Allergic Group Research Articles

Evaluating Non-IgE-mediated Allergens’ Immunoreactivity in Patients with “Intrinsic” Persistent Rhinitis with Help of the Leukocyte Adherence Inhibition Test

Background: The non-IgE-mediated immunoreactivities against common allergens are little understood conditions, especially in patients suffering from allergic respiratory disorders such as persistent rhinitis. Objective: The present study aims to evaluate the non-IgE-mediated immunoreactivity against common allergens, in allergen-reactive patients clinically diagnosed with persistent rhinitis without evidence of IgE-mediated hypersensitivity against these allergens. Methods: A group of 533 outpatients diagnosed with non-IgE-mediated allergen-reactive persistent rhinitis, were submitted to ex vivo Leukocyte Adherence Inhibition Tests (LAIT) with extracts of Dermatophagoides pteronyssinus, Hevea brasiliensis latex, dog dander, cat dander, cow’s milk proteins, beekeeping pollen and a mixture of airborne fungal extracts. Results: Cascade distribution column graphs were assembled according to the LAIT results among six ranges of Leukocyte Adherence Inhibition (LAI) of each allergen group. A column graph was plotted with the mean LAI results for each antigen for comparison. Conclusion: The LAIT is a potential tool to quantify the overall non-IgE-mediated cellular/humoral immunoreactivity against common allergens in patients clinically diagnosed with persistent rhinitis. Most studies must be done to evaluate the potential of the LAIT as a screening ex vivo provocation test to select the more reactive allergens to perform the diagnostic in vivo provocation tests.

Clinical characteristics of children infected with SARS-CoV-2 Omicron variant combined with allergic disease

Objective: To investigate the clinical characteristics of children with allergic diseases suffering from SARS-CoV-2 Omicron variant strains. Methods: This was a cross-sectional study. A total of 43 pediatric patients with allergic diseases infected by SARS-CoV-2 from April 25, 2022 to June 8, 2022 in Shanghai Jiao Tong University School of Medicine were selected as the allergic disease group, while 114 cases without underlying diseases and 16 cases with other underlying diseases were selected as control groups diagnosed at the same period. Clinical data including clinical features, laboratory tests, duration of hospitalization, and the time to negative turn of novel coronavirus nucleic acid were collected and analysed. Kruskal-Wallis H test, chi-square test or Fisher exact test were used for comparison among three groups. Results: Among the 43 patients with allergic diseases, 28 were males and 15 were females, with an age of 4.4 (2.1, 8.2) years on admission, including 32 mild cases and 11 common cases. The allergic disease group included 20 cases (46.5%) of atopic dermatitis and eczema, followed by 14 cases (32.6%) of rhinitis, 8 cases (18.6%) of food allergies, 7 cases (16.3%) of asthma, 4 cases (9.3%) of allergic conjunctivitis and 2 cases (4.7%) of drug allergy. Among the 114 cases without underlying diseases, 57 were males and 57 were females, with an age of 2.8 (1.2, 5.6) years on admission, including 93 mild cases and 21 common cases. Among the 16 cases with other underlying diseases, 9 were males and 7 were females, with an age of 3.0 (2.6, 10.8) years on admission, including 13 cases mild and 3 cases common cases. Children with allergic diseases had higher frequency of sore throat and vomiting than those without underlying diseases (10 cases (23.3%) vs.9 cases (7.9%), 14 cases (32.6%) vs. 11 cases (9.6%), χ²=6.93, 12.24, both P<0.05). The lymphocyte count of patients with allergic disease was lower than those without underlying disease (1.1 (0.7,1.7)×109 vs. 1.6 (1.1,2.7)×109/L, H=-28.00,P=0.005). There were no significant differences in age, gender, typing of SARS-CoV-2, the duration of hospitalization, cycle threshold values of SARS-CoV-2 and the time to negative turn of novel coronavirus nucleic acid among the three groups (all P>0.05). Conclusions: Children with allergic diseases may suffer from sore throat and vomiting more frequently when infected with SARS-CoV-2 Omicron variant. The combination of allergic diseases hardly influenced the disease course of SARS-CoV-2 in children.

Atopic Disorders and Their Risks of Migraine: A Nationwide Population-Based Cohort Study.

Migraine is a relatively common neurologic disorder. A possible link between atopic disorders and migraine has been suggested. This study investigated atopic disorders and their risks of migraine in the Korean population. From the Korean National Health Insurance Service database, patients aged ≥ 20 years who underwent health screening between January and December of 2009 were enrolled. To evaluate the risk of migraine, Cox proportional hazards regression analyses were performed. In multivariable analysis, the atopic dermatitis group (adjusted hazard ratio [aHR], 1.28; 95% confidence interval [CI], 1.23-1.33), asthma group (aHR, 1.32; 95% CI, 1.30-1.34) and allergic rhinitis group (aHR, 1.45; 95% CI, 1.44-1.46) had significantly increased risks of migraine compared to their respective control groups (P < 0.001). The patients with 1 (aHR, 1.43; 95% CI, 1.42-1.44), 2 (aHR, 1.50; 95% CI, 1.47-1.53), and 3 (aHR, 1.64; 95% CI, 1.43-1.88) atopic disorders had significantly increased risks of migraine compared to the control group (P < 0.001). Our results demonstrate that patients with atopic disorders may have increased risk of migraine and that the larger the number of concomitant atopic disorders, the higher the risk of migraine.

Sensitization patterns of plant panallergens in Georgian allergic population from the molecular perspective.

In allergy diagnostics, component-resolved diagnostics (CRD) allows the clinician to assess the presence of specific IgE (sIgE) to allergenic proteins. Molecular diagnostics has improved our ability to identify not only species-specific, but also panallergen components. To characterize the Georgian allergic population according to the most frequently recognized plant panallergen components (profilins, PR-10 and nonspecific lipid transfer proteins) using sensitization data from multiplex CRD and investigate their association with particular allergic diseases. Patients, IgE positive to at least one studied panallergen component, were selected out of total 435 allergic individuals and stratified in two age groups: children and adults. Descriptive statistics, Chi square test (χ2) and Pearson Correlation test (r) were used for analysing the data. 38% (164/435) of investigated allergic patients showed IgE reactivity to at least one molecule belonging to Profilin, PR-10 and nsLTP families. Generally, PR-10 reactive individuals represented the largest group of patients (56.0%), followed by Profilins (43.0%) and nsLTP (32.0%). For the PR-10 allergen group, IgE sensitization was dominated by Bet v 1, for Profilin - by Hev b 8 and for nsLTP - by Pru p 3. It was shown that sensitization with nsLTPs revealed statistically important associations with allergic rhinitis (p = 0.005) and dermatitis (p = 0.02). PR-10 allergen sensitization was associated with allergic rhinitis (p = 0.04) and asthma (p = 0.04). According to our results, sensitization to plant panallergens in the Georgian population creates characteristic features overlapping serotypes of Central Europe and Mediterranean region.

Diagnostic Value and Clinical Application of Nasal Fractional Exhaled Nitric Oxide in Subjects with Allergic Rhinitis.

Nitric oxide (NO) is a potential marker in the diagnosis and monitoring of treatment for the management of patients with allergic rhinitis (AR). The study aimed to determine the value of nasal fractional exhaled nitric oxide (FeNO) in the diagnosis and treatment response of AR patients. The participants were divided into control and allergic rhinitis groups based on the clinical symptoms and skin prick tests. The AR group was treated with intranasal corticosteroid after the diagnosis. The nasal fractional exhaled nitric oxide (FENO) levels were compared between control and AR groups. In the AR group, the visual analogue scale (VAS), Nasal Obstruction Symptoms Evaluation (NOSE) questionnaire, and nasal fractional exhaled nitric oxide (FeNO) were assessed pre- and post-treatment. One hundred ten adults were enrolled. The nasal FeNO level was significantly higher in AR compared to control (p < 0.001). Both the subjective (VAS and NOSE), both (p < 0.01) and objective (nasal FeNO, p < 0.001) assessments showed significant different pre- and post-treatment. The threshold level of nasal FeNO in the diagnosis of AR was 390.0 ppb (sensitivity of 73% and specificity of 80%) based on the receiver operator characteristic curve. Nasal FeNO level is significantly higher in AR compared to control group with significant difference pre- and post-treatment. The findings suggest nasal FeNO can serve as an adjunct diagnostic tool together with the monitoring of treatment response in AR.

Increased risk of cataract surgery in patients with allergic disease: a population based cohort study.

We investigated the association between cataract and allergic diseases, including atopic dermatitis (AD), allergic rhinitis (AR), and asthma using 2,631,015 subjects' data from the 2009 National Health Insurance Service-Health Screening Cohort in Korea. Each allergic disease was defined as three or more occasions of diagnosis within 1year with dedicated ICD-10 codes. The primary endpoint was newly received cataract surgery during the follow-up period. In total, 447,883 subjects had at least one allergic disease. During the mean follow-up of 7.8 ± 1.7years, newly developed cataract surgery was observed in 301,693 subjects (allergic group, n = 69,321; non-allergic group, n = 232,372). After adjusting for demographic characteristics (age, sex), systemic and ocular comorbidities, socioeconomic status, and lifestyle factors (smoking, drinking, regular exercise), the allergic group had a higher hazard ratio (HR) for cataract development compared with the non-allergic group. We further performed a subgroup analysis for patients regarding sex and age. In the subgroup analysis of subjects with AD, men aged < 50years had a higher HR compared to women of the same age group. In conclusion, subjects with allergic diseases had a higher risk of cataract surgery than their counterparts, and the combination of AD and AR resulted in the highest risk. Particularly, the association was more evident in male than female patients with AD aged < 50years.

Association between 19 Allergens and Chronic Constipation in Adults: NHANES 2005–2006

Introduction: There are increasing reports of a link between chronic constipation and allergies in children. However, similar epidemiological evidence is limited in the general adult population. Therefore, in this study, we attempted to assess the association between chronic constipation and allergy in adults aged ≥20 years in the USA. Methods: We established a logistic regression model to test the relationship between chronic constipation and 19 specific immunoglobulin E (sIgE) types in adults aged ≥20 years using large-sample data from the National Health and Nutrition Examination Survey database (2005–2006). The weekly defecation times of the allergic and non-allergic groups were compared using the t test. Results: We found that sIgE-sensitized participants had a 0.723 lower risk of chronic constipation than the general population (95% confidence interval (CI) = 0.566–0.923). There was a negative association between chronic constipation and sensitizations to peanut (odds ratio (OR) = 0.579, 95% CI = 0.381–0.935), egg (OR = 0.335, 95% CI = 0.134–0.838), dog (OR = 0.723, 95% CI = 0.522–0.965), and cockroach (OR = 0.540, 95% CI = 0.373–0.784). In addition, the frequency of defecation per week increased significantly in people allergic to peanuts and cockroaches (p < 0.05). Discussion/Conclusion: The results of this study demonstrate an inverse relationship between sIgE sensitization and chronic constipation in adults. However, the specific association mechanism needs to be further studied.

Efficacy and predictors of rapid response to omalizumab therapy in patients with seasonal allergic rhinitis: a cohort study

BACKGROUND: The availability of anti-IgE therapy for allergic rhinitis has actualized the need to develop variants of this treatment according to predictors of rapid response and techniques of treatment initiation. AIM: To study the efficacy and predictors of response to omalizumab in patients with seasonal allergic rhinitis. MATERIALS AND METHODS: Patients with moderate or severe seasonal allergic rhinitis in which traditional treatment for at least 3 months was not effective in the previous pollen season or in the current season were included. The decision to prescribe omalizumab was made based on the visual analog scale (VAS) in the previous or current season. The dosage and frequency of administration (every 2 or 4 weeks) were determined according to the table of values provided in the instructions. The patients were observed for 2 months. At follow-up visits (1 and 2 months later), allergic rhinitis symptom control was assessed using VAS and total nasal symptoms score (TNSS). Therapy was considered effective when the VAS remained 30 or decreased 30 after 4 and 8 weeks from the start of therapy, depending on the initiation period. RESULTS: The study enrolled 30 patients with allergic rhinitis history of 14 years, sensitization to 2 groups of allergens in 19 (63.3%) cases and bronchial asthma in 18 (60%). Omalizumab was initiated before the pollen season in 6 (20%) patients and during the season in 24 (80%) patients. After 4 weeks, allergic rhinitis manifestations were controlled in 23 (77%) patients, and by week 8, 100% of the patients with allergic rhinitis had fully responded to therapy. By 4 weeks of follow-up, the severity of allergic rhinitis symptoms on the VAS and TNSS scales decreased by 2.7 and 4.7 times, respectively. The proportion of patients with a slow response by week 4 of therapy was 23%. Body mass index (lower in the slow response group) and history of bronchial asthma (2.6 times longer in the slow responders) were associated with the achievement of this outcome. No adverse events were recorded. CONCLUSIONS: In patients with seasonal allergic rhinitis, omalizumab allows the control of disease manifestations after 4 weeks of therapy with its maintenance in the follow-up. Predictors of rapid response have been revealed; however, their clinical significance requires further study.

Bilirubin level is decreased in patients with allergic rhinitis

BackgroundThere are limitations in detecting methods for early diagnosis and screening of allergic rhinitis. Considering the anti-inflammatory and anti-oxidative effects of bilirubin, this study aims to explore the relationship between bilirubin and allergic rhinitis and to identify bilirubin-related candidate urinary protein biomarkers associated with allergic rhinitis. Methods63 allergic rhinitis patients (AR group) and 86 healthy controls (NC group) were enrolled. Venous blood was obtained to measure serum total IgE levels and bilirubin parameters. Patients in the AR group were then classified into the AR1 group (IgE > 125 IU/mL) and the AR2 group (IgE ≤ 125 IU/mL). After randomly selecting ten urine samples from the AR1 group, ten samples were chosen from the AR2 and the NC groups, respectively, according to age and gender matching. We employed a Tandem Mass Tag-Based liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) proteomics approach and targeted parallel-reaction monitoring(PRM) to identify and validate urinary biomarkers for allergic rhinitis. ResultsCompared with the NC group, the bilirubin levels of the AR group, AR1 group, and AR2 group were significantly lower. Although the bilirubin level of the AR1 group was lower than that of the AR2 group, the difference was not significant. Further urinary proteomics analysis found that the expression levels of proteins related to bilirubin metabolism and transportation in the AR1 and AR2 groups, including ABCC1, GSTA1, GSTO1, GSTM3, GSTM5, and BLVRB, were significantly higher than those in the NC group. By PRM-based quantification, GSTA1 and GSTO1 showed significant differences in different degrees of Allergic Rhinitis groups and healthy controls. The AUC of the combined diagnosis of GSTA1 and GSTO1 was 0.79 (95% CI 0.583–0.997, P = 0.007), and the sensitivity and specificity were 100% and 60.0%, respectively. ConclusionsBilirubin levels are associated with allergic rhinitis. Our study revealed that urine proteomics has a specific value for exploring the pathophysiological mechanism of bilirubin changes in AR patients and screening possible biomarkers.

Efficacy of epinephrine rinse in allergen immunotherapy with aeroallergen and venom

Introduction In a suburban allergy outpatient office, the practice of epinephrine rinse of subcutaneous allergen immunotherapy (SCIT) syringes prior to injection has been employed for over 30 years with documented favorable clinical outcomes. A retrospective study was conducted to explore the effectiveness of epinephrine rinsing of SCIT syringes in managing local site reactions (LSR) in patients with allergen hypersensitivity. Methods Chart review of patients currently receiving SCITs was conducted using the clinical database at the outpatient office. 549 SCITs were reviewed, and 140 cases were traced to employ the use of epinephrine rinse to improve LSRs. The data was separated into allergic rhinitis and venom immunotherapy groups and was recorded for both build-up and maintenance phases. Results Out of 140 total patients requiring epinephrine rinse, 88.6% were in the allergic rhinitis group and 11.4% were in the venom group. In the allergic rhinitis group, 69.3% of patients and 87.5% in the venom group required epinephrine rinse during the build-up phase. In the allergic rhinitis group, 65.7% patients receiving SCIT at maintenance dose and 69.8% patients at build-up dose had resolution of LSR post-epinephrine rinse. In the venom group, 64.2% patients receiving SCITs at build-up dose improved LSR after epinephrine rinse. Conclusion Epinephrine rinse technique prior to injection showed favorable outcomes in over 60% of patients currently receiving treatment for allergen hypersensitivity. Epinephrine rinse is beneficial during the build-up phase of SCIT to manage LSR to effectively increase allergen dose.

Intestinal proline is a potential anti-allergy factor for allergy diagnosis and therapy.

Allergy has become a public health problem worldwide, but effective diagnostic and therapeutic approaches are limited currently. Amino acids are essential macronutrients that potentially participated in the allergy process. This work aimed to investigate whether amino acids can be applied as a mediator for allergy diagnosis and therapy. Two cohort studies were performed to investigate the correlation between fecal amino acids and allergy responses, and a spleen cell model was used to validate the role of amino acids in regulating allergy. In a cohort study with 193 volunteers, fecal proline was found to be negatively correlated with serum IgE, and detailed data analysis revealed that people with high-IgE-mediated allergy had decreased odds of high intestinal proline. In another cohort study with distinct allergic and non-allergic individuals, proline concentration was significantly lower in the allergic group. Daily diet and metagenomics analysis showed that the proline intake and microbiota amino acid metabolism were not significantly different, implying that the body's proline metabolism might be different between allergic and non-allergic individuals. Furthermore, the spleen cell model demonstrated that proline specifically targeted Th2 and Treg activity. Overall, this work revealed a tight correlation between gut proline and serum IgE, indicating proline as a promising biomarker and a potential therapeutic method for allergic diseases.

Survey the effect of drug treatment on modulation of cytokines gene expression in allergic rhinitis.

Allergic rhinitis as common airway disease has high prevalence in all peoples worldwide. In allergic diseases, Th2 cells release type 2 cytokines that support the inflammation in airways. All the drugs used for allergic rhinitis do not cure completely, and the choice of drugs according to cost and efficacy is very important in all groups of atopic patients. Therefore, in this study, the effect of commercial drugs on cytokine gene expression has been studied. Male Balb/c mice were divided into six groups. Allergic rhinitis was induced in five of the six groups with ovalbumin, and four of these five groups were treated with salbutamol, budesonide, theophylline, and montelukast. The fifth group was used as positive control group and the sixth group as negative control group. For the survey, RNA was extracted, cDNA was synthesized, and quantitative real-time PCR was done for 21 genes. The four drugs had different effects on mRNA expression of cytokines (IL-1b, 2, 4, 5, 7, 8, 9, 11, 12, 13, 17, 18, 22, 25, 31, 33, 37, IFN-γ, TNF-α, TGF-β1, and eotaxin) in the allergic rhinitis groups. Salbutamol can be used during pregnancy and breastfeeding, but it has some side effects. Budesonide in the inhaled form is generally safe in pregnancy. Theophylline cannot control allergic attack in the long run. Montelukast is not useful in the treatment of acute allergic attacks. Immunomodulatory and anti-inflammatory effects of drugs in control of allergic rhinitis via Th2 cytokines can be new approaches in molecular medicine.

Allergen characteristics, quality, major allergen content and galenics for mite allergen-specific immunotherapy preparations

SummaryHouse dust mite extracts for allergen-specific immunotherapy (AIT) require in Germany as other common allergens (pollen from sweet grasses [except maize], birch, alder, hazel; bee and wasp venom) marketing authorisation according to the German Therapy Allergen Ordinance (“Therapieallergene-Verordnung”, [TAV]). Mite allergen extracts that have been approved and also those which are in the approval process are subject to government batch testing. Batch test passing is a prerequisite for marketability. Appropriate quality, efficacy, and safety are prerequisites for the approval of house dust mite extracts. Five HDM allergen extracts from four manufacturers are currently approved in Germany for subcutaneous or sublingual therapy; further extracts are in the approval process. The allergen strength of different products is not comparable; manufacturers use company-specific units to describe the strength. Of the three known major allergens (Group 1 allergens: Der p 1, Der f 1, Group 2 allergens: Der p 2, Der f 2 and Group 23: Der p 23, Der f 23) only Group 1 and Group 2 allergens are usually used to standardize the extracts. Group 23 allergens are localized in the outer membrane of mite faeces, and elution requires special extraction methods. To be efficacious in a single patient an allergen extracts used for AIT must contain all allergen components against which the patient is sensitised. Based on post hoc analyses of large clinical studies, it has been proven for house dust mite tablets that Der p 23 is also contained. In Germany, the Paul Ehrlich Institute is responsible for the approval of therapeutic allergens. For the marketing authorisation information on production procedures, and quality are necessary efficacy and safety (positive benefit risk ratio) of the product must be demonstrated in clinical trials according to the current state of the art.

The Interaction of Food Allergy and Diabetes: Food Allergy Effects on Diabetic Mice by Intestinal Barrier Destruction and Glucagon-like Peptide 1 Reduction in Jejunum.

The increase in food allergies and diabetes leads to the assumption that they are related. This study aimed to (1) verify the interaction between food allergy and diabetes and (2) explore the potential mechanisms by which food allergy promotes diabetes. Female BALB/c mice were grouped into a control group (CK), an ovalbumin-sensitized group (OVA), a diabetes group (STZ), and a diabetic allergic group (STZ + OVA) (Mice were modeled diabetes with STZ first, then were given OVA to model food allergies), and an allergic diabetic group (OVA + STZ) (Mice were modeled food allergies with OVA first, then were given STZ to model diabetes). The results showed that OVA + STZ mice exhibited a more serious Th2 humoral response, and they were more susceptible to diabetes. Furthermore, when the OVA + STZ mice were in the sensitized state, the intestinal barrier function was severely impaired, and mast cell activation was promoted. Moreover, we found that the effect of food allergy on diabetes is related to the inhibition of GLP-1 secretion and the up-regulation of the PI3K/Akt/mTOR/NF-κB P65 signaling pathway in the jejunum. Overall, our results suggest that food allergies have interactions with diabetes, which sheds new light on the importance of food allergies in diabetes.

Screening of B-cell epitopes of Der-p1 and Der-p2 major aeroallergens by computational approach for designing immunotherapeutics

Introduction and Aim: Allergic diseases are IgE-mediated hypersensitivity reactions affecting approximately 30% of the general population globally. Dermatophagoides pteronyssinus (Der-p) is the most prevalent house dust mite (HDM) species consisting of 23 mite allergen groups. Among these, group 1 and 2 are major allergenic proteins, which causes allergic asthma in 80% of sensitized individuals, with elevated IgE titres in the serum. This study involves in silico analysis of potential B-cell epitopes of group 1 and group 2 of Der-p, which can be utilized in designing immunotherapeutic vaccines. Materials and Methods: Allergen sequences obtained from the database- International Union of Immunological Societies (IUIS), for predicting of B-cell epitopes. The physiochemical properties and secondary structures of the obtained sequence were evaluated. The sequences were further subjected to determining antigenicity, surface accessibility, and prediction of linear and discontinuous B-cell epitope by utilizing IEDB tools. Results: The linear and discontinuous B-cell epitopes of Der-p1 and Der-p2 aeroallergen were predicted. Further, Der-p1 and Der-p2 showed 6 linear epitopes each respectively. Conformational epitopes predicted were 123 of Der-p1 and 72 of Der-p2 respectively, by the ElliPro tool. Based on the structure, antigenicity, and surface accessibility, only 10% of Der-p1 and Der-p2 which binds to B-cell epitopes are linear and the majority are discontinuous. Conclusion: The linear and conformational epitopes of Der-p1 and Der-p2 are predicted using in silico tools. These identified epitopes might be useful for developing epitope-based immunotherapeutics for HDM allergy.

Fungal sensitization in patients with severe atopic dermatitis as a distinct phenotype

Background. Many factors influence the development of atopic dermatitis (AD): genetic, environmental (including exposure to allergens), skin barrier damage, and activation of the T2-pathway immune response. Patients with AD, including those with severe disease, are prone to sensitization to various allergens, including fungal ones. Fungal sensitization (FS) promotes autoreactivity to the body's own structures due to shared epitopes with homologous fungal allergens. It can contribute to the development of allergic diseases, including AD, asthma, and rhinitis, as well as to their exacerbation and uncontrolled course. Since FS can be considered a factor aggravating AD, it is relevant to distinguish patients with FS and AD into a separate phenotype.&#x0D; Aim. To characterize the phenotype of patients with severe AD and FS using retrospective data analysis from a digital analytics platform in a real-world clinical setting.&#x0D; Materials and methods. A retrospective observational single-center study was conducted between 01.06.2017 and 01.07.2022. The study cohort included 88 patients with severe AD who were candidates for therapy or received treatment with either dupilumab or upadacitinib. FS was confirmed in 49 patients from the study group. Part of the cohort without FS (n=39) was used as a comparison group. Inclusion criteria: the age over 18 years old; severe AD (SCORAD40 points at the beginning of therapy); determination of specific immunoglobulin E to a panel of fungal allergens or individual fungi (or by the ImmunoCAP ISAC method to fungal allergen components). A digital analytics platform was used to generate primary data.&#x0D; Results. The phenotype of a patient with severe AD and confirmed FS was described. The patient profile is characterized by an extended sensitization spectrum (at least 34 allergen groups) with the most typical combination of pollen, epidermal, and FS. If there is a food allergy, it is of the classic "big eight" nature. Besides exacerbation of the skin disorder, its manifestations include angioedema of life-threatening localization and bronchospasm. Markers of T2 inflammation (high levels of immunoglobulin E and blood eosinophilia) are observed according to the test results, and the T2 endotype of allergy-related abnormalities is typical.&#x0D; Conclusion. Apparently, the presence of FS in patients with AD may exacerbate parenteral sensitization mechanisms, expanding its spectrum, including food allergens. Therefore, distinguishing the phenotype of severe AD with FS needs further detailing with a subsequent adaptation of monitoring and treatment methods of severe AD.

Sensitization characteristics of cockroach in Beijing area

Objective:To investigate the sensitization characteristics of cockroach in patients with allergic rhinitis（AR） and/or allergic asthma in Beijing area, and to provide basis for the prevention and treatment of cockroach sensitized population. Methods:Clinical data of patients with allergic rhinitis and/or asthma from January 2017 to December 2019 treated in the outpatient Department of Allergy of Beijing Shijitan Hospital were retrospectively analyzed.Skin prick test （SPT） was performed with cockroach allergen reagents. The cockroach sensitization of patients with different ages and diseases was compared, and the population distribution characteristics of cockroach sensitization were observed.Statistical analysis was performed using SAS 9.4 software. Results:A total of 9915 patients were enrolled in the end.The total positive rate of cockroach SPT was 24.79%（2458/9915）,with the highest positive rate （31.65%） in 15-19 years old group. The positive rate of SPT increased with age in patients less than 14 years old, while the positive rate of SPT was basically flat with age in patients more than 20 years old .The positive rate of cockroach SPT was 24.83% （2355/9484） in allergic rhinitis patients,26.38% （410/1554） in allergic asthma patients, and 27.34% （307/1123） in allergic rhinitis combined with asthma patients. Single cockroach SPT positive accounted for 9.64% （237/2458）, cockroach with other indoor inhalation allergens SPT positive accounted for 90.36% （2221/2458）. The positive SPT rates for combined Der f , Der p,house dust, cat dander, and dog dander were 74.25% （1825/2458）, 66.27% （1629/2458）, 58.99% （1450/2458）, 43.08% （1059/2458）, and 40.85% （1004/2458）, respectively.In allergic rhinitis，asthma，and allergic rhinitis combined with asthma，the cockroach SPT positive rate was higher in the adult group than that in juvenile group，and the difference of positive rate in allergic rhinitis group was statistically significant（25.81% vs 19.07%, P<0.001）.In the juvenile group, the positive rate of SPT in AR combined with asthma was higher than that in AR and that in asthma. Conclusion:Cockroach allergy in patients with AR and/or allergic asthma in Beijing is relatively high, most of them are sensitized by multiple inhalation allergens, and the sensitization degree of adults is higher than that of juvenile.

Anti-inflammatory effect of N-(trifluoromethylphenyl)- 2-cyano-3-hydroxy-crotonic acid amide and gluconic acid on allergic rhinitis and asthma controlling.

Allergic rhinitis and asthma are the main airway diseases with a higher prevalence. Eosinophilic inflammation, airway hyperresponsiveness, mucus hypersecretion, and reversible airflow obstruction are immunopathogenesis symptoms of rhinitis and asthma. Crotonic acid has bio-activity on the inflammation, and gluconic acid as chelator may protect crotonic acid activity in airway and together may control allergic rhinitis and asthma.Allergic rhinitis and asthma mice models were treated with crotonic and gluconic acids. The total IgE, histamine, IL-4, IL-5, and IL-13 levels were measured. In lung tissues, goblet cell hyperplasia, mucus hypersecretion, and inflammation were evaluated.The level of IL-5, goblet cell hyperplasia, and perivascular and peribronchial inflammation were controlled by crotonic acid in asthma and allergic rhinitis groups. But, total IgE, hista-mine, IL-4, and IL-13 levels, and mucus hypersecretion had no significant changes between treated and nontreated asthma and rhinitis groups.

Mild allergic airways responses to an environmental mixture increase cardiovascular risk in rats.

Recent epidemiological findings link asthma to adverse cardiovascular responses. Yet, the precise cardiovascular impacts of asthma have been challenging to disentangle from the potential cardiovascular effects caused by asthma medication. The purpose of this study was to determine the impacts of allergic airways disease alone on cardiovascular function in an experimental model. Female Wistar rats were intranasally sensitized and then challenged once per week for 5 weeks with saline vehicle or a mixture of environmental allergens (ragweed, house dust mite, and Aspergillus fumigatus). Ventilatory and cardiovascular function, measured using double-chamber plethysmography and implantable blood pressure (BP) telemetry and cardiovascular ultrasound, respectively, were assessed before sensitization and after single and final allergen challenge. Responses to a single 0.5 ppm ozone exposure and to the cardiac arrhythmogenic agent aconitine were also assessed after final challenge. A single allergen challenge in sensitized rats increased tidal volume and specific airways resistance in response to provocation with methacholine and increased bronchoalveolar lavage fluid (BALF) eosinophils, neutrophils, lymphocytes, cytokines interleukin (IL)-4, IL-5, IL-10, IL-1β, tumor necrosis factor-α, and keratinocyte chemoattract-growth-related oncogene characteristic of allergic airways responses. Lung responses after final allergen challenge in sensitized rats were diminished, although ozone exposure increased BALF IL-6, IL-13, IL-1 β, and interferon-γ and modified ventilatory responses only in the allergen group. Final allergen challenge also increased systolic and mean arterial BP, stroke volume, cardiac output, end-diastolic volume, sensitivity to aconitine-induced cardiac arrhythmia, and cardiac gene expression with lesser effects after a single challenge. These findings demonstrate that allergic airways responses may increase cardiovascular risk in part by altering BP and myocardial function and by causing cardiac electrical instability.

Genome assembly and annotation of Periplaneta americana reveal a comprehensive cockroach allergen profile.

One of the most common cockroach types in urban areas, the American cockroach (Periplaneta americana), has been reported to impose an increased risk of allergies and asthma. Limited groups of allergens (Per a 1-13) have been identified in this species due to the lack of genome-related information. To expand the allergen profile of P. americana, genomic, transcriptomic, and proteomic approaches were applied. With the support of a high-quality genome assembled using nanopore, Illumina, and Hi-C sequencing techniques, potential allergens were identified based on protein homology. Then, using enzyme-linked immunosorbent assay, selected allergens were tested in Thai patients allergic to P. americana. A chromosomal-level genome of P. americana (3.06 Gb) has been assembled with 94.6% BUSCO completeness, and its contiguity has been significantly improved (N50=151 Mb). A comprehensive allergen profile has been characterized, with seven novel groups of allergens, including enolase (Per a 14), cytochrome C (Per a 15), cofilin (Per a 16), alpha-tubulin (Per a 17), cyclophilin (Per a 18), porin3 (Per a 19), and peroxiredoxin-6 (Per a 20), showing IgE sensitivity in enzyme-linked immunosorbent assay. A new isoallergen of tropomyosin (Per a 7.02) and multiple potential isoallergens of Per a 5 were revealed using bioinformatics and proteomic approaches. Additionally, comparative analysis of P. americana with the closely related Blattodea species revealed the possibility of cross-reaction. The high-quality genome and proteome of P. americana are beneficial in studying cockroach allergens at the molecular level. Seven novel allergen groups and one isoallergen in Per a 7 were identified.