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Sánchez A, Padilla Y, Lorduy A, Sanchez J, Munera M, Baena C, Bernal C, Urrego J. In silico analysis of molecular mimicry between human aquaporin 3, Aspergillus fumigatus aquaporin and aquaporins from allergic sources. F1000Res 2024; 13:358. [PMID: 39310813 PMCID: PMC11415755 DOI: 10.12688/f1000research.142843.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2024] [Indexed: 09/25/2024] Open
Abstract
Background Atopic dermatitis (AD) is a chronic inflammatory skin condition that has a significant impact on quality of life. The immune response and allergy symptoms in AD are triggered by the recognition of specific allergens by IgE antibodies. Cross-reactivity can lead to auto-IgE responses, potentially worsening AD symptoms. Our research aimed to enhance our understanding of allergenic sources, including A. fumigatus, and their role in AD. We focused on molecular mimicry between human AQP3 and A. fumigatus aquaporin. Methods In our in-silico analysis, we compared the amino acid sequences of human aquaporin 3 (AQP3) and A. fumigatus aquaporin with 25 aquaporins from various allergenic sources, sourced from the UniProt and NCBI databases. Phylogenetic relationship analysis and homology-based modeling were conducted. We identified conserved antigenic regions located within the 3D structures. Results The global identity levels among the studied aquaporins averaged 32.6%. One antigenic site exhibited a remarkable local region, with a conserved identity of 71.4%. We categorized the aquaporins into five monophyletic clades (A-E), with group B showing the highest identity (95%), including six mammalian aquaporins, including AQP3. When comparing A. fumigatus aquaporins, the highest identity was observed with Malassezia sympodialis at 35%. Both human and A. fumigatus aquaporins have three linear and three discontinuous epitopes. Conclusions We identified potential linear and conformational epitopes of AQP3, indicating a possible molecular mimicry between humans and A. fumigatus aquaporins. This suggests autoreactivity and potential cross-reactivity, although further validation using in vitro and in vivo experiments is required.
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Affiliation(s)
- Andrés Sánchez
- Group of Research Medicine (GINUMED), Rafael Nunez University Corporation, Cartagena, Bolívar, Colombia
- Clinical and Experimental Allergy Group (GACE), University of Antioquia, Medellín, Antioquia, Colombia
- Research Group of Pharmaceutical, Cosmetic, and Food Technology (GITFCA), University of Cartagena, Cartagena, Bolívar, Colombia
| | - Yaquelin Padilla
- Research Group of Pharmaceutical, Cosmetic, and Food Technology (GITFCA), University of Cartagena, Cartagena, Bolívar, Colombia
| | - Adriana Lorduy
- Research Group of Pharmaceutical, Cosmetic, and Food Technology (GITFCA), University of Cartagena, Cartagena, Bolívar, Colombia
| | - Jorge Sanchez
- Clinical and Experimental Allergy Group (GACE), University of Antioquia, Medellín, Antioquia, Colombia
| | - Marlon Munera
- Group of Research Medicine (GINUMED), Rafael Nunez University Corporation, Cartagena, Bolívar, Colombia
| | - Claudia Baena
- Research Group of Pharmaceutical, Cosmetic, and Food Technology (GITFCA), University of Cartagena, Cartagena, Bolívar, Colombia
| | - Carlos Bernal
- Research Group of Pharmaceutical, Cosmetic, and Food Technology (GITFCA), University of Cartagena, Cartagena, Bolívar, Colombia
| | - Juan Urrego
- Research Group of Pharmaceutical, Cosmetic, and Food Technology (GITFCA), University of Cartagena, Cartagena, Bolívar, Colombia
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Rodinkova V, Yuriev S, Mokin V, Kryvopustova M, Shmundiak D, Bortnyk M, Kryzhanovskyi Y, Kurchenko A. Bayesian analysis suggests independent development of sensitization to different fungal allergens. World Allergy Organ J 2024; 17:100908. [PMID: 38800499 PMCID: PMC11126528 DOI: 10.1016/j.waojou.2024.100908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/05/2024] [Accepted: 04/18/2024] [Indexed: 05/29/2024] Open
Abstract
Background Fungi are known for their ability to cause allergies, but data on individual sensitization to them are insufficient. The purpose of the study was to carry out a comprehensive analysis of the fungal allergens' sensitization profile in the Ukrainian population and to determine both population and individual sensitivity to these allergens. Methods We utilized a set of ALEX allergy test data from 20,033 inhabitants of 17 regions of Ukraine from 1 to 89 years conducted in 2020-2022. A complex of programs in the Python language was developed and Bayesian network analysis was applied to determine the sensitivity combinations in individual patients to various fungal components. Results Sensitivity to Alt a 1 dominated and was observed in 79.39% of patients, and 62.17% of them were sensitive solely to Alt a 1. Exclusive sensitivity to Mala s 6 was second in individual patient profiles with a frequency of 4.06%. Combined sensitivity to Alt a 1 - Asp f 3 was third with a share of 3.28%. Pen ch and Cla h extracts stimulated the production of the lowest median sIgE levels. The highest median sIgE levels were for Alt a 1, Mala s 11 and Asp f 6, respectively. Median sIgE levels increased in adults compared to children for all components of Aspergillus fumigatus, as well as for Mala s 5 and Mala s 11. In the rest of the cases, they decreased in adults compared to children. The sensitization rates to fungi in general and specifically to Alternaria were lower in the western parts of Ukraine, especially in the Carpathian region, situated within the Broad-leaved Forest zone. The results of Bayesian modeling revealed that in the case of Alt a 1, the simultaneous absence of sensitivity to Cla h 8, Mala s 11, Mala s 5 and Mala s 6 molecules could condition the presence of sensitization to the major Alternaria allergen with a probability of 92.42%. In all other cases, there was a high probability of absence of sensitivity to particular allergen against the background of absence of sensitivity to other ones, which may indicate the independent development of sensitization to different fungal allergens. Conclusions Sensitivity to Alt a 1 dominated in the studied population with a lower rate in the western regions. The highest median sIgE levels were induced by Alt a 1, Mala s 11 and Asp f 6. Bayesian Analysis suggest a high probability of the independent development of sensitization to different fungal allergens. The idea that sensitization to one allergen may be protective against sensitization to another one(s) requires further clinical study.
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Affiliation(s)
- Victoria Rodinkova
- Department of Pharmacy, National Pirogov Memorial Medical University, Vinnytsia, Ukraine
| | - Serhii Yuriev
- Department of Clinical Immunology and Allergology, Bohomolets National Medical University, Kyiv, Ukraine
- Medical Centre, DIVERO, Kyiv, Ukraine
| | - Vitalii Mokin
- Department of System Analysis and Information Technologies, Vinnytsia National Technical University, Vinnytsia, Ukraine
| | - Mariia Kryvopustova
- Medical Centre, DIVERO, Kyiv, Ukraine
- Department of Pediatrics No 2, Bohomolets National Medical University, Kyiv, Ukraine
| | - Dmytro Shmundiak
- Department of System Analysis and Information Technologies, Vinnytsia National Technical University, Vinnytsia, Ukraine
| | - Mykyta Bortnyk
- Department of Pharmacy, National Pirogov Memorial Medical University, Vinnytsia, Ukraine
- Vasyl’ Stus Donetsk National University, Vinnytsia, Ukraine
| | - Yevhenii Kryzhanovskyi
- Department of System Analysis and Information Technologies, Vinnytsia National Technical University, Vinnytsia, Ukraine
| | - Andrii Kurchenko
- Department of Clinical Immunology and Allergology, Bohomolets National Medical University, Kyiv, Ukraine
- Medical Centre, DIVERO, Kyiv, Ukraine
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Kwong K, Robinson M, Sullivan A, Letovsky S, Liu AH, Valcour A. Fungal allergen sensitization: Prevalence, risk factors, and geographic variation in the United States. J Allergy Clin Immunol 2023; 152:1658-1668. [PMID: 37741553 DOI: 10.1016/j.jaci.2023.09.010] [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: 02/17/2023] [Revised: 08/30/2023] [Accepted: 09/08/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Many fungal species are associated with the pathogenesis of allergic disease, yet most epidemiologic studies on IgE-mediated fungal sensitization have only included a few species. OBJECTIVE We investigated fungal allergen sensitization prevalence, risk factors, and geographic variation in the United States. METHODS From 2014 to 2019, a total of 7,912,504 serum-specific IgE (sIgE) test results for 17 fungal species were measured in 1,651,203 patients aged 0-85 years by a US-wide clinical laboratory. Fungal sensitization prevalence, patterns, and relationship with demographic characteristics, clinical diagnoses, and geographic regions were analyzed. RESULTS Twenty-two percent of patients were positive (sIgE > 0.10 kUA/L) to at least 1 fungal allergen; 13.7% were positive to >2 fungal allergens. Fungal species-specific positivity rates ranged 7.4-18.6% and were highest for Candida albicans (18.6%), Alternaria alternata (16.6%), Stemphylium herbarum (14.9%), and Aspergillus fumigatus (14.2%). Other fungi that were frequently tested had relatively low positivity rates (eg, Cladosporium herbarum 11.1%, Penicillium chrysogenum 10.7%). Independent risk factors for test positivity for all fungal species included male sex, teen age (highest in those aged 10-19 years), atopic dermatitis, and asthma. Fungal sensitization was generally higher in urban areas and ecoregions composed predominantly of grasslands and prairies compared to woodlands and forest, although there was greater variation in sensitization risk to different fungi in different ecoregions. CONCLUSION Independent risk factors for fungal sensitization include male sex, teen ages, atopic dermatitis, asthma, and ecoregion.
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Affiliation(s)
- Kenny Kwong
- Department of Pediatrics, Division of Allergy-Immunology, Los Angeles County and University of Southern California Medical Center, Los Angeles, Calif.
| | | | | | | | - Andrew H Liu
- Pediatric Pulmonary & Sleep Medicine Section, and Breathing Institute, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo
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Lecolant S, Khelifi D, Neukirch C, Taillé C, Chabane H, Giboury Lafarge S, Sève E, Pham Thi N, Epstein M, Chollet Martin S, Nicaise Roland P. Comparaison des performances diagnostiques de deux biopuces IgE : ISAC® et ALEX2®. REVUE FRANÇAISE D'ALLERGOLOGIE 2023. [DOI: 10.1016/j.reval.2023.103289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Čelakovská J, Vaňková R, Skalská H, Krejsek J, Andrýs C. The role of PR 10 proteins and molecular components of moulds and yeast in atopic dermatitis patients. FOOD AGR IMMUNOL 2022. [DOI: 10.1080/09540105.2022.2130183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- J. Čelakovská
- Department of Dermatology and Venereology, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - R. Vaňková
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - H. Skalská
- Department of Informatics and Quantitative Methods, University of Hradec Králové, Hradec Králové, Czech Republic
| | - J. Krejsek
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - C. Andrýs
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
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Szczepańska M, Blicharz L, Nowaczyk J, Makowska K, Goldust M, Waśkiel-Burnat A, Czuwara J, Samochocki Z, Rudnicka L. The Role of the Cutaneous Mycobiome in Atopic Dermatitis. J Fungi (Basel) 2022; 8:1153. [PMID: 36354920 PMCID: PMC9695942 DOI: 10.3390/jof8111153] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/27/2022] [Accepted: 10/29/2022] [Indexed: 08/28/2024] Open
Abstract
Atopic dermatitis is a chronic inflammatory skin disorder characterized by eczematous lesions, itch, and a significant deterioration in the quality of life. Recently, microbiome dysbiosis has been implicated in the pathogenesis of atopic dermatitis. Changes in the fungal microbiome (also termed mycobiome) appear to be an important factor influencing the clinical picture of this entity. This review summarizes the available insights into the role of the cutaneous mycobiome in atopic dermatitis and the new research possibilities in this field. The prevalence and characteristics of key fungal species, the most important pathogenesis pathways, as well as classic and emerging therapies of fungal dysbiosis and infections complicating atopic dermatitis, are presented.
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Affiliation(s)
- Milena Szczepańska
- Department of Dermatology, Medial University of Warsaw, 02-008 Warsaw, Poland
| | - Leszek Blicharz
- Department of Dermatology, Medial University of Warsaw, 02-008 Warsaw, Poland
| | - Joanna Nowaczyk
- Department of Dermatology, Medial University of Warsaw, 02-008 Warsaw, Poland
| | - Karolina Makowska
- Department of Dermatology, Medial University of Warsaw, 02-008 Warsaw, Poland
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center, 55131 Mainz, Germany
| | - Anna Waśkiel-Burnat
- Department of Dermatology, Medial University of Warsaw, 02-008 Warsaw, Poland
| | - Joanna Czuwara
- Department of Dermatology, Medial University of Warsaw, 02-008 Warsaw, Poland
| | - Zbigniew Samochocki
- Department of Dermatology, Medial University of Warsaw, 02-008 Warsaw, Poland
| | - Lidia Rudnicka
- Department of Dermatology, Medial University of Warsaw, 02-008 Warsaw, Poland
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Tang R, Lyu X, Liu Y, Zhu M, Yang X, Wu Z, Han B, Wu S, Sun J. Four clinical phenotypes of cow’s milk protein allergy based on dairy product specific IgE antibody types in North China. Front Immunol 2022; 13:949629. [PMID: 36275773 PMCID: PMC9585381 DOI: 10.3389/fimmu.2022.949629] [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: 05/21/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
Background Cow’s milk protein allergy (CMPA) is a common allergy. Immunoglobulin E (IgE)-mediated cow’s milk allergy is associated with a high mortality risk and poor prognosis. The study aims to investigate whether there are different clinically CMPA phenotypes in China and to explore the association between CMPA phenotypes and specific IgE (sIgE) antibodies against different dairy products. Methods Serum sIgE against different animal milk and cow’s milk products and different milk components was measured by an allergen array. Four CMPA classifications were identified by the presence of serum sIgE: boiled milk-positive, yogurt-positive, buttermilk-positive, and raw milk-positive. Results Among the 234 participants included in the study, 9 were boiled milk sIgE-positive, 50 were yogurt sIgE-positive, 17 were buttermilk sIgE-positive, and 158 were only raw milk sIgE-positive. The boiled milk-positive group had the highest levels of raw milk sIgE and casein sIgE antibodies, followed sequentially by the yogurt-positive, buttermilk-positive, and raw milk-positive groups. The boiled milk group observed the highest levels of sIgE against raw milk, casein, α-lactalbumin, and β-lactoglobulin. These levels differed significantly from those in the other three groups. Allergic symptoms were distributed differently among the four study groups. The percentages of allergic patients with gastrointestinal tract symptoms in the above mentioned four groups ranged from high to low, and the percentages of patients with skin symptoms in the four groups ranged from low to high, respectively. Conclusion Based on dairy product sIgE antibody levels associated with different milk components and various clinical allergic symptom tendencies, we could distinguish four CMPA phenotypes.
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Affiliation(s)
- Rui Tang
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Allergy Department, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaohong Lyu
- Eight-year program of clinical medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yi Liu
- Hangzhou Zheda Dixun Biological Gene Engineering Co., Ltd., Hangzhou, China
| | - Mingzhi Zhu
- Hangzhou Zheda Dixun Biological Gene Engineering Co., Ltd., Hangzhou, China
| | - Xukai Yang
- Hangzhou Zheda Dixun Biological Gene Engineering Co., Ltd., Hangzhou, China
| | - Zhoujie Wu
- Hangzhou Zheda Dixun Biological Gene Engineering Co., Ltd., Hangzhou, China
| | - Bingnan Han
- Zheda Dixun Anti-Allergy Functional Molecular Laboratory, Department of Development Technology of Marine Resources, College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, China
- *Correspondence: Jinlyu Sun, ; Shandong Wu, ; Bingnan Han,
| | - Shandong Wu
- Hangzhou Zheda Dixun Biological Gene Engineering Co., Ltd., Hangzhou, China
- *Correspondence: Jinlyu Sun, ; Shandong Wu, ; Bingnan Han,
| | - Jinlyu Sun
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Allergy Department, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Jinlyu Sun, ; Shandong Wu, ; Bingnan Han,
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Mittermann I, Lupinek C, Wieser S, Aumayr M, Kuchler WW, Chan AW, Lee TH, Zieglmayer P. IgE reactivity patterns in Asian and central European cockroach-sensitized patients reveal differences in primary sensitizing allergen sources. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2022; 1:145-153. [PMID: 37781268 PMCID: PMC10509942 DOI: 10.1016/j.jacig.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/17/2022] [Accepted: 04/08/2022] [Indexed: 10/03/2023]
Abstract
Background The prevalence of cockroach (CR) sensitization and its relevance as a trigger of allergy symptoms differs greatly in different geographic areas. Objective This study aimed to compare molecular IgE reactivity profiles in CR-sensitized patients with perennial allergy symptoms from Hong Kong (HK) and Austria and identify the main primary sensitizers. Methods IgE sensitization was assessed by skin prick test and/or IgE reactivity with CR extract. Molecular IgE reactivity profiles were analyzed via multiplex assay for sensitization to allergens and extracts from CR, house dust mite (HDM), shellfish, and 3 additional insect species. Results HDM was the main primary sensitizer in both cohorts. In the HK group, genuine sensitization to CR was found in 45%, but none of the patients in the Austrian cohort was truly sensitized to that allergen source. Most patients from HK were cross-sensitized to other insects and/or shellfish, presumably by broad reactivity to tropomyosin and arginine kinase. About half of Austrian subjects lacked IgE to these pan-allergens, indicating co- but not cross-sensitization to insects and/or shellfish. Regarding IgE recognition frequencies, arginine kinases (64% HK, 10% Austria) and tropomyosins (42% HK, 15% Austria) were most frequently recognized; Bla g 4 (lipocalin) was detected in HK patients only (42%). Tropomyosin (Per a 7) was significantly more frequently recognized in patients with asthma. Sera from HDM-sensitized subjects from HK showed a higher proportion of sensitization to minor mite allergens. Conclusion Molecular profiling identified differences between CR-sensitized allergic patients from HK and Austria in terms of primary sensitizers and molecular IgE reactivity patterns. Tropomyosin from American cockroach (Per a 7) was shown to be significantly associated with asthma symptoms and might be suitable as biomarker for more severe respiratory allergy symptoms.
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Affiliation(s)
| | | | | | | | | | - Alson W.M. Chan
- Allergy Centre, Hong Kong Sanatorium and Hospital, Hong Kong, China
| | - Tak Hong Lee
- Allergy Centre, Hong Kong Sanatorium and Hospital, Hong Kong, China
| | - Petra Zieglmayer
- Vienna Challenge Chamber, Vienna, Austria
- Karl Landsteiner University, Krems, Austria
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Characterization of Distinct Microbiota Associated with Scalp Dermatitis in Patients with Atopic Dermatitis. J Clin Med 2022; 11:jcm11061735. [PMID: 35330061 PMCID: PMC8949928 DOI: 10.3390/jcm11061735] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 12/13/2022] Open
Abstract
Recent studies have focused on the role of skin microbiota in the pathogenesis of atopic dermatitis (AD). Among the various clinical phenotypes of AD, scalp dermatitis is a commonly observed clinical feature of AD. However, little is known about the pathogenesis of scalp dermatitis in AD. Hence, the aim of this study was to identify the distinct microbiota associated with scalp dermatitis in patients with AD. Using scalp swab samples from 10 patients with AD and 10 healthy controls, this study characterized the scalp microbiota in patients with AD via V3–V4 regions of the 16S rRNA gene sequencing for bacterial identification, and ITS2 gene sequencing for fungal identification. Among bacterial genera, Staphylococcus was the most abundant in AD than in healthy controls, whereas Cutibacterium was the most abundant species in the healthy controls. The most predominant scalp fungal microbiota was Malassezia both in AD and healthy controls, while a higher diversity of non-Malassezia fungi was observed in AD than in healthy controls. The study findings indicate the dysbiosis of scalp microbiota in AD and highlight the potential biomarker role of specific microbiota in AD on the scalp dermatitis.
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Namvar S, Labram B, Rowley J, Herrick S. Aspergillus fumigatus-Host Interactions Mediating Airway Wall Remodelling in Asthma. J Fungi (Basel) 2022; 8:jof8020159. [PMID: 35205913 PMCID: PMC8879933 DOI: 10.3390/jof8020159] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/29/2022] [Accepted: 02/01/2022] [Indexed: 12/03/2022] Open
Abstract
Asthma is a chronic heterogeneous respiratory condition that is mainly associated with sensitivity to airborne agents such as pollen, dust mite products and fungi. Key pathological features include increased airway inflammation and airway wall remodelling. In particular, goblet cell hyperplasia, combined with excess mucus secretion, impairs clearance of the inhaled foreign material. Furthermore, structural changes such as subepithelial fibrosis and increased smooth muscle hypertrophy collectively contribute to deteriorating airway function and possibility of exacerbations. Current pharmacological therapies focused on airway wall remodelling are limited, and as such, are an area of unmet clinical need. Sensitisation to the fungus, Aspergillus fumigatus, is associated with enhanced asthma severity, bronchiectasis, and hospitalisation. How Aspergillus fumigatus may drive airway structural changes is unclear, although recent evidence points to a central role of the airway epithelium. This review provides an overview of the airway pathology in patients with asthma and fungal sensitisation, summarises proposed airway epithelial cell-fungal interactions and discusses the initiation of a tissue remodelling response. Related findings from in vivo animal models are included given the limited analysis of airway pathology in patients. Lastly, an important role for Aspergillus fumigatus-derived proteases in triggering a cascade of damage-repair events through upregulation of airway epithelial-derived factors is proposed.
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Affiliation(s)
- Sara Namvar
- School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Science Centre, Manchester M13 9PT, UK; (B.L.); (J.R.)
- School of Science, Engineering and Environment, University of Salford, Salford M5 4WT, UK
- Correspondence: (S.N.); (S.H.)
| | - Briony Labram
- School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Science Centre, Manchester M13 9PT, UK; (B.L.); (J.R.)
| | - Jessica Rowley
- School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Science Centre, Manchester M13 9PT, UK; (B.L.); (J.R.)
| | - Sarah Herrick
- School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Science Centre, Manchester M13 9PT, UK; (B.L.); (J.R.)
- Correspondence: (S.N.); (S.H.)
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Panaitescu C, Haidar L, Buzan MR, Grijincu M, Spanu DE, Cojanu C, Laculiceanu A, Bumbacea R, Agache IO. Precision medicine in the allergy clinic: the application of component resolved diagnosis. Expert Rev Clin Immunol 2022; 18:145-162. [PMID: 35078387 DOI: 10.1080/1744666x.2022.2034501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
INTRODUCTION A precise diagnosis is key for the optimal management of allergic diseases and asthma. In vivo or in vitro diagnostic methods that use allergen extracts often fail to identify the molecules eliciting the allergic reactions. AREAS COVERED Component-resolved diagnosis (CRD) has solved most of the limitations of extract-based diagnostic procedures and is currently valuable tool for the precision diagnosis in the allergy clinic, for venom and food allergy, asthma, allergic rhinitis, and atopic dermatitis. Its implementation in daily practice facilitates: a) the distinction between genuine multiple sensitizations and cross-reactive sensitization in polysensitized patients; b) the prediction of a severe, systemic reaction in food or insect venom allergy; c) the optimal selection of allergen immunotherapy based on the patient sensitization profile. This paper describes its main advantages and disadvantages, cost-effectiveness and future perspectives. EXPERT OPINION The diagnostic strategy based on CRD is part of the new concept of precision immunology, which aims to improve the management of allergic diseases.
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Affiliation(s)
- Carmen Panaitescu
- Department of Functional Sciences, Physiology, Center of Immuno-Physiology and Biotechnologies (CIFBIOTEH), "Victor Babeș" University of Medicine and Pharmacy Timișoara, Romania.,Centre for Gene and Cellular Therapies in The Treatment of Cancer - OncoGen, "Pius Brinzeu" Clinical Emergency Hospital, Timisoara, Romania
| | - Laura Haidar
- Department of Functional Sciences, Physiology, Center of Immuno-Physiology and Biotechnologies (CIFBIOTEH), "Victor Babeș" University of Medicine and Pharmacy Timișoara, Romania
| | - Maria Roxana Buzan
- Department of Functional Sciences, Physiology, Center of Immuno-Physiology and Biotechnologies (CIFBIOTEH), "Victor Babeș" University of Medicine and Pharmacy Timișoara, Romania.,Centre for Gene and Cellular Therapies in The Treatment of Cancer - OncoGen, "Pius Brinzeu" Clinical Emergency Hospital, Timisoara, Romania
| | - Manuela Grijincu
- Department of Functional Sciences, Physiology, Center of Immuno-Physiology and Biotechnologies (CIFBIOTEH), "Victor Babeș" University of Medicine and Pharmacy Timișoara, Romania.,Centre for Gene and Cellular Therapies in The Treatment of Cancer - OncoGen, "Pius Brinzeu" Clinical Emergency Hospital, Timisoara, Romania
| | | | - Catalina Cojanu
- Transylvania University Brasov - Faculty of Medicine, Brasov
| | | | - Roxana Bumbacea
- Department of Allergy, "Carol Davila" University of Medicine and Pharmacy Bucharest, Romania
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Special Issue: Host Defense against Fungi. J Fungi (Basel) 2021; 7:jof7121054. [PMID: 34947036 PMCID: PMC8708056 DOI: 10.3390/jof7121054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 12/07/2021] [Indexed: 11/24/2022] Open
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MalaSelect: A Selective Culture Medium for Malassezia Species. J Fungi (Basel) 2021; 7:jof7100824. [PMID: 34682245 PMCID: PMC8538348 DOI: 10.3390/jof7100824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 11/16/2022] Open
Abstract
Malassezia species are fastidious and slow-growing yeasts in which isolation from polymicrobial samples is hampered by fast-growing microorganisms. Malassezia selective culture media are needed. Although cycloheximide is often used, some fungi, including the chief human commensal Candida albicans, are resistant to this compound. This study aimed to test whether the macrolide rapamycin could be used in combination with cycloheximide to develop a Malassezia-selective culture medium. Rapamycin susceptibility testing was performed via microdilution assays in modified Dixon against two M. furfur and five Candida spp. The MIC was the lowest concentration that reduced growth by a minimum of 90%. Rapamycin ± cycloheximide 500 mg/L was also added to FastFung solid, and yeast suspensions were inoculated and incubated for 72 h. Rapamycin MICs for Candida spp. ranged from 0.5 to 2 mg/L, except for C. krusei, for which the MIC was >32 mg/L. M. furfur stains were rapamycin-resistant. Rapamycin and cycloheximide supplementation of the FastFung medium effectively inhibited the growth of non-Malassezia yeast, including cycloheximide-resistant C. albicans and C. tropicalis. Based on our findings, this “MalaSelect” medium should be further evaluated on polymicrobial samples for Malassezia isolation and culture.
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Scala E, Caprini E, Abeni D, Meneguzzi G, Buzzulini F, Cecchi L, Villalta D, Asero R. A qualitative and quantitative comparison of IgE antibody profiles with two multiplex platforms for component-resolved diagnostics in allergic patients. Clin Exp Allergy 2021; 51:1603-1612. [PMID: 34523179 DOI: 10.1111/cea.14016] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 06/03/2021] [Accepted: 09/08/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Clinically complex phenotypes require more and more sophisticated and comprehensive diagnostic approaches, able to discriminate genuine sensitizations from cross-reactivity. Interpretative complexity of multiplex diagnostic arrays has somewhat limited their diffusion. This study compares two currently available methods, namely ISAC® test and ALEX2® test. METHODS In total, 140 allergic individuals, with a history of atopic dermatitis, adverse food reactions, allergic rhinitis and/or bronchial asthma were studied by Allergy Explorer-ALEX2® macroarray and ImmunoCAP ISAC112® . Lin's concordance correlation coefficient, intraclass correlation coefficient and Bland-Altman plots were used to verify the agreement between continuous values. Cohen's kappa coefficient (k) was assessed for the molecules available in both tests. The degree of relationship was analysed using Spearman's correlation (quantitative variables) and Pearson's χ2 or Fisher's exact test (categorical variables). RESULTS A substantial agreement (κ = 0.795) was observed between the two methods with 94,3% concordant results when results were dichotomized as negative or positive, but if double-negative results were discarded, the agreement dropped to 71%. Conversely, little or no concordance was observed comparing raw data. Considering the 102 molecules shared by both systems, 28/102 (27%) showed an almost perfect agreement (k > 0.81), and concordance was good (k > 0.61) in a further 32 (31%) cases. A perfect to substantial agreement was observed by comparing species-specific aeroallergens. Heterogeneous results emerged comparing panallergens (co-recognition ranging from 30% for tropomyosin/serum albumins to 70% for PR-10/profilin). The correlation among LTP, profilin and PR-10 assayed with ISAC® was better than ALEX2® , but the latter identified more positive cases due to the wider number of molecules available. The CCD blocker provided by ALEX® test abolishes the carbohydrate determinants signal in 60% of the 33 cases reactive to MUXF3 on the ISAC® test. CONCLUSION Despite the excellent concordance of the species-specific markers, the analysis of the panallergens provided in both methods suggests a better performance of the ISAC® test on those components, while the ALEX2® test, which includes a larger number of allergens, allowing a broader molecular detection.
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Affiliation(s)
- Enrico Scala
- Clinical and Laboratory Molecular Allergy Unit, IDI - IRCCS, Rome, Italy
| | - Elisabetta Caprini
- Clinical and Laboratory Molecular Allergy Unit, IDI - IRCCS, Rome, Italy
| | - Damiano Abeni
- Clinical and Laboratory Molecular Allergy Unit, IDI - IRCCS, Rome, Italy
| | - Giorgia Meneguzzi
- Clinical and Laboratory Molecular Allergy Unit, IDI - IRCCS, Rome, Italy
| | - Francesca Buzzulini
- Immunologia e allergologia, Ospedale S. Maria degli Angeli, Pordenone, Italy
| | - Lorenzo Cecchi
- SOS Allergy and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - Danilo Villalta
- Immunologia e allergologia, Ospedale S. Maria degli Angeli, Pordenone, Italy
| | - Riccardo Asero
- Ambulatorio di allergologia, Clinica San Carlo, Paderno Dugnano, Italy
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