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Hoof I, Bønnelykke K, Stranzl T, Brand S, Li X, Shamji MH, Meyers DA, Bateman ED, Bleecker E, Andersen PS. Genetic and T2 biomarkers linked to the efficacy of HDM sublingual immunotherapy in asthma. Thorax 2024; 79:332-339. [PMID: 38160049 DOI: 10.1136/thorax-2023-220707] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/03/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Hypersensitivity to house dust mite (HDM) allergens is a common cause of allergic asthma symptoms and can be effectively treated with allergy immunotherapy (AIT). OBJECTIVE To investigate whether genetic and type 2 (T2) inflammatory biomarkers correlate with disease severity in subjects with allergic asthma, and whether this can be modified by AIT. METHODS MITRA (NCT01433523) was a phase III, randomised, double-blind, placebo-controlled trial of HDM sublingual immunotherapy (SLIT)-tablets in adults with HDM allergic asthma. Post hoc analyses of the study population (N=742) evaluated associations between T2 inflammatory (blood eosinophils, eosinophil cationic protein (ECP), total IgE and tryptase) and genetic (single-nucleotide polymorphisms, SNP) biomarkers (n=582) for the primary study endpoint (time to first moderate/severe asthma exacerbation). SNP associations were verified in HDM-positive subgroup from an independent 3-year Severe Asthma Research Programme (SARP3) subject cohort. RESULTS An increased asthma exacerbation risk in subjects homozygous for SNP rs7216389 (chromosomal locus 17q12-21) was reduced (p=0.037) by treatment with HDM SLIT (HR=0.37 (95% CI 0.22 to 0.64), p<0.001). The associations between exacerbation risk and 17q12-21 SNPs were replicated in the SARP3 HDM-positive subgroup. High levels of T2 biomarkers were associated with increased risk of asthma exacerbations in the placebo group. HDM SLIT-tablet treatment reduced this risk (blood eosinophils: HR=0.50 (95% CI 0.30 to 0.85); ECP: HR=0.45 (95% CI 0.29 to 0.87); tryptase: HR=0.45 (95% CI 0.25 to 0.80)). The treatment effect was higher (p=0.006) for subjects with a higher number of elevated T2 biomarkers. CONCLUSIONS HDM SLIT-tablet AIT is efficacious in HDM-sensitised asthma subjects with a genetic asthma predisposition and/or an underlying T2 endotype. TRIAL REGISTRATION NUMBER NCT01433523.
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Affiliation(s)
- Ilka Hoof
- Translational Research, Alk-Abello A/S, Horsholm, Denmark
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital, Copenhagen, Denmark
| | - Thomas Stranzl
- Translational Research, Alk-Abello A/S, Horsholm, Denmark
| | | | - Xingnan Li
- Department of Medicine, The University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Mohamed H Shamji
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Deborah A Meyers
- Department of Medicine, The University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Eric D Bateman
- Division of Respiratory Medicine, Univ of Cape Town, Cape Town, South Africa
| | - Eugene Bleecker
- Medicine, University of Arizona, Health Sciences Center, Tucson, Arizona, USA
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Antonisamy B, Shailesh H, Hani Y, Ahmed LHM, Noor S, Ahmed SY, Alfaki M, Muhayimana A, Jacob SS, Balayya SK, Soloviov O, Liu L, Mathew LS, Wang K, Tomei S, Al Massih A, Mathew R, Karim MY, Ramanjaneya M, Worgall S, Janahi IA. Sphingolipids in Childhood Asthma and Obesity (SOAP Study): A Protocol of a Cross-Sectional Study. Metabolites 2023; 13:1146. [PMID: 37999242 PMCID: PMC10673587 DOI: 10.3390/metabo13111146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/25/2023] Open
Abstract
Asthma and obesity are two of the most common chronic conditions in children and adolescents. There is increasing evidence that sphingolipid metabolism is altered in childhood asthma and is linked to airway hyperreactivity. Dysregulated sphingolipid metabolism is also reported in obesity. However, the functional link between sphingolipid metabolism, asthma, and obesity is not completely understood. This paper describes the protocol of an ongoing study on sphingolipids that aims to examine the pathophysiology of sphingolipids in childhood asthma and obesity. In addition, this study aims to explore the novel biomarkers through a comprehensive multi-omics approach including genomics, genome-wide DNA methylation, RNA-Seq, microRNA (miRNA) profiling, lipidomics, metabolomics, and cytokine profiling. This is a cross-sectional study aiming to recruit 440 children from different groups: children with asthma and normal weight (n = 100), asthma with overweight or obesity (n = 100), overweight or obesity (n = 100), normal weight (n = 70), and siblings of asthmatic children with normal weight, overweight, or obesity (n = 70). These participants will be recruited from the pediatric pulmonology, pediatric endocrinology, and general pediatric outpatient clinics at Sidra Medicine, Doha, Qatar. Information will be obtained from self-reported questionnaires on asthma, quality of life, food frequency (FFQ), and a 3-day food diary that are completed by the children and their parents. Clinical measurements will include anthropometry, blood pressure, biochemistry, bioelectrical impedance, and pulmonary function tests. Blood samples will be obtained for sphingolipid analysis, serine palmitoyltransferase (SPT) assay, whole-genome sequencing (WGS), genome-wide DNA methylation study, RNA-Seq, miRNA profiling, metabolomics, lipidomics, and cytokine analysis. Group comparisons of continuous outcome variables will be carried out by a one-way analysis of variance or the Kruskal-Wallis test using an appropriate pairwise multiple comparison test. The chi-squared test or a Fisher's exact test will be used to test the associations between categorical variables. Finally, multivariate analysis will be carried out to integrate the clinical data with multi-omics data. This study will help us to understand the role of dysregulated sphingolipid metabolism in obesity and asthma. In addition, the multi-omics data from the study will help to identify novel genetic and epigenetic signatures, inflammatory markers, and mechanistic pathways that link asthma and obesity in children. Furthermore, the integration of clinical and multi-omics data will help us to uncover the potential interactions between these diseases and to offer a new paradigm for the treatment of pediatric obesity-associated asthma.
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Affiliation(s)
- Belavendra Antonisamy
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Harshita Shailesh
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Yahya Hani
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Lina Hayati M. Ahmed
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Safa Noor
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Salma Yahya Ahmed
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Mohamed Alfaki
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Abidan Muhayimana
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Shana Sunny Jacob
- Analytical Chemistry Core, Advanced Diagnostic Core Facilities, Sidra Medicine, Doha P.O. Box 26999, Qatar; (S.S.J.); (S.K.B.)
| | - Saroja Kotegar Balayya
- Analytical Chemistry Core, Advanced Diagnostic Core Facilities, Sidra Medicine, Doha P.O. Box 26999, Qatar; (S.S.J.); (S.K.B.)
| | - Oleksandr Soloviov
- Clinical Genomics Laboratory, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (O.S.); (L.L.); (L.S.M.); (K.W.)
| | - Li Liu
- Clinical Genomics Laboratory, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (O.S.); (L.L.); (L.S.M.); (K.W.)
| | - Lisa Sara Mathew
- Clinical Genomics Laboratory, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (O.S.); (L.L.); (L.S.M.); (K.W.)
| | - Kun Wang
- Clinical Genomics Laboratory, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (O.S.); (L.L.); (L.S.M.); (K.W.)
| | - Sara Tomei
- Omics Core, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (S.T.); (A.A.M.); (R.M.)
| | - Alia Al Massih
- Omics Core, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (S.T.); (A.A.M.); (R.M.)
| | - Rebecca Mathew
- Omics Core, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (S.T.); (A.A.M.); (R.M.)
| | - Mohammed Yousuf Karim
- Department of Pathology, Sidra Medicine, Doha P.O. Box 26999, Qatar;
- College of Medicine, Qatar University, Doha P.O. Box 2713, Qatar
| | - Manjunath Ramanjaneya
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar;
- Translational Research Institute, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
| | - Stefan Worgall
- Department of Pediatrics, Weill Cornell Medicine, New York, NY 10021, USA;
| | - Ibrahim A. Janahi
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
- Department of Pediatrics, Weill Cornell Medicine-Qatar, Doha P.O. Box 24144, Qatar
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Ji X, Chen H, Xie L, Chen S, Huang S, Tan Q, Yang H, Yang T, Ye X, Zeng Z, Wan C, Li L. The study of GSDMB in pathogenesis of psoriasis vulgaris. PLoS One 2023; 18:e0279908. [PMID: 36607980 PMCID: PMC9821418 DOI: 10.1371/journal.pone.0279908] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/16/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Gasdermin (GSDM) B is a member of the GSDM family, which is a protein that may be involved in the cell pyroptosis process and is associated with inflammatory diseases. OBJECTIVE To explore the correlation between GSDMB and psoriasis vulgaris. METHODS Skin lesions from 33 patients with psoriasis vulgaris and 69 normal controls were collected. ELISA and Western blot were adopted to detect proteins. The HaCaT cell line was transfected with 3 sets of interfering sequence siRNA, and the mRNA and protein levels before and after the transfection were measured by qPCR and Western blot respectively, so as to establish a cell model with low GSDMB gene expression; the MTT method was used to detect cells viability, flow cytometry to detect cell apoptosis. RESULTS The level of GSDMB protein in the skin lesions of patients with psoriasis vulgaris was lower than that in normal skin tissues (P < 0.05). The mRNA and protein expression levels of the target gene in the siRNA-GSDMB-3 group were lower than those in the control group (P < 0.05). The proliferation of HaCaT cells was decreased by MTT method and flow cytometry, and the apoptosis rate was increased (P < 0.05). CONCLUSION The expression level of GSDMB in psoriasis vulgaris lesion tissue is lower than that of normal skin tissue. The down-regulation of GSDMB expression can inhibit cell proliferation and promote cell apoptosis. GSDMB may play a role in the pathogenesis of psoriasis by affecting the differentiation of keratinocytes and the function of T cells.
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Affiliation(s)
- Xiaojuan Ji
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Huaqing Chen
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Ling Xie
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
- Construction Unit of Branch Center of National Clinical Research Center for Dermatologic and Immunological Diseases, Ganzhou, China
- Joint Organization of Jiangxi Clinical Medicine Research Center for Dermatology, Ganzhou, China
| | - Shiqi Chen
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Shan Huang
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Qi Tan
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Huifang Yang
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
- Construction Unit of Branch Center of National Clinical Research Center for Dermatologic and Immunological Diseases, Ganzhou, China
- Standardized Diagnosis and Treatment Center for, Ganzhou, China
| | - Tao Yang
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
- Construction Unit of Branch Center of National Clinical Research Center for Dermatologic and Immunological Diseases, Ganzhou, China
- Standardized Diagnosis and Treatment Center for, Ganzhou, China
| | - Xiaoying Ye
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
- Construction Unit of Branch Center of National Clinical Research Center for Dermatologic and Immunological Diseases, Ganzhou, China
- Joint Organization of Jiangxi Clinical Medicine Research Center for Dermatology, Ganzhou, China
- Standardized Diagnosis and Treatment Center for, Ganzhou, China
| | - Zhaolin Zeng
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
- Construction Unit of Branch Center of National Clinical Research Center for Dermatologic and Immunological Diseases, Ganzhou, China
- Joint Organization of Jiangxi Clinical Medicine Research Center for Dermatology, Ganzhou, China
- Standardized Diagnosis and Treatment Center for, Ganzhou, China
| | - Chunlei Wan
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
- Construction Unit of Branch Center of National Clinical Research Center for Dermatologic and Immunological Diseases, Ganzhou, China
- Joint Organization of Jiangxi Clinical Medicine Research Center for Dermatology, Ganzhou, China
- Standardized Diagnosis and Treatment Center for, Ganzhou, China
| | - Longnian Li
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
- Joint Organization of Jiangxi Clinical Medicine Research Center for Dermatology, Ganzhou, China
- Standardized Diagnosis and Treatment Center for, Ganzhou, China
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Ren T, Chen J, Yu Y, He H, Zhang J, Li F, Svendsen K, Obel C, Wang H, Li J. The association of asthma, atopic dermatitis, and allergic rhinitis with peripartum mental disorders. Clin Transl Allergy 2021; 11:e12082. [PMID: 34962724 PMCID: PMC8805685 DOI: 10.1002/clt2.12082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 10/24/2021] [Accepted: 11/17/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Atopic diseases are characterized by dysregulated inflammatory response, which may incur the onset of peripartum mental disorders, but the impact remains unknown. This study examined whether and to what extent the history of atopic diseases is associated with newly onset peripartum mental disorders. METHODS Using population-based registries, we identified all primiparous women who gave birth to live singletons in Denmark during 1978-2016 (n = 937,422). The exposure was hospital contact due to the three major types of atopic diseases-asthma, atopic dermatitis, and allergic rhinitis-before conception. The primary outcome was any hospital contact for mental disorder during pregnancy and 1-year postpartum, which was further classified into affective disorders, neurotic, stress-related and somatoform disorders, and substance abuse. The follow-up started from the date of conception and ended at the date of the first diagnosis of mental disorders, 1-year postpartum, death, emigration, or December 31, 2016, whichever came first. Cox regression was used, adjusted for calendar year, age at childbirth, education, residence, and Charlson comorbidity index. RESULTS A total of 24,016 (2.6%) women received diagnosis of at least one of the three atopic diseases before conception (asthma, 1.7%; atopic dermatitis, 0.6%; and allergic rhinitis, 0.8%). Exposure to asthma, atopic dermatitis, or allergic rhinitis was associated with a 37% increased overall risk of peripartum mental disorders (hazard ratio [HR], 1.37; 95% confidence interval [CI], 1.27-1.49). Higher risks were observed among women with more frequent hospital contacts for atopic disease (HR, 1.80; 95% CI, 1.37-2.35; ≥5 times), and with recent hospital contacts for atopic disease (HR, 1.74; 95% CI, 1.48-2.06; within 2 years before conception). Specific associations were observed between asthma and neurotic, stress-related and somatoform disorders (HR, 1.40; 95% CI, 1.21-1.62), and between atopic dermatitis and substance abuse (HR, 1.62; 95% CI, 1.12-2.34). CONCLUSIONS History of asthma, atopic dermatitis, and allergic rhinitis before conception was associated with increased risks of peripartum mental disorders. Women who have atopic diseases before pregnancy may benefit from systematic mental health monitoring.
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Affiliation(s)
- Tai Ren
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Clinical Medicine and Epidemiology, Aarhus University, Aarhus, Denmark
| | - Jiawen Chen
- Department of Dermatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongfu Yu
- Department of Biostatistics, Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Hua He
- Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Li
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Carsten Obel
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Hui Wang
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiong Li
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Clinical Medicine and Epidemiology, Aarhus University, Aarhus, Denmark
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Braun M, Klingelhöfer D, Oremek GM, Quarcoo D, Groneberg DA. Influence of Second-Hand Smoke and Prenatal Tobacco Smoke Exposure on Biomarkers, Genetics and Physiological Processes in Children-An Overview in Research Insights of the Last Few Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3212. [PMID: 32380770 PMCID: PMC7246681 DOI: 10.3390/ijerph17093212] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/16/2020] [Accepted: 04/29/2020] [Indexed: 02/07/2023]
Abstract
Children are commonly exposed to second-hand smoke (SHS) in the domestic environment or inside vehicles of smokers. Unfortunately, prenatal tobacco smoke (PTS) exposure is still common, too. SHS is hazardous to the health of smokers and non-smokers, but especially to that of children. SHS and PTS increase the risk for children to develop cancers and can trigger or worsen asthma and allergies, modulate the immune status, and is harmful to lung, heart and blood vessels. Smoking during pregnancy can cause pregnancy complications and poor birth outcomes as well as changes in the development of the foetus. Lately, some of the molecular and genetic mechanisms that cause adverse health effects in children have been identified. In this review, some of the current insights are discussed. In this regard, it has been found in children that SHS and PTS exposure is associated with changes in levels of enzymes, hormones, and expression of genes, micro RNAs, and proteins. PTS and SHS exposure are major elicitors of mechanisms of oxidative stress. Genetic predisposition can compound the health effects of PTS and SHS exposure. Epigenetic effects might influence in utero gene expression and disease susceptibility. Hence, the limitation of domestic and public exposure to SHS as well as PTS exposure has to be in the focus of policymakers and the public in order to save the health of children at an early age. Global substantial smoke-free policies, health communication campaigns, and behavioural interventions are useful and should be mandatory.
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Affiliation(s)
- Markus Braun
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, D-60590 Frankfurt, Germany; (D.K.); (G.M.O.); (D.Q.); (D.A.G.)
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Agache I, Akdis CA. Precision medicine and phenotypes, endotypes, genotypes, regiotypes, and theratypes of allergic diseases. J Clin Invest 2019; 129:1493-1503. [PMID: 30855278 PMCID: PMC6436902 DOI: 10.1172/jci124611] [Citation(s) in RCA: 181] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
A rapidly developing paradigm for modern health care is a proactive and individualized response to patients' symptoms, combining precision diagnosis and personalized treatment. Precision medicine is becoming an overarching medical discipline that will require a better understanding of biomarkers, phenotypes, endotypes, genotypes, regiotypes, and theratypes of diseases. The 100-year-old personalized allergen-specific management of allergic diseases has particularly contributed to early awareness in precision medicine. Polyomics, big data, and systems biology have demonstrated a profound complexity and dynamic variability in allergic disease between individuals, as well as between regions. Escalating health care costs together with questionable efficacy of the current management of allergic diseases facilitated the emergence of the endotype-driven approach. We describe here a precision medicine approach that stratifies patients based on disease mechanisms to optimize management of allergic diseases.
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Affiliation(s)
- Ioana Agache
- Transylvania University, Faculty of Medicine, Brasov, Romania
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
- Christine Kühne – Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
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Association study in African-admixed populations across the Americas recapitulates asthma risk loci in non-African populations. Nat Commun 2019; 10:880. [PMID: 30787307 PMCID: PMC6382865 DOI: 10.1038/s41467-019-08469-7] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 01/08/2019] [Indexed: 12/15/2022] Open
Abstract
Asthma is a complex disease with striking disparities across racial and ethnic groups. Despite its relatively high burden, representation of individuals of African ancestry in asthma genome-wide association studies (GWAS) has been inadequate, and true associations in these underrepresented minority groups have been inconclusive. We report the results of a genome-wide meta-analysis from the Consortium on Asthma among African Ancestry Populations (CAAPA; 7009 asthma cases, 7645 controls). We find strong evidence for association at four previously reported asthma loci whose discovery was driven largely by non-African populations, including the chromosome 17q12-q21 locus and the chr12q13 region, a novel (and not previously replicated) asthma locus recently identified by the Trans-National Asthma Genetic Consortium (TAGC). An additional seven loci reported by TAGC show marginal evidence for association in CAAPA. We also identify two novel loci (8p23 and 8q24) that may be specific to asthma risk in African ancestry populations.
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A decade of research on the 17q12-21 asthma locus: Piecing together the puzzle. J Allergy Clin Immunol 2018; 142:749-764.e3. [PMID: 29307657 PMCID: PMC6172038 DOI: 10.1016/j.jaci.2017.12.974] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/13/2017] [Accepted: 12/16/2017] [Indexed: 12/20/2022]
Abstract
Chromosome 17q12–21 remains the most highly replicated and significant asthma locus. Genotypes in the core region defined by the first genome-wide association study correlate with expression of 2 genes, ORM1-like 3 (ORMDL3) and gasdermin B (GSDMB), making these prime candidate asthma genes, although recent studies have implicated gasdermin A (GSDMA) distal to and post-GPI attachment to proteins 3 (PGAP3) proximal to the core region as independent loci. We review 10 years of studies on the 17q12–21 locus and suggest that genotype-specific risks for asthma at the proximal and distal loci are not specific to early-onset asthma and mediated by PGAP3, ORMDL3, and/or GSDMA expression. We propose that the weak and inconsistent associations of 17q single nucleotide polymorphisms with asthma in African Americans is due to the high frequency of some 17q alleles, the breakdown of linkage disequilibrium on African-derived chromosomes, and possibly different early-life asthma endotypes in these children. Finally, the inconsistent association between asthma and gene expression levels in blood or lung cells from older children and adults suggests that genotype effects may mediate asthma risk or protection during critical developmental windows and/or in response to relevant exposures in early life. Thus studies of young children and ethnically diverse populations are required to fully understand the relationship between genotype and asthma phenotype and the gene regulatory architecture at this locus. (J Allergy Clin Immunol 2018;142:749–64.)
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Schwantes EA, Evans MD, Cuskey A, Burford A, Smith JA, Lemanske RF, Jarjour NN, Mathur SK. Elevated fractional exhaled nitric oxide and blood eosinophil counts are associated with a 17q21 asthma risk allele in adult subjects. J Asthma Allergy 2017; 11:1-9. [PMID: 29296089 PMCID: PMC5741070 DOI: 10.2147/jaa.s149183] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background and objectives Genome-wide association studies identified single-nucleotide polymorphisms (SNPs) at the 17q21 locus conferring increased risk for childhood-onset asthma. Little is known about how these SNPs impact adult asthma patients. We sought to examine an adult population for associations between rs7216389 (17q21-associated SNP) and features of asthma including fractional exhaled nitric oxide (FeNO), eosinophil counts, and age of asthma onset. Methods Subjects were genotyped at SNP rs7216389. The geometric mean of FeNO measurements and peripheral blood eosinophil counts from 2008 to 2015 were collected. Demographics and medical history were collected including self-reported allergy diagnoses and age of asthma onset. Eosinophils, monocytes, and peripheral blood mononuclear cells (PBMCs) were isolated for the examination of ORMDL3 expression. Results FeNO levels from 157 genotyped subjects (31CC, 72CT, and 54TT) and peripheral eosinophil counts from 252 genotyped subjects (46CC, 122CT, and 84TT) were analyzed. In a sub-group analysis of asthma subjects, the number of attributable T alleles was associated with significantly lower age of asthma onset (P=0.03) and greater FeNO levels (geometric mean 30.0 ppb TT, 20.0 ppb CT, 20.0 ppb CC, P=0.02). In the total cohort of subjects, the T allele was associated with a higher percentage of individual eosinophil counts >200/mm3 (45% TT, 26% CT, 24% CC, P=0.005). Eosinophils expressed ORMDL3 mRNA and protein. Conclusion In adult subjects, the number of T alleles at SNP rs7216389 corresponds to significantly greater FeNO levels and peripheral eosinophil counts. The expression of ORMDL3 in eosinophils suggests that they may participate in mediating the asthma risk associated with the 17q21 locus.
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Affiliation(s)
| | | | - Alex Cuskey
- Division of Allergy, Pulmonary and Critical Care, Department of Medicine
| | - Alex Burford
- Division of Allergy, Pulmonary and Critical Care, Department of Medicine
| | - Judith A Smith
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Robert F Lemanske
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Nizar N Jarjour
- Division of Allergy, Pulmonary and Critical Care, Department of Medicine
| | - Sameer K Mathur
- Division of Allergy, Pulmonary and Critical Care, Department of Medicine
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10
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Vicente CT, Revez JA, Ferreira MAR. Lessons from ten years of genome-wide association studies of asthma. Clin Transl Immunology 2017; 6:e165. [PMID: 29333270 PMCID: PMC5750453 DOI: 10.1038/cti.2017.54] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/10/2017] [Accepted: 10/31/2017] [Indexed: 12/13/2022] Open
Abstract
Twenty-five genome-wide association studies (GWAS) of asthma were published between 2007 and 2016, the largest with a sample size of 157242 individuals. Across these studies, 39 genetic variants in low linkage disequilibrium (LD) with each other were reported to associate with disease risk at a significance threshold of P<5 × 10−8, including 31 in populations of European ancestry. Results from analyses of the UK Biobank data (n=380 503) indicate that at least 28 of the 31 associations reported in Europeans represent true-positive findings, collectively explaining 2.5% of the variation in disease liability (median of 0.06% per variant). We identified 49 transcripts as likely target genes of the published asthma risk variants, mostly based on LD with expression quantitative trait loci (eQTL). Of these genes, 16 were previously implicated in disease pathophysiology by functional studies, including TSLP, TNFSF4, ADORA1, CHIT1 and USF1. In contrast, at present, there is limited or no functional evidence directly implicating the remaining 33 likely target genes in asthma pathophysiology. Some of these genes have a known function that is relevant to allergic disease, including F11R, CD247, PGAP3, AAGAB, CAMK4 and PEX14, and so could be prioritized for functional follow-up. We conclude by highlighting three areas of research that are essential to help translate GWAS findings into clinical research or practice, namely validation of target gene predictions, understanding target gene function and their role in disease pathophysiology and genomics-guided prioritization of targets for drug development.
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Affiliation(s)
| | - Joana A Revez
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
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11
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Stokholm J, Chawes BL, Vissing N, Bønnelykke K, Bisgaard H. Cat exposure in early life decreases asthma risk from the 17q21 high-risk variant. J Allergy Clin Immunol 2017; 141:1598-1606. [PMID: 29102067 DOI: 10.1016/j.jaci.2017.07.044] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 06/27/2017] [Accepted: 07/03/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Early-life exposure to cats and dogs has shown diverging associations with childhood asthma risk, and gene-environment interaction is one possible explanation. OBJECTIVES We investigated interactions between cat and dog exposure and single nucleotide polymorphism rs7216389 variants in the chromosome 17q21 locus, the strongest known genetic risk factor for childhood asthma. METHODS Genotyping was performed in 377 children from the at-risk Copenhagen Prospective Studies on Asthma in Childhood2000. The primary end point was the development of asthma until age 12 years. The secondary end point was the number of episodes with pneumonia and bronchiolitis from 0 to 3 years of age. Exposures included cat and dog ownership from birth and cat and dog allergen levels in bedding at age 1 year. Replication was performed in the unselected COPSAC2010 cohort with follow-up until 5 years of age. RESULTS Cat and/or dog exposure from birth was associated with a lower prevalence of asthma among children with the rs7216389 high-risk TT genotype (adjusted hazard ratio, 0.16; 95% CI, 0.04-0.71; P = .015), with no effect in those with the CC/CT genotype (adjusted P = .283), demonstrating interaction between cat and dog exposure and the rs7216389 genotype (adjusted P = .044). Cat allergen levels were inversely associated with asthma development in children with the TT genotype (adjusted hazard ratio, 0.83; 95% CI, 0.71-0.97; P = .022), supporting the cat-rs7216389 genotype interaction (adjusted P = .008). Dog allergen exposure did not show such interaction. Furthermore, the TT genotype was associated with higher risk of pneumonia and bronchiolitis, and this increased risk was likewise decreased in children exposed to cat. Replication showed similar effects on asthma risk. CONCLUSION The observed gene-environment interaction suggests a role of early-life exposure, especially to cat, for attenuating the risk of childhood asthma, pneumonia, and bronchiolitis in genetically susceptible subjects.
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Affiliation(s)
- Jakob Stokholm
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Naestved Hospital, Naestved, Denmark
| | - Bo L Chawes
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Nadja Vissing
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Bønnelykke
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Hans Bisgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
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12
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Edwards MR, Saglani S, Schwarze J, Skevaki C, Smith JA, Ainsworth B, Almond M, Andreakos E, Belvisi MG, Chung KF, Cookson W, Cullinan P, Hawrylowicz C, Lommatzsch M, Jackson D, Lutter R, Marsland B, Moffatt M, Thomas M, Virchow JC, Xanthou G, Edwards J, Walker S, Johnston SL. Addressing unmet needs in understanding asthma mechanisms: From the European Asthma Research and Innovation Partnership (EARIP) Work Package (WP)2 collaborators. Eur Respir J 2017; 49:49/5/1602448. [PMID: 28461300 DOI: 10.1183/13993003.02448-2016] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 03/13/2017] [Indexed: 12/27/2022]
Abstract
Asthma is a heterogeneous, complex disease with clinical phenotypes that incorporate persistent symptoms and acute exacerbations. It affects many millions of Europeans throughout their education and working lives and puts a heavy cost on European productivity. There is a wide spectrum of disease severity and control. Therapeutic advances have been slow despite greater understanding of basic mechanisms and the lack of satisfactory preventative and disease modifying management for asthma constitutes a significant unmet clinical need. Preventing, treating and ultimately curing asthma requires co-ordinated research and innovation across Europe. The European Asthma Research and Innovation Partnership (EARIP) is an FP7-funded programme which has taken a co-ordinated and integrated approach to analysing the future of asthma research and development. This report aims to identify the mechanistic areas in which investment is required to bring about significant improvements in asthma outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Rene Lutter
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Benjamin Marsland
- University of Lausanne, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | | | | | | | - Georgina Xanthou
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
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13
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Ayabe T, Fukami M, Ogata T, Kawamura T, Urakami T, Kikuchi N, Yokota I, Ihara K, Takemoto K, Mukai T, Nishii A, Kikuchi T, Mori T, Shimura N, Sasaki G, Kizu R, Takubo N, Soneda S, Fujisawa T, Takaya R, Kizaki Z, Kanzaki S, Hanaki K, Matsuura N, Kasahara Y, Kosaka K, Takahashi T, Minamitani K, Matsuo S, Mochizuki H, Kobayashi K, Koike A, Horikawa R, Teno S, Tsubouchi K, Mochizuki T, Igarashi Y, Amemiya S, Sugihara S. Variants associated with autoimmune Type 1 diabetes in Japanese children: implications for age-specific effects of cis-regulatory haplotypes at 17q12-q21. Diabet Med 2016; 33:1717-1722. [PMID: 27352912 DOI: 10.1111/dme.13175] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 05/08/2016] [Accepted: 06/27/2016] [Indexed: 12/11/2022]
Abstract
AIMS The aim of this study was to clarify the significance of previously reported susceptibility variants in the development of autoimmune Type 1 diabetes in non-white children. Tested variants included rs2290400, which has been linked to Type 1 diabetes only in one study on white people. Haplotypes at 17q12-q21 encompassing rs2290400 are known to determine the susceptibility of early-onset asthma by affecting the expression of flanking genes. METHODS We genotyped 63 variants in 428 Japanese people with childhood-onset autoimmune Type 1 diabetes and 457 individuals without diabetes. Possible association between variants and age at diabetes onset was examined using age-specific quantitative trait locus analysis and ordered-subset regression analysis. RESULTS Ten variants, including rs2290400 in GSDMB, were more frequent among the people with Type 1 diabetes than those without diabetes. Of these, rs689 in INS and rs231775 in CTLA4 yielded particularly high odds ratios of 5.58 (corrected P value 0.001; 95% CI 2.15-14.47) and 1.64 (corrected P value 5.3 × 10-5 ; 95% CI 1.34-2.01), respectively. Age-specific effects on diabetes susceptibility were suggested for rs2290400; heterozygosity of the risk alleles was associated with relatively early onset of diabetes, and the allele was linked to the phenotype exclusively in the subgroup of age at onset ≤ 5.0 years. CONCLUSIONS The results indicate that rs2290400 in GSDMB and polymorphisms in INS and CTLA4 are associated with the risk of Type 1 diabetes in Japanese children. Importantly, cis-regulatory haplotypes at 17q12-q21 encompassing rs2290400 probably determine the risk of autoimmune Type 1 diabetes predominantly in early childhood.
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Affiliation(s)
- T Ayabe
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - M Fukami
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - T Ogata
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - T Kawamura
- Department of Pediatrics, Osaka City University Hospital, Osaka, Japan
| | - T Urakami
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - N Kikuchi
- Department of Pediatrics, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - I Yokota
- Department of Clinical Laboratory, Shikoku Medical Center for Children and Adults, Zentsuji, Japan
- Department of Pediatrics, Graduate School of Medical Sciences Tokushima University, Tokushima, Japan
| | - K Ihara
- Department of Pediatrics, Kyushu University Hospital, Fukuoka, Japan
- Department of Pediatrics, Oita University Hospital, Yufu, Japan
| | - K Takemoto
- Department of Pediatrics, Ehime University Hospital, Toon, Japan
- Department of Pediatrics, Sumitomo Besshi Hospital, Niihama, Japan
| | - T Mukai
- Department of Pediatrics, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - A Nishii
- Department of Pediatrics, JR Sendai Hospital, Sendai, Japan
| | - T Kikuchi
- Department of Pediatrics, Saitama Medical University Hospital, Saitama, Japan
- Department of Pediatrics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - T Mori
- Department of Pediatrics, Nagano Red Cross Hospital, Nagano, Japan
- Department of Pediatrics, Shinshu Ueda Medical Center, Ueda, Japan
| | - N Shimura
- Department of Pediatrics, Dokkyo Medical University Hospital, Shimotsuga, Japan
| | - G Sasaki
- Department of Pediatrics, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan
| | - R Kizu
- Department of Pediatrics, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - N Takubo
- Department of Pediatrics, Kitasato University Hospital, Sagamihara, Japan
- Department of Pediatrics and Adolescent Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - S Soneda
- Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan
| | - T Fujisawa
- Department of Pediatrics, National Mie Hospital, Tsu, Japan
| | - R Takaya
- Department of Pediatrics, Osaka Medical College, Takatsuki, Japan
| | - Z Kizaki
- Department of Pediatrics, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - S Kanzaki
- Department of Pediatrics, Tottori University Faculty of Medicine, Yonago, Japan
| | - K Hanaki
- Department of Pediatrics, Tottori Prefectural Kousei Hospital, Kurayoshi, Japan
| | - N Matsuura
- Department of Pediatrics, Teine Keijinkai Hospital, Sapporo, Japan
- Department of Early Childhood Care and Education, Seitoku University Junior College, Matsudo, Japan
| | - Y Kasahara
- Department of Pediatrics, Kanazawa University, Kanazawa, Japan
| | - K Kosaka
- Department of Pediatrics, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - K Minamitani
- Department of Pediatrics, Teikyo University Chiba Medical Center, Ichihara, Japan
| | - S Matsuo
- Matsuo Kodomo Clinic, Kyoto, Japan
| | - H Mochizuki
- Department of Metabolism and Endocrinology, Saitama Children's Medical Center, Saitama, Japan
| | - K Kobayashi
- Department of Pediatrics, University of Yamanashi Hospital, Chuo, Japan
| | - A Koike
- Miyanosawa Koike Child Clinic, Sapporo, Japan
| | - R Horikawa
- Division of Endocrinology and Metabolism, Department of Medical Subspecialties, National Medical Center for Children and Mothers, Tokyo, Japan
| | - S Teno
- Teno Clinic, Izumo, Japan
| | - K Tsubouchi
- Department of Pediatrics, Chuno Kosei Hospital, Seki, Japan
| | - T Mochizuki
- Department of Pediatrics, Osaka City General Hospital, Osaka, Japan
- Department of Pediatrics, Osaka Police Hospital, Osaka, Japan
| | - Y Igarashi
- Igarashi Children's Clinic, Sendai, Japan
| | - S Amemiya
- Department of Pediatrics, Saitama Medical University Hospital, Saitama, Japan
| | - S Sugihara
- Department of Pediatrics, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
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14
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Ng CL, Wang DY. Latest developments in allergic rhinitis in Allergy for clinicians and researchers. Allergy 2015; 70:1521-30. [PMID: 26443244 DOI: 10.1111/all.12782] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2015] [Indexed: 02/06/2023]
Abstract
Research efforts in allergic rhinitis have always been intense. Over the past 3 years, numerous breakthroughs in basic science and clinical research have been made, augmenting our understanding of this condition that afflicts a significant proportion of the global population. New epidemiological findings, novel insights into the molecular and cellular mechanisms of allergy, enhancement of current developmental theories, new concepts of the goals and endpoints of management, and latest therapeutic modalities that includes the harnessing of information technology and big data are some areas where important advances were made. We attempt to bring you a summary of the key research advances made in the field of allergic rhinitis from 2013 to 2015.
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Affiliation(s)
- C. L. Ng
- Department of Otolaryngology; Yong Loo Lin School of Medicine; National University of Singapore; National University Health System; Singapore City Singapore
| | - D. Y. Wang
- Department of Otolaryngology; Yong Loo Lin School of Medicine; National University of Singapore; National University Health System; Singapore City Singapore
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