Psychological Stress and Urticaria: Pathophysiologic and Therapeutic Updates

Xiang, YK., Türk, M., Ojeda, I.C. et al. Curr Treat Options Allergy 11, 194–210 (2024). https://doi.org/10.1007/s40521-024-00375-8

Abstract

Purpose of review

The goal of this review is to examine the relationship between psychological stress and chronic urticaria (CU), focusing on the underlying mechanisms and potential therapeutic interventions. The paper seeks to answer how stress exacerbates CU and the neuro-immunological pathways involved, providing insight into improving therapeutic strategies by considering the psychological dimensions of the disease.

Recent findings

Recent studies highlight the significant role of stress in aggravating CU through the dysregulation of the hypothalamic-pituitary-adrenal axis and neurogenic inflammation. Increased levels of neuropeptides like substance P and calcitonin gene-related peptide, as well as upregulated expression of the MRGPRX2 receptor, are implicated in the neuro-immune interactions that worsen CU symptoms.

OM-85 attenuates high-fat diet-induced obesity, insulin resistance, gut dysbiosis and nonalcoholic steatohepatitis in a murine model

Hewady S, Manuel CR, Pasquali C, Koya J, Reznik SE. Biomed Pharmacother. 2024 Dec 2;181:117710. doi: 10.1016/j.biopha.2024.117710.

Highlights

• OM-85 prevents obesity and insulin resistance in high-fat diet mice.

• OM-85 alters the intestinal microbiome and prevents gut dysbiosis.

• OM-85 attenuates non-alcoholic steatohepatitis.

• Immune modulators should be explored for their therapeutic effects on metabolism.

Graphical Abstract

Abstract

Background

Obesity is a global epidemic that is tied to a wide range of human disorders. Chronic consumption of a high-fat diet is linked to disruption of the intestinal microbiome, which drives obesity-related pathophysiology. Broncho-Vaxom® (OM-85), a bacterial lysate used for prophylaxis of recurrent respiratory tract infections, has both immunostimulatory and immunomodulatory functions.

Methods

Male C57Bl/6 mice were maintained on normal control vs. high-fat diets for 8 weeks and treated or untreated with OM-85 or with the probiotic Lactobacillus plantarum,

Perceptions of the impact of individual allergic rhinitis symptoms: A survey of ARIA clinical experts

Gil-Mata, SaraAsllani, Julijana et al.

World Allergy Organization Journal, Volume 17, Issue 12, 100999

Abstract

Background

Allergic rhinitis (AR) is a highly prevalent disease. We aimed to assess the symptoms that physicians who see patients with AR perceive as the most bothersome in their patients.

Methods

We performed a cross-sectional study based on an online questionnaire sent to all members of the Allergic Rhinitis and its Impact on Asthma (ARIA) initiative. The survey included questions on the physicians' perceptions of patients’ AR symptoms as well as of their own AR symptoms.

Results

Most frequent (A) and most bothersome (B and C) allergic rhinitis
symptoms perceived in patients by ARIA members
and reported by ARIA members.

Among 401 respondents, 155 (38.7%) reported having AR. ARIA members reported nasal symptoms to be the most frequent (89.7%) and bothersome (80.0%) symptoms experienced by themselves. Likewise, nasal symptoms were reported by ARIA members as the most frequent (94.8% in members with AR vs 96.0% in members without AR) and bothersome (57.0% in members with AR vs 67.9% in members without AR) in their patients.

Allergen-Specific Immunotherapy and Trained Immunity

Martín-Cruz, L. and Palomares, O. (2024). Allergy. https://doi.org/10.1111/all.16423

ABSTRACT

The high prevalence of allergic diseases reached over the last years is attributed to the complex interplay of genetic factors, lifestyle changes, and environmental exposome. Allergen-specific immunotherapy (AIT) is the single therapeutic strategy for allergic diseases with the potential capacity to modify the course of the disease. Our knowledge of the mechanisms involved in allergy and successful AIT has significantly improved. Recent findings indicate that long-term allergen tolerance upon AIT discontinuation not only relies on the generation of proper adaptive immune responses by the generation of allergen-specific regulatory T and B cells enabling the induction of different isotypes of blocking antibodies but also relies on the restoration of proper innate immune responses.

Mechanisms underlying trained immunity (TRIM).

Trained immunity (TRIM) is the process by which innate immune cells acquire memory by mechanisms depending on metabolic and epigenetic reprogramming, thus conferring the host with increased broad protection against infection.

Appropriate Allergic Rhinitis Medications Can Reduce Systemic Steroid Requirement and Prevent Rhinosinusitis

Byun MK, Yang WJ, Choi YJ et al.  J Clin Med. 2024 Nov 13;13(22):6809. doi: 10.3390/jcm13226809. 

Abstract

Forest plot for clinical outcomes compared
to other AR medication group.

Background: Allergic rhinitis (AR) is quite common and sometimes it requires systemic steroids and can be accompanied by coronavirus disease-2019 (COVID-19), rhinosinusitis, or asthma. We aimed to determine the comparative effect of different types of AR medications on clinical prognosis in real-world settings. Methods: We used national claims data provided by the National Health Insurance Service in the Republic of Korea. We enrolled 275,895 adult patients who were first diagnosed with AR and started AR medications between 1 January 2018 and 31 December 2018. We classified them into five groups according to the type of AR medication prescribed and analyzed their 3-year follow-up data.

When patient-reported respiratory symptoms shed light on pathophysiology in adult asthma: a cross-sectional study

Louis G, Pétré B, Sousa-Pinto B, Bousquet J, Van Ganse É, Schleich F, Louis R. Sci Rep. 2024 Dec 2;14(1):29997. doi: 10.1038/s41598-024-81745-9. 

Abstract

Schematic representation of the relationship between demographics, f
functional, inflammatory features and asthma symptoms.
+Corresponds to a positive association,
while −corresponds to a negative association.

While studies have demonstrated the impact of asthma symptoms on quality of life, very few studies have investigated the relationship between detailed asthma symptoms, as reported by the patient, and lung function and inflammation. A cross-sectional study was conducted on treated (ICS/LABA) adult (> 18 years) asthma patients recruited from the Liege University Hospital Asthma Clinic (Belgium) between 2018 and 2023 (n = 505).

Infertility, IL-17, IL-33 and Microbiome Cross-Talk: The Extended ARIA-MeDALL Hypothesis

Hamamah, S.; Barry, F.; Vannier, S.; Anahory, T.; Haahtela, T.; Antó, J.M.; Chapron, C.; Ayoubi, J.-M.; Czarlewski, W.; Bousquet, J.  Int. J. Mol. Sci. 2024, 25, 11981. https://doi.org/10.3390/ijms252211981

Abstract

Putative mechanisms between microbiome and diseases.

Infertility, defined as the inability to obtain pregnancy after 12 months of regular unprotected sexual intercourse, has increased in prevalence over the past decades, similarly to chronic, allergic, autoimmune, or neurodegenerative diseases. A recent ARIA-MeDALL hypothesis has proposed that all these diseases are linked to dysbiosis and to some cytokines such as interleukin 17 (IL-17) and interleukin 33 (IL-33).

Correlation between systemic allergen desensitisation and long-term asthma protection in mice following intravenous administration of the live tuberculosis vaccine MTBVAC

Calvo, Silvia et al. eBioMedicine, Volume 107, 105272

Summary

Background

MTBVAC is a live attenuated tuberculosis vaccine, currently undergoing phase III evaluation for tuberculosis prevention. In previous preclinical studies, we found that local pulmonary administration of MTBVAC via the intranasal route had a strong therapeutic effect against asthma. This effect correlated with the abrogation of allergen-specific Th2 response in the lungs.

Methods

Using different mouse models of asthma, we investigated the effect of MTBVAC administered by intravenous (IV) route and its potential as immunotherapeutic agent to induce desensitisation of allergen-specific responses at a systemic level. We explored the effects of this process in the efficacy against airway hyperresponsiveness (AHR) induced by exposure to different allergens.

Findings

IV MTBVAC efficacy in two models
of established asthma

IV MTBVAC was highly efficient at reducing AHR induced by different allergens.