Atopic Asthma Research Articles

Fruit vinegar as a promising source of natural anti-inflammatory agents: an up-to-date review.

Fruit vinegar is one of the most famous fruit byproducts worldwide with several unique properties. There are two types of fruit vinegar, artisanal and industrial, for consumers to choose from. This review aims to assess for the first time the phytochemistry of fruit vinegar and its anti-inflammatory effects. The present work was conducted based on a literature search that selected the relevant papers from indexed databases such as Scopus, Science Direct, MDPI, PubMed, Hindawi, and Web of Science. We used numerous terms to assure a good search in different databases, including fruit vinegar, phytochemistry, bioavailability and bioaccessibility, and anti-inflammatory effect. All articles were selected based on their relevance, quality, and problematic treatment. Literature data have shown that vinegar has a long medicinal history and has been widely used by different civilizations, due to its richness in bioactive molecules, vinegar plays an important role in the prevention and treatment of various inflammatory diseases, including atopic dermatitis, mastitis, asthma, arthritis, acute pancreatitis, and colitis. Fruit vinegar consumption benefit is highly dependent on its chemical composition, especially organic acids and antioxidants, which can act as nutraceuticals. Fruit vinegar has a rich chemical composition, including organic acids that can be transformed in the digestive system into compounds that play an important role in health-promoting features such as anti-inflammatory effects throughout the control of intestinal microbiota and pro-inflammatory cytokine production.

Circulating T follicular helper 2 cells, T follicular regulatory cells and regulatory B cells are effective biomarkers for predicting the response to house dust mite sublingual immunotherapy in patients with allergic respiratory diseases.

The relationships between T follicular helper (Tfh) cells and antigen-specific immunoglobulins (sIgs) in patients with allergic respiratory diseases who are receiving antigen immunotherapy (AIT) have not been fully clarified. Therefore, we started to perform house dust mite sublingual immunotherapy (HDM-SLIT) for 20 patients with atopic asthma comorbid with allergic rhinitis (AA+AR) who were already receiving ordinary treatments including inhaled corticosteroid (ICS). We examined percentages of circulating T follicular helper (cTfh) and regulatory (cTfr) cells and percentages of circulating regulatory T (cTreg) and B (cBreg) cells by FACS and we examined levels of Der-p/f sIgs by ELISA. Based on the symptom score (asthma control questionnaire: ACQ) and medication score ((global initiative for asthma: GINA) treatment step score) in patients with AA, the patients were divided into responders and non-responders. The percentage of cTfh2 cells significantly decreased and the percentage of cTfh1 cells significantly increased within the first year. Der-p/f sIgEs decreased after a transient elevation at 3 months in both groups. Notably, the percentage of cTfh2 cells and the ratio of cTfh2/cBreg cells and Der-p/f sIgEs greatly decreased in responders from 6 months to 12 months. The percentages of cTfr and cTreg cells showed significant negative correlations with the percentage of cTfh2 cells. The percentage of IL-4+ cTfh cells were significantly decreased and the percentage of IFN-γ+ cTfh cells were increased before treatment to 24 months in 6 patients examined (4 responders and 2 non-responders). We performed multi plelogistic regression analysis based on these results, the ratios of cTfh2/cTfr cells and cTfh2/cBreg cells at the start of therapy were statistically effective biomarkers for predicting the response to HDM-SLIT in patients with AA+AR.

Association of <i>NR3C1 Bcl1</i> gene polymorphism with impaired programmed cell death of lymphocytes in patients with atopic bronchial asthma

Atopic asthma is a chronic disease characterized by airway obstruction, bronchial hyperresponsiveness, and inflammation. Patients show increased activation of immune cells in the airways, especially T-lymphocytes, leading to chronic inflammation. The lymphocytes of asthma patients are known to have an impairment of the type 1 and 2 programmed cell death, i.e., apoptosis and autophagy, thus contributing to prolongation and intensification of inflammatory process. As compared to apoptosis, autophagy may also contribute to cell survival under stress conditions. Its disruption and hyperactivation leads to exacerbation of allergic responses. Glucocorticoids are the main drugs for the treatment of atopic bronchial asthma by activating the glucocorticoid receptor, thus triggering anti-inflammatory response and apoptosis of the cells. However, some patients exhibit resistance to therapy due to various factors, including single nucleotide polymorphisms of NR3C1 glucocorticoid receptor gene. The highest association between asthma severity and resistance to therapy was found for the GG variant of the NR3C1 Bcl1 polymorphism. Common molecular pathways for glucocorticoid receptor activation and programmed cell death and mediating molecules suggest a significant role for the polymorphic receptor variant in cell death. The aim of our study was to evaluate the effect of a single nucleotide polymorphism (G allele, i.e., Bcl1 polymorphism of NR3C1 gene) of glucocorticoid receptor on expression levels of genes that regulate apoptosis (BCL2, CASP3) and autophagy (BECN1, LC3) in lymphocytes of patients with moderate and severe atopic bronchial asthma. The study was performed with peripheral blood samples of 24 patients aged 20 to 45 years with an established diagnosis of moderate to severe atopic bronchial asthma. Using PCR technique with restriction fragment length polymorphism (RFLP) assay, the patients were distributed according to the genotypes of the BclI polymorphism of the NR3C1 gene: 12 patients with CC genotype, 8 persons with GC genotype, and 4 cases with GG genotype. The lymphocytes were isolated in Ficoll density gradient and cultivated with dexamethasone under the conditions of nutrient depletion. The level of gene expression was determined by real-time PCR. When studying associations between various genotypes of Bcl1 polymorphism and expression of cell death marker genes, the anti-apoptotic reactions were detected in lymphocytes of patients with GG polymorphism under the influence of dexamethasone thus being a potential mechanism for development of resistance to glucocorticosteroid therapy in asthma. Impaired activation of BECN1 gene expression in patients with the GG genotype may suggest deregulation of the autophagy in this group of patients, as a mode of programmed cell death. Moreover, in patients with GC genotype during long-term cultivation, exposure to dexamethasone increases the expression of the LC3 gene, indicating a more pronounced activation of autophagy. Hence, this work demonstrates differences in response of lymphocytes to synthetic glucocorticoid therapy, and probable effect of G allele (Bcl1 polymorphism) on dysregulation of programmed cell death under the influence of dexamethasone.

The relationship between exposure to environmental noise and risk of atopic dermatitis, asthma, and allergic rhinitis

BackgroundNoise is defined as unwanted sound. It may induce negative emotions and mental health problems and may even lead to increased suicide risk. However, the impact of noise exposure on environmental diseases and disease severity is not well understood. This study aimed to elucidate the association between night-time noise exposure and the prevalence of environmental diseases in South Korea. MethodsWe conducted an analysis of the Environmental Disease Database provide by the National Health Insurance Service (NHIS) from 2013 to 2017. After spatially interpolating the noise data provided by the National Noise Information System (NNIS), night-time noise values in the district level were obtained by calculating the mean noise values at the administrative district level. The linear regression analyses were performed to test the association between the age-standardized prevalence ratio (SPR) and the night-time noise exposure in the district level. ResultsIn areas with high night-time noise exposure (≥55 dB), the SPR for atopic dermatitis and allergic rhinitis were 1.0515 (95 % confidence interval [CI]:1.0508–1.0521) and 1.0202 (95 % CI:1.0201–1.0204), respectively, which were higher than those in the general population. The SPR for environmental diseases, including atopic dermatitis, asthma, and allergic rhinitis, was 1.0104 (95 % CI:1.0103–1.0105). Additionally, a significant linear association was observed between the level of nocturnal noise exposure and the total hospitalization period for atopic dermatitis (β = 399.3, p < 0.01). ConclusionWe provide evidence of a significant association between night-time environmental noise and environmental diseases, particularly atopic dermatitis and allergic rhinitis. Furthermore, we observed a significant linear association between night-time noise exposure and the severity of atopic dermatitis.

Association of cesarean section with asthma in children/adolescents: a systematic review and meta-analysis based on cohort studies

BackgroundWhether cesarean section (CS) is a risk factor for asthma in offspring is controversial. The purpose of this study was to investigate the association between CS and asthma in children/adolescents.MethodsPubmed, Embase, Web of Science, and Cochrane Library electronic databases were searched for cohort studies on the relationship between mode of delivery and asthma in children/adolescents up to February 2023. Birth via CS was considered an exposure factor. Asthma incidence was taken as a result.ResultsThirty-five cohort studies (thirteen prospective and twenty-two retrospective cohort studies) were included. The results showed that the incidence of asthma was higher in CS offspring (odds ratio (OR) = 1.18, P < 0.001) than in the vaginal delivery (VD) group. Partial subgroup analyses showed a higher incidence of asthma in female offspring born via CS (OR = 1.26, P < 0.001) compared with the VD group, while there was no difference in males (OR = 1.07, P = 0.325). Asthma incidence was higher in CS offspring than in the VD group in Europe (OR = 1.20, P < 0.001), North America (OR = 1.15, P < 0.001), and Oceania (OR = 1.06, P = 0.008). This trend was not found in the Asian population (OR = 1.17, P = 0.102). The incidence of atopic asthma was higher in offspring born via CS (OR = 1.14, P < 0.001) compared to the VD group. The CS group had a higher incidence of persistent asthma, but the difference did not reach statistical significance (OR = 1.15, P = 0.063).ConclusionIn this meta-analysis, CS may be a risk factor for asthma in offspring children/adolescents compared with VD. The relationship between CS and asthma was influenced by sex and region.

No associations between type 1 diabetes and atopic dermatitis, allergic rhinitis, or asthma in childhood: a nationwide Danish case-cohort study

Studies examining the association between type 1 diabetes (T1D) and atopic diseases, i.e., atopic dermatitis, allergic rhinitis and asthma have yielded conflicting results due to different algorithms for classification, sample size issues and risk of referral bias of exposed cohorts with frequent contact to health care professionals. Using Danish national registries and well-established disease algorithms, we examined the bidirectional association between T1D and atopic diseases in childhood and adolescence using Cox Proportional Hazard regression compared to two different unexposed cohorts from a population of 1.5 million Danish children born from 1997 to 2018. We found no associations between T1D and atopic dermatitis, allergic rhinitis, or asthma (defined after age five). However, in multivariable analysis we found an increased risk of persistent wheezing (defined as asthma medication before age five) after T1D with an adjusted hazard ratio (aHR) of 1.70 [1.17–2.45]. We also identified an increased risk of developing T1D after persistent wheezing with aHR of 1.24 [1.13–1.36]. This study highlights similar risks of atopic diseases in children with T1D and of T1D in children with atopic disease after age of five years versus healthy controls. However, more research is needed to understand the possible early immunological effects of the link between persistent wheezing and T1D.

Development of monoorganic and polyorganic phenotypes of bronchial asthma in children: the role of combined single-nucleotide variants

Background. Bronchial asthma (BA) in children is on one of the leading places in the morbidity and mortality structure among other allergic and atopic diseases. It can be developed in the form of a monoorganic phenotype (MOPh) or a polyorganic phenotype (POPh) with other nosologies of atopic march (AM): atopic dermatitis (AD) and allergic rhinitis/rhinoconjunctivitis (AR/ARC). This process is genetically determined, with single-nucleotide variants (SNV) of filaggrin (FLG), thymic stromal lymphopoietin (TSLP) and orsomucoid-like protein 3 ­(ORMDL3) genes playing a major role. The purpose of this study was to reveal the impact of rs_7927894 FLG, rs_11466749 TSLP and rs_7216389 ORMDL3 SNV genotype combinations in the deve­lopment of MOPh and POPh of atopic BA in children. Materials and me­thods. One hundred and twenty-one children of the main group and 105 controls took part in the study. The criteria for inclusion into the main group were: age from 3 to 18 years, clinically established and laboratory confirmed diagnoses of MOPh BA, POPh BA + AR/ARC and AD + AR/ARC + BA. The criteria for inclusion in the control group were: age from 3 to 18 years, exclu­ded diagnoses of BA, BA + AR/ARC and AD + AR/ARC + BA. All children underwent swabbing of the oral mucosa and real-time polymerase chain reaction with the obtained material to detect variants of rs_7927894 FLG, rs_11466749 TSLP and rs_7216389 ORMDL3 genotype combinations. The results were processed ­using the following statistical tools: logistic regression analysis with determination of odds ratio (OR) with 95% confidence interval (95% CI), receiver operating characteristic (ROC) analysis with determination of the area under the ROC curve (AUC), sensitivity (Se), specificity (Sp), Pearson’s correlation coefficient (r), Fisher’s ­exact test, Student’s t-test. The significance value was set at p &lt; 0.05, trend to reliability — at p = 0.0–0.1. Results. The structure of the significantly most frequent genotypes in the cohorts of the main group was as follows: C/T rs_7927894 FLG + C/T rs_7216389 ­ORMDL3 — BA = 8.7 %; C/T rs_7927894 FLG + T/T rs_7216389 ORMDL3: BA = 21.7 %, BA + AR/ARC = 18.1 %, AD + AR/ARC + BA = 15.4 %; C/T rs_7927894 FLG + A/A rs_11466749 TSLP: BA + AR/ARC = 31.9 %, AD + AR/ARC + BA = 42.3 %. Next, indicators of the genotypic combinations impact on the risk of BA phenotypes development related to the control group are provided. MOPh BA: C/T rs_7927894 FLG + T/T rs_7216389 ­ORMDL3: r = 0.299, OR = 9.44 (95% CI 2.07–43.03), AUC = 0.594 (0.507–0.682), Se/Sp = 21.7/97.1 % (p &lt; 0.001). POPh BA + AR/ARC: C/T rs_7927894 FLG + A/A rs_11466749 TSLP: r = 0.136, OR = 1.88 (95% CI 0.94–3.74), AUC = 0.560 (0.493–0.626), Se/Sp 31.9/80.0 % (p = 0.071); C/T rs_7927894 FLG + T/T rs_7216389 ORMDL3: r = 0.260, OR = 7.49 (95% CI 2.05–27.37), AUC = 0.576 (0.528–0.624), Se/Sp = 18.1/97.1 % (p &lt; 0.001). POPh AD + AR/ARC + BA: C/T rs_7927894 FLG + A/A rs_11466749 TSLP: r = 0.207, OR = 2.93 (95% CI 1.18–7.31), AUC 0.612 (0.507–0.716), Se/Sp = 42.3/80.0 % (р &lt; 0.05); C/T rs_7927894 FLG + C/T rs_7216389 ORMDL3: r = 0.173, OR = 2.50 (95% CI 0.99–6.30), AUC = 0.592 (0.489–0.695), Se/Sp = 38.5/80.0 % (p &lt; 0.05); C/T rs_7927894 FLG + T/T rs_7216389 ORMDL3: r = 0.222, OR = 6.18 (95% CI 1.29–29.6), AUC = 0.563 (0.490–0.635), Se/Sp = 15.4/97.1 % (p &lt; 0.01). The ratio of associations and risks for developing the phenotypes rela­ted to each other: BA + AR/ARC related to BA: C/T rs_7927894 FLG + C/T rs_7216389 ORMDL3: r = 0.171, OR = 3.50 (95% CI 0.75–16.41), AUC = 0.582 (0.504–0.659), Se/Sp = 25.0/91.3 % (p = 0.095); AD + AR/ARC + BA related to BA: C/T rs_7927894 FLG + C/T rs_7216389 ­ORMDL3: r = 0.345, OR = 6.56 (95% CI 1.26–34.23), AUC = 0.649 (0.537–0.761), Se/Sp = 38.5/91.3 % (р &lt; 0.05); C/T rs_7927894 FLG + A/A rs_11466749 TSLP: r = 0.270, OR = 3.48 (95% CI 0.92–13.17), AUC = 0.625 (0.500–0.750), Se/Sp 42.3/82.6 % (p = 0.059). Conclusions. MOPh BA has a significant association and an increased risk of development with the SNV genotype combination C/T rs_7927894 FLG + T/T rs_7216389 ORMDL3. POPh BA + AR/ARC has significant associations and increased risks of development with the following SNV genotype combinations: C/T rs_7927894 FLG + A/A rs_11466749 TSLP and C/T rs_7927894 FLG + T/T rs_7216389 ORMDL3. POPh AD + AR/ARC + BA has the most associations and increased risks of development within the following SNV genotype combinations: C/T rs_7927894 FLG + A/A rs_11466749 TSLP, C/T rs_7927894 FLG + C/T rs_7216389 ORMDL3, C/T rs_7927894 FLG + T/T rs_7216389 ORMDL3.

Plumbagin Attenuates Ovalbumin-induced Allergic Asthma in Mice through Inhibition of Inflammatory Response

Background Asthma is a prominent non-communicable inflammatory disease that affects both children and the elderly. Younger people are more prone to asthma, and most prescribed anti-asthmatic medicines relieve symptoms but do not cure the condition completely. We investigated the ability of a phytochemical plumbagin to alleviate ovalbumin (OVA)-induced asthma in BALB/c mice. Materials and Methods The allergic asthma-induced mice were treated with two different doses of 25 and 50 mg/kg bwt plumbagin, and to compare the efficacy of plumbagin, a standard drug dexamethasone treatment was given. OVA-specific IgE and eotaxin were quantified to determine the induction of asthma and the inhibitory role of plumbagin. Total leukocyte and differential count were done to assess the effect of plumbagin on inflammatory cells. Inflammatory cytokines inducing both atopic and non-atopic asthma were quantified to examine the efficacy of plumbagin against allergic and non-allergic-induced asthma. Nitric oxide (NO) and myeloperoxidase activity were measured to investigate the anti-asthmatic potential of plumbagin. The antioxidant potency of plumbagin was assessed by quantifying the levels of antioxidants and the oxidative stress marker malondialdehyde. Lung weight index and histopathological analysis of lung tissue were done to confirm the ameliorative potency of plumbagin against OVA allergen-induced asthma. Results Plumbagin treatment significantly decreased the status of OVA-specific IgE and eotaxin, thereby prevented the eosinophilic infiltration. It also inhibited the synthesis of both atopic and non-atopic inducing inflammatory cytokines. Plumbagin treatment also increased the levels of antioxidants and prevented the lung tissue damage, which was evidenced with our histopathology study of lung tissue. Conclusion Overall, our finding confirms that plumbagin is persuasively alleviated OVA allergen-induced asthma complications in mice model and may be an alternative for currently available anti-asthmatic drugs.

Allergy and autoimmunity in children: non-mutually exclusive diseases. A narrative review.

In last decades a simultaneous increase in the prevalence of atopic and autoimmune disorders in pediatric population has been observed. Despite the Th1-Th2 paradigm, supporting the polarization of the immune system with Th1 response involved in autoimmune diseases and Th2 response leading to hypersensitivity reactions, recent evidence suggests a possible coexistence of common pathogenic pathways as result of shared immune dysregulation. Similar genes and other mechanisms such as epithelial barrier damage, gut microbiota dysbiosis and reduced number of T regs and IL-10 contribute to the onset of allergy and autoimmunity. IgA deficiency is also hypothesized to be the crosslink between celiac disease and allergy by lowering gut mucous membrane protection from antigens and allergens. The present narrative review aims to give an overview of the co-occurrence of allergic and autoimmune disorders (celiac disease, inflammatory bowel diseases, type 1 diabetes mellitus, thyroid disease, juvenile idiopathic arthritis) in pediatric population, based on the available evidence. We also highlighted the common pathogenic pathways that may underpin both. Our findings confirm that allergic and autoimmune diseases are commonly associated, and clinicians should therefore be aware of the possible coexistence of these conditions in order to ameliorate disease management and patient care. Particular attention should be paid to the association between atopic dermatitis or asthma and celiac disease or type 1 diabetes and vice versa, for therapeutic interventions. Further studies are needed to better clarify mechanisms involved in the pathogenesis and eventually identify new therapeutic strategies.

Extracellular Matrix Remodeling in Atopic Dermatitis Harnesses the Onset of an Asthmatic Phenotype and Is a Potential Contributor to the Atopic March

The development of atopic dermatitis in infancy, and subsequent allergies, such as asthma in later childhood, is known as the atopic march. The mechanism is largely unknown, however the course of disease indicates an inter-epithelial crosstalk, through the onset of inflammation in the skin and progression to other mucosal epithelia. In this study, we investigated if and how skin-lung epithelial crosstalk contributes to the development of the atopic march. First, we emulated inter-epithelial crosstalk through indirect coculture of bioengineered atopic-like skin disease models and three-dimensional bronchial epithelial models triggering an asthma-like phenotype in the latter. A subsequent secretome analysis identified thrombospondin-1, CD44, complement factor C3, fibronectin, and syndecan-4 as potentially relevant skin-derived mediators. Because these mediators are extracellular matrix-related proteins, we then studied the involvement of the extracellular matrix, unveiling distinct proteomic, transcriptomic, and ultrastructural differences in atopic samples. The latter indicated extracellular matrix remodeling triggering the release of the above-mentioned mediators. Invivo mouse data showed that exposure to these mediators dysregulated activated circadian clock genes which are increasingly discussed in the context of atopic diseases and asthma development. Our data point toward the existence of a skin-lung axis that could contribute to the atopic march driven by skin extracellular matrix remodeling.

ВЛИЯНИЕ ВОЗРАСТА И ПОЛА НА СПИРОМЕТРИЧЕСКИЕ ПАРАМЕТРЫ У ПОДРОСТКОВ С БРОНХИАЛЬНОЙ АСТМОЙ

Peculiarities of the course of bronchial asthma (BA) in adolescents from the standpoint of the influence of age and gender on it cannot be considered fully studied as yet. Materials and methods used: the data were obtained from 367 patients’ records of atopic BA aged 10 to 17 years old (73,6% boys) who were treated for atopic BA at the Nizhny Novgorod City Children’s Clinical Hospital No. 1 (Nizhny Novgorod, Russia). The patients were divided into two age groups: early adolescence (EA, 10 to 14 y/o, 239 patients) and middle adolescence (MA, 15 to 17 y/o, 128). All patients underwent spirometric studies with an assessment of the forced vital capacity of the lungs (FVC), the ratio of forced expiratory volume in one second (FEV1) to FVC (FEV1/FVC), the average volume velocity of forced exhalation, averaged in the exhalation interval from 25 to 75% FVC (FEF25-75). Spirometric parameters were evaluated using the z-criteria of the Global Lung Initiative. Results: in the general group of patients, the zFVC index was statistically significantly lower in MA compared to EA (p=0,001), and the indicators of zFEV1/FVC and zFEF25-75 were statistically significantly higher in MA (p=0,020, p=0,022 respectively). In the cohort of boys, there were similar differences in spirometric parameters in EA and MA (p=0,009, p=0,002, p=0,002, respectively). In girls, the values of FVC in MA were statistically significantly lower than in EA (p=0,0310, as in the general cohort and the cohort of boys). At the same time, in girls, the indicators of zFEV1/FVC and zFEF25-75, reflecting bronchial permeability, were slightly lower in MA than in EA, but the differences were not statistically significant. Conclusion: in boys, but not in girls, the spirometric parameters reflecting bronchial patency in MA were statistically significantly higher than in EA. At the same time, in both boys and girls, the indicators of FVC decrease in MA compared to EA, remaining above the population median values of indicators.

Association between pertussis vaccination in infancy and childhood asthma: A population-based record linkage cohort study.

Asthma is among the commonest noncommunicable diseases of childhood and often occurs with other atopic comorbidities. A previous case-control study found evidence that compared to children who received acellular pertussis (aP) vaccines in early infancy, children who received one or more doses of whole-cell pertussis (wP) vaccine had lower risk of developing IgE-mediated food allergy. We hypothesized that wP vaccination in early infancy might protect against atopic asthma in childhood. Retrospective record-linkage cohort study of children between 5 and < 15 years old and born between January 1997, and December 1999, in the Australian states of Western Australia (WA) and New South Wales (NSW), receiving wP versus aP vaccine as the first pertussis vaccine dose. The main outcome and measures were first and recurrent hospitalizations for asthma; hazard ratios (HRs) and 95% confidence intervals (CIs) were computed by means of Cox and Andersen and Gill models. 274,405 children aged between 5 and < 15 years old (78.4% NSW-born) received a first dose of either wP (67.8%) or aP vaccine before 4 months old. During the follow-up period, there were 5,905 hospitalizations for asthma among 3,955 children. The incidence rate for first hospitalization was 1.5 (95% CI 1.4-1.5) per 1,000 child-years among children receiving wP vaccine as a first dose, and 1.5 (95% CI 1.4-1.6) among those vaccinated with aP vaccine as a first dose. The adjusted HRs for those who received wP vaccine versus aP vaccine as the first dose were 1.02 (95% CI 0.94-1.12) for first hospitalizations and 1.07 (95% CI 0.95-1.2) for recurrent hospitalizations for asthma. We found no convincing evidence of a clinically relevant association between receipt of wP versus aP vaccines in early infancy and hospital presentations for asthma in childhood.

Evaluation of the reproducibility of responses to nasal allergen challenge and effects of inhaled nasal corticosteroids.

Similar immune responses in the nasal and bronchial mucosa implies that nasal allergen challenge (NAC) is a suitable early phase experimental model for drug development targeting allergic rhinitis (AR) and asthma. We assessed NAC reproducibility and the effects of intranasal corticosteroids (INCS) on symptoms, physiology, and inflammatory mediators. 20 participants with mild atopic asthma and AR underwent three single blinded nasal challenges each separated by three weeks (NCT03431961). Cohort A (n = 10) underwent a control saline challenge, followed by two allergen challenges. Cohort B (n = 10) underwent a NAC with no treatment intervention, followed by NAC with 14 days pre-treatment with saline nasal spray (placebo), then NAC with 14 days pre-treatment with INCS (220 μg triamcinolone acetonide twice daily). Nasosorption, nasal lavage, blood samples, forced expiratory volume 1 (FEV1), total nasal symptom score (TNSS), peak nasal inspiratory flow (PNIF) were collected up to 24 h after NAC. Total and active tryptase were measured as early-phase allergy biomarkers (≤30 min) and IL-13 and eosinophil cell counts as late-phase allergy biomarkers (3-7 h) in serum and nasal samples. Period-period reproducibility was assessed by intraclass correlation coefficients (ICC), and sample size estimates were performed using effect sizes measured after INCS. NAC significantly induced acute increases in nasosorption tryptase and TNSS and reduced PNIF, and induced late increases in nasosorption IL-13 with sustained reductions in PNIF. Reproducibility across NACs varied for symptoms and biomarkers, with total tryptase 5 min post NAC having the highest reproducibility (ICC = 0.91). Treatment with INCS inhibited NAC-induced IL-13 while blunting changes in TNSS and PNIF. For a similar crossover study, 7 participants per treatment arm are needed to detect treatment effects comparable to INCS for TNSS. NAC-induced biomarkers and symptoms are reproducible and responsive to INCS. NAC is suitable for assessing pharmacodynamic activity and proof of mechanism for drugs targeting allergic inflammation.

Role and Molecular Mechanisms of Alternative Splicing of Th2-Cytokines IL-4 and IL-5 in Atopic Bronchial Asthma.

Bronchial asthma (BA) is a heterogeneous chronic inflammatory disease of the respiratory tract. Allergic (atopic) asthma is the most common (up to 80% of cases) phenotype developing through the Th2-dependent mechanisms involving cytokines: IL-4, IL-5, IL-9, and IL-13. The genes encoding Th2-cytokines have a mosaic structure (encode exons and introns). Therefore, several mature mRNA transcripts and protein isoforms can be derived from a single mRNA precursor through alternative splicing, and they may contribute to BA pathogenesis. Analysis of the published studies and databases revealed existence of the alternative mRNA transcripts for IL-4, IL-5, and IL-13. The alternative transcripts of IL-4 and IL-5 carry open reading frames and therefore can encode functional proteins. It was shown that not only alternative mRNA transcripts exist for IL-4, but alternative protein isoforms, as well. Natural protein isoform (IL-4δ2) lacking the part encoded by exon-2 was identified. Similarly, alternative mRNA transcript with deleted exon-2 (IL-5δ2) was also identified for IL-5. In this review, we summarize current knowledge about the identified alternative mRNA transcripts and protein isoforms of Th2-cytokinins, first of all IL-4 and IL-5. We have analyzed biological properties of the alternative variants of these cytokines, their possible role in the allergic asthma pathogenesis, and considered their diagnostic and therapeutic potential.

Prognosis of Childhood Atopic Asthma: A 6-year Follow-up Study

Prognosis of Childhood Atopic Asthma: A 6-year Follow-up Study

B-102 Screening Food Allergies in Our Health Primary Care Area

Abstract Background Allergy is the immunological disease with the greatest impact in the world. Food allergy typically manifests with cutaneous, digestive and/or respiratory symptoms, of immediate onset, usually immunoglobulin E-mediated. Doctors from primary health-care providers are often challenged with these patients, becoming the first-line for the recognition and management of food allergies. As a laboratory, our duty is to provide the health care system with the most effective diagnostic tools. Methods We recollected all the results from Primary care of our health area analyzed in our laboratory for one year. Screening assay included a panel of specific IgE antibodies to the most common food allergens: egg yolk, egg white, milk, cod, wheat, peanut and soybean. They were detected semi-quantitatively by enzyme-labeled chemiluminescent immunoassay using the Immulite Allergy Food Panel FP5 kit (Siemens Diagnostic Products Corporation, Los Angeles, USA), according to the test procedure. If the assay was positive, all specific IgE allergens contained in the mixture were analyzed separately to determine their responsibility for the positive screening test. Results Our laboratory processed 24 125 samples from primary care patients. Of these, 1251 were positive (greater than 0.35 Ku/L), which represented 5.19% positive of the total analyzed. Once all the specific IgE allergens contained in the mixture were analyzed, the results were: 608 positive for egg yolk, 753 positive for egg white, 523 positive for milk, 109 positive for cod, 405 positive for wheat, 597 positive for peanut and 480 positive for soybean. Conclusion As with most medical disorders, a thorough medical history is the initial step in diagnosing adverse food reactions. The medical history is extremely useful, especially in acute reactions, but it can be unreliable in chronic disorders such as atopic dermatitis and asthma. In vitro assays help in the diagnosis, but they must be considered as a screening and no diagnosis tool, especially when no symptoms are associated with the positive food allergen result. That’s why in vitro results must be confirmed by prick test, which is considered gold standard for allergy diagnosis. In our study, egg white is the most prevalent allergen detected (60.19%), followed in order by egg yolk (48.60%), peanut (47.72%), milk (41.81%), soybean (38.37%), wheat (32.37%) and being cod the least allergen detected (8.71%).

Sensing of protease activity as a triggering mechanism of Th2 cell immunity and allergic disease.

CD4 T-helper cell type 2 (Th2) cells mediate host defense against extracellular parasites, like helminths. However, Th2 cells also play a pivotal role in the onset and progression of allergic inflammatory diseases such as atopic dermatitis, allergic rhinitis, asthma, and food allergy. This happens when allergens, which are otherwise harmless foreign proteins, are mistakenly identified as "pathogenic." Consequently, the encounter with these allergens triggers the activation of specific Th2 cell responses, leading to the development of allergic reactions. Understanding the molecular basis of allergen sensing is vital for comprehending how Th2 cell responses are erroneously initiated in individuals with allergies. The presence of protease activity in allergens, such as house dust mites (HDM), pollen, fungi, or cockroaches, has been found to play a significant role in triggering robust Th2 cell responses. In this review, we aim to examine the significance of protease activity sensing in foreign proteins for the initiation of Th2 cell responses, highlighting how evolving a host protease sensor may contribute to detect invading helminth parasites, but conversely can also trigger unwanted reactions to protease allergens. In this context, we will explore the recognition receptors activated by proteolytic enzymes present in major allergens and their contribution to Th2-mediated allergic responses. Furthermore, we will discuss the coordinated efforts of sensory neurons and epithelial cells in detecting protease allergens, the subsequent activation of intermediary cells, including mast cells and type 2 innate lymphoid cells (ILC2s), and the ultimate integration of all signals by conventional dendritic cells (cDCs), leading to the induction of Th2 cell responses. On the other hand, the review highlights the role of monocytes in the context of protease allergen exposure and their interaction with cDCs to mitigate undesirable Th2 cell reactions. This review aims to provide insights into the innate functions and cell communications triggered by protease allergens, which can contribute to the initiation of detrimental Th2 cell responses, but also promote mechanisms to effectively suppress their development.

Paedoksan ameliorates allergic disease through inhibition of the phosphorylation of STAT6 in DNCB-induced atopic dermatitis like mice

Various allergic diseases such as atopic dermatitis (AD), allergic rhinitis, and asthma are considered incurable conditions that have yet to be fully conquered. Paedoksan (PDS), an herbal preparation consisting of 14 medicines, displays effective anti-inflammatory and anti-allergic properties, yet its underlying molecular mechanism is unknown. This study aims to uncover PDS’s mechanism for treating allergic diseases and suggest its therapeutic potential. Through a network pharmacological prediction, its impact on signal transducer and activator of transcription 6 (STAT6) regulation, a sub-mechanism of interleukin 4 (IL-4), a major inflammatory cytokine involved in degranulation and allergy, was investigated in RBL-2H3 cells and an atopic mouse model. PDS inhibits immunoglobulin E (IgE)-induced degranulation and STAT6 phosphorylation evoked by IL-4 in granulocytes. The downregulation of phospho-STAT6 and thymic stromal lymphopoietin (TSLP) by PDS was confirmed in 2,4-dinitrochlorobenzene (DNCB)-induced mouse skin. The results demonstrate that PDS exhibited remarkable effects on degranulation and STAT6 phosphorylation in RBL-2H3 cells, as well as in an atopic mouse model. Furthermore, the main active components from PDS based on chromatographic analysis showed good accordance with PDS’s effects on RBL-2H3 cells. In summary, these findings collectively suggest that PDS holds the potential to effectively suppress inflammatory and allergic reactions by obstructing the target IL-4 protein and its downstream effects, as elucidated through a network pharmacological analysis.

Periostin C-Terminal Is Intrinsically Disordered and Interacts with 143 Proteins in an In Vitro Epidermal Model of Atopic Dermatitis.

Human periostin is a 78-91 kDa matricellular protein implicated in extracellular matrix remodeling, tumor development, metastasis, and inflammatory diseases like atopic dermatitis, psoriasis, and asthma. The protein consists of six domains, including an N-terminal Cys-rich CROPT domain, four fasciclin-1 domains, and a C-terminal domain. The exons encoding the C-terminal domain may be alternatively spliced by shuffling four exons, generating ten variants of unknown function. Here, we investigate the structure and interactome of the full-length variant of the C-terminal domain with no exons spliced out. The structural analysis showed that the C-terminal domain lacked a tertiary structure and was intrinsically disordered. In addition, we show that the motif responsible for heparin-binding is in the conserved very C-terminal part of periostin. Pull-down confirmed three known interaction partners and identified an additional 140 proteins, among which nine previously have been implicated in atopic dermatitis. Based on our findings, we suggest that the C-terminal domain of periostin facilitates interactions between connective tissue components in concert with the four fasciclin domains.

Tumor Necrosis Factor-α (-308G>A) Gene Polymorphism and Its Association with Asthma and Atopy Status.

Asthma is one of the most prevalent chronic lung diseases that afflict genetically predisposed individuals. Certain cytokine gene polymorphisms have been associated with asthma. Tumor necrosis factor-alpha (TNF-α) is a potent inflammatory cytokine that can modulate nonspecific inflammation to influence asthma. This study aimed to define the relationship between the TNF gene polymorphism at position -308 and asthma susceptibility, as well as atopic and non-atopic asthma. Using polymerase chain reaction with sequence-specific primers, we investigated genotype frequencies and alleles of a polymorphic gene coding for TNF-α in 86 pediatric patients with asthma and 470 healthy controls of the same race. Seventy-four patients underwent a skin prick test. The homozygous AA variant (-308, rs1800629) was the most common genotype among patients, accounting for 63.3% of all cases. In contrast, homozygous GG (-308) was significantly less prevalent in the patient group compared to the control group. TNF A (-308) allele frequency was 85.5% among asthma patients and 16.6% among healthy controls. The genotype and allele frequencies of TNF (-308 A>G, rs1800629) did not differ between atopic and non-atopic asthma. In conclusion, TNF (-308) AA and AG genotypes are associated with asthma susceptibility in Iranian children, although there was no significant difference in polymorphism between atopic and non-atopic asthma and no difference in asthma severity groups.