Frontiers in allergy最新文献

{"title":"Case Report: Angiotensin converting enzyme inhibitors vs. angiotensin receptor blockers in the management of chronic hypertension: a case of lisinopril-induced rhinorrhea.","authors":"Alice A Amudzi, Giro Richard Samale, Xavier Vela-Parada","doi":"10.3389/falgy.2024.1480569","DOIUrl":"https://doi.org/10.3389/falgy.2024.1480569","url":null,"abstract":"<p><p>A 47-year-old woman presents to our clinic with a chief complaint of rhinorrhea; she had chronic hypertension managed with four antihypertensive drugs, including an ACE inhibitor. While dry cough is a well-known side effect associated with ACE inhibitors, this case highlights a common chief complaint yet less recognized side effect of ACE inhibitors and further emphasizes the idea that overall, angiotensin receptor blockers may be a better drug of choice in hypertension due to their favorable side effect profile.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1480569"},"PeriodicalIF":3.3,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric eosinophilic esophagitis: a Belgian single-center retrospective analysis reveals real-life difficulties in diagnosis and treatment.","authors":"Toon Dominicus, Lisa Nuyttens, Ilse Hoffman, Dominique M A Bullens","doi":"10.3389/falgy.2024.1478380","DOIUrl":"https://doi.org/10.3389/falgy.2024.1478380","url":null,"abstract":"<p><strong>Introduction: </strong>Eosinophilic esophagitis (EoE) is a chronic immune-mediated disorder characterized by eosinophilic infiltration of the esophageal mucosa.</p><p><strong>Methods: </strong>This study aimed to provide insights into the clinical characteristics, diagnostic evaluation, treatment modalities, and outcomes of EoE in a pediatric population through a retrospective analysis of 79 patients followed in a single tertiary referral center between 2014 and 2020.</p><p><strong>Results: </strong>As expected, a higher male prevalence was observed. Median age at diagnosis was 8.9 years, aligning with the typical presentation in childhood, emphasizing the need for early recognition. Clinical presentation varied, with vomiting, dysphagia, and abdominal pain being the most frequently reported symptoms. IgE-sensitization, food allergy and atopy were highly prevalent, with cow's milk, wheat, egg, soy, and peanuts being the most common allergens. Endoscopy results mostly revealed macroscopic abnormalities with linear furrows and microabscesses/white plaques being the most common features although a significant proportion of initial endoscopies (14/79) showed no macroscopic abnormalities, highlighting the importance of esophageal biopsies. Proton pump inhibitors (PPIs) were commonly used as a first-line treatment, with most patients receiving PPI therapy. Other treatment modalities, such as oral budesonide and exclusion diets either single or in combination, were also used. Remission was achieved in 69/79 or 87% patients, with different treatment regimens contributing to successful outcomes but subject to relapse upon time.</p><p><strong>Discussion: </strong>This study provides valuable insights into the clinical characteristics, diagnostic evaluation, treatment modalities, and outcomes of EoE in the pediatric population. It underscores the importance of early recognition, accurate diagnosis, and regular follow-up to effectively manage this chronic immune-mediated disorder but also demonstrates its complexity in real-life clinical setting.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1478380"},"PeriodicalIF":3.3,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baricitinib as monotherapy and with topical corticosteroids in moderate-to-severe atopic dermatitis: a systematic review and meta-analysis of dose-response.","authors":"Ibrahim H I Almoghayer, Abdul Mateen Soomro, Shah Dev, Muskan Turesh, Ateesh Kumar, Ravi Kumar, Aashish Meghjiani, Syeda Lamiya Mir, Muhammad Hassaan, Rehan Qureshi, Vishal Kumar, Taimoor Ashraf, F N U Deepak, Mohammad Arham Siddiq, Abdul Haseeb, Ayush Kumar","doi":"10.3389/falgy.2024.1486271","DOIUrl":"10.3389/falgy.2024.1486271","url":null,"abstract":"<p><strong>Introduction: </strong>Atopic dermatitis (AD) is a chronic inflammatory skin disorder that affects millions worldwide, presenting challenges in managing symptoms and quality of life. Current treatments include topical corticosteroids (TCS), but novel approaches, such as Janus kinase (JAK) inhibitors, show promise. Baricitinib, a selective JAK1 and JAK2 inhibitor, targets cytokines involved in AD and offers potential benefits beyond traditional therapies.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to evaluate the efficacy and safety of baricitinib in treating moderate-to-severe AD. We followed PRISMA guidelines and assessed data from PubMed, Cochrane Central, ScienceDirect, and ClinicalTrials.gov up to August 2024. The analysis included trials comparing baricitinib to placebo, with or without TCS, evaluating outcomes such as Investigator's Global Assessment (IGA) scores, Eczema Area and Severity Index (EASI) scores, and safety profiles.</p><p><strong>Results: </strong>Six RCTs involving 2,595 participants met the inclusion criteria. Baricitinib demonstrated significant improvements in IGA scores, EASI scores, Dermatology Life Quality Index (DLQI), and other outcome measures compared to placebo. The efficacy was consistent across different dosages (1 mg, 2 mg, 4 mg) and whether baricitinib was used with or without TCS. Safety analyses revealed a significant increase in treatment-emergent adverse events (TEAEs), particularly with the 2 mg and 4 mg dosages and with TCS.</p><p><strong>Conclusion: </strong>Baricitinib, both alone and in combination with TCS, significantly improves symptoms and quality of life in patients with moderate-to-severe AD, with efficacy consistent across dosages. The safety profile is overall acceptable, though a significant increase in TEAEs was observed, particularly with higher dosages and when used with TCS. Ongoing monitoring of TEAEs is recommended, and future trials with longer follow-up periods are suggested to better understand long-term outcomes.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1486271"},"PeriodicalIF":3.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hereditary alpha tryptasemia: elevated tryptase, female sex, thyroid disorders, and anaphylaxis.","authors":"Viktoria Puxkandl, Stefan Aigner, Wolfram Hoetzenecker, Sabine Altrichter","doi":"10.3389/falgy.2024.1461359","DOIUrl":"10.3389/falgy.2024.1461359","url":null,"abstract":"<p><strong>Introduction: </strong>The clinical significance of elevated baseline serum tryptase (BST) in the absence of mast cell disorders or allergic reactions has long been unclear. Recently, a genetic variation of the <i>TPSAB1</i> gene, which among others encodes for alpha tryptase, has been reported and named hereditary alpha tryptasemia (HaT). HaT has been linked to various manifestations, including severe allergic reactions. However, clinical studies are limited. In this study, we aimed to determine HaT prevalence and characterize its clinical manifestations in patients at a specialized allergy center.</p><p><strong>Methods: </strong>From January 2022 to December 2023, patients with elevated BST at least once were screened for HaT at the outpatient clinic. A control group included patients with a history of anaphylaxis undergoing specific Hymenoptera immunotherapy. <i>TPSAB1</i> copy numbers, BST levels, and clinical parameters were assessed and analyzed.</p><p><strong>Results: </strong>Of 47 patients with elevated BST (≥11.4 µg/L), 93% showed increased <i>TPSAB1</i> copy numbers. Individuals diagnosed with HaT displayed a BST range between 12.3 and 28.4 µg/L, with 84.1% associated with <i>TPSAB1</i> duplication and 15.9% with triplication. HaT predominated in women (86.4%) and was associated with thyroid disease (27.3%). Over half had a history of anaphylaxis (54.5%), which was mainly low-grade.</p><p><strong>Discussion: </strong>In patients with elevated BST but no mastocytosis, the most likely cause of elevated BST was an increase in the copy number of the <i>TPSAB1</i> gene. A heightened risk of anaphylaxis should be considered. Further research is needed to explore the predominance of women and the emerging link with thyroid disease.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1461359"},"PeriodicalIF":3.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the predictive potential of ADAM8 for disease control in chronic rhinosinusitis with nasal polyps.","authors":"Peiqiang Liu, Meng Liu, Yibin Sun, Weiwei Lei, Yu Xu","doi":"10.3389/falgy.2024.1488441","DOIUrl":"10.3389/falgy.2024.1488441","url":null,"abstract":"<p><strong>Background: </strong>A disintegrin and metalloproteinase 8 (ADAM8) has been implicated in eosinophilic inflammation; however, its role in chronic rhinosinusitis with nasal polyps (CRSwNP) remains to be elucidated. This study aimed to investigate the predictive significance of ADAM8 levels in nasal secretions for the endotypes and disease control status of CRSwNP.</p><p><strong>Methods: </strong>A cohort comprising 120 CRSwNP patients and 45 healthy controls (HCs) was assembled, delineating 53 non-eosinophilic CRSwNP (neCRSwNP) and 67 eosinophilic CRSwNP (eCRSwNP) patients. Immunohistochemistry and enzyme-linked immunosorbent assay (ELISA) were utilized to measure ADAM8 levels in nasal mucosal tissues and secretions from all participants. The receiver operating characteristic (ROC) curves and Pearson correlation analysis were employed to assess the predictive capability of ADAM8 levels in predictiving CRSwNP endotypes and disease control status.</p><p><strong>Results: </strong>ADAM8 levels in nasal secretions were elevated in CRSwNP patients compared to HCs, with a more pronounced increase observed in eCRSwNP patients. Elevated ADAM8 concentrations in nasal secretions were positively correlated with peripheral blood eosinophil counts and percentages, tissue eosinophil counts, serum total IgE, Lund-Mackay scores, and Lund-Kennedy scores. Ultimately, 103 CRSwNP patients completed the follow-up protocol, with 72 classified as the controlled group and 31 as the uncontrolled group. Uncontrolled CRSwNP patients exhibited significantly higher ADAM8 levels in nasal secretions compared to the controlled group. The ROC curves indicated that ADAM8 in nasal secretions exhibits robust discriminatory capacity for eCRSwNP and postoperative disease control status.</p><p><strong>Conclusion: </strong>ADAM8 in nasal secretions emerges as a potential novel biomarker for the prognostication of CRSwNP endotypes and the postoperative disease control status.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1488441"},"PeriodicalIF":3.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future of food allergy diagnosis.","authors":"Dominic S H Wong, Alexandra F Santos","doi":"10.3389/falgy.2024.1456585","DOIUrl":"10.3389/falgy.2024.1456585","url":null,"abstract":"<p><p>Food allergy represents an increasing global health issue, significantly impacting society on a personal and on a systems-wide level. The gold standard for diagnosing food allergy, the oral food challenge, is time-consuming, expensive, and carries risks of allergic reactions, with unpredictable severity. There is, therefore, an urgent need for more accurate, scalable, predictive diagnostic techniques. In this review, we discuss possible future directions in the world of food allergy diagnosis. We start by describing the current clinical approach to food allergy diagnosis, highlighting novel diagnostic methods recommended for use in clinical practice, such as the basophil activation test and molecular allergology, and go on to discuss tests that require more research before they can be applied to routine clinical use, including the mast cell activation test and bead-based epitope assay. Finally, we consider exploratory approaches, such as IgE glycosylation, IgG4, T and B cell assays, microbiome analysis, and plasma cytokines. Artificial intelligence is assessed for potential integrated interpretation of panels of diagnostic tests. Overall, a framework is proposed suggesting how combining established and emerging technologies can effectively enhance the accuracy of food allergy diagnosis in the future.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1456585"},"PeriodicalIF":3.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling heterogeneity and treatment of asthma through integrating multi-omics data.","authors":"Wei Zhang, Yu Zhang, Lifei Li, Rongchang Chen, Fei Shi","doi":"10.3389/falgy.2024.1496392","DOIUrl":"10.3389/falgy.2024.1496392","url":null,"abstract":"<p><p>Asthma has become one of the most serious chronic respiratory diseases threatening people's lives worldwide. The pathogenesis of asthma is complex and driven by numerous cells and their interactions, which contribute to its genetic and phenotypic heterogeneity. The clinical characteristic is insufficient for the precision of patient classification and therapies; thus, a combination of the functional or pathophysiological mechanism and clinical phenotype proposes a new concept called \"asthma endophenotype\" representing various patient subtypes defined by distinct pathophysiological mechanisms. High-throughput omics approaches including genomics, epigenomics, transcriptomics, proteomics, metabolomics and microbiome enable us to investigate the pathogenetic heterogeneity of diverse endophenotypes and the underlying mechanisms from different angles. In this review, we provide a comprehensive overview of the roles of diverse cell types in the pathophysiology and heterogeneity of asthma and present a current perspective on their contribution into the bidirectional interaction between airway inflammation and airway remodeling. We next discussed how integrated analysis of multi-omics data via machine learning can systematically characterize the molecular and biological profiles of genetic heterogeneity of asthma phenotype. The current application of multi-omics approaches on patient stratification and therapies will be described. Integrating multi-omics and clinical data will provide more insights into the key pathogenic mechanism in asthma heterogeneity and reshape the strategies for asthma management and treatment.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1496392"},"PeriodicalIF":3.3,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Dual monoclonal antibody therapy in chronic rhinosinusitis with nasal polyps and severe eosinophilic asthma-a proteome analysis.","authors":"Manon Blauwblomme, Philippe Gevaert, Sharon Van Nevel, Sebastian Riemann, Elke Vandewalle, Gabriele Holtappels, Natalie De Ruyck, Lara Derycke, Anne-Sophie Eeckels, Stijn Vanhee, Bart N Lambrecht, Guy Brusselle, Thibaut Van Zele","doi":"10.3389/falgy.2024.1484931","DOIUrl":"10.3389/falgy.2024.1484931","url":null,"abstract":"<p><strong>Context: </strong>Recent insights into type 2 inflammation have led to the development of monoclonal antibody therapies for severe asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). Despite add-on therapy with a monoclonal antibody, some individuals remain uncontrolled in terms of upper and/or lower airway symptoms, prompting an exploration of the efficacy of combining biological therapies and their impact on inflammatory pathways.</p><p><strong>Objectives: </strong>In this article, we present a distinctive case of a patient with CRSwNP, severe eosinophilic asthma, and uncontrolled upper airway symptoms, who experienced substantial clinical and local inflammatory improvements through dual monoclonal antibody therapy.</p><p><strong>Methods: </strong>We provide a detailed case description and analysis of the patient's nasal tissue and secretions to gain insights into the local nasal inflammation under this unique therapeutic approach.</p><p><strong>Results: </strong>The addition of an anti-IL-4Rα antibody led to an improvement in upper airway symptoms and a reduction in both eosinophilic and neutrophilic inflammation, despite prior anti-IL-5 therapy. These effects were consistently observed in both polyp tissue and nasal secretions.</p><p><strong>Conclusion: </strong>Our patient, with CRSwNP, severe eosinophilic asthma, and uncontrolled upper airway symptoms, experienced substantial improvement with dual monoclonal antibody therapy, without major complications or side effects.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1484931"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Acari Hypothesis, V: deciphering allergenicity.","authors":"Andrew C Retzinger, Gregory S Retzinger","doi":"10.3389/falgy.2024.1454292","DOIUrl":"10.3389/falgy.2024.1454292","url":null,"abstract":"<p><p>The Acari Hypothesis posits that acarians, i.e., mites and ticks, are operative agents of allergy. It derived from observations that allergens are molecular elements of acarians or acarian foodstuffs. A corollary of The Hypothesis provides how acarian dietary elements are selected as allergens; namely, a pattern recognition receptor native to the acarian digestive tract complexes with dietary molecules problematic to the acarian. By virtue of its interspecies operability, the receptor then enables not only removal of the dietary elements by the acarian immune system, but also-should such a complex be inoculated into a human-production of an element-specific IgE. Because pattern recognition receptors bind to molecules problematic to the organism from which the receptors originate, it follows that molecules targeted by adaptive IgE, i.e., allergens, must be problematic to acarians. This claim is supported by evidence that host organisms, when infested by acarians, upregulate representative members of allergenic molecular families. Appreciation of the relationship between allergens and acarians provides insight well beyond allergy, shedding light also on the anti-acarian defenses of many living things, especially humans.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1454292"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Anaphylaxis caused by traditional Chinese medicine in a patient with pollinosis.","authors":"Zhouxian Pan, Mengyuan Zhan, Qing Wang, Jun Liu, Yu Li, Fan Zhi, Jing Zhang, Jinhe Liu, Kai Guan, Liping Wen","doi":"10.3389/falgy.2024.1470638","DOIUrl":"10.3389/falgy.2024.1470638","url":null,"abstract":"<p><p>This case describes a patient with anaphylaxis caused by traditional Chinese medicine. Skin prick test with the traditional Chinese medicine decoction indicates that he was allergic to Suan Zao Ren. The patient had pollinosis and had never taken Suan Zao Ren before, thus we need to think the possibility of pollen food allergy syndrome. This paper also proposes a procedure for doctors to identify the specific culprit of traditional Chinese medicine decoction.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"5 ","pages":"1470638"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}