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Clinical and experimental allergy,
02/2022, Letnik:
52, Številka:
2
Journal Article
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The cover image is based on the Research Article Cat allergen exposure in a naturalistic exposure chamber: A prospective observational study in cat‐allergic subjects by Meagan O’Brien et al., ...https://doi.org/10.1111/cea.14087.
Statistical analysis was performed using the SAS statistical software with chi square analysis and logistic regression comparison. There were no significant differences in other allergen levels ...evaluated, including cat, dog, cockroach, or dust mite, between the two groups.
Zusammenfassung
Hintergrund:
Die Sensibilisierungsraten für Aeroallergene steigen weltweit. Die Prävalenz nimmt insbesondere in den westlichen Ländern zu. Ziel dieser Arbeit war es, (1) ...Sensibilisierungsraten und (2) Kreuzsensibilisierungsmuster in Haut‐Prick‐Tests (HPTs) für die wichtigsten Inhalationsallergene in Mitteldeutschland, angepasst an den regionalen Pollenflug, über 20 Jahre hinweg zu untersuchen.
Patienten und Methodik:
In dieser monozentrischen Studie wurden HPTs für Baumpollen, Gräserpollen und Hausstaubmilben (HDM) bei 4315 Patienten, darunter auch Kinder, mit Verdacht auf Atemwegsallergien von 1998–2017 ausgewertet.
Ergebnisse:
Die Sensibilisierungsraten für fast alle Aeroallergene zeigten einen signifikanten Anstieg über die Jahre, ohne relevante Veränderungen der regionalen Pollenzahlen. Die aktuellen Sensibilisierungsraten bei allen symptomatischen Patienten waren am höchsten für Gräser‐ (55,3 %) und Roggenpollen (59,6 %), wobei die HDM‐Sensibilisierung im Laufe der Zeit am stärksten zunahm (von 37,8 % auf aktuell 50,1 %). Ein geringer, aber konsistenter Anteil der Baumpollen‐sensibilisierten Patienten (3,6–7,8 %) zeigte jedoch isolierte positive HPTs auf Erlen‐ und/oder Haselpollen ohne Sensibilisierung auf Birkenpollen.
Schlussfolgerungen:
Wir zeigen einen signifikanten Anstieg der Gesamtzahl der sensibilisierten Patienten sowie eine Zunahme der Kreuzsensibilisierung gegen eng verwandte Allergene. Patienten mit ungewöhnlichen Monosensibilisierungsprofilen gegenüber häufigen Inhalationsallergenen müssen genauer untersucht werden, da diese Patienten derzeit von klinischen Studien zur Allergen‐Immuntherapie ausgeschlossen sind.
Accidental allergic reactions to food are frequent and can be severe and even fatal.
We sought to analyze the culprit food products and levels of unexpected allergens in accidental reactions.
A ...prospective cohort study was conducted in adults (n = 157) with a physician-confirmed diagnosis of food allergy. During a 1-year follow-up, 73 patients reported accidental allergic reactions and the culprit food products. Food samples received (n = 51) were analyzed for a wide range of suspected noningredient allergens, and risk was quantified.
A very diverse range of food products was responsible for the unexpected allergic reactions. Thirty-seven percent (19/51) of products analyzed had 1 to 4 culprit allergens identified that were not supposed to be present according to the ingredient declaration. Concentrations varied from 1 to 5000 mg of protein of the allergenic food per kilogram of food product and were greatest for peanut, milk, and sesame. Milk proteins posed the highest estimated risk for objective allergic reactions. The intake of culprit allergens by patients varied considerably. For those cases in which culprit allergens were detected, the intake of at least 1 allergen exceeded the reference dose or a culprit allergen with a yet unknown reference dose was present. Both patient neglect of precautionary allergen labeling statements and omission of using a precautionary allergen labeling statement by food manufacturers seem to contribute to accidental reactions.
A wide range of food products are causing accidental reactions in patients with food allergy. Eight different allergens not declared on the ingredient lists were detected in the culprit food products, all of which were representative of allergens regulated in the European Union.
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The WHO/IUIS Allergen Nomenclature Database (http://allergen.org) provides up‐to‐date expert‐reviewed data on newly discovered allergens and their unambiguous nomenclature to allergen researchers ...worldwide. This review discusses the 106 allergens that were accepted by the Allergen Nomenclature Sub‐Committee between 01/2019 and 03/2021. Information about protein family membership, patient cohorts, and assays used for allergen characterization is summarized. A first allergenic fungal triosephosphate isomerase, Asp t 36, was discovered in Aspergillus terreus. Plant allergens contained 1 contact, 38 respiratory, and 16 food allergens. Can s 4 from Indian hemp was identified as the first allergenic oxygen‐evolving enhancer protein 2 and Cic a 1 from chickpeas as the first allergenic group 4 late embryogenesis abundant protein. Among the animal allergens were 19 respiratory, 28 food, and 3 venom allergens. Important discoveries include Rap v 2, an allergenic paramyosin in molluscs, and Sal s 4 and Pan h 4, allergenic fish tropomyosins. Paramyosins and tropomyosins were previously known mainly as arthropod allergens. Collagens from barramundi, Lat c 6, and salmon, Sal s 6, were the first members from the collagen superfamily added to the database. In summary, the addition of 106 new allergens to the previously listed 930 allergens reflects the continuous linear growth of the allergen database. In addition, 17 newly described allergen sources were included.
Summary
Allergy is a major public health problem with a high socio‐economic impact. The number of allergic patients is expected to reach to four billion within two decades when the World's population ...reaches to 10 billion. Our knowledge on the molecular mechanisms underlying allergic diseases and allergen tolerance induction had significant advances during the last years. Nowadays, it is well accepted that the generation and maintenance of allergen‐specific regulatory T cells (Tregs) and regulatory B cells (Bregs) and the involvement of their suppressive cytokines and surface molecules are essential for the induction of allergen tolerance. These mechanisms play essential roles for the restoration of healthy immune responses to allergens in allergen‐specific immunotherapy (AIT) and healthy immune response during high‐dose antigen exposure in beekeepers and cat owners. AIT remains as the only disease‐modifying and curative treatment for allergic diseases and represents a perfect model to investigate the antigen‐specific immune responses in humans. A large number of clinical trials demonstrated AIT as an effective treatment in many patients, but it still faces several drawbacks in relation to efficacy, safety, long duration, and patient adherence. Novel strategies to overcome these inconveniences, such as the development of novel adjuvants and alternative routes of administration are being developed. The better understanding of the molecular mechanism governing the generation of Treg and Breg cells during allergen tolerance might well open new avenues for alternative therapeutic interventions in allergic diseases and help better understanding of other immune‐tolerance‐related diseases.
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