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Objective: The 'two-hit' hypothesis theorizes that early life allergic sensitization and respiratory infection interact to increase asthma risk. Methods: We sought to determine in a high allergy risk birth cohort whether interactions between early life allergic sensitization and respiratory infection were associated with increased risk for asthma at ages 6–7 years and 18 years. Allergic sensitization was assessed at 6, 12, and 24 months by skin prick testing to 3 food and 3 aeroallergens. Respiratory infection was defined as reported "cough, rattle, or wheeze" and assessed 4-weekly for 15 months, at 18 months, and age 2 years. Regression analysis was undertaken with parent-reported asthma at age 6–7 years and doctor diagnosed asthma at 18 years as distinct outcomes. Interactions between allergic sensitization and respiratory infection were explored with adjustment made for potential confounders. Results: Odds of asthma were higher in sensitized compared to nonsensitized children at age 6–7 years (OR = 14.46; 95% CI 3.99–52.4), There was no evidence for interactions between allergic sensitization and early life respiratory infection, with a greater frequency of respiratory infection up to 2 years of age associated with increased odds for asthma at age 6–7 years in both sensitized (OR = 1.13; 95% CI 1.02–1.25, n = 199) and nonsensitized children (OR = 1.31; 1.11–1.53, n = 211) (p interaction = 0.089). At age 18 years, these associations were weaker. Conclusions: Our findings do not support 'two-hit' interactions between early life allergic sensitization and respiratory infection on asthma risk. Both early life respiratory infections and allergic sensitization were risk factors and children with either should be monitored closely for development of asthma. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionTo study associations between fractional exhaled nitric oxide (FeNO) and asthma, airway symptoms, sensitization to common allergens, outdoor pollution and home environment among 380 students in eight junior high schools in two areas in Indonesia.Data on health and home were collected by a face-to face interview before measuring FeNO and performing skin prick test against common allergens. Exploratory linear mixed and logistic regression models were employed.Geometric mean of FeNO was 17.8 ppb (GSD 2.09) and 139 students (36.6%) had elevated FeNO (>20 ppb). In total, 107 students (28.2%) were sensitized to house dust mite (HDM) (Der p1 or Der f1), 4 (1.1%) to cat and 3 (0.8%) to mold (Cladosporium or Alternaria). Moreover, 20 students (5.3%) had diagnosed asthma, 38 (10.0%) had current wheeze, and 107 (28.2%) had current rhinitis. HDM sensitization, diagnosed asthma, current wheeze, and current rhinitis were associated with FeNO. In total, 281 students (73.9%) had mold or dampness, 232 (61.1%) had environmental tobacco smoke (ETS) and 43 (11.3%) had other odor at home. Indoor mold or dampness and other odor at home were associated with FeNO. ETS was negatively associated with FeNO.HDM sensitization and elevated FeNO can be common among children in this part of Indonesia. The high prevalence of elevated FeNO indicate that undiagnosed childhood asthma is common. Dampness, mold and odor at home can be associated with increased FeNO while ETS can be associated with decreased FeNO. [ABSTRACT FROM AUTHOR]

Atopic dermatitis, or eczema, is the most common chronic skin disorder, characterized by red and pruritic lesions. Its etiology is multifaceted, involving an interplay of factors, such as the allergic immune response, skin barrier dysfunction, and dysbiosis of the skin microbiota. Recent studies have explored the role of extracellular vesicles (EVs), which are lipid bilayer-delimitated particles released by all cells, in atopic dermatitis. Examination of the available literature identified that most studies investigated EVs released by Staphylococcus aureus, which were found to impact the skin barrier and promote the release of cytokines that contribute to atopic dermatitis development. In addition, EVs released by the skin fungus, Malassezia sympodialis, were found to contain allergens, suggesting a potential contribution to allergic sensitization via the skin. The final major finding was the role of EVs released by mast cells, which were capable of activating various immune cells and attenuating the allergic response. While research in this area is still in its infancy, the studies examined in this review provide encouraging insights into how EVs released from a variety of cells play a role in both contributing to and protecting against atopic dermatitis. [ABSTRACT FROM AUTHOR]

Fungi are ubiquitous living beings present in the indoor and outdoor environment. Spores and mycelium of fungi carried by air have a great impact on ecology, the economy, in particular on agriculture, as well as on human health. It has been established that the incidence of fungal pathologies has increased rapidly over the past two decades. Fungi can cause allergies, and can be infectious agents, especially in immunocompomised people. Fungal spores are powerful sources of allergenic molecules covering a wide range of biochemical classes. Together with the fungal mycelium, they can cause the development of hypersensitivity, which is one of the most common pathological immune responses. Currently, known fungal aeroallergens are found in 3 fungal classes – Basidiomycota, Ascomycota, and Zygomycota. Therefore, the goal of our work was to determine the level of sensitivity to fungal allergens in the population of Vinnytsya region in order to prevent allergies caused by fungi. Data analysis of IgE-mediated, genuine, sensitization to fungal allergens of Alternaria (Alt a 1, Alt a 6), Cladosporium (Cla h, Cla h 8), Aspergillus (Asp f 1, Asp f 3, Asp f 4, Asp f 6), Penicillium (Pen ch), Malassezia (Mala s 11, Mala s 5, Mala s 6) and Saccharomyces (Sac c) was carried out using a component-resolved allergy diagnostics by ALEX2 test. The data of 87 residents of the Vinnytsya region aged 1 to 66 who underwent molecular allergy diagnostics in 2020–2022 were taken into account. Sensitivity to fungal allergens was observed in 20 patients or 23.0% of those tested. Among them, the highest level of sensitivity, in 15 patients or 75% of the number of sensitive individuals, was observed for the Alternaria fungus. The allergen component Alt a 1 caused high and very high levels of sensitization in 3 and 7 patients, respectively. Sensitivity to Aspergillus and Malassezia had the second highest rate: 6 patients or 30% of sensitized individuals were sensitive to these two fungal allergens. Alternaria was the most important fungal agent causing sensitization of the examined population of Vinnytsya region. Aspergillus allergens, known for their ability to cause both allergic and infectious reactions, were next in clinical importance. Cladosporium, which usually produce a highest number of spores in the atmosphere among all fungi, was characterized by low allergenicity. High levels of both specific and total immunoglobulin E can be prognostic markers of clinical manifestations of fungal allergy. This information should be taken into account for the prevention of fungal allergy among the population when creating allergy forecasts.

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Over the years, the importance of the epithelium in the assessment of allergic sensitization and development of allergic diseases has increased. Sensitization to allergens appears to be influenced by genetic and external environmental factors. However, not all subjects exposed to environmental factors that damage epithelial cells suffer from allergic diseases. On this basis, identifying the signaling pathways that characterize the different phenotypes and endotypes of allergy is of high priority for a successful personalized therapy. Ecto-5ʹ-nucleotidase/CD73 is a membrane-bound enzyme responsible for extracellular adenosine accumulation from AMP derived, in turn, from the hydrolysis of extracellular ATP. Current knowledge suggests that CD73 expression and enzymatic activity at epithelial barriers would be of fundamental importance to control the first defense against allergens, by preserving both physical and immunological epithelial barrier functions. Here, we highlight evidence for a crucial role of CD73 in features of allergic sensitization and the potential of this enzyme as prognostic marker and target of therapeutic intervention. [ABSTRACT FROM AUTHOR]

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. We investigated fungal allergen sensitization prevalence, risk factors, and geographic variation in the United States. 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. 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. Independent risk factors for fungal sensitization include male sex, teen ages, atopic dermatitis, asthma, and ecoregion. [ABSTRACT FROM AUTHOR]

Introduction: Peanut allergy is one of the most prevalent food allergies globally. Currently, most research into the mechanisms involved in protein allergy focuses on the protein allergens under investigation, and information on the function of accompanying compounds, such as lipids, is scarce. Thus, this research investigates the role of peanut-associated lipids and invariant natural killer T (iNKT) cells in peanut allergy using a novel, human, in vitro assay. Methods: PBMCs from non-allergic and peanut-allergic subjects were stimulated with the glycolipid, a-Galactosylceramide (a-GalCer), over 14 days for iNKT cell expansion. Autologous dendritic cells (DCs) were stimulated with either peanut oil, the lipid-binding peanut allergen, Ara h 8, or both peanut oil and Ara h 8. The expanded iNKT cells were then immunomagnetically isolated and co-cultured for 5 h with autologous DCs, and cytokine expression was measured by flow cytometry. Results: A 5-fold higher iNKT cell population was observed in peanut-allergic subject peripheral blood compared to non-allergic controls. In all subjects, conventional flow analysis highlighted iNKTs co-cultured with autologous a-GalCer-pulsed DCs displayed increased IL-4 and IFN-y secretion within 5 hours of co-culture. A 10-parameter unsupervised clustering analysis of iNKT phenotype found significantly more CD3+CD8+CD25+IL-4+IL-5+IL-10+IFNg+ cells in non-allergic adults following culture with peanut oil. Conclusion: For the first time, we show iNKT cells are more abundant in peanutallergic adults compared to non-allergic adults, and peanut lipid-exposed iNKT cells resulted in the identification of a subset of CD8+ iNKT cells which was significantly lower in peanut-allergic adults. Thus, this study proposes a role for iNKT cells and peanut allergen-associated lipids in peanut allergy. [ABSTRACT FROM AUTHOR]

Evidences showed the link between allergy and depression, while the relationships of depression with allergy-related outcomes is insufficient. The objective of this study is to evaluate and compare the relationship of depression with allergy-related outcomes assessed using two different outcome indicators, in a population-based study. A cross-sectional study was performed of 1094 participants in the 2005–2006 National Health and Nutrition Examination Survey (NHANES). The self-reported allergic symptoms of allergic rhinitis (AR) status and immunoglobulin E (IgE) were used to evaluate the allergy-related outcomes. The depression disorder was defined as the ≥ 10 points on the Patient Health Questionnaire-9. Logistic and linear regression models were performed to illustrate the associations of depression and allergy-related outcomes. The prevalence of AR and depression was 34.2% and 6.8%, respectively. The odds of depression were 8.6% higher in participants with AR patients compared those without AR [odds ratio (OR) = 1.739, 95% confidence interval (CI): (1.034, 2.933)], while the odds of depression in participants with allergic sensitization and without allergic sensitization were not found significant difference. Allergy is positively associated with depression disorder, and patients with allergy-related outcomes, such as AR, may be at higher risk of depression, while the IgE level was not founded to be related with depression. In the treatment of AR patients with depression symptoms, early detection and management of mental problems are of importance. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to explore the differences in the pattern of allergen sensitization in CR individuals without or with asthma, according to asthma severity. Methods: A total of 1066 adults were evaluated. Asthma and chronic⁄allergic rhinits were identified by specialists, questionnaries and skin-prick test. The phenotypic characterization was avaliable from skin-prick test to an aeroallergen extended panel, total IgE and pulmonary function. Using questionnaires and clinical evaluation, participants were classified into the groups: chronic rhinitis alone (CRA) and chronic rhinitis + asthma, the latter subdivided into CR + mild asthma (CRMA) and CR + moderate to severe asthma (CRMSA). Aerollergen sensitization was defined by a positive prick test to one or more allergens associated with nasal symptoms and/or asthma. The association between CR and asthma was evaluated by multivariable logistic regression. The evidence of effect modification of pattern of sensitization in CR on the association with asthma severity and outcomes was examined by introducing interactions terms in the logistic regression models adjusting for confounders. Results: Frequency of sensitization to aeroallergens was higher in association with asthma in comparison to CRA (CRMA 70.4%; CRMSA 65.0%; CRA 47.0%; p = 0.000). Similarly, the presence of asthma was associated to aeroallergen multiple sensitization (51.5%) (OR = 2.10, 95% CI 1.27–3.50). Additionally, the sensitization to mites, cockroaches, animal epithelium, grasses, and molds, were higher in asthma (56.8%, 24.3%, 12%, 7.13% and 10.3%, respectively). Sensitization to Alternaria alternata, Cladosporium herbarum and dog epithelium was exclusive in asthma groups. A concomitant asthma diagnosis was directly associated with a positive allergen sensitization at least one allergen (62.7%, OR = 2.45, 95% CI 1.80–3.34) and polissensitization (51.5%, OR = 2.10, 95% CI 1.27–3.50). Conclusion: Asthma is associated with multiple allergen sensitization among patients with CR. Some unique profiles of aeroallergen sensitization were observed in patients with CR and asthma. Nevertheless, no difference was found in the sensitization in relation to asthma severity, which suggest atopy is not the main underlying mechanism for asthma severity among patients with CR. Level of evidence: Level 3.

Abstract Background The prevalence of atopic dermatitis (AD) has been increasing in recent years, especially in Asia. There is growing evidence to suggest the importance of dietary patterns in the development and management of AD. Here, we seek to understand how certain dietary patterns in a Singapore/Malaysia population are associated with various risks of AD development and exacerbation. Methods A standardized questionnaire following the International Study of Asthma and Allergies in Childhood (ISAAC) guidelines was investigator-administered to a clinically and epidemiology well-defined allergic cohort of 13,561 young Chinese adults aged 19–22. Information on their sociodemographic, lifestyle, dietary habits, and personal and family medical atopic histories were obtained. Allergic sensitization was assessed by a skin prick test to mite allergens. Spearman’s rank-order correlation was used to assess the correlation between the intake frequencies of 16 food types. Dietary patterns were identified using principal component analysis. Four corresponding dietary scores were derived to examine the association of identified dietary patterns with allergic sensitization and AD exacerbations through a multivariable logistic regression that controlled for age, gender, parental eczema, BMI, and lifestyle factors. Results The correlation is the strongest between the intake of butter and margarine (R = 0.65). We identified four dietary patterns, “high-calorie foods”, “plant-based foods”, “meat and rice”, and “probiotics, milk and eggs”, and these accounted for 47.4% of the variance in the dietary habits among the subjects. Among these patterns, moderate-to-high intake of “plant-based foods” conferred a negative association for chronic (Adjusted odds ratio (AOR): 0.706; 95% confidence interval (CI): 0.589–0.847; p

Abstract Background A strong association exists between high-excess free fructose (EFF) beverage consumption and prevalent allergy in children and adolescents; however, whether this association exists in the adult population is unclear. Therefore, this study aimed to investigate the relationship between high-EFF beverage intake and prevalent allergy. Methods This cross-sectional study extracted data from the National Health and Nutrition Examination Survey 2005–2006. Adults aged ≥ 20 were eligible for inclusion, excluding those without complete information on beverage intake, allergic symptom survey, and allergen-specific immunoglobulin E test results. A total of 2077 adults were included. Univariate and multivariable logistic regression analyses determined the associations between high-EFF beverage consumption, prevalent allergic symptoms, and allergic sensitization. Results After adjusting for confounders, there were no significant associations between high intake (vs. low) of sum of high-EFF beverage (adjusted odds ratio [aOR] = 1.10, 95% confidence interval [CI] 0.77, 1.57), apple juice (aOR = 0.95, 95% 0.55, 1.65), fruit drinks (aOR = 0.95, 95%CI 0.70, 1.29), soft drinks (aOR = 1.17, 95%CI 0.89, 1.55) and presence of allergic sensitization, or allergic symptoms. Stratified analyses also revealed no associations between high intake of high-EFF beverage in sum, presence of allergic symptoms or sensitization among individuals aged 20–39y, 40–59y, and ≥ 60y. Conclusions Our findings indicate no independent association between frequent intake of high-EFF beverage and increased likelihood of allergy in US adults.

Background: The level of environmental exposure throughout life may contribute to the prevalence of allergic sensitization and allergic disease. The alpine climate has been considered a healthy climate with little allergen exposure and pollution. We conducted a cross-sectional study to investigate local environmental exposure and concomitant prevalence of allergic sensitization among local school children born and raised in an alpine environment. Methods: Clinical and demographic data were collected with a questionnaire. Allergen content was assessed in residential settled dust samples, lifetime exposure to pollen and air pollution was calculated using data from national pollen and air pollution monitoring stations, and the allergic sensitization profile was determined with component resolved diagnostics (ISAC®). Univariate and multivariate regression models were used to estimate the relation between exposure and sensitization. Results: In a cohort of children born and raised in an alpine environment, sensitization to aeroallergens is quite common (38%), especially to grass (33%) and cat (16%). House dust mite allergen was detected in up to 38% of residential dust samples, but sensitization to HDM was low (2.5%). Pollutant levels were low, but an increasing trend was observed in the amount of ozone and PM10. Living close to a busy road was associated with increased odds OR (95% CI) for being sensitized to any allergen 2.7 (1.0–7.2), to outdoor allergens 2.8 (1.1–7.1) and being sensitized plus reporting symptoms of rhinoconjunctivitis 4.4 (1.3–14.8) and asthma 5.5 (1.4–21). Indoor living conditions, including the presence of visible mold, increased the odds of being sensitized to indoor allergens (1.9 (1.1–3.2) and being sensitized plus reporting symptoms of rhinoconjunctivitis 1.9 (1.0–3.6) and asthma 2.1 (1.0–4.1). Conclusion: In a healthy alpine environment, pollution might still be an important factor contributing to allergic sensitization.

BackgroundEarly life provides a window of opportunity to prevent allergic diseases. With a prevalence of 0.5–2% in infants, hen’s egg allergy is one of the most common food allergies. The immunomodulatory effects of human milk oligosaccharides (HMOs), 2′-fucosyllactose (2’FL), and 3-fucosyllactose (3FL) were studied in an in vitro mucosal immune model and an in vivo murine model for hen’s egg (ovalbumin) allergy.MethodsIntestinal epithelial cell (IEC)/dendritic cell (DC) and DC/T cell cocultures were used to expose IECs to ovalbumin (OVA) in an in vitro mucosal immune model. The effects of epithelial pre-incubation with 0.1% 2’FL or 3FL and/or 0.5 mM butyrate were studied. Three- to four-weeks-old female C3H/HeOuJ mice were fed AIN93G diets containing 0.1–0.5% 2’FL or 3FL 2 weeks before and during OVA sensitization and challenge. Allergic symptoms and systemic and local immune parameters were assessed.ResultsExposing IECs to butyrate in vitro left the IEC/DC/T cell cross-talk unaffected, while 2’FL and 3FL showed differential immunomodulatory effects. In 3FL exposed IEC-DC-T cells, the secretion of IFNγ and IL10 was enhanced. This was observed upon pre-incubation of IECs with 2’FL and butyrate as well, but not 2’FL alone. The presence of butyrate did not affect OVA activation, but when combined with 3FL, an increase in IL6 release from DCs was observed (p

IntroductionPeanut allergy is one of the most prevalent food allergies globally. Currently, most research into the mechanisms involved in protein allergy focuses on the protein allergens under investigation, and information on the function of accompanying compounds, such as lipids, is scarce. Thus, this research investigates the role of peanut-associated lipids and invariant natural killer T (iNKT) cells in peanut allergy using a novel, human, in vitro assay.MethodsPBMCs from non-allergic and peanut-allergic subjects were stimulated with the glycolipid, α-Galactosylceramide (α-GalCer), over 14 days for iNKT cell expansion. Autologous dendritic cells (DCs) were stimulated with either peanut oil, the lipid-binding peanut allergen, Ara h 8, or both peanut oil and Ara h 8. The expanded iNKT cells were then immunomagnetically isolated and co-cultured for 5 h with autologous DCs, and cytokine expression was measured by flow cytometry.ResultsA 5-fold higher iNKT cell population was observed in peanut-allergic subject peripheral blood compared to non-allergic controls. In all subjects, conventional flow analysis highlighted iNKTs co-cultured with autologous α-GalCer-pulsed DCs displayed increased IL-4 and IFN-y secretion within 5 hours of co-culture. A 10-parameter unsupervised clustering analysis of iNKT phenotype found significantly more CD3+CD8+CD25+IL-4+IL-5+IL-10+IFNγ+ cells in non-allergic adults following culture with peanut oil.ConclusionFor the first time, we show iNKT cells are more abundant in peanut-allergic adults compared to non-allergic adults, and peanut lipid-exposed iNKT cells resulted in the identification of a subset of CD8+ iNKT cells which was significantly lower in peanut-allergic adults. Thus, this study proposes a role for iNKT cells and peanut allergen-associated lipids in peanut allergy.

Background: The prevalence of allergic sensitization and allergic diseases has increased for decades in Northern Europe, but recent studies are lacking. Objective: We sought to study the prevalence trends of allergic sensitization, associated risk factors, and the association with asthma and allergic rhinitis (AR) among children in Northern Sweden. Methods: Three cohorts of children aged 7 to 8 years participated in a skin prick test (SPT) with 10 airborne allergens in 1996, 2006, and 2017, with 2148, 1693, and 1762 participants tested, respectively, representing 87% to 90% of schoolchildren in the catchment communities. Adjusted Poisson regression was used to identify risk factors for allergic sensitization and the association with asthma and AR. Results: The prevalence of any positive SPT response increased from 21% in 1996 to 30% in 2006 and remained at 30% in 2017 (P < .001). Sensitization to cat was the most common for all the years. The risk factor pattern for a positive SPT response was similar in all examinations, with positive and significant associations with a family history of allergy (risk ratio, 1.4-1.5) and negative and significant associations with having a cat at home (risk ratio, 0.7-0.8). The prevalence of physician-diagnosed asthma increased, but the association with allergic sensitization weakened. The opposite trends were found for AR—decreasing prevalence and strengthened association with allergic sensitization. Conclusions: The prevalence of allergic sensitization increased from 1996 to 2006 but plateaued in the next decade, whereas the risk factor pattern remained stable. The diverging trends of associations between allergic sensitization and asthma and AR suggest secular trends in the clinical management of allergic diseases.

Among animals defined as "pests", cockroaches and rodents (mouse and rat) represent the most common cause of airway allergic sensitization and bronchial asthma worldwide. Their frequency of sensitization has been widely assessed in US and other countries but poorly in Western Europe. This narrative review aims to provide a synthesis of data resulting in MEDLINE concerning allergic sensitization/asthma to pests as well as their related environmental/social risk factors, specifically in the European area. We performed a literature research in MEDLINE for clinical trials, randomized controlled trials, systematic reviews and meta-analyses. We selected studies to the following key words: allergic sensitization, allergic rhinitis, bronchial asthma, cockroach, hypersensitivity, integrated pest management, material hardship, medication compliance, mouse, pest, poverty, rat, rodents. Current evidence indicates that residence in poor and urban areas, exposure to outdoor/indoor pollutants and tobacco smoke, poverty, material hardship, poor-quality housing, differences in health care quality, medication compliance, health care access contribute to increased pest-related allergic sensitization and asthma morbidity. Further research should be done on many aspects of pest allergy such as a better characterization of allergens and epidemiological aspects. Relevant social actions should be carried out against poverty, healthcare disparities, psycho-social stress, poor compliance to therapy, with economic contributions to improve private and public living environments. Allergic sensitization to pests and pest-allergic respiratory diseases like asthma are "paradoxical" conditions, as they typically affect the poorest communities but can only be corrected by high-cost (diagnostic and preventive) interventions. We hope that progress can be made in this direction in the future. [ABSTRACT FROM AUTHOR]

Fungi are ubiquitous living beings present in the indoor and outdoor environment. Spores and mycelium of fungi carried by air have a great impact on ecology, the economy, in particular on agriculture, as well as on human health. It has been established that the incidence of fungal pathologies has increased rapidly over the past two decades. Fungi can cause allergies, and can be infectious agents, especially in immunocompomised people. Fungal spores are powerful sources of allergenic molecules covering a wide range of biochemical classes. Together with the fungal mycelium, they can cause the development of hypersensitivity, which is one of the most common pathological immune responses. Currently, known fungal aeroallergens are found in 3 fungal classes –Basidiomycota, Ascomycota, and Zygomycota. Therefore, the goal of our work was to determine the level of sensitivity to fungal allergens in the population of Vinnytsya region in order to prevent allergies caused by fungi. Data analysis of IgE-mediated, genuine, sensitization to fungal allergens of Alternaria (Alt a 1, Alt a 6), Cladosporium (Cla h, Cla h 8), Aspergillus(Asp f 1, Asp f 3, Asp f 4, Asp f 6), Penicillium(Pen ch), Malassezia (Mala s 11, Mala s 5, Mala s 6) and Saccharomyces(Sac c) was carried out using a component-resolved allergy diagnostics by ALEX2 test. The data of 87 residents of the Vinnytsya region aged 1 to 66 who underwent molecular allergy diagnostics in 2020–2022 were taken into account. Sensitivity to fungal allergens was observed in 20 patients or 23.0% of those tested. Among them, the highest level of sensitivity, in 15 patients or 75% of the number of sensitive individuals, was observed for the Alternaria fungus. The allergen component Alt a 1 caused high and very high levels of sensitization in 3 and 7 patients, respectively. Sensitivity to Aspergillus and Malassezia had the second highest rate: 6 patients or 30% of sensitized individuals were sensitive to these two fungal allergens. Alternaria was the most important fungal agent causing sensitization of the examined population of Vinnytsya region. Aspergillus allergens, known for their ability to cause both allergic and infectious reactions, were next in clinical importance. Cladosporium, which usually produce a highest number of spores in the atmosphere among all fungi, was characterized by low allergenicity. High levels of both specific and total immunoglobulin E can be prognostic markers of clinical manifestations of fungal allergy. This information should be taken into account for the prevention of fungal allergy among the population when creating allergy forecasts. [ABSTRACT FROM AUTHOR]

Background: A strong association exists between high-excess free fructose (EFF) beverage consumption and prevalent allergy in children and adolescents; however, whether this association exists in the adult population is unclear. Therefore, this study aimed to investigate the relationship between high-EFF beverage intake and prevalent allergy. Methods: This cross-sectional study extracted data from the National Health and Nutrition Examination Survey 2005–2006. Adults aged ≥ 20 were eligible for inclusion, excluding those without complete information on beverage intake, allergic symptom survey, and allergen-specific immunoglobulin E test results. A total of 2077 adults were included. Univariate and multivariable logistic regression analyses determined the associations between high-EFF beverage consumption, prevalent allergic symptoms, and allergic sensitization. Results: After adjusting for confounders, there were no significant associations between high intake (vs. low) of sum of high-EFF beverage (adjusted odds ratio [aOR] = 1.10, 95% confidence interval [CI] 0.77, 1.57), apple juice (aOR = 0.95, 95% 0.55, 1.65), fruit drinks (aOR = 0.95, 95%CI 0.70, 1.29), soft drinks (aOR = 1.17, 95%CI 0.89, 1.55) and presence of allergic sensitization, or allergic symptoms. Stratified analyses also revealed no associations between high intake of high-EFF beverage in sum, presence of allergic symptoms or sensitization among individuals aged 20–39y, 40–59y, and ≥ 60y. Conclusions: Our findings indicate no independent association between frequent intake of high-EFF beverage and increased likelihood of allergy in US adults. [ABSTRACT FROM AUTHOR]

Background: The use of molecular allergology has increasingly become common in the diagnosis and management of allergic diseases. However, there is still a lack of data on cat molecular allergens in adults. Therefore, we aimed to uncover the sensitization patterns to cat molecular allergens. Methods: Participants were recruited from the West Asthma Sweden Study, a population‐based study enriched with asthma subjects aged 16–75 years. Of 1872, 361 individuals were positive for cat dander immunoglobulin E and were further analysed for cat molecular allergens (Fel d 1/2/4/7). Sensitization patterns were classified as monosensitization, polysensitization, and concomitant sensitization, and were related to demographic and clinical measurements. Results: Among cat‐sensitized subjects, 84.2% were sensitized to secretoglobin, while 42.4% were sensitized to lipocalins. Nearly half of the subjects were monosensitized to Fel d 1. Polysensitization was observed in 20.2%, and concomitant sensitization to protein families was seen in 7.2%. Asthma prevalence, cat exposure, and rural living were associated with poly‐ and concomitant sensitization to protein families. Concomitant sensitization to single allergens was more common in those with asthma than in those without, while concomitant sensitization to both Fel d 1 and Fel d 4 was the most common pattern in individuals with asthma. Sensitization patterns also differed according to cat ownership and the degree of urbanization. Conclusion: Sensitization to molecular allergens was observed in 90.9% of cat‐sensitized subjects and showed variations across participants' background characteristics and the presence of asthma. Identification of sensitization patterns to cat allergens might provide better characterization of cat‐allergic subjects. [ABSTRACT FROM AUTHOR]

Objective: Respiratory tract allergies are common chronic diseases worldwide. Allergens have regional differences and vary from time to time. In this study, the aeroallergen sensitivity in our region was intended to be updated. Materials and Methods: This was a retrospective, regional study evaluating the skin prick test (SPT) results and information forms of 13410 patients who presented atour institution between January 2014 and March 2020. The relationship of allergen positivity with age and gender was analyzed. Results: The mean age of the study population was 38 years. In terms of gender, 71.1% of them were female, and 28.9% were male. The SPT positivity was 41.1%. Of the 13.7% of the patients had sensitivity toa single allergen, and 27.4% had sensitivity to multiple allergens. The most common allergens were weeds (54%), grass-ryepollens (45%), olive pollen (44%), and dust mites (38%). It was observed that allergen positivity was associated with age and gender. Most of our patients were women, but allergen positivity was higher in men. It was observed that allergen positivity decreased with increasing age. Conclusion: Recognition of regional allergens contributes to protective measures and leverages immunotherapy. This study has enabled us to learn about aeroallergen sensitivity in our region. [ABSTRACT FROM AUTHOR]

Atopic dermatitis, or eczema, is the most common chronic skin disorder, characterized by red and pruritic lesions. Its etiology is multifaceted, involving an interplay of factors, such as the allergic immune response, skin barrier dysfunction, and dysbiosis of the skin microbiota. Recent studies have explored the role of extracellular vesicles (EVs), which are lipid bilayer-delimitated particles released by all cells, in atopic dermatitis. Examination of the available literature identified that most studies investigated EVs released by Staphylococcus aureus, which were found to impact the skin barrier and promote the release of cytokines that contribute to atopic dermatitis development. In addition, EVs released by the skin fungus, Malassezia sympodialis, were found to contain allergens, suggesting a potential contribution to allergic sensitization via the skin. The final major finding was the role of EVs released by mast cells, which were capable of activating various immune cells and attenuating the allergic response. While research in this area is still in its infancy, the studies examined in this review provide encouraging insights into how EVs released from a variety of cells play a role in both contributing to and protecting against atopic dermatitis.

Abstract Background The use of molecular allergology has increasingly become common in the diagnosis and management of allergic diseases. However, there is still a lack of data on cat molecular allergens in adults. Therefore, we aimed to uncover the sensitization patterns to cat molecular allergens. Methods Participants were recruited from the West Asthma Sweden Study, a population‐based study enriched with asthma subjects aged 16–75 years. Of 1872, 361 individuals were positive for cat dander immunoglobulin E and were further analysed for cat molecular allergens (Fel d 1/2/4/7). Sensitization patterns were classified as monosensitization, polysensitization, and concomitant sensitization, and were related to demographic and clinical measurements. Results Among cat‐sensitized subjects, 84.2% were sensitized to secretoglobin, while 42.4% were sensitized to lipocalins. Nearly half of the subjects were monosensitized to Fel d 1. Polysensitization was observed in 20.2%, and concomitant sensitization to protein families was seen in 7.2%. Asthma prevalence, cat exposure, and rural living were associated with poly‐ and concomitant sensitization to protein families. Concomitant sensitization to single allergens was more common in those with asthma than in those without, while concomitant sensitization to both Fel d 1 and Fel d 4 was the most common pattern in individuals with asthma. Sensitization patterns also differed according to cat ownership and the degree of urbanization. Conclusion Sensitization to molecular allergens was observed in 90.9% of cat‐sensitized subjects and showed variations across participants' background characteristics and the presence of asthma. Identification of sensitization patterns to cat allergens might provide better characterization of cat‐allergic subjects.

Allergic bronchopulmonary aspergillosis (ABPA) is a lung disorder caused by immune‐mediated reactions mounted against Aspergillus fumigatus. The disorder most commonly complicates the course of patients with asthma and cystic fibrosis. From its first description in 1952, significant advances have been made in understanding the pathogenesis and the diagnosis and treatment of ABPA. In the last two decades, most research on ABPA has been published from India. The prevalence and clinical presentation may differ in India from that reported elsewhere. Herein, we review the epidemiology, clinical and radiological characteristics, and distinctive features of ABPA in the Indian subcontinent. To support the review, we surveyed pulmonologists nationwide to understand the challenges in diagnosing and managing ABPA. The survey has yielded valuable insights into the practices associated with the diagnosis and management of ABPA in India. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis and food allergy are two frequently concomitant manifestations of the presence of atopy. A substantial number of studies have been published on the association of birth order and sibship size (number of siblings) with atopic dermatitis, food allergy, and atopy. The present work is the first systematic synthesis of the existing literature on this topic. Methods: Fifteen databases were searched. Screening, data extraction, and quality assessment were performed by independent pairs. Comparable numerical data were statistically synthesized using random‐effects robust variance estimation. Results: In total, 114 studies were included out of 8819 papers obtained from database searches. Birth order ≥2 versus 1 was associated with lower risk of ever atopic dermatitis (pooled risk ratio [RR] 0.91, 95% CI 0.84–0.98), current food allergy (RR 0.77, 95% CI 0.66–0.90), and positive skin prick test (SPT) to common aeroallergens (RR 0.86, 95% CI 0.77–0.97). Sibship size ≥2 versus 1 was associated with decreased risk of current atopic dermatitis (RR 0.90, 95% CI 0.83–0.98), ever atopic dermatitis (RR 0.92, 95% CI 0.86–0.97), and positive SPT to common aeroallergens (RR 0.88, 95% CI 0.83–0.92). No putative associations were seen regarding atopy assessed through allergen‐specific immunoglobulin E with common allergens. Conclusion: The presence of siblings and being second‐born or later may decrease the lifetime risk of atopic dermatitis and food allergy, albeit marginally. Similar association was seen with SPT sensitization. However, significant protection was not found for IgE sensitization. [ABSTRACT FROM AUTHOR]

Background: Few studies address the dynamic changes of body mass index (BMI) Z-scores during infancy with breastfeeding and their impact on childhood atopic diseases. Methods: A total of 183 children from a birth cohort regularly followed-up for 4 years were enrolled in this study. Time series data of BMI Z-scores from 1 month to 2 years of age was clustered using K-means method in R software. Breastfeeding status during the first 6 months of life was recorded and classified. The total serum and specific immunoglobulin E (IgE) levels to food and inhalant allergens were measured at age 0.5, 1, 1.5, and 2 years. Results: Using K-means clustering, the dynamic changes in BMI Z-scores were classified into three clusters (cluster A, increasing, n = 62; cluster B; decreasing, n = 62; cluster C, constant low, n = 59). Despite having no statistical association with atopic diseases, a decreasing trend in infantile BMI Z-scores was significantly associated with a higher prevalence of IgE sensitization at age 1 which increased the risk of rhinitis development at age 4 (P = 0.007). No difference in BMI Z-scores was determined between different breastfeeding patterns. However, exclusive formula feeding ≥6 months was found to be significantly associated with mite sensitization at age 1.5 years which risks asthma development at age 4 (P = 0.001). Conclusions: A decreasing trend of BMI Z-scores during infancy is determined to be inversely associated with IgE and allergen sensitization, which may potentially increase the risk of allergies in early childhood.

Allergic sensitization starts with epithelial cell activation driving dendritic cells (DCs) to instruct T helper 2 (Th2) cell polarization. Food allergens trigger intestinal epithelial cell (IEC) activation. Human milk oligosaccharides may temper the allergic phenotype by shaping mucosal immune responses.We investigated in vitro mucosal immune development after allergen exposure by combining ovalbumin (OVA)-preexposed IEC with monocyte-derived DCs (OVA-IEC-DCs) and subsequent coculture of OVA-IEC-DCs with Th cells. IECs were additionally preincubated with 2′FL or 3FL.OVA activation increased IEC cytokine secretion. OVA-IEC-DCs instructed both IL13 (p < 0.05) and IFNγ (p < 0.05) secretion from Th cells. 2′FL and 3FL permitted OVA-induced epithelial activation, but 2′FL-OVA-IEC-DCs boosted inflammatory and regulatory T-cell development. 3FL-OVA-IEC lowered IL12p70 and IL23 in DCs and suppressed IL13 (p < 0.005) in T cells, while enhancing IL17 (p < 0.001) and IL10 (p < 0.005).These results show that OVA drives Th2- and Th1-type immune responses via activation of IECs in this model. 2′FL and 3FL differentially affect OVA-IEC-driven immune effects. 2′FL boosted overall T-cell OVA-IEC immunity via DC enhancing inflammatory and regulatory responses. 3FL-OVA-IEC-DCs silenced IL13, shifting the balance towards IL17 and IL10.This model demonstrates the contribution of IEC to OVA Th2-type immunity. 2′FL and 3FL modulate the OVA-induced activation in this novel model to study allergic sensitization.

Abstract Background Atopic dermatitis and food allergy are two frequently concomitant manifestations of the presence of atopy. A substantial number of studies have been published on the association of birth order and sibship size (number of siblings) with atopic dermatitis, food allergy, and atopy. The present work is the first systematic synthesis of the existing literature on this topic. Methods Fifteen databases were searched. Screening, data extraction, and quality assessment were performed by independent pairs. Comparable numerical data were statistically synthesized using random‐effects robust variance estimation. Results In total, 114 studies were included out of 8819 papers obtained from database searches. Birth order ≥2 versus 1 was associated with lower risk of ever atopic dermatitis (pooled risk ratio [RR] 0.91, 95% CI 0.84–0.98), current food allergy (RR 0.77, 95% CI 0.66–0.90), and positive skin prick test (SPT) to common aeroallergens (RR 0.86, 95% CI 0.77–0.97). Sibship size ≥2 versus 1 was associated with decreased risk of current atopic dermatitis (RR 0.90, 95% CI 0.83–0.98), ever atopic dermatitis (RR 0.92, 95% CI 0.86–0.97), and positive SPT to common aeroallergens (RR 0.88, 95% CI 0.83–0.92). No putative associations were seen regarding atopy assessed through allergen‐specific immunoglobulin E with common allergens. Conclusion The presence of siblings and being second‐born or later may decrease the lifetime risk of atopic dermatitis and food allergy, albeit marginally. Similar association was seen with SPT sensitization. However, significant protection was not found for IgE sensitization.

Background: Peanut-allergic individuals react upon their first known ingestion of peanuts, suggesting sensitization occurs through non-oral exposure. Increasing evidence suggests that the respiratory tract is a probable site for sensitization to environmental peanuts. However, the response of the bronchial epithelium to peanut allergens has never been explored. Furthermore, food matrix-derived lipids play an important role in allergic sensitization.Objective: To contribute to a better understanding of the mechanisms of allergic sensitization to peanuts via inhalation, by exploring the direct effect of the major peanut allergens Ara h 1 and Ara h 2 and peanut lipids on bronchial epithelial cells.Methods: Polarized monolayers of the bronchial epithelial cell line 16HBE14o- were stimulated apically with peanut allergens and/or peanut lipids (PNL). Barrier integrity, transport of allergens across the monolayers, and release of mediators were monitored.Results: Ara h 1 and Ara h 2 impacted the barrier integrity of the 16HBE14o- bronchial epithelial cells and crossed the epithelial barrier. Ara h 1 also induced the release of pro-inflammatory mediators. PNL improved the barrier function of the cell monolayers, decreased paracellular permeability and reduced the amount of allergens crossing the epithelial layer.Conclusion: Our study provides evidence of the transport of Ara h 1 and Ara h 2 across the airway epithelium, of the induction of a pro-inflammatory milieu, and identifies an important role for PNL in controlling the amount of allergens that can cross the epithelial barrier. These, all together, contribute to a better understanding of the effects of peanuts exposure on the respiratory tract.

However, our results suggest that higher n-3 to n-6 PUFA ratios may be linked to increased risk of early life wheezing illness. Keywords: allergic sensitization; eczema; polyunsaturated fatty acids; rhinitis; wheeze EN allergic sensitization eczema polyunsaturated fatty acids rhinitis wheeze 1 7 7 11/29/22 20221101 NES 221101 The increasing global prevalence of allergic diseases makes it imperative to identify modifiable risk factors for allergic disease development. We hypothesized that higher n-3 metabolites is protective against inflammation and allergy and that higher total n-3:total n-6 PUFAs, higher (DHA + EPA):AA and LA:AA ratios and lower ALA:(EPA + DHA) during pregnancy are associated with decreased pro-inflammatory cord blood cytokines at birth and consequently decreased risk of offspring allergic diseases in the first 8 years of life. [Extracted from the article]

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• The total IgE reference interval had low accuracy in identifying allergic diseases but higher accuracy in identifying allergic sensitization. • Considering allergen-specific IgE levels when establishing the total IgE reference interval resulted in a lower interval. • The new reference interval enhanced the accuracy of identifying allergic sensitization in children while maintaining its advantage in identifying allergic diseases in children. • Future studies on total IgE reference intervals need to consider the allergen-specific IgE status of the reference population. To establish a next-generation reference interval (RI) for total IgE (tIgE) and evaluate its usefulness. A new allergen-specific IgE (sIgE)-based tIgE RI, including a continuous RI in children, was established using the NHANES 2005–2006 project. The usefulness of the RI was evaluated by sensitivity (Sen), specificity (Spec), positive predictive value (PPV), negative predictive value (NPV), κ coefficient and consistency. The new tIgE RI showed better performance in identifying allergic sensitization (Sen 0.53, Spec 0.90, PPV 0.83, NPV 0.68, κ 0.44, consistency 0.72) than allergic diseases (Sen 0.37, Spec 0.75, PPV 0.55, NPV 0.60, κ 0.13, consistency 0.59). The 2014 U.S. tIgE RI was more effective in identifying allergic diseases (consistency 0.63 vs. 0.54, P <0.001) but less accurate in identifying allergic sensitization (consistency 0.59 vs. 0.67, P <0.001) in children than in adults. The new RI improved the accuracy of identifying allergic sensitization in children to a level similar to that in adults (consistency 0.72 vs 0.73, P =0.37) and maintained its advantage in identifying allergic diseases in children (consistency 0.64 vs 0.55, P <0.001). The established next-generation tIgE RI is useful for identifying allergic sensitization, especially in children. [ABSTRACT FROM AUTHOR]

Allergic sensitization and low lung function in early childhood are risk factors for subsequent wheezing and asthma. However, it is unclear how allergic sensitization affects lung function over time. We sought to test whether allergy influences lung function and whether these factors synergistically increase the risk of continued wheezing in childhood. We analyzed longitudinal measurements of lung function (spirometry and impulse oscillometry) and allergic sensitization (aeroallergen skin tests and serum allergen-specific IgE) throughout early childhood in the Urban Environmental and Childhood Asthma study, which included high-risk urban children living in disadvantaged neighborhoods. Intraclass correlation coefficients were calculated to assess lung function stability. Cluster analysis identified low, medium, and high allergy trajectories, which were compared with lung function and wheezing episodes in linear regression models. A variable selection model assessed predictors at age 5 years for continued wheezing through age 12 years. Lung function adjusted for growth was stable (intraclass correlation coefficient, 0.5-0.7) from age 5 to 12 years and unrelated to allergy trajectory. Lung function and allergic sensitization were associated with wheezing episodes in an additive fashion. In children with asthma, measuring lung function at age 5 years added little to the medical history for predicting future wheezing episodes through age 12 years. In high-risk urban children, age-related trajectories of allergic sensitization were not associated with lung function development; however, both indicators were related to continued wheezing. These results underscore the importance of understanding early-life factors that negatively affect lung development and suggest that treating allergic sensitization may not alter lung function development in early to mid-childhood. [ABSTRACT FROM AUTHOR]

BackgroundThe global demand of sustainable food sources leads to introduction of novel foods on the market, which may pose a risk of inducing allergic sensitization. Currently there are no validated in vitro assays mimicking the human mucosal immune system to study sensitizing allergenicity risk of novel food proteins. The aim of this study was to introduce a series of sequential human epithelial and immune cell cocultures mimicking key immune events after exposure to the common food allergen ovalbumin from intestinal epithelial cell (IEC) activation up to mast cell degranulation.MethodsThis in vitro human mucosal food sensitizing allergenicity model combines crosstalk between IEC and monocyte-derived dendritic cells (moDC), followed by coculture of the primed moDCs with allogenic naïve CD4+ T cells. During subsequent coculture of primed CD4+ T cells with naïve B cells, IgE isotype-switching was monitored and supernatants were added to primary human mast cells to investigate degranulation upon IgE crosslinking. Mediator secretion and surface marker expression of immune cells were determined.ResultsOvalbumin activates IEC and underlying moDCs, both resulting in downstream IgE isotype-switching. However, only direct exposure of moDCs to ovalbumin drives Th2 polarization and a humoral B cell response allowing for IgE mediated mast cell degranulation, IL13 and IL4 release in this sequential DC-T cell-B cell-mast cell model, indicating also an immunomodulatory role for IEC.ConclusionThis in vitro coculture model combines multiple key events involved in allergic sensitization from epithelial cell to mast cell, which can be applied to study the allergic mechanism and sensitizing capacity of proteins.

Objectives: This study aimed to assess the predictors of allergic sensitisation to titanium and nickel in patients undergoing orthodontic treatment.Methods: A total of 250 patients undergoing orthodontic treatment were invited to participate, and 235 were analysed (67% females). A patch test was performed using nickel sulphate, titanium, titanium dioxide, titanium oxalate, titanium nitride, and petrolatum as control. In addition, clinical signs of the oral mucosa, gingiva, tongue, lips, and allergological history were assessed.Results: The predictors of metal allergic sensitisation in patients undergoing orthodontic treatment were adult age (OR = 2.6; 95% CI: 1.2-5.5; p = 0.016), female sex (OR = 3.0; 95% CI: 1.1-7.9; p = 0.025), exfoliative cheilitis (OR = 4.8; 95% CI: 1.9-12.4; p = 0.001), history of contact hypersensitivity (OR = 7.0; 95% CI: 1.3-35.4; p = 0.025), history of contact hypersensitivity to metals (OR = 8.3; 95% CI: 1.4-50.2; p = 0.021), and piercings (OR = 5.4; 95% CI: 2.1-13.9; p = 0.001). When predictors were analysed separately for these two metals, titanium sensitisation predictors were contact hypersensitivity to metals and piercing, whereas nickel sensitisation predictors were age and piercing.Conclusion: A positive patch test alone cannot draw definite conclusions regarding allergy. However, metal allergies in patients with orthodontic appliances could be considered in cases of previous contact hypersensitivity, previous reactions to metals, exfoliative cheilitis, and piercing. [ABSTRACT FROM AUTHOR]

Background: Few data are available in Asian children regarding the validity of cord blood immunoglobulin E (IgE) in predicting allergic sensitization and pulmonary function. The relationship between cord blood IgE and fraction of exhaled nitric oxide (FeNO) remains unknown. This study investigated the associations of cord blood IgE with allergic sensitization, FeNO, pulmonary function, and allergic diseases in Asian children. Methods: Five hundred and sixty‐six Asian children with valid cord blood IgE measurements at birth participated a 6‐year follow‐up visit including a questionnaire, serum total and allergen‐specific IgE, FeNO measurement, and spirometry. Regression‐based analyses with covariates adjustment were applied. Results: Cord blood IgE levels were significantly associated with FeNO levels (β = 0.131, p <.001) and serum total IgE levels (β = 0.325, p <.001). Cord blood IgE levels were positively associated with allergic sensitization (adjusted odds ratio [AOR] = 2.22, p <.001), and sensitization to mites (p =.002), animals (p =.023), and foods (p =.048). Subjects with cord blood IgE ≥0.24 kU/L (the optimal cutoff) were significantly associated with an increased risk of allergic sensitization (AOR = 2.63, p <.001) and asthma (AOR = 2.35, p =.024) than those with cord blood IgE <0.24 kU/L. Subjects with cord blood IgE ≥0.24 kU/L had significantly higher FeNO levels than those with cord blood IgE <0.24 kU/L (p =.028). There were no significant associations between cord blood IgE levels and pulmonary function parameters. Conclusion: Cord blood IgE ≥0.24 kU/L predicts allergic sensitization, FeNO elevation, and asthma among Asian schoolchildren, suggesting cord blood IgE would be useful for identifying newborns at risk of subsequent allergic sensitization and allergic airway inflammation. [ABSTRACT FROM AUTHOR]

Introduction: The optimal time point for reading the mean wheal diameter (MWD) of a skin prick test (SPT) in infants is not established. We aimed to assess if either of two reading time points of the SPT, 10 or 15 min, was superior to detect allergic sensitization (AS) in 6-month-old infants. Methods: In 1,431 6-month-old infants from the population-based Preventing Atopic Dermatitis and ALLergies in children (PreventADALL) mother-child cohort, the SPT was performed with standard solutions for egg, cow's milk, peanut, wheat, soy, birch, timothy, dog, and cat. The MWD was measured after 10 and 15 min. AS was defined as a positive SPT with MWD ≥2 mm larger than the negative control. Results: Overall, 149 (10.4%) infants were sensitized to at least one allergen at 10 and/or 15 min, while 138 (9.6%) had a positive SPT at 10 min and 141 (9.9%) at 15 min. A total of 12,873 allergen pricks were performed with 212 (1.6%) being positive at any time point, 194 (1.5%) positive at 10 min, and 196 (1.5%) positive at 15 min. The mean (95% CI) histamine MWD of 3.8 (3.8, 3.9) mm at 10 min was significantly larger than the 3.6 (3.6, 3.7) mm at 15 min. Discussion/Conclusions: Reading the SPT after both 10 and 15 min increased the number of 6-month-old infants with documented AS compared to reading after one time point only. As neither 10 nor 15 min reading time was superior to the other in detecting AS, our results indicate that readings at both time points should be considered. However, the histamine MWD was significantly larger at 10 min compared to 15 min. Reappraisal of SPT reading in infancy may be warranted. [ABSTRACT FROM AUTHOR]

Background: Chronic rhinitis symptoms cause significant health burden among children and can have a heterogeneous presentation. Defining phenotypes of childhood chronic rhinitis and associated pathobiology may lead to prevention or improved treatments., Objectives: To identify longitudinal patterns of rhinitis symptoms in childhood and determine their associations with early life risk factors, allergic comorbidities, and nasal epithelial cell gene expression., Methods: Chronic rhinitis symptoms were evaluated from ages 1 through 11 years in 485 urban children at high risk for allergic disease in the Urban Environment and Childhood Asthma (URECA) birth cohort. We identified longitudinal rhinitis phenotypes and their relationships to early life exposures, atopic comorbidities, and patterns of nasal epithelial gene expression at age 11 years., Results: Chronic rhinitis symptoms started early in many children and were a risk factor for developing aeroallergen sensitization. We identified four longitudinal rhinitis phenotypes: low/minimal disease, persistent, persistent decreasing, and late increasing. Persistent rhinitis was most closely linked to allergic sensitization and asthma. Risk factors for persistent rhinitis included frequent colds (p<0.001), antibiotic use (p<0.001), and reduced exposure to common indoor aeroallergens (p=0.003). Compared to low/minimal disease, rhinitis phenotypes were associated with increased expression of canonical Type 2 genes and decreased expression of immune response genes., Conclusions: In urban children, rhinitis symptoms often precede aeroallergen sensitization. Rhinitis phenotypes based on symptoms had distinct risk factors and nasal transcriptome. These results suggest that focusing on early life risk factors and distinct immune mechanisms may be a target to preventing chronic rhinitis in childhood., (Copyright © 2024. Published by Elsevier Inc.)

The human milk microbiota (HMM) is thought to influence the long-term health of offspring. However, its role in asthma and atopy and the impact of host genomics on HMM composition remain unclear. Through the CHILD Cohort Study, we followed 885 pregnant mothers and their offspring from birth to 5 years and determined that HMM was associated with maternal genomics and prevalence of childhood asthma and allergic sensitization (atopy) among human milk-fed infants. Network analysis identified modules of correlated microbes in human milk that were associated with subsequent asthma and atopy in preschool-aged children. Moreover, reduced alpha-diversity and increased Lawsonella abundance in HMM were associated with increased prevalence of childhood atopy. Genome-wide association studies (GWASs) identified maternal genetic loci (e.g., ADAMTS8, NPR1, and COTL1) associated with HMM implicated with asthma and atopy, notably Lawsonella and alpha-diversity. Thus, our study elucidates the role of host genomics on the HMM and its potential impact on childhood asthma and atopy., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Solubility is a common feature of allergens. However, the causative relationship between this protein-intrinsic feature and sensitization capacity of allergens is not fully understood. This study aimed to proof the concept of solubility as a protein intrinsic feature of allergens., Methods: The soluble birch pollen allergen Bet v 1 was covalently coupled to 1 μm silica particles. IgE-binding and -cross-linking capacity was assessed by inhibition ELISA and mediator release assay, respectively. Alterations in adjuvanticity by particle-loading were investigated by activation of dendritic cells, mast cells and the Toll-like receptor 4 pathway as well as by Th2 polarization in an IL-4 reporter mouse model. In BALB/c mice, particle-loaded and soluble Bet v 1 were compared in a model of allergic sensitization. Antigen uptake and presentation was analysed by restimulating human Bet v 1-specific T cell lines., Results: Covalent coupling of Bet v 1 to silica particles resulted in an insoluble antigen with retained IgE-binding and -cross-linking capacity and no increase in adjuvanticity. In vivo, particle-loaded Bet v 1 induced significantly lower Bet v 1-specific (s)IgE, whereas sIgG1 and sIgG2a levels remained unaffected. The ratio of Th2 to Th1 cells was significantly lower in mice sensitized with particle-loaded Bet v 1. Particle-loading of Bet v 1 resulted in a 24-fold higher T cell activation capacity in Bet v 1-specific T cell lines, indicating more efficient uptake and presentation than of soluble Bet v 1., Conclusions: Our results show that solubility is a decisive factor contributing to the sensitization capacity of allergens. The reduction in sensitization capacity of insoluble, particle-loaded antigens results from enhanced antigen uptake and presentation compared to soluble allergens., (Copyright © 2024 Japanese Society of Allergology. Published by Elsevier B.V. All rights reserved.)

Introducción: La exposición a ambientes con elevada carga fúngica favorece la sensibilización alérgica a hongos ambientales, propiciando la aparición de enfermedades alérgicas en trabajadores expuestos a labores de archivos. Objetivo: Identificar la sensibilización cutánea y la colonización fúngica nasal en trabajadores expuestos a hongos alergénicos. Material y método: Estudio observacional y transversal en 72 trabajadores archivistas, a quienes se les realiza historia clínica, pruebas cutáneas por punción (PCP) con extractos de alérgenos fúngicos e identificación de la micobiota nasal. Se analizó edad, sexo, tiempo de exposición laboral, resultados de PCP, diámetro del habón y presencia de colonias fúngicas nasales. Se empleó método chi cuadrado (x2) para comparar frecuencias de sensibilización y t de Student para el tamaño del habón, con significación estadística para p < 0,05. Resultados: El tiempo promedio laboral de los 72 trabajadores en la institución fue de 12,3 años. El 54,17 % reportó la incidencia de una o más enfermedades en el último año: asma 22 (30,6 %), rinitis crónica 20 (27,8 %) y conjuntivitis alérgica 11 (15,3 %) principalmente. La cutirreacción a extractos fúngicos fue positiva en 40,28 % de los trabajadores, principalmente a Aspergillus fumigatus, Alternaria alternata y Penicillium chrysogenum. Se identificó micobiota nasal en el 73,61 % de los trabajadores, predominando los génerosAspergillus spp.(6 4%), Cladosporium spp. (14,70 %) y Penicillium spp (8 %). Conclusiones: La exposición laboral predispone a la colonización nasal por especies fúngicas y la sensibilización. Ambas constituyen factores a considerar en la incidencia significativa de enfermedades alérgicas. Introduction: Exposure to atmospheres with high loads of fungi, favors the allergic sensitization to environmental mushrooms propitiating the appearance of allergic illnesses in exposed filing work workers. Objective: To determine the relationship of occupational exposure to allergenic mushrooms with skin sensitization and nasal fungal colonization. Material and method: Observational and cross-sectional study in 72 archivist workers, who underwent medical history, skin prick tests (SPT) with extracts of fungal allergens, and identification of the nasal mycobiota. Age, sex, occupational exposure time, PCP results, wheel diameter, and presence of nasal fungal colonies were analyzed. Chi-square x2 was used to compare sensitization frequencies and Student's t-test for wheel size, with statistical significance if p < 0.05. Results: The 72 ARNAC workers had an average working time in the institution of 12.3 years. 54.17 % reported the incidence of one or more diseases in the last year: Asthma 22 (30,6 %), chronic rhinitis 20 (27.8 %) and Allergic conjunctivitis 11 (15,3 %) mainly. Skin-reaction to fungal extracts was positive in 40.28 % of the workers, mainly Aspergillus fumigatus, Alternaria alternata, and Penicillium notatum. The nasal mycobiota was identified in 73.61 % of workers; the genera Aspergillusspp (64 %), Cladosporium spp (14.70 %), and Penicillium spp (8%) predominate. Conclusions: Archival occupational exposure is decisive in the nasal colonization and the sensitization by fungal species. These constitute risk factors for the significant incidence of allergic illnesses

The perinatal period and early infancy are considered critical periods for lung development. During this period, adversities such as environmental exposures, allergic sensitization, and asthma are believed to impact lung health in adulthood. Therefore, we hypothesized that concomitant exposure to allergic sensitization and urban-derived fine particulate matter (PM2.5) in the early postnatal period of mice would cause more profound alterations in lung alveolarization and growth and differently modulate lung inflammation and gene expression than either insult alone in adult life. BALB/c mice were sensitized with ovalbumin (OVA) and exposed to PM2.5 from the fifth day of life. Then, we assessed lung responsiveness, inflammation in BALF, lung tissue, and alveolarization by stereology. In addition, we performed a transcriptomic analysis of lung tissue on the 40th day of life. Our results showed that young adult mice submitted to allergic sensitization and exposure to ambient PM2.5 since early life presented decreased lung growth with impaired alveolarization, a mixed neutrophilic-eosinophilic pattern of lung inflammation, increased airway responsiveness, and increased expression of genes linked to neutrophil recruitment when compared to animals that were OVA-sensitized or PM2.5 exposed only. Both, early life allergic sensitization and PM2.5 exposure, induced inflammation and impaired lung growth, but concomitant exposure was associated with worsened inflammation parameters and caused alveolar enlargement. Our experimental data provide pathological support for the hypothesis that allergic or environmental insults in early life have permanent adverse consequences for lung growth. In addition, combined insults were associated with the development of a COPD-like phenotype in young adult mice. Together with our data, current evidence points to the urgent need for healthier environments with fewer childhood disadvantage factors during the critical windows of lung development and growth.