Total Serum IgE Levels Research Articles

METRNL mitigates oxidative stress and inflammatory drawbacks in ovalbumin/lipopolysaccharide-induced allergic airway diseases via the IKK/IκB/NF-κB signaling pathway.

This study aimed to examine the potential impacts of METRNL as an antioxidant and anti-inflammatory through IκB kinase/inhibitor of nuclear factor-kappa B/nuclear factor-kappa-light-chain signaling pathway on many biomarkers and lung structure in rats with bronchial asthma induced by ovalbumin/lipopolysaccharide (OVA/LPS). Forty rats were randomly divided into four equal groups: control group, vehicle group, diseased (OVA/LPS) group OVA 2.5 ml/kg intratracheal installation/LPS 1.5 mg/kg intraperitoneally, and treated (OVA/LPS + METRNL) group, METRNL at a dose of 2 mg/rat/day IV. After 4 weeks, plasma and lung tissues were analyzed to assess oxidative stress inflammatory markers. Additionally, a histological assessment was conducted on lung tissues. Bronchial asthma was confirmed when increased levels of total serum IgE, total cell count, neutrophils, eosinophils, macrophages, and lymphocyte counts in the BAL fluid were observed. Moreover, OVA/LPS resulted in a reduction in levels of superoxide dismutase (SOD) while raising levels of malondialdehyde (MDA). Furthermore, it elevated concentrations of plasma inflammatory mediators, including tumor necrosis factor-alpha (TNF-alpha), interleukin 17 (IL-17), and transforming growth factor beta (TGF-β). The protective effects of METRNL were analyzed. The observed impacts are believed to result from the drug's anti-inflammatory and antioxidant properties and its action on the IKK/IκB/NF-κB signaling pathway. This investigation indicates that METRNL treatment positively improved rats' biochemical and histological aspects of OVA/LPS-induced airway allergic inflammation.

Cure for the itch: current clinical standards and therapies in allergic eczema

Allergic Eczema (AE) is a chronic, relapsing skin condition that significantly affects the quality of life of the AE patients and their caretakers. Decades of scientific and clinical research has helped understand the highly complex underpinnings of AE presentation wherein a multitude of variables, including the conspicuous variables such as environmental allergens, immunological triggers, genetic predisposition of individuals, to more nuanced socio-economic status, play an important part. Given the complexity of the disease, it is imperative to develop biomarkers enabling early and reliable clinical identifications and help in the active management of the disease, thereby minimizing the impact and burden of the disease on the patients. In this mini review, we provide a brief overview of AE, affected demographics, variables that trigger its onset, and summarize the discovery of various clinical biomarkers such as total and specific serum IgE levels, Th2 cytokine levels, filaggrin (FLG) mutations, periostin levels in skin, etc. that have been developed over the years to further improve the state of clinical monitoring of AE presentation and progression. Lastly, we also provide an overview of the clinical interventions and therapies, such as topical agents, phototherapy, and biologics, that are available to the patients to manage AE-related complications. While we have vastly improved the standard of care and diagnosis for the AE patients, there are still many unmet needs such as developing non-invasive, effective, and reliable clinical predictors and biomarkers which can usher better personalized treatments and provide a better quality of life to affected demographics.

An allergic subtype of acquired idiopathic generalized anhidrosis resistant to steroid pulse therapy – a retrospective, single-center, cohort study

Steroid pulse therapy is considered effective in the treatment of acquired idiopathic generalized anhidrosis (AIGA). However, nearly half of patients with AIGA do not respond to treatment, or relapse, suggesting the need to stratify patients on the basis of biomarkers to optimize the treatment plan. Although several factors associated with response to treatment, such as the duration since disease onset and serum carcinoembryonic antigen (CEA) levels, have been reported, the relationships between these factors and their effect on the relapse rate have not been evaluated. This retrospective cohort study of 210 patients showed a poor prognosis in patients with high serum total immunoglobulin E (IgE) levels because of a high relapse rate. Serum total IgE levels tended to be inversely related to serum CEA levels, but a multivariate analysis showed that high serum total IgE levels were an independent risk factor for relapse. However, low serum CEA levels were an independent risk factor for non-response to steroid pulse therapy, even after adjustment for factors such as the duration since disease onset, which showed an inverse trend with serum CEA levels. These results suggest that, in addition to the typical subtype of AIGA with high serum CEA levels in the active phase of the disease, there may be an allergic type of the disease with high serum total IgE levels and a poor prognosis with steroids. Therefore, stratifying patients by measuring serum total IgE and CEA levels may aid in predicting the effect of steroid pulse therapy.

Correlation between atopic eczema, total eosinophil counts and serum IgE - A case-control study

Background: Atopic eczema (AE) is a pruritic, chronically relapsing inflammatory skin condition and its prevalence is increasing globally. Researchers have convincingly correlated severity of AE with hemato-immunological abnormalities due to the complex interaction between genetic susceptibility genes and heightened immunological response. Aim and Objective: (a) To determine association between severity of atopic eczema and total eosinophil counts. (b) To determine association between severity of atopic eczema and total serum IgE levels. (c) To determine association between total eosinophil counts and total serum IgE Levels in atopic eczema. Materials and Methods: This was a case-control study conducted in the Department of Dermatology - OPD, Karnataka Institute of Medical Sciences, Hubballi, Karnataka. A total of 80 subjects were examined, 50 being AE cases (33 males & 17 females) and 30 age matched controls (20 males & 10 females).Study subjects underwent clinical evaluation and relevant investigations. SCORAD index, Serum IgE and Absolute Eosinophil Count (AEC) in both the groups. Results: Increased serum IgE, AEC were more frequently observed with AE patients than in control group. There exists a positive correlation between IgE, AEC and SCORAD in AE cases than in controls. The degree of correlation between SCORAD index and serum IgE is significantly positive (r =0.66, p<0.01) in cases than in controls and this correlation is higher than that between Serum IgE and AEC. Conclusion: The study results may conclude that the SCORAD index can be used as a cutaneous marker of hemato-immunological abnormalities. In resource poor circumstances SCORAD index can be used as a substitute for expensive blood investigation and may guide to select a proper, more effective therapeutic modality.

Predictors for the Efficacy of 4-Week Dupilumab Treatment in Atopic Dermatitis Patients

Predictors for the Efficacy of 4-Week Dupilumab Treatment in Atopic Dermatitis Patients

Factors associated with the efficacy of omalizumab treatment in chronic spontaneous urticaria.

Factors associated with the efficacy of omalizumab treatment in chronic spontaneous urticaria.

Factors associated with the efficacy of omalizumab treatment in chronic spontaneous urticaria

Factors associated with the efficacy of omalizumab treatment in chronic spontaneous urticaria

Exploring the immunological underpinnings of allergic conjunctivitis: the role of CD4 + T Cells and SLAM expression in ocular surface disease.

Allergic conjunctivitis is a common ocular disease characterized by inflammation of the conjunctiva, often associated with environmental allergens. CD4 + T cells and signal lymphocyte activation molecule (SLAM) expression has been implicated in the pathogenesis of allergic conjunctivitis, but their roles and interactions remain unclear. This prospective cross-sectional observational study enrolled 100 participants, 50 with allergic conjunctivitis and 50 healthy controls, to investigate the relationship between peripheral blood CD4 + T cells, SLAM expression, and allergic conjunctivitis. Participants were evaluated using the Aston university allergy questionnaire (AUAQ), ocular surface disease index (OSDI), and dry eye questionnaire (DEQ-5). Peripheral blood mononuclear cells were isolated and analyzed for SLAM expression on CD4 + T cells using flow cytometry. Total serum IgE levels were measured using ELISA. The allergic group demonstrated significantly higher AUAQ, OSDI, and DEQ-5 scores compared to the control group, indicating a more severe allergic and ocular surface disease burden. Flow cytometry analysis revealed a significant increase in SLAM expression on CD4 + T cells in the allergic group (22.6% ± 5.3%) compared to the control group (15.2% ± 4.7%) (p < 0.001). Total serum IgE levels were also significantly higher in the allergic group (255.3 ± 131.2IU/mL) compared to the control group (36.7 ± 19.8IU/mL) (p < 0.001). Spearman's rank correlation analysis indicated significant correlations between AUAQ and OSDI scores (R = 0.38, p < 0.001), and between TBUT and OSDI scores (R = 0.21, p = 0.008), suggesting that reduced tear film stability is associated with more severe ocular surface symptoms. The study findings suggest a significant association between allergic symptoms, ocular surface disease, and immunological markers in individuals with allergic conjunctivitis. The increased SLAM expression on CD4 + T cells and elevated total serum IgE levels in the allergic group may play a pivotal role in the pathophysiology of allergic conjunctivitis. These insights could inform the development of targeted therapies that address both the allergic and ocular surface components of the disease, potentially improving management and outcomes for patients with allergic conjunctivitis.

Inula japonica Thunb. and its active compounds ameliorate airway inflammation by suppressing JAK-STAT signaling.

Inula japonica Thunb. and its active compounds ameliorate airway inflammation by suppressing JAK-STAT signaling.

Laboratory Changes During Dupilumab Treatment for Atopic Dermatitis.

Laboratory Changes During Dupilumab Treatment for Atopic Dermatitis.

Immunoglobulin E, the potential accelerator of comorbid psoriasis and atherosclerosis.

Immunoglobulin E, the potential accelerator of comorbid psoriasis and atherosclerosis.

Efficacy and Safety of Dupilumab Across Different Th2-Type-Mediated Diseases: A Real-Life Preliminary Experience

Background: Dupilumab, a fully human monoclonal antibody targeting the interleukin (IL)-4/IL-13 pathway, is able to dampen T helper (Th)2-mediated inflammation in several conditions characterized by this particular type of phlogosis. The aim of this study was to review the efficacy and safety of dupilumab treatment in conditions underpinned by Th2-type inflammation in a cohort of real-world patients referred to our outpatient clinic. Methods: Data from all patients with atopic dermatitis, chronic rhinosinusitis with nasal polyps, asthma, and other Th2-type-mediated inflammatory conditions treated with dupilumab were retrospectively reviewed. Results: Twenty-two patients were included in the study: 14 with atopic dermatitis, 5 with chronic rhinosinusitis with nasal polyps, 2 with asthma, and 1 with prurigo nodularis; some of the patients had more than one atopic condition. A complete response was observed in 13 out of 22 patients (59.1%); when partial responses were included in the analysis, the overall response rate was 86.4%. No adverse events were recorded, either locally or systemically. Total IgE levels dropped in all patients, in some cases reaching values close to those typically observed in nonatopic subjects. When eosinophilia was present at baseline, this also normalized during dupilumab treatment. Conclusions: Dupilumab was safe and effective across multiple conditions driven by Th2-type chronic inflammation; effective interference with the Th2-type pathway was inferred by the progressive reduction in serum total IgE levels, which reached the normal range in a fraction of patients, and by the reduction in peripheral blood eosinophil counts. Further studies in different Th2-mediated diseases are warranted.

Plasmacytoid Dendritic Cells Display Surface but Not Membrane-Bound IgE Across a Broad Range of Total Serum IgE Levels

Introduction: Plasmacytoid dendritic cells (pDC) are unique antigen-presenting cells that may be implicated in allergic disease because they bind IgE on their surface and modulate important Th1/Th2 cytokine responses. The authors previously discovered that IgE is not readily removed from pDCs using omalizumab to the same extent observed for basophils, suggesting that a portion of the IgE on pDCs may be membrane bound. Methods: A cross-sectional study was performed and recruited adult volunteers from Johns Hopkins Asthma &amp; Allergy Clinic, Baltimore, Maryland, USA, between 2022–2023. Individuals with varying levels of serum IgE were selected, and those on subcutaneous immunotherapy or biologic therapy were excluded. Basophils and pDCs were isolated using established protocols. In order to isolate peripheral blood mononuclear cells, blood was also drawn from consenting donors with a wide range in total serum IgE levels. B cells and pDCs were identified by flow cytometry by gating on CD19/CD27 and blood dendritic cell antigen 2/CD123, respectively. Quilizumab, a mouse anti-human monoclonal IgG1 antibody with specificity only for membrane-bound IgE and surrogate for omalizumab, was used to detect this molecule in both cell types. Results: When used in vitro at 1.5 mg/mL, omalizumab removed ~80–90% of the IgE expressed by basophils. In contrast, IgE expression decreased only 30–40% on similarly treated pDCs. There was no significant difference in the number of pDCs staining for membrane-bound IgE between the isotype control and quilizumab (P=0.125, 0.165). However, the proportion CD19+27+ B cells staining for quilizumab compared to other PBMC was 54:1 (P=0.015). Conclusion: While pDCs express significant levels of surface-bound IgE, there is no appreciable amount of membrane-bound IgE noted. The reason for omalizumab’s poor ability to remove pDC-bound IgE compared to its effectiveness at removing circulating IgE remains unknown.

Serum Periostin as a Potential Biomarker in the Evaluation of Allergic Rhinitis: A Pilot Study.

Although periostin has recently emerged as a new mediator in chronic allergic diseases, particularly in upper airway disease, its significance as a biomarker for allergic rhinitis (AR) is still unclear. Therefore, we aimed to assess the potential of periostin as a novel candidate biomarker for diagnosing and assessing the severity of AR. A total of 40 patients with AR and 22healthy controls, all aged over 18 years, were recruited for the study. Participants underwent examinations to assess serum levels of total IgE (tIgE), specific IgE (sIgE), periostin, and remodeling-related factors, as well as fractional exhaled nitric oxide (FeNO) and fractional nasal nitric oxide (FnNO). Additionally, clinical characteristics questionnaire and nasal function assessments were completed by AR patients. The levels of serum periostin were significantly higher in patients with AR compared to healthy controls (Z=-3.605, p<0.001). There was a notable positive correlation between serum periostin and FeNO (r=0.398, p=0.012), FnNO (r=0.379, p=0.017), as well as the visual analogue scale (VAS) score for ocular tearing (r=0.351, p=0.026) in AR patients. Furthermore, the serum periostin levels were higher in moderate-to-severe AR compared to mild AR cases (Z=-2.007, p=0.045). The level of serum periostin in AR patients showed a sequential increase corresponding to shortness of breath scores from 0 to 3 (Z=10.137, p=0.017). The predicted probability of serum periostin demonstrated moderate diagnostic accuracy in detecting AR (AUC=0.773, p<0.001). Serum periostin shows potential as a candidate biomarker for detecting AR and can serve as a surrogate biomarker for assessing airway inflammation in AR patients.

Laboratory Changes During Dupilumab Treatment for Atopic Dermatitis.

Laboratory Changes During Dupilumab Treatment for Atopic Dermatitis.

Multi-biofluid metabolomics analysis of allergic respiratory rhinitis and asthma in early childhood.

Multi-biofluid metabolomics analysis of allergic respiratory rhinitis and asthma in early childhood.

Predictive cytokines of omalizumab in the treatment of chronic spontaneous urticaria

Predictive cytokines of omalizumab in the treatment of chronic spontaneous urticaria

Decoding Pediatric Laryngopharyngeal Reflux: Unraveling Symptoms Through Multichannel Intraluminal Impedance and pH Insights.

Background: The relationship between symptoms of laryngopharyngeal reflux (LPR) and objective reflux measurements obtained through multichannel intraluminal impedance-pH (MII-pH) monitoring remains unclear. Objectives: The aim of this study was to investigate the relationship between LPR symptoms and objective reflux episodes and possible associations between fibreoptic ENT findings, eosinophil counts, and serum IgE levels with reflux episodes detected by MII-pH. Methods: In this prospective study, MII-pH monitoring, fiberoptic laryngoscopy, nasal swabs for eosinophils, total serum IgE levels, and symptom assessment (Reflux Symptom Index, RSI) were performed in all children with suspected LPR. The Reflux Findings Score (RFS) was determined based on the laryngoscopy findings. Results: A total of 113 patients (mean age, 8 years) with LPR symptoms were included in the study. The number of reflux episodes was highest in children with chronic cough and recurrent broncho-obstruction. Secondary outcomes showed positive correlations between reflux episodes and ENT findings, particularly hypopharyngeal hyperemia, arytenoid hyperemia, and arytenoid erythema (p < 0.01, p < 0.001, and p < 0.001, respectively). The number of total, acidic, and weakly acidic reflux episodes was significantly positively correlated with RSI and RFS. Proximal total, acidic, and weakly acidic reflux episodes showed significant correlations with eosinophil counts in nasal swabs but negative correlations with serum IgE levels. Conclusions: This study highlights the significant role of weakly acidic reflux in pediatric LPR and its association with respiratory symptoms. Our findings emphasize the importance of objective monitoring techniques in the assessment of LPR and provide insights for refining diagnostic and management strategies.

Tralokinumab Treatment in Adult Atopic Dermatitis Patients: 28-Week Evaluation of Clinical Effectiveness, Safety, Serum Proteins and Total IgE Levels.

Tralokinumab-a biological that specifically targets interleukin-13-is one of the newer advanced systemic treatments for patients with moderate-to-severe atopic dermatitis (AD). Although safety and efficacy have been shown in phase-III clinical trials, daily practice data are needed. Therefore, the aim of this study was to evaluate 28-week safety and effectiveness, serum proteins and total IgE levels in adult AD patients treated with tralokinumab in daily practice. Data of all adult AD patients who started treatment with tralokinumab and participated in the BioDay registry were collected at baseline, and after 4,16 and 28 weeks of treatment. Clinical efficacy was evaluated by clinical outcome measures, such as the Eczema Area and Severity Index (EASI) as well as patient-reported outcome measures, such as the numerical rating scale (NRS) for pruritus. Adverse events were evaluated. In a subgroup of patients, 18 proteins as well as total IgE levels were measured in serum. A total of 84 patients were included, of whom 39 were dupilumab-naïve (D-naïve) and 45 were dupilumab non-naïve (D-non-naïve) patients. All primary outcomes significantly improved during 28 weeks of tralokinumab treatment and the probability of achieving EASI ≤ 7 and NRS-pruritis ≤ 4 was 75.8% (56.9-88.2) and 51.4% (28.0-74.2), respectively. The disease severity-associated proteins TARC/CCL17 and PARC/CCL18 decreased during treatment, and total IgE levels significantly decreased in the D-naïve patients. The most reported adverse events were eye disorders (n = 24, 28.6%). A total of 23 patients (27.4%) discontinued treatment due to adverse events and/or ineffectiveness, with hair loss being the most common adverse event leading to treatment discontinuation (n = 6). Tralokinumab is an effective treatment for moderate-to-severe AD in adult patients, in both dupilumab-naïve patients and patients who previously failed on dupilumab treatment. The clinical effect is supported by the biological data.

Arctiin Alleviates Atopic Dermatitis Against Inflammation and Pyroptosis Through Suppressing TLR4/MyD88/NF-κB and NLRP3/Caspase-1/GSDMD Signaling Pathways.

Atopic dermatitis (AD) is a prevalent skin condition worldwide. The immune response plays a crucial role in the pathogenesis of AD. Arctiin (ARC), a natural lignan, has been extensively investigated because of its anti-inflammatory, antioxidant, and anticancer properties. However, the impact of ARC on AD remains uncertain. Therefore, this study investigated the therapeutic effects of ARC in AD. AD-like lesions were induced in mice by applying 2,4-dinitrochlorobenzene (DNCB). The efficacy of ARC in AD was assessed by measuring skin lesion scores and thickness, pathological observation, and serum IgE concentrations. The expression of relevant proteins and genes in the back skin of the mice was assessed. Moreover, the TLR4/MyD88/NF-κB and NLRP3/Caspase-1/GSDMD signaling pathways were assessed in HaCaT cells stimulated with TNF-α and IFN-γ. ARC effectively alleviated AD-like dermatitis induced by DNCB in mice, reducing the skin thickness, mast cell infiltration in skin tissue, and serum total IgE levels. In addition, the expression of IL-1β and the mRNA transcription of TSLP and IFN-γ were downregulated. ARC also suppressed the TLR4/MyD88/NF-κB pathway, and molecular docking confirmed that ARC had exceptional binding properties with TLR4. Moreover, ARC ameliorated pyroptosis by inhibiting the activation of the nod-like receptor protein-3/Caspase-1/GSDMD cascade. ARC has remarkable anti-AD effects by inhibiting inflammation and pyroptosis through the TLR4/MyD88/NF-κB and NLRP3/Caspase-1/GSDMD signaling pathways. This suggests that ARC has potential as a new drug candidate for treating AD, which provides a novel approach to the clinical management of AD.