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Background: Respiratory allergies mostly allergic rhinitis and asthma represent an important and increasing public health problem and one of the priorities for the European health systems. There is an increasing public concern regarding the persistence and severity of allergic diseases and many difficulties of health systems in providing prompt specialized medical assistance. Our study aims to highlight the main results of the Alliance 4Life project focused on the evaluation of the burden and management of respiratory allergies in primary care from Romania and comparative health-related data from four Central and Eastern European countries. Method: We developed a questionnaire focused on patients with allergic rhinitis and asthma directly addressed to general practitioner (GP) specialists from Romania who attended the annual national conference in Bucharest. Results: The main results showed that patients with respiratory allergies are frequently encountered in primary care practice, only a few patients are evaluated by allergists and there is a clear need for education in this field. Conclusions: This preliminary study confirms that respiratory allergies represent a considerable burden in primary care and the questionnaire may be a useful tool in further studies considering the experience of other healthcare systems. More advanced studies integrating epidemiology with data on air pollution and environmental conditions should be envisaged. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Registries can yield important insights on allergen immunotherapy (AIT) outcomes in daily clinical practice. However, systematic recordings of adverse events (AE) due to AIT in real‐life are lacking.The Allergen Immunotherapy Adverse Events Registry (ADER) is a prospective, multicenter registry on real‐life AIT safety. Data on adults (>18 years old) with respiratory allergies receiving AIT with mites, pollens, epithelia, and/or molds were retrieved and analyzed from ADER. The frequency, characteristics and risk factors of AE were investigated. The MedDRA terminology was used to record AE.A total of 1545 individuals with a mean age of 33 ± 10 years receiving 1815 AIT courses (n = 1060 sublingual (SLIT); n = 755 subcutaneous (SCIT)) in centers from eight countries were included. Patients had allergic rhinitis (65%) or, asthma only (3.7%) or rhinitis with asthma (31.2%). Grass was the most frequent specific sensitizer (60.7%), followed by mites (45.5%), birch pollen (20.6%), epithelia (16.1%), and molds (8%). There were 296 AE recorded in 115 patients (7.4%). A higher frequency of AE occurred during up‐dosing (59%) compared to maintenance. Severe reactions were rare (0.2%), all in the context of SCIT. After 6 weeks of maintenance only one moderate AE was recorded. The most frequently reported symptoms were from the respiratory system and the skin. Having asthma, doing SCIT, AIT with mugwort, cat, or birch were associated with higher risk for AE while the use of allergoids induced lower risk.In real life clinical practice, AIT‐associated AE occur in a minority of patients, while severe reactions are rare. The presence of asthma and use of SCIT are risk factors, while the use of modified allergens lowers the risk. [ABSTRACT FROM AUTHOR]

Respiratory sensitization is a complex immunological process eventually leading to hypersensitivity following re-exposure to the chemical. A frequent consequence is occupational asthma, which may occur after long latency periods. Although chemical-induced respiratory hypersensitivity has been known for decades, there are currently no comprehensive and validated approaches available for the prospective identification of chemicals that induce respiratory sensitization, while the expectations of new approach methodologies (NAMs) are high. A great hope is that due to a better understanding of the molecular key events, new methods can be developed now. However, this is a big challenge due to the different chemical classes to which respiratory sensitizers belong, as well as because of the complexity of the response and the late manifestation of symptoms. In this review article, the current information on respiratory sensitization related processes is summarized by introducing it in the available adverse outcome pathway (AOP) concept. Potentially useful models for prediction are discussed. Knowledge gaps and gaps of regulatory concern are identified. [ABSTRACT FROM AUTHOR]

Background: The increasing prevalence of allergies and asthma has led to a growing global socioeconomic burden. Since the outbreak of the COVID-19 pandemic, the health and lifestyles of children and adolescents have changed dramatically. It's unclear how this shift impacted allergy and asthma, with limited studies addressing this question. We aim to explore the difference of the prevalence of allergies and asthma among US children and adolescents during and before the COVID-19 pandemic using a nationally representative sample of US children and adolescents. Methods: This cross-sectional study included 31,503 participants in the National Health Interview Survey (NHIS) between 2018 and 2021. Allergies and asthma were defined on an affirmative response in the questionnaire by a parent or guardian. Chi-square tests were used to compare baseline characteristics with allergies and asthma for categorical variables. Differences in prevalence during and before the COVID-19 pandemic were estimated with weighted logistic regression, adjusting for demographic factors. Interaction analyses explored variations across strata. Results: In US children and adolescents aged 0 to 17, prevalence of any allergy was 26.1% (95% CI, 24.8%- 27.4%) in 2018 and 27.1% (95% CI, 25.9%- 28.2%) in 2021. Thereinto, in 2018, prevalence of respiratory allergies, food allergies and skin allergies were 14.0% (95% CI, 13.1%- 15.0%), 6.5% (95% CI, 5.8%- 7.1%) and 12.6% (95% CI, 11.6%- 13.5%), respectively, and in 2021, 18.8% (95% CI, 17.8%- 19.9%), 5.8% (95% CI, 5.2%- 6.4%) and 10.7% (95% CI, 9.9%- 11.5%), respectively. And prevalence of asthma was 11.1% (95% CI, 10.5%- 11.7%) in 2018–2019 and 9.8% (95% CI, 9.2%- 10.4%) in 2020–2021. Prevalence of respiratory allergies, skin allergies and asthma during and before the COVID-19 pandemic in children and adolescents had statistically significant differences. The differences persisted after adjusting for demographic and socioeconomic variables. Conclusion: Prevalence of respiratory allergies increased and the prevalence of both skin allergies and asthma decreased among US children and adolescents during the COVID-19 pandemic compared with the pre-COVID-19 pandemic. Further research is required to explore the association between allergic diseases and the pandemic, with a particular emphasis on the impact of lifestyle changes resulting from measures to prevent COVID-19 infection. [ABSTRACT FROM AUTHOR]

IgE-mediated wheat allergy can take on various forms, including childhood food allergy to wheat, wheat-dependent exercise-induced anaphylaxis in young adults, baker's respiratory allergy/asthma in workers exposed to wheat flour inhalation, and contact urticaria that is caused by hydrolyzed wheat proteins in some cosmetics, and that is sometimes associated with a food allergy. Singleplex and multiplex immunoassays detect specific IgE antibodies to wheat allergenic molecular biomarkers such as omega-5 gliadin Tri a 19, lipid transfer protein Tri a 14, and alpha-amylase inhibitors. The fluorescence enzyme immunoassay with capsulated cellulose polymer solid-phase coupled allergens is a commonly used singleplex assay. Multiplex methods include the ELISA-based macroarray immunoassay using nano-bead technology and a microarray immunoassay on polymer-coated slides. Another promising diagnostic tool is the basophil activation test performed with omega-5 gliadin and other wheat protein types. Detailed comprehension of the structural and immunological features of the numerous wheat allergens significant in clinical settings is imperative for advancing diagnostic biomarkers for IgE-mediated wheat allergies. [ABSTRACT FROM AUTHOR]

Nearly a third of the world's population suffers from pollen‐induced respiratory allergies—and the number is rising. For those affected, the situation is becoming more stressful every year with climate change, rising atmospheric CO2 levels, and urbanization. These phenomena form a complex interface between human health and global change, yet the critical information needed to unravel it remains fragmented. A holistic big data approach, with close collaboration between Earth system scientists and health experts, is urgently needed to achieve meaningful insights that advance our understanding and management of increasing pollen‐induced respiratory allergies under global change. [ABSTRACT FROM AUTHOR]

Persistent and unresolved inflammation is a common underlying factor observed in several and seemingly unrelated human diseases, including cardiovascular and neurodegenerative diseases. Particularly, in atopic conditions, acute inflammatory responses such as those triggered by insect venom, food or drug allergies possess also a life‐threatening potential. However, respiratory allergies predominantly exhibit late immune responses associated with chronic inflammation, that can eventually progress into a severe phenotype displaying similar features as those observed in other chronic inflammatory diseases, as is the case of uncontrolled severe asthma. This review aims to explore the different facets and systems involved in chronic allergic inflammation, including processes such as tissue remodelling and immune cell dysregulation, as well as genetic, metabolic and microbiota alterations, which are common to other inflammatory conditions. Our goal here was to deepen on the understanding of an entangled disease as is chronic allergic inflammation and expose potential avenues for the development of better diagnostic and intervention strategies. [ABSTRACT FROM AUTHOR]

Background: Some epidemiological studies suggest that early exposure to animal allergens during infancy reduces the risk of bronchial asthma in school-age children. However, the observed associations in some cases may be an effect of the study used (epidemiological observational studies, especially a cross-sectional study) and indicate reverse causality. Aim: This study aimed to determine the association between exposure to animal allergens and the prevalence of respiratory diseases, including bronchial asthma, considering the potential impact of reverse causality on the observed relationships. Material and methods: An analysis of data from a cross-sectional epidemiological study conducted in 2020 involving 3237 primary school students aged 7–15 years in the Silesian Province (Southern Poland) was carried out. The parents of students completed a questionnaire based on The International Study on Asthma and Allergies in Childhood (ISAAC). The relationship between the occurrence of chronic cough, wheezing, and dyspnea in the last 12 months, night waking due to dyspnea, and asthma in the presence of pets was assessed. Exposure to animal allergens was determined by answering the question, "Are there any furry or feathered animals in the home?" with three response options: "yes; they have been in the past; no" (Scenario 1). For the analyses and to reveal a potential reverse causality effect, the last two response categories regarding pet ownership were combined to form a "no" category in Scenario 2, and the first two answers were combined into a "yes" category in Scenario 3. A chi-square test was used to assess the relationship between variables, and a statistical significance level of p < 0.05 was adopted. Results: Chronic cough affected 9.5% of children, wheezing in the last 12 months—9.2%, night waking due to dyspnea—5.8%, dyspnea in the last 12 months—4.8%, bronchial asthma—9.2%. Analysis considering the category of having or not having pets (yes vs. no) showed that bronchial asthma was statistically significantly more common in children who did not have pets at home (10.9% vs. 7.9%, p = 0.002). A similar situation was observed for wheezing in the past 12 months (10.7% vs. 8.1%; p = 0.01) and nocturnal awakening due to dyspnea (6.8% vs. 5.1%, p = 0.03). No statistically significant differences were observed for the other symptoms. Analysis by time of pet ownership (a. present; b. present but in the past; c. not present) highlighted similar relationships. Asthma (a. 7.7% vs. b. 13.4% vs. c. 7.7%; p = 0.004), wheezing in the past 12 months (a. 8.1% vs. b. 8.9% vs. c. 10.9%, p = 0.03) and night waking (a. 5.0% vs. b. 4.5% vs. c. 7.1%; p = 0.04) were more common in children without pets and those who had owned pets in the past. The highest proportion of children with asthma was in homes where pets were present in the past. Conclusions: Analyses indicating a relationship between a higher prevalence of asthma and some respiratory symptoms, and the absence of pets cannot be considered as a casual association. The analysis conducted did not reveal a reverse causality effect. The results of observational epidemiological studies, especially a cross-sectional study, should always be interpreted with caution, considering possible distortions and conclusions drawn. [ABSTRACT FROM AUTHOR]

The factors influencing caregivers' understanding of pediatric respiratory diseases, such as bronchiolitis, can guide patient care and the acceptability of treatment methods within the healthcare system. This study aims to identify illness perceptions and perform a needs assessment among caregivers of children diagnosed with respiratory diseases. This is a prospective, cross-sectional, questionnaire-driven study of a representative sample of caregivers whose children had an acute respiratory illness. The telephone-administered questionnaire was comprised of (1) demographic items; (2) illness perception questionnaire-revised (IPQ-R); and (3) items about personal barriers, the latter 2 of which employed a 5-point Likert response. Cronbach's alpha (α) was used to measure the internal consistency reliability for each item within the IPQ-R. The Pearson 2-tailed correlation coefficient was used to correlate questionnaire items. We included 75 caregivers whose children have been diagnosed with bronchiolitis (51%), reactive airway disease (RAD) (35%), asthma (33%), and wheezing (44%). We found no significance between the child's diagnosis and the site of recruitment. The most important components of the illness perception were illness coherence (α =0.849), psychological attributions (α =0.903), and barriers to diagnosis (α =0.633). Understanding caregivers' perceptions of respiratory diseases will lead to better treatment acceptance. We must clarify the terms used to define bronchiolitis from viral-induced wheezing, RAD, and the first asthma episode in older infants. Identifying caregivers' gaps in knowledge will help establish a cohesive approach to personalized treatment of respiratory diseases in children and their diagnosis. [ABSTRACT FROM AUTHOR]

The aim was to evaluate the prediction of house dust mite allergy in children diagnosed with allergic disease based on their skin moisture and sebum levels. This is a case–control study including children with asthma, allergic rhinitis (AR), and atopic dermatitis (AD) and a healthy control group. The participants' skin moisture and sebum levels were measured non-invasively using a digital device. A total of 421 patients and 143 healthy children were included. The median value of skin moisture percentage was statistically significantly lower in asthma, AR, and AD patients compared to the control group (p < 0.001 for each). The median value of skin sebum percentage was significantly lower in asthma and AD patients compared to the control group (p = 0.002 and p = 0.003, respectively). ROC analysis was performed to assess the predictive value of skin moisture percentage for house dust mite allergy in respiratory allergic diseases (asthma and AR) and AD separately. Using a cut-off point of 35.5% for skin moisture in asthma and AR patients, the sensitivity and specificity were 81.3% and 56.5%, respectively. Although the specificity is low, the high sensitivity value is promising. The non-invasive measurement of skin sebum and moisture could provide convenience to clinicians in the diagnosis and management of allergic diseases. [ABSTRACT FROM AUTHOR]

Ragweed pollen allergy is the most common seasonal allergy in western Romania. Prolonged exposure to ragweed pollen may induce sensitization to pan-allergens such as calcium-binding proteins (polcalcins) and progression to more severe symptoms. We aimed to detect IgE sensitization to recombinant Amb a 9 and Amb a 10 in a Romanian population, to assess their potential clinical relevance and cross-reactivity, as well as to investigate the relation with clinical symptoms. rAmb a 9 and rAmb a 10 produced in Escherichia coli were used to detect specific IgE in sera from 87 clinically characterized ragweed-allergic patients in ELISA, for basophil activation experiments and rabbit immunization. Rabbit rAmb a 9- and rAmb a 10-specific sera were used to detect possible cross-reactivity with rArt v 5 and reactivity towards ragweed and mugwort pollen extracts. The results showed an IgE reactivity of 25% to rAmb a 9 and 35% to rAmb a 10. rAmb a 10 induced basophil degranulation in three out of four patients tested. Moreover, polcalcin-negative patients reported significantly more skin symptoms, whereas polcalcin-positive patients tended to report more respiratory symptoms. Furthermore, both rabbit antisera showed low reactivity towards extracts and showed high reactivity to rArt v 5, suggesting strong cross-reactivity. Our study indicated that recombinant ragweed polcalcins might be considered for molecular diagnosis.

This retrospective study aimed to assess allergic sensitisation among adult patients tested at National Health Laboratory Service (NHLS) laboratories across nine provinces in South Africa. With a primary focus on identifying prevalent allergens, the investigation extends to comparative analyses with workers tested at the National Institute for Occupational Health (NIOH) and explores trends during a ten-year period from 2012. The overarching objective was to ascertain the potential value of leveraging routine public-health data for comprehensive occupational allergy (OA) surveillance, attempting to fill a critical gap in existing South African OA data. In examining allergic sensitisation, the study spanned NHLS laboratory tests conducted from January 2012 to December 2021, encompassing adult demographic ages from 18 to 65 years, which represent the typical working age of South Africans. The results for allergens recommended by the South African Allergic Rhinitis Working Group and other allergens of relevance in occupational settings were extracted and analysed, providing a robust foundation for a nuanced exploration of sensitisation patterns. Of the 31 913 NHLS laboratory records, 48.48% of adults tested positive for ImmunoCAP Phadiatop, indicative of atopy. In addition, the percentage sensitisation to common aeroallergens of 538 workers tested at the NIOH using the skin-prick test method was compared to those of patients tested at the NHLS. Furthermore, the study uncovered a spectrum of sensitisation patterns, with house-dust mites and grass pollens emerging as predominant allergens. Occupational allergens, including latex, alpha-amylase and chlorhexidine, manifested as noteworthy contributors to sensitisation, shedding light on potential workplace hazards. Provincial variations in sensitisation patterns underscore the nuanced nature of allergic responses across different regions. Dermatophagoides pteronyssinus dominated in five provinces, signifying geographical disparities in allergen prevalence. Intriguingly, comparison with NIOH data reveals significantly higher sensitisation rates in NHLS patients for specific allergens, which suggests potential variations in testing methodologies and patient selection between the two institutions. Drawing from these insights, the study concluded that routine NHLS data are of critical importance for trend analysis and preventive strategies. The high prevalence of sensitisation to common allergens underscores the imperative for targeted preventive measures. This study, bridging the gap in OA data, lays the groundwork for future research exploring the intricate associations between routine allergen sensitisation testing and OA surveillance. [ABSTRACT FROM AUTHOR]

Casuarina (Australian pine, She-oak) is native to Australia and South East Asia and is known for its abundant wind-borne pollen. Despite not being considered a major aeroallergen, some patients report respiratory symptoms upon exposure, with positive skin prick tests (SPT) to Casuarina pollen extract. This study investigates Casuarina pollen dispersal patterns in Sydney, Australia, over a 10-year period, from 2008 to 2018, revealing a bimodal distribution of pollen from September to October (southern hemisphere spring) and February to March (mid-late summer). Analysis of historical SPT data shows 20% of individuals with respiratory allergies reacting positively to Casuarina pollen extract, with almost 90% of these also reacting to grass pollen, suggesting potential cross-reactivity. Notably, there are no exclusive reactions to Casuarina pollen. Understanding the prolonged pollen season underscores the importance of year-round monitoring for accurate characterization. Currently lacking are commercially available skin test extracts or specific IgE assays for Casuarina sensitization, necessitating challenge studies to confirm clinical symptoms directly attributable to Casuarina pollen. By elucidating the seasonal dynamics and meteorological drivers of Casuarina pollen dispersion, alongside the potential allergenicity suggested by skin prick tests, this study paves the way for improved management of Casuarina-related allergies and highlights the critical need for further research on native Australian plant allergens. [ABSTRACT FROM AUTHOR]

Earth's climate is changing at an unprecedented pace, primarily due to anthropogenic causes including greenhouse gas emissions. Evidence shows a strong link between climate change and its effects on asthma. Healthcare professionals must be educated to advocate for and lead effective strategies to reduce the health risks of climate change. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionThis meta-analysis aimed to evaluate the effectiveness and adverse effects of specific immunotherapy (SIT) in the management of respiratory allergens, including allergic asthma, rhinitis, and related disorders, based on a review of current literature up to November 8, 2022.We conducted a search of databases, including PubMed, Embase, Cochrane, and Web of Science, to identify relevant randomized controlled trials (RCTs) assessing respiratory allergy-specific immunotherapy. We employed the Consolidated Standards of Reporting Trials (CONSORT) Statement to select RCTs that adhered to rigorous reporting standards. Specifically, we focused on double-blind placebo-controlled (DBPC) trials and open studies involving both adults and children, considering factors such as dosage, inclusion criteria, allergens, and primary outcome measurements.A total of 25 meta-analyses were included in this study. Among them, 14 evaluated sublingual-specific allergen immunotherapy (SLIT), 4 assessed subcutaneous allergen immunotherapy (SCIT), 4 explored both sublingual and subcutaneous immunotherapy, and 3 investigated intralymphatic immunotherapy. The outcomes of these meta-analyses indicated a reduction in medication scores in 20 cases and a decrease in symptom scores in 23 cases. Additionally, six studies reported on changes in IgE levels, seven studies focused on IgG4, four studies examined FEV1 (forced expiratory volume in 1 s), and eight studies reported on symptom and medication scores. Furthermore, 11 studies reported on differences in adverse reactions.The results of our meta-analysis suggest that specific immunotherapy, while associated with some adverse effects, effectively reduces the symptoms of asthma and rhinitis. Therefore, we recommend its use in the treatment of respiratory allergies. [ABSTRACT FROM AUTHOR]

Objective: A correlation between the intensity of S. aureus colonization and skin inflammation has been demonstrated. 30-60% of S. aureus bacteria in patients with atopic dermatitis (AD) generate exotoxins, specifically superantigen-like enterotoxins A-B-C-D and toxic shock syndrome toxin-1. This study aimed to determine the role of serum staphylococcal enterotoxin A (SEA) and staphylococcal enterotoxin B (SEB)-specific IgE antibodies in children with AD. Materials and Methods: Forty-four children with AD, 30 with allergic respiratory disease (ARD) without AD, and 25 nonatopic healthy children were included in this study. AD cases were diagnosed according to Hanifin and Rajka criteria. The severity of AD was evaluated by the "Eczema Area and Severity Index". Serum total IgE (tIgE), SEA-specific IgE and SEB-specific IgE levels were analyzed in all children. Results: Serum tIgE levels were significantly elevated in children with ARD without AD compared to children with AD and healthy children (p=0.041). However, there was no significant difference in the levels and the rates of positive SEA-specific IgE and SEB-specific IgE for children with AD, children with ARD without AD, and healthy children. A significantly positive correlation was detected between the EASI scores and SEA-IgE levels in children with AD (p=0.002). Conclusion: Although the role of SEA in the pathogenesis of AD through IgE-mediated mechanisms is not fully known, the data in our study seems to provide support to the role of SEA on the severity of AD. To conclude, adding antistaphylococcal treatment to antiinflammatory therapy may be helpful in obtaining an effective clinical response in children with moderate to severe AD. [ABSTRACT FROM AUTHOR]

Background and Objectives: As the COVID-19 pandemic brought surges of hospitalized patients, it was important to focus on reducing overuse of tests and procedures to not only reduce potential harm to patients but also reduce unnecessary exposure to staff. The objective of this study was to create a Choosing Wisely in COVID-19 list to guide clinicians in practicing high-value care at our health system. Methods: A Choosing Wisely in COVID-19 list was developed in October 2020 by an interdisciplinary High Value Care Council at New York City Health + Hospitals, the largest public health system in the United States. The first phase involved gathering areas of overuse from interdisciplinary staff across the system. The second phase used a modified Delphi scoring process asking participants to rate recommendations on a 5-point Likert scale based on criteria of degree of evidence, potential to prevent patient harm, and potential to prevent staff harm. Results: The top 5 recommendations included avoiding tracheal intubation without trial of noninvasive ventilation (4.4); not placing routine central venous catheters (4.33); avoiding routine daily laboratory tests and batching laboratory draws (4.19); not ordering daily chest radiographs (4.17); and not using bronchodilators in the absence of reactive airway disease (4.13). Conclusion: We successfully developed Choosing Wisely in COVID-19 recommendations that focus on evidence and preventing patient and staff harm in a large safety net system to reduce overuse. [ABSTRACT FROM AUTHOR]

The emergence of COVID-19 caused by SARS-CoV-2 prompted an unprecedented global response to develop vaccines at an accelerated pace. Messenger RNA (mRNA) and adenovirus vector vaccines emerged as the frontrunners in global immunization efforts, significantly reducing hospitalization, severity, and mortality, supplemented by inactivated virus-based vaccines in developing countries. However, concerns regarding adverse effects, including allergic reactions, have been raised. This study aimed to investigate the adverse effects following COVID-19 vaccination, particularly in atopic and non-atopic individuals. A cohort of 305 volunteers receiving BNT162, ChAdOx1, or CoronaVac vaccines were assessed based on a Skin Prick Test (SPT), specific IgE levels, and clinical history of asthma and rhinitis. Adverse effects were self-reported and scored across the different vaccination shots. The results indicated a notable presence of mild adverse effects following the first and third doses, regardless of vaccine type. ChAdOx1 recipients experienced more adverse effects compared to those receiving BNT162 and CoronaVac, including headaches, muscle pain, fever, chills, nausea, and flu-like symptoms. Atopic individuals receiving ChAdOx1 reported more adverse effects, such as muscle pain, fever, and chills, compared to non-atopic individuals. Conversely, headaches were more frequently reported in non-atopic individuals receiving BNT162 compared to atopic individuals. No anaphylaxis or allergic reactions were reported, indicating valuable evidence supporting the safety of COVID-19 vaccination in individuals with respiratory allergies. This study highlights the importance of understanding vaccine-related adverse effects, particularly in vulnerable populations, to inform vaccination strategies and address safety concerns in global immunization campaigns. [ABSTRACT FROM AUTHOR]

This article discusses the assessment of sIgE to rLep d 2 for detecting Lepidoglyphus destructor sensitization. Lepidoglyphus destructor is an important aeroallergen in certain regions of Europe. The study aimed to analyze the sensitivity, specificity, and positive and negative likelihood ratios of sIgE to L. destructor benchmarked against rLep d 2. The results showed a high correlation between L. destructor and rLep d 2, and the sensitivity and specificity of sIgE to rLep d 2 were 71.64% and 96.43% respectively. However, determining sIgE to rLep d 2 did not offer additional diagnostic value compared to skin prick tests and specific IgE tests for L. destructor. [Extracted from the article]

Imported allergens are involved in many allergic reactions, with unexpected and unusual implications. They can be involved in developing asthma, allergic rhinoconjunctivitis, Hymenoptera venom allergies and food allergies. Imported allergens can be implied in respiratory allergies attributable to commercial practices and accidental diffusion through air currents that have introduced non-native species in new geographical contexts. Ambrosia artemisiifolia L., a plant native to North America and currently in the western part of Lombardy, represents an example. Moreover, a variation in the pollen concentration in the Northwest Tuscany area and Trentino Alto-Adige was observed. Cannabis sativa is another imported allergen used frequently by adolescents. Regarding potential imported food allergens, there is no validated list. Imported food allergens derive from ethnic foods, referring to Mexican/Latin American, Chinese/Japanese, Southeast Asian, Arab/Middle Eastern and African cuisine. Four insect flours were recently introduced to the European and Italian markets (Acheta domesticus, Alphitobius diaperinus, Tenebrio molitor and Locusta migratoria). The association between the accidental introduction through commercial traffic, climate change, and the absence of natural enemies in the destination ecosystem is related to the introduction of a specific Hymenoptera, Vespa velutina, in Italy and Europe. External events attributable to human activities, such as climate change and the introduction of non-native plants, foods and Hymenoptera through trade, have contributed to the issue of imported allergens. Making the correct diagnosis and guiding the diagnostic and therapeutic path in this particular context represent the concerns of the pediatric allergist. [ABSTRACT FROM AUTHOR]

Fractional exhaled nitric oxide (FeNO) is a non-invasive biomarker of eosinophilic airway inflammation. FeNO is elevated in allergic asthma and its production increases in the airways in the presence of Type-2 inflammation. Both individual and occupational factors are associated with increased FeNO in workers with occupational asthma. This review focuses on identifying the specific predictors of elevated FeNO in workers at risk of developing occupational respiratory allergy and asthma, with a specific focus on those settings where it is used for medical screening and surveillance. The review found that individual factors such as age and atopy are associated with increased FeNO, whereas smoking and inhaled steroid use are consistently associated with decreased FeNO levels. Occupational factors such as exposure to either high or low molecular weight agents, occupational allergic sensitisation, the nature of work, the duration of employment and the level of exposure to occupational allergen(s) are associated with elevated FeNO. More recent evidence suggests that it is the agent's ability to induce an IgE-mediated mechanism, and not its molecular weight or its nature, that is responsible for elevated FeNO levels in occupationally exposed workers. Stronger epidemiological study designs such as cohort studies are needed that offer better opportunities to investigate these relationships in a more refined manner. [ABSTRACT FROM AUTHOR]

Respiratory allergic diseases affect over 500 million people globally and pose a substantial burden in terms of morbidity, mortality, and healthcare costs. Restrictive factors such as geographical disparities, infectious pandemics, limitations in resources, and shortages of allergy specialists in underserved areas impede effective management. Telemedicine encompasses real-time visits, store-and-forward option triage, and computer-based technologies for establishing efficient doctor-patient communication. Recent advances in digital technology, including designated applications, informative materials, digital examination devices, wearables, digital inhalers, and integrated platforms, facilitate personalized and evidence-based care delivery. The integration of telemonitoring in respiratory allergy care has shown beneficial effects on disease control, adherence, and quality of life. While the COVID-19 pandemic accelerated the adoption of telemedicine, certain concerns regarding technical requirements, platform quality, safety, reimbursement, and regulatory considerations remain unresolved. The integration of artificial intelligence (AI) in telemonitoring applications holds promise for data analysis, pattern recognition, and personalized treatment plans. Striking the balance between AI-enabled insights and human expertise is crucial for optimizing the benefits of telemonitoring. While telemonitoring exhibits potential for enhancing patient care and healthcare delivery, critical considerations have to be addressed in order to ensure the successful integration of telemonitoring into the healthcare landscape. [ABSTRACT FROM AUTHOR]

Background: Allergic diseases, including respiratory and food allergies, as well as allergic skin conditions have surged in prevalence in recent decades. In allergic diseases, the gut microbiome is dysbiotic, with reduced diversity of beneficial bacteria and increased abundance of potential pathogens. Research findings suggest that the microbiome, which is highly influenced by environmental and dietary factors, plays a central role in the development, progression, and severity of allergic diseases. The microbiome generates metabolites, which can regulate many of the host's cellular metabolic processes and host immune responses. Aims and Methods: Our goal is to provide a narrative and comprehensive literature review of the mechanisms through which microbial metabolites regulate host immune function and immune metabolism both in homeostasis and in the context of allergic diseases. Results and Discussion: We describe key microbial metabolites such as short‐chain fatty acids, amino acids, bile acids and polyamines, elucidating their mechanisms of action, cellular targets and their roles in regulating metabolism within innate and adaptive immune cells. Furthermore, we characterize the role of bacterial metabolites in the pathogenesis of allergic diseases including allergic asthma, atopic dermatitis and food allergy. Conclusion: Future research efforts should focus on investigating the physiological functions of microbiota‐derived metabolites to help develop new diagnostic and therapeutic interventions for allergic diseases. [ABSTRACT FROM AUTHOR]

Pulmonary disease represents a substantial global health burden. Increased air pollution, especially fine particulate matter (PM2.5) is the most concerned proportion of air pollutants to respiratory health. PM2.5 may carry or combine with other toxic allergens and heavy metals, resulting in serious respiratory allergies and anaphylactic reactions in the host. Available treatment options such as antihistamines, steroids, and avoiding allergens/dust/pollutants could be limited due to certain side effects and immense exposure to air pollutants, especially in most polluted countries. In this mini-review, we summarized how PM2.5 triggers respiratory hyperresponsiveness and inflammation, and the probiotic Lactiplantibacillus plantarum supplementation could minimize the risk of the same. L. plantarum may confer beneficial effects in PM2.5-associated pulmonary inflammation due to significant antioxidant potential. We discussed L. plantarum's effect on PM2.5-induced reactive oxygen species (ROS), inflammatory cytokines, lipid peroxidation, and DNA damage. Available preclinical evidence shows L. plantarum induces gut-lung axis, SCFA, GABA, and other neurotransmitter signaling via gut microbiota modulation. SCFA signals are important in maintaining lung homeostasis and regulating intracellular defense mechanisms in alveolar cells. However, significant research is needed in this direction to contemplate L. plantarum's therapeutic potential in pulmonary allergies. [ABSTRACT FROM AUTHOR]

Over the past few years, a diverse range of automatic real-time instruments has been developed to respond to the needs of end users in terms of information about atmospheric bioaerosols. One of them, the SwisensPoleno Jupiter, is an airflow cytometer used for operational automatic bioaerosol monitoring. The instrument records holographic images and fluorescence information for single aerosol particles, which can be used for identification of several aerosol types, in particular different pollen taxa. To improve the pollen identification algorithm applied to the SwisensPoleno Jupiter and currently based only on the holography data, we explore the impact of merging fluorescence spectra measurements with holographic images. We demonstrate, using measurements of aerosolised pollen, that combining information from these two sources results in a considerable improvement in the classification performance compared to using only a single source (balanced accuracy of 0.992 vs. 0.968 and 0.878). This increase in performance can be ascribed to the fact that often classes which are difficult to resolve using holography alone can be well identified using fluorescence and vice versa. We also present a detailed statistical analysis of the features of the pollen grains that are measured and provide a robust, physically based insight into the algorithm's identification process. The results are expected to have a direct impact on operational pollen identification models, particularly improving the recognition of taxa responsible for respiratory allergies. [ABSTRACT FROM AUTHOR]

Introduction: Prenatal exposure to environmental chemicals may be associated with allergies later in life. We aimed to examine the association between prenatal dietary exposure to mixtures of chemicals and allergic or respiratory diseases up to age 5.5 y. Methods: We included 11,638 mother-child pairs from the French "Étude Longitudinale Française depuis l'Enfance" (ELFE) cohort. Maternal dietary exposure during pregnancy to eight mixtures of chemicals was previously assessed. Allergic and respiratory diseases (eczema, food allergy, wheezing and asthma) were reported by parents between birth and age 5.5 years. Associations were evaluated with adjusted logistic regressions. Results are expressed as odds ratio (OR[95%CI]) for a variation of one SD increase in mixture pattern. Results: Maternal dietary exposure to a mixture composed mainly of trace elements, furans and polycyclic aromatic hydrocarbons (PAHs) was positively associated with the risk of eczema (1.10 [1.05; 1.15]), this association was consistent across sensitivity analyses. Dietary exposure to one mixture of pesticides was positively associated with the risk of food allergy (1.10 [1.02; 1.18]), whereas the exposure to another mixture of pesticides was positively but slightly related to the risk of wheezing (1.05 [1.01; 1.08]). This last association was not found in all sensitivity analyses. Dietary exposure to a mixture composed by perfluoroalkyl acids, PAHs and trace elements was negatively associated with the risk of asthma (0.89 [0.80; 0.99]), this association was consistent across sensitivity analyses, except the complete-case analysis. Conclusion: Whereas few individual chemicals were related to the risk of allergic and respiratory diseases, some consistent associations were found between prenatal dietary exposure to some mixtures of chemicals and the risk of allergic or respiratory diseases. The positive association between trace elements, furans and PAHs and the risk of eczema, and that between pesticides mixtures and food allergy need to be confirmed in other studies. Conversely, the negative association between perfluoroalkyl acids, PAHs and trace elements and the risk of asthma need to be further explored. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic brought unprecedented global disruption to both healthcare providers and patients with respiratory allergies. There are limited real-life data on the impact of the COVID-19 pandemic on the risk perception of patients with allergy treated with allergen immunotherapy (AIT). Objective: To understand the risk perception of allergic patients treated with sublingual immunotherapy (SLIT) before and during the pandemic, and their attitudes towards COVID-19 infection and vaccination. Methods: This was a non-interventional, cross-sectional survey conducted from October to November 2021 in France. Adult patients, who had been prescribed and had received a Stallergenes SLIT (liquid or liquid and tablets) before the pandemic (from August 1, 2018 to March 10, 2020) and during the pandemic (from March 11, 2020 to August 31, 2021), were identified from the Stallergenes named-patient products (NPP) database. Patients completed an online questionnaire. Data were analyzed descriptively. Results: A total of 5258 patients from all over France completed the questionnaire. Mean (±SD) age of the respondents was 39.3 (±13.0) years and 66.9% were female. Some of them (11.8%) were obese (BMI >30 kg/m2). Main allergic diseases were rhinitis (80.0% of patients) with or without conjunctivitis, and asthma (39.0%). More than half of the patients experienced moderate to severe (58.0%) and persistent allergic rhinitis profile (70.4%). Most patients were poly-allergic (72.7%), mostly to house dust mites (61.9%), grass pollens (61.5%), tree pollens (57.8%), and cat dander (37.2%). Only 14.1% of patients experienced an aggravation of their allergy symptoms during lockdown and 14.8% were infected with COVID-19, with hospitalization required for 1.8%. Only 3.1% of patients reported their SLIT initiation as being postponed due to the pandemic. SLIT was changed, temporarily interrupted or permanently discontinued during the pandemic in 21.9% of patients. Changes mainly concerned the maintenance dose for SLIT-liquid (63.2%). SLIT modification was due to COVID-19 infection in only 4.2%. Most patients did not feel vulnerable (53.1%), anxious (55.2%), at risk to present severe symptoms of COVID-19 (77.1%), or at risk to transmit coronavirus (80.4%). However, greater anxiety was reported in patients with allergic asthma (33.6%) or other respiratory disorders (50.4%). Patients who felt vulnerable partly assigned their vulnerability to their allergic disease (59.3%). Suffering from an allergic disease did not make patients feel more vulnerable to side effects of COVID-19 vaccine for 79.6% of them. Conclusion: Overall, most patients with allergy and under SLIT were not strongly concerned by the COVID-19 infection. SLIT did not have a negative impact on the COVID-19 symptoms.

Allergic rhinitis and asthma are prevalent in tropical countries like the Philippines. Pollen grains from anemophilous plant species may trigger these respiratory allergies. Pollen extracts from common allergenic plants are currently produced locally in the Philippines and are utilized for the diagnosis and immunotherapy of patients with respiratory allergies. Further improvement of their quality is necessary to avoid false negative or false positive diagnoses, as well as to increase the effectiveness of immunotherapy and avoid adverse reactions. This study aimed to characterize the morphology of the collected pollen grains and assess the pollen purity, protein concentration, and electrophoretic profile of the allergenic pollen extracts. Pollen identification and percent purity of the pollen collections were assessed via microscopy and hemocytometer. Lowry assay was performed to identify the total protein concentration of the pollen extracts before subjecting them to SDS-PAGE and silver staining. The pollen samples from varying plant families have distinct features that will aid in their proper identification. Collected aggregates of pollen samples with pollen purity of < 90%, like T. procumbens, A. saman, L. leucocephala, and M. indica, manifest darker colors compared to their actual color. On the other hand, the color of collected pollen samples with pollen purity = 90% are commonly yellow or off-white, which is their natural color. The total protein concentration of the crude pollen extracts ranges from 2.87-9.63 mg/mL. The pollen extracts revealed protein bands at molecular weights ranging from 10-250 kD on SDS-PAGE. Proper characterization of a particular pollen may help in assessing the purity of the collected pollen. Higher pollen purity may contribute to the assurance that the positive diagnosis was due to the target pollen of a plant and not due to contaminations from other components. The result of this study may be considered for the improvement of the crude pollen allergen extract production for clinical use. It is also recommended to assess the effect of the environmental condition where the pollen was collected in terms of the actual proteins present after allergen extraction. [ABSTRACT FROM AUTHOR]

More than 10% of the world's population suffers from an immunoglobulin E (IgE)-mediated allergy to cats which is accompanied mainly by respiratory symptoms such as rhinitis and asthma. Several cat allergen molecules have been identified, but their allergenic activity has not been investigated in depth. Purified cat allergen molecules (Fel d 1, Fel d 2, Fel d 3, Fel d 4, Fel d 6, Fel d 7 and Fel d 8) were characterized via mass spectrometry and circular dichroism spectroscopy regarding their molecular mass and fold, respectively. Cat-allergen-specific IgE levels were quantified via ImmunoCAP measurements in IgE-sensitized subjects with (n = 37) and without (n = 20) respiratory symptoms related to cat exposure. The allergenic activity of the cat allergens was investigated by loading patients' IgE onto rat basophils expressing the human FcεRI receptor and studying the ability of different allergen concentrations to induce β-hexosaminidase release. Purified and folded cat allergens with correct masses were obtained. Cat-allergen-specific IgE levels were much higher in patients with a respiratory allergy than in patients without a respiratory allergy. Fel d 1, Fel d 2, Fel d 4 and Fel d 7 bound the highest levels of specific IgE and already-induced basophil degranulation at hundred-fold-lower concentrations than the other allergens. Fel d 1, Fel d 4 and Fel d 7 were recognized by more than 65% of patients with a respiratory allergy, whereas Fel d 2 was recognized by only 30%. Therefore, in addition to the major cat allergen Fel d 1, Fel d 4 and Fel d 7 should also be considered to be important allergens for the diagnosis and specific immunotherapy of cat allergy. [ABSTRACT FROM AUTHOR]

Anti-Ascaris lumbricoides (Asc) IgE and IgG can immunomodulate the allergy; however, the influence of these isotypes has not been investigated in the giardiasis and allergy. Therefore, the frequency of respiratory allergy (RA) symptoms in Giardia lamblia–infected children, with or without anti-Asc IgE, IgG1, or IgG4 and Th1, Th2/Treg, and Th17 cytokine production, was evaluated. We performed a case–control study with children aged 2–10 years old selected by questionnaire and stool exams to form the groups: infected or uninfected with RA (G-RA, n = 55; nG-RA, n = 43); infected and uninfected without RA (G-nRA, n = 59; nG-nRA, n = 54). We performed blood leukocyte counts and in vitro culture. Cytokine levels in the supernatants (CBA), serum total IgE and anti-Asc IgE (ImmunoCAP), IgG1, IgG4, and total IgA (ELISA) were measured. Infection was not associated with allergy. Infected children showed increased levels of anti-Asc IgG1, IL-2, IFN-γ, IL-4, and IL-10. There was a lower frequency of allergy-related symptoms in anti-Asc IgG1–positive children than IgG1-negative (OR = 0.38; CI = 0.17–0.90, p = 0.027) and few eosinophils in G-RA than in G-nRA and more in G-nRA than in nG-nRA, whereas TNF-α levels were higher in the G-RA than in the nG-nRA group. For infected and positive anti-Asc IgG1, there was higher TNF-α and IL-10 production than G/-IgG1. IL-10 levels were lower in nG/ + IgG1 than in infected or non-infected, and both were negative for anti-Asc IgG1. Th1/Th2/IL-10 profiles were stimulated in the infected patients, and in those with circulating anti-Asc IgG1, the TNF-α production was strengthened with a lower risk for respiratory allergy symptoms. [ABSTRACT FROM AUTHOR]

Background. Climate change is undisputedly one of the most significant problems in the world. Children's respiratory health can be particularly affected by climate change, which contributes to triggering respiratory allergic diseases through many allergies. Aim. This study was conducted to evaluate the effect of climate change educational intervention on knowledge and health-related behaviors of children with respiratory allergic diseases Design. A quasi-experimental research design was utilized. Subjects. A convenience sample was used including 73 children aged 8 to 15 years diagnosed with respiratory allergic diseases. Setting. The study was carried out at allergy and immunology outpatient clinics affiliated to Mansoura University Children's Hospital (MUCH). Tools of data collection. Three tools were used for data collection: demographic and clinical data structured interview sheet, children knowledge regarding climate changes questionnaire and children's climate change health-related behaviors questionnaire. Results: There was a statistically significant difference between the children's knowledge score and daily health-related behaviors score regarding climate change pre- and post-intervention (P=0.000). There was a positive correlation between children's knowledge and their health-related behaviors pre- and post-educational intervention (p= 026 & 0.021 respectively). Conclusion. The study highlights the potential of climate change education in boosting knowledge and health-related behaviors among children with respiratory allergic diseases, thereby promoting a sustainable healthy future. Recommendation. This study emphasizes the need for climate education in pediatric healthcare to protect vulnerable children from public health threats, requiring further research for long-term effects and scalability. [ABSTRACT FROM AUTHOR]

Objective • To research the mechanism of acupuncture and moxibustion in treating and preventing allergic rhinitis. Methods • We searched PubMed; Google Scholar; Semantic Scholar; Academic Keys; Citation; Dimensions; EuroPub; Index (A & HCI); Compendex; Conference Proceedings Citation; and Science Citation Index. We reviewed the mechanism of acupuncture and moxibustion in the prevention and treatment of allergic rhinitis from the perspectives of Th1/Th2 balance regulation, IgE level reduction, lowering of inflammatory cell infiltration in the nasal mucosa, regulation of nasal neuropeptide (substance P) level, inhibition of Toll-like receptors, and NFκB protein expression. Results • Acupuncture can play a therapeutic role in AR. Combining different aspects such as the influence on Th1 and Th2 subsets of cells, regulation of Th1/Th2 balance, reduction of IgE level, reduction of inflammatory cell infiltration in the nasal mucosa, regulation of nasal neuropeptide (substance P) level, inhibition of Toll-like receptor, and NFκB protein expression, the mechanism of action of acupuncture for AR can be elucidated more comprehensively. Conclusion • Acupuncture and moxibustion can be used to treat allergic rhinitis in several ways. [ABSTRACT FROM AUTHOR]

Introduction: Airborne fungi induce allergic symptoms in 3–10% of the population worldwide. To better prevent and manage fungi-related allergic diseases, it is essential to identify the genus and the distribution profile of airborne fungi. Methods: With this purpose in mind, we carried out a 12-month volumetric sampling study to monitor the airborne fungi and retrospectively analyzed the sensitization profile of four dominant fungi (Cladosporium, Alternaria, Aspergillus, and Penicillium) among respiratory allergies during the same study period in Wuhan, China. Results: A total of 29 different fungal genuses were identified, and the peak fungal concentration period was found to be in September and October, followed by May and June. The most prevalent fungi in this area were Cladosporium (36.36%), Ustilago (20.12%), and Alternaria (13.87%). In addition, the skin prick test data from 1,365 respiratory allergies patients showed that 202 (14.80%) of them were sensitized to fungi. The sensitization rates to Cladosporium, Alternaria, Aspergillus, and Penicillium were 11.72%, 4.69%, 1.98%, and 4.76%, respectively. The seasonal fluctuation of Alternaria and Aspergillus correlated with their sensitization rates. Among the fungal sensitized patients, 76 (37.62%) were sensitized to two or more kinds of fungi. The serum-specific IgE tests suggested low to high correlations existed between these fungi; however, these correlations were not found between fungi and other allergens. Conclusion: Our study provides the distribution profile and reveals the clinical significance of the airborne fungi in Wuhan, which will facilitate the precise management of fungal allergy. [ABSTRACT FROM AUTHOR]

Allergic diseases are a major health problem due to their increasing incidence and high prevalence worldwide. Asthma has several aetiologies, and allergy plays an important role in its development in approximately 60% of adults and 80% of children and adolescents. Although the link between aeroallergen sensitization and asthma exacerbations has been long recognized, the investigations of the triggering allergens may be superficial in many asthma cases. The main allergenic sources related to asthma, and other allergic diseases, are pollens, mites, fungi, and animal epithelia. Fungi are considered the third most frequent cause of respiratory pathologies. Asthma caused by several fungi species may have a bad prognosis in some cases due to its severity and difficulty in avoidance methods. Despite the recognised relevance of fungi in respiratory allergies, the knowledge about fungal allergens seems to be scarce, with few descriptions of new allergens, compared to other allergenic sources. The study of major, minor, and cross-reactive fungal allergens, and their relevance in the allergic disease, might be crucial, not only to accurately diagnose these allergies, but also to predict exacerbations and responses to therapies, as well as for the development of personalized treatment plans in a fast-changing climate scenario. • Fungi is the kingdom with the lower rate of new allergen description, suggesting it is still an understudied allergen source. • In addition to major allergens, minor allergens have shown great relevance in allergy and should be given more consideration. • Study of fungal allergens seem crucial to accurately diagnose allergy, predict exacerbations and develop personalized treatments. [ABSTRACT FROM AUTHOR]

Introduction: Air pollution is a current major health issue. The burden of airborne pollutants and aeroallergen levels varies throughout the year, as well as their interaction and consequences. Prenatal exposure during pregnancy has been associated with adverse perinatal outcomes. The aim of this study was to evaluate the impact of air pollutants on perinatal outcomes in patients with or without respiratory allergy. Material and methods: Nested case–control retrospective study on 3006 pregnant women. Correlations between concentrations of common pollutants in each trimester of pregnancy and on average during the whole pregnancy and both gestational age at delivery and birthweight were studied. Pearson's correlation coefficient and binary logistic regression were used. Results: In general, pollutants correlated more strongly with birthweight than with gestational age at delivery. Nine‐month NO2, SO2, CO, and benzene, and second‐trimester CO negatively correlated with birthweight, whereas only first‐trimester NO2 showed a very mild correlation with gestational age at delivery. Negative correlations between pollutants and birthweight were much stronger in the respiratory allergy group (n = 43; 1.4%) than in the non‐allergic group. After adjustments, the most significant predictive pollutant of birthweight was SO2 in both groups. The best predictive model was much stronger in the allergic group for third‐trimester SO2 (R2 = 0.12, p = 0.02) than in the non‐allergic group for total SO2 (R2 = 0.002, p = 0.02). For each unit that SO2 increased, birthweight reduced by 3.22% vs. 1.28% in each group, respectively. Conclusions: Air pollutant concentrations, especially SO2, negatively influenced birthweight. The impact of this association was much stronger and more relevant in the group of women with respiratory allergies. [ABSTRACT FROM AUTHOR]

Background: We have identified and reported a novel antigen, nonprotein‐specific secreted EP1‐like glycoprotein (51 kDa), for lettuce‐related respiratory allergy. Objective: We aimed to identify a novel antigen for lettuce‐related respiratory allergy that is different from epidermis‐specific secreted EP1‐like glycoprotein. Methods: Immunoblotting was performed using an immunoglobulin E‐specific antibody. The antigen‐antibody reaction was confirmed by means of enzyme‐linked immunosorbent assaying. LC‒MS/MS analysis was carried out to detect a novel protein found in sera from 3 of 13 patients with lettuce‐related respiratory allergy. Finally, we purified a novel protein from Escherichia coli. Results: Immunoblotting assays showed common bands of 17 kDa in the sera of 3 of 13 patients. An enzyme‐linked immunosorbent assay confirmed that the patient sera reacted with lettuce latex juice. A 17 kDa protein band that showed antigenic reactivity in 3 of 13 patient sera was identified as a kirola‐like protein by LC‒MS/MS. In addition, although we purified this protein, we failed to show the inhibitory effect. Conclusion: A 17 kDa protein that is a potentially novel antigen of lettuce‐associated respiratory allergy was identified. In further studies, we will focus on purifying this novel protein to diagnose lettuce allergy. Key message: Immunoblotting analysis showed common bands at 17 kDa for lettuce latex and patient serum.The 17 kDa protein bands were identified as kirola‐like protein by LC‒MS/MS.We purified the kirola‐like protein. [ABSTRACT FROM AUTHOR]

Purpose: Allergic diseases have reached epidemic proportions globally, affecting nearly 30% of the world's population. One of the most prominent sources of allergens is fungi, causing up to 6% of respiratory diseases in the general population. However, the cause of respiratory allergies is not always identifiable. Therefore, we studied the ability of two representatives of common powdery mildew (Erysiphales), Erysiphe palczewskii and Erysiphe convolvuli, to induce a proinflammatory response in in vitro models of the upper and lower respiratory tract.Materials and Methods: Two cell lines, BEAS-2B and A549, were used to mimic upper and lower respiratory epithelial cells. The toxicity of fungal extracts was assessed with MTT and flow cytometry assay. The production of reactive oxygen species in the cells was measured with flow cytometry. ELISA tests were used to determine the production of proinflammatory cytokines. The presence of the cell integrity marker was assessed with the immunofluorescence method.Results: In both cell lines, the extract of E. palczewskii and E. convolvuli microfungi induced marked production of proinflammatory IL-1β, TNF-α, and GM-CSF cytokines involved in developing allergic reactions. The higher levels of these cytokines with higher reactive oxygen species synthesis positively correlated with the disruption of epithelial cell junctions.Conclusion: We conclude that E. palczewskii and E. convolvuli microfungi have strong proinflammatory and proallergenic potential, but this finding needs in vivo confirmation.Plain Language Summary: Phytopathogenic microfungi, commonly found in human environments, act as plant parasites. They harm plant yields, the quality of agricultural products, and the aesthetic appeal of ornamental plants. Additionally, these fungi pose a potential threat to human health due to their role as prominent allergen sources. Among the most significant allergenic fungi are Alternaria, Aspergillus, Cladosporium, Penicillium, and Fusarium. However, it is worth noting that even widely prevalent phytopathogenic microfungi, such as E. palczewskii and E. convolvuli, may also induce allergy symptoms. These fungi cause extensive plant infestations, releasing vast spores, particularly during spring, summer, and autumn. Consequently, the dispersion of plants and their parasitic fungi increases the risk of human exposure to potential allergens. Since the underlying causes of allergies are not always identified through conventional skin or blood tests, it is crucial to describe new fungal allergens for hypersensitivity diagnosis. Our study demonstrates that parasitic microfungi exhibit significant pro-inflammatory properties in in vitro upper and lower respiratory tract models. [ABSTRACT FROM AUTHOR]

Invasive plant species can suppress local biodiversity, affect soil properties and modify the landscape. However, an additional concern of plant invasions that has been more disregarded is their impact on environmental human health. Here, we discuss the case of Cortaderia selloana (Schult. & Schult.f.) Asch. & Graebn, as an example of a worldwide invasive species with a strong environmental impact. We summarise the main facts regarding the C. selloana invasion, the recent clinical evidence of its impact on human health and the great potential expansion of the species in the context of climate change. C. selloana constitutes a clear example to boost demands from policy makers for urgent and efficient measures to control or eradicate invasive species, also in ruderal areas. This aggressive invader is still out of relevant binding international invasive species catalogues, including the European List of Invasive Alien Species of Union concern (Union list), and is still subjected to extensive trading in some European countries. Therefore, including C. selloana in the Union list becomes mandatory to impose full restrictions on keeping, importing, selling, breeding and cultivating the species. [ABSTRACT FROM AUTHOR]

Background: Asthma and allergic diseases have increased in recent decades and are more common in industrialized countries. Industrial areas with a considerably high number of inhabitants and vehicles can favor the presence of serious air pollution and therefore the appearance and exacerbation of respiratory allergy symptoms. The objective of this study was to determine the relationship between exposure to environmental pollutants with exacerbation of respiratory allergy. Methods: A total of 240 subjects above 6 years old who lived in the metropolitan area of Monterrey, Nuevo León, Mexico, with diagnosis of allergic rhinitis and/or asthma, were included. The subject's address was registered in the database and the rhinitis control assessment test (RCAT) and the asthma control test (ACT) were applied. Environmental data were obtained from the Environmental Monitoring System (SIMA) of Nuevo León. Geolocation of industries and avenues in proximity of subject's addresses and SIMA stations were obtained through geographic information systems using ArcGis software. Results: The relation between pollutants and subjects’ RCAT, ACT, and spirometry results in the 14 stations was established. PM10 and forced vital capacity (FVC) had an r = 0.074 with p = 0.005, PM10 and absolute FEV1/FVC ratio presented an r = −0.102 with a p = 0.000; The distance found to be associated with a worsening of respiratory symptoms was living 165 m from a main road or 241 m from an industrial establishment. Conclusions: Exposure to pollutants present in the environment are factors associated with increased symptoms in subjects with respiratory allergies.

This document is an editorial titled "Understanding the impact of lung ventilation heterogeneity" published in Frontiers in Medical Technology. The authors, Brooks Kuhn and Igor Barjaktarevic, discuss the concept of ventilation heterogeneity (VH) in respiratory physiology. They explain that VH can occur due to various factors such as gravity, anatomical differences in the airways, and mechanical interaction with the chest wall. The authors highlight the clinical relevance of VH in respiratory diseases such as asthma, COPD, and acute respiratory distress syndrome (ARDS). They also discuss the need for improved diagnostic and therapeutic technologies to better understand and treat VH. The editorial concludes by emphasizing the importance of accounting for regional variations in lung physiology for more personalized care. [Extracted from the article]

Aim:The skin prick test (SPT) is the standard tool for determining respiratory allergen sensitizations. Different allergen sensitization patterns have been observed within countries and regions according to geographical and seasonal variations. This study aims to identify the sensitization pattern of children in different age groups and to define the minimum number and type of allergen extracts in an SPT to detect a sensitized child.Materials and Methods:This retrospective study was conducted in the Outpatient Clinic of the Pediatric Allergy, Immunology, and Pulmonology Unit of a tertiary Children’s Hospital from October 2019 to December 2020. Children aged between 2 and 18 years suspected of inhalant allergy with the presence of clinically relevant symptoms were included. The results of SPT were collected from medical records to determine the optimal panel to cover 95% of the sensitized children.Results:A total of 1821 patients with SPT results were evaluated. Forty-three patients (2.4%) were excluded from the study because some allergen extracts did not apply. Consequently, 1778 children (male/female ratio of 1.33) were included in the study. The median age (interquartile range) was 8 years (2-18). The most common sensitizations were to grasses (Lolium perenne and Poa pratensis), trees (Olea europaea and Fraxinus excelsior), cereals (Avena sativa and Hordeum vulgare), animal dander (cat and dog), and weeds (Plantago lanceolata and Ambrosia artemisiifolia). The rate of sensitization tended to increase with age. Applying an SPT that included six allergen extracts for 2-5 years, five for 6-11 years, and four for 12-18 years was sufficient to identify 95% of sensitized children.Conclusion:A test panel with six allergen extracts was sufficient to identify most of the sensitized children and adolescents suspected of allergy and had clinically relevant symptoms. An SPT with fewer allergen sources was required to detect older sensitized children than younger children.

Background: It has been known for a long time that the prevalence of allergy pathology throughout the world has been steadily increasing, this determines the need for regular screening epidemiological studies; high-quality allergy diagnostics makes it possible to identify the disease in the early stages of development, carry out timely selection of drug pathogenetic therapy, which, in turn, helps to significantly reduce the risk of exacerbation of an allergic disease and the onset of more severe forms of allergopathology. The general patterns of the formation of respiratory allergies include the age-related dynamics of the spectrum, the development of polysensitization, as well as the hierarchical value of aeroallergens. Purpose of the study: to study the spectrum of sensitization in people with respiratory allergies: allergic rhinitis (AR), bronchial asthma (BA) of varying severity, atopic dermatitis (AD) in the Republic of Karakalpakstan, which is characterized by a long period of flowering of weeds (wormwood, solyanka, quino) - end of August end of November, cereal grasses (timothy, foxtail, rye, bluegrass). - end of February - end of July; The duration of flowering is related to the peculiarities of climatic and geographical conditions. Materials and methods: from January to May 2022, a clinical allergological examination was carried out on 120 patients with allergic diseases: of them 90 children aged 2-18 years, 36 children with AR, 24 with BA, 30 children with AD and 30 adult patients, 12 with AR, 12 with AD, 6 with AD. To study the total concentration in blood serum, we used Monobyte test systems manufactured in the USA; Allergen-specific IgE was determined using Alkor Bio test systems manufactured in Russia; standard diagnostic allergens were used for skin prick testing (JSC NPO Microgen, Stavropol). Results: In 75% of patients, combined sensitization to pollen, household and food allergens, 20% only to pollen and food allergens of different groups, and 5% have monosensitization to pollen allergens. Conclusion: Spectrum of sensitization to aeroallergens in the studied region of the republic Karakalpakstan is characterized to a greater extent by pollen sensitization in both children and adults with various allergic diseases, with a predominance of multiple sensitizations in all age groups. [ABSTRACT FROM AUTHOR]

Allergen-specific immunotherapy (AIT) describes the establishment of peripheral tolerance through repeated allergen exposure, which qualifies as the only curative treatment for allergic diseases. Although conventional subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) have been approved to treat respiratory allergies clinically, the progress made is far from satisfactory. Epicutaneous immunotherapy (EPIT) exploits the skin's immune properties to modulate immunological response, which is emerging as a promising alternative and has shown effectiveness in many preclinical and clinical studies for both respiratory and food allergies. It is worth noting that the stratum corneum (SC) barrier impedes the effective delivery of allergens, while disrupting the SC layer excessively often triggers unexpected Th2 immune responses. This work aims to comprehend the immunological mechanisms of EPIT, and summarize the innovative system for sufficient delivery of allergens as well as tolerogenic adjuvants. Finally, the safety, acceptability, and costeffectiveness of these innovative delivery systems are discussed, which directs the development of future immunotherapies with all desirable characteristics. [ABSTRACT FROM AUTHOR]

Background/aim: Cupressus sempervirens is a tree native to the Mediterranean region. We aimed to investigate the frequency of sensitization/allergy to Cupressus arizonica pollen, which is not native to Anatolia. Materials and methods: Patients aged 5-18 years who underwent respiratory allergy screening in Türkiye's largest referral center over a 1-year period were reviewed retrospectively for a diagnostic study of Cupressus allergy. Results: Of 246 patients, 207 (67.6% male) with a median age of 11.7 (IQR 9.2-15) years were found to be aeroallergen-sensitive and C. arizonica (32%) was the second most common sensitivity after grass pollen (83.6%). In the C. arizonica-sensitive subgroup, only 3% (2/67) were monosensitive, and grass (77.6%), cat (38.8%), and weeds (38.8%) were the most common co-sensitivities. Cup a 1 specific IgE (sIgE) was measured in 26 patients with C. arizonica sensitivity and all were found to be positive. A nasal allergen challenge (NAC) was performed for 44 of 67 patients with C. arizonica sensitivity, and 13 of 44 patients had a positive outcome (NAC+) at the highest two extract concentrations. The Cupressus wheal sizes and Cup a 1 sIgE levels of the NAC+ subgroup were higher than those of the NAC-subgroup but reached significance only for wheal size [6 (5-7.5) vs. 4.5 (4-6), p=0.004]. The NAC+ subgroup reported more frequent nasal discharge, congestion, and eye symptoms than the NAC-subgroup during the relevant pollen season. Conclusion: C. arizonica sensitivity has increased in the East Mediterranean region, similarly to North Mediterranean data, and this is associated with the presence of allergy both clinically and in laboratory findings. C. arizonica should be included in the aeroallergen screening panels of children from the East Mediterranean. [ABSTRACT FROM AUTHOR]

Objective • To analyze specific immunotherapy and followup management for respiratory allergic diseases in children. Methods • A total of 100 children with allergic bronchial asthma admitted to our hospital from November 2020 to October 2021 were selected. Based on different treatment schemes, they were divided into two groups: the routine treatment group and the immunotherapy group, with 50 cases in each group. The routine treatment group received standard care, while the immunotherapy group underwent specific immunotherapy. Assessment parameters included asthma symptom control score, pulmonary function, immune function, levels of inflammatory factors, clinical efficacy, and adverse reactions. Results • After treatment and during follow-up, the immunotherapy group showed significantly lower scores for daytime and nighttime symptoms compared to the routine treatment group (P < .05). The immunotherapy group also exhibited higher FEV1/FVC and PEF% values compared to the routine therapy group after treatment and at follow-up (P<.05). Furthermore, the immunotherapy group showed higher levels of CD3+, CD4+, and CD4+/ CD8+ and lower levels of CD8+ compared to the routine therapy group (P<.05). Additionally, the immunotherapy group demonstrated lower levels of IL-4 and IL-12 compared to the routine therapy group after treatment and during follow-up (P < .05). The total effective rate of the immunotherapy group was higher than that of the routine therapy group (P < .05). The incidence of adverse reactions in the immunotherapy group was similar to that in the routine therapy group (P>.05). Conclusions • Specific immunotherapy is a significantly effective approach to managing children’s allergic bronchial asthma. It effectively controls asthma symptoms, improves lung function and immune response, and reduces inflammatory factors. It showed superior clinical efficacy and minimal adverse reactions; specific immunotherapy, therefore, is a safe and beneficial treatment option that warrants further promotion and application. [ABSTRACT FROM AUTHOR]

Aim: Cat allergen hypersensitivity is a clinical condition that can affect patients across a wide spectrum, ranging from mild allergic rhinitis to severe asthma. Since cat hypersensitivity can occur through indirect exposure, non-cat owners also have the risk of developing cat allergies. The aim of this study was to investigate the effects of direct and indirect exposure patterns on the clinical features of allergic rhinitis and allergic asthma in patients with cat hypersensitivity. Methods: In our study, designed as a retrospective cohort, the demographic and clinical characteristics of 257 patients diagnosed with cat allergy and allergic rhinitis who were followed up and treated between January 2022 and March 2023 were evaluated. Cat and non-cat owner patients were compared in terms of symptoms of allergic rhinitis, treatment steps for allergic rhinitis, and frequency, control and treatment steps for allergic asthma. Results: The median (interquartile range) age of the patients was 29 (23-38), and 182 of them were female (70.8%). The visual analogue scale symptom scores of cat owners were significantly higher than those of non-cat owners (p=0.022 and p=0.023, respectively). The rate of moderate or severe allergic rhinitis that persisted despite treatment was higher in cat owners (31.8%) than in non-cat owners (17.8%). Additionally, allergic asthma frequency in cat owners with moderate or severe allergic rhinitis symptoms despite medical treatment was more common than in cat owners with mild rhinitis (p=0.026). Conclusion: Direct exposure to cat allergens is associated with poor control of allergic rhinitis symptoms. These patients should avoid contact with cats. If avoidance is not possible, the clinical condition of these patients should be closely monitored, as they may have treatment-resistant respiratory allergies. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the levels of skin moisture and sebum in children with a house dust allergy without skin symptoms. This was a case–control study involving children, aged 0–18 years, who were being followed up for an allergic airway disease in a pediatric allergy clinic. Age, gender, hemogram parameters, and IgE values were evaluated. The skin moisture and sebum percentages of the patients and control group were measured by a non-invasive bioimpedance method using a portable digital skin moisture and sebum measurement device on the cubital fossa. The median value of the skin moisture percentage in the house dust mite allergy-positive patient group was significantly lower than that in the house dust mite allergy-negative patients and the control group (p < 0.001). The house dust mite allergy-positive patient group had the lowest skin sebum content. However, there was no statistical significance among the groups in terms of skin sebum percentage (p = 0.102). In the study, children with a house dust allergy were found to have lower levels of skin moisture and sebum. The regular use of moisturizers for children with a house dust allergy should be kept in mind as an effective solution to protect the skin barrier and reduce skin symptoms. [ABSTRACT FROM AUTHOR]