Dermatophagoides pteronyssinus

翼状窦尘螨
  • 文章类型: Journal Article
    暴露于储存螨(SM)和屋尘螨(HDM)过敏原是致敏和哮喘发展的危险因素;然而,相关的免疫反应及其病理尚未得到充分研究。HDMs粉尘螨和翼状螨螨和SM热解螨是诱发哮喘的有效过敏原。大多数SM相关研究通过测量个体的免疫球蛋白(Ig)E表达来关注个体的过敏反应。考虑到对该主题的研究有限,本研究旨在研究HDM和SM诱导的免疫反应的差异,并对小鼠哮喘模型的肺组织进行组织学分析,以了解HDM和SM的差异效应.结果表明,所有螨物种都会引起气道炎症。用腐殖质T.腐殖质攻击的小鼠具有最高的气道阻力和总细胞,嗜酸性粒细胞,支气管肺泡灌洗液(BALF)中的中性粒细胞计数。SM致敏组比HDM致敏组表现出更严重的病变和粘液分泌过多。尽管HDM和SM的暴露程度相同,暴露于SM的小鼠对呼吸肺组织的损伤更为严重,导致粘蛋白分泌过多和纤维化增加。此外,这些研究结果表明,在哮喘模型中,SM致敏在粘膜免疫中诱导的超敏反应比HDM致敏更显著.
    Exposure to storage mite (SM) and house dust mite (HDM) allergens is a risk factor for sensitization and asthma development; however, the related immune responses and their pathology have not been fully investigated. The HDMs Dermatophagoides farinae and Dermatophagoides pteronyssinus and SM Tyrophagus putrescentiae are potent allergens that induce asthma. Most SM-related studies have focused on the allergic reactions of individuals by measuring their immunoglobulin (Ig)E expression. Considering the limited research on this topic, the present study aims to investigate the differences in the immune responses induced by HDMs and SMs and histologically analyze lung tissues in a mouse asthma model to understand the differential effects of HDM and SM. The results revealed that all mite species induced airway inflammation. Mice challenged with T. putrescentiae had the highest airway resistance and total cell, eosinophil, and neutrophil counts in the bronchoalveolar lavage fluid (BALF). The SM-sensitized groups showed more severe lesions and mucus hypersecretions than the HDM-sensitized groups. Although the degree of HDM and SM exposure was the same, the damage to the respiratory lung tissue was more severe in SM-exposed mice, which resulted in excessive mucin secretion and increased fibrosis. Furthermore, these findings suggest that SM sensitization induces a more significant hypersensitivity response in mucosal immunity than HDM sensitization in asthma models.
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  • 文章类型: Journal Article
    粉尘螨(D.farinae)和翼状螨(D.翼楼)是常见的室内尘螨(HDMs)。HDMs是常见的吸入性过敏原,会导致一系列过敏性疾病,如鼻炎,特应性皮炎,和哮喘。这些疾病的流行病学与暴露于螨虫有关。因此,在本研究中,开发了一种称为多重环介导等温扩增(LAMP)的方法来检测环境尘螨。多重LAMP测定法允许在单个管中进行扩增,并且对于单个尘螨和混合尘螨,ITS质粒检测限均低至40fg/µL(D.翼楼和D.farinae),比经典的PCR技术灵敏十倍。此外,将多重LAMP方法应用于单个尘螨和临床粉尘样品,以确认其有效性。多重LAMP分析显示出更高的灵敏度,更简单的仪器,以及测试结果的可视化,表明该方法可以用作传统的HDM检测技术的替代方法。
    Dermatophagoides farina (D. farinae) and Dermatophagoides pteronyssinus (D. pteronyssinus) are the prevalent kinds of house dust mites (HDMs). HDMs are common inhalant allergens that cause a range of allergic diseases, such as rhinitis, atopic dermatitis, and asthma. The epidemiology of these diseases is associated with exposure to mites. Therefore, in the present study, a method named multiplex loop-mediated isothermal amplification (LAMP) was developed to detect environmental dust mites. The multiplex LAMP assay allows amplification within a single tube and has an ITS plasmid detection limit as low as 40 fg/µL for both single dust mites and mixed dust mites (D. pteronyssinus and D. farinae), which is up to ten times more sensitive than classical PCR techniques. Furthermore, the multiplex LAMP method was applied to samples of single dust mites and clinical dust to confirm its validity. The multiplex LAMP assay exhibited higher sensitivity, simpler instrumentation, and visualization of test results, indicating that this method could be used as an alternative to traditional techniques for the detection of HDMs.
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  • 文章类型: Journal Article
    背景:翼状螨和粉尘螨属于Pyroglyphidae家族(“Dermaticoidinae”亚家族),分别具有Derp1,Derp2和Derp23以及Derf1和Derf2的变应原蛋白。欧照梅尼,属于Pyroglyphidae家族(亚家族:“Pyroglyphinae”),其主要致敏蛋白是Eurm1,一种致敏来源。通过皮肤试验评估对D.pteronysinus和D.farinae的敏感性,而对E.maynei的敏感性评估较少。
    目的:这项实验工作旨在分析在巴里的M.Albanesi过敏和免疫学部门治疗的呼吸道过敏患者对E.maynei的致敏率,意大利,并分析了E.maynei与D.farinae和D.pteronysinus的主要致敏蛋白的序列同源性。
    方法:在这项现实生活中的研究中,65例患者入组。特别是,呼吸道过敏患者接受了常见呼吸道过敏原的皮肤点刺试验,包括欧彩玛尼.在E.maynei的主要过敏原蛋白与D.pteronysinus和D.farinae的主要过敏原蛋白之间进行序列同源性分析。
    结果:对E.maynei敏感的患者占41.5%。所有患有E.maynei致敏的患者均对D.farinae和D.pteronysinus致敏。Derp1和Derf1蛋白与Eurm1蛋白序列的序列同源性分析显示出84.4%和86%的同一性,分别。
    结论:近50%的屋尘螨致敏患者对E.maynei有伴随致敏作用。交叉敏化可能是由于Derf1、Derp1和Eurm1相似性。
    BACKGROUND: Dermatophagoides pteronyssinus and Dermatophagoides farinae belong to the family Pyroglyphidae (subfamily: \"Dermatophagoidinae\") and have the respective allergenic proteins of Der p1, Der p2, and Der p23 and Der f1 and Der f2. Euroglyphus maynei, belongs to the family Pyroglyphidae (subfamily: \"Pyroglyphinae\") and its main allergenic protein is Eur m1, a source of sensitization. Sensitization to D. pteronyssinus and D. farinae is assessed through skin tests, while sensitization to E. maynei is assessed less frequently.
    OBJECTIVE: This experimental work aims to analyze the prevalence of sensitization to E. maynei in patients with respiratory allergies treated at M. Albanesi Allergy and Immunology Unit in Bari, Italy, and the sequence homology of major allergenic proteins of E. maynei with D. farinae and D. pteronyssinus was analyzed.
    METHODS: In this real-life study, 65 patients were enrolled. In particular, patients with respiratory allergy were subjected to skin prick tests for common respiratory allergens, including Euroglyphus maynei. The sequence homology analysis was performed between the major allergenic proteins of E. maynei and those of D. pteronyssinus and D. farinae.
    RESULTS: Sensitization to E. maynei accounts for 41.5% of patients. All patients with E. maynei sensitization had concomitant sensitization to D. farinae and D. pteronyssinus. The analysis of sequence homology of Der p1 and Der f1 proteins with the sequence of Eur m1 protein demonstrated an identity of 84.4% and 86%, respectively.
    CONCLUSIONS: Nearly 50% of house dust mites-sensitized patients have a concomitant sensitization to E. maynei. The cross-sensitization could be due to Der f1, Der p1, and Eur m1 similarity.
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  • 文章类型: Journal Article
    过敏原提取物和重组过敏原用于过敏诊断和免疫疗法。由于来自不同制造商的过敏原提取物缺乏关于其组成的适当标准化,针对特定变应原组分的单克隆抗体(MAb)可用于它们在变应原提取物中的鉴定和定量。本研究旨在产生针对翼状尘螨的过敏原Derp21的MAb,用于分析过敏原提取物。
    重组Derp21在大肠杆菌中表达并使用亲和层析纯化。使用杂交瘤技术产生针对Derp21的MAb。使用新开发的夹心酶联免疫吸附测定法分析了屋尘螨(HDM)过敏原提取物,蛋白质印迹和微阵列免疫测定。
    针对重组Derp21产生的MAb进行了详细表征,并证明与天然Derp21具有反应性。开发并优化了用于定量Derp21的高特异性夹心酶联免疫吸附测定。检测变应原,并且仅在来自不同制造商的六个分析的HDM变应原提取物中的三个中测定其浓度。
    通过基于MAb的免疫测定的HDM分析显示了它们在过敏原组成上的差异。结果证明了过敏原特异性MAb作为表征过敏原提取物的工具的重要性,并且在将其用于过敏诊断或免疫疗法之前需要对其进行适当的标准化。
    UNASSIGNED: Allergen extracts and recombinant allergens are used in allergy diagnostics and immunotherapy. Since allergen extracts from different manufacturers lack proper standardization regarding their composition, monoclonal antibodies (MAbs) against specific allergen components can be used for their identification and quantification in allergen extracts. This study aimed to generate MAbs against allergen Der p 21 of Dermatophagoides pteronyssinus for the analysis of allergen extracts.
    UNASSIGNED: Recombinant Der p 21 was expressed in E. coli and purified using affinity chromatography. MAbs against Der p 21 were generated using hybridoma technology. House dust mite (HDM) allergen extracts were analyzed using the newly developed sandwich enzyme-linked immunosorbent assay, Western blotting and microarray immunoassay.
    UNASSIGNED: MAbs raised against recombinant Der p 21 were characterized in detail and proven to be reactive with natural Der p 21. Highly specific sandwich enzyme-linked immunosorbent assay for the quantification of Der p 21 was developed and optimized. The allergen was detected and its concentration was determined in only three of six analyzed HDM allergen extracts from different manufacturers.
    UNASSIGNED: HDM analysis by MAb-based immunoassays shows their differences in allergen composition. The results demonstrate the importance of allergen-specific MAbs as a tool for the characterization of allergen extracts and the need for their appropriate standardization before their use for allergy diagnostics or immunotherapy.
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  • 文章类型: Journal Article
    背景:中药(TCM)XYQFT由10种草药组成。根据NHIRD,XYQFT是治疗哮喘最常用的十大中药处方之一。
    目的:本研究的目的是探讨XYQFT能否减轻慢性哮喘小鼠模型的哮喘症状,并确定肥大细胞的免疫调节机制。
    方法:BALB/c小鼠每周一次用40μL(2.5μg/μL)翼状螨(Derp)气管内(it)刺激,连续6周,并在Derp刺激前30分钟以1g/kg口服XYQFT。气道超敏反应,在小鼠中评估BALF中的炎症细胞和血液中的总IgE。此外,用DNP-IgE刺激RBL-2H3细胞(肥大细胞),之后加入不同浓度的XYQFT持续30分钟以评估XYQFT对DNP刺激的RBL-2H3细胞的基因表达和脱颗粒的影响。在XYQFT中的化合物使用LC-MS/MS鉴定后,用PBD法鉴定抑制肥大细胞GM-CSF和COX-2基因表达的化学成分。
    结果:气道超敏反应试验证明XYQFT能显著缓解Derp诱导的气道超敏反应。此外,支气管肺泡灌洗液的细胞计数和分型显示,XYQFT治疗可显著减少Derp诱导的炎症细胞浸润。ELISA检查进一步表明,在XYQFT施用后,血清中Derp-诱导的总IgE水平显著降低。此外,XYQFT抑制脱颗粒和基因表达(IL-3,IL-4,ALOX-5,IL-13,GM-CSF,COX-2,TNF-α,DNP刺激后RBL-2H3细胞中的MCP-1)。发现XYQFT中的化合物黄皂素AIII和根宽宁是抑制肥大细胞中COX-2和GM-CSF基因表达的关键因素。
    结论:通过调节肥大细胞,XYQFT抑制炎症细胞浸润,哮喘小鼠模型的气道超敏反应和特异性免疫。此外,XYQFT通过抗原皂甙AIII和根kwanin协同抑制肥大细胞中GM-CSF和COX-2基因的表达。
    BACKGROUND: The traditional Chinese medicine (TCM) XYQFT is composed of 10 herbs. According to the NHIRD, XYQFT is one of the top ten most commonly used TCM prescriptions for asthma treatment.
    OBJECTIVE: The aim of this study was to explore whether XYQFT reduces asthma symptoms in a mouse model of chronic asthma and determine the immunomodulatory mechanism of mast cells.
    METHODS: BALB/c mice were intratracheally (it) stimulated with 40 μL (2.5 μg/μL) of Dermatophagoides pteronyssinus (Der p) once a week for 6 consecutive weeks and orally administered XYQFT at 1 g/kg 30 min before Der p stimulation. Airway hypersensitivity, inflammatory cells in the BALF and total IgE in the blood were assessed in mice. In addition, RBL-2H3 cells (mast cells) were stimulated with DNP-IgE, after which different concentrations of XYQFT were added for 30 min to evaluate the effect of XYQFT on the gene expression and degranulation of DNP-stimulated RBL-2H3 cells. After the compounds in XYQFT were identified using LC‒MS/MS, the PBD method was used to identify the chemical components that inhibited the expression of the GM-CSF and COX-2 genes in mast cells.
    RESULTS: The airway hypersensitivity assay demonstrated that XYQFT significantly alleviated Der p-induced airway hypersensitivity. Moreover, cell counting and typing of bronchoalveolar lavage fluid revealed a significant reduction in Der p-induced inflammatory cell infiltration with XYQFT treatment. ELISA examination further indicated a significant decrease in Der p-induced total IgE levels in serum following XYQFT administration. In addition, XYQFT inhibited the degranulation and expression of genes (IL-3, IL-4, ALOX-5, IL-13, GM-CSF, COX-2, TNF-α, and MCP-1) in RBL-2H3 cells after DNP stimulation. The compounds timosaponin AIII and genkwanin in XYQFT were found to be key factors in the inhibition of COX-2 and GM-CSF gene expression in mast cells.
    CONCLUSIONS: By regulating mast cells, XYQFT inhibited inflammatory cell infiltration, airway hypersensitivity and specific immunity in a mouse model of asthma. In addition, XYQFT synergistically inhibited the expression of the GM-CSF and COX-2 genes in mast cells through timosaponin AIII and genkwanin.
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  • 文章类型: Journal Article
    背景:哮喘被广泛认为是一种炎症性疾病。在这种炎症微环境的背景下,缺氧的参与及其对相关通路的影响已引起广泛关注。然而,缺氧的确切作用,一个普遍的环境因素,在哮喘的发展和进展中仍然知之甚少。
    方法:用屋尘螨(HDM)提取物处理小鼠23天以诱导哮喘。通过暴露于不同条件将小鼠分为室内空气(RA)组和间歇性低氧(IH)组,并在低氧方案之前对上述组进行IH预处理(IHP)。通过气道高反应性评估小鼠的气道炎症,粘液分泌过多,和炎症细胞的募集。免疫组织化学用于定量NF-κB的表达水平。随后,我们修改了过敏原的剂量,以研究缺氧对哮喘的影响是否受不同剂量过敏原的影响.
    结果:与RA和IH组相比,HDM治疗组小鼠炎症细胞浸润和气道高反应性加重(p<0.05)。此外,炎症介质释放增加,NF-κB表达水平升高(p<0.05)。重要的是,发现高剂量过敏原对哮喘的影响(p<0.05).
    结论:IHP治疗可能加剧HDM诱导的哮喘气道炎症,与NF-κB的参与,特别是在高剂量过敏原刺激下。
    BACKGROUND: Asthma is widely recognized as an inflammatory disorder. In the context of this inflammatory microenvironment, the involvement of hypoxia and its impact on related pathways have drawn considerable attention. However, the exact role of hypoxia, a prevalent environmental factor, in the development and progression of asthma remains poorly understood.
    METHODS: Mice were treated with house dust mite (HDM) extracts for 23 days to induce asthma. Mice were divided into room air (RA) group and intermittent hypoxic (IH) group by exposing to different conditions and IH preconditioning (IHP) were underwent to the above groups before the hypoxic regimen. Airway inflammation in mice was evaluated by airway hyperresponsiveness, excessive mucus secretion, and recruitment of inflammatory cells. Immunohistochemistry was employed to quantify the expression levels of NF-κB. Subsequently, the dose of allergen was modified to investigate whether the impact of hypoxia on asthma is affected by different doses of allergens.
    RESULTS: Compared to the RA and IH groups, HDM-treated mice in the IHP group exhibited aggravated inflammatory cell infiltration and airway hyperresponsiveness (p<.05). Moreover, there was an increased release of inflammatory mediators and higher expression levels of NF-κB (p<.05). Importantly, the impact ia on asthma was found to be influenced by high dose of allergen (p<.05).
    CONCLUSIONS: IHP treatment potentially exacerbates HDM-induced airway inflammation in asthma, with the involvement of NF-κB, particularly under high-dose allergen stimulation.
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  • 文章类型: Journal Article
    室内尘螨(HDM)被广泛认为是过敏性疾病中最常见的过敏原。变应原特异性免疫疗法(AIT)已成功应用于HDM的临床治疗中。通过人工智能(AI)设计的基于低变应原性B细胞表位的疫苗代表了重组低变应原性变应原衍生物的重要进展。
    使用Alphafold2构建Derf36的三维蛋白质结构。基于人工智能的工具被用来预测B细胞表位,随后通过IgE反应测试进行验证。然后合成低变应原性Derf36,表达,和纯化。通过酶联免疫吸附测定(ELISA)评估降低的变应原性,免疫印迹,和嗜碱性粒细胞激活试验.根据患者外周血单核细胞(PBMC)中的细胞因子表达评估了对低变应原性Derf36和Derf36的T细胞反应。通过分别用低变应原性Derf36和Derf36进行兔免疫来评估和比较免疫原性。还检查了阻断IgG抗体对Derf36变应原的特异性IgE结合活性和嗜碱性粒细胞活化的抑制作用。
    最终选择的非过敏性B细胞表位是25-48、57-67、107-112、142-151和176-184。低变应原性Derf36显示IgE结合活性显著降低。使用低变应原性Derf36研究了IgE与Derf36结合的竞争性抑制,只能实现20%的抑制,与Derf36(98%)的抑制作用相比,大大降低了。低变应原性Derf36表现出与阴性对照相似的低嗜碱性粒细胞刺激比,它可以诱导PBMC中IFN-γ的水平升高,而不是Th2细胞因子IL-5和IL-13的水平升高。疫苗特异性兔阻断IgG抗体可抑制患者Derf36的IgE结合和嗜碱性粒细胞刺激活性。
    这项研究代表了AI策略的首次应用,以促进基于B细胞表位的低变应原性Derf36疫苗的开发,由于其降低的变应原性和诱导IgG阻断的高免疫原性,它可能成为HDM过敏患者的有前途的免疫疗法。
    The house dust mite (HDM) is widely recognized as the most prevalent allergen in allergic diseases. Allergen-specific immunotherapy (AIT) has been successfully implemented in clinical treatment for HDM. Hypoallergenic B-cell epitope-based vaccine designed by artificial intelligence (AI) represents a significant progression of recombinant hypoallergenic allergen derivatives.
    The three-dimensional protein structure of Der f 36 was constructed using Alphafold2. AI-based tools were employed to predict B-cell epitopes, which were subsequently verified through IgE-reaction testing. Hypoallergenic Der f 36 was then synthesized, expressed, and purified. The reduced allergenicity was assessed by enzyme-linked immunosorbent assay (ELISA), immunoblotting, and basophil activation test. T-cell response to hypoallergenic Der f 36 and Der f 36 was evaluated based on cytokine expression in the peripheral blood mononuclear cells (PBMCs) of patients. The immunogenicity was evaluated and compared through rabbit immunization with hypoallergenic Der f 36 and Der f 36, respectively. The inhibitory effect of the blocking IgG antibody on the specific IgE-binding activity and basophil activation of Der f 36 allergen was also examined.
    The final selected non-allergic B-cell epitopes were 25-48, 57-67, 107-112, 142-151, and 176-184. Hypoallergenic Der f 36 showed significant reduction in IgE-binding activity. The competitive inhibition of IgE-binding to Der f 36 was investigated using the hypoallergenic Der f 36, and only 20% inhibition could be achieved, which is greatly reduced when compared with inhibition by Der f 36 (98%). The hypoallergenic Der f 36 exhibited a low basophil-stimulating ratio similar to that of the negative control, and it could induce an increasing level of IFN-γ but not Th2 cytokines IL-5 and IL-13 in PBMCs. The vaccine-specific rabbit blocking IgG antibodies could inhibit the patients\' IgE binding and basophil stimulation activity of Derf 36.
    This study represents the first application of an AI strategy to facilitate the development of a B-cell epitope-based hypoallergenic Der f 36 vaccine, which may become a promising immunotherapy for HDM-allergic patients due to its reduced allergenicity and its high immunogenicity in inducing blocking of IgG.
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  • 文章类型: Journal Article
    关于胸腺B细胞的研究在文献中很少,但是有人认为它们可以对免疫系统发挥调节和调节功能。胸腺B细胞可以在调节世界范围内最常见的过敏背景中起一定作用,由螨翼状尘螨(Derp)诱发的特应性。这里,我们的目的是评估Der特应性个体产生的多克隆IgG谱是否会影响来自7天以下非特应性儿童的人胸腺B的归巢和细胞因子谱.为了这个目的,我们生产了多克隆IgG制剂并在其存在下培养了人胸腺细胞。我们还评估了IgG亚类以及IgG与胸腺B细胞膜的直接相互作用。我们的结果可以证明,与模拟条件相比,Derp-特异性IgG不能降低α4β7归巢分子的表达,如在响应其他IgG制剂时观察到的,并且可以降低产生IFN-γ和IL-9的胸腺B细胞的频率。与对照条件相比,Derp-异位IgG还可以诱导胸腺产生IL-10的B细胞。来自Derp-特应性个体的IgG未能减少产生IL-13的胸腺B细胞的数量,与模拟条件相比,与其他IgG制剂观察到的减少不同。所有IgG制剂具有相似水平的IgG亚类并直接与胸腺B细胞膜相互作用。最后,我们使用未观察到IgG效应的外周非特应性B细胞进行了实验.总之,我们的观察表明,在过敏个体中诱导的IgG可以调节非特应性胸腺B细胞,可能产生易于过敏发展的胸腺B细胞,这似乎不会发生在成熟的B细胞中。
    Studies about thymic B cells are scarce in the literature, but it was suggested that they can exert modulatory and regulatory functions on the immune system. Thymic B cells can play some role in regulating the most frequent allergic background worldwide, the atopy induced by the mite Dermatophagoides pteronyssinus (Der p). Here, we aimed to evaluate if the polyclonal IgG repertoire produced by Der p-atopic individuals can influence the homing and cytokine profile of human thymic B derived from non-atopic children aged less than seven days. With this purpose, we produced polyclonal IgG formulations and cultivated human thymocytes in their presence. We also assessed IgG subclasses and the direct interaction of IgG with thymic B cell membranes. Our results could demonstrate that Der p-atopic IgG could not reduce the expression of α4β7 homing molecule as observed in response to the other IgG formulations and could reduce the frequency of IFN-γ- and IL-9-producing thymic B cells compared to the mock condition. Der p-atopic IgG could also induce thymic IL-10-producing B cells compared to control conditions. The IgG derived from Der p-atopic individuals failed to diminish the population of IL-13-producing thymic B cells, unlike the reduction observed with other IgG formulations when compared to the mock condition. All IgG formulations had similar levels of IgG subclasses and directly interacted with thymic B cell membranes. Finally, we performed experiments using peripheral non-atopic B cells where IgG effects were not observed. In conclusion, our observation demonstrates that IgG induced in allergic individuals can modulate non-atopic thymic B cells, potentially generating thymic B cells prone to allergy development, which seems to not occur in mature B cells.
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  • 文章类型: Journal Article
    背景:目前尚不清楚致敏模式是否能将重度复发性喘息(SRW)/重度哮喘(SA)患儿与非重度复发性喘息(NSRW)/非重度哮喘(NSA)患儿区分开来。我们的目的是确定致敏模式是否可以区分NSRW/NSA的法国COBRAPed队列和SRW/SA的儿童。
    方法:分析了125名学龄前儿童(3-6岁)和170名学龄儿童(7-12岁)的112种成分(c-sIgE)(ImmunoCAP®ISAC)的IgE。采用监督分析和聚类方法来确定c-sIgE阳性儿童的致敏模式。
    结果:我们在51%的学龄前儿童和75%的学龄儿童中观察到c-sIgE致敏。NSRW对室内尘螨(HDM)成分的敏感性高于SRW(53%vs.24%,p<.01)。在SA中,对非特异性脂质转移蛋白(nsLTP)成分的敏感性高于NSA(16%vs.4%,p<.01)并与FEV1/FVC<-1.64z分数相关。在敏感的儿童中,确定了七个具有不同模式的集群。在每个年龄组中确定的两个更广泛的集群的特征是几乎没有敏感,主要是HDM。“具有多个敏化的一个簇(n=4),主要是草花粉,HDM,PR-10和nsLTP与学龄儿童的SA相关。
    结论:尽管患有喘息/哮喘的儿童表现出频繁发生和高水平的致敏,致敏模式没有提供强烈的信号来区分患有严重疾病的儿童和患有轻度疾病的儿童。这些结果表明,喘息/哮喘的严重程度可能取决于IgE和非IgE介导的机制。
    BACKGROUND: It is unclear whether sensitization patterns differentiate children with severe recurrent wheeze (SRW)/severe asthma (SA) from those with non-severe recurrent wheeze (NSRW)/non-severe asthma (NSA). Our objective was to determine whether sensitization patterns can discriminate between children from the French COBRAPed cohort with NSRW/NSA and those with SRW/SA.
    METHODS: IgE to 112 components (c-sIgE) (ImmunoCAP® ISAC) were analyzed in 125 preschools (3-6 years) and 170 school-age children (7-12 years). Supervised analyses and clustering methods were applied to identify patterns of sensitization among children with positive c-sIgE.
    RESULTS: We observed c-sIgE sensitization in 51% of preschool and 75% of school-age children. Sensitization to house dust mite (HDM) components was more frequent among NSRW than SRW (53% vs. 24%, p < .01). Sensitization to non-specific lipid transfer protein (nsLTP) components was more frequent among SA than NSA (16% vs. 4%, p < .01) and associated with an FEV1/FVC < -1.64 z-score. Among sensitized children, seven clusters with varying patterns were identified. The two broader clusters identified in each age group were characterized by \"few sensitizations, mainly to HDM.\" One cluster (n = 4) with \"multiple sensitizations, mainly to grass pollen, HDM, PR-10, and nsLTP\" was associated with SA in school-age children.
    CONCLUSIONS: Although children with wheeze/asthma display frequent occurrences and high levels of sensitization, sensitization patterns did not provide strong signals to discriminate children with severe disease from those with milder disease. These results suggest that the severity of wheeze/asthma may depend on both IgE- and non-IgE-mediated mechanisms.
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  • 文章类型: Observational Study
    背景:德国治疗变应原条例(TAO)引发了房屋尘螨(HDM)变应原免疫疗法(AIT)产品市场的持续动荡。三种HDM皮下AIT(SCIT)产品在德国获得批准,因此将在计划于2026年完成TAO程序后上市。总的来说,有关HDMAIT长期有效性的临床试验数据很少.我们在回顾性研究中评估了真实世界数据(RWD),基于纵向索赔数据库的观察性队列研究,该数据库包括所有德国法定医疗保健处方的60%,以显示其中一种产品在日常生活中的长期有效性。此分析的目的是根据AIT国际准则的要求,提供对螨AIT有效性的每种产品分析。
    方法:纳入了在2009年至2013年期间使用天然HDM产品(SCIT组)接受首次(索引)SCIT处方的5至70岁受试者。正好3:1匹配的对照组仅接受有症状的AR药物的处方(非AIT组);长达6年随访的评估期于2017年2月结束。研究终点是过敏性鼻炎(AR)和哮喘的进展,至少2年治疗后哮喘发生和哮喘发作时间。
    结果:总计,SCIT组包括892名受试者(608名成人和284名儿童/青少年),非AIT组包括2676名受试者(1824名成人和852名儿童/青少年)。在SCIT至少2年后的随访期间,对于AR药物,SCIT组的处方数量减少了62.8%(p<.0001),对于哮喘药物,则减少了42.4%(p=.0003).SCIT与非AIT组的新发哮喘风险显著降低27.0%(p=.0212)。SCIT的哮喘预防作用发生在治疗开始后15个月。在SCIT组中,与非AIT组相比,哮喘发作时间延长(p=.0010).
    结论:在使用原生HDM产品对SCIT进行的第一个基于RWD的产品分析中,5~70岁的患者在接受至少2年治疗后,AR和哮喘进展减少,长期受益于AIT.效果似乎在治疗终止后持续长达6年。观察到哮喘发作的风险显着降低,治疗15个月后开始。
    The German Therapy Allergen Ordinance (TAO) triggered an ongoing upheaval in the market for house dust mite (HDM) allergen immunotherapy (AIT) products. Three HDM subcutaneous AIT (SCIT) products hold approval in Germany and therefore will be available after the scheduled completion of the TAO procedure in 2026. In general, data from clinical trials on the long-term effectiveness of HDM AIT are rare. We evaluated real-world data (RWD) in a retrospective, observational cohort study based on a longitudinal claims database including 60% of all German statutory healthcare prescriptions to show the long-term effectiveness of one of these products in daily life. Aim of this analysis was to provide a per product analysis on effectiveness of mite AIT as it is demanded by international guidelines on AIT.
    Subjects between 5 and 70 years receiving their first (index) prescription of SCIT with a native HDM product (SCIT group) between 2009 and 2013 were included. The exactly 3:1 matched control group received prescriptions for only symptomatic AR medication (non-AIT group); the evaluation period for up to 6 years of follow-up ended in February 2017. Study endpoints were the progression of allergic rhinitis (AR) and asthma, asthma occurrence and time to the onset of asthma after at least 2 treatment years.
    In total, 892 subjects (608 adults and 284 children/adolescents) were included in the SCIT group and 2676 subjects (1824 adults and 852 children/adolescents) in the non-AIT group. During the follow-up period after at least 2 years of SCIT, the number of prescriptions in the SCIT group was reduced by 62.8% (p < .0001) for AR medication and by 42.4% for asthma medication (p = .0003). New-onset asthma risk was significantly reduced in the SCIT vs non-AIT group by 27.0% (p = .0212). The asthma-preventive effect of SCIT occurred 15 months after start of the treatment. In the SCIT group, the time to onset of asthma was prolonged compared to the non-AIT group (p = .0010).
    In this first product based RWD analysis on SCIT with a native HDM product, patients aged 5 to 70 years benefited from AIT in the long term in terms of reduced progression of AR and asthma after at least 2 years of treatment. The effects seemed to last for up to 6 years after treatment termination. A significantly reduced risk of asthma onset was observed, starting after 15 months of treatment.
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