Asian Pacific journal of allergy and immunology最新文献

{"title":"Recurrence rate and risk factors of recurrent anaphylaxis: A ten-year retrospective cohort study.","authors":"Suwannee Uthaisangsook, Nadda Padsee, Sagoontee Inkate","doi":"10.12932/AP-130325-2047","DOIUrl":"10.12932/AP-130325-2047","url":null,"abstract":"<p><strong>Background: </strong>Few studies have investigated the risk factors for recurrent anaphylaxis. Identifying these factors may help patients implement preventive measures.</p><p><strong>Objective: </strong>To determine the rate and risk factors for recurrent anaphylaxis, assess the time to recurrence, and compare the characteristics, triggers, and clinical manifestations between recurrent and non-recurrent cases.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at Naresuan University Hospital from March 2011 to February 2021, using medical records of patients with ICD-10-confirmed anaphylaxis. Risk factors for recurrence were analyzed using Cox proportional hazards regression model.</p><p><strong>Results: </strong>A total of 439 anaphylactic episodes were identified in 381 patients (49 children, 332 adults). Of these, 42 patients (11.2%) experienced 58 recurrent episodes (7/49 [14.3%] children, 35/332 [10.6%] adults). Food and medications were the most and second most common triggers. The median time to recurrence was 9.9 months (IQR: 3.1-18.8), while the median follow-up duration for non-recurrent cases was 41.8 months (IQR: 23.8-61.8). The recurrent anaphylaxis rate was 4.1 events per 100 person-years. Statistically significant risk factors included a history of food, a history of insect, a history of drug allergies, chest discomfort, and severe anaphylaxis (HR [95%CI]: 3.31 [1.50-7.29], p = 0.003; 4.96 [1.47-16.82], p = 0.010; 5.87 [2.64-13.07], p < 0.001; 2.43 [1.19-4.99], p = 0.015; and 2.29 [1.07-4.88], p = 0.033, respectively). Conversely, palpitations were associated with a lower risk of recurrence (HR 0.11 [0.01-0.86], p = 0.036).</p><p><strong>Conclusions: </strong>Identifying risk factors in anaphylaxis patients enhances medical care and aids in preventing recurrence.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367842","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":"Oral immunotherapy directs systemic transcriptomic changes in children with hen's egg allergy.","authors":"Sehun Jang, Ji Hwan Moon, Hosu Kim, Soyoung Jeong, Sanghee Shin, Jeongmin Song, Jung Ho Lee, Hyun Seung Choi, Christine Suh-Yun Joh, Yoonyeol Lee, Yeong Hee Kim, Min Hee Lee, Hyun Je Kim, Jihyun Kim, Kangmo Ahn","doi":"10.12932/AP-011124-1965","DOIUrl":"10.12932/AP-011124-1965","url":null,"abstract":"<p><strong>Background: </strong>Hen's egg (HE) is a major food allergen in children. Oral immunotherapy (OIT) has emerged as a promising therapeutic option for hen's egg allergy (HEA), but the precise immunological mechanisms underlying HE-OIT are not fully understood.</p><p><strong>Objective: </strong>We aimed to investigate the systemic immune phenotype in children with HEA and to examine transcriptomic changes during HE-OIT.</p><p><strong>Methods: </strong>We enrolled 16 children, aged between 3 and 12 years, diagnosed with HEA (median age, 4.5 years). Peripheral blood mononuclear cells were collected before the initiation of HE-OIT and after the completion of the build-up phase. The transcriptomics of the samples were analyzed using single-cell RNA sequencing.</p><p><strong>Results: </strong>All eight patients (8/8) whose blood samples were collected after the build-up phase achieved desensitization to 60 g of boiled HE white (6.0 g of HE proteins). Following the OIT build-up phase, significant reductions in total CD4+ T cells and early activated CD4+ T cell were observed (P = 0.001 and 0.045, respectively), while the frequencies of late activated CD4+ T cells and fully activated CD8+ T cells were increased (P = 0.019 and 0.038, respectively). Clonal analysis revealed proliferation within the late activated CD8+ T cell subset following OIT, indicative of the exhausted state of CD8+ T cells. Additionally, the population of regulatory T cells with abundant IKZF2 expression was significantly increased after the OIT build-up phase.</p><p><strong>Conclusions: </strong>HE-OIT was associated with systemic immune cell transcriptomic changes, suggesting that its efficacy derives from these immune alterations.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367841","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":"Enhanced performances of the short-PCR coupled lateral flow assay in the detection of Candida albicans in clinical blood samples.","authors":"Oranee Srichaiyapol, Bhanubong Saiboonjan, Sawinee Ngernpimai, Chonphaksorn Ponsue, Nutcha Sa-Ingthong, Patsara Thongmee, Lumyai Wonglakorn, Chutipapa Sukkasem, Rinjong Promson Kendal, Jureerut Daduang, Ratree Tavichakorntrakool, Arpasiri Srisrattakarn, Aroonwadee Chanawong, Molin Wongwattanakul, Aroonlug Lulitanond, Patcharaporn Tippayawat","doi":"10.12932/AP-190125-2018","DOIUrl":"10.12932/AP-190125-2018","url":null,"abstract":"<p><strong>Background: </strong>Candida albicans remains the most common fungal pathogen among the species, causing candidemia. Thus, early diagnosis is indispensable in patients with severe underlying infections.</p><p><strong>Objective: </strong>To develop a short-polymerase chain reaction (short-PCR) coupled with lateral flow strip (LFS) assay for the detection of C. albicans in clinical blood samples.</p><p><strong>Methods: </strong>A short-PCR-LFS was enhanced to detect clinical isolates and clinical blood samples. The ITS2 gene of C. albicans was amplified using the modified primers-probes to produce highly specific, dual-labeled amplicons. The sensitivity and specificity of the test system were evaluated using C. albicans, Candida spp. other than C. albicans and other microbial DNAs. The test system was validated by 44 clinical isolates and 51 clinical blood samples.</p><p><strong>Results: </strong>The short-PCR-LFS revealed a high specificity for C. albicans with no cross-reactivity and a limit of detection (LOD) of 0.1 ng per 2 mL of blood and 2 CFU/mL using a direct colony as a template. The result was consistent with the validation by short-PCR agarose gel electrophoresis (AGE). The short-PCR-LFS assay showed all positives with all C. albicans relevant samples and exhibited negative for other microbial relevance samples.</p><p><strong>Conclusions: </strong>The entire process of this system provides visual detection results less than 1 h with high sensitivity, high specificity, DNA extraction-free method, and little dependence on instruments. Thus, it can be considered as a promising method for professional use to early detect and identify clinical relevance samples of C. albicans.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367840","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":"A Delphi consensus on nebulized budesonide for adults with asthma and COPD.","authors":"Phunsup Wongsurakiat, Akrawat Rattanawongpaibul, Atikun Limsukon, Chirawat Chiewchalermsri, Kittipong Maneechotesuwan, Kittiyaporn Wiwatcharagoses, Kumpol Kornthatchapong, Narongkorn Saiphoklang, Pitsucha Sanguanwit, Pornanan Domthong, Tirachat Sewatanon, Wipa Reechaipichitkul, Theerasuk Kawamatawong","doi":"10.12932/AP-190824-1910","DOIUrl":"https://doi.org/10.12932/AP-190824-1910","url":null,"abstract":"<p><strong>Background: </strong>Inhaled corticosteroids (ICS) represent an alternative treatment option to systemic corticosteroids (SCS) in the treatment of asthma and chronic obstructive pulmonary disease (COPD); however, detailed clinical guidance on the use of nebulized ICS, such as budesonide, in the management of asthma and COPD remains scarce.</p><p><strong>Objective: </strong>To review the literature and develop Delphi consensus statements on the use of nebulized ICS for the management of asthma and COPD in adults.</p><p><strong>Methods: </strong>An expert panel of 13 respiratory physicians, comprising pulmonologists (n = 9), allergists (n = 1), and emergency department consultants (n = 3) from tertiary medical centers in Thailand, undertook a Delphi procedure with the aim of developing evidence-based consensus statements on the use of nebulized ICS in patients with asthma and COPD. Panelists used a 5-point Likert scale to score their agreement with each statement.</p><p><strong>Results: </strong>A total of 12 Delphi consensus statements pertaining to the use of nebulized ICS in the management of asthma and COPD in both acute and maintenance care were developed. The overall consensus of the panel across the 12 statements was very high (mean agreement score, 4.2-4.9/5). The panelists expressed strongest consensus agreement (84.6% strong agreement) with the following two statements: 1) inhalation devices are the cornerstone of drug delivery in patients with asthma and COPD, and 2) for adult asthma and COPD patients with severe exacerbations, nebulization is more suitable for drug delivery than a pMDI plus spacer.</p><p><strong>Conclusions: </strong>Nebulized budesonide is an effective and well tolerated treatment option for the management of asthma and COPD.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207484","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":"TNFAIP3 regulates inflammatory arthritis through the differentiation of monocytes into macrophages.","authors":"Lu Zhang, Wanlan Jiang, Biqing Zhang, Ting Xu, Shiliang Zhou, Mingyuan Cai, Jinyun Chen, Min Wu","doi":"10.12932/AP-090924-1921","DOIUrl":"https://doi.org/10.12932/AP-090924-1921","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a disease characterized by synovitis. The synovium of RA patients is rich in macrophages, which are differentiated mainly from monocytes. The susceptibility gene of RA, tumor necrosis factor-α inducible protein 3 (tnfaip3), is considered an anti-inflammatory factor. Our previous study revealed the abnormal protein expression of TNFAIP3 in monocytes from patients with RA.</p><p><strong>Objective: </strong>In the present study, we aimed to explore the role of TNFAIP3 in monocytes in RA and its potential functions.</p><p><strong>Methods: </strong>In vivo, we injected adenoviral vectors overexpressing tnfaip3 into mice with collagen-induced arthritis (CIA) (the TNFAIP3-oe group). Arthritis scores, as well as the expression of iNOS and CD206 in the synovium, were compared between the TNFAIP3-oe group and the CIA group. In vitro, we used lentivirus transfection to upregulate/downregulate the expression of tnfaip3 in THP-1 cells. The ability of these cells to migrate, secrete cytokines and differentiate into macrophages was compared.</p><p><strong>Results: </strong>Compared with that in the CIA group, arthritis in the TNFAIP3-oe group was ameliorated (p = 0.030). Moreover, the joints of these mice presented more CD206+ cells and fewer iNOS+ cells (both p < 0.001), indicating the anti-inflammatory effect of TNFAIP3 and its regulation of macrophage polarization. In vitro, the tnfaip3-depleted cells (the TNFAIP3-i group) had greater migration and differentiated into M1 macrophages, and more cells overexpressing tnfaip3 (the TNFAIP3-oe group) differentiated into M2 macrophages. Furthermore, cells in the TNFAIP3-i group showed increased secretion of the proinflammatory cytokines IL-6 and MMPs.</p><p><strong>Conclusions: </strong>Taken together, these findings suggest that TNFAIP3 in monocytes can regulate inflammatory arthritis by modulating monocyte migration, differentiation, and cytokine secretion.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207487","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":"Allergenicity potential of protein extract from freshwater and saltwater fish based on heat stability and antibody-binding frequency.","authors":"Atika H Falihah, Zulfi Azizah, Bayu Ba Santoso, Ika P Sari, Muhammad Na Sahid","doi":"10.12932/AP-221024-1958","DOIUrl":"https://doi.org/10.12932/AP-221024-1958","url":null,"abstract":"<p><strong>Background: </strong>Saltwater fish are associated with more allergic reactions compared to freshwater fish. However, the factors contributing to this difference remain unclear.</p><p><strong>Objective: </strong>To compare the heat stability of freshwater and saltwater fish proteins, and assess their binding affinity to allergen-specific antibodies.</p><p><strong>Methods: </strong>Protein extracts were isolated from saltwater fish-Selar crumenophthalmus, Euthynnus affinis, Ambassis urotaenia, and freshwater fish i.e., Rasbora argyrotaenia, Monopterus albus, and Poecilia reticulata. Protein extract from Penaeus monodon served as a standard allergen source. Both raw and heat-treated protein extracts were subjected to SDS-PAGE analysis. The number of protein bands, their molecular sizes, and intensities were evaluated. Protein binding frequencies to anti-tropomyosin antibodies and IgE-containing serum from allergic patients were measured using ELISA.</p><p><strong>Results: </strong>The P. monodon protein extract < 100 kDa demonstrated heat stability, while A. urotaenia proteins < 40 kDa were also heat-stable. Raw protein extracts from R. argyrotaenia and M. albus exhibited binding frequencies to anti-tropomyosin IgG of 28.18 ± 1.05% and 14.79 ± 0.91%, respectively. In saltwater fish, raw protein extracts from A. urotaenia and S. crumenophthalmus showed binding frequencies of 61.74 ± 1.87% and 34.68 ± 1.39%, respectively. Freshwater and saltwater fish heat-treated protein extracts displayed binding frequencies below 10%. All heat-treated protein samples exhibited higher binding frequencies to polyclonal IgE in patient sera compared to their raw counterparts.</p><p><strong>Conclusions: </strong>Proteins smaller than 20 kDa exhibit significant heat stability. Raw protein extracts show higher binding frequencies to monoclonal IgG against crustacean tropomyosin, while heat-treated samples have increased binding frequency to IgE-containing human serum.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207485","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":"Differences in asthma-related outcomes by anti-IL-5 biologics, omalizumab, and dupilumab based on blood eosinophil counts.","authors":"Yuya Kimura, Maho Suzukawa, Norihiko Inoue, Shinobu Imai, Hiromasa Horiguchi, Manabu Akazawa, Hirotoshi Matsui","doi":"10.12932/AP-290623-1645","DOIUrl":"10.12932/AP-290623-1645","url":null,"abstract":"<p><strong>Background: </strong>Selecting optimal biologics based on type 2 biomarkers has been of interest in severe asthma treatment. However, few direct biomarker stratification-based comparisons have been made.</p><p><strong>Objective: </strong>To compare the effectiveness of anti-IL-5 (mepolizumab, benralizumab), omalizumab, and dupilumab in reducing the number of hospitalizations from asthma and exacerbations across all and eosinophil-stratified subgroups.</p><p><strong>Methods: </strong>A retrospective cohort study using the National Hospital Organization database (2016-2020) was performed. Asthmatic patients using biologics were selected, and the baseline backgrounds of the groups were balanced using inverse probability treatment weighting for propensity scores. Weighted rate ratios (RRs) were obtained using a Poisson regression model.</p><p><strong>Results: </strong>Among the 320 patients with asthma using biologics, 205 (64.1%), 75 (23.4%), and 40 (12.5%) were categorized into the anti-IL-5, omalizumab, and dupilumab groups, respectively. After weighting, there were 47.1, 30.0, and 62.6 hospitalizations per 100 person-years [omalizumab vs. anti-IL-5: weighted RR, 0.61 (0.34-1.08); dupilumab vs. anti-IL-5: 1.48 (0.81-2.72)], and 117.0, 134.6, and 287.3 exacerbations per 100 person-years [omalizumab vs. anti-IL-5: 1.13 (0.83-1.54); dupilumab vs. anti-IL-5: 2.69 (1.91-3.78)] in these respective groups. In patients with eosinophil of ≥ 300/μL, the dupilumab group had more exacerbations compared with the anti-IL-5 group [weighted RR, 2.85 (1.82-4.46)]. In patients with eosinophil of < 300/μL, the omalizumab group had fewer hospitalizations compared with the anti-IL-5 group [weighted RR, 0.32 (0.13-0.51)].</p><p><strong>Conclusion: </strong>Anti-IL-5 biologics may be more effective than dupilumab in patients with high blood eosinophil counts, while less effective than omalizumab in patients with low eosinophil counts.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"290-299"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139110727","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":"The natural history of childhood-onset nonallergic rhinitis; a long-term follow-up study.","authors":"Kantima Kanchanapoomi, Witchaya Srisuwatchari, Punchama Pacharn, Nualanong Visitsunthorn, Orathai Jirapongsananuruk","doi":"10.12932/AP-140922-1455","DOIUrl":"10.12932/AP-140922-1455","url":null,"abstract":"<p><strong>Background: </strong>Non-allergic rhinitis (NAR) is characterized by symptoms of nasal inflammation without allergic sensitization. The long-term outcome of NAR in children is poorly defined.</p><p><strong>Objective: </strong>To determine the natural history of childhood-onset NAR and the development of allergic rhinitis (AR) in these children.</p><p><strong>Methods: </strong>NAR patients who were followed for more than 10 years were evaluated at 3-5 years (E2) and 9-12 years (E3) after the first evaluation (E1). Nasal symptoms, disease severity, comorbidities, medication used, and aeroallergen sensitization were assessed.</p><p><strong>Results: </strong>Eighty-two NAR patients (58.5% male) completed all 3 evaluations. The age at onset was 2.0 (range 2.0-4.0) years. The follow-up period was 13.6 (range 12.3-14.3) years. At E2, 37.8% of patients developed AR. At E3, the patients were classified into four groups based on results of skin prick tests in E2 and E3 (group I: NAR→NAR→NAR, 39.0%, group II: NAR→NAR→AR, 23.2%, group III: NAR→AR→NAR, 12.2% and group IV: NAR→AR→AR, 25.6%). The most common aeroallergen sensitization was house dust mite. The family history of atopy, asthma and allergic rhinitis were higher in group III and IV than other groups (p < 0.05). The atopic dermatitis, obstructive sleep apnea and adenotonsillar hypertrophy at E1 and E2 were predominantly found in group IV (p < 0.05). At E2, group III and IV patients had higher proportion of exposure to house dust, animal dander and smoking compared to other groups (p < 0.05). The overall remission rate was 14.6%.</p><p><strong>Conclusions: </strong>Children with NAR should be reevaluated periodically to determine aeroallergen sensitization for the appropriate diagnosis and management.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"168-177"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9661269","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":"Mucosal brushings for nasal specific IgE to predict house dust mite driven allergic rhinitis.","authors":"Aneeza W Hamizan, Raquel Alvarado, Khaizurin Tajul Arifin, Farah Dayana Zahedi, Ng Chong Sian, Anna Fariza Jumaat, Salina Husain, Man Sau Wong","doi":"10.12932/AP-031122-1495","DOIUrl":"10.12932/AP-031122-1495","url":null,"abstract":"<p><strong>Background: </strong>Skin prick testing and serological identification of allergen specific immunoglobulin E (spIgE) are standard tests for allergic rhinitis but can only identify systemic responses. In contrast, nasal allergen challenge (NAC), directly assess localized nasal mucosal reactivity, but is time consuming. Identification of spIgE from nasal brushings (nasal spIgE) is an alternative technique.</p><p><strong>Objective: </strong>This study aimed to determine the diagnostic performance of nasal spIgE compared to NAC in order predict house dust mite (HDM) driven AR.</p><p><strong>Methods: </strong>A diagnostic cross-sectional study involving adult rhinitis patients was performed. Sensitization to HDM allergens (Dermatophagoides pteronyssinus (DP), Dermatophagoides farina (DF) were assessed serologically and/or skin prick test, nasal brushing and NAC. Patients with both positive systemic test and NAC were defined to have HDM driven AR, while patients with a positive systemic test and negative NAC were defined to have non-clinically relevant HDM sensitization. The performance of nasal spIgE to predict positive NAC was determined using the receiver operating curve. The chosen cut-off was then used to predict HDM driven AR among those with positive systemic test.</p><p><strong>Results: </strong>118 patients (29.42 ± 9.32 years, 61.9% female) were included. Nasal spIgE was predictive of positive NAC (AUC 0.93, 95%CI: 0.88-0.98, p < 0.01). Among those with positive systemic test, the cut-off value of >0.14 kUA/L was able to predict HDM AR from incidental HDM sensitization with 92% sensitivity and 86% specificity.</p><p><strong>Conclusions: </strong>Nasal spIgE is comparable to NAC. A cut-off value of >0.14 kUA/L identifies HDM-driven AR from incidental sensitization among patients with positive systemic tests for allergy.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"198-205"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9661272","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":"Effect of budesonide nasal irrigation on Hypothalamic-Pituitary-Adrenal Axis in patients with chronic rhinosinusitis post endoscopic sinus surgery: A prospective study.","authors":"Jesada Kanjanaumporn, Sorranut Thaweboon, Songklot Aeumjaturapat, Kornkiat Snidvongs, Supinda Chusakul, Kachorn Seresirikachorn, Lalita Prathanee","doi":"10.12932/AP-121124-1968","DOIUrl":"10.12932/AP-121124-1968","url":null,"abstract":"<p><strong>Background: </strong>Corticosteroids added to high volume saline nasal irrigation have been introduced as a more effective method of delivering corticosteroids to the sinuses than nasal sprays. However, information regarding the effect of this intervention on the hypothalamic-pituitary-adrenal (HPA) axis is still limited.</p><p><strong>Objective: </strong>To evaluate the safety of long-term corticosteroid (6 months) nasal irrigation in patients with chronic rhinosinusitis (CRS) post endoscopic sinus surgery.</p><p><strong>Methods: </strong>Seventeen patients with CRS were included. After undergoing endoscopic sinus surgery, the patients were prescribed budesonide nasal irrigations (250 ml via squeeze bottle) twice daily (1 mg/day) for six months. The serum morning cortisol levels of these patients were then evaluated at 3 and 6 months post-operatively.</p><p><strong>Results: </strong>Median serum morning cortisol levels were 10.5 mcg% at pre-operative baseline; 10.3 mcg% at 3 months; and 11.2 mcg% at 6 months on post-operative follow-up. There were no significant changes in the serum morning cortisol levels (P value = 0.71 and 0.63 respectively). Three of 17 patients (17.65%) had mildly abnormal serum morning cortisol levels (4, 4.3 and 4.9 mcg%) at 3 months. However, these levels were within a normal range at 6 months.</p><p><strong>Conclusions: </strong>Serum morning cortisol levels were not significantly changed after usage of budesonide nasal irrigation for 6 months.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"346-351"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673488","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}