BACKGROUND: While B-cells have historically been implicated in allergy development, a growing body of evidence supports their role in atopic dermatitis (AD). B-cell differentiation across ages in AD, and its relation to disease severity scores, has not been well defined.
OBJECTIVE: To compare the frequency of B-cell subsets in blood of 0-5, 6-11, 12-17, and ≥18 years old patients with AD versus age-matched controls.
METHODS: Flow cytometry was used to measure B-cell subset frequencies in the blood of 27 infants, 17 children, 11 adolescents, and 31 adults with moderate-to-severe AD and age-matched controls. IgD/CD27 and CD24/CD38 core gating systems and an 11-color flow cytometry panel were used to determine frequencies of circulating B-cell subsets. Serum total and allergen-specific IgE (sIgEs) levels were measured using ImmunoCAP®.
RESULTS: Adolescents with AD had lower frequencies of major B-cells subsets (p < .03). CD23 expression increased with age and was higher in AD compared to controls across all age groups (p < .04). In AD patients, multiple positive correlations were observed between IL-17-producing T-cells and B-cell subsets, most significantly non-switched memory (NSM) B-cells (r = .41, p = .0005). AD severity positively correlated with a list of B-cell subsets (p < .05). IL-9 levels gradually increased during childhood, reaching a peak in adolescence, paralleling allergen sensitization, particularly in severe AD. Principal component analysis of the aggregated environmental sIgE data showed that while controls across all ages tightly clustered together, adolescents with AD demonstrated distinct clustering patterns relative to controls.
CONCLUSIONS: Multiple correlations between B-cells and T-cells, as well as disease severity measures, suggest a complex interplay of immune pathways in AD. Unique B-cell signature during adolescence, with concurrent allergen sensitization and IL-9 surge, point to a potentially wider window of opportunity to implement interventions that may prevent the progression of the atopic march.

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

Immune engineering and modulation are the basis of a novel but powerful tool to treat immune diseases using virus-like particles (VLPs). VLPs are formed by the viral capsid without genetic material making them non-infective. However, they offer a wide variety of possibilities as antigen-presenting platforms, resulting in high immunogenicity and high efficacy in immune modulation, with low allergenicity. Both animal and plant viruses are being studied for use in the treatment of food allergies. These formulations are combined with adjuvants, T-stimulatory epitopes, TLR ligands, and other immune modulators to modulate or enhance the immune response toward the presented allergen. Here, the authors present an overview of VLP production systems, their immune modulation capabilities, and the applicability of actual VLP-based formulations targeting allergic diseases.

Allergy to fur animals is becoming an increasingly common clinical problem in everyday medical practice. Depending on the route of exposure to the allergen, patients present with many, often non-specific symptoms. The most common illnesses among people with allergies to the above-mentioned allergens are as follows: allergic rhinitis, allergic conjunctivitis, atopic bronchial asthma, food allergy, allergic contact dermatitis, and sometimes anaphylactic shock. In recent years, there has been a change in the holistic approach to the treatment of allergy patients. The method of treatment should be tailored to a specific patient, taking into account his or her predispositions, economic possibilities, and therapeutic goals. The article describes the main methods of treating allergies, focusing primarily on allergies to fur animals. Allergy treatment always requires great care, and qualification for specific types of therapy should be preceded by a thorough and accurate diagnosis.

Chronic exposure to harmful pollutants, chemicals, and pathogens from the environment can lead to pathological changes in the epithelial barrier, which increase the risk of developing an allergy. During allergic inflammation, epithelial cells send proinflammatory signals to group 2 innate lymphoid cell (ILC2s) and eosinophils, which require energy and resources to mediate their activation, cytokine/chemokine secretion, and mobilization of other cells. This review aims to provide an overview of the metabolic regulation in allergic asthma, atopic dermatitis (AD), and allergic rhinitis (AR), highlighting its underlying mechanisms and phenotypes, and the potential metabolic regulatory roles of eosinophils and ILC2s. Eosinophils and ILC2s regulate allergic inflammation through lipid mediators, particularly cysteinyl leukotrienes (CysLTs) and prostaglandins (PGs). Arachidonic acid (AA)-derived metabolites and Sphinosine-1-phosphate (S1P) are significant metabolic markers that indicate immune dysfunction and epithelial barrier dysfunction in allergy. Notably, eosinophils are promoters of allergic symptoms and exhibit greater metabolic plasticity compared to ILC2s, directly involved in promoting allergic symptoms. Our findings suggest that metabolomic analysis provides insights into the complex interactions between immune cells, epithelial cells, and environmental factors. Potential therapeutic targets have been highlighted to further understand the metabolic regulation of eosinophils and ILC2s in allergy. Future research in metabolomics can facilitate the development of novel diagnostics and therapeutics for future application.

The study aimed to select apple varieties suitable for allergy sufferers and people with diabetes. The total polyphenol content, sugar content, acidity, and antioxidant activity of the apple fruit juices were determined using spectrophotometric techniques. The allergenic content in the apple juices was also measured. The strength of sensitisation was assessed using the ELISA method. Given their minimal content of both profilins and Bet v 1 homologues, Koksa Pomarańczowa (4.24 ± 0.08 µg/g Bet v 1 and 4.49 ± 0.82 ng/g profilins) and Książę Albrecht Pruski (5.57 ± 0.07 µg/g Bet v 1 and 3.34 ± 0.09 ng/g profilins) were identified as suitable for people with allergies. For people with diabetes, the most suitable apple variety was found to be Jakub Lebel, providing large doses of antioxidants and polyphenols (41.10 ± 0.20 and 5.16 ± 0.42, respectively) and a relatively low sugar content (9.06 g/100 g).

Background/Objectives: The importance of non-invasive biomarkers for the diagnosis and monitoring of allergic diseases in childhood is currently unknown. From this perspective, data on the role of the total (t) immunoglobulin E (IgE) in relation to different allergic diseases across different age groups until adulthood remain unclear. The potential association of tIgE levels with types of allergic diseases diagnosed in an specialized tertiary allergy center, in relation to sex and the age group spanning from birth to 20 years, are evaluated in the present study. Methods: In this retrospective study, the tIgE values were obtained from children assessed for allergy-associated symptoms in our department from January 2015 to December 2020. The tIgE values were analyzed in relation to age and diagnosis. Results: Data from 2127 patients (1321 boys (62.1%)), with a median age of 6.31 (3.01-9.95) years, were available. The tIgE median values for the studied population were 132 (37.7-367.5) kU/lt. The tIgE values showed a significant increase from 0-2 years to 2-5 and 5-12 years, but not from 5-12 to 12-20 years. Boys exhibited significantly higher tIgE values compared to girls. Furthermore, the tIgE levels were significantly increased in children with asthma, allergic rhinitis, food allergy, and atopic dermatitis in comparison to children without these diagnoses. Conclusions: The total IgE values exhibit a significant and progressive longitudinal increase in children with allergic diseases, particularly notable in the 0-2 and 5-12 age groups, in boys, and in children diagnosed with atopic conditions.

BACKGROUND: General pediatric providers are the frontline for early peanut introduction discussions, but many feel ill-equipped to handle such discussions as guidelines have quickly changed.
OBJECTIVE: We hypothesized that a clinical decision support (CDS) tool could improve peanut introduction discussions.
METHODS: CDS tools were designed by stakeholders, improved through usability testing, and integrated into the current note templates. Based on queries of electronic health record (EHR), we did a pre-post performance evaluation of peanut introduction conversations, barriers for introduction, and percentage of 12-month WCC visits that had successfully introduced peanut. Providers completed surveys before and after intervention to assess awareness of early peanut introduction and comfort using CDS.
RESULTS: Providers\' awareness of early peanut introduction guidelines increased from 17.8% to 66.7% after the CDS tool was implemented. 79.1% were comfortable using the tool. The CDS tool improved peanut introduction conversations at the 4-month well-child (WCC) care visit from 2.4% to 81.2%, at the 6-month WCC visit from 3.0% to 84.2%, and at the 12-month WCC visit from 2.7% to 82.9%. 56.6% of families had a plan to introduce peanut at the 4-month WCC visit. Of those who did not have a plan, the most common barrier was family\'s unawareness of the benefits of early peanut introduction. At the 12-month visit, 62.8% of families had introduced peanut without concerns.
CONCLUSIONS: A point-of-care CDS tool encouraged more discussions by general pediatric providers on early peanut introduction to all patients. CDS tools should be considered in quality improvement projects as an implementation method for the most up-to-date guidelines.

For clinicians involved in improving healthcare for patients with allergic and immunologic conditions, advocacy on a broader level through public outreach is key to advancing value-based care. In this article, we provide a toolkit of strategies and resources that can be used to raise public awareness of important issues through various mediums, including podcasts and social media, newspapers, testimonies, presentations, and interviews. A simple approach to effective media interactions is described using the acronym \"RATIO\", which stands for Research, Audience, Targeted topic, Interview rephrasing, and Optimism. The acronym also reminds the person who is presenting information that only a fraction of what is discussed will be recalled, and an even smaller proportion will be implemented. Key points should be made early. Examples of key talking points are provided for selected topics, including food allergy, anaphylaxis, asthma, rhinitis, and broader healthcare advocacy.