Search Results (345)

Whether the spongiotic reaction caused by the interaction of keratinocytes, T-lymphocytes, inflammatory dendritic epidermal cells (IDECs), and Langerhans cells (LCs) observed in atopic dermatitis (AD) represents a common feature of spongiosis in various skin diseases remains unclear. We analyzed the characteristics of spongiosis in AD compared with those in other eczematous dermatitis and inflammatory skin diseases by using immunohistochemical methods. Infiltration of IDECs (CD11c+ cells and/or CD206+ cells) and T-lymphocytes, accompanied by degenerated keratinocytes and aggregated LCs (CD207+ cells), was frequently observed as a common feature of spongiosis in multiple conditions. However, IDECs expressing IgE were identified exclusively in IgE-mediated AD. Aggregation of IDECs was predominantly observed in the spongiosis of adaptive immune-mediated eczematous disorders, such as AD and allergic contact dermatitis. These IDEC aggregations constituted the major components of the epidermal dendritic cell clusters seen in AD and other eczematous or eczematoid dermatoses, and may serve as a useful distinguishing marker from Pautrier collections seen in cutaneous T-cell lymphoma. These findings suggest that IDECs, in cooperation with other immune cells, may play a pivotal role in spongiosis formation in AD and various skin diseases, although the underlying immunopathological mechanisms differ among these conditions. Full article

Asthma is defined as a chronic respiratory disease, the processes of which are mainly related to the hyperreactivity of the immune system. Airway hyperresponsiveness and remodeling are other hallmarks of asthma that are strongly involved in the progression of the disease. Moreover, asthma is associated with the occurrence of atopic dermatitis, chronic sinusitis, allergic rhinitis, and a high profile of T2-type cytokines, such as IL-4, IL-5 and IL-13. The hyperresponsiveness of the immune system is a consequence of aberrant levels of alarmins, endogenous molecules that induce pro-inflammatory responses. They are released as a result of a defect or cell death, leading to the initiation of an inflammatory reaction. High-mobility group box 1 (HMGB1), S100 proteins, interleukin-33 (IL-33), thymic stromal lymphopoietin (TSLP), and IL-25 bind to various receptors, influencing the behavior of immune cells, resulting in stimulated migration and activation of these cells. In this review, we will discuss the potential role of alarmins in the pathogenesis of asthma. Full article

Background/Objectives: The role of maternal diet in atopic dermatitis (AD) requires better understanding, as AD often manifests early in life and precedes other allergic diseases. We evaluated the association between maternal diet and AD up to 2 years of age. Methods: A total of 116 mother–child dyads from the CARE birth cohort study were included. Maternal diet during pregnancy was assessed with a validated self-administered 97-item food frequency questionnaire, and dietary scores were calculated. AD was evaluated at ages 4 months, 1 year, and 2 years. The associations between maternal dietary patterns and AD were examined by logistic regression analysis adjusting for total energy intake, gender of the child, maternal antibiotic therapy during pregnancy, and history of atopic disease among both parents. Results: Of the 116 children, 27 (23.3%) developed AD by 2 years, 11 of whom (40.7%) had persistent AD within the first 2 years. AD risk was reduced with a higher Mediterranean diet score during pregnancy (upper median > 3 points versus lower median: adjusted OR 0.24, 95% CI 0.08–0.69, p = 0.009) and with greater dietary diversity, as measured by the number of items consumed (upper median > 53 items versus lower median: OR 0.19, 95% CI 0.06–0.58, p = 0.005). No association was found with macronutrients and micronutrients. Red meat consumption showed a positive association with the persistent AD phenotype (adjusted OR 5.04, 95% CI 1.47 to 31.36, p = 0.034). Conclusions: Adherence to a Mediterranean diet and a diverse diet during pregnancy may decrease the risk of developing early childhood AD. This highlights the synergistic role of nutrients in dietary patterns as they modulate immune development and disease susceptibility. Full article

Background/Objectives: Atopic dermatitis (AD) is a chronic inflammatory skin condition with rising global prevalence. Increasing maternal antibiotic use during pregnancy has raised concerns about its potential link to childhood allergic diseases, including AD. However, existing meta-analyses have yielded inconsistent results. A systematic review and meta-analysis were conducted to investigate the association between prenatal antibiotic exposure, including intrapartum antibiotic prophylaxis (IAP), and the risk of AD developing in offspring. Methods: A systematic search protocol (PROSPERO ID: CRD42024577804) was conducted up to 29 August 2024, across the PubMed, Embase, and Cochrane databases. Cohort and case–control studies reporting associations between maternal antibiotic exposure during pregnancy or intrapartum and the risk of AD in offspring were included. Data were analyzed using RevMan Web and Comprehensive Meta-Analysis software. Results: Twenty studies involving 3,256,929 mother–child pairs were reviewed. The meta-analysis data demonstrated that prenatal antibiotic exposure was associated with AD in the main analysis (odds ratio [OR]: 1.12, 95% CI 1.03–1.21), but not in a separate analysis with a pooled hazard ratio (HR) (HR: 1.12, 95% CI 0.96–1.31). Trim-and-fill correction for significant publication bias (Egger’s test p = 0.003) in the main analysis resulted in a non-significant effect size (OR: 1.09, 95% CI 0.99–1.20). Subgroup analysis and meta-regression suggested that publication years and sample sizes contributed significant heterogeneity (p < 0.05). Regarding IAP and the risk of AD, no association was found (OR: 1.62, 95% CI 0.87–3.00). Conclusions: Current evidence in the existing literature does not support a positive relationship between antibiotic exposure, either during pregnancy or in the intrapartum period, and the risk of development of AD in offspring. However, substantial heterogeneity and the very low certainty of evidence limit the strength of our findings. Further studies that address confounders more thoroughly are needed to confirm these results. Full article

The gut microbiota plays a crucial role in early-life development, influencing various aspects of health and disease. Dysbiosis, an imbalance in the gut microbiota, has been linked to multiple health conditions, including allergies, asthma, and obesity. In early life, the gut microbiota plays a key role in the development and maturation of the immune system. Probiotics, live microorganisms that confer health benefits when administered in adequate amounts, have emerged as a potential treatment approach for dysbiosis in early life. Dysbiosis can alter the resistance to pathogens, promoting atopic diseases, food sensitization, and infections such as necrotizing enterocolitis (NEC). Probiotics have been shown to modulate the composition and function of the gut microbiota in the perinatal and infant periods. They can increase the abundance of beneficial bacteria, such as Bifidobacteria and Lactobacilli, and reduce the levels of potentially harmful bacteria. Not all probiotics are created equal. The effects of probiotics can vary depending on the specific strain used. Probiotics have also been investigated for their potential benefits in other areas of infant health, such as reducing the risk of respiratory infections and improving growth and development. This review aims to analyze the current data in the literature and to evaluate the health benefits of probiotic administration in early life. Several studies have investigated the use of probiotics in preventing or treating allergic diseases, such as eczema and food allergies. While some studies have shown promising results, more research is needed to fully understand the benefits and risks of probiotics in early life. In conclusion, using probiotics to prevent dysbiosis-related conditions may be considered a method of ‘programming’ the individual for optimal health maintenance. Full article

Background: Cardiovascular disorders, especially atherosclerosis, have been associated with allergic inflammation. In addition to traditional inflammatory responses, there is evidence that the development and instability of coronary artery plaque may be influenced by effector cells of allergic inflammation. This review examines the phases of allergic pathology, the immunological mechanisms of atherosclerosis, and the clinical link between allergic diseases (asthma, atopic dermatitis, allergic rhinitis, and food allergy) and cardiovascular disease (CVD), along with future therapeutic perspectives. Material and Method: A literature search was conducted in PubMed, Google scholar; ScienceDirect, Scopus, and studies published between 2014–2024 were taken into consideration. Keywords included allergic inflammation, eosinophils, mast cells, reactive oxygen species, atherosclerosis, Th2 cells, and cytokines. Epidemiological studies and review articles were included. Results: Emerging evidence suggests that allergic inflammation contributes to atherosclerosis through interconnected mechanisms such as eosinophil activation, reactive oxygen species production, mast cell degranulation, and endothelial dysfunction. Th2-driven immune responses, which are mediated by cytokines such as IL-4, IL-5, and IL-13, as well as eosinophil activity and mast cell degranulation, play a crucial role in vascular inflammation and plaque progression. Additionally, changes in lipid metabolism contribute to this process. Epidemiological studies support this connection, indicating that patients with chronic allergic conditions such as asthma, allergic rhinitis, food allergy, and atopic dermatitis experience increased cardiovascular morbidity. However, most current data are observational, and our understanding of the underlying mechanisms in humans remains limited, often relying on insights gained from preclinical models. Conclusions: A potential mechanism for cardiovascular risk is suggested by the interaction between atherosclerosis and allergic inflammation. Promising alternatives for treating allergic inflammation and cardiovascular issues include novel treatments like cytokine inhibitors, mast cell stabilizers, and biologics that target certain pathways. Further research is necessary to see whether concentrating on allergy pathways could lead to innovative treatments for cardiovascular disorders or vice versa. Full article

House dust mites (HDMs) are a major source of indoor allergens, significantly contributing to allergic rhinitis, asthma and atopic dermatitis. This review examines the epidemiology, microbiological classification and pathophysiology of HDM allergy, highlighting key allergens such as Der p 1, Der p 2 and Der p 23. Furthermore, we discuss the pivotal role of allergen-specific immunotherapy (AIT), the only disease-modifying treatment for immunoglobulin (Ig)-E disease. Recent studies have identified predictive biomarkers for allergen-specific immunotherapy (AIT) efficacy, including the specific IgE to total IgE (sIgE/tIgE) ratio and regulatory follicular T cell profiles, supporting a more personalized approach to therapy. Additionally, emerging immunotherapy strategies, such as recombinant allergens and peptide-based formulations, aim to improve safety and clinical outcomes. As HDM allergy prevalence rises globally, further research into optimizing diagnostics and treatment strategies remains crucial for enhancing patient care. Full article

Grass pollen allergies significantly contribute to atopic diseases such as asthma and allergic rhinitis, resulting in considerable healthcare burdens. Objective: In this study, molecular sensitization patterns to grass pollen in Swiss patients were addressed. The research utilized a retrospective cohort approach using ImmunoCAP™ ISAC testing from October 2015 to July 2020. Clinical histories, demographics, and skin prick test results were collected for analysis. The minimum patient age was 18 years and the average patient age was 41.3 years, with a female predominance (68.5%). In total, 4814 measurements were analyzed. Allergic rhinitis was the most common clinical symptom, followed by asthma and urticaria. A total of 1963 patients (40.8%) revealed sensitization to grass pollen. The most common sensitizations were found to the major allergens Phl p 1 (86%) and Phl p 5 (65%), but also to Phl p 4 (62%). Monosensitization was mostly found to allergens Phl p 1 (266/13.5%) and Phl p 4 (157/7.9%), and less so to Phl p 5 (33/1.7%). Notably, the Phl p 4-monosensitized subgroup showed only an 18% positivity rate in skin prick tests and presented mostly with urticaria. This study gives insights into the spectrum of grass pollen allergies in a Central European setting and underscores the possibly underestimated role of Phl p 4 among grass pollen allergens, especially in a subgroup that suffers mainly from seasonal urticaria. Monovalent sensitization to Phl p 4 can also cause seasonal rhinitis and might therefore be missed if only Phl p 1/p 5 are tested. A better understanding of sensitization patterns will further improve diagnosis and treatment options. Full article

Allergic diseases share a type 2 immune reaction and elevated oxidative stress, contributing to disease pathogenesis and exacerbations. Vitamin C (ascorbic acid), a fundamental exogenous antioxidant, has been hypothesized to attenuate these pathological mechanisms. This narrative review critically examined the most recent evidence concerning the role of vitamin C in preventing and managing allergic diseases, including asthma, allergic rhinitis, and atopic dermatitis. This narrative review consisted of three steps: conducting the search, reviewing abstracts and full texts, and discussing results. For this reason, we consulted the PubMed database to detect the pertinence of studies according to the review’s conduct. The final search ended in March 2025 and included English-language-based international articles, online reports, and electronic books. The keywords “vitamin C and allergic disease” and “vitamin C and immune system” were used. After the complete search, we read the abstracts to ensure that they concerned the topic of interest. Recent evidence suggests a protective role for vitamin C in asthma, with several studies reporting reduced oxidative stress markers, improved lung function, and decreased airway inflammation following regular intake or supplementation. Higher dietary vitamin C intake correlates with lower asthma prevalence and severity, particularly in pediatric populations. Conversely, the findings regarding allergic rhinitis and atopic dermatitis are heterogeneous. While topical ascorbic acid derivatives show promise in atopic dermatitis models, oral vitamin C intake does not appear to affect allergic rhinitis or dermatitis risk significantly. Vitamin C demonstrates potential as an add-on therapy in asthma management by attenuating oxidative stress and type 2 respiratory inflammation. However, its role in allergic rhinitis and atopic dermatitis remains less clear. Further multicentric, well-designed clinical trials are necessary to establish definitive guidelines for vitamin C supplementation in allergic disease management. Full article

Background/Objectives: The incidence of food allergies and other allergic diseases is rising. Emerging evidence links both antimicrobials and acid-suppressive therapy with gut dysbiosis, which is implicated in allergy development. We investigated the relationship between the use of acid-suppressive medications or antimicrobials in infancy and the risk of developing childhood allergic diseases. Methods: The US network in the TriNetX platform was used to identify patients prescribed proton pump inhibitors (PPIs), histamine-2 receptor antagonists (H₂RAs), antimicrobials ≥1, or antimicrobials ≥3 times during their first year of life from October 2015 to January 2022. ICD-10 diagnoses were used to assess two-year outcomes of anaphylaxis, food allergy, and atopic dermatitis. A sub-analysis in gastroesophageal reflux (GERD) patients was also performed. Results: Risks of anaphylaxis and food allergy increased with the prescription of PPIs (risk ratio [95% CI], 2.49 [1.40–4.41], 5.33 [4.97–5.71]), H₂RAs (4.48 [3.43–5.86], 4.21 [4.01–4.41]), and antimicrobials ≥1 (2.41 [2.13–2.72], 1.90 [1.86–1.94]), or ≥3 times (3.69 [3.12–4.37], 2.79 [2.70–2.88]). Risk of atopic dermatitis was increased in both H₂RA (1.41 [1.35–1.48]) and antimicrobial groups (2.25 [2.22–2.28], 3.35 [3.29–3.41]), but not in the PPI group. In the GERD sub-analysis, anaphylaxis risk was not significantly different, food allergy risk was increased in both PPI (2.30 [2.08–2.53]) and H₂RA groups (1.77 [1.63–1.92]), and atopic dermatitis decreased in the PPI group (0.76 [0.67–0.85]) but slightly increased in the H₂RA group (1.11 [1.03–1.20]). Conclusions: Exposure to acid-suppressive or antimicrobial medications during infancy was associated with increased risk of food allergy and anaphylaxis in early childhood. In infants diagnosed with GERD, exposure to acid-suppressive medications was still associated with increased food allergy risk. Full article

Background/Objectives: In recent years, due to the emergence of antimicrobial resistance, probiotics have been increasingly used during pregnancy and lactation with real maternal–fetal benefits. Probiotic intervention, especially multi-strain probiotics, due to their anti-inflammatory, metabolic, and immunomodulatory actions, can be performed prophylactically and therapeutically with promising results regarding maternal, fetal, and neonatal health. The administration of probiotics can modulate the maternal microbiome, regulate microflora imbalance in various conditions (overweight/obesity, gestational diabetes mellitus (GDM), preeclampsia, allergic diseases), and influence several reactions such as modulating the non-specific cellular immune system, metabolic processes, and inhibition of pathogens. This study aimed to analyze, based on available data, how the administration of probiotic supplements to women during pregnancy can modify immunometabolic responses to microbial dysbiosis to limit weight gain and the risk of obesity, to improve glucose homeostasis and reduce the risk of GDM, to prevent preeclampsia and its effects on maternal–fetal outcomes, and to reduce rates of atopic eczema and allergic diseases in infants. Methods: We performed a systematic search in MEDLINE/PubMed to identify studies that have investigated the effects of probiotic intervention on the immunometabolic response in pregnancy and lactation, especially in women with diabetes, overweight/obesity, preeclampsia, and allergic conditions. Results: Fifty-six RCT studies, totaling 15,044 women, matched the inclusion criteria, of which eight were for interventions on the immune response, twenty on allergic conditions, seven on obesity and excess weight gain in pregnancy, and twenty-one on GDM. Conclusions: Due to the heterogeneous structure and the size of the samples, the methodologies, formulations, moment of initiation, and study durations, future research is needed to establish their effectiveness and safety in pregnancy and lactation regarding maternal-fetal health and outcomes in childhood and adult life. Full article

Background/Objectives: Atopy and spondyloarthritis (SpA) are immune-mediated diseases driven by distinct T-helper (Th) cell pathways—Th2 for atopy and Th1/Th17 for SpA. The coexistence of these divergent immune responses is increasingly recognized, particularly in the context of biological therapies that target pro-inflammatory cytokines. This study aimed to investigate Th2 cytokine profiles (IL-4, IL-5, IL-13) in atopic SpA patients receiving biological therapy to better understand how such treatment may influence immune regulation in this complex clinical setting. Methods: We conducted a prospective observational cross-sectional study on 136 SpA patients stratified by biological therapy and atopy status. Serum IL-4, IL-5, and IL-13 levels were quantified using LUMINEX immunoassays. Patients were grouped into biologically treated (BT) and Bio-Naïve (BN) cohorts and further sub-categorized by atopic phenotype (allergic rhinitis, asthma, dermatitis). Statistical comparisons of cytokine levels were made using SPSS IBM version 26 to explore associations with clinical and demographic variables. Results: IL-13 levels were significantly elevated in BT-atopic patients, particularly those with allergic rhinitis and atopic dermatitis, suggesting biological therapy may modulate Th2 responses. IL-5 remained elevated in allergic asthma cases despite treatment, indicating persistent eosinophilic activity. No significant correlation was found between cytokine levels and disease duration or therapy length. Conclusions: Biological therapy in SpA may influence Th2 cytokine expression, notably IL-13, in atopic patients. These findings underscore the importance of immune profiling in guiding personalized treatment strategies and highlight the need for further investigation into the long-term immunomodulatory effects of biologics in patients with overlapping Th1/Th2-driven diseases. Full article

Background and Objectives: Asthma is a prevalent chronic respiratory disease in children, with increasing rates in Saudi Arabia. Allergen sensitization plays a crucial role in asthma development and severity. This study aimed to investigate the prevalence and clinical impact of aeroallergen and food sensitization in children with asthma in Southwestern Saudi Arabia. Materials and Methods: A retrospective chart review was conducted at Abha Maternity and Children’s Hospital, including 194 children aged 3–12 years with atopic asthma. Sensitization to 26 common aeroallergens and food allergens was assessed using the EUROLINE Allergy test. Associations between sensitization patterns, atopic comorbidities (allergic rhinitis and eczema), and asthma-related outcomes (hospitalizations, medication use, and school absenteeism) were analyzed. Results: A high prevalence of sensitization was observed (74.2% for aeroallergens; 56.7% for food allergens). Aeroallergen sensitization was associated with older age (p < 0.001), male sex (p = 0.026), allergic rhinitis (p < 0.001), eczema (p = 0.295), and increased asthma morbidity, including hospitalizations (p = 0.002) and corticosteroid use (p = 0.012). Food sensitization was associated with eczema (p < 0.001) but did not significantly impact other asthma outcomes. Poly-sensitization was associated with a higher prevalence of eczema (p = 0.003). Dust mite sensitization was a strong independent predictor of severe asthma (adjusted odds ratio = 4.4, 95% CI = 1.7–11.8, p = 0.003). Conclusions: This study demonstrates a high prevalence of aeroallergen and food sensitization among children with atopic asthma in Southwestern Saudi Arabia, with distinct sensitization patterns and associated comorbidities. Aeroallergen sensitization, particularly to dust mites, was associated with increased asthma morbidity, highlighting the importance of comprehensive sensitization assessment in this population. While limited by its retrospective design, this study provides valuable insights into the interplay between sensitization and childhood asthma, informing future research and clinical practice. Full article

Atopic dermatitis (AD) is one of the forms of allergic dermatitis and the most common chronic recurring inflammatory skin disease. In case of allergic dermatitis, oxidative stress (OS) promotes inflammation, disrupts the skin’s barrier function, and facilitates the penetration of allergens into the body. As a result, studying oxidative stress and its influence on the course and spread of these diseases is important in the search for new treatment strategies. This literature review aims to discover the effect of oxidative stress on the course of atopic dermatitis and review additional options for treatment. A comprehensive literature review was performed using the medical databases “PubMed” and the specialized search engine “Google Scholar” using the PICO model. Analyzed scientific articles were published from 2019 to 2024 in English. Of the 167 initial studies, 51 articles were included based on relevance, language, and release date. The other 116 articles were rejected due to incomplete publications and publications involving animals. Key biomarkers are associated with oxidative stress, including urinary 8-hydroxydeoxyguanosine (8-OHdG), malondialdehyde (MDA), glutathione, and glutathione disulfide, and they correlate directly with the severity of atopic dermatitis. This research emphasizes that antioxidants, such as vitamins, sun protection, coenzyme Q10, a balanced diet, melatonin, flavonoids, and NB-UVB therapy may have a positive impact on the pathogenesis and progression of atopic dermatitis. Full article

Quercetin, a natural flavonoid, present in various vegetables and fruits, has garnered increasing attraction for its potential antiallergic properties. Its broad-spectrum activity depends on its anti-inflammatory, immunomodulatory, and antioxidant effects, which target the critical pathways involved in type 2-driven allergic inflammation. Quercetin inhibits mast cell degranulation, reduces the production of histamine and pro-inflammatory cytokines, and restores homeostasis of the immune system by modulating the Th1/Th2 and Treg/Th17 balances. Additionally, its antioxidant properties help to dampen oxidative stress, a critical factor in the pathophysiology of allergic diseases. In vitro studies have consistently demonstrated quercetin’s ability to suppress allergic reactions. In contrast, in vivo studies, particularly in murine models of allergic rhinitis, have confirmed its efficacy in relieving symptoms (such as nasal itching, sneezing, rhinorrhea, and congestion) and dampening type 2 mucosal inflammation. Preclinical evidence also supports its therapeutic potential in asthma, conjunctivitis, atopic dermatitis, and food allergies. However, human studies are still scarce, as only two clinical trials investigated quercetin as a monotherapy. Both studies reported promising results, including symptom reduction and improved quality of life, though larger, randomized trials are needed to validate these findings. Some other studies have investigated multicomponent products that also contain quercetin. This review aimed to report and discuss the most recent in vitro and in vivo evidence on quercetin’s application in allergic models. It also provides a comprehensive overview of human studies, highlighting its potential as an agent in food supplements to manage patients with allergic diseases. Moreover, this review introduces a new quercetin phospholipids formulation that may represent a keystone in clinical use. The literature search was based on a PubMed consultation considering the most recent (last five years) publications using the keywords “quercetin and allergic disease” and “quercetin and immune system”. Full article