Allergologia et immunopathologia最新文献

{"title":"Allergy to cabazitaxel: Cross-reactivity between taxanes.","authors":"Paola C Fernández-Paredes, Mariola Navarro Guerrero, Elisa Peñalver de la Puente, J Damian Lopez-Sanchez","doi":"10.15586/aei.v54i2.1458","DOIUrl":"10.15586/aei.v54i2.1458","url":null,"abstract":"<p><p>A 46-year-old man, with HIV infection A2 stage and chronic C hepatitis was diagnosed with stage 4 prostate cancer with bone metastases in September 2019. His treatment was started with docetaxel, receiving five cycles with good tolerance, after which he received hormonal treatment. Currently, he presents progression of the disease and docetaxel is reintroduced. After infusing the first 5 mL, he showed respiratory distress with thoracic pain and low oxygen saturation (88%) together with lumbar pain. Both tryptase and interleukin 6 (IL-6) levels in blood were measured at the time of the reaction, and were elevated. The case was discussed in an oncology clinical round, and it was decided a change to cabazitaxel. Allergy tests were performed, including skin prick and intradermal tests, with docetaxel and cabazitaxel. A positive result to intradermal test with docetaxel, 10 mg/mL, was obtained 24 h later. Then 48 h later, another positive intradermal test reaction with 1-mg/mL docetaxel as skin ulceration was reported. However, skin prick and intradermal tests with cabazitaxel were negative.Drug provocation test with cabazitaxel was subsequently performed. After the infusion of 11 mL, the patient presented pharyngeal obstruction with dyspnoea, facial erythema, genital pruritus, and cervical pain that required treatment with intramuscular epinephrine. The results of the allergy study were not concordant with clinical presentation and confirmed the poor predictive value of taxane skin tests.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 2","pages":"148-150"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world effectiveness and safety of dupilumab in children with atopic dermatitis: a Latin American single-center study.","authors":"Victor Gonzalez-Uribe, Hector Rodrigo Pastrana-Ayala, Luis Angel Hernandez-Zarate, Carlos Andres Gomez-Nuñez, Maria Julia Rendon-Salazar, Tamara Hernandez-Hernandez, Ricardo Martinez-Tenopala, Zaira Selene Mojica-Gonzalez","doi":"10.15586/aei.v54i2.1402","DOIUrl":"10.15586/aei.v54i2.1402","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD) is common in children (affecting ~20% of children globally) and imposes a substantial burden. Many children in Latin America have moderate-to-severe AD with limited access to advanced therapies, highlighting an unmet need for safe and effective treatment options. Dupilumab, a targeted anti-interleukin-4 (IL-4)-IL-13 biologic, has demonstrated efficacy in pediatric AD, but real-world data in Latin American children are scarce.</p><p><strong>Methods: </strong>We conducted a single-center retrospective observational study in Mexico City with children (aged 4-18 years) with moderate-to-severe AD treated with dupilumab from 2018 to 2024. Clinical outcomes (Eczema Area and Severity Index; Scoring Atopic Dermatitis [SCORAD], and pruritus Numerical Rating Scale [NRS]) and quality-of-life (Dermatology Life Quality Index) were assessed at baseline and ~3, ~6, and ~12 months. Changes over time were analyzed using nonparametric tests, and adverse events were documented.</p><p><strong>Results: </strong>In all, 23 children (~50% female) with severe, treatment-refractory AD were included. Dupilumab led to rapid and significant improvement in all endpoints (P < 0.001). In 12 months, most patients achieved clear or almost clear skin with no pruritus (median SCORAD and itch NRS = 0), and quality-of-life scores improved from a median of 19 to 3. No serious adverse events occurred; mild conjunctivitis was reported in 13% patients (with one discontinuation).</p><p><strong>Conclusion: </strong>In this Latin American pediatric cohort, dupilumab achieved marked and sustained improvements in disease severity and quality of life, with a favorable safety profile. This real-world study addresses a regional evidence gap and supports dupilumab as an effective and well-tolerated treatment for moderate-to-severe pediatric AD.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 2","pages":"28-34"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147429906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypersensitivity reactions with proton pump inhibitors: five years of clinical experience.","authors":"Melis Yağdıran, Kurtuluş Aksu, Özgür Akkale, Hatice Çelik Tuğlu, Onur Telli, Fatma Dindar Çelik, Gürgün Tuğçe Vural Solak","doi":"10.15586/aei.v54i2.1537","DOIUrl":"10.15586/aei.v54i2.1537","url":null,"abstract":"<p><strong>Introduction: </strong>Proton pump inhibitors (PPIs) are generally well tolerated and are frequently prescribed drugs because their risk of adverse effects is 1-3%. Although PPIs have a good safety profile, allergic reactions to these molecules can occur. We aimed to investigate hypersensitivity reactions in patients who underwent oral provocation tests with PPIs in our clinic.</p><p><strong>Methods: </strong>In all, 58 subjects who applied to allergy clinic between January 2018 and December 2023 with a history of early allergic reactions with PPIs and subsequently underwent oral provocation testing to find a diagnostic or safe alternative PPI were included in our study. Information on the subjects' demographic and clinical data and the results of provocation tests was recorded by reviewing patient records.</p><p><strong>Results: </strong>Of the 58 subjects included in the study, 44 (75.9%) were females. The mean age of the patients was 54.4 ± 13.8 years. Fifty-three (91.4%) subjects had a history of allergic reactions to a single PPI and 5 (8.6%) subjects had a history of allergic reactions to two different PPIs, such as lansoprazole, pantoprazole, rabeprazole, esomeprazole, and omeprazole. Intradermal skin testing was performed in 51 (87.9%) of the subjects and all were found to be negative. After the provocation test, only two patients (3.4%) developed early-onset hypersensitivity reactions, one with lansoprazole and the other with esomeprazole.</p><p><strong>Conclusion: </strong>Skin testing is a valuable tool in predicting hypersensitivity reactions associated with PPIs. Although rare, hypersensitivity reactions may occur in patients with negative skin tests.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 2","pages":"70-75"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of topical intranasal curcumin in the experimentally induced allergic rhinitis model in rats (revised).","authors":"Erbay Demir, Muhsin Koten, Fatma Elif Usturalı Keskin, Canan Eryıldız, Selis Gülseven Güven","doi":"10.15586/aei.v54i2.1719","DOIUrl":"10.15586/aei.v54i2.1719","url":null,"abstract":"<p><p>Curcumin, a flavonoid derived from turmeric, has demonstrated antioxidant, anti-inflammatory, and antiallergic effects. This study evaluated the therapeutic efficacy of intranasal curcumin in an allergic rhinitis (AR) rat model. Forty rats were randomized into four groups: a sham control, an AR model with no treatment (negative control), an AR model treated with intranasal mometasone furoate (positive control), and an AR model treated with intranasal curcumin. Allergic symptoms (sneezing, itching, nasal discharge) were evaluated by both unblinded and blinded observers. Serum Ovalbumin (OVA)-specific IgE levels were measured using ELISA. Nasal mucosal histopathology (edema, cilia loss, goblet cell hyperplasia, inflammation, eosinophilia) was assessed by light microscopy. Intranasal curcumin significantly improved histopathological findings and reduced allergic symptoms, with efficacy comparable to steroid treatment. It alleviates AR symptoms and inflammation, suggesting a promising, low-cost alternative for AR management.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 2","pages":"135-142"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creation of an international Inter-Society Pediatric Allergology Network (ISPAN): preliminary data from a survey of pediatric allergist in Italy, Spain, and Portugal.","authors":"Maria Angela Tosca, Chiara Trincianti, Ana Martinez-Canavate Burgos, Liberio Ribeiro, Maria Mesa Del Castillo, Ana Neves, Salvatore Barberi, Franco Frati, Michele Miraglia Del Giudice","doi":"10.15586/aei.v54i2.1609","DOIUrl":"10.15586/aei.v54i2.1609","url":null,"abstract":"<p><p>Allergic rhinitis and asthma are among the most important chronic diseases in children and young adults, with increasing prevalence and significant impact on the healthcare system and quality of life. Allergen Immunotherapy (AIT) remains the only causal treatment capable of modifying the natural course of allergy. However, despite its proven efficacy, real-world data on its application in the pediatric population remain limited. This study aimed to evaluate and compare the management and clinical practice of allergic diseases in the pediatric population, particularly the current use of AIT for respiratory allergy, by pediatricians and allergists in Italy, Spain, and Portugal. A comprehensive online survey developed by the pediatric allergy societies of the three countries was distributed to pediatric allergists to collect demographic data, diagnostic and treatment approaches, and AIT prescription attitudes. A total of 171 responses were analyzed in this study. The results show that most allergists treat high numbers of pediatric allergic patients on weekly basis, primarily using skin and laboratory tests for diagnosis of allergy, and pulmonary function tests to diagnose asthma. AIT was prescribed by the majority of allergists (91.2%), primarily for children aged ≥5 years, and mainly for allergic rhinoconjunctivitis and asthma. Of the respondents, 64.1% chose sublingual AIT over subcutaneous AIT (35.9%) because of compliance (77.6%) or practical reasons (67.9%). Patients were mainly treated for 3 years (39.7%) to 5 years (21.2%) and were regularly monitored every 6 months (51.3%). This initiative marks the first multinational collaboration between pediatric national allergology societies in Mediterranean countries, establishing a fundamental network for future collaborations. This study provides valuable insights and encourages further efforts to harmonize pediatric allergy care across similar sociocultural and environmental regions.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 2","pages":"57-61"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal tobacco smoke exposure in 12,405 mother-infant pairs: findings from the EISL Phase 3 in South America.","authors":"Javier Mallol, Dirceu Solé, Viviana Aguirre, Carolina S Aranda, Luis Garcia-Marcos, Herberto Chong-Neto, Nelson Rosario, Marilyn Urrutia-Pereira, Gabriela Szulman, Jurg Niederbacher, Erika Arruda-Chavez, Eliana Toledo, Lillian Sánchez, Catalina Pinchak","doi":"10.15586/aei.v54i2.1647","DOIUrl":"10.15586/aei.v54i2.1647","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence, risk factors for perinatal tobacco smoking, and the effects on infants' respiratory health in 12,450 mother-infant pairs from South America.</p><p><strong>Methods: </strong>Cross-sectional population-based study in eleven centres from six countries, using a standardised questionnaire completed by parents.</p><p><strong>Results: </strong>The prevalence of smoking during pregnancy was 8.4%, ranging from 1.4% in Lima to 15.3% in Montevideo; current maternal smoking was 15.3%, from 5.4% in Lima to 34.4% in Santiago; and second-hand tobacco smoke (SHS) at home was 29.8%, from 13.7% in Lima to 50.7% in Santiago. SHS and current maternal smoking were strong and independent risk factors for smoking during pregnancy (p < 0.0001). Low maternal education and monthly household income were significant risk factors for perinatal tobacco exposure. The prevalence and severity of wheezing, admissions for wheezing, pneumonia diagnosis, and admissions for pneumonia were significantly higher (p < 0.0001) in infants exposed to tobacco smoke.</p><p><strong>Conclusions: </strong>The prevalence of smoking during pregnancy, current maternal tobacco smoking, and SHS remain high in South America. Perinatal tobacco smoke exposure is strongly related to greater wheezing severity and a higher prevalence of admissions for wheezing and pneumonia during the first year of life. Low socioeconomic status and low maternal education were the most significant risk factors for smoking during pregnancy, as well as for current maternal smoking and the presence of SHS at home. Our results point to the urgent need to improve the quantity and quality of education against tobacco smoking in girls and families, starting very early in life.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 2","pages":"125-134"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147429753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of oral food challenge in children with IgE-mediated food allergy.","authors":"Aymen Hişmioğulları, Özlem Sancaklı, Melike Ocak, Soner Günder, Figen Çelebi Çelik, Kadir Buğra Sarı, Ayça Demir, Canan Şule Karkıner, Özge Atay, Demet Can","doi":"10.15586/aei.v54i3.1625","DOIUrl":"10.15586/aei.v54i3.1625","url":null,"abstract":"<p><strong>Background: </strong>Oral food challenges (OFCs) are the gold standard for diagnosing IgE-mediated food allergies in children, although they carry an inherent risk of inducing allergic reactions, including anaphylaxis. This study examined clinical outcomes and predictors of positive OFC results in a pediatric cohort from a region with high exposure to sesame and tree nuts.</p><p><strong>Methods: </strong>We retrospectively analyzed 310 OFCs in 211 children (median age: 21 months [IQR: 14-37.3]) at a tertiary pediatric allergy center from January 1 to December 31, 2023. Reaction patterns and predictors of OFC positivity, including age, sex, initial reaction type, skin prick test (SPT) wheal size, and serum-specific IgE (sIgE) levels, were evaluated.</p><p><strong>Results: </strong>OFC positivity occurred in 12.3% (38/310) of the challenges, and was most commonly triggered by milk or dairy products (44.7%), tree nuts (23.6%), and eggs (18.4%). Cutaneous symptoms predominated (94.7%), followed by gastrointestinal (10.6%) and respiratory (7.9%) manifestations. Anaphylaxis occurred in 13.2% (5/38) of the positive OFCs. Positive OFC patients were older (P = 0.009), had longer follow-up (P = 0.046), and were more likely to have presented with urticaria (P < 0.001) or anaphylaxis (P < 0.001). Multivariate logistic regression identified milk or dairy products (OR: 3.326, 95% CI: 1.437-7.702, P = 0.005), sesame (OR: 7.022, 95% CI: 1.194-41.311, P = 0.031), and hazelnut (OR: 11.286, 95% CI: 3.858-33.017, P < 0.001) as independent predictors of OFC positivity.</p><p><strong>Conclusion: </strong>OFC positivity was 12.3%, and was predominantly triggered by milk, tree nuts, and eggs. Severe reactions, including anaphylaxis, occurred despite low sIgE and SPT values, confirming the limited utility of sensitization markers in predicting clinical reactivity. Older age, longer follow-up, history of urticaria or anaphylaxis, and challenges with milk, sesame, or hazelnut were independently associated with positive OFCs. These results underscore the critical role of risk-stratified, closely monitored OFCs in ensuring diagnostic accuracy and guiding safe, personalized management in pediatric IgE-mediated food allergy.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 S Pt 1","pages":"10-17"},"PeriodicalIF":2.1,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of <i>IL-13</i> gene polymorphisms in pediatric patients with food allergy.","authors":"Maria-Teodora Coșoreanu, Camelia-Elena Berghea, Felicia Galoș, Luis-Ovidiu Popa, Mara-Ioana Ionescu, Andreea Ioan, Ioana Țieranu, Eliza-Elena Cinteză, Olivia-Mihaela Popa","doi":"10.15586/aei.v54iSP1.1637","DOIUrl":"10.15586/aei.v54iSP1.1637","url":null,"abstract":"<p><p>Food allergies represent immune-mediated adverse reactions to dietary proteins, with incompletely elucidated causes and etiopathogenic mechanisms, and have a significant negative impact on the quality of life of children and their families. The aim of the study was to assess the associations between <i>IL-13</i> gene single-nucleotide polymorphisms (SNPs) rs20541 and rs1800925 and the risk of developing IgE-mediated or non-IgE-mediated food allergies, as well as other patient characteristics. The study included 115 healthy controls and 165 children with food allergy, divided into two groups based on the presence of either IgE-mediated (N=85) or non-IgE-mediated (N=80) food allergy, all of Romanian origin. Genotyping of the two SNPs was performed using Real-Time PCR with TaqMan Allelic Discrimination Assays. OpenEpi and PLINK v1.07 were used for the statistical analysis. The frequency of carriers of the minor allele T of rs1800925 was significantly higher in patients with non-IgE-mediated food allergy (50% vs. 35.6%, p=0.04, OR=1.8). CT heterozygotes of rs1800925 were at high risk for non-IgE-mediated food allergy compared to CC and TT homozygotes (p=0.01, OR=2.13). No associations were found with IgE-mediated food allergy. The present study investigates for the first time <i>IL-13</i> gene SNPs in non-IgE-mediated food allergy. The results provide evidence that variation in the <i>IL-13</i> gene is involved in the pathogenesis of this disease. Further investigation is required to confirm these findings.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 S Pt 1","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146155448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of immunotherapy with a mixture of polymerized allergen extracts of <i>Alternaria alternata</i> and <i>olea europaea</i> in children.","authors":"Javier Torres-Borrego, Laura Pilar Marín López, Raquel Castañeda-Mendieta, Ana Martínez-Cañavate Burgos","doi":"10.15586/aei.v54i1.1499","DOIUrl":"10.15586/aei.v54i1.1499","url":null,"abstract":"<p><strong>Background: </strong>In southern Europe, allergy to <i>Alternaria alternata</i> (<i>A. alternata</i>) and <i>Olea europaea</i> (<i>O. europaea</i>) pollen are prevalent, significantly contributing to allergic conditions like asthma and rhinitis. This study investigates the effectiveness and safety of immunotherapy in pediatric patients utilizing a glutaraldehyde-polymerized allergen extract mixture of <i>A. alternata</i> and <i>O. europaea</i>.</p><p><strong>Methods: </strong>This real-world, retrospective, observational study included pediatric patients diagnosed with rhinitis with or without asthma, co-sensitized to <i>A. alternata</i> and <i>O. europaea</i>. Patients received immunotherapy with a mixture of individually polymerized allergen extracts of <i>A. alternata</i> and <i>O. europaea</i>, each at a concentration of 10,000 TU/mL. Effectiveness was assessed by comparing rhinitis and asthma severity and medication requirements before and after at least 6 months of treatment. Safety was evaluated by documenting local and systemic adverse reactions.</p><p><strong>Results: </strong>A total of 49 patients were included, with a median treatment duration of 9 months. Prior to treatment, 84% (41/49) of patients had moderate-severe rhinitis, which significantly decreased to 49% (24/49) posttreatment (p=0.001). Asthma severity also improved considerably, with the proportion of patients experiencing intermittent-mild asthma rising from 8% pretreatment to 61% posttreatment. The use of medication for both rhinitis and asthma also declined. Out of 424 injections, only two local reactions were reported (0.47%), with no systemic reactions.</p><p><strong>Conclusion: </strong>Immunotherapy using a mixture of glutaraldehyde-polymerized <i>A. alternata</i> and <i>O. europaea</i> extract is both safe and effective in reducing the severity of rhinitis and asthma in children. This treatment exhibits a high safety profile, with a very low incidence of adverse reactions, making it a promising therapeutic option for pediatric patients with coexisting sensitivities to these common allergens.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 1","pages":"139-144"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of obstructive sleep apnea syndrome in bronchial asthma patients: investigating the obesity-inflammation interplay through LEP, IL-6, and NLR.","authors":"Lili Miao","doi":"10.15586/aei.v54i1.1473","DOIUrl":"10.15586/aei.v54i1.1473","url":null,"abstract":"<p><strong>Background: </strong>Bronchial asthma (BA) frequently coexists with obstructive sleep apnea syndrome (OSAS). The obesity-inflammation axis may underlie this overlap, but pragmatic predictors and biomarker utility remain incompletely defined.</p><p><strong>Objective: </strong>To identify clinical predictors of OSAS in BA and evaluate the diagnostic performance of leptin (LEP), interleukin-6 (IL-6), and neutrophil-to-lymphocyte ratio (NLR), individually and in combination.</p><p><strong>Materials and methods: </strong>In a prospective study, 263 adults with BA were enrolled and classified into OSAS (n=124) and non-OSAS (n=139) groups by polysomnography. The OSAS group was stratified by apnea-hypopnea index (AHI) into mild (n=59), moderate (n=42), and severe (n=23). Clinical variables were compared with univariate tests. Independent predictors were identified using binary logistic regression. Serum LEP and IL-6 (immunoassays) and NLR (hematology) were measured. Biomarker-AHI relationships were assessed by Spearman's correlation. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curves and DeLong's test.</p><p><strong>Results: </strong>On univariate analysis, OSAS cases were older and more often male, with higher rates of obesity, severe BA, neck circumference >40 cm, rhinitis, and gastroesophageal reflux disease (GERD). Logistic regression confirmed obesity, severe BA, neck circumference >40 cm, rhinitis, and GERD as independent predictors. LEP, IL-6, and NLR were significantly higher in OSAS than non-OSAS and increased progressively across AHI strata. LEP correlated strongly with IL-6, IL-6 with NLR, and LEP with NLR to a lesser extent (all P<0.001). For diagnosing BA-OSAS, AUCs were 0.746 (LEP), 0.771 (IL-6), 0.742 (NLR), and 0.826 for their combination, which outperformed individual markers (DeLong, P<0.05).</p><p><strong>Conclusion: </strong>Obesity, neck circumference >40 cm, severe BA, rhinitis, and GERD independently predict OSAS in BA. LEP, IL-6, and NLR correlate with OSAS severity, and their combined use provides superior diagnostic value for identifying BA-OSAS comorbidity and may aid targeted screening and referral. (≈240 words).</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 1","pages":"96-104"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}