{"title":"Molecular characteristics of atopic dermatitis patients with clinical remission","authors":"Andrés Sánchez Biol, MSc, PhD(c) , Ana Caraballo MD , Leidy Alvarez MD, MSc, PhD(c) , Oscar Valencia MD , María-Nelly Restrepo MD , Rodrigo Gaviria MD , Margarita Velasquez-Lopera MD, PhD , Juan-Ricardo Urrego QFB, PhD , Jorge Sánchez MD, MSc, PhD","doi":"10.1016/j.waojou.2024.100983","DOIUrl":"10.1016/j.waojou.2024.100983","url":null,"abstract":"<div><h3>Introduction</h3><div>Atopic dermatitis (AD) is a frequent disease in infants with diverse clinical evolution. Although multiple studies have assessed inflammatory changes in chronic AD, little is known about the molecular transition from symptomatic stage to clinical remission without pharmacotherapy.</div></div><div><h3>Objective</h3><div>The aim of the study was to evaluate clinical and inflammatory factors and its relationship with AD clinical evolution.</div></div><div><h3>Methods</h3><div>Three groups of participants older than 10 years of age were recruited; 2 AD groups and 1 non-AD group. The AD-remission group (more than 1 year without AD symptoms and without pharmacotherapy), the AD-persistent group (AD symptoms and pharmacotherapy), and 1 non-AD group. We measured eosinophil peroxidase (EPX), eosinophil cationic protein (ECP), IgE autoantibodies against these antigens, and natural moisturizing factor (NMF).</div></div><div><h3>Results</h3><div>Different inflammatory profiles within each group were observed: AD-persistent group is characterized by a high frequency of IgE autoantibodies (55.5%), contrasting with the low occurrence in the non-AD group (2%) and a moderate frequency in the AD-remission group (21.4%). A similar distribution was observed for the other type 2 inflammatory biomarkers (Eosinophils, total IgE, EPX, ECP) and NMF.</div></div><div><h3>Conclusion</h3><div>Patients with AD-remission maintain a minimal T2 inflammation. We identified different potential biomarkers for prognosis of AD evolution. Further studies are necessary to evaluate the mechanisms that allow the coexistence of the inflammatory process without clinical symptoms.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 11","pages":"Article 100983"},"PeriodicalIF":3.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142555667","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}
Marysia Tiongco-Recto MD , Kent Woo MD , Wen-Hung Chung MD PhD , Gilbert T. Chua MBBS , Kiran Godse MD PhD , Ma Teresita Gabriel MD , Alexander Headley MBBS , Irene Lee Chew Kek MBBS , Kanokvalai Kulthanan MD , Mongkol Lao-Araya MD , Liwen Ma MD , Le Huyen My MD PhD , Siriwan Wananukul MD , Dinesh Nagrale MD
{"title":"Prioritising patient-centred care in the management of chronic urticaria in Asia-Pacific countries","authors":"Marysia Tiongco-Recto MD , Kent Woo MD , Wen-Hung Chung MD PhD , Gilbert T. Chua MBBS , Kiran Godse MD PhD , Ma Teresita Gabriel MD , Alexander Headley MBBS , Irene Lee Chew Kek MBBS , Kanokvalai Kulthanan MD , Mongkol Lao-Araya MD , Liwen Ma MD , Le Huyen My MD PhD , Siriwan Wananukul MD , Dinesh Nagrale MD","doi":"10.1016/j.waojou.2024.100984","DOIUrl":"10.1016/j.waojou.2024.100984","url":null,"abstract":"<div><h3>Background</h3><div>Chronic urticaria (CU), in both inducible and spontaneous forms, is associated with a substantial burden in the Asia-Pacific region (APAC). Patient-centred care recognises patients desire to be involved in decisions regarding their health. Although patient-centred approaches have previously not been studied in the context of CU management, they have demonstrated benefits in the management of other chronic conditions.</div></div><div><h3>Methods</h3><div>Information and opinions regarding the barriers and solutions to the implementation of patient-centred approaches to the management of CU were gathered from a group of 13 expert dermatologists and allergist/immunologists from APAC through surveys and a face-to-face meeting.</div></div><div><h3>Results</h3><div>Barriers identified there included a lack of awareness of CU amongst patients, delays in consulting healthcare providers, financial constraints, and low adherence. Particular issues raised included a lack of suitable online information for patients (83% of experts), and patients accessing oral corticosteroids without a prescription. Compliance issues were also identified as key reasons for inadequate responses to treatments (67% of experts). Solutions proposed by the authors were improving patients' knowledge about their condition (92% strongly agree, 8% agree), physicians’ consideration of patient characteristics when choosing treatments (92% strongly agree, 8% agree), implementing shared decision-making (85% strongly agree, 15% agree), and using patient-reported outcome measures (70% strongly agree, 23% agree).</div></div><div><h3>Conclusion</h3><div>Expert opinion within APAC supports the use of patient-centred approaches to improve the management of <span>CU</span>. We provide several recommendations focusing on patient education and involvement in disease management as well as disease monitoring methods that can be implemented by physicians in APAC.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 11","pages":"Article 100984"},"PeriodicalIF":3.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142555671","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}
Wen Liu , Zhen Liu , Xiao-di Sun , Zeng-qiang Liu , Yuan-yuan Dong , Shi Qiu
{"title":"Investigating the causal association between heme oxygenase-1 and asthma: A bidirectional two-sample Mendelian randomization analysis in a European population","authors":"Wen Liu , Zhen Liu , Xiao-di Sun , Zeng-qiang Liu , Yuan-yuan Dong , Shi Qiu","doi":"10.1016/j.waojou.2024.100987","DOIUrl":"10.1016/j.waojou.2024.100987","url":null,"abstract":"<div><h3>Background</h3><div>The association between heme oxygenase-1 (HO-1) and asthma has been a subject of debate in both observational and experimental studies. We aimed to evaluate the potential causal relationship between HO-1 and asthma.</div></div><div><h3>Materials and methods</h3><div>A bidirectional two-sample Mendelian randomization (TSMR) study was conducted to examine the causal relationship between HO-1 and asthma. In the forward Mendelian randomization (MR) analyses, HO-1 was considered as the exposure, while asthma as the outcome. Conversely, in the reverse MR analyses, asthma was regarded as the exposure, and HO-1 as the outcome. Data for HO-1 and asthma were obtained from publicly accessible genome-wide association studies (GWAS). These causal relationships were identified through 5 MR methods, namely MR-Egger, weighted median, inverse-variance weighted (IVW), simple mode, and weighted mode. Additionally, sensitivity tests were conducted to assess the robustness of MR study. Finally, additional asthma datasets and childhood asthma were selected to validate the findings.</div></div><div><h3>Results</h3><div>In the forward MR analyses, according to the IVW method, genetically predicted HO-1 displays a negative correlation with the risk of asthma (OR 0.947, 95% CI 0.905–0.990). It was not found any SNP overly sensitive or disproportionately responsible for the outcome. No evidence of heterogeneity and pleiotropy between SNPs was observed. Genetically predicted asthma was not associated with HO-1 in reverse MR analyses using the IVW method. The same results were validated in additional asthma datasets and in childhood asthma.</div></div><div><h3>Conclusion</h3><div>The results of MR analysis revealed heme oxygenase-1 as a protective factor for asthma.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 11","pages":"Article 100987"},"PeriodicalIF":3.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528810","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}
Yura Ha BS , Min Ju Pyo MS , Ye Eun Hong BS , So Hye Nam MD , Woo-Jung Song MD, PhD , Hyouk-Soo Kwon MD, PhD , Tae-Bum Kim MD, PhD , Yoo Sook Cho MD, PhD , Ji-Hyang Lee MD, PhD
{"title":"Non-episodic angioedema with eosinophilia as a differential diagnosis of eosinophilia in young females","authors":"Yura Ha BS , Min Ju Pyo MS , Ye Eun Hong BS , So Hye Nam MD , Woo-Jung Song MD, PhD , Hyouk-Soo Kwon MD, PhD , Tae-Bum Kim MD, PhD , Yoo Sook Cho MD, PhD , Ji-Hyang Lee MD, PhD","doi":"10.1016/j.waojou.2024.100981","DOIUrl":"10.1016/j.waojou.2024.100981","url":null,"abstract":"<div><h3>Background</h3><div>Episodic angioedema with eosinophilia, also known as Gleich's syndrome, is a differential diagnosis in patients with recurrent angioedema with higher blood eosinophils. Meanwhile, less has been elucidated regarding non-episodic angioedema with eosinophilia (NEAE). This study aimed to examine the prevalence, clinical characteristics, and disease course of NEAE.</div></div><div><h3>Methods</h3><div>By reviewing the electronic medical records, we identified patients with NEAE among those referred to allergy clinics due to eosinophilia from January 2021 to December 2023 at Asan Medical Center.</div></div><div><h3>Results</h3><div>Among 687 patients with eosinophilia, 58 (8.4%) were diagnosed with and treated for NEAE. All patients were females, with a mean age of 31.79 years. The mean absolute blood eosinophil count was 4468.76 cells/μL. All patients reported symmetric angioedema of the lower legs, and 37 (63.8%) had additional angioedema of the upper arms. Twenty-five (43.1%) patients reported a preceding event prior to onset of angioedema. Systemic corticosteroids (mean total dose 1745 ± 508.49 mg) were prescribed to all patients, with a treatment duration of approximately 40 days to achieve resolution. Following the resolution of angioedema, 6 patients experienced persistent arthralgia, 1 developed chronic spontaneous urticaria, and 1 developed hypereosinophilic syndrome.</div></div><div><h3>Conclusions</h3><div>NEAE is an essential differential diagnosis in young female patients with eosinophilia, particularly those presenting with symmetric peripheral angioedema.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 11","pages":"Article 100981"},"PeriodicalIF":3.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528765","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":"Retrospective evaluation of pediatric anaphylaxis cases according to WAO and NIAID/FAAN/EAACI criteria: A single center experience","authors":"Funda Aytekin Güvenir MD , Gökhan Yörüsün MD , Ragıp Dere MD , Ahmet Selmanoğlu MD , Zeynep Şengül Emeksiz MD , Emine Dibek Mısırlıoğlu MD","doi":"10.1016/j.waojou.2024.100982","DOIUrl":"10.1016/j.waojou.2024.100982","url":null,"abstract":"<div><h3>Background</h3><div>Anaphylaxis is an emergency that must be correctly recognized and treated by every health care professional. With the update of the World Allergy Organization (WAO) criteria in 2020, differences between the European Academy of Allergy and Immunology (EAACI)/The National Institute of Allergy and Infectious Diseases (NIAID) and the Food Allergy and Anaphylaxis Network (FAAN) and WAO criteria have come to the fore.</div></div><div><h3>Objective</h3><div>The aim of our study is to compare the effectiveness of these 2 criteria in diagnosing anaphylaxis in pediatric patients.</div></div><div><h3>Methods</h3><div>Patients aged 0–18 years who applied to Ankara Bilkent City Hospital Pediatric Immunology and Allergy Clinic between September 1, 2020 and September 1, 2023 due to systemic allergic reaction and were diagnosed with anaphylaxis were evaluated retrospectively. The clinical findings of the patients were re-evaluated accordingto WAO 2020 and NIAID/FAAN/EAACI criteria.</div></div><div><h3>Results</h3><div>Included in the study were 492 patients who met the inclusion criteria. Median age was 3.8 years (IQR: 0.9–11.4). The majority of patients were male (59.6%). There were 466 patients (94.1%) diagnosed with anaphylaxis according to both NIAID/FAAN/EAACI and WAO criteria. Three patients (0.6%) with isolated laryngeal involvement and 23 (4.7%) patients with isolated respiratory findings (bronchospasm) were diagnosed only according to WAO Criterion 2, for a total of 26 patients (5.3%).</div></div><div><h3>Conclusion</h3><div>Although the majority of patients were diagnosed with both criteria, 5.3% were diagnosed only according to the WAO criteria. After contact with a suspected or known allergen, the presence of isolated respiratory or laryngeal findings without skin findings should be a warning before anaphylaxis progresses to more serious stages.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 11","pages":"Article 100982"},"PeriodicalIF":3.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528764","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}
Danilo Di Bona MD, PhD , Giovanni Paoletti MD , Michal Ordak PhD , Silvano Dragonieri MD, PhD , Josiane Cognet-Sice PharmD , Silvia Scurati PhD , Giorgio Walter Canonica MD
{"title":"A 300 IR 5-grass pollen sublingual immunotherapy tablet-specific systematic review and meta-analysis confirms its clinical benefits for patients with allergic rhinoconjunctivitis with or without asthma","authors":"Danilo Di Bona MD, PhD , Giovanni Paoletti MD , Michal Ordak PhD , Silvano Dragonieri MD, PhD , Josiane Cognet-Sice PharmD , Silvia Scurati PhD , Giorgio Walter Canonica MD","doi":"10.1016/j.waojou.2024.100985","DOIUrl":"10.1016/j.waojou.2024.100985","url":null,"abstract":"<div><h3>Background</h3><div>In the realm of allergen immunotherapy (AIT), the quality of evidence varies across different products, making it unjustifiable to extend overall conclusions to all AIT products, as highlighted by WAO and EAACI.</div></div><div><h3>Objective</h3><div>To confirm the efficacy of the 300 IR 5-grass pollen sublingual AIT (SLIT)-tablet through a specific meta-analysis of randomized controlled trials (RCTs) involving patients with allergic rhino-conjunctivitis (ARC) with/without mild/intermittent asthma.</div></div><div><h3>Methods</h3><div>Data from published RCTs on the 300 IR 5-grass SLIT-tablet were gathered from electronic databases (MEDLINE, ISI Web of Science, LILACS, the Cochrane Library and <span><span>ClinicalTrial.gov</span><svg><path></path></svg></span>) and manual searches up to November 2023. Populations, treatments, and outcome data were combined. Efficacy was assessed based on symptom score (SS) and medication score (MS), measured as standardized mean difference (SMD) or mean difference (MD).</div></div><div><h3>Results</h3><div>Results from 5 RCTs comprising 1468 patients revealed a significant reduction in SS (SMD, −0.36; 95%confidence interval [CI], −0.52 to −0.19; <em>P</em> < 0.05) and MS (SMD, −0.29; 95%CI, −0.40 to −0.19; <em>P</em> < 0.05) compared to placebo. The difference of −0.36 SMD for SS corresponds to a MD of −1.26 SS points, greater than the minimal important difference. Subgroup analysis did not show differences in efficacy according to age, asthma status, and geographic location of the study (USA, Canada, Europe, Russia). No safety issues were reported.</div></div><div><h3>Conclusion</h3><div>This product-specific meta-analysis reinforces the evidence of clinical benefits associated with the 300 IR 5-grass SLIT-tablet, suggesting its appropriateness as a therapeutic choice for patients with ARC, irrespective of concurrent asthma, and exhibiting a favorable safety profile.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 11","pages":"Article 100985"},"PeriodicalIF":3.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528763","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":"Japanese version of the food allergy quality of life questionnaire 10: An easy-to-use instrument","authors":"Shigenori Kabashima MD, PhD , Kiwako Hanada Yamamoto MD, PhD , Yumiko Miyaji MD , Yuri Endo Kram MD , Mami Shimada MD , Seiko Hirai MD , Hiroya Ogita MD , Tomoyuki Kiguchi MD , Yusuke Inuzuka MD, PhD , Kenji Toyokuni MD, PhD , Makoto Irahara MD, PhD , Fumi Ishikawa MD , Miori Sato MD , Mayako Saito-Abe MD, PhD , Hiroki Yasudo MD, PhD , Tatsuki Fukuie MD, PhD , Ichiro Nomura MD, PhD , Audrey DunnGalvin PhD , Yukihiro Ohya MD, PhD","doi":"10.1016/j.waojou.2024.100979","DOIUrl":"10.1016/j.waojou.2024.100979","url":null,"abstract":"<div><h3>Background</h3><div>The health-related quality of life (HRQL) of people with food allergies should be evaluated to provide high-quality medical care. Currently, there is no available easy-to-use and reliable instrument for assessing HRQL clinically in Japan.</div></div><div><h3>Methods</h3><div>The Food Allergy Quality of Life Questionnaire 10 (FAQLQ10) in English was translated into Japanese, and this was referred to as the Japanese version of the Food Allergy Quality of Life Questionnaire 10 (FAQLQ10-J). Participants aged up to 18 years, who had food allergy, and their parents were instructed to complete the FAQLQ10-J and the Food Allergy Independent Measure, a self-report instrument. For comparison, participants without food allergies were also included in the survey.</div></div><div><h3>Results</h3><div>The FAQLQ10-J, which included forms for individuals aged 8–12 years, teenagers, and caregivers was developed. The responders completed each form within approximately 3 min. An analysis of responses showed that each form had a good internal consistency, test–retest reliability, construct validity, and discriminant validity. Moreover, based on an examination of the relationship between demographic data and FAQLQ10-J scores, items such as possession of an adrenaline auto-injector, participant age, and number of eliminated foods might influence HRQL.</div></div><div><h3>Conclusions</h3><div>We developed the FAQLQ10-J, which is a simple, reliable, and effective tool for assessing HRQL among Japanese individuals with food allergy. Its use may provide a more detailed understanding of HRQL among individuals with food allergy in clinical settings and may facilitate the development of more individual-oriented treatments.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 11","pages":"Article 100979"},"PeriodicalIF":3.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528766","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":"Adherence to a modified Mediterranean diet and in association with asthma and wheezing in schoolchildren: A cross-sectional study","authors":"Faezeh Poursoleiman PhD , Bahareh Sasanfar PhD , Nasrin Behniafard MD , Zahra Nafei MD , Elahe Akbarian MS , Abbas Khalili MD , Amin Salehi-Abargouei PhD","doi":"10.1016/j.waojou.2024.100948","DOIUrl":"10.1016/j.waojou.2024.100948","url":null,"abstract":"<div><h3>Background</h3><div>Limited investigations have focused on the association between the Mediterranean dietary (MeD) and asthma among children and adolescents. We aimed to study the associations between a modified Mediterranean dietary pattern and asthma symptoms in children living in Iran.</div></div><div><h3>Method</h3><div>This cross-sectional study was conducted among 7667 children and adolescence. Data on dietary intakes, asthma symptoms and other possible confounders, were collected using a questionnaire completed by parents. The relationship between Mediterranean diet (MeD) and asthma was assessed using logistic regression.</div></div><div><h3>Results</h3><div>We found that participants in the highest quartile of MeD score had 32% lower odds of wheezing in the past 12 months in the whole population when compared with those in the lowest quartile (OR: 0.68; 95% CI: 0.51–0.90; P<sub>trend</sub> < 0.001). Regarding the wheezing, a linear reducing trend was observed in girls (OR: 0.88; 95% CI: 0.62–1.25; P<sub>trend</sub> = 0.04); and a significant protective association was seen among boys (OR: 0.45; 95% CI: 0.28–0.73; P<sub>trend</sub> < 0.001). Analyses by gender showed, girls and boys in the highest quartile had 68% and 51% lower odds of current asthma in comparison with the first quartile.</div></div><div><h3>Conclusion</h3><div>Mediterranean-style diet emphasizing high in fruits, vegetables, and cereals and low in fast foods is associated with reduced wheezing as an asthma-related symptom. On the other hand, meat intake has adverse correlation with asthma prevalence. No association was found between this dietary pattern and asthma. Further prospective investigations should be conducted to confirm these findings.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 11","pages":"Article 100948"},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446571","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}