Ishii ,&nbsp;Natsuko Asakura ,&nbsp;Michihiro Hide","doi":"10.1016/j.alit.2024.11.004","DOIUrl":"10.1016/j.alit.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Type I allergy to sweat is involved in the pathogenesis of atopic dermatitis (AD) and cholinergic urticaria (CholU), with MGL_1304 from <em>Malassezia globosa</em> being the major causative antigen. Currently, no standard diagnostic test exists for sweat allergy that uses serum.</div></div><div><h3>Methods</h3><div>The ImmunoCAP (iCAP) system to measure antigen-specific IgE was developed using recombinant MGL_1304 (rMGL_1304). Using a positive histamine release test (HRT) against the semi-purified sweat antigen (QR) as a criterion for diagnosing sweat allergy, the diagnostic usefulness of anti-MGL_1304 IgE detected through iCAP was analyzed in comparison with conventional anti-<em>Malassezia</em> antigen m227 IgE (anti-m227 IgE).</div></div><div><h3>Results</h3><div>The iCAP system with rMGL_1304 detected anti-MGL_1304 IgE in serum samples without detection of non-specific reactions. In 93 patients with AD or CholU, of which 58 were HRT-positive, anti-MGL_1304 IgE titers correlated with histamine release levels in HRT against QR better than anti-m227 IgE titers. The cutoff value for sweat allergy diagnosis was 1.55 U_A/mL for anti-m227 IgE (sensitivity: 79.3 %; specificity: 65.7 %) and 0.671 U_A/mL for anti-MGL_1304 IgE (sensitivity: 84.5 %; specificity: 80.0 %). Clinical features of AD and CholU were partially associated with anti-m227 IgE and anti-MGL_1304 IgE titers but not with histamine release in HRT using QR.</div></div><div><h3>Conclusions</h3><div>Anti-MGL_1304 IgE detection using iCAP is simple and can help diagnosis of sweat allergy with better accuracy than conventional anti-<em>Malassezia</em> antigen IgE.</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 2","pages":"Pages 316-324"},"PeriodicalIF":6.2,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899391","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 corneal squamous cell carcinoma antigen-1 in early infancy in predicting atopic dermatitis and food allergy: A prospective study.","authors":"Maki Ozawa, Chika Katagiri, Chieko Okamura, Masashi Miyai, Yukiko Matsunaga, Daichi Murata, Christopher Takaya Knight, Tomoko Onodera, Masayuki Asano, Junko Endo, Ryoko Omori, Toshiya Takahashi, Masatoshi Saito, Takushi Hanita, Shimpei Watanabe, Shinichi Sato, Nobuko Tabata, Osamu Iizawa, Yoshihide Asano, Setsuya Aiba","doi":"10.1016/j.alit.2024.11.005","DOIUrl":"https://doi.org/10.1016/j.alit.2024.11.005","url":null,"abstract":"<p><strong>Background: </strong>Identification of predictive biomarkers is crucial for formulating preventive interventions and halting the progression of atopic march. Although controversial, the use of accessible markers to predict or detect early onset of atopic diseases is highly desirable. Therefore, this study aimed to investigate whether corneal squamous cell carcinoma antigen-1 (SCCA1) collected from infants can predict the development of atopic dermatitis and food allergy.</p><p><strong>Methods: </strong>This prospective study enrolled 117 infants aged 2 months (55 female and 62 male infants). The participants were monitored to evaluate the occurrence of eczematous changes at several time points, and stratum corneum samples were obtained. The association of corneal SCCA1 with the development of atopic dermatitis and food allergy in the first 3 years of life was evaluated using univariate and multivariate logistic regression.</p><p><strong>Results: </strong>The corneal SCCA1 level was significantly higher in children who developed atopic dermatitis than in children who did not (cheek at 2 months: 1653.06 ± 178.48 ng/mg vs. 786.95 ± 101.59 ng/mg, P = 0.0033). The corneal SCCA1 level was also significantly higher in children who developed food allergy than in children who did not (perioral skin at 2 months: 2567.31 ± 408.09 ng/mg vs. 1120.85 ± 188.49 ng/mg, P = 0.0018).</p><p><strong>Conclusions: </strong>The findings suggest that non-invasive measurements of corneal SCCA1 at 2 months of age is useful for predicting atopic dermatitis and food allergy in infants at risk for atopic dermatitis and subsequent food allergy.</p>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigator-initiated, multi-center, single-arm, open-label study of the effectiveness of canakinumab in Japanese patients with Schnitzler syndrome","authors":"Naotomo Kambe ,&nbsp;Mayuko Yamamoto ,&nbsp;Koji Takemura ,&nbsp;Shin-ichiro Kagami ,&nbsp;Yoshie Kawahara ,&nbsp;Hajime Yoshifuji ,&nbsp;Tomoyasu Jo ,&nbsp;Kazushi Izawa ,&nbsp;Satoshi Nakamizo ,&nbsp;Norimitsu Inoue ,&nbsp;Tatsuya Ito ,&nbsp;Yoko Amino ,&nbsp;Yumiko Ibi ,&nbsp;Satoshi Morita ,&nbsp;Nobuo Kanazawa","doi":"10.1016/j.alit.2024.10.001","DOIUrl":"10.1016/j.alit.2024.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Schnitzler syndrome is an adult-onset autoinflammatory disease characterized by an urticaria-like rash and monoclonal gammopathy with fever and fatigue. Although some treatments have shown efficacy in clinical trials, no approved treatment exists. We aimed to assess canakinumab, an anti-IL-1β monoclonal antibody, in Japanese patients.</div></div><div><h3>Methods</h3><div>This phase II, multicenter, single-arm, open-label study enrolled five patients with active disease from four hospitals. Patients received a single subcutaneous dose of canakinumab 150 mg. The primary endpoint was the proportion of patients achieving a complete clinical response (CR), based on physician global assessment on Day 7. If a CR was not achieved on Day 7 or by 8 weeks post-treatment, the dose was increased to 300 mg. Dosing continued every 8 weeks until 24 weeks. The study also evaluated patient-reported disease activity and changes in acute inflammatory markers, including white blood cell count, neutrophil count, C-reactive protein concentration, and serum amyloid A level. Quality of life was assessed using the Dermatology Life Quality Index and the 36-item Short Form health survey. Safety was also evaluated.</div></div><div><h3>Results</h3><div>Sixty percent (3/5) of patients had a CR on Day 7. One of the remaining two patients had a CR 7 days after the dose was increased to 300 mg. All five patients, including those who did not achieve a CR, showed improvement in inflammatory markers and quality of life scores, and no new adverse events were detected.</div></div><div><h3>Conclusions</h3><div>In this trial, canakinumab showed a potential for usefulness in Japanese patients with Schnitzler syndrome.</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 2","pages":"Pages 254-262"},"PeriodicalIF":6.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847438","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":"Prevalence and clinical impact of asthma-COPD overlap in severe asthma","authors":"Miho Wakazono ,&nbsp;Hirokazu Kimura ,&nbsp;Ichizo Tsujino ,&nbsp;Nobuyasu Wakazono ,&nbsp;Michiko Takimoto-Sato ,&nbsp;Munehiro Matsumoto ,&nbsp;Kaoruko Shimizu ,&nbsp;Houman Goudarzi ,&nbsp;Hironi Makita ,&nbsp;Masaharu Nishimura ,&nbsp;Satoshi Konno","doi":"10.1016/j.alit.2024.11.003","DOIUrl":"10.1016/j.alit.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Patients with asthma-COPD overlap (ACO) have a greater symptom burden, worse respiratory function, and more frequent exacerbations than those with asthma alone. However, only a few studies have investigated the prevalence and clinical course of ACO in severe asthma. This study aimed to examine the comorbid rate of ACO and its clinical impact on severe asthma.</div></div><div><h3>Methods</h3><div>We prospectively enrolled 127 patients with severe asthma from 30 hospitals and clinics. Favorable treatment adherence was ensured, and the prevalence of ACO was assessed using the Japanese Respiratory Society ACO criteria. Patients were categorized into two groups, ACO and non-ACO, and their clinical characteristics were compared. The exacerbation rates with a 3-year follow-up and the annual change in FEV₁ with a 5-year follow-up of 105 individuals were evaluated. The exacerbation-free rate was analyzed using the Kaplan–Meier method and the Cox proportional hazards model.</div></div><div><h3>Results</h3><div>The prevalence of ACO in severe asthma was 31.5 %. Patients with ACO were older, more frequently male, and had a longer duration of asthma than those without. No significant difference was observed in exacerbation rates between the ACO and non-ACO groups (62.2 % vs. 63.2 %, P = 0.91) or the annual change in FEV₁ (−39.2 mL/year vs. −31.2 mL/year, P = 0.11).</div></div><div><h3>Conclusions</h3><div>The prevalence of ACO in our multicenter cohort study on severe asthma was approximately 30 %. The presence of ACO was not an independent risk for exacerbations or decline in FEV₁.</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 2","pages":"Pages 308-315"},"PeriodicalIF":6.2,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820018","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":"Epidemiology and risk factors of non-esophageal eosinophilic gastrointestinal diseases in Japan: A population-based study","authors":"Akinari Sawada ,&nbsp;Takumi Imai ,&nbsp;Yasutaka Ihara ,&nbsp;Fumio Tanaka ,&nbsp;Yasuhiro Fujiwara","doi":"10.1016/j.alit.2024.10.007","DOIUrl":"10.1016/j.alit.2024.10.007","url":null,"abstract":"<div><h3>Background</h3><div>Non-esophageal eosinophilic gastrointestinal diseases (non-EoE EGIDs) are allergic conditions where Th-2-predominant inflammation causes symptoms related to gastrointestinal tract dysfunction. No studies have reported the incidence of non-EoE EGIDs. In addition, little is known about the influence of lifestyle factors on the condition.</div></div><div><h3>Methods</h3><div>We used a large health claim database from January 2005 to September 2022. Non-EoE EGIDs cases were identified on the basis of the International Classification of Diseases-tenth Revision code, K52.8. The incidence and prevalence of non-EoE EGIDs were estimated by Poisson and binomial distribution, respectively. For each case, 10 controls were randomly selected for a nested case–control study to identify potential risk factors of non-EoE EGIDs.</div></div><div><h3>Results</h3><div>Of 15,200,895 individuals, 1,368 new cases of non-EoE EGIDs were identified. The incidence and prevalence of non-EoE EGIDs in 2022 were 3.07 (95% CI 2.67–3.52) per 100,000 person-years and 17.23 (95% CI 16.38–18.11) per 100,000 individuals, respectively, which were approximately 6 and 9 times higher than those in 2010. Allergic rhinitis (OR 1.63 (95% CI 1.16–2.29), <em>p</em> = 0.005), chronic sinusitis (OR 2.41 (95% CI 1.58–3.66), <em>p</em> &lt; 0.001), and urticaria (OR 2.32 (95% CI 1.45–3.70), <em>p</em> &lt; 0.001) were related to an increased risk of adult non-EoE EGIDs. Whilst atopic dermatitis (OR 2.28 (95% CI 1.35–3.86), <em>p</em> = 0.006) and the perinatal factors (OR 3.68 (95% CI 1.13–12.02), <em>p</em> = 0.031) were associated with an increased risk of pediatric non-EoE EGIDs. No association was seen with lifestyle factors such as obesity, smoking and alcohol consumption.</div></div><div><h3>Conclusions</h3><div>The incidence and prevalence of non-EoE EGIDs have increased over the past two decades.</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 2","pages":"Pages 292-300"},"PeriodicalIF":6.2,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781649","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":"Effectiveness of benralizumab in the Tokyo Asthma Study (TOAST): A real-world prospective interventional trial","authors":"Katsunori Masaki ,&nbsp;Maho Suzukawa ,&nbsp;Hitoshi Sasano ,&nbsp;Norihiro Harada ,&nbsp;Yasunari Miyazaki ,&nbsp;Hideki Katsura ,&nbsp;Etsuko Tagaya ,&nbsp;Junko Terada ,&nbsp;Masayuki Hojo ,&nbsp;Naoya Sugimoto ,&nbsp;Hiroyuki Nagase ,&nbsp;Yuta Kono ,&nbsp;Hisato Hiranuma ,&nbsp;Yasuhiro Gon ,&nbsp;Ryo Takemura ,&nbsp;Misato Irie ,&nbsp;Reina Nakamura ,&nbsp;Hiroki Kabata ,&nbsp;Jun Miyata ,&nbsp;Koichi Fukunaga","doi":"10.1016/j.alit.2024.10.009","DOIUrl":"10.1016/j.alit.2024.10.009","url":null,"abstract":"<div><h3>Background</h3><div>Biologics are integral in the management of severe asthma. As the effectiveness of the anti-IL-5 receptor antibody benralizumab in Japan remains elusive, this study aimed to assess its real-world effectiveness in Japanese patients with severe asthma.</div></div><div><h3>Methods</h3><div>This prospective, interventional, single-arm clinical trial was conducted across ten facilities in Japan between September 2020 and July 2022. Adult patients with severe eosinophilic asthma (peripheral blood eosinophil count ≥150 cells/μl) were enrolled and treated with benralizumab. The primary endpoint was the change in ACQ-5 score from baseline to week 24.</div></div><div><h3>Results</h3><div>Of 103 patients, 98 (mean age: 62.1 years, women: 55.1 %, regular oral corticosteroids [OCS] treatment: 20.4 %) were included in the analysis. From baseline to week 24, benralizumab significantly improved ACQ-5 (−0.67, 95 % CI: −0.94 to −0.39) and AQLQ (0.71, 95 % CI: 0.46 to 0.96) scores with an increase in FEV1 (87 ml, 95 % CI: 15–159 ml). The maintenance OCS dose and the percentage of OCS users decreased from 13.9 mg/day to 6.0 mg/day and from 20.4 % to 9.2 %, respectively. Multivariable analysis identified baseline blood eosinophil count (≥400 cells/μl) and fractional exhaled nitric oxide (≥22 ppb) as independent predictors of therapeutic response to benralizumab. Benralizumab treatment was discontinued due to nonserious adverse events and patient choice in four and three patients, respectively.</div></div><div><h3>Conclusions</h3><div>In a real-world setting in Japan, patients with severe eosinophilic asthma treated with benralizumab demonstrated substantial improvements in asthma control, quality of life, and respiratory function with reduced OCS usage. Trial registration: Japan Registry of Clinical Trials (jRCTs031190237).</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 2","pages":"Pages 274-282"},"PeriodicalIF":6.2,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781648","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}