Correlation between sensitization to house dust mite major allergens, age, and symptoms in Japanese house dust mite allergic subjects

Exploring geographical variances in component-resolved diagnosis within the Asia-Pacific region

Component-resolved diagnostics (CRD) have revolutionized allergy diagnosis, offering enhanced accuracy and insights into allergen sensitization patterns. This review explores geographical variances in CRD for food and aeroallergens across the Asia-Pacific region. We examine the varying prevalence of allergic diseases and the utility of CRD in diagnosing common food allergies, including peanut, shellfish, fish, wheat, and fruits. Notable differences in serum-specific (sp)IgE sensitization patterns and the clinical relevance of particular allergen components are observed between populations in Asian countries and those in Europe and the United States. For food allergies, the literature reports significant differences in allergen components and their diagnostic utility across various countries. Peanut allergy diagnostics, particularly Ara h 2 spIgE, show varying sensitivity and specificity between Asian and Western populations. In shellfish allergy, emerging allergens beyond tropomyosin are gaining importance in the Asia-Pacific region. Fish and wheat allergies also demonstrate unique sensitization patterns, emphasizing the need for region-specific diagnostic approaches. Regarding aeroallergens, pollen sensitization profiles vary widely across the region, influenced by local flora and climate, to influence symptoms of pollen food allergy syndrome. House dust mite allergens remain a significant concern, with high sensitization rates to major components like Der p 1, Der p 2, and the emerging Der p 23. The cross-reactivity between house dust mite and shellfish allergens is particularly relevant in this region. These findings emphasize the need for region-specific CRD approaches, considering local allergen profiles and sensitization patterns. As the prevalence of allergic diseases continues to rise in the Asia-Pacific, further research into locally relevant allergens and their components is crucial for improving diagnosis, patient management, and targeted immunotherapy strategies in this diverse region.

Exploring the Role of Allergenic Components in Children with House Dust Mite-Induced Allergic Diseases

Purpose

To investigate the main characteristics of HDM-induced allergic diseases in children and to explore allergen component-specific sensitization patterns, features, and correlations with clinical symptoms.

Methods

Serum samples were collected from children with HDM-induced allergic diseases. Information on age, sex, and clinical symptoms was recorded. A protein chip method was used to detect specific IgE (sIgE) against HDM components, including Der p 1, Der f 1, Der p 2, Der f 2, Der p 5, Der p 7, Der p 10, Der p 21, and Der p 23.

Results

116/120 (96.67%) exhibited positive reactions to HDM components. The highest positive rates were for Der p 1 (95.83%) and Der f 1 (95.83%), followed by Der p 2 (86.67%), Der f 2 (85.83%), and Der p 23 (62.50%). Der p 5, 7, and 23 positivity increased with age. Notably, Der p 23 positivity was higher in the allergic asthma (AA) group than in the non-AA, atopic dermatitis (AD), and allergic rhinitis (AR) groups and higher in AR with AA than AR-only. Der p 2 and Der f 2 had higher positive rates in respiratory allergies than in AD alone. The impact of other HDM components on different allergic diseases was minimal. Pearson correlation analysis demonstrated strong positive correlations between sIgE concentrations for various HDM components, especially between Der p 2 and Der f 2 (r = 0.96, p < 0.01).

Conclusion

Der p 1, Der f 1, Der p 2, Der f 2, and Der f 23 are the major allergens, with Der p 5, 7, and 23 showing age-specific sensitization patterns. Der p 2 and Der f 2 are closely associated with respiratory allergies, whereas Der p 23 is particularly linked to the development of asthma. There is a general positive correlation among the sIgE concentrations of various HDM components.

Changes in and Potential Mechanisms of Circulating IgA+CD27-Class-Switched Memory B Cells in Patients With Allergic Rhinitis

Background

The role of memory B cells and their subgroups in allergic rhinitis (AR) and allergen immunotherapy (AIT) remains unclear. This study aimed to investigate the characteristics of memory B cells in the circulation of patients with AR and those undergoing AIT, as well as their clinical significance.

Methods

This study involved a cohort comprising 32 healthy control subjects, 39 individuals diagnosed with AR, and 31 AR patients who had received AIT for over one year. Visual analog scale (VAS) scores were used for symptom assessment, and the serum concentrations of immunoglobulins and cytokines were quantified. This study evaluated alterations in the proportions of peripheral blood memory B cells and their subpopulations, plasma cells, and various T-cell subsets across the three participant groups.

Results

The proportion of IgA+CD27- class-switched memory B cells in the AR group significantly decreased compared to the control group, but significantly increased following AIT (P < 0.05). In AR patients, circulating IgA+CD27- class-switched memory B cells were significantly positively correlated with Treg cells, IL-10, and IL-4 and significantly negatively correlated with IFN-γ, total IgE, sIgE, and VAS scores (P < 0.05). After AIT, the number of circulating IgA+CD27- class-switched memory B cells in AR patients was significantly positively correlated with the number of Treg cells and IL-10 and significantly negatively correlated with the VAS score (P < 0.05).

Conclusion

The IgA+CD27- class-switched memory cell subset in human peripheral blood may serve as a potential biomarker for evaluating AR symptoms and treatment efficacy. Its mechanism may be associated with interactions between T and B cells.

Augmented type 2 inflammatory response in allergic rhinitis patients experiencing systemic reactions to house dust mite subcutaneous immunotherapy

BACKGROUND

Subcutaneous immunotherapy (SCIT) can induce systemic reactions (SRs) in certain patients, but the underlying mechanisms remain to be fully elucidated.

METHODS

AR patients who were undergoing standardized HDM SCIT (Alutard, ALK) between 2018 and 2022 were screened. Those who experienced two consecutive SRs were included in the study group. A control group was established, matched 1:1 by gender, age, and disease duration with the study group, who did not experience SRs during SCIT. Clinical and immunological parameters were recorded and analyzed both before SCIT and after 1 year of treatment.

RESULTS

A total of 161 patients were included, with 79 (49.07%) in the study group. The study group had a higher proportion of AR combined asthma (26.8% vs. 51.8%, p < 0.001) and higher levels of sIgE to HDM and HDM components (all p < .001). Serum IL-4 and IL-13 levels in the study group were higher than those in the control group (p < .05). The study group received a lower maintenance dosage of HDM extracts injections than control group due to SRs (50000SQ vs. 100000SQ, p < .05). After 1 year of SCIT, the VAS score, the lung function parameters of asthmatic patients over 14 years old significantly improved in both groups (all p < .05). After a 7-day exposure to 20 μg/mL HDM extracts, the percentages of Th1, Th17, Tfh10, and Th17.1 in PBMCs decreased, while the Tfh13 cells significantly increased in the study group (p < .05).

CONCLUSION

The type 2 inflammatory response is augmented in HDM-induced AR patients who experienced SRs during SCIT. Despite this, SCIT remains effective in these patients when administered with low-dosage allergen extracts.

Dust mite component Analysis: Identifying key allergens components for effective immunotherapy in allergic rhinitis

BACKGROUND

The aim of this study was to examine the frequency of sensitization to house dust mite (HDM) components among allergic rhinitis patients receiving subcutaneous immunotherapy (SCIT), and to assess the correlation between SCIT efficacy and specific IgE (sIgE) levels for allergenic HDM components.

METHODS

Serum samples and clinical data were collected from 38 allergic rhinitis patients receiving HDM-SCIT at baseline and after 1 year of treatment. Effective treatment was defined as a therapeutic index (TI) of at least 50% after 1 year. Cytokine levels were analyzed using commercial ELISA kits, while serum total and specific IgE levels were determined by the fluoroenzymeimmunoassay technique. The ALLEOS 2000 magnetic particle chemiluminescence system was used to measure sIgE levels for Der f, Der p 1, Der p 2, Der p 10, and Der p 23.

RESULTS

Allergic rhinitis patients undergoing HDM-SCIT had a high rate of allergic sensitization to the HDM major allergens Der p (100%), Der f (100%), Der p 1 (94.74%), Der p 2 (94.74%), and Der p 23 (36.84%). Patients who responded to SCIT had higher levels of IgE for HDM components at baseline, while those with ineffective treatment showed an opposite performance, particularly for Der p 1 (P＜0.05). After 1 year of treatment, effective and ineffective patients showed opposite trends in sIgE for dust mite components (decreased in effective patients, increased in ineffective patients). HDM-SCIT led to a significant reduction in IL-2, IL-4, IL-6, and EOS% (P＜0.05). IgE for Der p, Der f, Der p 1, Der p 2, and HDM sIgE were significantly positively correlated (P < 0.001). The correlation heatmap analysis based on changes in values reveals a negative correlation between CSMS score changes and sIgE for Der f and Der p 1, and a positive correlation with IL-2, IL-10, and TNF (P < 0.05).

CONCLUSIONS

The molecular sensitization profiles during HDM-SCIT are variable and relate to treatment efficacy. Molecular diagnosis can assist allergists in identifying patients eligible for HDM-SCIT, thereby enhancing the treatment's clinical efficacy. Serum cytokine levels of IL-2, IL-4, IL-6，and EOS% may serve as useful biomarkers for monitoring HDM-SCIT efficacy.

Molecular Mapping of Allergen Exposome among Different Atopic Phenotypes

Climate change and exposure to environmental pollutants play a key role in the onset and aggravation of allergic diseases. As different climate-dependent patterns of molecular immunoglobulin E (IgE) reactivity have been regionally described, we sought to investigate the evolving allergen exposome in distinctive allergic phenotypes and subtropical weather conditions through a Precision Allergy Molecular Diagnosis (PAMD@) model. Concurrent sensitization to several house dust mites (HDM) and storage mite molecules were broadly dominant in the investigated cohort, followed by the major cat allergen Fel d 1, and regardless of the basal allergic disease. Although a complex repertoire of allergens was recognized, a steadily increasing number of IgE binding molecules was associated with the complexity of the underlying atopic disease. Besides the highly prevalent IgE responses to major HDM allergens, Der p 21, Der p 5, and Der p 7 also showed up as serodominant molecules, especially in subjects bothered by asthma and atopic dermatitis. The accurate characterization of the external exposome at the molecular level and their putative role as clinically relevant allergens is essential to elucidate the phenotypic diversity of atopic disease in terms of personalized diagnosis and therapy.

The relationship of D. pteronyssinus allergic component sIgE and sIgG₄ in house dust mite allergic rhinitis or/and allergic asthma patients

Objective: House-dust mite sensitization is an important cause of allergic asthma and/or rhinitis in southern China. This study aimed to analyze the immune effect and relationship between the Dermatophagoides pteronyssinus components specific immunoglobulin E (sIgE) and sIgG₄. Methods: The serum levels of sIgE and sIgG₄ to D. pteronyssinus allergen components Der p 1, 2, 3, 5, 7, 10, and 23 were detected in 112 patients with allergic rhinitis (AR) and/or allergic asthma (AA). Results: Overall, Der p 1 had the highest positive rate of sIgE (72.3%), followed by Der p 2 (65.2%) and Der p 23 (46.4%). Meanwhile, the highest positive rates of sIgG₄ were for Der p 2 (47.3%), Der p 1 (33.0%), and Der p 23 (25.0%). The patients with AR and AA had a higher positive rate (43.4%) of sIgG₄ than that in the patients with AR (42.4%) and the patients with AA (20.4%; p = 0.043). In patients with AR, the positive rate of sIgE in Der p 1 (84.8%) was higher than that in sIgG₄ (42.4%; p = 0.037), but the positive rate of sIgG₄ in Der p 10 (21.2%) was higher than that in sIgE (18.2%; p < 0.001). Most of the patients were positive for sIgE and sIgG₄ of Der p 2 and Der p 10 at the same time. However, positive results for sIgE alone were just found in Der p 7 and Der p 21. Optimal scale analysis showed that Der p 2, Der p 7, and Der p 21 sIgG₄ were closely related to AR and AA (Cronbach α = 0.917). Conclusion: Herein, the D. pteronyssinus allergen components showed different characteristics among the patients with AR, patients with AA, and patients with AR and AA in southern China. Thus, sIgG₄ may be play an important role in allergic reactions.

A prospective study on the difference of clinical outcomes between elderly and adult patients with allergic rhinitis

OBJECTIVE

The guiding significance of existing guidelines for the diagnosis, treatment and health management of AR in elderly patients is unclear. The aim of this study is to analyze the clinical characteristics and therapeutic effects of elderly and adult AR patients by prospective study.

METHODS

A total of 131 AR patients were recruited and divided into elderly group and adult group according to age. After receiving the same pharmacological treatment for 4 weeks, the differences of the two groups in clinical scores including TNSS-4, RQLQ and VAS were compared.

RESULTS

After 4 weeks treatment, all clinical scores in the adult group were improved compared with the baseline levels, while in the elderly group, only the TNSS-4 score was significantly reduced, and the RQLQ and VAS scores were not significantly improved. The changes of TNSS-4, RQLQ, and VAS scores in the elderly group were significantly inferior to those in the adult group (LS mean differences were 1.60, 8.80, and 11.10, respectively; P < 0.001).

CONCLUSION

We confirmed that elderly and adult AR patients had different clinical characteristics and outcomes, and the degree of improvement in the adult group was significantly better than that in the elderly group. Therefore, it is urgent for us to establish a clinical guideline suitable for the elderly AR population to give more scientific and reasonable recommendations for diagnosis and treatment.