Treatment Of Allergic Diseases Research Articles

Management of patients with allergic diseases during pregnancy: lecture

ABSTRACT. In connection with the considerable increase of prevalence of allergic diseases (AD) there all more often are situations, when it will be to decide the question of management of patients a doctor with an allergy during pregnancy. Prevalence of AD (allergic rhinitis/conjunctivitis, allergic phenotypes of bronchial asthma and hives, atopic dermatitis, food/drug/insect allergy, anaphylaxis) among pregnant women can arrive 30 %. It is possible to distinguish three types of influence of pregnancy on clinical motion of AD: 1) presence of pregnancy does not affect motion of AD; 2) on a background pregnancy comes remission of AD; 3) on a background pregnancy arise up intensifying of AD and their motion are burdened. It is difficult to predict exactly how the course of AD will occur during pregnancy, while the nature of treatment of a pregnant woman with AD and the level of their control are extremely important. At pregnancy diagnosis of AD is based on data of allergic anamnesis, food diary, physical inspection. Thus realization of skin and provocative tests with allergens contra-indicated. Application of provocative tests is also forbidden with a histamine, а methacholine and an acetylcholine. At treatment of pregnant from AD must be taken into account possible side effects of antiallergic drugs. Setting of modern medicinal facilities allows in most cases to control motion of allergic pathology for pregnant and avoid development of side effects of drugs. Treatment of AD during pregnancy the best result must provide for a mother and child. Medical workers must inform the women of reproductive age and pregnant of potential risks and present/absent proofs of unconcern/ununconcern of diagnostic and curative events.

Guominkang formula alleviate inflammation in eosinophilic asthma by regulating immune balance of Th1/2 and Treg/Th17 cells.

The number of patients with allergic asthma is rising yearly, and hormonal drugs, such as dexamethasone, have unique advantages and certain limitations. In the treatment of allergic diseases especially allergic asthma, increasing the percentage or the function of immunosuppressive cells, such as Treg cells, may achieve a good effect. On the basis of good clinical results, we found that Guominkang (GMK) especially high-concentration GMK can achieve a similar effect with dexamethasone in controlling the symptoms of allergic asthma and inhibiting inflammation of allergic asthma. In our study, GMK can inhibit the recruitment of inflammatory cells, decrease mucus production, and reduce airway resistance. Besides, GMK can reconstruct the cellular immune balance of Th1/2 and Treg/Th17 cells. Metabolome results show that DL-glutamine, L-pyroglutamic acid, prostaglandin b1, prostaglandin e2, and 3,4-dihydroxyhydrocinnamic acid are the metabolic biomarkers and are associated with Th1/2 and Treg/Th17 cell balance. GMK can also change the gut microbiota in the allergic asthma mouse model. The genus_Muriculum, genus_(Clostridium) GCA900066575, genus_klebsiella, genus_Desulfovibrio, genus_Rikenellaceae RC9 gut group, family_Chitinophagaceae, family_Nocardioidaceae, and genus_Corynebacterium are gut microbiota biomarkers treated by GMK. Among these biomarkers, genus_Muriculum is the gut microbiota biomarker associated with Th1/2 and Treg/Th17 cell balance. Interestingly, we first found that DL-glutamine, L-pyroglutamic acid, prostaglandin b1, prostaglandin e2, and 3,4-dihydroxyhydrocinnamic acid are all associated with genus_Muriculum. GMK will be a new strategy for the treatment of eosinophilic asthma, and biomarkers will also be a new research direction.

Anti-allergic function of the cell wall (DeinoWall) from Deinococcus radiodurans

Deinococcus radiodurans is an extremophile, well known to be extremely resistant to external stresses due to its unique physiological system and structure of cellular components. Although the proportion of D. radiodurans has been reported to be negatively correlated with atopic dermatitis, the exact function of D. radiodurans in allergic diseases and its precise mechanisms have not been studied. In the present study, we hypothesize that D. radiodurans or its cellular constituents play a critical role in the skin to prevent allergic inflammatory responses by modulating immunity. Heat-killed D. radiodurans inhibited the production of Th2 cytokines, such as IL-4 and IL-5, induced by ovalbumin (OVA) stimulation in splenocytes from OVA-sensitized mice. Among the cellular constituents of D. radiodurans, such as cell wall (DeinoWall), cell membrane (DeinoMem), and exopolysaccharide (DeinoPol), only DeinoWall inhibited the production of Th2 cytokines and 2,4-dinitrochlorobenzene (DNCB)-induced atopic dermatitis (AD), a Th2-predominant allergic disease in mice. Moreover, serum IgE levels and infiltration of mast cells into skin lesions, the markers of Th2 response induced by DNCB application, were significantly inhibited by treatment with DeinoWall. Remarkably, DeinoWall induced the maturation of bone marrow-derived dendritic cells (BMDCs) that promote Th1-biased immunity, which might balance Th1/Th2 and regulate allergic inflammatory responses. Collectively, these results suggest that DeinoWall acts as a major cellular constituent in the negative regulation of allergic inflammatory responses by D. radiodurans and might be a viable candidate for the treatment of allergic diseases.

Impact of coronavirus pandemic on safety and time of administration of subcutaneous immunotherapy among pediatric patients

Introduction: Allergen immunotherapy is the only targeted therapy that can modify the natural course of allergic diseases. In pediatric patients, SCIT with aeroallergens is an effective treatment and should be considered as a preventive strategy in the treatment of allergic diseases, even though one of the major concerns about it is its safety. The main purposes of this study were to assess the safety of SCIT ultra-rush schedules with polymerized extracts in a pediatric population and to determine the impact of the COVID-19 pandemic on the safety and time of administration of subcutaneous immunotherapy among pediatric patients. Methods: A retrospective medical records review of patients under 18 years of age undergoing SCIT was made and re-scheduling due to restrictions imposed by the COVID-19 pandemic was recorded. Results: A total of 192 pediatric patients were included. Fifty-nine (31%) had local reactions and systemic reactions were not reported. In March 2020, the first case of COVID-19 was diagnosed in Portugal and all non-urgent appointments and procedures were postponed. In our group of pediatric patients, 43 (22%) were referred to primary care, 38 (20%) stopped AIT definitively and 111 (58%) maintained administrations in the hospital. Only 2 (2%) of them had reactions upon reinitiation. Conclusion: In this study, the ultra-rush protocol using polymerized extracts was safe in pediatric patients. Although the effectiveness of AIT may be compromised due to prolonged suspension of the treatment, it is important to note that despite longer interruptions, administrations may continue without compromising safety, maintaining shorter visits and a lower number of injections.

Burden of Allergic Disease in Racial and Ethnic Structurally Oppressed Communities Within Canada and the United States: A Scoping Review

The social determinants of health have been extensively studied as potential mediating variables in the development and/or progression of many chronic illnesses, including allergic diseases, and may contribute to social inequities as barriers in accessing health care. We aimed to perform a scoping literature review to describe the burden of disease and access to health care for treatment of allergic disease within literature specific to structurally oppressed racial and ethnic populations. We performed a scoping review, guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines for Scoping Reviews, of 3 scientific databases and 5 relevant gray literature sites. Search strategy including keywords describing race and ethnicity were selected based on the acceptable nomenclature in Canada and the United States. We imposed no restrictions on date or country of publication, study design, or age of participants. Our literature search yielded 1,198 potentially relevant articles following deduplication. After title and abstract, and subsequently full-text screening, a total of 12 (1.08% of all articles) were included. These 12 included studies pointed toward a higher burden of allergic and atopic disease, including increased presentations to emergency departments, hospitalizations, mortality, younger age of diagnosis, and/or greater severity of disease, among Black or African American individuals, than the general population. Allergies beyond the top 9 food allergens, eosinophilic esophagitis, and asthma appeared to be more prevalent and more severe in this population than in the general population. There appears to be an increased burden of allergic and atopic disease among the Indigenous Peoples of Canada, whereas this was not noted for Latinx or Hispanic populations, in part due to a paucity of studies involving these populations. Owing to a lack of published literature, no conclusions could be drawn regarding allergy and atopy in Native American populations. Structurally oppressed racial and ethnic communities may face an increased burden of allergic and atopic disease-but that this may be magnified by issues regarding oppression, access, and social environment that warrant further investigation.

Roles of type 1 regulatory T (Tr1) cells in allergen-specific immunotherapy.

Allergen-specific immunotherapy (AIT) is the only causative treatment for allergic diseases by modification of the immune response to allergens. A key feature of AIT is to induce immunotolerance to allergens by generating antigen-specific regulatory T (Treg) cells in allergic patients. Type 1 regulatory T (Tr1) cells and forkhead box protein 3 (Foxp3)-expressing Treg cells are well known among Treg cell subsets. Foxp3 was identified as a master transcription factor of Treg cells, and its expression is necessary for their suppressive activity. In contrast to Foxp3+ Treg cells, the master transcription factor of Tr1 cells has not been elucidated. Nevertheless, Tr1 cells are generally considered as a distinct subset of Treg cells induced in the periphery during antigen exposure in tolerogenic conditions and can produce large amounts of anti-inflammatory cytokines such as interleukin-10 and transforming growth factor-β, followed by down-regulation of the function of effector immune cells independently of Foxp3 expression. Since the discovery of Tr1 cells more than 20 years ago, research on Tr1 cells has expanded our understanding of the mechanism of AIT. Although the direct precursors and true identity of these cells continues to be disputed, we and others have demonstrated that Tr1 cells are induced in the periphery by AIT, and the induced cells are re-activated by antigens, followed by suppression of allergic symptoms. In this review, we discuss the immune mechanisms for the induction of Tr1 cells by AIT and the immune-suppressive roles of Tr1 cells in AIT.

Network Pharmacology and Molecular Docking Study of Yupingfeng Powder in the Treatment of Allergic Diseases.

Objective To explore the potential mechanisms of Yupingfeng Powder (YPFP) in the treatment of allergic diseases by using network pharmacology and molecular docking technology. Methods The active components and targets of YPFP were screened by the TCMSP database. The targets associated with atopic dermatitis, asthma, allergic rhinitis, and food allergy were obtained from GeneCards and OMIM databases, respectively. The intersection of the above disease-related targets was identified as allergy-related targets. Then, allergy-related targets and YPFP-related targets were crossed to obtain the potential targets of YPFP for allergy treatment. A protein-protein-interaction (PPI) network and a drug-target-disease topology network were constructed to screen hub targets and key ingredients. Next, GO and KEGG pathway enrichment analyses were performed separately on the potential targets and hub targets to identify the biological processes and signaling pathways involved. Finally, molecular docking was conducted to verify the binding affinity between key ingredients and hub targets. Results In this study, 45 active ingredients were identified from YPFP, and 48 allergy-related targets were predicted by network pharmacology. IL6, TNF, IL1B, PTGS2, CXCL8, JUN, CCL2, IL10, IFNG, and IL4 were screened as hub targets by the PPI network. However, quercetin, kaempferol, wogonin, formononetin, and 7-O-methylisomucronulatol were identified as key ingredients by the drug-target-disease topological network. GO and KEGG pathway enrichment analysis indicated that the therapeutic effect of YPFP on allergy involved multiple biological processes and signaling pathways, including positive regulation of fever generation, positive regulation of neuroinflammatory response, vascular endothelial growth factor production, negative regulation of cytokine production involved in immune response, positive regulation of mononuclear cell migration, type 2 immune response, and negative regulation of lipid storage. Molecular docking verified that all the key ingredients had good binding affinity with hub targets. Conclusion This study revealed the key ingredients, hub targets, and potential mechanisms of YPFP antiallergy, and these data can provide some theoretical basis for subsequent allergy treatment and drug development.

Current Use of Probiotics and Prebiotics in Allergy

The microbiome plays an important role in the pathogenesis of allergic diseases. This review updates the reader on studies aimed at influencing allergic diseases through modulation of the gut microflora. A nonsystematic review of the literature was performed, focusing on relevant trials evaluating the effect of probiotics/prebiotics/symbiotics in the prevention and treatment of allergic disease. For each allergic disease, we were able to find not only a substantial number of clinical trials but also systematic reviews. Specific guidelines, based on systematic reviews and meta-analyses, are available for the prevention of allergic disease and for the treatment of food allergy. In each of the areas examined-allergic rhinitis, allergic asthma, atopic dermatitis, food allergy, and gastrointestinal allergies-there are substantial uncertainties in the efficacy of gut microflora modulation in prevention and treatment. At present, practicing clinicians can avail themselves of intestinal flora modulators as an adjunct in the prevention of atopic dermatitis but not of other forms of allergic diseases. Their effects on the treatment of allergic diseases remain controversial.

A STUDY ON THE ROLE OF PROBIOTICS IN NASAL ALLERGY

INTRODUCTION: One of the major components of the commensal microbial flora, which is being frequently used as probiotics in the intestinal tract of humans, is Lactobacilli. It exerts health benefits beyond inherent basic nutrition, and its role in increasing the immunomodulating capacity of the host is widely accepted. In the treatment of allergic diseases, the beneficial effect of probiotics has been demonstrated. OBJECTIVE This study was aimed to observe the effectiveness of probiotics in reducing the symptoms of nasal allergy. METHODS Total 50 patients suffering from Allergic Rhinitis (AR) were administered with probiotics for a period of six weeks post which the VAS and IgE scores of the symptoms (Rhinorrhea, Sneezing, and Nasal obstruction) were statistically analyzed. The pre and post treatment VAS and IgE scores were collected and analyzed. RESULTS It showed that there was a reduction in the scores after the administration of probiotics. CONCLUSIONS This prospective study demonstrated the presence of significant improvement in the VAS and IgE scores among the following nasal symptoms - Rhinorrhea, Sneezing, and Nasal obstruction with the administration of probiotics in the patients suffering with AR. KEYWORDS Allergic rhinitis, probiotics, nasal obstruction, rhinorrhea and sneezing.

Application of Bioengineered Bacteria in Allergic Diseases

In recent years, increasing attention has been paid to bioengineered bacteria as vectors for the treatment of allergic diseases. The methods for preparing bioengineered bacteria that can express exogenous genes are improving. Research has focused mainly on application of bioengineered bacteria expressing recombinant allergens, hypoallergenic derivatives of allergens, T-cell epitope derivatives, cytokines, or as mucosal adjuvants to enhance immunotherapy effects. This strategy offers new ideas for the treatment of allergic diseases. This review summarizes recent advances in use of live bioengineered bacteria in allergic diseases as well as the challenges of using microorganisms (or their components) in immunotherapy.

Expression of galectin-13 in allergic diseases involving airway, skin and mucous membranes

To detect the expression of galectin-13 in allergic diseases and provide a new way for the diagnosis and treatment of allergic diseases. A retrospective analysis method was used to screen 216 patients with allergic diseases with house dust mites or aspergillus as allergens who visited the Department of Allergy and Department of Respiratory of Tongji Hospital attached Tongji Medical College, Huazhong University of Science and Technology from March 2018 to May 2021. These allergic diseases included allergic asthma, allergic bronchopulmonary aspergillosis, allergic rhinitis, allergic conjunctivitis, atopic dermatitis, allergic urticaria. 25 subjects without underlying diseases were selected as healthy controls. The galectin-13 content in serum in each group were detected, and the Pearson correlation was used to determine the correlation between the galectin-13 content in serum in each group and blood eosinophil count, blood specific IgE, the score scale of allergic disease. The expression of Galectin-13 was increased in allergic asthma group (71.44±39.44) pg/ml, allergic bronchopulmonary aspergillosis group (100.10±47.62) pg/ml, allergic rhinitis group (54.11±24.81) pg/ml and dermatitis group (44.12±19.51) pg/ml. The expression of galectin-13 was not significantly increased in allergic urticaria group (32.75±10.29) pg/ml and the allergic conjunctivitis group (30.55±9.87) pg/ml. The galectin-13 content in serum, was positively correlated with blood eosinophil count(rs=0.54, P<0.001) and house dust mite specific IgE (rs=0.51, P<0.001) in allergic asthma group, and was positively correlated with blood eosinophil count(rs=0.63, P=0.025) and aspergillus fumigatus specific IgE (rs=0.58, P=0.046) in allergic bronchopulmonary aspergillosis group. It was positively correlated with blood eosinophil count (rs=0.52, P=0.000 2) and house dust mite specific IgE (rs=0.41, P=0.005) in allergic rhinitis group. In allergic conjunctivitis group, the expression of galectin-13 was positively correlated with conjunctivitis symptom score (rs=0.47, P=0.048). In atopic dermatitis group, the expression of galectin-13 was positively correlated with blood eosinophil count (rs=0.58, P<0.001) and house dust mite specificity IgE (rs=0.47, P=0.002). In allergic urticaria group, the expression of galectin-13 was not significantly correlated with blood eosinophil count or house dust mite specific IgE. Galectin-13 may be related to the occurrence and progress of allergic diseases and may be involved in the occurrence of eosinophilic inflammation.

Oral administration of Lactiplantibacillus plantarum 22A-3 exerts anti-allergic activity against intestinal food allergy mouse models sensitized and challenged with ovalbumin

In recent years, researches on food components with anti-allergic effects have been gathering attention, because of the expectation for the establishment of a safe and effective treatment for food allergy. Previous studies have reported that Lactiplantibacillus plantarum 22A-3 (LP22A3) inhibited degranulation of mast cells and reduced IgE production. We have developed a gastrointestinal allergy system in which mice are sensitized by intraperitoneal and oral administration of OVA and then challenged by oral administration of high doses of OVA. As a result, an increase in the amount of IgE in the blood and a decrease in the temperature of the colon were confirmed, and it was clarified that food allergy was induced by oral administration of high dose of OVA as the challenge. Oral administration of LP22A3 ameliorated allergic responses significantly by reducing the amount of IgE in the blood and to recovered the decrease of rectal temperature. However, LP22A3 did not affect the intestinal barrier function. Administered LP22A3 significantly suppressed mRNA expression of OX40L and IL-4. These results suggested that LP22A3 suppressed Th2 differentiation and IL-4 production via downregulation of OX40L, and consequently suppressed IgE production. LP22A3 might provide a safe and effective treatment for allergic diseases due to ability modulating intestinal immune system.

The kinase p38α functions in dendritic cells to regulate Th2-cell differentiation and allergic inflammation

Dendritic cells (DCs) play a critical role in controlling T helper 2 (Th2) cell-dependent diseases, but the signaling mechanism that triggers this function is not fully understood. We showed that p38α activity in DCs was decreased upon HDM stimulation and dynamically regulated by both extrinsic signals and Th2-instructive cytokines. p38α-specific deletion in cDC1s but not in cDC2s or macrophages promoted Th2 responses under HDM stimulation. Further study showed that p38α in cDC1s regulated Th2-cell differentiation by modulating the MK2−c-FOS−IL-12 axis. Importantly, crosstalk between p38α-dependent DCs and Th2 cells occurred during the sensitization phase, not the effector phase, and was conserved between mice and humans. Our results identify p38α signaling as a central pathway in DCs that integrates allergic and parasitic instructive signals with Th2-instructive cytokines from the microenvironment to regulate Th2-cell differentiation and function, and this finding may offer a novel strategy for the treatment of allergic diseases and parasitic infection.

Identification of an immunodominant IgE epitope of Der p 39, a novel allergen of Dermatophagoides pteronyssinus

BackgroundHouse dust mites (HDMs) are the main source of indoor inhalatory allergens that cause IgE-mediated allergic diseases. The discovery and identification of HDM allergens are important for the diagnosis and treatment of allergic diseases. ObjectiveWe sought to identify a Group 39 Dermatophagoides pteronyssinus (Der p) allergen, namely Der p 39, and explore its immunodominant IgE epitopes. MethodsHomology analysis of amino acid (aa) sequences in HDM and human troponin C (TnC)-like protein was performed. Total RNA of Der p was extracted and used to amplify Der p 39 cDNA with specific primers. Recombinant Der p 39 protein was expressed with a pET-His prokaryotic expression system and purified with Ni-NTA resins. IgE binding was evaluated with western blot, dot blot, and enzyme-linked immunosorbent assay (ELISA) experiments. The IgE binding epitopes of Der p 39 were identified by observing HDM-allergic sera interactions with truncated and hybrid proteins formed from Der p 39 and human TnC-like proteins. ResultsThe Der p 39 open reading frame (ORF) cDNA was found to be 462 base pairs and registered in the NCBI library (GenBank no. MZ336019.1). Der p 39, which encoded 153 aa, was found to have 35.63% and 99.35% homology with human TnC and Dermatophagoides farina (Der f) 39, respectively. IgE-ELISA showed IgE binding with expressed and purified recombinant Der p 39 (18 kDa) in 5/87 (5.75%) HDM-allergic sera samples. Analyses of IgE binding with Der p 39-based truncated and hybrid proteins indicated that IgE binding epitopes are likely located in the C-terminal region and dependent on conformational structure. The data from this study were submitted to the World Health Organization and International Union of Immunological Societies (WHO/IUIS) Allergen Nomenclature database. ConclusionDer p 39 was identified as a minor HDM allergen with a conformational IgE binding epitope. These findings could have important theoretical implications in the development of HDM allergy diagnostics and therapeutics.

Thioredoxin-1: A Promising Target for the Treatment of Allergic Diseases.

Thioredoxin-1 (Trx1) is an important regulator of cellular redox homeostasis that comprises a redox-active dithiol. Trx1 is induced in response to various stress conditions, such as oxidative damage, infection or inflammation, metabolic dysfunction, irradiation, and chemical exposure. It has shown excellent anti-inflammatory and immunomodulatory effects in the treatment of various human inflammatory disorders in animal models. This review focused on the protective roles and mechanisms of Trx1 in allergic diseases, such as allergic asthma, contact dermatitis, food allergies, allergic rhinitis, and drug allergies. Trx1 plays an important role in allergic diseases through processes, such as antioxidation, inhibiting macrophage migration inhibitory factor (MIF), regulating Th1/Th2 immune balance, modulating allergic inflammatory cells, and suppressing complement activation. The regulatory mechanism of Trx1 differs from that of glucocorticoids that regulates the inflammatory reactions associated with immune response suppression. Furthermore, Trx1 exerts a beneficial effect on glucocorticoid resistance of allergic inflammation by inhibiting the production and internalization of MIF. Our results suggest that Trx1 has the potential for future success in translational research.

Effect of Japanese Cedar Pollen Sublingual Immunotherapy on Asthma Patients with Seasonal Allergic Rhinitis Caused by Japanese Cedar Pollen.

Allergen immunotherapy is a promising treatment for allergic diseases that induce immune tolerance through the administration of specific allergens. In this study, we investigate the efficacy of sublingual immunotherapy (SLIT) in asthmatic patients with SAR-JCP and the dynamics of the parameters before and after treatment in a real-world setting. This was a prospective single-center observational study. Patients with asthma and SAR-JCP (n = 24) were recruited for this study and assessed using symptom questionnaires before SLIT and a year after the SLIT. In addition, a respiratory function test, forced oscillation technique, and blood sampling test were performed during the off-season before and after SLIT. The one-year SLIT for asthma patients with SAR-JCP significantly improved not only allergic rhinitis symptoms, but also asthma symptoms during the JCP dispersal season, and significantly improved airway resistance during the off-season. The change in the asthma control test and the visual analog scale score during the season before and after SLIT was negatively and positively correlated with the change in peripheral blood γδ T cells off-season before and after SLIT, respectively. It was suggested that improvement in asthma symptoms during the JCP dispersal season after SLIT was associated with reduced peripheral blood γδ T cells.

Dehydroandrographolide targets CD300f and negatively regulated MRGPRX2-induced pseudo-allergic reaction.

Mas-related G protein-coupled receptor X2 (MRGPRX2) mediates mast cells (MCs) activation, which is a key target for the treatment of allergic diseases. However, there are few drugs targeting MRGPRX2. Leukocyte mono-immunoglobulin-like receptor 3 (CD300f) is a negative regulator of FcεRΙ-mediated MC activation. However, the regulatory effect of CD300f on MRGPRX2 remains unclear. Dehydroandrographolide (DA) is a main contributor of Andrographis paniculata (Burm.f.) Nees (family: Acanthaceae) have been shown to inhibit type I hypersensitivity. The aim of this study was to determine whether DA negatively regulated MRGPRX2-mediated MC activation via CD300f and showed therapeutic effect on pseudo-allergic reactions. Mouse allergic models and MC degranulation were detected in vivo and in vitro, and inflammatory mediators were detected. siRNA interference and Biacore were used to verify the target. DA inhibited pseudo-allergic reactions by reducing vasodilation and serum cytokine levels in mice and inhibited MRGPRX2-mediated MC activation. The regulatory effect of DA was significantly decreased after the knockdown of CD300f expression. Moreover, DA upregulated the phosphorylation level of Src homology region 2 domain-containing phosphatase (SHP)-1 and SHP-2, which are key kinases in the negative regulatory signaling pathways associated with CD300f. In conclusion, DA negatively regulates MRGPRX2-mediated MC activation via CD300f to inhibit pseudo-allergic reactions.

Association of delayed chronotype with allergic diseases in primary school children

ABSTRACT To investigate the associations of sleep midpoint for both weekdays and weekends, and chronotype, with allergic diseases, specifically asthma, allergic rhinitis, and eczema in primary school children. In this cross-sectional study, we evaluated 10409 children between 7 and 12 years of age (mean 9.21 ± 1.51 years; male 52.2%). Each allergic disease was defined as children with both diagnosed disease and current symptoms, and the reference group was described as children without any allergic symptoms. Sleep durations and mid-sleep times were calculated by reported sleep timing. Chronotype was determined by mid-sleep time on free days corrected for oversleeping. Children with allergies have shorter sleep duration and later sleep preferences. Late weekly sleep midpoints were associated with higher odds of allergies, and the odds were even higher for later weekday midpoints than their weekend counterparts. Regarding chronotype, the more evening chronotype, the higher the odds of allergic rhinitis and eczema. Additionally, effect of weekday late sleep midpoint on allergies was stronger as the participants who slept less (asthma: aOR,1.62, 95 CI%,1.25–2.10, p < .001; allergic rhinitis: aOR,2.12, 95 CI%,1.68–2.67, p < .001; eczema: aOR, 1.94, 95 CI%,1.52–2.48, p < .001). Further, the associations of chronotype with allergic rhinitis were confounded by second-hand smoking exposure. Our study, which finds an association between chronotype and the odds of three allergic diseases, hopes to improve sleep health awareness, especially in the particular population with allergic diseases, and describes the importance of evaluating modifiable behavioral factors, such as sleep habits, as a plausible factor for the prevention and treatment of allergic diseases.

Dupilumab-Associated Adverse Events During Treatment of Allergic Diseases.

Among the new biological therapies for atopic diseases, dupilumab is a fully human monoclonal antibody directed against IL-4Rα, the common chain of interleukin-4 and interleukin-13 receptors. Dupilumab showed clinical improvements in patients with atopic dermatitis, asthma, and chronic rhinosinusitis and is currently under development for other indications. While dupilumab is considered to be well tolerated, a number of recent publications have reported various adverse events. This review aims to summarize the current knowledge about these adverse events, which may help clinicians to improve the follow-up of patients on dupilumab. Injection-site reactions are the most common reported adverse event. However, dupilumab has also been shown to cause ophthalmic complications (e.g., dry eyes, conjunctivitis, blepharitis, keratitis, and ocular pruritus), head and neck dermatitis, onset of psoriatic lesions, progression of cutaneous T-cell lymphoma exacerbation, alopecia areata, hypereosinophilia, and arthritis. Most are managed during dupilumab treatment continuation, but some (e.g., severe conjunctivitis) may result in a discontinuation of treatment. Their molecular origin is unclear and requires further investigations. Among other hypothesis, it has been suggested that T helper (Th)2-mediated pathway inhibition may worsen Th1/Th17-dependent immune responses. An ophthalmological examination for the presence of potential predictive indicators of ophthalmic adverse events is recommended before initiation of dupilumab therapy.

Immune Metabolism-An Opportunity to Better Understand Allergic Pathology and Improve Treatment of Allergic Diseases?

Immune Metabolism-An Opportunity to Better Understand Allergic Pathology and Improve Treatment of Allergic Diseases?