Common Allergic Diseases Research Articles

Characteristics of Fungal Monosensitization in Turkey

Study ObjectiveFungi are recognized as allergenic sources and may play a role in the development, persistency, and severity of allergic diseases. Alternaria, Cladosporium, Penicillium, and Aspergillus, which belong to the Phylum Ascomycota, are well-characterized four genera among fungi species. To our knowledge, there is not enough data about monosensitization to fungi. We aimed to investigate the characteristics of monosensitized patients to fungal allergens. Patients-MethodsSixty-seven adult patients, who had a positive skin prick test reaction with fungal allergen out of a total of 4200 SPT results performed between January 2015 and June 2022 in two tertiary centers were included in the study. The clinical data of the patients were obtained retrospectively from the hospital medical records. ResultsFifty-six (83.6%) patients were sensitized to one type of fungal allergen (Female/Male: 38/18) and eleven (16.4%) (Female/Male: 9/2) were sensitized to two types of fungi. Aspergillus was the most prevalent fungal allergen, followed by Cladosporium and Alternaria. Allergic rhinitis was the most common allergic disease. ConclusionMonosensitization to fungal allergens is rare. Monosensitization to at least one fungal allergen may lead to significant allergic diseases by potentially impacting the immune system.

Integrating 16S rRNA Sequencing, Microflora Metabolism, and Network Pharmacology to Investigate the Mechanism of SBL in Alleviating HDM-Induced Allergic Rhinitis.

Allergic rhinitis (AR) is a series of allergic reactions to allergens in the nasal mucosa and is one of the most common allergic diseases that affect both children and adults. Shi-Bi-Lin (SBL) is the modified formula of Cang Er Zi San (CEZS), a traditional Chinese herbal formula used for treating AR. Our study aims to elucidate the anti-inflammatory effects and mechanisms of SBL in house dust mite-induced AR by regulating gut microflora metabolism. In vivo studies showed that nasal allergies and the infiltration of inflammatory cells in the nasal epithelium were significantly suppressed by SBL. Moreover, SBL restored the impaired nasal epithelial barrier function with an increased tight junction protein expression and reduced the endothelial nitric oxide synthase (eNOS). Interestingly, SBL significantly reconstituted the abundance and composition of gut microbiota in AR mice; it increased the relative abundance of potentially beneficial genera and decreased the relative abundance of harmful genera. SBL also restored immune-related metabolisms, which were significantly increased and correlated with suppressing inflammatory cytokines. Furthermore, a network analysis and molecular docking indicated IL-6 was a possible target drug candidate for the SBL treatment. SBL dramatically reduced the IL-6 level in the nasal lavage fluid (NALF), suppressing the IL-6 downstream Erk1/2 and AKT/PI3K signaling pathways. In conclusion, our study integrates 16S rRNA sequencing, microflora metabolism, and network pharmacology to explain the immune mechanism of SBL in alleviating HDM-induced allergic rhinitis.

Identification of cross-reactive IgE-binding proteins from Philippine allergenic grass pollen extracts.

Respiratory allergies are one of the most common allergic diseases that affect Filipinos. Grass pollen accounts for the majority of the outdoor allergens triggering these respiratory allergies. Cross-reactivity among the Philippine grass pollen grains has not been extensively studied. This study aims to investigate the cross-reactivity of our local grasses and identify the cross-reactive allergens. Grass pollen grains were collected and processed into crude allergenic extracts. The IgE-reactivity of these crude allergenic pollen extracts was studied using sera from patients who tested positive for the mentioned extracts. The proteins from the immunoblots of cross-reactive pollen allergen extracts were sequenced and identified. Allergenic pollen proteins were identified as cross-reactive among the grass pollen extracts. Four of these have not been listed yet as grass allergens in the World Health Organization/International Union of Immunological Societies allergen nomenclature database. Local grass pollen allergens are cross-reactive with probable new allergens identified.

Micronutrients and Allergic Diseases: A Mendelian Randomization Study

Introduction: Previous studies have indicated a controversy regarding the association between dietary micronutrient concentrations and the risk of allergic diseases. In this study, we employed Mendelian randomization (MR) analysis using data from two samples to investigate the causal relationship between circulating micronutrient concentrations and three allergic diseases. Methods: In this study, we considered 16 circulating micronutrients as exposure variables (beta carotene, calcium, copper, folate, iron, lycopene, magnesium, phosphorus, selenium, vitamin A1, vitamin B6, vitamin B12, vitamin C, vitamin D, vitamin E, and zinc); and three common allergic diseases (allergic asthma [AA], atopic dermatitis [AD], and allergic rhinitis [AR]) as outcomes. The inverse variance weighted (IVW) method was primarily applied for MR analysis, supplemented by MR-Egger and weighted-median methods to corroborate the IVW results; and sensitivity analysis was conducted to ensure the robustness of the MR assumptions. Results: Our results revealed that an increase in serum phosphorus and zinc concentrations may diminish the risk of AA, while for AD an increase in serum zinc concentration may reduce the risk, but an increase in serum vitamin C concentration may elevate the risk. As for AR, an increase in serum phosphorus and selenium concentrations appeared to be associated with a reduced risk. We did not find evidence for an association between other micronutrients and the risk of allergic diseases. Conclusion: Our study indicates that an increase in serum phosphorus and zinc concentrations may reduce the risk of AA, while an increase in serum zinc concentration may reduce the risk of AD, but an increase in serum vitamin C concentration may elevate the risk of AD. An increase in serum phosphorus and selenium concentrations is associated with a reduced risk of AR. This provides additional support for research on the effects of micronutrients on allergic diseases.

Research and Analysis on the Pathogenesis of Allergic Rhinitis in Children and Its Treatment by Chinese and Western Medicine

Allergic rhinitis in children is a common allergic disease, when it recurs, the symptoms are significant, long-lasting, to children's daily life and learning has brought a huge burden.Western medicine has abundant clinical experience in treating this kind of disease, but the unique dialectical thinking and treatment system of traditional Chinese medicine also show undeniable advantages.The purpose of this study was to explore the etiology of allergic rhinitis in children, the relationship between allergic rhinitis and TCM syndrome types, and the advantages and disadvantages of TCM and WM treatment.It is found that allergen, heredity, environmental factors and immune imbalance are the common causes leading to high incidence of diseases. On the whole, TCM can classify different syndrome types and apply corresponding treatment methods, effective relief of the disease, improve the quality of life.We hope this paper can provide a new perspective and guidance for clinical diagnosis and treatment.

Fish and shellfish allergy: Presentation and management differences in the UK and US—analysis of 945 patients

Seafood allergy (SA), including allergy to shellfish (crustacean and mollusks) and fish, is among the 4 most common food allergies causing anaphylaxis, but there are limited data showing SA clinical management in different countries. We sought to characterize a large cohort of patients with fish and shellfish allergy and to facilitate standardization of future care for this increasingly common allergic disease. We performed a retrospective, observational, noninterventional study from 945 patients from 2015 to 2019 in 7 hospitals in the United States and the United Kingdom to evaluate SA. Achi-square test was used to detect differences in family history, medical history, and current symptoms between patients in 2 countries. Underdiagnosed anaphylaxis in patients with SA was associated with underuse of epinephrine (adrenaline) autoinjectors in both countries. Oral food challenge was used only when skin or serologic test results were negative. Asthma and allergic rhinitis were more common in the US patients withSA, but eczema was more common in UK patients with SA (P< .001). Respiratory, gastrointestinal, and neurological symptoms were higher in UK patients with SA than in US patients with SA (P< .001). In international multicenter cohorts of patients with fish and shellfish allergy, there are opportunities for improvement in management. Physician identification of anaphylaxis, use of diagnostic oral food challenges, and anaphylaxis treatment with epinephrine are areas with significant knowledge gaps in need of improvement in the United Kingdom and the United States. There is an opportunityfor the development of unified, standardized diagnostic protocols for SA with distribution for allergists and trainees.

An Overview of Adherence—What It Is and Why It Is Important

Asthma, allergic rhinitis, and food allergy are common allergic diseases, yet adherence to many management options remains poor, leading to worse health outcomes and financial implications for society and health systems. The underlying causes of non-adherence are numerous, ranging from patient specific factors to broader socioeconomic and systems-based factors. In this review, we aim to discuss the definition of adherence, which can be divided into 3 components: initiation, implementation, and persistence, as well as to review various methods of measuring adherence. Subsequently, we will review the epidemiology of adherence to asthma and allergic rhinitis medications, allergen immunotherapy, and oral immunotherapy. Finally, we will discuss the multifaceted etiology of poor adherence and its subsequent impact on patients and society.

Epidemiological profile of allergic respiratory disease in Mexican children

Objective: Report the prevalence and severity of the most common allergic diseases in children living in Monterrey, México. Methods: Cross-sectional multi-center survey on the most common allergic diseases, completed by parents of 6-7-year-old children and by 13-14- year-old adolescents in the Monterrey metropolitan area, between January 2018 and December 2019. Results: A total of 3,044 questionnaires were eligible for the analysis. Among children between 6-7 years old, 30.2% (n = 143/473) presented wheezing at any time in their life; with a higher prevalence in the male population. In the adolescent group, 26.4% reported having experienced wheezing at some point in their life, with a slight predominance in the female group (54.9%). Conclusions: Knowing the prevalence of allergic diseases in our population gives us tools to generate strategies that allow us to provide the best quality healthcare to our patients. Keywords: Asthma; Rhinitis; Eczema; Wheezing; Allergy And Immunology; Child.

Epidemiological profile of allergic respiratory disease in Mexican children

Report the prevalence and severity of the most common allergic diseases in children living in Monterrey, México. Cross-sectional multi-center survey on the most common allergic diseases, completed by parents of 6-7-year-old children and by 13-14- year-old adolescents in the Monterrey metropolitan area, between January 2018 and December 2019. A total of 3,044 questionnaires were eligible for the analysis. Among children between 6-7 years old, 30.2% (n = 143/473) presented wheezing at any time in their life; with a higher prevalence in the male population. In the adolescent group, 26.4% reported having experienced wheezing at some point in their life, with a slight predominance in the female group (54.9%). Knowing the prevalence of allergic diseases in our population gives us tools to generate strategies that allow us to provide the best quality healthcare to our patients.

Experience of allergen-specific immunotherapy in the patient with oral and systemic manifestations of birch pollen allergy

Introduction. Allergy to birch pollen is a common allergic disease. The main allergen of birch pollen is Bet v 1. The Bet v 1 protein structure is the similar to proteins of hazel, alder and elm pollen, as well as fruits proteins (apples, apricots, peaches, cherries) and vegetables ones (carrots, celery). Therefore, children with an allergy to the Bet v 1 protein may experience oral allergy syndrome (OAS) and even anaphylaxis when eating these foods. Allergen-specific immunotherapy (ASIT) is the indication for the pollen allergy treatment.Presentation of the clinical case. A 11 years old child was observed with a diagnosis of bronchial asthma, allergic form, moderate persistent clinical course. Pollinosis. Allergic rhinitis. Allergic conjunctivitis. Allergy to birch pollen (Bet v 1). Cross food hypersensitivity: oral syndrome (PR-10 proteins) and anaphylaxis (hazelnuts, peanuts). Systemic manifestations of pollen allergy limit immunotherapy due to the possible development of adverse reactions.The child was prescribed sublingual immunotherapy (SLIT) with the medication “Staloral birch pollen allergen”. Baseline therapy was chosen for the child to achieve control of asthma and rhinitis, a hypoallergenic diet with the exclusion of significant food allergens was prescribed. Asthma and rhinitis exacerbation and OAS was observed during the 1st and 2nd treatment courses. Against the background of baseline therapy, SLIT was continued. The full maintenance dose was achieved during the 3rd SLIT course. Immunotherapy contributed to the reduction of symptoms of rhinitis and asthma, reduction of disease clinical course severity, reduction of baseline medications doses and OAS relief.

Current Management of Allergic Rhinitis

Allergic rhinitis (AR) is the most common allergic disease worldwide and one of the most common chronic diseases in general. Allergic rhinitis is caused by inhalant allergens from outdoor and indoor environments with varying significance of different allergens in global regions. We provide options for the current management for AR including pharmacological treatments and nonpharmacological options and allergen immunotherapy (AIT). A literature review has been conducted in Medline, Pubmed, as well as the national and international study (ClinicalTrials.gov) and guideline registers and the Cochrane Library. Human studies published on the topic in the period up to and including November 2023 were taken into account. Allergen avoidance measures, pharmacotherapy, and AIT are the cornerstones of AR treatment. Nonpharmacological measures and behavioral recommendations should be adequately added. Tools of precision medicine are already playing a significant role and will be part of the diagnostic and therapeutic standard in the future. Patients benefit most in a network of different pharmacological and nonpharmacological treatment measures including AIT. Application of precision medicine tools for diagnosis and treatment will improve standards of care.

Ampelopsis Brevipedunculata (Maxim.) Trautv Extract Alleviates Symptoms of Atopic Dermatitis in NC/Nga Mice

Atopic dermatitis is a common allergic skin disease characterized by eczema, dryness, and severe itching, which has a significant impact on patients’ quality of life. Its pathogenesis involves immune dysregulation and impaired skin barrier function. In this study, the therapeutic potential of Ampelopsis brevipedunculata (Maxim.) Trautv for alleviating atopic dermatitis symptoms was investigated using the NC/Nga mouse model. A. brevipedunculata (Maxim.) Trautv was effective in attenuating the atopic dermatitis-like epidermal thickening and the immune cell infiltration in the skin lesions induced by the atopic dermatitis ointment. Additionally, A. brevipedunculata (Maxim.) Trautv suppressed the production of inflammatory mediators and chemokines associated with atopic dermatitis progression. In addition, A. brevipedunculata (Maxim.) Trautv exhibited restorative effects on skin barrier dysfunction by increasing the expression of key barrier proteins. Mechanistically, A. brevipedunculata (Maxim.) Trautv modulated the mitogen-activated protein kinase pathway and inhibited nuclear factor-kappa B activation. These findings highlight the potential of A. brevipedunculata (Maxim.) Trautv as a promising therapeutic agent for treating atopic dermatitis and provide insight into its mechanisms of action.

Identifying allergic-rhinitis-associated genes with random-walk-based method in PPI network

Allergic rhinitis is a common allergic disease with a complex pathogenesis and many unresolved issues. Studies have shown that the incidence of allergic rhinitis is closely related to genetic factors, and research on the related genes could help further understand its pathogenesis and develop new treatment methods. In this study, 446 allergic rhinitis-related genes were obtained on the basis of the DisGeNET database. The protein–protein interaction network was searched using the random-walk-with-restart algorithm with these 446 genes as seed nodes to assess the linkages between other genes and allergic rhinitis. Then, this result was further examined by three screening tests, including permutation, interaction, and enrichment tests, which aimed to pick up genes that have strong and special associations with allergic rhinitis. 52 novel genes were finally obtained. The functional enrichment test confirmed their relationships to the biological processes and pathways related to allergic rhinitis. Furthermore, some genes were extensively analyzed to uncover their special or latent associations to allergic rhinitis, including IRAK2 and MAPK, which are involved in the pathogenesis of allergic rhinitis and the inhibition of allergic inflammation via the p38-MAPK pathway, respectively. The new found genes may help the following investigations for understanding the underlying molecular mechanisms of allergic rhinitis and developing effective treatments.

Association of autoimmune and allergic diseases with senile cataract: a bidirectional two-sample Mendelian randomization study.

Many observational studies have been reported that patients with autoimmune or allergic diseases seem to have a higher risk of developing senile cataract, but the views are not consistent. In order to minimize the influence of reverse causality and potential confounding factors, we performed Mendelian Randomization (MR) analysis to investigate the genetic causal associations between autoimmune, allergic diseases and senile cataract. Single nucleotide polymorphisms associated with ten common autoimmune and allergic diseases were obtained from the IEU Open genome-wide association studies (GWAS) database. Summary-level GWAS statistics for clinically diagnosed senile cataract were obtained from the FinnGen research project GWAS, which consisted of 59,522 individuals with senile cataracts and 312,864 control individuals. MR analysis was conducted using mainly inverse variance weighted (IVW) method and further sensitivity analysis was performed to test robustness. As for ten diseases, IVW results confirmed that type 1 diabetes (OR = 1.06; 95% CI = 1.05-1.08; p = 2.24×10-12), rheumatoid arthritis (OR = 1.05; 95% CI = 1.02-1.08; p = 1.83×10-4), hypothyroidism (OR = 2.4; 95% CI = 1.42-4.06; p = 1.12×10-3), systemic lupus erythematosus (OR = 1.02; 95% CI = 1.01-1.03; p = 2.27×10-3), asthma (OR = 1.02; 95% CI = 1.01-1.03; p = 1.2×10-3) and allergic rhinitis (OR = 1.07; 95% CI = 1.02-1.11; p = 2.15×10-3) were correlated with the risk of senile cataract. Celiac disease (OR = 1.04; 95% CI = 1.01-1.08; P = 0.0437) and atopic dermatitis (OR = 1.05; 95% CI = 1.01-1.10; P = 0.0426) exhibited a suggestive connection with senile cataract after Bonferroni correction. These associations are consistent across weighted median and MR Egger methods, with similar causal estimates in direction and magnitude. Sensitivity analysis further proved that these associations were reliable. The results of the MR analysis showed that there were causal relationships between type 1 diabetes, rheumatoid arthritis, hypothyroidism, systemic lupus erythematosus, asthma, allergic rhinitis and senile cataract. To clarify the possible role of autoimmune and allergy in the pathophysiology of senile cataract, further studies are needed.

PJ‑001, a small‑molecule proteolysis‑targeting chimera, ameliorates atopic dermatitis‑like inflammation in mice by inhibiting the JAK2/STAT3 pathway and repairing the skin barrier.

Atopic dermatitis (AD) is a common allergic skin disease, and its pathogenesis involves genetic and environmental factors, as well as the immune response and skin barrier. PJ-001 is a small-molecule proteolysis-targeting chimera, which can degrade proteins related to the Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) pathway. In the present study, 0.5% 2,4-dinitrofluorobenzene was used to induce a mouse model of AD. Following treatment with PJ-001, the number of scratches and the severity of skin damage in the AD mice were recorded. Pathological changes in skin lesions were observed with hematoxylin and eosin staining. The expression levels of JAK2/STAT3, Toll-like receptor 4/nuclear factor-κB (TLR4/NF-κB), Beclin 1 and microtubule-associated protein 1 light chain 3 (LC3) were detected using western blotting. Furthermore, reverse transcription-PCR was used to detect the mRNA expression levels of filaggrin (FLG) and keratin 17, and the change in interleukin-10 levels in the splenic tissue of the mice. Compared with in the control group, the model group exhibited severe skin lesions. Following treatment with PJ-001, the AD-like inflammation in mice decreased. The expression levels of LC3 II/LC3 I and Beclin 1 were significantly reduced (P<0.01), and the expression levels of JAK2, STAT3, TLR4 and NF-κB were significantly downregulated (P<0.001). Additionally, the mRNA expression levels of FLG were significantly upregulated (P<0.001). These results indicated that PJ-001 may alleviate the skin condition in a mouse model of AD. The underlying mechanism may involve inhibition of the JAK/STAT signaling pathway, thereby suppressing the release of inflammatory factors, reducing excessive autophagy at the site of skin lesions, and enhancing the skin barrier function. In conclusion, PJ-001 could be considered a potential therapeutic option for AD.

Ferroptotic alveolar epithelial type II cells drive TH2 and TH17 mixed asthma triggered by birch pollen allergen Bet v 1

Asthma is a common allergic disease characterized by airway hypersensitivity and airway remodeling. Ferroptosis is a regulated death marked by iron accumulation and lipid peroxidation. Several environmental pollutants and allergens have been shown to cause ferroptosis in epithelial cells, but the relationship between birch pollinosis and ferroptosis in asthma is poorly defined. Here, for the first time, we have identified ferroptosis of type II alveolar epithelial cells in mice with Bet v 1-induced asthma. Further analysis revealed that treatment with ferrostatin-1 reduced TH2/TH17-related inflammation and alleviated epithelial damage in mice with Bet v 1-induced asthma. In addition, ACSL4-knocked-down A549 cells are more resistant to Bet v 1-induced ferroptosis. Analysis of clinical samples verified higher serum MDA and 4-HNE concentrations compared to healthy individuals. We demonstrate that birch pollen allergen Bet v 1 induces ferroptosis underlaid TH2 and TH17 hybrid asthma. Lipid peroxidation levels can be considered as a biomarker of asthma severity, and treatment with a specific ferroptosis inhibitor could be a novel therapeutic strategy.

Quantitative and species changes in the local microbiota of the upper respiratory tract in allergic rhinitis

BACKGROUND: The role of local microflora in the pathogenesis of allergic rhinitis has not been sufficiently studied; therefore, the study of changes in the nasal microbiome is of interest from a scientific and practical point of view.&#x0D; AIM: To evaluate changes in the local microbiota of the nasal mucosa in patients with seasonal and year-round allergic rhinitis before and after pharmacological and allergen-specific therapy.&#x0D; MATERIALS AND METHODS: An observational retrospective single-center case-control study was conducted, which included 182 patients with allergic rhinitis. The groups were randomized according to the diagnosis (seasonal and year-round allergic rhinitis) and the therapy used: basic pharmacotherapy and allergen-specific (sublingual) immunotherapy.&#x0D; RESULTS: In total, 182 patients completed the study, of which 50 had seasonal allergic rhinitis, 51 had seasonal allergic rhinitis + atopic asthma (aged 7–42 years), and 81 had year-round allergic rhinitis, which included 29 aged 12–54 years and 52 with year-round allergic rhinitis + atopic asthma, aged 12–39 years. Patients with allergic rhinitis were divided into two subgroups: those who received basic therapy to achieve remission and those who received allergen-specific (sublingual) immunotherapy. After basic therapy, the abundance of Staphylococcus aureus in the local microbiota of the upper respiratory tract in patients with seasonal allergic rhinitis decreased by 1.4 times; in the allergen-specific (sublingual) immunotherapy group, its abundance more significantly decreased (3.9 times; p 0.05). In the group with year-round allergic rhinitis, the same pattern was noted. In the group with seasonal allergic rhinitis and year-round allergic rhinitis and the group with both allergen-specific (sublingual) immunotherapy and atopic asthma who received a full course of allergen-specific (sublingual) immunotherapy, the activation index of blood basophils by rSplA-proteinase S. aureus was reduced by 1.2–1.5 compared with the value in those who received basic pharmacotherapy.&#x0D; CONCLUSION: Patients with allergic rhinitis exhibited quantitative and qualitative significant changes in the microbiome of the upper respiratory tract mucosa, one of the consequences of which is the development of IgE-mediated sensitization to S. aureus products. Allergen-specific immunotherapy for patients with allergic rhinitis leads to decreased colonization of the nasal mucosa with S. aureus and decreased sensitization to rSplA proteinase.

Unveiling the potent effect of vitamin D: harnessing Nrf2/HO-1 signaling pathways as molecular targets to alleviate urban particulate matter-induced asthma inflammation

BackgroundAsthma is the most common allergic disease characterized by an inflammatory response in the airways. Mechanismly, urban particulate matter (PM) is the most widely air pollutant associated with increased asthma morbidity and airway inflammation. Current research found that vitamin D is an essential vitamin with anti-inflammatory, antioxidant and other medical efficacy. Inadequate or deficient vitamin D often leads to the pathogenesis and stability of asthma. NGF exacerbates airway inflammation in asthma by promoting smooth muscle cell proliferation and inducing the Th2 immune response. Activation of the Nrf2/HO-1 signaling pathway can exert a protective effect on the inflammatory response in bronchial asthma. However, the specific mechanism of this pathway in PM-involved asthmatic airway smooth muscle cells remains unclear.MethodsMice were sensitized and challenged with Ovalbumin (OVA) to establish an asthma model. They were then exposed to either PM, vitamin D or a combination of both, and inflammatory responses were observed. Including, acetylcholine stimulation at different concentrations measured airway hyperresponsiveness in mice. Bronchoalveolar lavage fluid (BALF) and serum were collected for TNF-α, IL-1β, IL-6, and Nerve growth factor (NGF) analysis. Additionally, lung tissues underwent histopathological examination to observe alveolar structure and inflammatory cell infiltration. Specific ELISA kits were utilized to determine the levels of the inflammatory factors TNF-α, IL-1β, IL-6, and Nerve growth factor (NGF). Nrf2/HO-1 signaling pathways were examined by western blot analysis. Meanwhile, we constructed a cell system with low HO-1 expression by lentiviral transfection of airway smooth muscle cells. The changes of Nrf2, HO-1, and NGF were observed after the treatment of OVA, PM, and Vit D were given.ResultsThe in vivo results showed that vitamin D significantly alleviated pathological changes in lung tissue of PM-exposed mice models. Mechanismly, vitamin D decreased substantial inflammatory cell infiltration in lung tissue, as well as the number of inflammatory cells in BALF. Furthermore, vitamin D reduced the heightened inflammatory factors including of TNF-α, IL-1β, IL-6, and NGF caused by PM exposure, and triggered the activity of nucleus Nrf2 and HO-1 in PM-exposed asthmatic mice. Notably, knockdown HO-1 weakens the Vitamin D- mediated inhibition to pollution toxicity in asthma. Importantly, in vitro experiments on OVA-stimulated mice airway smooth muscle cells, the results showed that OVA and PM, respectively, reduced Nrf2/HO-1 and increased NGF’s expression, while vitamin D reversed the process. And in the HO-1 knockdown cell line of Lenti-si-HO-1 ASMCs, OVA and PM reduced Nrf2’s expression, while HO-1 and NGF’s expression were unchanged.ConclusionsThe above results demastrate that vitamin D downregulated the inflammatory response and the expression of NGF by regulating the Nrf2/HO-1 signaling pathways in airway smooth muscle cells, thereby showing potent anti-inflammatory activity in asthma.

The gut metagenome harbors metabolic and antibiotic resistance signatures of moderate-to-severe asthma.

Asthma is a common allergic airway disease that has been associated with the development of the human microbiome early in life. Both the composition and function of the infant gut microbiota have been linked to asthma risk, but functional alterations in the gut microbiota of older patients with established asthma remain an important knowledge gap. Here, we performed whole metagenomic shotgun sequencing of 95 stool samples from a cross-sectional cohort of 59 healthy and 36 subjects with moderate-to-severe asthma to characterize the metagenomes of gut microbiota in adults and children 6 years and older. Mapping of functional orthologs revealed that asthma contributes to 2.9% of the variation in metagenomic content even when accounting for other important clinical demographics. Differential abundance analysis showed an enrichment of long-chain fatty acid (LCFA) metabolism pathways, which have been previously implicated in airway smooth muscle and immune responses in asthma. We also observed increased richness of antibiotic resistance genes (ARGs) in people with asthma. Several differentially abundant ARGs in the asthma cohort encode resistance to macrolide antibiotics, which are often prescribed to patients with asthma. Lastly, we found that ARG and virulence factor (VF) richness in the microbiome were correlated in both cohorts. ARG and VF pairs co-occurred in both cohorts suggesting that virulence and antibiotic resistance traits are coselected and maintained in the fecal microbiota of people with asthma. Overall, our results show functional alterations via LCFA biosynthetic genes and increases in antibiotic resistance genes in the gut microbiota of subjects with moderate-to-severe asthma and could have implications for asthma management and treatment.

Tic disorder in allergic rhinitis children and adolescents: a case-control study

BackgroundAllergic rhinitis is the most common allergic disease. It can accompany psychological disorders such as tic disorders due to the prolonged course of the symptoms of allergic rhinitis. This pioneer case-control study aims to investigate tic disorders in children and adolescents under 18 years of age diagnosed with allergic rhinitis.MethodThe case group in this study consisted of patients who had both allergic rhinitis and tic disorders. Patients with allergic rhinitis without tic disorders were also enrolled as the control group with matched gender and age. Demographic characteristics, tic classifications, and contributing factors for allergic rhinitis and tic disorders were studied among the cases. Tic disorders were evaluated using DSM-5 criteria for the classification of tic disorders.Results47 patients in the case group and 47 patients in the control group were included in this study. 53.2% and 46.8% were males and females in the case group, respectively. The mean age of the patients was 10.46 ± 3.97 years old. Sound tics were more common among the patients compared to motor tics. Patients with concomitant AR and tic disorders had more days per week with AR symptoms (P-value ≤ 0.001; OR (every day vs. three days a week = 11.02(2.98, 40.76))). Most patients with sound tick were women (p: 0.026), and most patients with motion tic were in the Provisional tic disorder group (p: 0.001). The history of infantile eczema was seen more in patients without sound tic (p: 0.025), and otitis media was significantly less common among patients with sound tics (p: 0.026). Provisional tic disorder was the most common class among the patients. In the case group (coexistence between allergic rhinitis and tic) compared to the control group, patients had significantly more days with AR symptoms per week.ConclusionThis preliminary study indicates that Provisional tic disorder was the most common classification of tic among patients with allergic rhinitis, especially in patients with motor tics. Asthma in motor tics, a history of food allergy in infancy, and a history of infantile eczema were also common among patients with vocal tics. Also, patients with allergic rhinitis and tic had more severe disease (more symptoms per week) than those with rhinitis alone. These findings emphasize the association of tic disorders with immunological pathways.