Both the precise origin of IgE-positive B cells1 and the detailed specificities of local IgE remain elusive, but studies in allergic rhinitis and conjunctivitis reported that part of this local IgE ...might bind to aeroallergens, such as pollens.2 Our group also reported that functional IgE antibodies to house dust mite (Dermatophagoides pteronyssinus) allergens are detected in sputum from patients with nonatopic asthma.3 Similarly, D pteronyssinus-specific IgE was reported to be functional in nasal polyp tissues from nonatopic donors.4 The clinical relevance of local specific IgE has been shown by the demonstration that anti-IgE is effective in nasal polyposis and asthma independent of atopy.5 In the present study we sought to evaluate sputum IgE antibodies to D pteronyssinus in a larger series of asthmatic patients and to correlate this local response to TH2/eosinophilic inflammation and notably to periostin, which was recently identified as a surrogate serum marker of airway eosinophilia in asthmatic patients. Another possibility relates to the site of sampling because it is uncertain whether tissue-bound IgE levels and secretory (sputum) IgE levels are correlated and could be affected by different local factors, including epithelial transport through the low-affinity receptor for IgE (CD23). ...allergen-specific IgE responses should be clarified in patients with nonatopic asthma by assessing the different compartments of the bronchial mucosa, ideally by using different techniques, to detect the presence of local IgE antibodies.
A New Digital Tool to Assess Allergic Rhinitis Symptom Control Bousquet, Jean, MD, PhD; Price, David, MD, FRCGP, MRCGP, DRCOG; Acaster, Sarah, BSc ...
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY,
02/2016, Letnik:
137, Številka:
2
Journal Article, Conference Proceeding
Recenzirano
Odprti dostop
Rationale MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) is a simple patient-centered-system using information and communications technology tools and a clinical decision support ...system (CDSS) based on the ARIA 2015 revision.
Background The receptor for advanced glycation end products (RAGE) is a multiligand receptor that exists as a membrane-bound (mRAGE) form and a soluble (sRAGE) form. RAGE is reported to play a role ...in diverse pathologies including lower airway conditions, but the exact mechanism of action remains poorly understood. In the upper airways, the involvement of RAGE remains completely unexplored. Objective To investigate the involvement of RAGE in the human upper airway conditions chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP). Methods Protein levels of sRAGE, mRAGE, IL-5, and eosinophil cationic protein (ECP) were quantitatively assessed in inflamed tissue of CRSsNP and CRSwNP patients. Nasal tissue of subjects without disease served as control. Ex vivo human sinonasal tissue stimulation assays were used to assess the effect of Staphylococcus aureus and ECP on sRAGE processing. Results sRAGE protein levels were higher in CRSsNP tissue, whereas mRAGE protein levels were lower than in controls. In CRSwNP patients, both tissue sRAGE and mRAGE protein levels were reduced. Low tissue sRAGE protein concentrations were associated with high IL-5 and ECP protein levels. In vitro , S aureus induced the release of sRAGE from the tissue, while ECP was shown to be implicated in the breakdown of free sRAGE. Conclusions We demonstrate for the first time that RAGE protein is highly expressed in human upper airways under normal physiology and that it is subject to differential processing in CRSsNP and CRSwNP, identifying S aureus and ECP as novel and crucial players in this process.
Background Randomized trials provide evidence to inform treatment decisions. The Consolidated Standards of Reporting Trials (CONSORT) Statement is a set of recommendations for the reporting of ...trials. Objective We sought to assess the quality of reporting allergen-specific immunotherapy trials according to CONSORT criteria. Methods The reporting of the procedure, randomization, dropouts, strict conduct of intention-to-treat (ITT) analysis, and sample size calculation according to CONSORT were assessed in the 46 subcutaneous and 48 sublingual immunotherapy (SLIT) blind, placebo-controlled randomized trials published between 1996 and 2009 in English. Results One subcutaneous immunotherapy (2.2%) and 3 SLIT (6.6%) trials met CONSORT Statement criteria. These were used for the registration of sublingual tablets to the European Medicines Agency. In subcutaneous immunotherapy, 16 (35%) studies reported a CONSORT flow chart, and 12 (26%) provided a description of dropouts. Adequate randomization was reported in 9 (35%) studies, and incomplete randomization was reported in 15 (33%). Power analysis was reported in 15 (33%) studies. In SLIT, 20 (42%) studies reported a CONSORT flow chart, and 16 (32%) a description of dropouts. ITT analysis was carried out in 1 (2.2%) SLIT study, and a modified ITT analysis was used in 1 (2.2%) subcutaneous immunotherapy study and 2 (4.4%) SLIT studies. Adequate randomization was reported in 6 (12%) studies, and incomplete randomization was reported in 16 (32%). Power analysis was reported in 15 (27%) studies. Conclusion As in other areas of medicine, the quality of reporting of most immunotherapy trials is low, and only 4.2% of SLIT randomized controlled trials met all of the criteria of the CONSORT Statement. Use of the CONSORT criteria should be encouraged.
Rationale Loss of smell is a major consequence for chronic sinusitis patients with nasal polyps and is a severity marker with significant impact on quality of life.
Rationale Long-term control of chronic rhinosinusitis with nasal polyposis (CRSwNP) is a challenge despite medical treatment and endoscopic sinus surgery (ESS).
Vaccination against viral and bacterial pathogens represents a challenging issue in allergic subjects, mainly concerning patients undergoing allergen immunotherapy (AIT). For this reason, an ...international survey has been performed involving a panel of experts who responded to a series of questions, also concerning the COVID-19 impact on allergen immunotherapy and vaccinations.
The results showed that co-administration of vaccines and AIT requires caution, mainly during the pandemic era. Moreover, the choice of AIT product should be oriented considering also the safety profile.
Type 2 CRSwNP is characterized by severe symptoms, multiple comorbidities, longer recovery course and high recurrence rate. A simple and cost-effective diagnostic model for CRSwNP endotype ...integrating clinical characteristics and histopathological features is urgently needed.
To establish a clinical diagnostic model of inflammatory endotype in CRSwNP based on the clinical characteristics, pathological characteristics, and cytokines profile in the polyp tissue of patients.
A total of 244 participants with CRSwNP were enrolled at 2 different centers in China and Belgium from 2018 to 2020. IL-5 level of nasal polyp tissue was used as gold standard. Clinical characteristics were used to establish diagnostic models. The area under the receiver operating curve (AUC) was used to evaluate the diagnostic performance. The study was approved by the ethics board of the First Affiliated Hospital of Sun Yat-sen University (2020 302), and written informed consent was obtained from all subjects before inclusion.
In total, 134 patients from China (training set) and 110 patients from Belgium (validation set) were included. The logistic regression (LR) model in predicting inflammatory endotype of CRSwNP showed the AUC of 83%, which was better than the diagnostic performance of machine learning models (AUC of 61.14%–82.42%), and single clinical variables. We developed a simplified scoring system based on LR model which shows similar diagnostic performance to the LR model (P = 0.6633).
The LR model in this diagnostic study provided greater accuracy in prediction of inflammatory endotype of CRSwNP than those obtained from the machine learning model and single clinical variable. This indicates great potential for the use of diagnostic model to facilitate inflammatory endotype evaluation when tissue cytokines are unable to be measured.
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