The journal of allergy and clinical immunology. Global最新文献

{"title":"Refractory phenotype of Aspergillus-sensitized asthma with bronchiectasis and allergic bronchopulmonary aspergillosis","authors":"Natsuko Nomura MD, PhD ,&nbsp;Hisako Matsumoto MD, PhD ,&nbsp;Koichiro Asano MD, PhD ,&nbsp;Yusuke Hayashi MD ,&nbsp;Akihito Yokoyama MD, PhD ,&nbsp;Yoshihiro Nishimura MD, PhD ,&nbsp;Naozumi Hashimoto MD, PhD ,&nbsp;Takuro Sakagami MD, PhD ,&nbsp;Koichi Fukunaga MD, PhD ,&nbsp;Nobuyuki Hizawa MD, PhD ,&nbsp;Akira Yamasaki MD, PhD ,&nbsp;Hiroyuki Nagase MD, PhD ,&nbsp;Noboru Hattori MD, PhD ,&nbsp;Mitsuko Kondo MD, PhD ,&nbsp;Norihiro Harada MD, PhD ,&nbsp;Hisatoshi Sugiura MD, PhD ,&nbsp;Mari Miki MD, PhD ,&nbsp;Tomoki Kimura MD, PhD ,&nbsp;Mikio Toyoshima MD, PhD ,&nbsp;Osamu Matsuno MD, PhD ,&nbsp;Yoko Sato","doi":"10.1016/j.jacig.2024.100364","DOIUrl":"10.1016/j.jacig.2024.100364","url":null,"abstract":"<div><h3>Background</h3><div>Sensitization to <em>Aspergillus,</em> mucus plugs, and bacterial colonization may coexist and relate to a refractory phenotype during follow-up in asthma with bronchiectasis and allergic bronchopulmonary aspergillosis (ABPA).</div></div><div><h3>Objective</h3><div>This study aimed to clarify the features of <em>Aspergillus</em>-sensitized refractory asthma with bronchiectasis and determine the refractory phenotype in this population and ABPA.</div></div><div><h3>Methods</h3><div>This study included cases of the oldest available <em>Aspergillus fumigatus</em>–specific IgE data and chest computed tomography images from a nationwide survey of refractory asthma with bronchiectasis. The characteristics of the <em>A fumigatus</em>–IgE positive (<em>Af</em> sIgE⁺) group were investigated and compared with its nonsensitized counterpart (<em>Af</em> sIgE⁻) and ABPA group. Cluster analysis was conducted to determine the refractory phenotype.</div></div><div><h3>Results</h3><div>The <em>Af</em> sIgE⁺ group (n = 35) demonstrated type 2 inflammation levels intermediate between the ABPA (n = 42) and <em>Af</em> sIgE⁻ (n = 38) groups while exhibiting higher blood monocyte counts than the <em>Af</em> sIgE⁻ group. Cluster analysis conducted in patients with ABPA and <em>Af</em> sIgE⁺ newly determined 2 clusters: one was characterized by a younger age of asthma onset with fungal detection in sputum, and the other was characterized by mucus plugs and inflammation with eosinophils and monocytes, which was significantly related to mucus plugs, airflow limitation, and trend to show exacerbation. In the latter cluster, mucus plugs persisted, and 30% yielded <em>Pseudomonas aeruginosa</em> in the sputum &lt;5 years later.</div></div><div><h3>Conclusion</h3><div>The refractory phenotype with persistent mucus plugs was identified in <em>Aspergillus</em>-sensitized refractory asthma with bronchiectasis and ABPA. Mucus plug prevention is warranted.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100364"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723731","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":"Sinusitis and rhinitis among US veterans deployed to Southwest Asia and Afghanistan after September 11, 2001","authors":"Jennifer Maccarone MD ,&nbsp;Carrie A. Redlich MD ,&nbsp;Andrew Timmons MS ,&nbsp;Anna M. Korpak PhD ,&nbsp;Nicholas L. Smith PhD ,&nbsp;Karen S. Nakayama BS ,&nbsp;Coleen P. Baird MD, MPH ,&nbsp;Paul Ciminera MD ,&nbsp;Farrah Kheradmand MD ,&nbsp;Vincent S. Fan MD, MPH ,&nbsp;Jaime E. Hart ScD ,&nbsp;Petros Koutrakis PhD ,&nbsp;Ware G. Kuschner MD ,&nbsp;Octavian C. Ioachimescu MD, PhD, MBA ,&nbsp;Michael Jerrett PhD ,&nbsp;Philippe R. Montgrain MD ,&nbsp;Susan P. Proctor DSc ,&nbsp;Christine H. Wendt MD ,&nbsp;Cherry Wongtrakool MD ,&nbsp;Emily S. Wan MD, MPH ,&nbsp;Eric Garshick MD, MOH","doi":"10.1016/j.jacig.2024.100367","DOIUrl":"10.1016/j.jacig.2024.100367","url":null,"abstract":"<div><h3>Background</h3><div>Post-9/11 veterans were exposed to environmental and occupational pollutants during deployment.</div></div><div><h3>Objective</h3><div>Our aim was to determine associations between deployment-related exposures and sinusitis and rhinitis.</div></div><div><h3>Methods</h3><div>Between April 2018 and March 2020, veterans with land-based deployment after 9/11 who were living within 25 miles of 6 Department of Veteran Affairs medical centers were randomly chosen by using a Defense Manpower Data Center roster. Participants completed interviewer-administered questionnaires, which included a 32-item deployment exposure battery and self-report of rhinitis and health professional–diagnosed sinusitis. Exposure categories included burn pit smoke, combustion engine exhaust/ground dust, other open combustion sources, toxicants, and military job-related VGDF. Each item was scored on the basis of frequency and duration of exposure; ordinal scores were summed and scaled to 100 within each category. Odds ratios (ORs) were estimated using logistic regression for sinusitis and rhinitis separately. ORs were scaled per 20-point exposure score.</div></div><div><h3>Results</h3><div>Among the 1960 participants, the incidences of sinusitis and rhinitis with onset during deployment were 2.1% and 3.6%, respectively; the incidences of postdeployment onset were 5.1% and 5.6%, respectively. Toxicant exposure consisted mainly of “applying pesticide, insecticide, or repellent to your own skin or to your own clothing” and was associated with rhinitis with onset during deployment (OR = 1.50 [95% CI = 1.31-1.84]) and onset after deployment (OR = 1.21 [95% CI = 0.93-1.50]). There were no associations with burn pit smoke or other exposure categories.</div></div><div><h3>Conclusion</h3><div>Veterans with deployment exposures to toxicants were at increased risk of rhinitis, particularly during deployment. The clinical evaluation of postdeployment veterans should address rhinitis as a deployment-related condition.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100367"},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701742","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":"On-treatment clinical remission of severe asthma with real-world longer-term biologic use","authors":"Bradley E. Chipps MD ,&nbsp;Njira Lugogo MD ,&nbsp;Warner Carr MD ,&nbsp;Wenjiong Zhou PhD ,&nbsp;Arpan Patel PharmD ,&nbsp;Donna D. Carstens MD ,&nbsp;Frank Trudo MD, MBA ,&nbsp;Christopher S. Ambrose MD, MBA","doi":"10.1016/j.jacig.2024.100365","DOIUrl":"10.1016/j.jacig.2024.100365","url":null,"abstract":"<div><h3>Background</h3><div>There are limited real-world data describing the proportion of patients with severe asthma (SA) who achieve on-treatment clinical remission with long-term biologic treatment.</div></div><div><h3>Objective</h3><div>Our aim was to examine the proportion and characteristics of adults with SA who achieved clinical remission with biologic therapy.</div></div><div><h3>Methods</h3><div>CHRONICLE is an observational study of US subspecialist–treated adults with SA. Sites reported exacerbations and biologic use from 12 months before enrollment forward. Monthly Asthma Control Test scores and 6-monthly specialist assessments of asthma control were collected. Patients who enrolled from February 2018 to February 2023, began taking a biologic during the study observation period, and continued use of that biologic for at least 12 months were evaluated. Incident on-treatment clinical remission was defined in a 12-month interval as the absence of exacerbations and systemic corticosteroid use, a 50% or greater improvement in Asthma Control Test scores of least 20 points in the latest 6 months, and specialist report of asthma control.</div></div><div><h3>Results</h3><div>Among the evaluable patients (n = 611), the median duration of biologic use was 39.6 months. In at least one 12-month interval during the study, 79.9% of patients had no exacerbations or systemic corticosteroid use and 46.0% met the definition of clinical remission at any point. The point prevalence of clinical remission increased from 22.3% at 12 to 13 months of biologic use to 34.3% at 47 to 48 months of biologic use.</div></div><div><h3>Conclusions</h3><div>In a real-world cohort of patients with SA with longer-term biologic treatment, almost one-half achieved on-treatment clinical remission. With at least 1 year of biologic therapy, clinical remission is a feasible treatment goal in SA.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100365"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701741","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":"Health care transition rates and associated factors for adolescents with asthma","authors":"Mindy K. Ross MD ,&nbsp;Anna-Barbara Moscicki MD ,&nbsp;Kosuke Kawai ScD ,&nbsp;Lucia Chen MS","doi":"10.1016/j.jacig.2024.100363","DOIUrl":"10.1016/j.jacig.2024.100363","url":null,"abstract":"<div><h3>Background</h3><div>Adolescents and young adults with asthma face increased risks during the health care transition (HCT) from pediatric to adult care. Despite guidelines advocating for more HCT preparedness, this does not consistently occur in clinical practice. The rates of exposure to transition preparation in adolescents with asthma are unknown.</div></div><div><h3>Objectives</h3><div>Our goal was to understand the rates of HCT exposure among adolescents with asthma in the United States, along with predictive characteristics associated with receiving HCT exposure, as determined by using data from a nationally representative survey.</div></div><div><h3>Methods</h3><div>We studied adolescents aged 12 to 17 years with asthma in the 2020-2021 National Survey of Children’s Health data set. We explored associations between sociodemographic, health-related, and provider practice–related variables and HCT exposure through univariate analysis and multivariable logistic regression.</div></div><div><h3>Results</h3><div>Only 19% of adolescents with asthma from this cohort met criteria indicating that they had received HCT exposure. In our multivariable analysis, being older, being female, having a provider actively work with the child to make positive choices about health, having a written care plan addressing transition, having routine preventive care visits, and having a caregiver who has someone with whom to discuss health insurance into adulthood were associated with higher odds of HCT exposure. Hispanic ethnicity, lack of insurance, and residence in a metropolitan area were associated with lower odds of receiving preparation for transitional care but were not significant in the multivariable model.</div></div><div><h3>Conclusions</h3><div>Our findings underscore the need to improve transitional care preparation for adolescents with asthma, with attention needed to address disparities based on sociodemographic factors, including health care access.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100363"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701679","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":"In memoriam: Euan R. Tovey, July 11, 1948, to June 28, 2024","authors":"Martin Chapman PhD ,&nbsp;Ginger L. Chew ScD ,&nbsp;Julian Crane MD ,&nbsp;Jeroen Douwes PhD ,&nbsp;Brett J. Green PhD ,&nbsp;Elliott Horner PhD ,&nbsp;Guy Marks PhD ,&nbsp;Lidia Morawska PhD ,&nbsp;Matthew S. Perzanowski PhD ,&nbsp;Félix E. Rivera-Mariani PhD","doi":"10.1016/j.jacig.2024.100362","DOIUrl":"10.1016/j.jacig.2024.100362","url":null,"abstract":"","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100362"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701743","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":"Global differences and risk factors influencing drug hypersensitivity quality of life: A multicenter, multiethnic study of drug allergy across 3 continents","authors":"Ana M. Copaescu MD, FRCP ,&nbsp;Hugo W.F. Mak MBBS ,&nbsp;Sara Vogrin MBiostat ,&nbsp;Natasha E. Holmes PhD ,&nbsp;Jason A. Trubiano PhD ,&nbsp;Philip H. Li MD","doi":"10.1016/j.jacig.2024.100354","DOIUrl":"10.1016/j.jacig.2024.100354","url":null,"abstract":"<div><h3>Background</h3><div>Penicillin allergy labels are associated with many adverse outcomes. Fear and restriction of future medication use also have an impact on health-related quality of life (HR-QoL). However, the impact of a drug allergy on HR-QoL and its associated factors remains unknown.</div></div><div><h3>Objective</h3><div>We sought to investigate the impact of penicillin allergy labels and compare the factors associated with HR-QoL impairment among patients in an international multicenter, multiethnic cohort.</div></div><div><h3>Methods</h3><div>HR-QoL was measured using the 6-item Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q) and compared among patients labeled with penicillin allergy, before their allergy evaluation, from 8 adult allergy/immunology clinics across Asia, Australia, and North America.</div></div><div><h3>Results</h3><div>We recruited 643 patients labeled with penicillin allergy (median age, 56 years [interquartile range, 39-67]; male:female ratio, 1:2.2), with 273 (42.5%), 186 (28.9%), and 184 (28.6%) from Asia, North America, and Australia, respectively. The median DrHy-Q score was 8.3 (interquartile range, 0.0-29.2). All patients underwent penicillin allergy evaluation, and 96% (617 of 643) were delabeled following negative provocation test results. Female patients (8.3 vs 4.2; <em>P</em> = .003), those with other concomitant antimicrobial allergy labels (20.8 vs 4.2; <em>P</em> = .004), and patients from Asia (33.3 vs 4.2 [North America] vs 0 [Australia]; <em>P</em> &lt; .001) had significantly higher DrHy-Q scores, reflecting a reduced HR-QoL. Ethnicity as well as other allergy variables were not significant in the multivariate analysis.</div></div><div><h3>Conclusions</h3><div>Regional differences, ethnicity, and other risk factors influence HR-QoL impairment among patients labeled with penicillin allergy. Future studies are needed to understand the contributions of regional sociodemographic factors and identify interventions to improve HR-QoL.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100354"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654087","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":"Omics analysis reveals galectin-3 to be a potential key regulator of allergic inflammation in hereditary angioedema","authors":"Supriya D. Mahajan PhD, MPH ,&nbsp;Ravikumar Aalinkeel PhD ,&nbsp;Jessica L. Reynolds PhD ,&nbsp;Janvhi S. Machhar MS ,&nbsp;Berhane Ghebrehiwet DVM, DSc ,&nbsp;Stanley A. Schwartz MD, PhD","doi":"10.1016/j.jacig.2024.100353","DOIUrl":"10.1016/j.jacig.2024.100353","url":null,"abstract":"<div><h3>Background</h3><div>Hereditary angioedema (HAE) is a rare inherited disorder that predisposes an individual to develop vasogenic edema. Bradykinin release, which increases vascular permeability, results in angioedema. C1 esterase inhibitor (C1-INH) is a major regulator of critical enzymes involved in bradykinin generation and mutations in genes that encode the C1 inhibitor of complement factor 1, which prevent its synthesis (type I HAE), form a dysfunctional protein (type II HAE), or have normal functioning C1-INH (type III HAE, aka HAE-III).</div></div><div><h3>Objectives</h3><div>The goals of this study were to use a systems biology analysis to identify novel biomarkers to aid in the diagnosis of HAE-III and to elucidate its underlying pathogenic mechanisms.</div></div><div><h3>Methods</h3><div>Blood samples were obtained from HAE-III subjects and age- and sex-matched healthy controls. DNA, RNA, and protein purified from the samples were subjected to multiomics analysis using a 1-shot liquid chromatography–mass spectrometry–based multiomics platform (Omni-MS, Dalton Bioanalytics) to profile proteins, lipids, electrolytes, and metabolites enabling concurrent analysis of diverse analyte classes.</div></div><div><h3>Results</h3><div>A total of 1647 novel identifications that included genes, proteins, and metabolites were made when comparing HAE-III samples to control samples. Our identification library included MSFragger for protein identification, LipiDex for lipid identification, and Compound Discoverer for metabolite identification, enabling differential expression analysis. Key findings included a significant increase in the expression levels of galectin-3, lysosomal α-glucosidase, platelet factor 4, and platelet-derived growth factor subunit A in HAE-III subjects compared to controls, all of which generate an immunomodulatory response.</div></div><div><h3>Conclusion</h3><div>Galectin-3 plays a critical role in eosinophil recruitment and airway allergic inflammation. It may contribute to chronic inflammation and fibrosis resulting in leaky vasculature, and it could be a potential therapeutic target in HAE-III.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100353"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653488","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":"Questionnaire-based real-world survey of diagnosing food allergy in children: Utilization of oral food challenge tests and other diagnostic methods","authors":"Chisa Kumagai MD ,&nbsp;Norio Kawamoto MD, PhD ,&nbsp;Yuki Miwa MD ,&nbsp;Tomoko Kaneyama MD ,&nbsp;Saori Kadowaki MD, PhD ,&nbsp;Minako Kawamoto MD, PhD ,&nbsp;Hidenori Ohnishi MD, PhD","doi":"10.1016/j.jacig.2024.100356","DOIUrl":"10.1016/j.jacig.2024.100356","url":null,"abstract":"<div><h3>Background</h3><div>Oral food challenge tests are considered the reference standard for diagnosing food allergies; however, studies on their real-world implementation rates are limited.</div></div><div><h3>Objective</h3><div>The study aimed to investigate the proportion of school-age children who underwent the oral food challenge test and to understand the motivations behind food elimination and utilization of various health care services.</div></div><div><h3>Methods</h3><div>The questionnaire-based survey for the parents of the students who submitted the “Certificate for School Life Management (For Allergic Diseases)” was conducted across public elementary and junior high schools in Gifu prefecture, Japan.</div></div><div><h3>Results</h3><div>The study encompassed parents of 3457 children with food allergies who submitted the certificate. Approximately one third of those eliminating the 3 major allergens—eggs (32.5%), milk (27.6%), and wheat (33.5%)—were diagnosed via oral food challenge tests, and approximately two thirds were diagnosed using a combination of symptoms and blood tests, suggesting most children were diagnosed appropriately. However, many children were diagnosed and eliminated foods based solely on blood tests without any symptoms of other allergens, such as buckwheat (55.8%), peanuts (29.2%), and tree nuts (21.2%), suggesting that it was likely that these children unnecessarily eliminated foods. Elimination of buckwheat because of anxiety was associated with eliminating other foods for the same reason and with eliminating 2 or more foods.</div></div><div><h3>Conclusion</h3><div>Examination of the real-world application of the proposed recommendations for the accurate diagnosis of food allergies suggests that closely monitoring their practical application should be conducted in each case to avoid unnecessary food elimination from children’s diets.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100356"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653490","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":"NFATc1 in CD4+ T cells and CD11c+ dendritic cells drives TH2-mediated eosinophilic inflammation in allergic asthma","authors":"Zuqin Yang MSc ,&nbsp;Susanne Krammer RPh ,&nbsp;Hannah Mitländer ,&nbsp;Janina C. Grund ,&nbsp;Sabine Zirlik MD ,&nbsp;Stefan Wirtz PhD ,&nbsp;Manfred Rauh PhD ,&nbsp;Atefeh Sadeghi Shermeh MSc ,&nbsp;Susetta Finotto PhD","doi":"10.1016/j.jacig.2024.100355","DOIUrl":"10.1016/j.jacig.2024.100355","url":null,"abstract":"<div><h3>Background</h3><div>Asthma, a chronic lung disease, is a significant public health problem worldwide. It is marked by increased T_H2 response resulting in eosinophil accumulation. The pathophysiology of asthma involves various cell types, including epithelial cells, dendritic cells (DCs), innate lymphoid cells, B cells, and effector cells. Nuclear factor of activated T cells, cytoplasmic 1 (NFATc1), a critical transcription factor for immune regulation, is known for its role in T cells and, more recently, in myeloid cells. However, the specific contributions of NFATc1 in T cells and DCs in the context of asthma are not well understood.</div></div><div><h3>Objective</h3><div>We explored NFATc1’s role in T cells and DCs in modulating T_H2 immune responses within the pathophysiology of allergic asthma.</div></div><div><h3>Methods</h3><div>We induced asthma in mice lacking <em>Nfatc1</em> in CD4⁺ T cells or CD11c⁺ DCs using house dust mite, thereby enabling investigation into NFATc1’s role in both cell types in experimental allergic asthma. Additionally, we examined NFATc1 expression in these cell types and its correlation with blood eosinophil levels in an adult asthma cohort.</div></div><div><h3>Results</h3><div>In a house dust mite–induced asthma model, we found that <em>Nfatc1</em> deficiency either in CD4⁺ T cells or CD11c⁺ DCs resulted in reduced T_H2-driven eosinophilic inflammation, IgE levels, and mast cell presence in the lung of asthmatic mice. <em>Nfatc1</em>’s absence in CD4⁺ T cells directly hampered T_H2 cell polarization and functionality, whereas in CD11c⁺ DCs, it affected DC differentiation and maturation, thereby weakening T-cell priming, proliferation, and subsequent T_H2 differentiation. Correspondingly, translational research indicated significant correlations between CD4⁺NFATc1⁺ and CD11c⁺NFATc1⁺ cell populations and eosinophil levels in asthmatic patients, but not in healthy controls.</div></div><div><h3>Conclusion</h3><div>NFATc1 in T cells and DCs modulates T_H2-mediated eosinophilic inflammation in allergic asthma, thus offering insight into asthma pathogenesis and identifying NFATc1 as a potential target for therapeutic intervention.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100355"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653489","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":"Associations of aeroallergen testing with reduced oral corticosteroid bursts among adults with asthma","authors":"Patrick K. Gleeson MD, MSCE ,&nbsp;Knashawn H. Morales ScD ,&nbsp;Timothy M. Buckey MD, MBE ,&nbsp;Olajumoke O. Fadugba MD ,&nbsp;Andrea J. Apter MD, MSc, MA ,&nbsp;Jason D. Christie MD, MSCE ,&nbsp;Blanca E. Himes PhD","doi":"10.1016/j.jacig.2024.100348","DOIUrl":"10.1016/j.jacig.2024.100348","url":null,"abstract":"<div><h3>Background</h3><div>Aeroallergen testing can improve precision care for persistent asthma. How testing benefits diverse populations of adults with asthma and the importance of the aeroallergen sensitization and test modality used remain poorly understood.</div></div><div><h3>Objective</h3><div>We evaluated whether aeroallergen testing was associated with a reduction in oral corticosteroid (OCS) bursts.</div></div><div><h3>Methods</h3><div>We used electronic health record data to conduct a retrospective cohort study of adults with asthma who were prescribed an inhaled corticosteroid and had an allergy/immunology visit in a large health system between January 1, 2017, and June 30, 2022. We used negative binomial regression models to evaluate whether testing was associated with fewer OCS bursts in the 12-month period after an initial visit among all patients and those without chronic obstructive pulmonary disease (COPD) and smoking histories. We then repeated these analyses while considering effects of sensitization to aeroallergen categories and whether the testing was via skin prick or serum-specific IgE.</div></div><div><h3>Results</h3><div>A total of 684 (48.4%) of 1,412 patients underwent testing. Testing was not associated with fewer bursts overall (incidence rate ratio [IRR] = 0.84 vs no testing, <em>P</em> = .08), but it was among never smokers without COPD (461 of 927 tested, IRR = 0.69, <em>P</em> = .005). Among never smokers without COPD, sensitization to 5-7 aeroallergen categories (IRR = 0.57 vs no test, <em>P</em> = .003) and receipt of skin prick tests (IRR = 0.58 vs no test, <em>P</em> &lt; .0005) were associated with fewer bursts.</div></div><div><h3>Conclusion</h3><div>Aeroallergen testing was associated with reduced OCS bursts among adults with asthma who were never smokers without COPD. This association varied according to aeroallergen sensitization and test modality used.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100348"},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654085","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}