Mite Allergen Research Articles

Pregnancy does not affect progression of mild experimental asthma in sheepx.

Asthma is the most common respiratory condition during pregnancy and increases the risks of adverse pregnancy and perinatal outcomes. Asthma symptoms change in ∼60% of pregnancies, but whether this is due to pregnancy itself is unclear. We tested the hypothesis that physiological changes during pregnancy worsen asthma severity in an ovine experimental model of allergic asthma. Three-year-old Merino ewes were randomly allocated to either control or allergic asthma groups. Asthma was induced through sensitisation and repeated airway challenge with house dust mite allergen. We compared airway function, circulating cytokine profile and airway immune response to allergen challenge throughout the study and airway structure between groups, in non-pregnant (control n=8, asthma n=9), singleton-pregnant (control n=5, asthma n=8) and twin-pregnant ewes (control n=6, asthma n=9). Within non-pregnant animals, transpulmonary pressure at Day 132 of the study was 37% higher in asthmatic than control ewes (P=0.031), but not different between treatments in singleton-pregnant (P=0.594) or twin-pregnant (P=0.074) ewes. Between premating and Day 132, dynamic compliance decreased more in asthmatic than control ewes (P=0.040), and this change did not differ between litter sizes (P=0.096). Neither asthma nor pregnancy affected eosinophils in bronchoalveolar lavage or lung tissue. There was no evidence of lung airway remodelling in the cohort. The results of this study suggest that pregnancy does not increase asthma symptoms or severity of mild asthma. KEY POINTS: Asthma severity changes in ∼60% of pregnancies, but whether this is due to pregnancy itself is unclear. Using a sheep model of allergic asthma, we tested the hypothesis that physiological changes during pregnancy worsen asthma severity. Dynamic compliance decreased to a greater extent in asthmatic than control ewes over the course of the study, indicating the development of a mild asthma phenotype, and this decrease was similar in non-pregnant, singleton-pregnant and twin-pregnant ewes. Eosinophil proportions in bronchoalveolar lavage and lung tissue were not affected by either asthma or pregnancy, nor was there evidence of lung airway remodelling in this cohort. Our findings suggest that pregnancy does not increase asthma symptoms or severity of mild asthma.

Prevalence and Mite Allergen Recognition in an Area of Low Environmental Exposure.

Prevalence and Mite Allergen Recognition in an Area of Low Environmental Exposure.

High risk of asthma among early teens is associated with quantitative differences in mite and cat allergen specific IgE and IgG4: a modified Th2 related antibody response revisited.

Although proteins derived from cats are an important contributor to indoor allergen exposure in relation to asthma, it has been known for at least twenty years that some children who live in a house with a cat can become clinically tolerant to these animals. In 2001, we reported that children exposed to high levels of cat allergens made high levels of IgG4 antibodies to the cat allergen Feld1, and we coined the term "a modified Th2 response". However, this phenomenon is still poorly understood. We studied serum antibodies among 616 individuals in the Viva unselected birth cohort recruited at their early teen visit (mean age 13.1 SD 0.8). IgE and IgG4 antibodies were measured by ImmunoCAP to inhaled allergens as well as the best characterised component allergens of cat, Feld1, Feld2, Feld4, and Feld7, and the dust mite allergens Derp1, Derp2, Derp10, and Derp23. The results confirm that young teens living in a home with a cat make high levels of IgG4 specific for cat allergens, and that those antibodies, and specifically those to Feld1 are negatively associated with asthma. By contrast, the IgG4 responses to Feld4 and Feld7 are significantly lower and have no significant association with asthma. Perhaps more surprisingly, a similar effect is seen in relation to dust-mite allergens. Although the allergen Derp1 is a major part of the IgE response to mite allergens, this protein also induced high prevalence and levels of IgG4 antibodies and has a less strong relationship to asthma than IgE to Derp2 or Derp23. Indeed, values of specific IgE to Derp1 >3.5IU/mL were not significantly related to asthma (OR 1.5 CI 0.8-2.8, p=0.3, Chi2 test). The prevalence and levels of specific IgG4 to these less abundant allergens are significantly lower for Derp2 and almost absent for Derp23. High exposure to specific allergens in household dust can enhance production of both sIgE and sIgG4 antibodies, while allergens where abundance is significantly lower in dust can induce sIgE with limited or no sIgG4. The result is that the less abundant allergens, i.e., Feld4, Feld7, Derp2, and Derp23, may have a significantly higher relevance to asthma than expected because they induce less sIgG4. This work was funded by R01-AI20565 (TPM) and support for the IgE and IgG4 assays provided by Phadia/Thermo Fisher Kalamazoo, Michigan. Project Viva is also supported by NIH R01HD034568 and R24ES.

CD131 antagonism blocks inflammation, emphysema and fibrosis in an asthma-COPD overlap mouse model originating in early life.

Asthma-COPD overlap (ACO) is characterized by patients exhibiting features of both asthma and COPD. Currently, there is no specific treatment for ACO. This study aimed to investigate the therapeutic potential of targeting CD131, a shared receptor subunit for IL-3, IL-5 and GM-CSF, in ACO development and in preventing acute viral exacerbations. A two-hit mouse model of ACO was established by house dust mite (HDM) allergen sensitization to model asthma, and elastase treatment to model emphysema. In a separate model, human rhinovirus 1b (RV1b) was used to induce an acute asthma exacerbation. A neutralizing antibody against CD131 was used to block CD131 in vivo signalling. Mice exposed to HDM and elastase developed cardinal features for asthma and COPD, including airway hyperreactivity (AHR) and emphysema. A mixed granulocytic inflammatory profile was identified in the lungs, including expansion of monocyte-derived macrophages, neutrophils and eosinophils. RT-qPCR analysis detected heightened gene expression of Mmp12, Il5 and Il13. Transcriptomic analysis further revealed pathway enrichment for type 2 inflammation and macrophage activation. Blockade of CD131 effectively reduced the lung inflammation and prevented the development of AHR, airway fibrosis and emphysema. Interestingly, pathway enrichment for Th1 response and interferon production detected in the model was not affected by the treatment. Consistently, CD131 antagonism prevented RV1b-induced asthma exacerbation without compromising RV1b clearance. CD131 signalling coordinates multiple pathological pathways that drive airway inflammation and lung remodelling in ACO. Hence, CD131 antagonism represents a novel approach to combating the immunopathology in the complex ACO setting.

The association of environmental house dust mite allergens and crustacean allergy: the Japan Environment and Children’s Study (JECS)

The association of environmental house dust mite allergens and crustacean allergy: the Japan Environment and Children’s Study (JECS)

Molecular Signatures of Aeroallergen Sensitization in Respiratory Allergy: A Comparative Study Across Climate-Matched Populations

Climate change is significantly altering the dynamics of airborne allergens, affecting their seasonality, allergenicity, and geographic distribution, which correlates with increasing rates of allergic diseases. This study investigates aeroallergen sensitization among populations from Tenerife, Spain, and Lima, Peru—two regions with similar climates but distinct socio-economic conditions. Our findings reveal that Spanish individuals, particularly those with asthma, demonstrate higher sensitization levels to a broader range of allergens, especially mites, with 85% of participants reacting to at least one mite allergen. In contrast, Peruvian patients exhibit a narrower spectrum of sensitization. These results highlight the influence of environmental factors, such as pollution and socio-economic disparities, on allergen exposure and immune responses. Moreover, this study underscores the necessity for region-specific diagnostic and therapeutic strategies to effectively address these variations. By elucidating the intricate relationship between climate change, environmental factors, and allergen sensitization, this research offers insights into respiratory allergic conditions, advocating for tailored interventions to mitigate their impact across diverse populations.

Advances of the exposome at individual levels and prevention in atopic dermatitis.

Atopic dermatitis (AD), or eczema, is an inflammatory skin disease related to environmental factors. As a heterogeneous disease, it presents with complex phenotypes and endotypes. A variety of intrinsic and extrinsic factors can promote the development of AD. While there has been extensive discussion on environmental exposure at the population and community levels, discourse on exposome at individual levels in AD remains insufficient. For example, allergens, microorganisms, parasites, dietary factors, and psychological factors such as stress and anxiety play important roles in AD development. Microorganisms, in particular, exhibit altered composition and diversity on the skin of AD patients, influencing skin barrier integrity and immune responses. The impact of certain microorganisms, such as fungi and viruses, on AD has garnered increasing attention because of their important role in maintaining skin homeostasis. Dietary factors, including sugar intake and histamine-rich foods, may modulate AD risk and severity, although findings are controversial. Allergens, particularly house dust mite allergens, and aeroallergens, exacerbate AD symptoms by promoting inflammation and barrier dysfunction. Since AD is often the first step in the atopic march, its primary prevention measures are crucial. Some preventive measures involving microorganisms, diet, and moisturizers remain controversial. Effective preventive strategies necessitate a clear understanding of the complex mechanisms of AD, especially host-microbe-environment interactions. This review summarizes recent advances in understanding various risk and protective factors, as well as primary prevention measures for AD.

Clinical Trial With a Depigmented, Polymerized Mite Mixture Extract at Maximum Concentrations.

Efficacy of allergen immunotherapy is dose-dependent; however, high doses of allergen may imply a greater risk of adverse reactions. To assess the safety and tolerability of subcutaneous immunotherapy (SCIT) with mixtures of mite allergen extracts, Dermatophagoides pteronyssinus/Blomia tropicalis (Dpt/Bt) and Dermatophagoides pteronyssinus/Lepidoglyphus destructor (Dpt/Ld) at maximum concentrations, in adult patients with allergic rhinitis or rhinoconjunctivitis, and controlled allergic asthma due to a clinically relevant sensitisation to these mites. An open-label, noncontrolled, nonrandomised, phase IIb clinical trial was carried out in three hospitals in Spain between September 2014 and May 2018. Patients received SCIT of either Dpt/Bt (100/1000 DPP/mL) or Dpt/Ld (100/100 DPP/mL) in two phases: a rush build-up phase on the first day (0.2 mL and 0.3 mL with a 30-min interval) and a monthly maintenance phase administration (0.5 mL) up to 48 months. Forty patients were recruited for the study, seven allocated to the Dpt/Bt group and 33 to the Dpt/Ld. None experienced immediate or delayed systemic Grade ≥ 2 reactions (EAACI classification) (systemic reactions were mostly Grade 1) nor died during the study. Local reactions were mostly mild (0‒10 cm). Thirty-nine patients (97.5%) experienced at least one adverse event (AE). Of the 283 reported AEs, eight (2.8%) were systemic reactions experienced by six (15%) subjects and 14 (4.9%) were local reactions sustained by ten (25%) subjects. SCIT treatment of patients with allergic rhinitis or rhinoconjunctivitis and controlled asthma with mixtures of Dpt/Bt and Dpt/Ld allergen extracts at maximum concentrations showed a favourable safety profile.

Unveiling the Impact of Smoking on Allergic Rhinitis: Disease Severity and Efficacy of Subcutaneous Immunotherapy.

To evaluate the impact of smoking statuses on disease severity and subcutaneous immunotherapy (SCIT) efficacy in allergic rhinitis (AR). Open observational cohort study. Tertiary referral center. Five hundred and five AR patients undergoing dust mite allergen SCIT were categorized into never smokers, former smokers, and current smokers. AR severity was assessed using widely employed questionnaires. The changes in questionnaire scores pre- and post-SCIT were evaluated for SCIT efficacy. The differences in disease severity and SCIT efficacy were compared for different smoking statuses among AR patients. Compared to never smokers, former and current smokers exhibited higher proportion of male, alcohol, and asthma (P < .05). Current smokers had a greater prevalence of allergic conjunctivitis than former smokers (P < .05). Before SCIT, AR severity was similar across 3 groups, even after adjusting for confounders (P > .05). Current smokers reported lower SCIT efficacy in the first year (P < .05). By the third year, 3 groups showed comparable long-term efficacy (P > .05). However, current smokers experienced a significant decrease in benefits 2 years post-SCIT (P < .05) and lower improvement rates at the end of the 3-years SCIT period and 2 years following SCIT (P < .05). AR patients across different smoking statuses demonstrated similar baseline disease severity and long-time SCIT efficacy. Active smoking was associated with increased asthma risk, delayed early SCIT efficacy perception, reduced improvement over 3 years, and diminished benefits 2 years after SCIT. Prompt smoking cessation is crucial to mitigate these effects.

Construction of a Hybrid Vaccine Based on Der f 35-Derived Peptides with Reduced Allergenicity

Plain Language SummaryWe constructed a hybrid vaccine against the major house dust mite allergen Der f 35 based on the selection of the low or non-allergic peptide fragments derived from B-cell epitope regions. The designed vaccine and original Der f 35 were prepared, and the vaccine exhibited decreased allergenicity and Th2 activity compared to Der f 35. The vaccine was able to induce antibodies when used to immunize rabbits, and the antibodies could inhibit immunoglobulin E (it can mediate allergy reaction when it cross-linked with certain allergens and its receptor) reaction to Der f 35.

Comparison of CD30L and OX40L Reveals CD30L as a Promising Therapeutic Target in Atopic Dermatitis.

Blocking IL-13 is highly efficacious in patients with Th2-biased atopic dermatitis (AD), and recent clinical data have highlighted that targeting the T cell costimulatory molecules OX40 and OX40L (TNFSF4) holds promise for future treatment of AD. We asked whether targeting another T cell costimulatory molecule, CD30L (TNFSF8), might also be a possible treatment option in AD. Single-cell RNA-seq data from human AD skin lesions was analyzed to identify pathogenic IL-13- or IL-22-producing T cells and assess expression of CD30 and its ligand in comparison to OX40 and its ligand. Additionally, a murine model of AD with repetitive exposure to house dust mite allergen was used to compare neutralizing antibodies against CD30L with those against IL-13 or OX40L. Analysis of several scRNA-seq datasets from skin lesions of AD patients showed that transcripts for CD30 or CD30L were found expressed with OX40 or OX40L in the primary T cell populations that also expressed mRNA for IL13 and/or IL22. Suggesting that this could be therapeutically relevant, mice treated prophylactically with a blocking CD30L antibody were protected from developing maximal allergen-induced AD features, including epidermal and dermal thickening, immune cell infiltration, and expression of AD-related genes, similar to mice treated with a blocking IL-13 antibody. Moreover, therapeutic neutralization of CD30L in mice with experimental AD also reduced all of the pathological skin lesion features to a comparable extent as blocking OX40L. These data suggest that targeting the CD30-CD30L axis might hold promise as a future therapeutic intervention in human AD, similar to targeting the OX40-OX40L axis.

Adjuvant Effect of Lactobacillus paracasei in Sublingual Immunotherapy of Asthmatic Mice.

Background: Sublingual immunotherapy (SLIT) has shown promise in mitigating allergic asthma symptoms; nevertheless, its high dose and prolonged duration of treatment raise safety concerns. This study explored the potential of Lactobacillus paracasei (L. paracasei) to enhance the effectiveness of SLIT in a mouse model of allergic asthma. Methods: Allergic asthma was induced in Balb/c mice following sensitization and challenge with a house dust mite (HDM) allergen. Subsequently, the mice were subjected to SLIT (66 and 132 µg) either alone or in combination with L. paracasei supplementation. Asthma-associated parameters, including rubbing frequency, IgE level, cytokine profiles, and histological changes, were evaluated to assess treatment efficacy. Results: mice that received SLIT 132 µg combined with the probiotic (combined 132) demonstrated a significant reduction in allergic symptoms (rubbing). This treatment strategy led to a marked IgE and eosinophil level decrease in serum; an increase in anti-inflammatory cytokines like IFN-γ and IL-10; and a reduction in pro-inflammatory cytokines IL-17 and TNF-α. The combination therapy also mitigated lung inflammation and supported the restoration of the structural integrity of the colon, promoting the recovery of goblet cells and mucus secretion. Probiotic treatment alone also effectively reduced IgE levels, increased IFN-γ, and decreased levels of IL-17 and TNF-α. Conclusions: The adjuvant effect of L. paracasei in enhancing SLIT represents a promising approach for improving asthma treatment efficacy.

Leptin augments IL-13-induced airway eotaxins and submucosal eosinophilia in obesity-associated asthma

Airway tissue eosinophilia can be an observed feature of obesity-associated type 2 (T2) asthma, but the processes mediating this inflammation are unknown. To investigate a process whereby leptin, an adipokine elevated in obesity, potentiates pulmonary eosinophilia and eotaxin production by airway fibroblasts in T2 asthma. We assessed associations between body mass index and airway eosinophilia as well as leptin and eotaxin production in 78 participants with asthma, 36 of whom exhibited obesity. Cultured human airway fibroblasts and mouse models of chronic allergic airway disease were used to evaluate leptin's effect on eotaxin production and lung eosinophilia. The role of IL-13 receptor alpha 2 (IL-13Rα2) in mediating these processes was examined using specific neutralizing antibodies invitro. In participants with T2 asthma and obesity, we observed that airway tissue eosinophilia did not associate with traditional T2 inflammation metrics such as peripheral and/or bronchoalveolar lavage fluid eosinophil counts or with fractional exhaled nitric oxide. Alternatively, we observed elevated bronchoalveolar lavage fluid leptin and eotaxin-1 levels. In airway fibroblasts from participants with asthma, leptin augmented IL-13-induced eotaxin-1 and eotaxin-3 production and IL13RA2 expression. In mice, elevated leptin promoted airway IL-13Rα2 and eotaxin production by lung fibroblasts and lung tissue eosinophilia following chronic house dust mite allergen exposure. Inhibition of IL-13Rα2 reduced combined leptin and IL-13-stimulated eotaxin secretion by human airway fibroblasts. We identified a potential association explaining airway tissue eosinophil retention in obesity-associated T2 asthma through leptin-mediated enhancement of IL-13-induced eosinophil chemokine production by airway fibroblasts, a process requiring IL-13Rα2.

Combined Dupilumab and Allergen-Specific Immunotherapy in Severe Refractory Atopic Dermatitis.

Although combining allergen immunotherapy with biologics has shown promise in treating atopic diseases such as asthma and allergic rhinitis, atopic dermatitis (AD) remains notably underexplored in this context. This study aimed to investigate the efficacy and safety of combining dupilumab with subcutaneous immunotherapy (SCIT) for severe AD refractory to standard treatments. This was a single-center retrospective analysis assessing patients with severe AD treated with combined dupilumab and SCIT, dupilumab, or SCIT alone at the Severance Hospital, Seoul, Korea. The inclusion criteria encompassed severe AD diagnosis, specific immunoglobulin (Ig) E levels to house dust mite allergens, and treatment follow-up for at least 18 months. Eczema Area and Severity Index (EASI) scores, serum biomarker levels, and adverse event records were regularly collected. Forty-eight patients with AD were analyzed, showing significant improvement in EASI scores and favorable changes in serum biomarkers over 144 weeks. The combination therapy led to a sustained reduction in AD severity, a significant reduction in total IgE and specific IgE levels, and an increment in allergen-specific IgG4. All patients experienced only mild and temporary side effects, not requiring treatment discontinuation. Combining dupilumab with SCIT offers a promising therapeutic option for patients with severe, treatment-refractory AD, reducing disease severity and inducing favorable immunological changes without increasing adverse effects.

Betamethasone improved near-term neonatal lamb lung maturation in experimental maternal asthma.

Maternal asthma is associated with increased rates of neonatal lung disease, and fetuses from asthmatic ewes have fewer surfactant-producing cells and lower surfactant-protein B gene (SFTPB) expression than controls. Antenatal betamethasone increases lung surfactant production in preterm babies, and we therefore tested this therapy in experimental maternal asthma. Ewes were sensitised to house dust mite allergen, and an asthmatic phenotype induced by fortnightly allergen lung challenges; controls received saline. Pregnant asthmatic ewes were randomised to receive antenatal saline (asthma) or 12mg intramuscular betamethasone (asthma+beta) at 138 and 139 days of gestation (term=150 days). Lambs were delivered by Caesarean section at 140 days of gestation and ventilated for 45min before tissue collection. Lung function and structure were similar in control lambs (n=16, 11 ewes) and lambs from asthma ewes (n=14, 9 ewes). Dynamic lung compliance was higher in lambs from asthma+beta ewes (n=12, 8 ewes) compared to those from controls (P=0.003) or asthma ewes (P=0.008). Lung expression of surfactant protein genes SFTPA (P=0.048) and SFTPB (P<0.001), but not SFTPC (P=0.177) or SFTPD (P=0.285), was higher in lambs from asthma+beta than those from asthma ewes. Female lambs had higher tidal volume (P=0.007), dynamic lung compliance (P<0.001), and SFTPA (P=0.037) and SFTPB gene expression (P=0.030) than males. These data suggest that betamethasone stimulates lung maturation and function of near-term neonates, even in the absence of impairment by maternal asthma.

Risk Factors and Comorbidities of Recurrent Nasal Polyposis.

Chronic rhinosinusitis is divided into two groups, which are Chronic rhinosinusitis with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP). The rate of post-surgical recurrence in the CRSwNP is high, and predicting factors are unknown. This study aims to identify and evaluate risk factors associated with treatment-resistant and recurrent CRSwNP. This cross-sectional study evaluates demographic data and atopic risk factors in patients with CRSwNP, including a high IgE level (≥100 U/mL), skin prick test (SPT) for aeroallergens, aspirin-exacerbated respiratory disease (AERD), and asthma prevalence. An oral aspirin challenge was performed to diagnose AERD. 191 patients with CRSwNP were enrolled, with 73 patients in the recurrent, and 118 patients in the non-recurrent group. The mean age of the patients in the recurrent group was 45.08±12.05. The mean age of the patients in the non-recurrent group was 42.89±11.73. 49. Asthma prevalence in recurrent- CRSwNP is significantly higher than non-recurrent CRSwNP Asthma severity in recurrent CRSwNP and AERD patients was significantly higher than in nonrecurrent CRSwNP and non-AERD patients. The level of IgE in the recurrent- CRSwNP is higher than non-recurrent CRSwNP. Positive SPT results for tree, weed, and mite allergens were higher in the non-recurrent- CRSwNP group compared to the recurrent CRSwNPgroup. Asthma had a significantly higher difference in AERD compared to non-AERD. The level of IgE in AERD is higher than non-AERD. Recurrent CRSwNP patients and AERD patients had Higher IgE levels. Asthma is more prevalent and more severe in both AERD and recurrent CRSwNP. However, a positive SPT result has been seen higher in non-recurrent CRSwNP.

House dust mite allergen directly activates ILC2 cells via the TLR4 signaling pathway in allergic airway diseases

Unlike T cells and B cells, the activation process of group 2 innate lymphoid cells (ILC2s) is mainly driven by epithelial cell derived cytokines rather than specific antigen recognition. Whether antigens have a direct role in activating ILC2s remains poorly understood. Following stimulation, type 2 cytokine secretions and cell death were assessed in house dust mite (HDM)-stimulated ILC2s. To investigate the underlying mechanisms, RNA-sequencing (RNA-seq) was performed on HDM-stimulated ILC2s. The validation experiments were done through in vitro stimulation assays and an HDM-induced asthmatic murine model, using specific inhibitors targeting receptor and relevant proteins of signaling pathways. HDM stimulation increased the secretion of IL-5 and IL-13 cytokines from ILC2s, inhibited apoptosis of ILC2, and promoted the proliferation of ILC2s. As confirmed by RNA-seq, HDM stimulation upregulated genes in ILC2s, including those responsible for type 2 cytokines, ILC2s-specific transcriptional factors, and related receptors. Both toll-like receptor (TLR) 1 and TLR4 were constitutively expressed on ILC2s, however, only TLR4 was predominantly upregulated upon HDM stimulation. TAK242, a specific TLR4 inhibitor, significantly blocked the effect of HDM on ILC2s, in terms of type 2 cytokine secretions and cell death. Using specific inhibitors in pathways, we confirmed that HDM promoted ILC2s activation via TLR4-ERK, p38, and NF-κB signaling pathways. Allergen HDM directly activates ILC2s through TLR4 mediated-ERK/p38/NF-κB signaling pathway. These findings provide new insights into how antigens propagate type 2 immune response via ILC2s, contributing to chronic inflammations in allergic airway diseases.

Effect of mite-specific subcutaneous immunotherapy on patients with allergic rhinitis

This study analyzed the effect of mite-specific subcutaneous immunotherapy (SCIT) on patients with allergic rhinitis (AR). We enrolled 98 AR patients visiting our hospital from April 2017 to April 2019 and grouped them in a random number table. The control group (n=49) received conventional treatment for three years. The SCIT used a standardized mite allergen injection for the experimental group (n=49) for three years. The study compared total nasal symptom score (TNSS), daily medication score (DMS), total combined score (TCS), visual analog scale (VAS) score, mini-rhinitis quality of life questionnaire (MiniRQLQ) score, and serum immunoglobulin E (sIgE) level before and after treatment. The overall response rate was higher in the experimental group than in the control group (59.18% vs. 30.61%, p&lt;0.05). After treatment, the experimental group had lower values for TCS and VAS score (p&lt;0.05); motion score; practical problems; nasal, ocular, and other symptoms (p&lt;0.05); and sIgE, Dermatophagoides pteronyssinus (Dp)-sIgE, and Dermatophagoides farinae (Df)-sIgE levels (p&lt;0.05) than the control group. The sIgE, Dp-sIgE, and Df-sIgE levels were lower in the effective group than in the ineffective group (p&lt;0.05). The areas under the ROC curves of IgE, Dp-sIgE, and Df-sIgE and their combination for predicting the therapeutic effect of mite-specific SCIT on AR were 0.839, 0.779, 0.814, and 0.903, respectively. Mite-specific SCIT relieved clinical symptoms and improved the quality of life of AR patients, probably by decreasing the IgE expression level.

Dupilumab and House Dust Mite Immunotherapy in Patients with Atopic Dermatitis: A Preliminary Study.

Severe atopic dermatitis (AD) is a complex disease requiring systemic treatment. This study aimed to assess the effectiveness of combined therapy consisting of dupilumab and sublingual dust mite allergen immunotherapy (SLIT-HDM) in patients with severe AD and HDM allergies. Patients diagnosed with severe AD were included in this randomised, placebo-controlled, double-blind 12-month trial; they received SLIT for HDMs and/or dupilumab for 12 months and were compared with patients on cyclosporine. The primary outcomes for the treatment arms were changes in the Eczema Area and Severity Index (EASI), body surface area (%BSA), and Investigator Global Assessment (IsGA) over 12 months. The secondary outcomes were the proportion of patients who achieved IsGA success and reduced medication scores. Significant improvements were observed in all analysed groups after 12 months of therapy based on the EASI, %BSA, and IsGA. However, the most substantial changes were observed in the groups treated with dupilumab or a combination of SLIT-HDM and dupilumab. Additionally, the proportion of patients who achieved an IsGA reduction was significantly greater in the group receiving combination therapy than in the other groups (9/14 [64% of the group receiving SLIT-HDM] vs. 11/14 [73% of the group receiving dupilumab] vs. 15/17 [88% of the group receiving dupilumab and SLIT-HDM] vs. 7/13 [53% of the group receiving cyclosporine]) (p < 0.05). In patients with severe AD and HDM allergies, combination treatment with dupilumab and allergen immunotherapy for HDMs may increase the therapeutic benefit over treatment with these methods separately.

Component-resolved diagnosis: enhancing precision diagnosis and clinical management of shellfish allergies

Shellfish, being one of the eight major food allergens, affects approximately 3% of the global population. The occurrence of shellfish allergy is not only related to the individual's immune system sensitivity but is also influenced by geographical environment, food availability, and dietary habits. Although crustaceans (such as shrimp, crab, and lobster) and mollusks (such as oysters, mussels, and squid) are collectively referred to as shellfish, they exhibit significant differences in biological evolution and the spectrum of allergenic molecules they contain, leading to various allergic reactions. Accurate identification of allergenic proteins is crucial for the diagnosis and management of shellfish allergies, with key allergenic protein families including tropomyosin, arginine kinase, and hemocyanin. Furthermore, due to the diversity of shellfish allergens and their cross-reactivity with dust mite and insect allergens, diagnosing and managing shellfish allergies is complex, especially concerning tropomyosin and arginine kinase protein families. Currently, there are no specific immunotherapy treatments for shellfish allergies, and clinical management primarily relies on avoiding allergens and using anti-allergy medications. This article thoroughly interprets the " Molecular Allergology User's Guide 2.0 (MAUG 2.0)" published by the European Academy of Allergy and Clinical Immunology (EAACI) and the latest research on shellfish allergies both domestically and internationally. It highlights the significant role of allergen component diagnostics in optimizing the diagnostic and treatment processes for shellfish allergies, effectively assisting clinicians in accurately identifying common allergens and cross-reactions, thereby providing patients with more personalized diagnosis and treatment plans.