Respiratory allergies: a general overview of remedies, delivery systems, and the need to progress

AI-IoT Low-Cost Pollution-Monitoring Sensor Network to Assist Citizens with Respiratory Problems

The proliferation and great variety of low-cost air quality (AQ) sensors, combined with their flexibility and energy efficiency, gives an opportunity to integrate them into Wireless Sensor Networks (WSN). However, with these sensors, AQ monitoring poses a significant challenge, as the data collection and analysis process is complex and prone to errors. Although these sensors do not meet the performance requirements for reference regulatory-equivalent monitoring, they can provide informative measurements and more if we can adjust and add further processing to their raw measurements. Therefore, the integration of these sensors aims to facilitate real-time monitoring and achieve a higher spatial and temporal sampling density, particularly in urban areas, where there is a strong interest in providing AQ surveillance services since there is an increase in respiratory/allergic issues among the population. Leveraging a network of low-cost sensors, supported by 5G communications in combination with Artificial Intelligence (AI) techniques (using Convolutional and Deep Neural Networks (CNN and DNN)) to predict 24-h-ahead readings is the goal of this article in order to be able to provide early warnings to the populations of hazards areas. We have evaluated four different neural network architectures: Multi-Linear prediction (with a dense Multi-Linear Neural Network (NN)), Multi-Dense network prediction, Multi-Convolutional network prediction, and Multi-Long Short-Term Memory (LSTM) network prediction. To perform the training of the prediction of the readings, we have prepared a significant dataset that is analyzed and processed for training and testing, achieving an estimation error for most of the predicted parameters of around 7.2% on average, with the best option being the Multi-LSTM network in the forthcoming 24 h. It is worth mentioning that some pollutants achieved lower estimation errors, such as CO2 with 0.1%, PM10 with 2.4% (as well as PM2.5 and PM1.0), and NO2 with 6.7%.

Allergen-specific immunotherapy by recombinant Der P1 allergen-derived peptide-based vaccine in an allergic mouse model

AIM

Increased IgE levels have made house dust mite allergens one of the most frequent causes of allergies worldwide. Treatment reduces the IgE antibodies and types two cytokines, namely interleukin-4 (IL-4) and IL-13. Although existing treatments significantly reduce IgE or IL-4/IL-13, they are very costly. This study aimed to construct a recombinant protein derived from rDer p1 peptides in the form of an immunotherapy approach and to measure the response of IgE and IgG antibodies.

METHODS

The proteins were isolated, purified, and evaluated using the SDS-PAGE and Bradford test and confirmed by using Western blot. To evaluate immunotherapy efficiency, 24 BALB/C mice were sensitized intraperitoneally with house dust mites (HDM) adsorbed to Aluminum hydroxide (Alum) and randomly divided into four groups of six: control sensitized, HDM extract, rDer p1, and DpTTDp vaccine. To immunization, four groups of random mice were each treated with phosphate-buffered saline, 100 μg of rDer p1 protein, DpTTDp, or HDM extract, every 3 days. Direct ELISA determined HDM-specific IgG and IgE subclasses. Data were analyzed in SPSS and Graph pad prism software. Values of p < .05 were considered significant.

RESULTS

After immunization of mice, the rDer P1 and recombinant vaccine like HDM extract increased IgG antibody titer and decreased IgE-dependent reactivity in allergic mice to rDer P1. Also, the levels of inflammatory IL-4 and IL-13 cytokines as allergic stimulants decreased.

CONCLUSION

The use of present available recombinant proteins is considered a viable, cost-effective, and long-term option for providing effective HDM allergy immunotherapy vaccines without side effects.

Integration of in vitro allergy test results and ratio analysis for the diagnosis and treatment of allergic patients (INTEGRA)

The introduction of molecular diagnosis into routine clinical practice has substantially improved the diagnosis and management of allergic patients by allowing clinicians to precisely identify the allergenic molecule responsible for immunoglobulin E (IgE)‐mediated allergies. However, it can be challenging to accurately interpret the results of molecular assays, partly due to the limited evidence base. In this context, a panel of experts with extensive experience in interpreting in vitro measures of total and serum specific IgE reviewed the available scientific evidence. After this review, the panel selected a series of representative case studies to demonstrate how determination of specific and total IgE values and the relationship between them (ratio analysis) can add value to the diagnostic process by more precisely defining the patient’s sensitization profile. Finally, the experts developed a series of recommendations on the clinical application of ratio analysis to optimize and complement the classical approach to allergy diagnosis.

Mechanisms of Particles in Sensitization, Effector Function and Therapy of Allergic Disease

Humans have always been in contact with natural airborne particles from many sources including biologic particulate matter (PM) which can exhibit allergenic properties. With industrialization, anthropogenic and combustion-derived particles have become a major fraction. Currently, an ever-growing number of diverse and innovative materials containing engineered nanoparticles (NPs) are being developed with great expectations in technology and medicine. Nanomaterials have entered everyday products including cosmetics, textiles, electronics, sports equipment, as well as food, and food packaging. As part of natural evolution humans have adapted to the exposure to particulate matter, aiming to protect the individual's integrity and health. At the respiratory barrier, complications can arise, when allergic sensitization and pulmonary diseases occur in response to particle exposure. Particulate matter in the form of plant pollen, dust mites feces, animal dander, but also aerosols arising from industrial processes in occupational settings including diverse mixtures thereof can exert such effects. This review article gives an overview of the allergic immune response and addresses specifically the mechanisms of particulates in the context of allergic sensitization, effector function and therapy. In regard of the first theme (i), an overview on exposure to particulates and the functionalities of the relevant immune cells involved in allergic sensitization as well as their interactions in innate and adaptive responses are described. As relevant for human disease, we aim to outline (ii) the potential effector mechanisms that lead to the aggravation of an ongoing immune deviation (such as asthma, chronic obstructive pulmonary disease, etc.) by inhaled particulates, including NPs. Even though adverse effects can be exerted by (nano)particles, leading to allergic sensitization, and the exacerbation of allergic symptoms, promising potential has been shown for their use in (iii) therapeutic approaches of allergic disease, for example as adjuvants. Hence, allergen-specific immunotherapy (AIT) is introduced and the role of adjuvants such as alum as well as the current understanding of their mechanisms of action is reviewed. Finally, future prospects of nanomedicines in allergy treatment are described, which involve modern platform technologies combining immunomodulatory effects at several (immuno-)functional levels.

Self-Reported Prevalence of Allergies in the USA and Impact on Skin-An Epidemiological Study on a Representative Sample of American Adults

Background: The rising prevalence of allergies can substantially impact the skin, which is one of the largest targets for allergic and immunologic responses. Objective: Here, we describe the results of an online survey assessing self-reported allergy prevalence in Americans, outline the populations who report allergies, and characterize the skin conditions associated with allergy. Methods: An online survey was conducted in the USA of 2008 adults as a representative sample of the general American population. Results: 41.7% of American adults (mean age 44.7 ± 15.3 years old) reported having allergies. Reported allergies included respiratory allergies (45.2%), skin allergies (41.4) and food allergies (33.9%). 47.7% of those who reported allergies also reported experiencing associated skin reactions. In addition, those who reported allergies were 2 to 4.5 times more likely to report a cutaneous skin disease, 7 times more likely to report sensitive skin, and twice as likely to report experiencing skin reactions when using skincare products compared to those who did not report allergies. Conclusions: It is estimated that over 100 million American adults have allergies. These results will help raise awareness about the burden of allergies and the need to develop solutions to mitigate their impact on health.

Basophil biomarkers as useful predictors for sublingual immunotherapy in allergic rhinitis

Prevalence of allergic diseases is increasing worldwide. Allergen-specific immunotherapy (ASIT) is potentially the only curative treatment for allergy, but there is a lack of reliable methods to monitor the immune responses to ASIT and to predict clinical efficacy. Recently, the definition of allergen sensitivity threshold (CD-Sens) by Basophil Activation Tests has been suggested as potential method in this context. The aim of this study was to compare trends of CD-Sens, measured by the markers CD63 and CD203c, and clinical symptoms in subjects with allergic rhinitis receiving Sublingual Immunotherapy (SLIT). 26 rhinitis patients allergic to Parietaria were selected and matched into two groups; a SLIT treated group (SG) and a reference group (RG) treated by traditional anti-allergic medications. Visual Analogue Scale (VAS) score for the four cardinal symptoms of rhinitis and peripheral blood was collected before the first dose of SLIT (T₀) and after 12 months (T₁₂) to define the severity of the symptoms and the sensitivity of basophils to Parietaria. The comparison between T0 and T12 in SG patients showed a significant decrease of symptom severity (VAS score) and an increased tolerability of basophils to Parietaria (CD-Sens) both by CD63 and CD203c. But, only CD203c seems to be correlated with the clinical symptoms. These data corroborate the hypothesis that SLIT could change the immunological course of allergic sensitization already in the first year, and that an immunological parameter as CD-Sens measured by CD63 and CD203c expression on stimulated basophils could be useful to monitor the changes in the immune system.