Mast cell signaling and its role in urticaria.

Puxeddu I, Pistone F, Pisani F, Levi-Schaffer F.  Ann Allergy Asthma Immunol. 2024 Apr 23:S1081-1206(24)00242-4. doi: 10.1016/j.anai.2024.04.023.

Abstract

Skin MC receptors and ligands involved in CSU

Chronic urticaria (CU) is a mast cells (MC)-driven disease characterized by the development of itching wheals and/or angioedema. In the last decades, outstanding progress has been made in defining the mechanisms involved in MC activation, and novel activating and inhibitory receptors expressed in MC surface were identified and characterized. Besides an IgE-mediated activation via FcεRI-cross-linking, other activating receptors, including Mas-related G protein–coupled receptor-X2 (MRGPRX2), C5a receptor and protease-activated receptors (PAR1 and PAR2) are responsible for MC activation.

Ambient pollen exposure and pollen allergy symptom severity in the EPOCHAL study

Luyten A, Bürgler A, Glick S et al.  Allergy. 2024 Apr 24. doi: 10.1111/all.16130. 

Abstract

Background

Ambient pollen exposure causes nasal, ocular, and pulmonary symptoms in allergic individuals, but the shape of the exposure–response association is not well characterized. We evaluated this association and determined (1) whether symptom severity differs between subpopulations; (2) how the association changes over the course of the pollen season; and (3) which pollen exposure time lags affect symptoms.

Methods

Adult study participants (n = 396) repeatedly scored severity of nasal, ocular, and pulmonary allergic symptoms, resulting in three composite symptom scores. We calculated hourly individually relevant pollen exposure to seven allergenic plants (alder, ash, birch, hazel, grasses, mugwort, and ragweed) considering personal sensitization and exposure time lags of up to 96 h. We fitted generalized additive mixed models, with a random personal intercept, adjusting for weather and air pollution as potential time-varying confounders.

Interstitial Lung Disease: A Review

Maher TM.  JAMA. Published online April 22, 2024. doi:10.1001/jama.2024.3669

Abstract

Importance  Interstitial lung disease (ILD) consists of a group of pulmonary disorders characterized by inflammation and/or fibrosis of the lung parenchyma associated with progressive dyspnea that frequently results in end-stage respiratory failure. In the US, ILD affects approximately 650 000 people and causes approximately 25 000 to 30 000 deaths per year.

Observations  The most common forms of ILD are idiopathic pulmonary fibrosis (IPF), which accounts for approximately one-third of all cases of ILD, hypersensitivity pneumonitis, accounting for 15% of ILD cases, and connective tissue disease (CTD), accounting for 25% of ILD cases. ILD typically presents with dyspnea on exertion. Approximately 30% of patients with ILD report cough. Thoracic computed tomography is approximately 91% sensitive and 71% specific for diagnosing subtypes of ILDs such as IPF. Physiologic assessment provides important prognostic information. A 5% decline in forced vital capacity (FVC) over 12 months is associated with an approximately 2-fold increase in mortality compared with no change in FVC.

Precision Dermatology: A Review of Molecular Biomarkers and Personalized Therapies

Tan, Isabella J., Alicia Podwojniak, Aarushi Parikh, and Bernard A. Cohen. 2024.  Current Issues in Molecular Biology 46, no. 4: 2975-2990. https://doi.org/10.3390/cimb46040186

Abstract

The evolution of personalized medicine in dermatology signifies a transformative shift towards individualized treatments, driven by the integration of biomarkers. These molecular indicators serve beyond diagnostics, offering insights into disease staging, prognosis, and therapeutic monitoring. Specific criteria guide biomarker selection, ensuring attributes like specificity, sensitivity, cost feasibility, stability, rapid detection, and reproducibility. This literature review, based on data from PubMed, SCOPUS, and Web of Science, explores biomarkers in Hidradenitis Suppurativa (HS), Psoriasis, Atopic Dermatitis (AD), Alopecia Areata (AA), Vitiligo, and Chronic Spontaneous Urticaria (CSU). In HS, TNF-α, IL-1β, and MMPs serve as biomarkers, influencing targeted therapies like adalimumab and anakinra.

Rhinoconjunctivitis severity induced by cat exposure influences early and late asthmatic responses: Evidence from an environmental exposure chamber

Piotin A, Godet J, Domis N, de Blay F. Clin Exp Allergy. 2024; 00: 1-11. doi:10.1111/cea.14485

Abstract

Background

The impact of allergic rhinoconjunctivitis on the early (EAR) and late asthmatic response (LAR) has yet to be assessed during optimal allergen exposure conditions.

Objective

We aimed to assess predictive factors of the EAR and LAR and to evaluate the relation between rhinitis, conjunctivitis and asthma induced by cat allergen exposure in an environmental exposure chamber (EEC).

Methods

Data from two cohort studies involving asthmatic patients with cat allergy who performed a cat allergen exposure challenge in ALYATEC EEC were analysed. Spirometry, visual analogue scale (VAS) for asthma, VAS for rhinitis, Total Nasal Symptoms Score, Total Ocular Symptoms Score (TOSS), Rhinoconjunctivitis Total Symptoms Score and Abelson score were used to assess asthma, rhinitis and conjunctivitis during and after exposure.

Results

Correlation map between respiratory and rhinoconjunctivitis parameters
in patients with an EAR during cat allergen exposure.

An EAR occurred in 65.1% of patients, 32.1% of whom had a LAR. The diameter of the prick test to cat allergens and non-specific bronchial hypersensitivity level were independent risk factors for EAR (p < .05). No independent risk factors for LAR were identified. Rhinoconjunctivitis severity during exposure correlated with the asthma VAS during EAR and LAR (p < .05). Allergen exposure time needed to trigger an EAR correlated with the Abelson score during exposure (p < .05). The asthma VAS and TOSS during exposure correlated with faster LAR occurrence (p < .05).

The incidence of upper respiratory infections in children is related to the concentration of vanadium in indoor dust aggregates.

Prokopciuk N, Taminskiene V, Vaideliene L et al.  Front Public Health. 2024 Mar 21;12:1339755. doi: 10.3389/fpubh.2024.1339755.

Abstract:

Background: It has been reported that the disease-initiated and disease-mediated effects of aerosol pollutants can be related to concentration, site of deposition, duration of exposure, as well as the specific chemical composition of pollutants.

Objectives: To investigate the microelemental composition of dust aggregates in primary schools of Vilnius and determine trace elements related to acute upper respiratory infections among 6-to 11-year-old children.

Methods: Microelemental analysis of aerosol pollution was performed using dust samples collected in the classrooms of 11 primary schools in Vilnius from 2016 to 2020. Sites included areas of its natural accumulation behind the radiator heaters and from the surface of high cupboards. The concentrations of heavy metals (Pb, W, Sb, Sn, Zr, Zn, Cu, Ni, Mn, Cr, V, and As) in dust samples were analyzed using a SPECTRO XEPOS spectrometer. The annual incidence rates of respiratory diseases in children of each school were calculated based on data from medical records.

A rare condition: montelukast allergy

Dindar Çelik F, Çelik Tuğlu H, Yağdıran M, Akkale Ö, Telli O, Aksu K. Eurasian J Pulmonol 2024;26:70-2.

Abstract

Montelukast, selective leukotriene (LT) receptor antagonist specific for cysteinyl LT type 1 receptors, serves as an alternative treatment option for asthma and different allergic clinical conditions. However montelukast, itself, may rarely induce hypersensitivity reactions. Although rare, clinicians, especially those working in pulmonology and allergy clinics, should be aware of the potential for montelukast to cause hypersensitivity reactions. 

Herein, we present a 61-year-old female patient who was followed up with Samter’s syndrome and developed urticarial rashes after montelukast treatment, and montelukast allergy was confirmed by oral drug provocation test.

PDF

Allergen Component Testing: Key in Diagnosing Atypical Pollen-Food Allergy Syndrome

Lee Qiyu M, Dawson T, Moulsdale P.  Cureus 16(4): e58722. doi:10.7759/cureus.58722

Abstract

This case report details the complex presentation, diagnosis, and management of a teenager with pollen-food allergen syndrome (PFAS), formerly known as oral allergy syndrome. PFAS, mediated by immunoglobulin E (IgE) antibodies, stems from the cross-reactivity between pollens and uncooked plant-based foods, leading to a spectrum of symptoms, such as itching or tingling of the oral cavity. A UK survey indicated an average PFAS prevalence of 2%, with apples, hazelnuts, and kiwifruit commonly implicated. The presented case involved a 15-year-old girl referred from the respiratory clinic to the allergy clinic due to episodes of sore throat and urticaria rash following Nutella (chocolate paste containing hazelnut) and peanut consumption. 

Summary of the allergen component testing results.

Extensive diagnostic measures, including specific IgE testing, skin prick tests, and allergen component testing, revealed cross-reactivity between Bet v 1 and hazelnut allergens.