Pathogenesis of allergic diseases and implications for therapeutic interventions

Comorbidities and multimorbidity in asthma

PURPOSE OF REVIEW

To describe the associations between asthma and relevant comorbidities, and appraise the latest evidence on the management strategies of asthmatics with comorbid conditions.

RECENT FINDINGS

Conditions such as allergic rhinitis, chronic rhinosinusitis with and without nasal polyps, gastroesophageal reflux disease, obesity, chronic obstructive pulmonary disease, bronchiectasis, anxiety and depression have been linked to worse outcomes in asthma. Recognition and treatment of these conditions is important in asthma, particularly in those with uncontrolled or severe asthma. Biologics for asthma have been effective in those with chronic rhinosinusitis with nasal polyps and chronic obstructive pulmonary disease (COPD), with emerging evidence in bronchiectasis. Weight loss programs with diet and exercise improve asthma control. Anxiety and depression are often unrecognized in patients with asthma.

SUMMARY

Comorbid conditions have been recognized as important factors in the diagnosis and treatment of asthma, particularly in patients who have severe disease and remain uncontrolled. Comorbidities in asthma are correlated with poor quality of life and asthma control, increased healthcare utilization and their treatment is associated with improved outcomes.

Genomic structural equation modeling elucidates the shared genetic architecture of allergic disorders

BACKGROUND

The intricate shared genetic architecture underlying allergic disorders-including allergic asthma, atopic dermatitis, contact dermatitis, allergic rhinitis, allergic conjunctivitis, allergic urticaria, anaphylaxis, and eosinophilic esophagitis-remains incompletely characterized.

METHODS

Our study employed genomic structural equation modeling (Genomic SEM) to define the common factor representing the shared genetic architecture of allergic disorders. Coupled with diverse post-GWAS analytical methods, we aimed to discover susceptible loci and investigate genetic associations with external traits. Furthermore, we explored enriched genetic pathways, cellular layers, and genomic elements, and investigated putative plasma protein biomarkers. Polygenic risk score (PRS) analyses, leveraging our integrated GWAS data, were conducted to assess chromosomal-level risk associations for allergic disorders.

RESULTS

A well-fitted genomic SEM integrated GWAS data, revealing the shared genetic architecture of allergic disorders. We identified a total of 2038 genome-wide significant SNP loci (p < 5e-8), including 31 previously unreported loci. Fine-mapping of variants and gene sets pinpointed 2 causal variants and 31 candidate susceptible genes. Genetic correlation analyses further illuminated the shared genetic architecture underlying multiple traits, notably psychiatric disorders. Preliminary findings identified four putative causal plasma protein biomarkers.

CONCLUSION

Notably, this study presents the first comprehensive genetic characterization of allergic disorders through a GWAS analysis of an unmeasured composite phenotype, providing novel insights into shared etiological pathways across these conditions.

Tolerogenic nanovaccines for the treatment of type I allergic diseases

The high prevalence of type I allergic diseases such as allergic rhinitis, allergic asthma, food allergies, allergic conjunctivitis, and atopic dermatitis has emerged as a significant public health concern globally. Failure of immune tolerance to ordinarily harmless substances or stimulation, and subsequent induction of T helper 2 cells by antigen-presenting cells evokes the allergic immune response, which results in persistent inflammation, tissue damage, and organ function impairment. Current therapeutic approaches for allergic diseases include avoiding allergen exposure, corticosteroids, biologics, etc. However, these strategies only relieve allergic symptoms but hardly prevent the deteriorative progression and may have adverse effects on patients. With the rapid development of nanotechnology and immunology, emerging tolerogenic nanovaccines represent novel approaches with the potential to cure type I allergic diseases rather than merely alleviate symptoms. In this review, we expound the burgeoning field of tolerogenic nanovaccines against type I allergic diseases, highlight various types of antigens employed in constructing allergen extracts, protein/peptide and nucleic acid-based tolerogenic nanovaccines, and discuss their application in allergic rhinitis, allergic asthma, food allergies, allergic conjunctivitis, and atopic dermatitis.

Cross-sectional Survey of Allergic Diseases in Staff and Their Families at Designated Allergic Disease Medical Hospitals in Japan: Calculation of Age-adjusted Prevalence

BACKGROUND

Continuous epidemiological surveys using consistent methodologies are essential for assessing the prevalence of allergic diseases. In 2021, a cross-sectional survey on allergic diseases was conducted, targeting staff and their families at Designated Allergic Disease Medical Hospitals across 41 prefectures in Japan. By 2022, these hospitals had been established in all 47 prefectures of Japan.

METHODS

A prevalence survey of allergic diseases was conducted in 2022 using the same questionnaire as that used in 2021, encompassing hospitals across all 47 prefectures. Age-adjusted prevalence rates were calculated using the 2015 population model for comparison with the 2021 survey data.

RESULTS

The 2022 survey included 76 hospitals and 24,444 participants (males, 10,668; women, 13,776; median age, 35 years; interquartile range, 18-50 years). The overall prevalence of allergic diseases was 63.0% (95% confidence interval:62.3-63.6). Age-adjusted prevalence of a history per 100,000 people for each allergic disease was as follows (; 95% confidence interval): bronchial asthma (13,279; 12,776-13,782), atopic dermatitis (12,786; 12,379-13,193), food allergies (13,143; 12,689-13,596), perennial allergic rhinitis (28,132; 27,673-28,982), pollinosis (38,959; 38,216-39,703), allergic conjunctivitis (19,751; 19,188-20,313), metal allergies (2,111; 1,898-2,325), drug allergies (4,478; 4,149-4,806), and anaphylaxis (1,602; 1,417-1,787). The prevalence of perennial allergic rhinitis, pollinosis, and allergic conjunctivitis was higher than that in 2021.

CONCLUSIONS

This survey is the first in Japan to calculate the age-adjusted prevalence of allergic diseases. Moreover, pollinosis is the most common allergic disease in Japan.

Global prevalence of sexual dysfunction in women with skin diseases: a systematic review and meta-analysis

BACKGROUND

Skin diseases are a category of chronic conditions that often impact patients' appearance, potentially leading to psychological issues, including sexual dysfunction. The present study is an attempt to determine the global prevalence of female sexual dysfunction (FSD) in women with skin diseases.

METHODS

For this systematic review and meta-analysis, databases including PubMed, Web of Science, Scopus, Science Direct, Embase, and Google Scholar were systematically searched for relevant studies. All published research up to April 2024 imported into EndNote for further analysis. A random-effects model was applied for the analysis, and the I² statistic was used to assess study heterogeneity.

RESULTS

Analysis of 24 studies (45 datasets) indicated that the overall prevalence of FSD in women with skin diseases was estimated at 61.3% (95% CI: 53.9-68.2%). Additionally, subgroup analysis based on skin disease type revealed an FSD prevalence of 69.8% (95% CI: 56.7-80.2%) in women with vitiligo, 59.2% (95% CI: 49.1-68.5%) in those with psoriasis, and 56.5% (95% CI: 47.8-64.8%) in women with hidradenitis suppurativa.

CONCLUSION

There was a high prevalence of FSD in women with skin diseases. There is a need for policy makers and healthcare providers to prioritize the well-being of these patients.

Association between allergic diseases and mental health conditions: An umbrella review

BACKGROUND

The mental health conditions of allergic diseases have been investigated, but the consistency and magnitude of their effects are unclear. The aim of this umbrella review was to systematically evaluate the published evidence on allergic diseases and mental health conditions to establish a new hierarchy of evidence and identify gaps in this area of research.

METHODS

We systematically searched PubMed, Embase, Web of Science, and the Cochrane Database of Systematic Reviews from database inception to April 30, 2024. We included systematic reviews that conducted meta-analyses that examined the association of allergic diseases and mental health conditions. We calculated summary effect estimates (odds ratios), 95% confidence intervals, I2 statistics, 95% prediction intervals, small study effects, and excess significance biases. We used AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews 2) to appraise the methodologic quality of the included studies.

RESULTS

We identified 21 eligible articles, which yielded 37 associations (348,405,029 total population) of allergic diseases and mental health conditions. The credibility of evidence was convincing (class I) for asthma and risk of attention-deficit/hyperactivity disorder (odds ratio 1.34, 95% confidence interval 1.24-1.44); and highly suggestive (class II) for allergic rhinitis and risk of tic disorders (2.61, 1.90-3.57), allergic rhinitis and risk of sleep disorders (2.17, 1.87-2.53), food allergy and risk of autism spectrum disorder (2.79, 2.08-3.75), atopic dermatitis and risk of depression (1.60, 1.43-1.79), atopic dermatitis and risk of anxiety (1.62 1.42-1.85), atopic dermatitis and risk of attention-deficit/hyperactivity disorder (1.28, 1.18-1.40), atopic dermatitis and risk of suicidal ideation (1.44, 1.25-1.65), asthma and risk of depression (1.64, 1.50-1.78), asthma and risk of anxiety (1.95, 1.68-2.26), asthma and risk of tic disorders (1.90, 1.57-2.30), asthma and risk of suicidal ideation (1.52, 1.37-1.70), and asthma and risk of suicide attempts (1.60, 1.33-1.92).

CONCLUSIONS

Allergic diseases are associated with increased risk of a range of mental health conditions, with the most convincing evidence for asthma. However, these associations do not imply causality, and there is large heterogeneity in these associations, which requires high-quality primary studies to identify causality and strength of evidence.

Interactions between protein Z and lycopene: A win-win scenario for both security and stability

Malt protein Z (PZ), the main albumin in malt endosperm, exhibits trypsin inhibitory activity and has the ability to bind fat-soluble active molecules. However, its potential utilization as a food ingredient necessitates an evaluation of its allergenicity. Lycopene has many functional activities, such as antioxidant and treatment or alleviation of various diseases, but its tendency to degrade easily hinders its effective utilization. Therefore, this paper investigates the allergenicity of PZ and provides a win-win scenario that PZ interacts with lycopene. PZ interacts with lycopene through non-covalent interactions with a ratio of 4.07 ± 0.20, leading to the formation of homogenous particles with an increased absolute zeta potential, from -7.3 ± 0.2 to -20.0 ± 0.6. Unsurprisingly, the presence of lycopene alleviates the allergenicity of PZ by decreasing the IgE, mMcp-1 and vascular permeability, such as the plasma mMcp-1 decreased from 245.0 ± 5.2 ng/mL for the PZ group to 217.8 ± 4.1 ng/mL for the PZ-LYC group. To uncover the potential mechanism, the linear antigenic epitopes of PZ by ABCpred were predicted, which are almost the potential binding site of lycopene at PZ. On the other hand, PZ improved the storage stability of lycopene. The addition of PZ increased lycopene retention in solution from 14.9 ± 2.7 % to 65.5 ± 2.8 % over 10 days at room temperature with light exposure. These results provide foundations for PZ utilization concerning security, and give ways to protect bioactive molecules.

Prevalence of immunoglobulin E sensitization to various inhaled allergens among the residents of the Northern United Arab Emirates: Automated evaluation of a membrane-based test system

OBJECTIVES

To determine specific positive immunoglobulin E (IgE) antibodies to various inhaled allergens in residents of Ajman and the northern region of the United Arab Emirates (UAE) using an automated evaluation of a membrane-based test.

METHODS

A total of 104 patients' blood samples were received from various hospitals and clinics in Ajman and other northern Emirates regions at Thumbay Laboratory, Thumbay University Hospital, Ajman, UAE, to carry out inhalation allergy tests during the study period of 12 months (February 2023 until January 2024). Using the EUROLINE immunoblotting method, 20 different inhalation allergens-impregnated latex strips were used to carry out the allergy test on the patients' serum samples.

RESULTS

In total, 67 (64.4%) patients tested positive for various inhaled allergens. Approximately 59.7% (n=40) of the positive patients were commonly sensitized to the house dust mites Dermatophagoides farinae and Dermatophagoides pteronyssinus, cockroach, and Candida albicans. High to very high IgE antibody titers (17.5≤sIgE<50.0 and 50.0≤sIgE<100.0 kU/l) to the dust mites were detected in the patients' age groups 1-15 and 31-45 years, and 31.25% of them from the same age groups were polysensitized to ≥3 different allergens.

CONCLUSION

The prevalence of positive IgE to various allergens among men was higher than women. These findings highlight the prevalence of IgE sensitization to various inhaled allergens to emphasize more public awareness and implement preventive measures necessary for controlling inhalation allergy-related diseases.

Association between allergic diseases and hypertension: Co-occurrence pattern analysis

Background: The hypertension risk in the co-occurrence of allergic diseases remains largely unknown. Objective: We aimed to investigate the association between allergic diseases co-occurrence pattern and hypertension morbidity and mortality, and to evaluate additive interaction effects between allergic diseases. Methods: A nationally representative population from the U.S. National Health Interview Survey 2012 was enrolled. Hypertension and five specific allergic diseases, including asthma, allergic rhinitis (AR), food allergy (FA), eczema, and other allergy (OA), were determined. Hypertension mortality was identified until December 31, 2019. We evaluated additive interaction effects between two allergic diseases on hypertension risk: relative excess risk due to interaction (RERI) and attributable proportion of joint effect due to interaction (AP) (shown as percentages) were calculated. For modifiable lifestyle factors with significant heterogeneity in the subgroups, we examined the effect modification. Results: Totally, 34,392 participants were enrolled. Four co-occurrence patterns of two allergic diseases were associated with an increased risk of hypertension, including AR + FA (odds ratio [OR] 2.25 [95% confidence interval {CI}, 1.52-3.35]), eczema + OA (OR 1.94 [95% CI, 1.14-3.30]), AR + eczema (OR 1.76 [95% CI, 1.18-2.64]), asthma + AR (OR 1.67 [95% CI, 1.33-2.08]). Five co-occurrence patterns of three allergic diseases were associated with increased risk of hypertension. Additive interactions were seen in AR + FA (RERI, 0.65; AP, 29%), eczema + OA (RERI, 0.43; AP, 22%), AR + eczema (RERI, 0.21; AP, 12%), and asthma + AR (RERI, 0.05; AP, 3%). The significant association between asthma + FA and hypertension was only seen among participants with a body mass index (BMI) ≥ 30 kg/m² (p = 0.021). With a median follow-up of 7.5 years, one co-occurrence pattern of asthma + FA showed a significant increased risk of hypertension mortality (hazard ratio 4.32, 95% CI: 1.52-12.23), with an additive interaction was observed (RERI, 2.33; AP, 52%). Conclusion: We identified several allergic diseases co-occurrence patterns with a significantly increased risk of hypertension morbidity and mortality. Potential biologic additive effect among allergic diseases and effect modification of BMI was found. Precision primary prevention of hypertension is necessary for patients with co-occurring allergic diseases.

Bioinformatics and Network Pharmacology Identify the Therapeutic Role of Guominkang in Allergic Asthma by Inhibiting PI3K/Akt Signaling

Background

As a classical regulating formula, Guominkang (GMK) has been extensively employed in clinical practice to treat the allergic asthma (AA) and alleviate allergy symptoms, however, the underlying mechanism remains elusive. The aim of this study was to explored the mechanism of action through which GMK combats AA.

Methods

Potential target genes for the compounds were identified from the database and subjected to functional enrichment analysis. Subsequently, a protein-protein interaction (PPI) network was constructed in order to screen the core target and confirmed by molecular docking. An asthma model was further developed in mice and airway hyperresponsiveness and lung pathological changes were observed following drug administration. The expression of PI3K and AKT proteins in lung tissues was then detected by Western blotting. Subsequently, the GSE104468 data were normalised and visualised using the R language, compared to the PI3K-Akt pathway gene set to identify overlapping genes, constructed a PPI network and analysed correlations between genes.

Results

267 compounds and 475 disease-relevant GMK targets have been obtained, primarily in the areas of chemokine binding, drug binding, and PI3K-Akt pathway modulation. Molecular docking simulations revealed that predicted targets (PI3K, TNF, IL6, AKT1, SRC, TP53, and STAT3) could be closely bonded with component of GMK. According to in vivo experiments, GMK could reduce mucus obstruction and airway inflammation (P < 0.05), decrease airway hyperresponsiveness (P < 0.05), and inhibited the PI3K-Akt pathway (P < 0.05). After normalising the genes in the dataset between AA and healthy individuals, GO showed that 388 DEGs were associated with PI3K/AKT signaling pathway. The PPI network showed that the overlapping gene were located in the centre of asthma-associated network and that exhibited a correlation with the PI3K-Akt signaling pathway.

Conclusion

Based on our findings, GMK potentially acts via the PI3K/Akt pathway and alleviates allergic symptoms in AA.

Advances in research on gut microbiota and allergic diseases in children

Epidemiological studies indicate a rising prevalence of allergic diseases, now recognized as a major global public health concern. In children, the progression of these diseases often follows the "atopic march," beginning with eczema, followed by food allergies, allergic rhinitis, and asthma. Recent research has linked gut microbiota dysbiosis to the development of allergic diseases in children. The gut microbiota, a crucial component of human health, plays a vital role in maintaining overall well-being, highlighting its potential in preventing and modifying the course of allergic diseases. This review examines the relationship between childhood allergic diseases and gut microbiota, drawing on the latest evidence. We first elaborated the concepts of allergic diseases and gut microbiota, followed by a discussion of the developmental trajectory of the gut microbiota in healthy children. This review further explored the richness, diversity, and composition of the gut microbiota, as well as specific microbial taxa associated with allergic disease. Lastly, we discussed the current status and future potential of probiotic interventions in managing pediatric allergic diseases.

Assessment of the bidirectional causal association between Helicobacter pylori infection and allergic diseases by mendelian randomization analysis

This article employed a bidirectional Mendelian randomization (MR) analysis to deduce the causal relationship between H. pylori infection (Seven H. pylori antibodies: CagA, Catalase, GroEL, IgG, OMP, UREA, and VacA) and allergic diseases. This study primarily employed the Inverse-Variance Weighted (IVW)method, supplemented by MR-Egger regression and the Weighted median (WM) method approach, to comprehensively assess the causal relationship between exposure and outcome. Sensitivity analysis, including Cochran's Q test, MR-Egger regression intercept, MR-PRESSO test, and leave-one-out analysis, verified the reliability of the results. In the forward MR analysis, the IVW analysis outcomes showed the causal relationship existed between the allergic urticaria (AU) and Catalase antibody, allergic asthma (AA) and allergic rhinitis (AR) with OMP antibody, and allergic conjunctivitis (AC) and VacA antibody; in the reverse MR analysis, the results of the IVW analysis revealed that CagA antibody was positively associated with AU. Sensitivity analysis indicated that the causal relationship was robust. Higher levels of Catalase antibody may potentially increase the risk of AU development; increased OMP antibody levels might be associated with a higher risk for AA, yet could potentially be a protective factor against AR; greater VacA antibody levels might possibly decrease the incidence of AC; individuals with AU might have a higher likelihood of exhibiting elevated CagA antibody levels. It is suggested that H. pylori infection could potentially influence the onset and progression of allergic diseases via the "gut-skin", "gut-lung", "gut-nose", and "gut-eye" axis; moreover, skin diseases may potentially impact the gut microbiota imbalance through the "skin-gut" axis.

Simultaneous detection of multiple food allergens using high signal-to-background SERS probes

Avoiding exposure to food allergens remains the most reliable way to protect allergic individuals. Therefore, it is essential to develop selective, sensitive, and rapid methods for detecting food allergens. Herein, we introduce a novel SERS-based sandwich immunoassay that utilizes three distinct types of SERS detection probes: Ag@CA NPs, AgAu@PB NPs, and Ag@MB NPs, along with magnetic capture probes, to simultaneously detect almond, lactoglobulin, and gliadin allergens. These SERS probes generate unique Raman peaks at 1987 cm-1, 2151 cm-1, and 2223 cm-1 in the Raman-silent region (1800-2800 cm-1), effectively avoiding interference from the Raman-fingerprint region (400-1800 cm-1) of potential food matrix substrates. This design ensures high signal-to-background ratios and detection accuracy, achieving limits of detection (LODs) of 7.4 pg/mL for almonds, 66 pg/mL for lactoglobulin, and 0.36 pg/mL for gliadin, with corresponding recoveries ranging from 83.7 % to 118.8 %, 98.9 % to 112.2 %, and 91.9 % to 109.5 %, respectively, demonstrating satisfactory analytical performance.

Jieyu Guben decoction alleviates combined allergic rhinitis and asthma syndrome by balancing Th17/Treg expression and restoring PPARD

BACKGROUND

This study was designed to assess the efficacy of the Jieyu Guben Decoction (JYGBD), a novel formula that has not been reported, in treating rats with combined allergic rhinitis and asthma syndrome (CARAS) and the mechanism.

METHODS

CARAS rats were induced by ovalbumin (OVA) sensitization and treated with JYGBD to analyze the allergic symptoms and the production of OVA-specific antibodies. Hematoxylin-eosin staining, periodic acid-Schiff staining, Toluidine blue staining, Giemsa staining, and MASSON staining were applied to examine the impact of JYGBD treatment on the histopathological damage of nasal mucosa and lungs. Targets of JYGBD were predicted, and the impact of JYGBD on T helper 17 (Th17) inflammation was analyzed. Peroxisome proliferator-activated receptor delta (PPARD) was artificially silenced to assess the effects of PPARD deficiency on Th17 inflammation. The regulation of PPARD on methyl-CpG-binding protein 2 (MECP2) was analyzed as well.

RESULTS

JYGBD alleviated allergic conditions in rats and inhibited inflammatory cell infiltration and damage in nasal mucosa and lung tissues. The molecular targets of JYGBD were related to Th17 differentiation, and JYGBD alleviated Th17 inflammation in CARAS rats and inhibited Th17 differentiation in vitro. PPARD-mediated transcriptional inhibition of MECP2 blocked signal transducer and activator of transcription 3 (STAT3) activation to alleviate Th17/regulatory T cells (Treg) imbalance. MECP2 deletion and inhibition of STAT3 signaling alleviated PPARD knockdown-induced Th17/Treg imbalance and attenuated CARAS in rats.

CONCLUSION

JYGBD induces PPARD-mediated transcriptional inhibition of MECP2 to block STAT3 signaling pathway activation, which restores Th17/Treg homeostasis to alleviate CARAS.

The Etiology of IgE-Mediated Food Allergy: Potential Therapeutics and Challenges

Immunoglobulin E (IgE)-mediated food allergy has been dramatically increasing in incidence over the last few decades. The combinations of both genetic and environmental factors that affect the microbiome and immune system have demonstrated significant roles in its pathogenesis. The morbidity, and at times mortality, that occurs as the result of this specific, reproducible, but impaired immune response is due to the nature of the shift from a regulatory T (Treg) cellular response to a T helper 2 (Th2) cellular response. This imbalance caused by food allergens results in an interleukin (IL)-4 and IL-13 dominant environment that drives B cell activation and differentiation into IgE-producing plasma cells. The resulting symptoms can range from mild to more severe anaphylaxis, and even death. Current therapeutic strategies involve avoidance and broad symptom management upon accidental exposure; however, no definitive cure exists. This narrative review highlights how the elucidation of the pathogenesis of IgE-mediated food allergy resulted in the development of therapeutics that are more specific to these individual receptors and molecules which have been relatively successful in mitigating this potentially life-threatening allergic response. However, potential adverse effects and re-sensitization following the conclusion of treatment has urged the need for improved therapeutic methods. Therefore, given the understanding of their mechanism of action and the overlap with the mechanism of IgE-mediated food allergies, probiotics and small molecule natural compounds may provide novel therapeutic and preventative strategies. This is compelling, as they have demonstrated success in clinical trials and may provide hope to improve quality of life in allergy patients.

The Therapeutic Potential of Kiwi Extract as a Source of Cysteine Protease Inhibitors on DNCB-Induced Atopic Dermatitis in Mice and Human Keratinocyte HaCaT Cells

The discovery of effective cysteine protease inhibitors with crude protein kiwi extracts (CPKEs) has created novel challenges and prospects for pharmaceutical development. Despite extensive research on CPKEs, limited research has been conducted on treating atopic dermatitis (AD). Therefore, the objective of this work was to investigate the anti-inflammatory effects of CPKEs on TNF-α activation in a HaCaT cell model and in a DNCB (1-chloro-2, 4-dinitrochlorobenzene)-induced atopic dermatitis animal model. The molecular weight of the CPKE was determined using SDS-PAGE under non-reducing (17 kDa and 22 kDa) and reducing conditions (25 kDa, 22 kDa, and 15 kDa), whereas gelatin zymography was performed to examine the CPKE's inhibitory impact on cysteine protease (actinidin and papain) activity. Moreover, the CPKE remains stable at 60 °C, with pH levels varying from 4 to 11, as determined by the azocasein assay. CPKE treatment decreased the phosphorylation of mitogen-activated protein kinase (MAPK) and Akt, along with the activation of nuclear factor-kappa B (NF-κB)-p65 in tumor necrosis factor-α (TNF-α)-stimulated HaCaT cells. Five-week-old BALB/c mice were treated with DNCB to act as an AD-like animal model. The topical application of CPKE to DNCB-treated mice for three weeks substantially decreased clinical dermatitis severity and epidermal thickness and reduced eosinophil infiltration and mast cells into ear and skin tissues. These findings imply that CPKE derived from kiwifruit might be a promising therapy option for inflammatory skin diseases such as AD.

Advances in Biologic Therapies for Allergic Diseases: Current Trends, Emerging Agents, and Future Perspectives

Biologic therapies have revolutionized the treatment of severe allergic diseases, including asthma, atopic dermatitis (AD), chronic spontaneous urticaria (CSU), chronic rhinosinusitis with nasal polyps (CRSwNP), eosinophilic gastrointestinal diseases (EGIDs), and allergic rhinitis (AR). These molecularly targeted agents provide significant benefits for patients unresponsive to conventional treatments by addressing underlying immune mechanisms, particularly type 2 inflammation driven by cytokines such as IL-4, IL-5, and IL-13. Recent advancements include biologics targeting alarmins like thymic stromal lymphopoietin (TSLP) and IL-33, which may address both type 2 and non-type 2 inflammation, broadening their therapeutic scope. Despite their effectiveness, biologics remain expensive, posing socioeconomic challenges, and there are concerns regarding long-term safety and inter-individual variability in responses. Promising innovations such as bispecific antibodies and ultra-long-acting agents are under investigation, alongside digital health tools like remote biomarker monitoring and AI-driven decision support systems, which aim to enhance personalized care. However, disparities in access, particularly for underserved populations, underscore the need for policy reforms and affordable biosimilars. This review synthesizes recent findings and emerging trends, highlighting the evolving role of biologics in transforming allergic disease management and offering insights into future research directions.

N6-methyladenosine in inflammatory diseases: Important actors and regulatory targets

N6-methyladenosine (m6A) is one of the most prevalent epigenetic modifications in eukaryotic cells. It regulates RNA function and stability by modifying RNA methylation through writers, erasers, and readers. As a result, m6A plays a critical role in a wide range of biological processes. Inflammation is a common and fundamental pathological process. Numerous studies have investigated the role of m6A modifications in inflammatory diseases. This review highlights the mechanisms by which m6A contributes to inflammation, focusing on pathogen-induced infectious diseases, autoimmune disorders, allergic conditions, and metabolic disorder-related inflammatory diseases.

Narrative Review of Genetic and Immunological Mechanisms Involved in the Pathogenesis of Kimura's Disease: New Therapeutic Targets

Kimura's disease (KD) is a rare, chronic inflammatory disorder that predominantly affects young men of East Asian descent. It is characterized by painless solid masses primarily localized to the deep subcutaneous tissues of the head and neck, eosinophilia, and elevated serum immunoglobulin E (IgE). While the exact cause remains unclear, the pathogenesis is thought to involve dysregulated immune responses, particularly those mediated by T-helper cells 2 (Th2), eosinophils, and IgE production. Advances in molecular biology have suggested that genetic factors play a significant role in the development and progression of this chronic inflammatory condition. Recent studies have implicated several genes and immune pathways in its development, and understanding these genetic components may provide insights into better diagnostic tools and therapeutic strategies for KD. In this regard, biological therapies, by targeting the immune mechanisms underlying KD, have been used to treat this challenging condition with promising results, contributing to a better understanding of the pathogenesis of this rare disorder. The aim of this study was to review the literature concerning the genetic factors and immune mechanisms that contribute to the pathogenesis of KD, with a special focus on the role of biological therapies.

Immunomodulatory functions of algal bioactive compounds

Algae, a crucial constituent of marine systems, serve an indispensable function as primary producers, supporting the marine food web, contributing to carbon sequestration, and providing habitats that sustain biodiversity. This review focuses on the bioactive constituents of algae, including polysaccharides, polyphenols, polypeptides, and terpenoid compounds, and discusses their potential applications in treating immune-related diseases, as well as the mechanisms through which they modulate immune responses. The bioactive substances derived from algae, including polyphenols, bioactive peptides, terpenes, polysaccharides and other compounds, may play a preventive role by modulating allergic responses and reducing the incidence of inflammation and cancer.

EUFOREA meeting on defining disease states in allergic rhinitis: towards a unified language in AR

Allergic rhinitis (AR), the most prevalent immunological disease, affects approximately 400 million individuals globally and can significantly impact quality of life (QoL). Despite nearly 25 years of guidelines, AR remains largely under- diagnosed, suboptimally treated and poorly controlled. In the light of new knowledge and treatment options, there is a necessity to update or revise fundamental AR definitions to facilitate communication across diverse specialties engaged in its treatment and to improve patient care. The European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) convened a meeting of experts and patient representatives to deliberate the optimal methodology for measuring AR treatment responses and establishing novel treatment goals. This paper presents a consensus on revised AR definitions, including control, severe allergic rhinoconjunctivitis (SARC), refractory severe allergic rhinoconjunctivitis (R-SARC), remission, resolution, improvement, exacerbation, treatable traits (TTs), treat to target, relapse, progression, disease modification, and prevention.

Aspalathin, a Primary Rooibos Flavonoid, Alleviates Mast Cell-Mediated Allergic Inflammation by the Inhibition of FcεRI Signaling Pathway

Mast cells are primary cells initiating allergic inflammation by the release of various allergic mediators, such as histamine and pro-inflammatory cytokines. Aspalathin (ASP) is the predominant flavonoid found exclusively in rooibos, an herb that has been traditionally used in allergy relief therapy. In the present study, we investigated the beneficial effects of ASP on mast cell-mediated allergic inflammation. For in vivo study, two well-known mast cell-mediated local and systemic allergic inflammation mouse models were used: passive cutaneous anaphylaxis (PCA) and active systemic anaphylaxis mouse models (ASA). Oral administration of ASP dose-dependently suppressed immunoglobulin (Ig)E-mediated PCA responses evidenced by Evans blue extravasation, ear thickening, and mast cell degranulation. ASP also significantly mitigated ovalbumin-induced ASA responses, including hypothermia, histamine secretion, and the production of IgE and interleukin-4. Notably, ASP was more effective in suppressing allergic inflammation than nothofagin, another prominent flavonoid known as an anti-allergic component of rooibos. The regulatory mechanism of mast cell activation by ASP was clarified using mast cell line and primary cultured mast cells (RBL-2H3 and mouse bone marrow-derived mast cells). ASP reduced IgE-stimulated mast cells degranulation and intracellular calcium influx by the inhibition of FcεRI signaling pathway (Lyn, Fyn, and Syk). Moreover, ASP reduced pro-inflammatory cytokine expressions by inhibiting two major transcription factors, nuclear factor of activated T cells and nuclear factor-κB. Collectively, we proposed that ASP could be a potential therapeutic candidate for the treatment of mast cell-mediated allergic inflammatory diseases.

The Impact of Climate, Aeroallergens, Pollution, and Altitude on Exercise-Induced Bronchoconstriction

Exercise-induced bronchoconstriction (EIB) with or without underlying asthma is a condition with complex pathophysiology, where many factors play a role in its development and clinical presentation. EIB can be impacted by various environmental factors including climate, environmental allergens, air pollution, and altitude. Although it might be hard to escape one's environment, patients should nevertheless be counseled on how the environment could impact their symptoms. Patient education regarding environmental factors could help overcome impediments to exercise and improve performance.

Effects of topical isoxsuprine ointment on imiquimod-induced psoriasiform skin inflammation in mice

This study assesses the potential positive impact of a 0.05% isoxsuprine ointment on psoriasiform skin inflammation generated by imiquimod in mouse models. Thirty-two male albino mice were allocated into four groups: the control group (which received topical emollients twice daily for 16 days), the induction group (which received imiquimod cream (5%) for 8 days, twice daily followed by petrolatum gel (15%) for another 8 days), and the other two groups, which received imiquimod cream (5%) for 8 days followed by either clobetasol ointment (0.05%) or isoxsuprine ointment (0.05%) twice daily for an additional 8 days. At the end of the experiment, mice were sacrificed by ethical standards, and levels of TNF-α, IL-6, IL-17A, IL-23, and VEGF were measured; PASI and Backer's score were examined, in addition to the histopathology of skin tissue. Each clobetasol and isoxsuprine group displayed a significant reduction in tissue homogenate levels of TNF-α, IL-6, IL-17A, IL-23, and VEGF, besides increments in IL-10 compared to the induction group. Some markers (IL-17A, IL23, and VEGF) showed no significant difference between clobetasol and the isoxsuprine group. In contrast, the other markers (TNF-α, IL6, and IL10) showed significant differences between clobetasol and isoxsuprine groups. Isoxsuprine ointment showed comparable efficacy to clobetasol ointment in treating imiquimod-induced psoriasiform skin inflammation in mice models, probably due to its possible effect of anti-inflammatory and immunomodulatory activities.

Promising role of peroxisome proliferator-activated receptors in respiratory disorders, a review

Several studies indicate various pharmacological and therapeutic effects of peroxisome proliferator-activated receptors (PPARs) in different disorders. The current review describes the influences of PPARs on respiratory, allergic, and immunologic diseases. Various databases, including PubMed, Science Direct, and Scopus, were searched regarding the effect of PPARs on respiratory and allergic disorders from 1990 to 2024. The effects of PPARs stimulation on experimental animal models of respiratory diseases such as asthma, chronic obstructive pulmonary diseases (COPD), pulmonary fibrosis (PF), and lung infections were shown. Therapeutic potential mediated through PPARs has also been demonstrated in lung cancer, lung infections, and allergic and immunologic disorders. However, few clinical studies showed PPARs mediated therapeutic effects on asthma and COPD. The PPARs-mediated effects on various respiratory disorders were shown through antioxidant, immunomodulatory, anti-inflammatory, and other mechanisms. Therefore, this review indicated possible remedy effects mediated by these receptors in treating respiratory, allergic, and immunologic diseases. Moreover, this mechanistic review paves the way for researchers to consider further experimental and clinical studies.

Sesamin Alleviates Allergen-Induced Diarrhea by Restoring Gut Microbiota Composition and Intestinal Barrier Function

Food allergens are the key triggers of allergic diarrhea, causing damage to the immune-rich ileum. This weakens the mucosal barrier and tight junctions, increases intestinal permeability, and exacerbates allergen exposure, thereby worsening the condition. Sesamin, a natural lignan isolated from sesame seed, has shown potential in regulating immune responses, but its effects on intestinal health remain unclear. In this study, we constructed an ovalbumin (OVA)-induced allergic diarrhea mouse model, which demonstrated increased mast cell degranulation, reduced tight junction integrity, and impaired intestinal barrier function. Pro-inflammatory cytokines were significantly increased in the ileum, along with unbalanced cluster of differentiation 4 (CD4+) T-cell immunity, altered gut microbiota composition, and disrupted bacterial metabolism. Sesamin treatment significantly alleviated intestinal damage by modulating gut microbiota abundance, enhancing short-chain fatty acid (SCFA) production, and increasing SCFA receptor expression. This study suggests that sesamin may be a promising therapeutic candidate for allergic diarrhea and intestinal injury.

Evaluation of the frequency of restless legs syndrome in children diagnosed with allergic diseases

OBJECTIVE

We aimed to determine the frequency of restless legs syndrome (RLS) in children with allergic diseases.

METHODS

The age, gender, height, weight, BMI z-scores, and laboratory values of children diagnosed with asthma, allergic rhinitis, atopic dermatitis, and chronic urticaria, as well as a healthy control group, were examined. RLS was assessed using a questionnaire based on the diagnostic criteria of the International Restless Legs Syndrome Study Group. Neurological examination findings, questionnaire results, and RLS severity scores were evaluated by a pediatric neurology specialist.

RESULTS

The study evaluated data from 270 children diagnosed with allergic diseases and 150 healthy controls. Both groups were statistically similar in terms of age, gender, weight, height, and BMI z-scores (p > 0.05). The frequency of RLS was reported as 13.3% in children with allergic airway disease, 15.5% in those with allergic skin disease, and 6.7% in the control group. The frequency of RLS in children with allergic airway disease and allergic skin disease was significantly higher compared to the control group (p = 0.041 and p = 0.022, respectively). The frequency of mild RLS in children with allergic diseases and the control group was 43.6% (n = 17) and 50% (n = 5), respectively (p = 0.737). The rate of females with RLS was significantly higher than those without RLS (69.2% vs. 30.8%) (p = 0.045). According to logistic regression analysis, individuals with allergic diseases were 2.307 (95.0% CI of OR 1.087 to 4.897) times more likely to develop RLS compared to those without allergic diseases (p = 0.029).

CONCLUSION

The frequency of RLS is higher in children with allergic diseases. Early diagnosis of RLS may allow for a holistic management of quality-of-life-reducing problems, such as sleep disorders, that may be associated with both conditions.

Research team diversity impacts scientific output in allergy and immunology programs

Background

This study examined the relationship between the disciplinary diversity of research teams and research output (RO) in allergy and immunology programs funded by the National Institutes of Health (NIH) in the United States, Medical Research Council (MRC) in the United Kingdom, and Japan Society for the Promotion of Science (JSPS).

Methods

Using a dataset containing 1243, 3645, and 1468 articles funded by the NIH, MRC, and JSPS, respectively, we analyzed the correlation between disciplinary diversity and RO in allergy and immunology programs that received grants from 2017 to 2021. Diversity was measured using All Science Journal Classification codes counts, Shannon-Wiener index, and newly developed Omnidisciplinary index (o-index). The impact of diversity on RO was evaluated Normalized Paper Count (reflecting research quantity), Normalized Top 1% Paper Count (reflecting research excellence), and Normalized Top 10% Paper Count (reflecting research substantiality).

Results

There were no significant differences in diversity between the funding agencies, indicating a marginal relationship between team composition and RO (p = 0.641 for Shannon-Winner index). RO was positively correlated with team diversity in NIH- and MRC-funded programs and positively correlated with the degree of specialization in JSPS-funded programs.

Conclusions

These results underscore the complexity of the relationship between research team diversity and RO and the influence of contextual factors such as country-specific characteristics and grant program objectives. Specifically, the analysis of JSPS-funded groups suggests that the degree of specialization has a greater impact on RO than disciplinary diversity. This study contributes to ongoing efforts to optimize team composition to improve RO in allergy and immunology programs.

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.

The potential role of n-3 fatty acids and their lipid mediators on asthmatic airway inflammation

Asthma, is a common, significant and diverse condition marked by persistent airway inflammation, with a major impact on human health worldwide. The predisposing factors for asthma are complex and widespread. The beneficial effects of omega-3 (n-3) polyunsaturated fatty acids (PUFAs) in asthma have increasingly attracted attention recently. In asthma therapy, n-3 PUFAs may reduce asthma risk by controlling on levels of inflammatory cytokines and regulating recruitment of inflammatory cells in asthma. The specialized pro-resolving mediators (SPMs) derived from n-3 PUFAs, including the E- and D-series resolvins, protectins, and maresins, were discovered in inflammatory exudates and their biosynthesis by lipoxygenase mediated pathways elucidated., SPMs alleviated T-helper (Th)1/Th17 and type 2 cytokine immune imbalance, and regulated macrophage polarization and recruitment of inflammatory cells in asthma via specific receptors such as formyl peptide receptor 2 (ALX/FPR2) and G protein-coupled receptor 32. In conclusion, the further study of n-3 PUFAs and their derived SPMs may lead to novel anti-inflammatory asthma treatments.

Enoximone alleviates atopic dermatitis-like skin inflammation via inhibition of type 2 T helper cell development

Atopic dermatitis (AD) is an inflammatory skin disease that affects approximately 15-20 % of the children and 1-3 % of the adults worldwide. Corticosteroids and calcineurin inhibitors are used in AD therapy; however, they cause various side effects. Current studies focus on novel therapeutic targets such as phosphodiesterases (PDEs) to mitigate AD. However, the relationship between PDE3 inhibitors and AD has not yet been reported. This study aimed to investigate the therapeutic effects and pharmaceutical mechanisms of enoximone (Enox), a PDE3 inhibitor. Mice were stimulated with 2,4-dinitrochlorobenzene (DNCB) to induce AD-like skin inflammation and were topically treated with Enox for 2 weeks. Treatment with Enox reduced the dermatitis score, skin water loss, IgE production, and expression of cytokines and chemokines that were elevated by DNCB. Histologically, Enox treatment reduced the skin thickness and the infiltration of various inflammatory cells, including macrophages, mast cells, eosinophils, and type 2 T helper (Th2) cells. HuT78, a human T cell line, was used to investigate the differentiation of T cells into Th2 cells. Enox treatment decreased the expression of Th2 cytokines and GATA3, a Th2 cell marker in HuT78, and suppressed signaling pathways that play a crucial role in Th2 cell differentiation. Collectively, the results demonstrate that Enox alleviates AD-like skin inflammation by inhibiting T-cell development. Thus, Enox may be a therapeutic candidate for the treatment of AD.

Terpenoids, a Rising Star in Bioactive Constituents for Alleviating Food Allergy: A Review about the Potential Mechanism, Preparation, and Application

Food allergies affect approximately 2.5% of the global population, with a notable increase in prevalence observed each year. Terpenoids, a class of natural bioactive constituents, have been widely utilized in the management of immune- and inflammation-related disorders, and their potential in alleviating food allergies is increasingly being recognized. This article summarizes various terpenoids derived from plant, fungal, and marine sources. Among them, triterpenoids, such as oleanolic acid, ursolic acid, and lupeol, possess the highest proportion and bioactivity in alleviating food allergy. Additionally, the mechanisms by which terpenoids may mitigate allergic diseases were categorically outlined, focusing on their roles in epithelial mucosal barrier function, immunomodulatory effects during the sensitization phase, inhibition of effector cells, oxidative stress, and regulation of microbial homeostasis. Finally, the advantages and limitations of natural extraction and artificial synthesis methods were compared, and the application of terpenoids in the food industry were also discussed. This article serves as a useful reference for the development of methods or functional foods based on terpenoids, which could represent a promising avenue for alleviating food allergy.

Atopic dermatitis: pathogenesis and therapeutic intervention

The skin serves as the first protective barrier for nonspecific immunity and encompasses a vast network of skin-associated immune cells. Atopic dermatitis (AD) is a prevalent inflammatory skin disease that affects individuals of all ages and races, with a complex pathogenesis intricately linked to genetic, environmental factors, skin barrier dysfunction as well as immune dysfunction. Individuals diagnosed with AD frequently exhibit genetic predispositions, characterized by mutations that impact the structural integrity of the skin barrier. This barrier dysfunction leads to the release of alarmins, activating the type 2 immune pathway and recruiting various immune cells to the skin, where they coordinate cutaneous immune responses. In this review, we summarize experimental models of AD and provide an overview of its pathogenesis and the therapeutic interventions. We focus on elucidating the intricate interplay between the immune system of the skin and the complex regulatory mechanisms, as well as commonly used treatments for AD, aiming to systematically understand the cellular and molecular crosstalk in AD-affected skin. Our overarching objective is to provide novel insights and inform potential clinical interventions to reduce the incidence and impact of AD.

Dissecting the pathogenic effects of smoking in blood DNA methylation on allergic diseases

Background

Allergic diseases, such as asthma and allergic rhinitis, present significant health challenges globally. Elucidating the genetic and epigenetic foundations is crucial for developing effective interventions.

Methods

We performed two-sample Mendelian Randomization (MR) analyses to investigate the associations between smoking behaviors and various allergic diseases, leveraging data from the FinnGen database. Additionally, we examined the relationships of DNA methylation (CpG sites) with allergic diseases, employing mQTLs as epigenetic proxies. Furthermore, we conducted reverse MR analyses on CpG sites that exhibited cross-allergic disease effects.

Results

In our genomic MR analysis, smoking behaviors such as smoking initiation and the number of cigarettes smoked per day were identified to be causally associated with an increased risk of asthma. Additionally, there was suggestive evidence linking smoking initiation to atopic contact dermatitis. Our epigenetic MR analysis found that methylation changes at 46 CpG sites, assessed via mQTLs, were significantly associated with asthma risk. Notably, cg17272563 (PRRT1), cg03689048 (BAT3), cg20069688 (STK19), and cg20513976 (LIME1) were identified with cross-allergic effects. Crucially, reverse MR analysis substantiated these associations.

Conclusions

Our study has highlighted the associations between smoking behaviors and allergic diseases in the genetic and epigenetic landscape, notably asthma. We identified several DNA methylation-related CpG sites, such as cg03689048 (BAT3), cg17272563 (PRRT1), and cg20069688 (STK19), which demonstrate cross-allergic potential and reverse causal relationships.

Bifidobacterium breve DSM 32583 and Limosilactobacillus fermentum CECT5716 postbiotics attenuate S. aureus and IL-33-induced Th2 responses

Over the past decades, the prevalence of allergic diseases noticeably increased in industrialized countries. The Th2 immune response plays a central role in these pathologies and its modulation using pro-/postbiotics constitutes a promising approach to prevent or alleviate disease symptoms. The aim of this in vitro study, was to investigate the ability of human milk-derived Bifidobacterium breve DSM 32583 (Bb) and Limosilactobacillus fermentum CECT5716 (Lf), to modulate the Th2 induced responses. To this end, Th2 cells were generated by co-culturing of human naïve Th cells with monocyte-derived dendritic cells (moDCs) either stimulated with Staphylococcus aureus or IL-33. The immunomodulatory effects of pro-/postbiotic preparations of Bb and Lf on moDCs and Th2 cells were evaluated in terms of maturation markers expression and cytokines production. Remarkably, the tested strains induced the anti-inflammatory cytokine IL-10 in moDCs, in a strain-, dose- and viability-dependent manner with no significant upregulation of IL-12p70 nor CD83, CD86 or HLA-DR. Interestingly, Bb and Lf postbiotics were able to dampen the Th2/Th1 response induced upon S. aureus- or IL-33 stimulation. They were also able to synergistically induce IL-10 in moDCs and T cells, upon co-stimulation with LPS. Finally, we observed that live probiotics triggered a mild Th1 response that was attenuated in the presence of galacto-oligosaccharides. Altogether, Bb and Lf pro-/postbiotics exhibited remarkable immune regulatory effects on both moDCs and Th2 cells. Therefore, further in vivo studies should be considered to validate these findings and assess their ability to prevent allergy or alleviate its symptoms in affected patients.

Neuropeptides or their receptors in pathogenesis of lung diseases and therapeutic potentials

There are complex interactions between the immune system and the nervous system in the lung. The nervous system perceives environmental stimuli and transmits these signals to immune cells via neurotransmitters, which is essential for effective immunity and environmental balance. Neuropeptides are important neurotransmitters in the lung, where they regulate immune responses through direct and indirect mechanisms, affecting the occurrence and development of lung diseases. In this review, we emphasize the role of neuropeptides in the pathogeneis of lung diseases and their potential therapeutic value for lung diseases.

Green carbon dots derived from Zingiberis Rhizoma Carbonisatum alleviate ovalbumin-induced allergic rhinitis

Background

Allergic rhinitis (AR) affects up to 40% of the population, leading to significant healthcare expenditures. Current mainstream treatments, while effective, can lead to side effects and do not address the underlying immunological imbalances. Zingiberis Rhizoma Carbonisatum (ZRC), the partially charred product of Zingiberis Rhizoma (ZR), has been widely used clinically in China since ancient times to treat respiratory disorders.

Methods

Inspired by the similarity between high-temperature pyrolysis and carbonization processing of herbal medicine, ZRC derived CDs (ZRC-CDs) were extracted and purified through several procedures. Then, the physicochemical characteristics of CDs were delineated through a suite of characterization methods. Moreover, our investigation zeroed in on elucidating the ameliorative impacts of CDs on ovalbumin-induced rat models alongside their underlying mechanisms.

Results

ZRC-CDs with particle sizes ranging from 1.0 to 3.5 nm and rich surface functional groups. Additionally, we observed that ZRC-CDs significantly attenuated nasal symptoms and pathological damage in ovalbumin-induced AR rats, and modulated lipid metabolism and type 2 inflammatory responses. They also inhibit PI3K/AKT and JAK/STAT pathways, which are associated with metabolism and inflammation. Importantly, ZRC-CDs demonstrated high biocompatibility, underscoring their potential as a novel therapeutic agent.

Conclusion

ZRC-CDs offer a promising alternative for AR treatment and could help facilitate broader clinical use of the ZRC. In addition, the exploration of the inherent bioactivity of CDs can help to broaden their biological applications.

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.

Household fuel use, smoking and prevalence of self-reported allergic rhinitis in university students in Palestine: a cross-sectional study

Purpose

In Palestine, few studies investigated the prevalence of allergies and the factors associated with their occurrence. An online survey was conducted on health complex University students in Jerusalem to determine the prevalence of allergy rhinitis (AR) and its relationship with indoor environmental exposures.

Methods

This study employed a modified online Google form of the Global Asthma Network's Adult Questionnaire. The data were reported as frequency and percentage. The chi-square test of independence was performed to investigate the association between AR diagnosis and other factors. Multivariable models were used to identify the independent risk factors for AR after adjusting for potential confounders.

Results

Data was collected from a total of 819 participants. The mean age of the participants was 20 ± 2 years and 78.1% (n = 640) were females. The AR diagnostic rate was 10.3%. In addition, having asthma and eczema were found to be substantially associated with AR. Additionally, a family history of AR and other allergens were major predictors of AR. The findings revealed that utilizing animal dung for heating increased the likelihood of AR fourfold (AOR = 4.870, p-value = 0.004), whereas e-cigarette vaping increased the possibility of AR by 2.5 times. However, using natural gas for cooking was not significantly associated with AR, and participant age was only slightly associated with AR diagnosis.

Conclusions

Our study found that the AR prevalence rate is low when compared to the same population in other countries. Genetics, biomass fuel consumption, and e-smoking are all significant risk factors for AR in Palestine. An awareness campaign must be developed to educate university students and the general public about the risks of smoking, indoor air pollution, respiratory disorders, and AR. Longitudinal research is required to discover whether these associations are only transient.

[Efficacy of biologics for severe asthma on allergic comorbidities]

Identification of therapeutic targets other than asthma can guide the choice of biologics in cases of severe asthma. Some of the allergic diseases (atopic dermatitis, food allergies, allergic rhinoconjunctivitis) that may be associated with asthma can be treated with biologics. In this review, we aim to assess the effectiveness of these biologic therapies on the allergic comorbidities of asthma. In the treatment of atopic dermatitis, only Dupilumab, an anti-IL4Rα, has proven its effectiveness and has received reimbursement authorization for this indication. In patients presenting with allergic rhinoconjunctivitis, Omalizumab has shown effectiveness, but has not been approved for this indication. Data from post-hoc analyses of studies on severe asthma likewise suggest the effectiveness of Dupilumab regarding allergic rhinitis. While these two biologic therapies have shown positive signals, inducing oral food tolerance, the relevant data are not robust. Biologic therapies targeting IL-5 or its receptor (Mepolizumab, Benralizumab) have seldom been evaluated in allergic comorbidities, excepting atopic dermatitis, for which their effectiveness has not been proven. Lastly, there are interesting data on the combination of biologic therapy and allergen immunotherapy in cases of allergic rhinitis and food allergies, but they need to be confirmed by randomized studies.

Blocking the HIF-1α/glycolysis axis inhibits allergic airway inflammation by reducing ILC2 metabolism and function

BACKGROUND

The role of lung group 2 innate lymphoid cell (ILC2) activation in allergic asthma is increasingly established. However, the regulatory mechanisms underlying hypoxia-inducible factor-1α (HIF-1α)-mediated glycolysis in ILC2-mediated allergic airway inflammation remain unclear.

OBJECTIVE

To investigate the role of the HIF-1α/glycolysis axis in ILC2-mediated allergic airway inflammation.

METHODS

Glycolysis and HIF-1α inhibitors were used to identify their effect on the function and glucose metabolism of mouse and human ILC2s in vivo and vitro. Blocking glycolysis and HIF-1α in mice under interleukin-33 (IL-33) stimulation were performed to test ILC2 responses. Conditional HIF-1α-deficient mice were used to confirm the specific role of HIF-1α in ILC2-driven airway inflammation models. Transcriptomic, metabolic, and chromatin immunoprecipitation analyses were performed to elucidate the underlying mechanism.

RESULTS

HIF-1α is involved in ILC2 metabolism and is crucial in allergic airway inflammation. Single-cell sequencing data analysis and qPCR confirmation revealed a significant upregulation of glycolysis-related genes, particularly HIF-1α, in murine lung ILC2s after IL-33 intranasal administration or injection. Treatment with the glycolysis inhibitor 2-deoxy-D-glucose (2-DG) and the HIF-1α inhibitor 2-methoxyestradiol (2-ME) abrogated inflammation by suppressing ILC2s function. Conditional HIF-1α-deficient mice showed reduced ILC2 response and airway inflammation induced upon IL-33 or house dust mite (HDM) stimulation. Transcriptome and metabolic analyses revealed significantly impaired glycolysis in lung ILC2s in conditional HIF-1α knockout mice compared to that in their littermate controls. Chromatin immunoprecipitation results confirmed the transcriptional downregulation of glycolysis-related genes in HIF-1α-knockout and 2-DG-treated mice. Furthermore, impaired HIF-1α/glycolysis axis activation is correlated with downregulated ILC2 in patients with asthma.

CONCLUSION

The HIF-1α/glycolysis axis is critical for controlling ILC2 responses in allergic airway inflammation and has potential immunotherapeutic value in asthma.

Gleditsiae Sinensis Fructus ingredients and mechanism in anti-asthmatic bronchitis research

BACKGROUND

Gleditsiae Sinensis Fructus (GSF) is commonly used in traditional medicine to treat respiratory diseases such as bronchial asthma. However, there is a lack of research on the chemical composition of GSF and the pharmacological substance and mechanism of action for GSF in treating bronchial asthma.

PURPOSE

The chemical constituents of GSF were analyzed using ultrahigh-performance liquid chromatography-quadrupole-Orbitrap high-resolution mass spectrometry (UHPLC-Q-Orbitrap HRMS). In this study, we combined network pharmacology, molecular docking techniques, and experimental validation to explore the therapeutic efficacy and underlying mechanism of GSF in the treatment of bronchial asthma.

METHODS

Characterization of the chemical constituents of GSF was conducted using UHPLC-Q-Orbitrap HRMS. The identified chemical components were subjected to screening for active ingredients in the Swiss Absorption, Distribution, Metabolism, and Excretion (ADME) database. Relevant databases were utilized to retrieve target proteins for the active ingredients and targets associated with bronchial asthma disease, and the common targets between the two were selected. Subsequently, the protein-protein interaction (PPI) network was constructed using the String database and Cytoscape software to identify key targets. Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed using the Metascape database. The "component-common target" network was constructed using Cytoscape to identify the primary active ingredients. Molecular docking validation was conducted using AutoDock software. The bronchial asthma mouse model was established using ovalbumin (OVA), and the lung organ index of the mice was measured. Lung tissue pathological changes were observed using hematoxylin and eosin (HE), Periodic Acid-Schiff (PAS), and Masson staining. The respiratory resistance (Penh) of the mice was assessed using a pulmonary function test instrument. An enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of IgE, IL-4, IL-5, and IL-13 in the mouse serum. Immunofluorescence staining was performed to detect the protein expression levels of AKT and PI3K in the lung tissues. An in vitro experiment was performed to observe the effects of echinocystic acid (EA) on IL-4 stimulated Human ASMCs (hASMCs). Cell viability was measured using a CCK-8 assay to calculate the IC50 value of the EA. A wound healing test was conducted to observe the effect of EA on degree of healing. RT-qPCR was performed to detect the influence of EA on the mRNA expression levels of ALB, SRC, TNF-α, AKT1, and IL6 in the cells.

RESULTS

A total of 95 chemical constituents were identified from the GSF. Of these, 37 were identified as active ingredients. There were 169 overlapping targets between the active ingredients and the disease targets. A topological analysis of the protein-protein interaction (PPI) network identified the core targets as IL6, TNF, ALB, AKT1, and SRC. An enrichment analysis revealed that the treatment of bronchial asthma with GSF primarily involved the AGE-RAGE signaling pathway and the PI3K-Akt signaling pathway, among others. The primary active ingredients included 13(s)-HOTRE, linolenic acid, and acacetin. The molecular docking results demonstrated a favorable binding activity between the critical components of GSF and the core targets. Animal experimental studies indicated that GSF effectively improved symptoms, lung function, and lung tissue pathological changes in the OVA-induced asthmatic mice, while alleviating inflammatory responses. GSF decreased the fluorescent intensity of the AKT and PI3K proteins. The IC50 value of EA was 30.02μg/ml. EA (30) significantly promoted the proliferation of IL4-stimulated hASMCs cells. EA (30) significantly increased the expression of ALB and SRC mRNA and decreased the expressions of TNF-α, AKT, and IL6 mRNA.

CONCLUSION

The multiple active ingredients found in GSF exerted their anti-inflammatory effects through multiple targets and pathways. This preliminary study revealed the core target and the mechanism of action underlying its treatment of bronchial asthma. These findings provided valuable insights for further research on the pharmacological substances and quality control of GSF.

Efficacy of Biologic Therapies in the Management of Allergic Rhinitis: A Systematic Review

Allergic rhinitis (AR) is a common chronic condition characterized by nasal congestion, sneezing, and itching, which significantly impacts quality of life. Traditional treatments, including antihistamines and intranasal corticosteroids, often fall short in managing moderate-to-severe cases. Recently, biologic therapies such as omalizumab and dupilumab have emerged as potential alternatives. This systematic review aims to evaluate the efficacy and safety of these biologic therapies in the management of AR. A comprehensive literature search was conducted across PubMed, Embase, Cochrane Library, and Web of Science to identify studies published between 2000 and 2024. Studies included were randomized controlled trials, cohort studies, and post-hoc analyses that assessed the impact of biologics on AR symptoms. Data on study characteristics, population demographics, intervention details, and outcomes were extracted and analyzed. The review included nine studies evaluating omalizumab and dupilumab. Omalizumab demonstrated significant improvements in nasal symptoms and quality of life, with notable efficacy in reducing symptoms and improving asthma control in patients with moderate-to-severe AR. Dupilumab also showed positive outcomes, particularly in patients with comorbid asthma and perennial AR, by reducing severe exacerbations and improving symptom scores. Biologic therapies, including omalizumab and dupilumab, offer promising alternatives for the management of AR, especially in cases that are severe or refractory to conventional treatments. The evidence supports their efficacy in improving symptoms and quality of life. Nevertheless, further research is required to address the limitations identified, including the need for long-term data and clarification of the mechanisms of action. These findings underscore the potential of biologics in advancing the treatment of AR and highlight the importance of ongoing research to optimize patient outcomes.

Retinoic Acid (RA): A Critical Immunoregulatory Molecule in Asthma and Allergies

INTRODUCTION

Asthma and allergies are chronic inflammatory disorders that are triggered owing to aberrant responses of the immune system against typically innocent environmental substances. Retinoic acid (RA) represents a biologically active metabolite of vitamin A (VA) and high-affinity ligand for RA receptor (RAR) that is implicated in a wide variety of biological processes, including cell proliferation, differentiation, apoptosis, organogenesis, reproduction, and immune responses. In the immune system, RA contributes to the induction of regulatory T (Treg) cells, adhesion molecules required for homing of B and T cells in the gut, and tolerance. Noteworthy, RA has a pivotal role in maintaining the balance of Th17-Treg cells and is also indispensable for appropriate responses of T helper (Th) cells.

AIMS

This mini-review article intends to expose the immune functions of RA, with an emphasis on the enzymatic pathways converting VA into RA and its receptor-dependent actions in asthma and allergies.

CONCLUSIONS

Recent findings have depicted that RA levels are reduced in asthma and allergies and that treatment with RA alleviates allergy symptoms and airway inflammation. RA also modulates allergic airway disorders by inhibiting Th2/Th17 response and increasing Treg cells. Therefore, RA could be considered a novel and promising therapeutic agent to be studied and used for treating these diseases.

A Review on Asthma and Allergy: Current Understanding on Molecular Perspectives

Asthma, a complex disease characterized by persistent airway inflammation, remains an urgent global health concern. We explored the critical role of allergic biomarkers and dysregulated immune system in asthma through an extensive literature review in databases such as Web of Science, PubMed, EMBASE, Scopus, and Google Scholar. This review summarizes the growing data on the pivotal role of allergic biomarkers and dysregulated immune system in the development and evolution of asthma. Recent studies have uncovered several biomarkers that elucidate intrinsic allergic mechanisms in individuals with asthma. This article highlights these biomarkers' potential in predicting asthma onset, assessing its intensity, guiding therapeutic interventions, and tracking disease progression. We also explore the innovative therapeutic prospects arising from the convergence of allergy and dysregulated immune system in asthma and emphasize the potential for precision medicine approaches. Understanding allergic biomarkers intertwined with a dysregulated immune system heralds a new era in asthma treatment and points to improved and individualized treatment modalities.

The NLRP3 inflammasome in allergic diseases: mechanisms and therapeutic implications

In recent years, there has been a global increase in the prevalence of allergic diseases, including allergic rhinitis, chronic rhinosinusitis, allergic asthma, atopic dermatitis, allergic conjunctivitis, and food allergies. Since the pathogenic mechanisms of these allergic diseases are not yet fully understood, targeted and effective therapies are lacking. The NLRP3 inflammasome, a multiprotein complex implicated in various inflammatory diseases, can be activated by diverse stimuli. It assembles into NLRP3 inflammasome complexes through conformational changes, initiating the proteolytic cleavage of dormant procaspase-1 into active caspase-1 and promoting the maturation of inflammatory cytokines, including IL-1β and IL-18. Dysfunction of the NLRP3 inflammasome may serve as a key driver of inflammatory diseases, leading to pyroptosis and amplifying the local inflammatory response. As preliminarily demonstrated, specific NLRP3 inflammatory vesicle inhibitors play refectory roles in animal models of allergic diseases, and it is believed that specific NLRP3 inflammasome inhibitors may be potential therapeutic agents for allergic diseases. This review highlights the progress of research on the NLRP3 inflammasome in allergic diseases, explores its contribution to different types of allergic diseases, and identifies promising clinical targets for intervention.

Correlation between forkhead box P3 (rs3761548) gene polymorphism and serum interleukin13 as biomarkers of severity in Egyptian allergic conjunctivitis: a retrospective study

Introduction

The genetic variants that alter human Forkhead Box P3 (FOXP3) function may have a part in the establishment of allergic conjunctivitis. Our study aimed to evaluate the FOXP3 polymorphism, serum interleukin13 (IL13) and total immunoglobulin E (IgE) levels in allergic conjunctivitis and assess their role as biomarkers for allergic conjunctivitis risk and severity.

Methods

This study included 52 cases and 52 controls. Blood samples were taken from allergic conjunctivitis patients and controls for total IgE, IL13 measurement and detection of FOXP3 (rs3761548) gene polymorphism.

Results

There was a statistically significant difference between the allergic conjunctivitis group and healthy control group regarding FOXP3 (rs3761548) polymorphism with those have AA genotype are 12 times at risk for allergic conjunctivitis and A allele increases the risk of allergic conjunctivitis by about 4 times. There was statistically significant difference between mild/moderate and severe allergic conjunctivitis regarding FOXP3 (rs3761548) polymorphism with those have AA genotype are 53 times at risk for severe allergic conjunctivitis and A allele increases the risk of severe allergic conjunctivitis by about 6 times. Also, there was a significantly higher value of total IgE IU/ml, IL13 Pg/ml value in severe allergic conjunctivitis compared to moderate/mild allergic conjunctivitis. The best cutoff values of total IgE and serum IL13 for detecting the severity of allergic conjunctivitis were ≥320 IU/ml and ≥40 Pg/ml and the area under the curve were 0.89 and 0.95 respectively.

Conclusion

The research significantly contributes to find correlation of FOXP3 polymorphism, total IgE and IL13 with risk and severity of allergic conjunctivitis which are limited in the literature on the perceived value relevance of FOXP3 polymorphism in allergic conjunctivitis risk and severity.

PIM1 signaling in immunoinflammatory diseases: an emerging therapeutic target

PIM1, the proviral integration site for Moloney murine leukemia virus, is a member of the serine/threonine protein kinase family. It is involved in many biological events, such as cell survival, cell cycle progression, cell proliferation, and cell migration, and has been widely studied in malignant diseases. However, recent studies have shown that PIM1 plays a prominent role in immunoinflammatory diseases, including autoimmune uveitis, inflammatory bowel disease, asthma, and rheumatoid arthritis. PIM1 can function in inflammatory signal transduction by phosphorylating multiple inflammatory protein substrates and mediating macrophage activation and T lymphocyte cell specification, thus participating in the development of multiple immunoinflammatory diseases. Moreover, the inhibition of PIM1 has been demonstrated to ameliorate certain immunoinflammatory disorders. Based on these studies, we suggest PIM1 as a potential therapeutic target for immunoinflammatory diseases and a valid candidate for future research. Herein, for the first time, we provide a detailed review that focuses on the roles of PIM1 in the pathogenesis of immunoinflammatory diseases.

Baicalin Attenuates Type 2 Immune Responses in a Mouse Allergic Asthma Model through Inhibiting the Production of Thymic Stromal Lymphopoietin

INTRODUCTION

Baicalin is a flavonoid chemical extracted and purified from the traditional Chinese medicine named Scutellaria baicalensis Georgi, which possesses broad pharmacological properties. Our work aimed to explore the protective role of baicalin in allergic asthma and its potential mechanisms on regulating type 2 immune response.

METHODS

Mice were injected intraperitoneally with ovalbumin (OVA) twice, further challenged with OVA aerosol for continuous 5 days. For baicalin group, mice were pre-administrated with baicalin. After the final challenge, the immune cells in bronchoalveolar lavage fluid (BALF) and blood were examined. The cytokines were evaluated by ELISA. Histological inspections were examined by hematoxylin and eosin staining and Periodic Acid-Schiff staining. Thymic stromal lymphopoietin (TSLP) expression in lungs were detected using immunohistochemistry and Western blotting.

RESULTS

The eosinophils infiltrating in BALF were reduced remarkably in baicalin-treated asthmatic mice. Baicalin decreased OVA-induced inflammatory cytokines and total serum immunoglobulin E secretion significantly. Moreover, baicalin alleviated the asthmatic pathological changes and substantially suppressed TSLP expression in the lung tissues.

CONCLUSION

Our study indicates that baicalin attenuates OVA-induced allergic asthma in mice effectively by suppressing type 2 immune responses, which might provide a novel insight into the anti-asthmatic activity of baicalin.