Sex difference in IgE sensitization associated with alcohol consumption in the general population

Exploration of IgE Specific to Staphylococcal Serine Protease-Like Protein A as a Phenotypic Marker in Late-Onset Asthma

PURPOSE

Staphylococcus aureus (SA) secretes pro-allergic molecules, including staphylococcal enterotoxins (SEs) and serine protease-like proteins (Spls). While IgE sensitization to SE has been relatively well documented in relation to severe eosinophilic late-onset asthma, the clinical implications of IgE sensitization to Spls remain unclear. We explored the clinical relevance of Spl-IgE in late-onset asthmatics.

METHODS

Adults with late-onset asthma (onset age ≥ 40 years) were prospectively enrolled. Demographic and clinical characteristics were assessed, and serum levels of total IgE, SE-IgE, and SplA-IgE were measured. Nasal swabs were obtained to assess SA colonization.

RESULTS

Among 109 participants, SplA-IgE levels were significantly associated with blood eosinophilia, total IgE, SE-IgE sensitization, and male sex, but not with SA colonization, asthma severity, or lung function.

CONCLUSION

Sensitization to SplA-IgE may indicate a type 2 inflammatory phenotype, but its role in asthma warrants further investigation.

Environmental exposures associated with atopy in a rural community in Gwanda district, Zimbabwe: a cross-sectional study

Introduction

The increasing prevalence of allergic diseases in Zimbabwe may be attributed to changing environmental exposure patterns. In this study, we sought to identify the most influential environmental and lifestyle factors that may explain the observed atopy in a rural community in Zimbabwe.

Methods

Using a cross-sectional study, information on a wide array of environmental and lifestyle exposures was self-reported by a sample of participants (children aged <18 years and adults aged ≥18 years) in the Gwanda district, Zimbabwe. To consenting participants, we performed skin prick testing (SPT) at a local clinic in Gwanda district to identify atopic individuals. Variables with a p value <0.25 from univariate analysis were included in backward-elimination multiple logistic regression analysis. Separate regression analyses were conducted for children (n = 108), adults (n = 388), and a subgroup of adults who reported ever being employed in any potentially harmful occupation (n = 153).

Results

Compared with boys, girls were more likely to be sensitised to at least one allergen (OR = 4.87, 95% CI = 1.22-19.51). Among adults, the likelihood of sensitisation increased with increasing age (OR = 1.02, 95% CI = 1.01-1.03) and with a history of bloody urine and/or schistosomiasis (OR = 2.20, 95% CI = 0.98-4.95). In the subgroup of adults who reported ever being employed in any potentially harmful occupation, atopic sensitisation was associated with a history of tuberculosis (TB; OR = 3.37, 95% CI = 1.08-10.52) and a history of bloody urine and/or schistosomiasis (OR = 4.36, 95% CI = 1.40-13.65). Other notable, though not significant, factors were passive or parental smoking, alcohol consumption, indoor dampness and visible mould on walls.

Conclusion

Girls were more likely to be sensitised to at least one allergen when compared to boys. Among adults, atopic sensitisation was positively associated with age, parental smoking, alcohol consumption and history of bloody urine or schistosomiasis but negatively associated with indoor cooking. A history of TB or helminth infection increased the likelihood of atopy among adults with history of employment. Longitudinal studies to explore the temporal and causal relationships between these factors and allergic outcomes are essential. There is a need for early public health interventions to address environmental and lifestyle factors for the prevention and control of allergic diseases in African rural communities.

Dietary factors and the risk of atopic dermatitis: a Mendelian randomisation study

Previous studies have revealed an association between dietary factors and atopic dermatitis (AD). To explore whether there was a causal relationship between diet and AD, we performed Mendelian randomisation (MR) analysis. The dataset of twenty-one dietary factors was obtained from UK Biobank. The dataset for AD was obtained from the publicly available FinnGen consortium. The main research method was the inverse-variance weighting method, which was supplemented by MR‒Egger, weighted median and weighted mode. In addition, sensitivity analysis was performed to ensure the accuracy of the results. The study revealed that beef intake (OR = 0·351; 95 % CI 0·145, 0·847; P = 0·020) and white bread intake (OR = 0·141; 95 % CI 0·030, 0·656; P = 0·012) may be protective factors against AD. There were no causal relationships between AD and any other dietary intake factors. Sensitivity analysis showed that our results were reliable, and no heterogeneity or pleiotropy was found. Therefore, we believe that beef intake may be associated with a reduced risk of AD. Although white bread was significant in the IVW analysis, there was large uncertainty in the results given the wide 95 % CI. Other factors were not associated with AD in this study.

Age-related changes in ocular mucosal tolerance: Lessons learned from gut and respiratory tract immunity

The ocular surface is the part of the visual system directly exposed to the environment, and it comprises the cornea, the first refractive tissue layer and its surrounding structures. The ocular surface has evolved to keep the cornea smooth and wet, a prerequisite for proper sight, and also protected. To this aim, the ocular surface is a bona fide mucosal niche with an immune system capable of fighting against dangerous pathogens. However, due to the potential harmful effects of uncontrolled inflammation, the ocular surface has several mechanisms to keep the immune response in check. Specifically, the ocular surface is maintained inflammation-free and functional by a particular form of peripheral tolerance known as mucosal tolerance, markedly different from the immune privilege of intraocular structures. Remarkably, conjunctival tolerance is akin to the oral and respiratory tolerance mechanisms found in the gut and airways, respectively. And also similarly, this form of immunoregulation in the eye is affected by ageing just as it is in the digestive and respiratory tracts. With ageing comes an increased prevalence of immune-based ocular surface disorders, which could be related to an age-related impairment of conjunctival tolerance. The purpose of this review was to summarize the present knowledge of ocular mucosal tolerance and how it is affected by the ageing process in the light of the current literature on mucosal immunoregulation of the gut and airways.

The association between olfactory dysfunction and cardiovascular disease and its risk factors in middle-aged and older adults

While previous studies have reported olfactory dysfunction (OD) in relation to cardiovascular disease (CVD), few population-based studies have investigated whether such associations differ by sex. The purpose of this study was to identify the association between CVD and its risk factors with OD, and the sex-associated differences within the general population. We examined 20,016 adults aged 40 and older from the Korean National Health and Nutrition Examination Survey. All subjects reported on their history of OD. CVD and its risk factors included coronary artery disease (CAD), stroke, hypertension, diabetes, obesity, abdominal obesity, and hypertriglyceridemia; logistic regression was used to analyse their associations with OD, and additive interaction was used to analyse the interaction between risk factors and sex. In males, CAD was more likely to be associated with OD (odds ratio [OR] 1.81, 95% confidence interval [CI] 1.05–3.14), whereas abdominal obesity was associated with OD in females (OR 1.39, 95% CI 1.06–1.84).Additive interaction were observed between abdominal obesity and female sex with a relative excess risk of interaction of 0.45 (95% CI 0.26–0.63). Our findings suggest the relationship between OD and CVD and its risk factors and sex-associated differences among middle-aged and older adults.

AllergoOncology: ultra-low IgE, a potential novel biomarker in cancer-a Position Paper of the European Academy of Allergy and Clinical Immunology (EAACI)

Elevated serum IgE levels are associated with allergic disorders, parasitosis and specific immunologic abnormalities. In addition, epidemiological and mechanistic evidence indicates an association between IgE-mediated immune surveillance and protection from tumour growth. Intriguingly, recent studies reveal a correlation between IgE deficiency and increased malignancy risk. This is the first review discussing IgE levels and links to pathological conditions, with special focus on the potential clinical significance of ultra-low serum IgE levels and risk of malignancy. In this Position Paper we discuss: (a) the utility of measuring total IgE levels in the management of allergies, parasitosis, and immunodeficiencies, (b) factors that may influence serum IgE levels, (c) IgE as a marker of different disorders, and d) the relationship between ultra-low IgE levels and malignancy susceptibility. While elevated serum IgE is generally associated with allergic/atopic conditions, very low or absent IgE may hamper anti-tumour surveillance, indicating the importance of a balanced IgE-mediated immune function. Ultra-low IgE may prove to be an unexpected biomarker for cancer risk. Nevertheless, given the early stage of investigations conducted mostly in patients with diseases that influence IgE levels, in-depth mechanistic studies and stratification of malignancy risk based on associated demographic, immunological and clinical co-factors are warranted.

Sex differences in the association between asthma incidence and modifiable risk factors in Korean middle-aged and older adults: NHIS-HEALS 10-year cohort

Background

This study investigated the sex-specific incidence of asthma and the effects of modifiable risk factors, particularly obesity, on asthma incidence among middle-aged and older individuals in Korea.

Methods

We used data from the National Health Insurance Service-Health Screening Cohort (NHIS-HEALS), which includes health examinees aged 40–79 years in 2002–2003. In total, 459,529 participants with baseline anthropometric measurements were followed-up for 10 years and the development of asthma was evaluated (2004–2013). For subgroup analysis, 246,019 participants who had body mass index (BMI) and waist circumference (WC) measurements taken in 2008–2009 were included in the analysis of the asthma incidence for 2010–2013. Factors associated with asthma were analysed using Cox proportional hazard models.

Results

The cohort comprised 4,248,813 (men, 2,358,541; women, 1,890,272) person-years of follow-up for 2004–2013. The asthma incidence was 10.58 and 15.03 per 1000 person-years for men and women, respectively. Asthma incidence increased with age, notably so in men. Obesity based on the baseline BMI was significantly associated with asthma development in both sexes (men, HR = 1.23, 95% confidence interval (CI) = 1.13–1.34; women, HR = 1.40 95% CI = 1.32–1.48). High WC was also related to asthma incidence in both sexes with statistical significance (men, HR = 1.34, 95% CI = 1.16–1.57; women, HR = 1.19 95% CI = 1.03–1.37). Analysis of the combined effects of BMI and WC showed that men had a higher asthma risk in the group with both general obesity and abdominal obesity than in the group with non-abdominal obesity and normal BMI. However, obese women had a higher risk of asthma regardless of abdominal obesity. Similarly, smoking was associated with asthma in both sexes but drinking and physical activity showed different associations between the sexes.

Conclusions

Our results revealed that asthma incidence was substantially high at old age and lifestyle factors were associated with asthma development. Practical strategies including weight control and healthy lifestyle modification are required to prevent asthma in older people.