Application of Nanoparticles for Immunotherapy of Allergic Rhinitis

Li K, Jin J, Yang Y, Luo X, Wang Y, Xu A, Hao K, Wang Z. Int J Nanomedicine. 2024 Nov 18;19:12015-12037. doi: 10.2147/IJN.S484327. 

Abstract: 

Graphical abstract

Allergen Immunotherapy (AIT) is the only etiological therapeutic method available for allergic rhinitis (AR). Currently, several options for AIT in the market, such as subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT), have different routes of administration. These traditional methods have achieved encouraging outcomes in clinic. However, the side effects associated with these methods have raised the need for innovative approaches for AIT that improve safety, shorten the course of treatment and increase local drug concentration. Nanoparticles (NPs) are particles ranging in size from 1 to 100 nm, which have been hired as potential adjuvants for AIT. NPs can be employed as agents for modulating immune responses in AR or/and carriers for loading proteins, peptides or DNA molecules.

Efficacy of probiotics as adjuvant therapy in bronchial asthma: a systematic review and meta-analysis

Balan, D., Baral, T., Manu, M.K. et al. Allergy Asthma Clin Immunol 20, 60 (2024). https://doi.org/10.1186/s13223-024-00922-7

Abstract

Background

Asthma is a chronic, heterogeneous disease characterized by airway inflammation. Asthma exacerbations significantly increase the disease burden, necessitating new therapeutic approaches. Emerging evidence suggests probiotics, through the gut-lung axis, may benefit asthma management by modulating immune responses and reducing inflammation.

Methods

This systematic review and meta-analysis adhered to PRISMA guidelines and was registered with PROSPERO (CRD42023480098). A comprehensive search of PubMed, Scopus, Web of Science, and Embase was conducted up to March 2024. Inclusion criteria encompassed randomized controlled trials (RCTs) evaluating probiotic interventions in asthma patients. Statistical analysis was done using RevMan 5.3, with odds ratios (OR) and 95% confidence intervals (CI) calculated, and heterogeneity assessed using I2 statistics.

Results

Forest plot for asthma control test

Twelve RCTs, comprising 1401 participants, met the inclusion criteria. The probiotic strains investigated included various Lactobacillus and Bifidobacterium species. Meta-analysis revealed significant improvements in asthma control test scores (OR 1.18, 95% CI: 1.18–3.64, p = 0.0001) following probiotic supplementation. Probiotics also improved fractional exhaled nitric oxide (FeNO) in one study, but pooled FeNO and eosinophil data were not statistically significant (p = 0.46 and p = 0.29, respectively). One study observed fewer asthma exacerbations in the probiotic group (24/212) compared to placebo (67/210), with no difference in exacerbation duration.

Conclusion

Probiotic supplementation may be beneficial in improving asthma symptom control with no significant impact on lung function indices or eosinophil levels. Probiotics can be a potential adjunctive therapy in asthma management, particularly for asthma symptom control.

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Pathogenesis and Key Cells in Allergic Rhinitis

He Y, Chen Y, Xu S, Luo Y, Qin F, Hu W. Int Arch Allergy Immunol. 2024 Nov 19:1-12. doi: 10.1159/000541666.

Abstract

a, b Key cells in AR and their pathology.

Background: Allergic rhinitis (AR) is one of the most common chronic diseases worldwide, with prevalence rates as high as 50% in high-income countries. Patients with AR often have symptoms such as runny nose, itchy nose, nasal congestion, sneezing, and signs of edema and pallor of the nasal mucosa, and these pathologies have a major impact on the patient’s learning, sleep, and quality of life, often resulting in significant pain and a huge economic burden for the patient.

TNF-α inhibitors as therapy for drug-induced severe cutaneous adverse reactions: a case series

Chu Y, Xu M, Dong X, Zhou J. J Dermatolog Treat. 2024 Dec;35(1):2422924. doi: 10.1080/09546634.2024.2422924. 

Abstract

Process of the 40-year-old male patient diagnose as TEN.

Background: Severe cutaneous adverse reactions (SCARs) including acute generalized exanthematous pustulosis (AGEP), drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS) and its related diseases, and toxic epidermal necrolysis (TEN) are of great concern due to their high mortality rates. While systemic corticosteroids have been widely used to treat SCARs, their efficacy has been debated due to the increased risk of infection. In recent years, tumor necrosis factor (TNF)-α inhibitors have emerged as a new therapeutic option.

Objectives: This study aimed to report the clinical outcomes of different types of SCARs treated with TNF-α inhibitors.

EAACI guidelines on the management of IgE-mediated food allergy

Santos AF, Riggioni C, Agache I, et al. Allergy. 2024; 00: 1-23. doi:10.1111/all.16345

Abstract

Management of IgE-mediated food allergy.

This European Academy of Allergy and Clinical Immunology (EAACI) guideline provides recommendations for the management of IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Following the confirmation of IgE-mediated food allergy diagnosis, allergen avoidance and dietary advice (with support of a specialised dietitian, if possible) together with the provision of a written treatment plan, education on the recognition of allergic symptoms and prescription of medication including adrenaline using an auto-injector are essential.

Idiopathic Hypereosinophilic Syndrome Presenting as Eosinophilic Hepatitis

Drake Seccurro, Debra W. Yen, Yashu Dhamija, et al. AIM Clinical Cases.2024;3:e240539. [Epub 19 November 2024]. doi:10.7326/aimcc.2024.0539

Abstract

Idiopathic hypereosinophilic syndrome (IHES) is defined by peripheral eosinophilia of more than 1500 eosinophils/µL for a 6-month duration with signs of organ involvement in the absence of parasitic infection, allergic reaction, or other recognized causes of eosinophilia. 

Portal inflammation with eosinophilic infiltration.

It is known to affect multiple organs with activated eosinophils that may lead to organ failure. Thirty percent of patients have liver involvement described as hepatomegaly and mildly elevated liver enzymes. We describe a rare case in which IHES was diagnosed after our patient presented with isolated acute hepatitis and was found to have peripheral eosinophilia and prominent eosinophils on liver biopsy.

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Roflumilast Cream, 0.15%, for Atopic Dermatitis in Adults and Children INTEGUMENT-1 and INTEGUMENT-2 Randomized Clinical Trials

Simpson EL, Eichenfield LF, Alonso-Llamazares J et al. JAMA Dermatol. 2024;160(11):1161-1170. doi:10.1001/jamadermatol.2024.3121

Key Points

Question  What is the efficacy and safety of once-daily roflumilast cream, 0.15%, in patients with atopic dermatitis (AD)?

Findings  In 2 phase 3 randomized clinical trials of 1337 individuals with AD, significantly more patients treated with once-daily roflumilast cream, 0.15%, achieved Validated Investigator Global Assessment for Atopic Dermatitis success at 4 weeks than patients treated with vehicle cream. Roflumilast was well tolerated with low rates of adverse events in both trials.

Meaning  An effective, well-tolerated, once-daily, nonsteroidal treatment like roflumilast cream, 0.15%, may address several unmet needs and substantially improve the treatment landscape for patients with AD.

Abstract

Importance  Safe, effective, and well-tolerated topical treatment options available for long-term use in patients with atopic dermatitis (AD) are limited and associated with low adherence rates.

Allergen Immunotherapy for a Year Can Effectively Reduce the Risk of Postoperative Recurrence of Adenoid Hypertrophy in Children with Concurrent Allergic Rhinitis (IMPROVEII)

 Hua HL, Deng YQ, Tang YC, Wang Y, Tao ZZ.  J Asthma Allergy. 2024;17:1115-1125

https://doi.org/10.2147/JAA.S477376

Abstract:

Background: Adenoid hypertrophy (AH) and allergic rhinitis (AR) are common pediatric diseases, seriously affecting the quality of life and growth of children. The recurrence rate of AH is higher for patients with than for those without concurrent AR. Allergen specific immunotherapy (AIT) is the only effective therapy for modifying the course of allergic diseases. This study sought to investigate the efficacy of AIT in preventing AH recurrence in patients with AR who underwent adenoidectomy.

Methods: This study included 134 children aged 5– 12 years with concurrent AH and AR. They were separated into the subcutaneous immunotherapy (SCIT) group treated with a double-mite allergen preparation or the non-AIT group treated symptomatically with only medications. The adenoid/nasopharyngeal ratio at one year after adenoidectomy was used to assess AH recurrence.