Asian Pacific journal of allergy and immunology最新文献

{"title":"Evaluation of the clinical performance of multiple serum sIgE detection systems based on component-resolved diagnosis.","authors":"Zhifeng Huang, Aoli Li, Ziyu Yin, Tong Chen, Hui Gan, Zhiwei Lin, Mingshan Xue, Huimin Huang, Baoqing Sun","doi":"10.12932/AP-290923-1702","DOIUrl":"10.12932/AP-290923-1702","url":null,"abstract":"<p><strong>Background: </strong>Serum allergen-specific IgE (sIgE) detection is an important tool in the diagnosis of allergic diseases. However, the absence of international standards for sIgE detection systems raises questions about the comparability of different systems.</p><p><strong>Objective: </strong>This study aims to evaluate three common allergen sIgE detection systems, with a primary focus on detecting dust mite allergens.</p><p><strong>Methods: </strong>We recruited 85 children with rhinitis and 15 healthy control children. The subjects underwent testing with three different sIgE detection systems, including magnetic particle flow fluorescence, magnetic particle chemiluminescence, and protein chip, to detect sIgE levels to HDM extracts. In addition, skin prick testing (SPT) was conducted, and protein chip technology was performed to measure sIgE levels to component proteins.</p><p><strong>Results: </strong>Our findings reveal strong consistency between SPT and the three in vitro detection systems, with consistency exceeding 71.76% for dust mite allergens. Moreover, there was excellent consistency and RAST class consistency among the three in vitro detection systems, with scores exceeding 94.12% and 89.00%, respectively. And for the 13 additional allergens crude extracts sIgE simultaneously detected by systems 1 and 2, the results showed that the consistency of both systems was above 87.00%, and the RAST class consistency was above 82.00%.</p><p><strong>Conclusion: </strong>The three serum sIgE detection systems exhibited an approximate 80% concordance rate with SPT in identifying dust mite allergens. Furthermore, these systems demonstrated excellent consistency and RAST class consistency among themselves. These findings suggest that the three assays introduced in this study are interchangeable in allergen diagnosis.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"318-327"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327185","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":"Characteristics of anaphylaxis from tertiary-care hospital in lower northern Thailand: A ten-year retrospective cross-sectional study.","authors":"Suwannee Uthaisangsook, Nichayada Hirunwattana, Chayanis Kajornrojanaruk, Nadda Padsee","doi":"10.12932/AP-010424-1831","DOIUrl":"10.12932/AP-010424-1831","url":null,"abstract":"<p><strong>Background: </strong>The prevalence and etiology of anaphylaxis vary based on geographic regions, study design, and definition used. Anaphylaxis leading to emergency department visits and hospitalizations has increased worldwide.</p><p><strong>Objective: </strong>The prevalence and etiology of anaphylaxis vary based on geographic regions, study design, and definition used. Anaphylaxis leading to emergency department visits and hospitalizations has increased worldwide.</p><p><strong>Methods: </strong>A cross-sectional retrospective analysis of medical records from patients with ICD-10 confirmed anaphylaxis was performed at Naresuan University Hospital between March 2011 and February 2021.</p><p><strong>Results: </strong>We identified 439 anaphylaxis episodes in 381 patients within 10 years. The average annual occurrence rates of anaphylactic episodes were 25.0 per 100,000 outpatient and emergency department visits and 11.2 per 100,000 inpatient visits. Both pediatric and adult anaphylaxis events increased annually, from 13.3 (children: 20.5, adults: 12.4) in 2012 to 46.6 (children: 52.6, adults: 46.1) episodes per 100,000 visits in 2021. Peak incidence was observed in adolescents and young adults. Food was the most common trigger, with shrimp and fried insects being predominant. Risk factors for severe anaphylaxis were underlying cardiovascular diseases, drug triggers, and wheezing. Epinephrine was administered in 98.4% of all episodes. Although, there were no fatalities, only 11.4% of patients received prescriptions for self-injectable epinephrine.</p><p><strong>Conclusion: </strong>The study underscores an increasing trend of anaphylaxis affecting both children and adults in lower northern Thailand, with shrimp and fried insects as common triggers.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"362-373"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603245","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":"Type 2 high asthma phenotype in children: A multidimensional clustering analysis.","authors":"Soyoung Bae, Hyejin Lee","doi":"10.12932/AP-151025-2163","DOIUrl":"https://doi.org/10.12932/AP-151025-2163","url":null,"abstract":"<p><strong>Background: </strong>Asthma is a heterogeneous disease with diverse and poorly defined phenotypes, especially in children.</p><p><strong>Objective: </strong>We aimed to classify childhood asthma phenotypes using unsupervised cluster analysis based on type 2 (T2) biomarkers and to evaluate their clinical characteristics and outcomes.</p><p><strong>Methods: </strong>We retrospectively analyzed 614 pediatric patients. Hierarchical clustering was performed using four variables: age, absolute eosinophil count (AEC), eosinophil cationic protein (ECP), and total immunoglobulin E (IgE). Clinical characteristics and two-year clinical outcomes were compared across clusters. The effect of age was examined using Analysis of Covariance (ANCOVA) and age-tertile subgroup analyses.</p><p><strong>Results: </strong>Three distinct clusters were identified. Cluster 2, the T2-high asthma group (n = 157; median age: 8.0 years), was characterized by male predominance (69.4%), the highest levels of T2 biomarkers (AEC, ECP, IgE, FeNO; all P < 0.001), airway hyperresponsiveness (BDR, P = 0.024; PC20, P < 0.001), and reduced lung function (FEV1, P = 0.002). In contrast, Cluster 1 (n = 252; median age: 4.0 years) showed the highest exacerbation and steroid use rates but relatively low T2 biomarker levels. Cluster 3 (n = 205; median age: 12.0 years) had moderate T2 levels and the lowest exacerbation burden. After adjusting for age, Cluster 2 maintained 4-6 folds higher T2 biomarker levels compared to other clusters (all P <0.001). These cluster-specific differences were not observed in the age tertile subgroup analysis.</p><p><strong>Conclusions: </strong>The identified school-age T2-high cluster in childhood asthma exhibits distinct immunological and clinical phenotypes, characterized by high airway hyperresponsiveness, atopic features, and decreased lung function.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147462486","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":"Stability of house dust mite raw materials: Impact of storage conditions and lyophilization.","authors":"Teerapong Wangapai, Nitaya Indrawattana, Prapagorn Vongjareonsanti, Pichet Ruenchit, Dichapong Kanjanawasee, Thapani Srisai, Anchalee Tungtrongchitr, Nawannaporn Saelim","doi":"10.12932/AP-090425-2062","DOIUrl":"https://doi.org/10.12932/AP-090425-2062","url":null,"abstract":"<p><strong>Background: </strong>Dermatophagoides pteronyssinus and D. farinae are major indoor allergens. Raw materials derived from these house dust mites (HDMs) are used to produce allergen extracts. The stability of these materials is influenced by storage form and conditions, which can affect protein integrity.</p><p><strong>Objective: </strong>To compare storage formats and conditions for maintaining physicochemical stability of HDM raw materials.</p><p><strong>Methods: </strong>Pure mite bodies (PMBs), prepared in fresh frozen and lyophilized forms, were stored at -80°C, -20°C, and 25°C. Over a 12-month period, samples were assessed for total protein and major allergens (Der p 1 and Der f 1) using ELISA. Protein integrity was analyzed by SDS-PAGE. Accelerated stability testing at 25°C for up to 14 days was also performed.</p><p><strong>Results: </strong>Storage at -80°C best preserved total protein and Group 1 allergen content over 12 months. At -20°C, moderate declines were observed, with D. farinae showing greater reductions than D. pteronyssinus. Lyophilized samples were generally more stable than fresh-frozen ones at -20C°. Accelerated testing at 25°C caused marked losses over 14 days.</p><p><strong>Conclusions: </strong>Ultra-low temperature storage (-80°C) remains optimal for preserving physicochemical stability of HDM raw materials. Lyophilization with -20°C storage is a promising, context-dependent option; however, in the absence of residual-moisture and immunological data, these findings should be interpreted as preliminary and limited to raw-material handling.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147462701","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":"Comparison of multiplex arrays: AllergyChip and Alex2. IgE detection for inhalant allergens.","authors":"Laimis Silimavicius, Kacper Packi, Mege Cerniauskiene, Linas Griguola","doi":"10.12932/AP-040625-2088","DOIUrl":"https://doi.org/10.12932/AP-040625-2088","url":null,"abstract":"<p><strong>Background: </strong>Accurate diagnosis of IgE-mediated allergic diseases is crucial for effective management. This study compared the diagnostic performance of two multiplex allergy assays-AllergyChip and ALEX2-by measuring IgE reactivity to 31 inhalant allergens in serum from 90 participants.</p><p><strong>Objective: </strong>To compare the diagnostic performance of AllergyChip with ALEX2 as reference method for specific IgE detection.</p><p><strong>Methods: </strong>Agreement between the assays was evaluated by calculating overall (OPA), positive (PPA), and negative percentage agreement (NPA). Cohen's kappa measured agreement beyond chance. ROC analysis evaluated AllergyChip's ability to discriminate between positive and negative sIgE results. Spearman's correlation assessed concordance between sIgE classes, and Bland-Altman analysis evaluated quantitative agreement.</p><p><strong>Results: </strong>AllergyChip showed substantial agreement with ALEX2 (OPA 88%, Cohen's kappa 0.792). ROC analysis showed excellent discrimination (AUC 0.891). Spearman's correlation (Rs 0.792) indicated strong agreement. However, AllergyChip had PPA below 70% for nine allergens, notably 0% for Phl p 12 and 30% for Bet v 2.</p><p><strong>Conclusions: </strong>AllergyChip performs well in detecting IgE to inhalant allergens and may be a viable alternative assay. However, its lower sensitivity for certain allergens suggests it should complement, rather than replace, ALEX2, particularly in cost-sensitive settings. Further studies are needed to confirm these findings and improve accuracy in multiplex allergy diagnostics.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147462698","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":"Bullous Systemic Lupus Erythematosus in a Southeast Asian Cohort: High Systemic Association Driving Systemic Therapy.","authors":"Chuda Rujitharanawong, Kanokvalai Kulthanan, Papapit Tuchinda, Sasipha Nuttawong, Mananchaya Julraksa, Leena Chularojanamontri","doi":"10.12932/AP-241125-2180","DOIUrl":"https://doi.org/10.12932/AP-241125-2180","url":null,"abstract":"<p><strong>Background: </strong>Bullous systemic lupus erythematosus (BSLE) is a rare autoimmune blistering disorder occurring in association with systemic lupus erythematosus (SLE). Owing to its rarity, current knowledge remains limited, particularly in Southeast Asian populations.</p><p><strong>Objective: </strong>This study retrospectively evaluated the clinical, histopathologic, immunofluorescence, and serologic features of BSLE, together with a review of the existing literature.</p><p><strong>Methods: </strong>This review included patients diagnosed with BSLE at Siriraj Hospital, Mahidol University, between 2003 and 2024.</p><p><strong>Results: </strong>Among 9,055 patients with cutaneous lupus erythematosus, 12 were identified as having BSLE (incidence 0.13%). The median age was 39.5 years with equal sex distribution. Most patients (75%) presented with BSLE at the time of SLE diagnosis, while others developed it later. Lesions appeared on sun-exposed and non-sun-exposed areas, mainly the extremities, and mucosal involvement occurred in 33.3%. Direct immunofluorescence most frequently demonstrated immunoglobulin (Ig) G deposition (91.7%), followed by complement 3 (83.3%), IgM (75%), and IgA (50%), typically with linear and/or granular deposition of IgG and C3 along the basement membrane zone. Antinuclear antibodies were present in all patients. Systemic involvement was common (75%), most frequently affecting the kidneys (66.7%), followed by hematologic abnormalities (58.3%). Owing to disease severity, most patients required treatment with systemic corticosteroids in combination with immunosuppressive agents rather than dapsone alone to achieve disease control.</p><p><strong>Conclusions: </strong>This study and literature review highlight that, although BSLE is an uncommon cutaneous manifestation of SLE, it is strongly associated with systemic involvement, particularly renal and hematologic disease, which often necessitates treatment with immunosuppressive agents.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147462708","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":"Factors associated with poor asthma control in children: A prediction model.","authors":"Wanaporn Anuntaseree, Kanokpan Ruangnapa, Araya Yuenyongviwat, Kantara Saelim, Pharsai Prasertsan","doi":"10.12932/AP-170724-1894","DOIUrl":"10.12932/AP-170724-1894","url":null,"abstract":"<p><strong>Background: </strong>Inhaled corticosteroids (ICS) are the first-line therapy for pediatric asthma. However, very few studies have developed simple tools for predicting treatment outcomes in pediatric asthma.</p><p><strong>Objective: </strong>This study aimed to construct a predictive model for poor asthma control in children after 6 months of ICS therapy.</p><p><strong>Methods: </strong>This retrospective study included children with asthma, aged 6-15 years, who received ICS with complete follow-up for 6 months. The potential factors associated with poor asthma control were also assessed. Poor control was considered if the child had partial or uncontrolled symptoms according to the Global Initiative for Asthma guidelines.</p><p><strong>Results: </strong>Among the 165 eligible children, 33 (20%) had poor symptom control. The factors associated with poor control were a history of more than four exacerbations in the 12 months before ICS treatment (odds ratio [OR], 3.39 [1.06, 10.83]), the presence of moderate to severe allergic rhinitis symptoms at the 6-month follow-up visit (OR, 21.93 [2.97, 162.05]), and poor adherence to asthma medications (OR, 4.16 [1.32, 13.12]). By incorporating these factors, a model for predicting poorly controlled asthma was constructed and converted into a nomogram with a total score of 200, with prediction risk ranging from 0 to 100%. The area under the receiver operating characteristic curve of the developed model was 0.737, indicating a moderate performance level.</p><p><strong>Conclusions: </strong>We developed a predictive tool for poor asthma control. The model has a good discriminatory ability and is simple to use, which could facilitate the individualized management of children with asthma.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"75-83"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709086","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":"Total airway mechanics and fractional exhaled nitric oxide levels of children living in banjihas (semi-basements).","authors":"Ji Hee Kwak, Ju Hee Kim, Eun Kyo Ha, Hye Mi Jee, Youn Ho Shin, Hey Sung Baek, Man Yong Han","doi":"10.12932/AP-050224-1780","DOIUrl":"10.12932/AP-050224-1780","url":null,"abstract":"<p><strong>Background: </strong>The ISAAC phase III study in Korea found a higher incidence of wheezing illnesses among residents in basements or semi-basements.</p><p><strong>Objective: </strong>This study investigates the link between living in banjihas (semi-basements) and airway resistance and Th2 airway inflammation in Korean children, compared to those on higher floors.</p><p><strong>Methods: </strong>We assessed 575 fifth- and sixth-grade students (aged 10-12) in an inner-city area of South Korea. The study utilized impulse oscillometry to measure small and total airway resistance (Rrs20-5 and Rrs0, respectively) and Fractional Exhaled Nitric Oxide (FeNO) measurements to evaluate airway inflammation. We also considered a range of biological and environmental factors, including allergen sensitization, serum 25-hydroxyvitamin D levels, and urinary metabolites like VOCs, bisphenol, and triclosan. Participants were categorized by living floors: banjihas, first-fifth floors, and sixth floors or higher.</p><p><strong>Results: </strong>Twenty-five children (4.3%) lived in banjihas, 311 (54.1%) on the first to fifth floor, and 239 (41.6%) on the sixth floor or above. Despite similar levels of allergen sensitization and urinary pollutant metabolite levels across all groups, banjiha dwellers showed significantly higher total airway resistance (adjusted &1: 0.633, 95%CI: 0.156, 1.109; P = 0.009) and a greater prevalence of elevated FeNO levels (> 35 ppb) (P = 0.033). These findings persisted after adjusting for critical factors like height, gender, BMI z-score, and birth conditions.</p><p><strong>Conclusion: </strong>Children in banjihas exhibit elevated airway resistance and FeNO levels independently of allergen sensitization or pollution exposure, underscoring the necessity for enhanced focus on their respiratory health in such living conditions.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"114-121"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603210","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":"NLRP3 inhibition attenuates the allergic rhinitis symptoms in a mouse model.","authors":"Minhyung Lee, Young-Kyung Ko, Sehun Jang, Chan Hee Gil, Kyoung Mi Eun, Yu-Lian Zhang, Sung-Woo Cho, Dae Woo Kim, Hyun Jik Kim, Chae-Seo Rhee","doi":"10.12932/AP-301223-1756","DOIUrl":"10.12932/AP-301223-1756","url":null,"abstract":"<p><strong>Background: </strong>Recent human and animal studies have demonstrated that Nod-like receptor family, pyrin domain-containing 3 (NLRP3) inflammasome is closely involved in the development of allergic diseases.</p><p><strong>Objective: </strong>To identify the mechanism underlying the activation of NLRP3 inflammasome signaling pathway in an ovalbumin (OVA)-induced allergic rhinitis (AR) mice model and to validate the effect of a specific inhibitor of the NLRP3, MCC950.</p><p><strong>Methods: </strong>Mice were divided into three groups and each group consisted of ten mice (saline group, the negative control group; OVA group, the OVA-induced AR model group; and OVA+MCC group, treated with 10 mg/kg MCC950). MCC950 was administered intraperitoneally every second day. Multiple parameters of AR, including NLRP3, caspase-1, interleukin (IL)-1β, and IL-18 were evaluated by using ELISA, RT-qPCR, histopathology, and immunohistochemistry.</p><p><strong>Results: </strong>The mRNA and protein levels of NLRP3, caspase-1, IL-1β and IL-18 were upregulated in the OVA group compared with those of the saline group. MCC950 significantly inhibited the mRNA and protein levels of NLRP3, caspase-1, IL-1β and IL-18 in nasal tissue. Further, AR symptoms and eosinophil count were normalized after MCC950 treatment. However, OVA-specific IgE was not restored in the OVA+MCC group.</p><p><strong>Conclusion: </strong>NLRP3 inflammasome signaling pathway may be an alternative pathway to induce AR symptoms in OVA-induced AR model. MCC950 is a specific inhibitor of NLRP3 cascade, which attenuates AR symptoms regardless of IgE.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"51-59"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603209","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":"Impact of allergen sensitization on phenotypes of T2-low asthma: a post-hoc analysis of a nationwide cohort study, NHOM Asthma.","authors":"Sahoko Imoto, Hiroyuki Nagase, Maho Suzukawa, Yuma Fukutomi, Nobuyuki Kobayashi, Masami Taniguchi, Ken Ohta","doi":"10.12932/AP-090625-2090","DOIUrl":"10.12932/AP-090625-2090","url":null,"abstract":"<p><strong>Background: </strong>Asthma is a heterogeneous disease influenced by genetic and environmental factors. Type 2 (T2)-high asthma has been extensively studied; however, the pathophysiological mechanisms of T2-low asthma remain unclear.</p><p><strong>Objective: </strong>The present study aimed to determine the clinical indices contributing to asthma exacerbation and identify the phenotypes of T2-low asthma.</p><p><strong>Methods: </strong>We used data from the NHOM Asthma Study (N = 1925), a nationwide asthma cohort study conducted in Japan. T2-low asthma was defined by eosinophils < 150/μL and fractional exhaled nitric oxide levels < 25 ppb. The clinical indices associated with asthma exacerbation were identified using univariate and multivariate analyses. Hierarchical cluster analysis was performed to classify the phenotypes of T2-low asthma.</p><p><strong>Results: </strong>Multivariate analysis revealed that younger age and comorbid allergic diseases contributed to the exacerbation of T2-low asthma. Four phenotypes were identified: Cluster 1 (n = 19, 7.8%, smoking-related T2-low asthma with preserved pulmonary function), Cluster 2 (n = 18, 7.4%, smoking-related T2-low asthma with low pulmonary function), Cluster 3 (n = 99, 40.7%, elderly, female-dominant, late-onset T2-low asthma), and Cluster 4 (n = 107, 44.0%, younger, female-dominant, comorbid with allergic disease T2-low asthma). Clusters 2 and 4 were prone to asthma exacerbation, indicating distinct allergen sensitization.</p><p><strong>Conclusions: </strong>These findings indicate that antigen-specific IgE profiles may reflect the phenotypic heterogeneity of T2-low asthma and could serve as potential biomarkers for identifying subgroups at increased risk of exacerbations.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"151-160"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278920","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}