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Gao YQ, Seah JJ, Wang ML, Tang QP, Wang DY, Bi XY, Han HW, Zhang TS, Ma J. An unusually high prevalence of allergic rhinitis at high altitudes in 6-7 year old children - An epidemiological study. World Allergy Organ J 2024; 17:100887. [PMID: 38742158 PMCID: PMC11089395 DOI: 10.1016/j.waojou.2024.100887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 05/16/2024] Open
Abstract
Objectives To compare the epidemiology and disease patterns of allergic rhinitis (AR) at 2 different altitudes in children aged 6-7 years, and subsequently to compare with and augment data from international studies. Materials and methods This is a multistage, clustered and stratified random sample study. The study area comprises 2 distinct areas within Yunnan Province, China. Low altitude was represented by Xishuangbanna Prefecture (XB), while high altitude was represented by Diqing Prefecture (DiQ). Each study area was subdivided into 3 sub-areas, and children aged 6-7 years were randomly sampled based on proportion-weighted sampling. The area studied includes the well-known area of Shangri-La city. Questionnaires were distributed and jointly completed by study participants and their parents or guardians, under the guidance of professional medical staff. Results 2796 valid questionnaires out of 2933 distributed were obtained (survey response rate 95.3%). The prevalence of AR is statistically significantly higher at high altitude (DiQ, 36.0%, 95%CI 33.2-38.8) as compared to low altitude (XB, 19.7%, 95%CI 17.8-21.6) (p < 0.001). Both areas studied had a greater prevalence of AR compared to international data. In both XB and DiQ, male gender, history of early antibiotic use, urban place of birth and place of residence, presence of smokers within the same household, family history of allergic diseases (such as atopic dermatitis), as well as higher parental educational level were all associated with a higher prevalence of AR (p < 0.05). In DiQ, the prevalence of AR in Han ethnicity was greater than that of ethnic minorities (p < 0.05). In XB, being a single child was associated with an increased prevalence of AR compared to those who had siblings (p < 0.05). Conclusion Our study found that the prevalence of AR is relatively greater at higher altitudes. Genetic and environmental factors both play an important role in the pathogenesis of AR. While altitude may be an important environmental factor, confounding factors may include humidity, temperature and distribution pattern of common aeroallergens.
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Affiliation(s)
- Ying-Qin Gao
- Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, China
| | - Jun Jie Seah
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mei-Lan Wang
- Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, China
| | - Qing-ping Tang
- Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, China
| | - De-Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Infectious Diseases Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xian-Yun Bi
- Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, China
| | - Hua-wei Han
- Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, China
| | - Tie-Song Zhang
- Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, China
| | - Jing Ma
- Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, China
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Wang N, Song J, Sun SR, Zhu KZ, Li JX, Wang ZC, Guo CL, Xiang WX, Tong YL, Zeng M, Wang H, Xu XY, Yao Y, Liu Z. Immune signatures predict response to house dust mite subcutaneous immunotherapy in patients with allergic rhinitis. Allergy 2024; 79:1230-1241. [PMID: 38403941 DOI: 10.1111/all.16068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/07/2024] [Accepted: 01/23/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Identifying predictive biomarkers for allergen immunotherapy response is crucial for enhancing clinical efficacy. This study aims to identify such biomarkers in patients with allergic rhinitis (AR) undergoing subcutaneous immunotherapy (SCIT) for house dust mite allergy. METHODS The Tongji (discovery) cohort comprised 72 AR patients who completed 1-year SCIT follow-up. Circulating T and B cell subsets were characterized using multiplexed flow cytometry before SCIT. Serum immunoglobulin levels and combined symptom and medication score (CSMS) were assessed before and after 12-month SCIT. Responders, exhibiting ≥30% CSMS improvement, were identified. The random forest algorithm and logistic regression analysis were used to select biomarkers and establish predictive models for SCIT efficacy in the Tongji cohort, which was validated in another Wisco cohort with 43 AR patients. RESULTS Positive SCIT response correlated with higher baseline CSMS, allergen-specific IgE (sIgE)/total IgE (tIgE) ratio, and frequencies of Type 2 helper T cells, Type 2 follicular helper T (TFH2) cells, and CD23+ nonswitched memory B (BNSM) and switched memory B (BSM) cells, as well as lower follicular regulatory T (TFR) cell frequency and TFR/TFH2 cell ratio. The random forest algorithm identified sIgE/tIgE ratio, TFR/TFH2 cell ratio, and BNSM frequency as the key biomarkers discriminating responders from nonresponders in the Tongji cohort. Logistic regression analysis confirmed the predictive value of a combination model, including sIgE/tIgE ratio, TFR/TFH2 cell ratio, and CD23+ BSM frequency (AUC = 0.899 in Tongji; validated AUC = 0.893 in Wisco). CONCLUSIONS A T- and B-cell signature combination efficiently identified SCIT responders before treatment, enabling personalized approaches for AR patients.
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Affiliation(s)
- Nan Wang
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, China
| | - Jia Song
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, China
| | - Shi-Ran Sun
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, China
| | - Ke-Zhang Zhu
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, China
| | - Jing-Xian Li
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, China
| | - Zhi-Chao Wang
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, China
| | - Cui-Lian Guo
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, China
| | - Wen-Xuan Xiang
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yun-Long Tong
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ming Zeng
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, China
| | - Heng Wang
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, China
| | - Xiao-Yan Xu
- Department of Otolaryngology-Head and Neck Surgery, China Resources & Wisco General Hospital, Wuhan, China
| | - Yin Yao
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zheng Liu
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Zhi L, Bai Y, Liao W, Chen G, Gao T, Wan X, Liang J, Liu L, Chen L, Zhang W, Bai J. The safety and tolerability of a one strength dose-escalation scheme for subcutaneous immunotherapy with a native house dust mite extract in Chinese children: A multicenter, randomized, open label clinical trial. Heliyon 2024; 10:e29450. [PMID: 38655350 PMCID: PMC11036000 DOI: 10.1016/j.heliyon.2024.e29450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/06/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024] Open
Abstract
Background Allergen immunotherapy (AIT) is still the only treatment that may affect the natural cause of allergic disease. This study is to investigate whether an accelerated up-dosing scheme for subcutaneous allergen immunotherapy (SCIT) using a native house dust mite (HDM) allergen extract is as safe as the standard 3-strengths dose-escalation scheme in children with moderate to severe allergic rhinitis or rhinoconjunctivitis with or without asthma in China. Methods In this multicenter, open label, randomized controlled trial, the children aged 5-14 years were randomized 1:1 either to One Strength group or the Standard group. The dose escalation scheme for patients in the One Strength group included 6 injections of strength 3, whereas the Standard group comprised 14 injections using strength 1, 2, and 3. All treatment-emergent adverse events (TEAEs) were recorded and analyzed. The 5-point Likert scale was used to assess tolerability (ChiCTR2100050311). Results Overall, 101 children were included in the Safety Set (One Strength group: 50 vs. Standard group: 51). A total of 26 TEAEs were reported for 15 children. TEAEs related to AIT occurred in 10 % of the children in the One Strength group and 11.8 % of the Standard group. The number of systemic adverse reactions was comparable in both groups (One Strength: 5 vs. Standard: 4). No serious TEAEs was recorded for either group. 90.0 % of patients in the One Strength group reached the maintenance dose without an interventional dose adjustment due to adverse events, compared to 78.4 % in the Standard group. All patients who completed the dose-escalation phase reached the recommended maintenance dose of 1.0 ml of strength 3.Investigators and patients rated the tolerability of the One Strength regimen slightly better than the Standard scheme. Conclusions This exploratory study suggests that the accelerated One Strength dose-escalation scheme is comparable in safety and tolerability to the Standard regimen. However, due to the preliminary nature and small sample size, further research with larger sample sizes and robust study designs is necessary for confirmation.
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Affiliation(s)
- Lili Zhi
- Department of Allergy, The First Affiliated Hospital of Shandong First Medical University, Jinan, 250014, China
| | - Yan Bai
- Department of Pediatrics, Union Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Wang Liao
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Guohua Chen
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Tingting Gao
- Department of Allergy, The First Affiliated Hospital of Shandong First Medical University, Jinan, 250014, China
| | - Xia Wan
- Department of Pediatrics, Union Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Jiawen Liang
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Lingling Liu
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Liang Chen
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Wenna Zhang
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Jun Bai
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
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Tian J, Yang F. Site-specific tyrosine nitration of group 1 allergens of house dust mite Dermatophagoides farinae (der f 1) and Dermatophagoides pteronyssinus (der p 1) in indoor dusts. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 330:121716. [PMID: 37142204 DOI: 10.1016/j.envpol.2023.121716] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/04/2023] [Accepted: 04/24/2023] [Indexed: 05/06/2023]
Abstract
Nitration can enhance the allergenicity of proteins. The nitration status of house dust mite (HDM) allergens in indoor dusts, however, remains to be elucidated. In the study, site-specific tyrosine nitration degrees of the two important HDM allergens Der f 1 and Der p 1 in indoor dust samples were investigated by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). The measured concentrations of native and nitrated allergens in the dusts were in the range of 0.86-29 μg g-1 for Der f 1 and from below the detection limit to 29 μg g-1 for Der p 1. Site-specific analysis revealed that all ten tyrosine residues in Der f 1 and Der p 1 were nitrated to different degrees in the investigated samples. The preferred nitration sites were Y56 in Der f 1 and Y37 in Der p 1 with the nitration degrees of 7.6-84% and 17-96% among the detected tyrosine residues, respectively. The measurements reveal high site-specific nitration degrees for tyrosine in Der f 1 and Der p 1 detected in the indoor dust samples. Further investigations are required to find out if the nitration really aggravates the health effects of HDM allergens and if the effects are tyrosine site-dependent.
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Affiliation(s)
- Jingyi Tian
- Key Laboratory of Environment Remediation and Ecological Health, Ministry of Education, College of Environmental and Resource Sciences, Zhejiang University, 310058, Hangzhou, China
| | - Fangxing Yang
- Key Laboratory of Environment Remediation and Ecological Health, Ministry of Education, College of Environmental and Resource Sciences, Zhejiang University, 310058, Hangzhou, China.
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Multimorbidity of Allergic Conditions in Urban Citizens of Southern China: A Real-World Cross-Sectional Study. J Clin Med 2023; 12:jcm12062226. [PMID: 36983228 PMCID: PMC10059830 DOI: 10.3390/jcm12062226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/15/2023] [Accepted: 03/02/2023] [Indexed: 03/15/2023] Open
Abstract
Background: Extensive knowledge of allergic multimorbidities is required to improve the management of allergic diseases with the industrialization of China. However, the demography and allergen distribution patterns of allergic multimorbidities in China remain unclear, despite the increasing prevalence of allergies. Methods: This was a real-world, cross-sectional study of 1273 outpatients diagnosed with one or more allergic diseases in Guangzhou, the most populated city of southern China, with leading industrial and commercial centers, between April 2021 and March 2022. Seven allergic diseases (allergic rhinitis (AR), asthma (AS)/cough variant asthma (CVA), atopic dermatitis (AD)/eczema, food allergy (FA), allergic conjunctivitis (AC), drug allergy (DA), and anaphylaxis) were assessed. Positive rates of sensitization to different allergens were measured using an allergen detection system of the UniCAP (Pharmacia Diagnostics, Sweden) instrument platform to compare the groups of allergic multimorbidities against a single entity. Results: There were 659 (51.8%) males and 614 (48.2%) females aged from 4 months to 74 years included in the analysis. The study participants who were diagnosed with allergic diseases had an average of 1.6 diagnoses. Overall, 46.5% (592 of 1273) of the patients had more than one allergic condition, and allergic rhinitis was the most common type of multimorbidity. Women were more likely to suffer from an allergic disease alone, whereas allergic multimorbidities were more likely to be diagnosed in men (p = 0.005). In addition, allergic multimorbidities were common in all age groups, with an incidence ranging from 37.1% to 57.4%, in which children and adolescents were more frequently diagnosed with allergic multimorbidities than adults (18–60 years old) (all p < 0.05). Allergic multimorbidity was observed throughout the year. A difference in the positive rate of allergens sensitization and total immunoglobulin E (tIgE) levels between different allergic multimorbidities was observed. Conclusions: Allergic multimorbidities were very commonly found in nearly half of all patients with allergies. The proportion of allergic multimorbidities varied with the type of disease, sex, age, and allergen distribution pattern. These findings may help clinicians to develop “One health” strategies for the clinical management of allergic diseases.
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Xu F, Tian J, Yang F. House dust mite allergens and nitrated products: Identification and risk assessment in indoor dust. J Environ Sci (China) 2023; 124:198-204. [PMID: 36182131 DOI: 10.1016/j.jes.2021.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 06/16/2023]
Abstract
Air pollutants can potentially lead to nitration of allergic proteins, thus promoting sensitization of these allergens. However, little is currently known about the nitration status of house dust mite (HDM) allergens. We identified the occurrence of nitrated products of two major HDM allergens Der f 1 and Der p 1 in dust samples collected from college dormitories in eastern China and assessed their associated health risk. The results showed that both non-nitrated and nitrated forms of the two allergens were detected in the dust in the range of non-detected (ND)-10.6, 1.44-15.4, ND-22.4, ND-7.28 µg/g for non-nitrated Der f 1, nitrated Der f 1, non-nitrated Der p 1 and nitrated Der p 1, respectively. The median rates of nitration were determined as 74.0% for Der f 1 and 20.4% for Der p 1 at consideration of one nitration site. Further analysis reveals that the levels of HDM allergens and their nitrated products were found to be generally higher during winter, in dormitories of lower altitude and with female occupants. Furthermore, the calculated risk indexes were at considerably high levels. Our findings suggest that nitrated HDM allergens have already accumulated in the environment at such significant levels and their associated health risk calls for our immediate attention.
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Affiliation(s)
- Fan Xu
- Key Laboratory of Environment Remediation and Ecological Health, Ministry of Education, College of Natural Resources and Environmental Science, Zhejiang University, Hangzhou 310058, China
| | - Jingyi Tian
- Key Laboratory of Environment Remediation and Ecological Health, Ministry of Education, College of Natural Resources and Environmental Science, Zhejiang University, Hangzhou 310058, China
| | - Fangxing Yang
- Key Laboratory of Environment Remediation and Ecological Health, Ministry of Education, College of Natural Resources and Environmental Science, Zhejiang University, Hangzhou 310058, China.
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Wang C, Bao Y, Chen J, Chen X, Cheng L, Guo YS, Hao C, Lai H, Li H, Li J, Liu C, Liu Y, Liu Z, Lou H, Lv W, Nong G, Qiu Q, Ren X, Shao J, Shen YH, Shi L, Song XC, Song Y, Tang S, Wang H, Wang X, Wang X, Wang Z, Wei Q, Xie H, Xing Z, Xu R, Xu Y, Yang Q, Yao H, Ye J, You Y, Yu H, Yu Y, Zhang H, Zhang G, Zhang Y, Zhi Y, Zhou W, Zhu L, Zhu X, Chai R, Chen D, Guan K, Huang Z, Huang Y, Ma T, Ma Y, Meng Y, Ren L, Wang J, Wang N, Xian M, Xiang R, Zheng M, Zhang L. Chinese Guideline on Allergen Immunotherapy for Allergic Rhinitis: The 2022 Update. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2022; 14:604-652. [PMID: 36426395 PMCID: PMC9709690 DOI: 10.4168/aair.2022.14.6.604] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/23/2022] [Accepted: 11/06/2022] [Indexed: 09/16/2023]
Abstract
In the last few decades, there has been a progressive increase in the prevalence of allergic rhinitis (AR) in China, where it now affects approximately 250 million people. AR prevention and treatment include allergen avoidance, pharmacotherapy, allergen immunotherapy (AIT), and patient education, among which AIT is the only curative intervention. AIT targets the disease etiology and may potentially modify the immune system as well as induce allergen-specific immune tolerance in patients with AR. In 2017, a team of experts from the Chinese Society of Allergy (CSA) and the Chinese Allergic Rhinitis Collaborative Research Group (C2AR2G) produced the first English version of Chinese AIT guidelines for AR. Since then, there has been considerable progress in basic research of and clinical practice for AIT, especially regarding the role of follicular regulatory T (TFR) cells in the pathogenesis of AR and the use of allergen-specific immunoglobulin E (sIgE) in nasal secretions for the diagnosis of AR. Additionally, potential biomarkers, including TFR cells, sIgG4, and sIgE, have been used to monitor the incidence and progression of AR. Moreover, there has been a novel understanding of AIT during the coronavirus disease 2019 pandemic. Hence, there was an urgent need to update the AIT guideline for AR by a team of experts from CSA and C2AR2G. This document aims to serve as professional reference material on AIT for AR treatment in China, thus improving the development of AIT across the world.
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Affiliation(s)
- Chengshuo Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Nasal Diseases and Beijing Laboratory of Allergic Diseases, Beijing Institute of Otorhinolaryngology, Beijing, China
- Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, China
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | | | - Jianjun Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Xiaoyang Chen
- Department of Pulmonary and Critical Care Medicine, Second Affiliated Hospitial of Fujian Medical University, Respiratory Medicine Center of Fujian Province, Quanzhou, China
| | - Lei Cheng
- Department of Otorhinolaryngology & Clinical Allergy Center, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Yin Shi Guo
- Department of Allergy & Immunology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chuangli Hao
- Department of Respiratory Diseases, Children's Hospital of Soochow University, Suzhou, China
| | - He Lai
- Department of Allergy, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huabin Li
- Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Jing Li
- Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Changshan Liu
- Department of Pediatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yun Liu
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zheng Liu
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongfei Lou
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Lv
- Department of Otorhinolaryngology, Peking Union Medical College Hospital, Beijing, China
| | - Guangmin Nong
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qianhui Qiu
- Department of Otolaryngology-Head and Neck Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiumin Ren
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jie Shao
- Department of Pediatrics, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi-Hong Shen
- Department of Respiratory Diseases, The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou, China
| | - Li Shi
- Department of Otolaryngology,The Second Hospital of Shandong University, Jinan, China
| | - Xi-Cheng Song
- Department of Otorhinolaryngology Head and Neck Surgery, Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Yuxin Song
- Department of Allergy, Harbin Children's Hospital, Harbin, China
| | - Suping Tang
- Department of Allergy, Fuzhou Children's Hospital Affiliated to Fujian Medical University, Fuzhou, China
| | - Hongtian Wang
- Department of Allergy, Beijing ShiJiTan Hospital, Capital Medical University, Beijing, China
| | - Xiangdong Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Nasal Diseases and Beijing Laboratory of Allergic Diseases, Beijing Institute of Otorhinolaryngology, Beijing, China
| | - Xueyan Wang
- Department of Allergy, Beijing ShiJiTan Hospital, Capital Medical University, Beijing, China
| | - Zhenlin Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qingyu Wei
- Department of Allergy, Shengjing Hospital of China Medical University, Shenyang, China
| | - Hua Xie
- Department of Allergy, Northern Theatre General Hospital, Shenyang, China
| | - Zhimin Xing
- Department of Otolaryngology-Head and Neck Surgery, Peking University People's Hospital, Beijing, China
| | - Rui Xu
- Department of Allergy of Otorhinolaryngology Hospital, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yu Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qintai Yang
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Hongmei Yao
- Department of Respiratory and Critical Care Medicine, Guizhou Provincial People's Hospital, Guiyang, China
| | - Jing Ye
- Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yiwen You
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of Nantong University, Nantong, China
| | - Hongmeng Yu
- Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Yongmei Yu
- Department of Otorhinolaryngology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Huanping Zhang
- Department of Allergy, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Gehua Zhang
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yuan Zhang
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Yuxiang Zhi
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Weikang Zhou
- Department of Allergy, Chongqing General Hospital, Chongqing, China
| | - Li Zhu
- Department of Otorhinolaryngology, The Third Hospital of Peking University, Beijing, China
| | - Xinhua Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ruonan Chai
- Department of Allergy, Northern Theatre General Hospital, Shenyang, China
| | - Dehua Chen
- Department of Allergy of Otorhinolaryngology Hospital, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Kai Guan
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zizhen Huang
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yanran Huang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Tingting Ma
- Department of Allergy, Beijing ShiJiTan Hospital, Capital Medical University, Beijing, China
| | - Yuemei Ma
- Department of Allergy, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yifan Meng
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Lei Ren
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Jianxing Wang
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Nan Wang
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mo Xian
- Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Rong Xiang
- Department of Otorhinolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ming Zheng
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Luo Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
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8
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Zhang P, Bian S, Wang X, Chen Z, Yang L, Xiao F, Guan K. A real-world retrospective study of safety, efficacy, compliance and cost of combination treatment with rush immunotherapy plus one dose of pretreatment anti-IgE in Chinese children with respiratory allergies. Front Immunol 2022; 13:1024319. [PMID: 36268011 PMCID: PMC9577550 DOI: 10.3389/fimmu.2022.1024319] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe efficacy of allergen immunotherapy (AIT) in treating pediatric allergy has been clearly demonstrated, however, many patients hesitate to initiate AIT due to weekly hospital visits during the 3-4 months up-dosing phase. Meanwhile, rush immunotherapy (RIT) shortens the duration of the up-dosing phase to 7 days. However, considering that patients receiving RIT are exposed to the allergens during a much shorter period of time and thus may be at a greater risk of systemic reactions, RIT is currently underused, especially in children. This study investigated the utility of combination treatment with RIT plus 1 dose of pretreatment anti-IgE in children with respiratory allergies.MethodsIn this retrospective study, we reviewed records of children with allergic rhinitis (AR) and/or allergic asthma (AA) sensitized to dust mite allergens receiving RIT+1 dose of pretreatment anti-IgE (the RIT group) or conventional immunotherapy (the CIT group) at our hospital from January 2020 to March 2021. Data such as visual analogue scale (VAS) scores, comprehensive symptom and medication score (CSMS), allergy blood test results, adverse reactions, compliance and cost were collected and analyzed.Results40 patients in the RIT group and 81 patients in the CIT group were included in this study. Both treatments were well tolerated and patients in the 2 treatment groups had comparable local and systemic reactions. Compared to CIT, RIT + anti-IgE combination led to significantly faster symptomatic improvement as demonstrated by significantly decreased VAS and CSMS starting as early as 1 month after AIT initiation (P<0.05). Nobody dropped out in the RIT group during the 1 year follow-up, while 11 out of 81 patients in the CIT group dropped out (loss rate 13.5%). Thus, the RIT group had a significantly higher compliance rate than the CIT group (P<0.05). Finally, the 2 treatment regimens had comparable cost per patient per injection (P> 0.05).ConclusionsRIT + 1 dose of pretreatment anti-IgE combination has practical advantages over CIT, including comparable safety, better compliance, and probably a faster onset of clinical efficacy at no additional cost, so it can be an useful regimen for the treatment of Chinese children with respiratory allergies.
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Affiliation(s)
- Pingping Zhang
- Department of Pediatrics, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Allergy, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Sainan Bian
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xibin Wang
- Department of Pediatrics, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhuanggui Chen
- Department of Pediatrics, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Allergy, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Lifen Yang
- Department of Pediatrics, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- *Correspondence: Lifen Yang, ; Feng Xiao, ; Kai Guan,
| | - Feng Xiao
- Department of Stomatology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- *Correspondence: Lifen Yang, ; Feng Xiao, ; Kai Guan,
| | - Kai Guan
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Lifen Yang, ; Feng Xiao, ; Kai Guan,
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9
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Seasonal distribution of inhaled allergens in allergic asthma patients with or without allergic rhinitis. Chin Med J (Engl) 2022; 135:1867-1869. [PMID: 34924508 PMCID: PMC9521760 DOI: 10.1097/cm9.0000000000001894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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10
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Wang W, Wang J, Song G, Xie H, Lin X, Chai R, Zhu R, He Y, Tang J, Wang J, Yang J, Zhi L, Wu L, Jiang Y, Zhou X, Huang D, Wang N, Xu R, Gao Y, Chen Z, Liu J, Han X, Tan G, Wu J, Zhao D, Chen J, Zhang X, Li M, Sun Y, Jiang Y, Zhang W, Qiu Q, Liu C, Yin J, Hao G, Li H, Xu Y, Chen S, Zhang H, Chen S, Meng J, Zeng D, Tang W, Hao C, Li J, Zhong N. Environmental and sensitization variations among asthma and/or rhinitis patients between 2008 and 2018 in China. Clin Transl Allergy 2022; 12:e12116. [PMID: 35136540 PMCID: PMC8809046 DOI: 10.1002/clt2.12116] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 12/09/2021] [Accepted: 01/07/2022] [Indexed: 02/05/2023] Open
Abstract
Background Little is known about the changes in allergen sensitization in China secondary to the environmental variations over the past decade. We aimed at investigating the variations in sensitization among asthma and/or rhinitis patients in China between 2008 and 2018. Methods This study analyzed cross‐sectional data from national surveys conducted in China in 2008 and 2018. After finishing the questionnaire, participants underwent serum specific IgE measurements. A total of 2322 and 2798 patients were enrolled in 2008 and 2018, respectively. The significance of differences in sensitization rates among four regions of China were assessed. Correlation analysis was used to identify the associations of sensitization with climate change and planting of Artemisia desertorum between the two surveys. Results Compared with 2008, the general sensitization rate to mites significantly increased in 2018, which ranked highest among all tested allergens. Sensitization to pollens, especially Artemisia vulgaris, showed the greatest increase in the north. The annual mean temperature, rainfall and relative humidity in all four regions, and the Artemisia desertorum coverage in the northeastern area, increased significantly in 2018 as compared with 2008. From 2008 to 2018, an increase in Dermatophagoides pteronyssinus sensitization was significantly associated with an increase in relative humidity (r = 0.54, p = 0.037). The increase in A. vulgaris sensitization was significantly associated with the increase in the A. desertorum planting area (r = 0.67, p = 0.006) and with a decrease in rainfall (r = −0.59, p = 0.021). Conclusions House dust mites remain the most important allergen in Chinese individuals with asthma and/or rhinitis. Pollen sensitization dramatically increased in northern China. Increases in sensitization to dust mites and Artemisia were related to the increases in humidity and planting area of A. desertorum.
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11
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Huang HJ, Resch-Marat Y, Casset A, Weghofer M, Zieglmayer P, Zieglmayer R, Lemell P, Horak F, Chen KW, Potapova E, Matricardi PM, Pauli G, Grote M, Valenta R, Vrtala S. IgE recognition of the house dust mite allergen Der p 37 is associated with asthma. J Allergy Clin Immunol 2021; 149:1031-1043. [PMID: 34419535 DOI: 10.1016/j.jaci.2021.07.040] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 06/09/2021] [Accepted: 07/20/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND House dust mite (HDM) allergens are major elicitors of allergic reactions worldwide. OBJECTIVE Identification, characterization, and evaluation of diagnostic utility of a new important HDM allergen was performed. METHODS A cDNA coding for a new Dermatophagoides pteronyssinus (Dp) allergen, Der p 37, was isolated from a Dp expression library with allergic patients' IgE antibodies. Recombinant Der p 37 (rDer p 37) expressed in Escherichia coli was purified, then characterized by mass spectrometry, circular dichroism, and IgE reactivity by ImmunoCAP ISAC technology with sera from 111 clinically defined HDM-allergic patients. The allergenic activity of rDer p 37 was studied by basophil activation and CD4+ T-cell responses by carboxyfluorescein diacetate succinimidyl ester dilution assays. Specific antibodies raised against rDer p 37 were used for the ultrastructural localization of Der p 37 in mites by immunogold transmission electron microscopy. RESULTS Der p 37, a 26 kDa allergen with homology to chitin-binding proteins, is immunologically distinct from Der p 15, 18, and 23. It is located in the peritrophic membrane of fecal pellets. Der p 37 reacted with IgE antibodies from a third of HDM-allergic patients and induced specific basophil- and CD4+ T-cell activation. Der p 37 IgE-positive patients had significantly higher IgE levels to major HDM allergens, reacted with more HDM allergens, and had a higher risk (odds ratio = 3.1) of asthma compared to Der p 37-negative patients. CONCLUSIONS Der p 37, a new Dp allergen recognized by a third of HDM-allergic patients, may serve as a surrogate marker for severe HDM sensitization and asthma.
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Affiliation(s)
- Huey-Jy Huang
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Yvonne Resch-Marat
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Anne Casset
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Margit Weghofer
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Petra Zieglmayer
- Vienna Challenge Chamber, Vienna, Austria; Karl Landsteiner University, Krems, Austria
| | | | | | | | - Kuan-Wei Chen
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Ekaterina Potapova
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Paolo M Matricardi
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Gabrielle Pauli
- Service de Pneumologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Monika Grote
- Institute of Medical Physics and Biophysics, University of Muenster, Muenster, Germany
| | - Rudolf Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria; NRC Institute of Immunology FMBA of Russia, Moscow, Russia; Laboratory for Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russia; Karl Landsteiner University, Krems, Austria
| | - Susanne Vrtala
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
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12
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Xiang L, Liu F, Zhi L, Jiang W, Liu C, Xie H, Zhou X, Sun Y, Zheng Y, Zhu R, Tao Z, Xia W, Lai H, Wei Q, Cheng L, Tang Y, Xu R, Huang H, Zhou Q, Chang P. Safety of semi-depot house dust mite allergen extract in children and adolescents with allergic rhinitis and asthma. Immunotherapy 2020; 13:227-239. [PMID: 33317341 DOI: 10.2217/imt-2020-0232] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aim: Multicenter study to investigate the safety of mite extract product Novo-Helisen Depot, Strengths 1 to 3 (NHD3), as subcutaneous immunotherapy (SCIT), in Chinese children and adolescents with allergic rhinitis (AR) and allergic asthma (AA). Patients & methods: We evaluated SCIT-related adverse events (AEs) during NHD3 14-week initial therapy in children (5-11 years) and adolescents (12-17 years) with perennial symptomatic AR and AA. Results: Among 3600 injections in 250 patients, 361/3600 (10.0%) injections caused SCIT-related AEs in 96/250 (38.4%) patients, 321/3600 injections (8.9%) caused local reactions in 89/250 (35.6%) and 40/3600 injections (1.1%) caused systemic reactions in 23/250 (9.2%). Conclusion: Initial SCIT treatment using NHD3 was safe and well tolerated in Chinese children and adolescents with AR and AA.
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Affiliation(s)
- Li Xiang
- Department of Allergy, Beijing Children's Hospital, Beijing 100045, China
| | - Fengxia Liu
- Department of Allergy, Weifang People's Hospital, Weifang 261200, China
| | - Lili Zhi
- Department of Allergy, Central Hospital of Zibo, Zibo 255020, China
| | - Weihong Jiang
- Department of Otorhinolaryngology, Xiangya Hospital of Central South University, Changsha 410008, China
| | - Changshan Liu
- Department of Pediatrics, The Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Hua Xie
- Department of Respiratory, General Hospital of Northern Theater Command, Shenyang 110015, China
| | - Xiaoqin Zhou
- Department of Pediatrics, Hubei Provincial Maternal & Child Health Hospital, Wuhan 430070, China
| | - Yuemei Sun
- Department of Allergy, Yantai Yuhuangding Hospital, Yantai 264000, China
| | - Yuejie Zheng
- Department of Respiratory, Shenzhen Children's Hospital, Shenzhen 518026, China
| | - Rongfei Zhu
- Department of Allergy, Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan 430030, China
| | - Zezhang Tao
- Department of Otorhinolaryngology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Wanmin Xia
- Department of Pediatric Respiratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - He Lai
- Department of Allergy, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Qingyu Wei
- Department of Allergy, General Hospital of Northern Theater Command, Shenyang 110003, China
| | - Lei Cheng
- Department of Otorhinolaryngology & Clinical Allergy Center, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.,International Centre for Allergy Research, Nanjing Medical University, Nanjing 210029, China
| | - Yu Tang
- Department of Respiratory, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450018, China
| | - Rui Xu
- Department of Allergy of Otorhinolaryngology Hospital, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Huijie Huang
- Department of Allergy, Beijing Children's Hospital, Beijing 100045, China
| | - Queena Zhou
- Medical Affairs, Merck Serono Co., Ltd, Beijing 100016, China
| | - Peter Chang
- Global Biostatistics, Epidemiology, Medical Writing (GBEM), Merck Serono Co., Ltd, Beijing 100016, China
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13
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González-Pérez R, Poza-Guedes P, Pineda F, Forstenlechner P, Castillo M, Mederos-Luís E, Aumayr M, Matheu V, Alava-Cruz C, Sánchez-Machín I. Mite Molecular Profile in the Th2-Polarized Moderate-to-Severe Persistent Asthma Endotype Subjected to High Allergen Exposure. Int Arch Allergy Immunol 2020; 182:21-31. [PMID: 32927455 DOI: 10.1159/000510118] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/10/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The association among the IgE responses to prevailing groups of house dust mite (HDM) allergens in the concurrent asthma phenotypes has not been determined. OBJECTIVE The aim of the present study lays on a component-resolved diagnosis (CRD) model to investigate the mite molecular signature in subjects with type-2 inflammation asthma. METHODS We selected patients showing a clinically relevant sensitization to HDMs with moderate-to-severe persistent asthma. Skin prick test (SPT) with standardized mite extracts, a broad customized CRD serum sIgE panel including 9 Dermatophagoides pteronyssinus allergens and the related protein allergenic characterization, was investigated in all serum samples. RESULTS Ninety out of 93 (96.77%) patients with a positive SPT to HDM showed a concordant sIgE (≥0.35 kUA/L) to the crude extract of D. pteronyssinus. Major allergens (Der p 2, Der p 23, and Der p 1) were present in >70% of all subjects, with mid-tier allergens (Der p 5, Der p 7, and Der p 21) reaching up to 51% in the present cohort. A complex pleomorphic repertoire of HDM molecules recognized by IgE was depicted, including 38 distinct profiles. CONCLUSIONS AND CLINICAL RELEVANCE The proposed CRD panel approach, containing the most prevalent HDM allergens, appeared to be sufficient to obtain a precise D. pteronyssinus molecular diagnosis in asthmatics with a climate-dependent high-mite allergen exposure and coexisting sensitization. A dominant role of both major and mid-tier allergens has been confirmed in moderate and severe persistent asthmatics with the preponderant Th2-high endotype.
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Affiliation(s)
- Ruperto González-Pérez
- Allergy Department, Hospital Universitario de Canarias, Tenerife, Spain, .,Severe Asthma Unit, Hospital Universitario de Canarias, Tenerife, Spain,
| | - Paloma Poza-Guedes
- Allergy Department, Hospital Universitario de Canarias, Tenerife, Spain.,Severe Asthma Unit, Hospital Universitario de Canarias, Tenerife, Spain
| | | | | | | | | | | | - Víctor Matheu
- Allergy Department, Hospital Universitario de Canarias, Tenerife, Spain
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14
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González-Pérez R, Poza-Guedes P, Pineda F, Castillo M. Depiction of Major Mite Allergens in Severe Allergic Rhinitis with High Mite Perennial Exposure. Turk Arch Otorhinolaryngol 2020; 58:155-162. [PMID: 33145499 DOI: 10.5152/tao.2020.5365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 08/25/2020] [Indexed: 11/22/2022] Open
Abstract
Objective Airway diseases, including allergic rhinitis, are prompted by specific IgE antibodies against airborne allergens and notably those derived from mites. The presented study focused on the specific IgE immediate response to Dermatophagoides pteronyssinus (D. pteronyssinus) mite major allergens and the corresponding pertinence of molecular diagnosis in patients bothered with severe persistent rhinitis. Methods Individuals exhibiting confirmed sensitization to D. pteronyssinus along with a clinical diagnosis of coexisting severe allergic rhinitis were included in the study. In vivo investigations encompassed intradermal testing with a battery of standardized allergenic extracts, concurrent with in vitro specific IgE to the crude extract of D. pteronyssinus, and associated individual molecular allergens were assessed. Results Fifty-five out of 59 subjects showed serodominant IgE responses to the major allergens Der p 1, Der p 2 and Der p 23. Both Der p 2 and Der p 23 reached a prevalence above 80%, while group 10 allergen tropomyosin was scarcely depicted (<10%) and exclusively present in younger individuals. Conclusion The proposed component-resolved diagnosis panel accurately recognized 93.22% of D. pteronyssinus allergic patients. The raised seroprevalence of IgE response to Der p 23 also confirmed this constituent as a major D. pteronyssinus allergen in severe allergic rhinitis. A molecular approach appears to be essential to frame a more precise diagnosis and eventually a personalized immunotherapy regarding this allergic condition.
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Affiliation(s)
- Ruperto González-Pérez
- Department of Allergy & Severe Asthma Unit, Hospital Universitario de Canarias, Tenerife, Spain
| | - Paloma Poza-Guedes
- Department of Allergy & Severe Asthma Unit, Hospital Universitario de Canarias, Tenerife, Spain
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15
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Tulaeva I, Kratzer B, Campana R, Curin M, van Hage M, Karsonova A, Riabova K, Karaulov A, Khaitov M, Pickl WF, Valenta R. Preventive Allergen-Specific Vaccination Against Allergy: Mission Possible? Front Immunol 2020; 11:1368. [PMID: 32733455 PMCID: PMC7358538 DOI: 10.3389/fimmu.2020.01368] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/28/2020] [Indexed: 12/17/2022] Open
Abstract
Vaccines for infectious diseases have improved the life of the human species in a tremendous manner. The principle of vaccination is to establish de novo adaptive immune response consisting of antibody and T cell responses against pathogens which should defend the vaccinated person against future challenge with the culprit pathogen. The situation is completely different for immunoglobulin E (IgE)-associated allergy, an immunologically-mediated hypersensitivity which is already characterized by increased IgE antibody levels and T cell responses against per se innocuous antigens (i.e., allergens). Thus, allergic patients suffer from a deviated hyper-immunity against allergens leading to inflammation upon allergen contact. Paradoxically, vaccination with allergens, termed allergen-specific immunotherapy (AIT), induces a counter immune response based on the production of high levels of allergen-specific IgG antibodies and alterations of the adaptive cellular response, which reduce allergen-induced symptoms of allergic inflammation. AIT was even shown to prevent the progression of mild to severe forms of allergy. Consequently, AIT can be considered as a form of therapeutic vaccination. In this article we describe a strategy and possible road map for the use of an AIT approach for prophylactic vaccination against allergy which is based on new molecular allergy vaccines. This road map includes the use of AIT for secondary preventive vaccination to stop the progression of clinically silent allergic sensitization toward symptomatic allergy and ultimately the prevention of allergic sensitization by maternal vaccination and/or early primary preventive vaccination of children. Prophylactic allergy vaccination with molecular allergy vaccines may allow halting the allergy epidemics affecting almost 30% of the population as it has been achieved for vaccination against infectious diseases.
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Affiliation(s)
- Inna Tulaeva
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.,Laboratory of Immunopathology, Department of Clinical Immunology and Allergology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Bernhard Kratzer
- Center for Pathophysiology, Infectiology and Immunology, Institute of Immunology, Medical University of Vienna, Vienna, Austria
| | - Raffaela Campana
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Mirela Curin
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Marianne van Hage
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Antonina Karsonova
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ksenja Riabova
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Alexander Karaulov
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Musa Khaitov
- NRC Institute of Immunology FMBA of Russia, Moscow, Russia
| | - Winfried F Pickl
- Center for Pathophysiology, Infectiology and Immunology, Institute of Immunology, Medical University of Vienna, Vienna, Austria
| | - Rudolf Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.,Laboratory of Immunopathology, Department of Clinical Immunology and Allergology, Sechenov First Moscow State Medical University, Moscow, Russia.,NRC Institute of Immunology FMBA of Russia, Moscow, Russia.,Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
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16
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Li H, Chen S, Cheng L, Guo Y, Lai H, Li Y, Lin X, Liu Z, Qiu Q, Shao J, Shi L, Tian M, Wang C, Wang H, Wang X, Wei Q, Wei Y, Xiang L, Yang Q, Zhao C, Zhang H, Zhi Y, Gao J, Li Q, Liu J, Wang K, Zhou W, Zhang L. Chinese guideline on sublingual immunotherapy for allergic rhinitis and asthma. J Thorac Dis 2019; 11:4936-4950. [PMID: 32030209 DOI: 10.21037/jtd.2019.12.37] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Huabin Li
- Department of Otolaryngology, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China
| | - Shi Chen
- Center for Prevention and Treatment of Pediatric Asthma, Hainan General Hospital, Haikou 570102, China
| | - Lei Cheng
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.,International Centre for Allergy Research, Nanjing Medical University, Nanjing 210029, China
| | - Yinshi Guo
- Department of Allergy & Immunology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - He Lai
- Department of Allergy, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
| | - Yong Li
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University, Hangzhou 310006, China
| | - Xiaoping Lin
- Department of Allergy, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Zheng Liu
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Qianhui Qiu
- Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Jie Shao
- Department of Pediatrics, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Li Shi
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan 250022, China
| | - Man Tian
- Respiratory Department, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Chengshuo Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100073, China
| | - Hongtian Wang
- Department of Otolaryngology, Head and Neck Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China.,Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Xueyan Wang
- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Qingyu Wei
- Department of Allergy, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Yongxiang Wei
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Li Xiang
- Department of Allergy, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Qintai Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
| | - Changqing Zhao
- Department of Otolaryngology, Second Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Huanping Zhang
- Department of Pulmonary and Critical Care Medicine, First Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Yuxiang Zhi
- Department of Allergy, Peking Union Medical College Hospital, Beijing 100730, China
| | - Junxiao Gao
- Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Quansheng Li
- Department of Allergy, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Juan Liu
- Department of Otolaryngology, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China
| | - Kuiji Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100073, China
| | - Wencheng Zhou
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.,International Centre for Allergy Research, Nanjing Medical University, Nanjing 210029, China
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100073, China
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17
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Simon D. Recent Advances in Clinical Allergy and Immunology 2019. Int Arch Allergy Immunol 2019; 180:291-305. [PMID: 31694018 DOI: 10.1159/000504364] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 10/25/2019] [Indexed: 11/19/2022] Open
Abstract
The immune system has vital functions for homeostasis and host defense. Thus, imbalances of the immune system whether associated with allergy, hypersensitivity, or autoimmunity are of great importance, as is manifest from common diseases such as atopic diseases, urticaria, and angioedema, and drug hypersensitivity reactions. These can affect patients' quality of life and can generate high costs for health care. Epidemiological studies have provided evidence for changing patterns of allergic diseases caused by lifestyle and climate changes which have consequences for medical care. Deeper insights into the pathogenesis of allergic/immunologic diseases, combined with novel technologies, provide improved diagnostic options and treatment measures. This review will summarize novel aspects of the epidemiology, pathogenic mechanisms, as well as disease management in the fields of allergy and clinical immunology.
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Affiliation(s)
- Dagmar Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland,
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18
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Cai ZL, Zhang Z, Luo WL, Hou YB, He YS, Chen JJ, Ji K. Identification of immunodominant IgE epitopes of the major house dust mite allergen Der f 24. Int J Mol Med 2019; 44:1888-1898. [PMID: 31545417 PMCID: PMC6777665 DOI: 10.3892/ijmm.2019.4345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 08/16/2019] [Indexed: 11/17/2022] Open
Abstract
Previously, a ubiquinol-cytochrome c reductase binding protein (UQCRB) homolog was identified in the house dust mite (HDM) species Dermatophagoides farinae (Der f) as a major allergen. In the present study, the immunodominant immunoglobulin E (IgE) epitope of the protein Der f 24 was investigated. Analysis of the homologous amino acid (aa) sequences in Der f and human UQCRB was performed. Four different recombinant Der f 24 and hybrid proteins formed by integrating Der f and human UQCRB sequences were expressed in Escherichia coli, purified using Ni-NTA resins, and IgE-binding activity was determined using IgE-western blotting and enzyme-linked immunosorbent assay (ELISA) experiments. IgE epitopes were further identified by IgE-dot blotting and IgE-ELISA with synthetic polypeptides and HDM-allergic sera. Three-dimensional (3D) structural modeling was used to analyze the position of the immuno-dominant IgE epitope. The amino acid sequence homology between Der f 24 and the human UQCRB protein was determined to be 39.34%. IgE-ELISA and western blot analysis showed that all of the Der f-human UQCRB hybrid proteins generated, except for the one lacking 59 residues of the N-terminal region of Der f 24, were bound by allergic serum IgE. A synthetic polypeptide consisting of 32 residues of the N-terminal reacted with IgEs from HDM-allergic sera and could be used to generate high titer specific IgG or specific IgE antibodies in immunized mice. The 32-aa N-terminal region of Der f 24 was localized to a structural protrusion, which may facilitate specific IgE-binding. These results indicate that the immunodominant IgE epitope of Der f 24 is located mainly in a 32-residue region of the N-terminus. These findings may inform the mechanisms of HDM allergy sensitization and allergy immunotherapy development.
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Affiliation(s)
- Ze-Lang Cai
- Department of Biochemistry and Molecular Biology, Health Science Center of Shenzhen University, Shenzhen, Guangdong 518060, P.R. China
| | - Zhen Zhang
- Department of Biochemistry and Molecular Biology, Health Science Center of Shenzhen University, Shenzhen, Guangdong 518060, P.R. China
| | - Wen-Li Luo
- Department of Biochemistry and Molecular Biology, Health Science Center of Shenzhen University, Shenzhen, Guangdong 518060, P.R. China
| | - Yi-Bo Hou
- Department of Biochemistry and Molecular Biology, Health Science Center of Shenzhen University, Shenzhen, Guangdong 518060, P.R. China
| | - Yong-Shen He
- Department of Biochemistry and Molecular Biology, Health Science Center of Shenzhen University, Shenzhen, Guangdong 518060, P.R. China
| | - Jia-Jie Chen
- Department of Biochemistry and Molecular Biology, Health Science Center of Shenzhen University, Shenzhen, Guangdong 518060, P.R. China
| | - Kunmei Ji
- Department of Biochemistry and Molecular Biology, Health Science Center of Shenzhen University, Shenzhen, Guangdong 518060, P.R. China
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