Search Results (375)

Micro-RNAs (miRNAs) are short, non-coding RNA molecules regulating genes’ expression. Studies published over last years demonstrated that they play an important role in allergic diseases by regulating humoral and cellular immunity, cytokine secretion and epithelium function. Some of them seem potential non-invasive biomarkers facilitating diagnosis of the most common allergic diseases, such as allergic rhinitis (miR-21, miR-126, miR-142-3p, miR-181a, miR-221), asthma (miR-16, miR-21, miR-126, miR-146a, miR-148a, miR-221, miR-223) and atopic dermatitis (miR-24, miR-124, miR-155, miR-191, miR-223, miR-483-5p), or objectively assessing severity of inflammation and endotype of the disease. In spite of the large body of literature available, its scientific value is limited due to the small numbers of study participants, heterogeneity of populations enrolled, and diverse methodology. Some studies have revealed significant changes in miRNAs’ profile in the course of allergen immunotherapy. Tolerance induction is associated with processes controlled by miRNAs: enhanced activity of Treg cells and increased production of tolerogenic IL-10 and TGF-β. Thus, miRNAs may be candidates as biomarkers of successful immunotherapy. Finally, they are also possible therapeutic agents or targets of therapies based on antagomirs blocking their activity. However, so far no studies are available that demonstrate efficacy in overcoming delivery barriers, tissue targeting or drugs’ safety. As a consequence, despite promising results of in vitro and animal model studies, translation into human therapeutic agents is uncertain. Full article

Background/Objectives: GATA-binding protein 3 (GATA-3) is a crucial transcription factor that drives type 2 immune responses, and it is actively involved in allergic conditions such as asthma, allergic rhinitis (AR), and atopic dermatitis (AD). However, the molecular mechanisms GATA-3 uses to modulate immune responses and its potential therapeutic targeting are not fully understood. This systematic review aimed to summarize studies on the role of GATA-3 in immune responses, particularly in allergic diseases, and evaluate GATA-3’s potential as a therapeutic target. Methods: We searched PubMed, Scopus, Web of Science, Cochrane, and Science Direct for studies published before April 2025. Articles were sifted through using predefined criteria, and risk of bias was measured with RoB 2 for clinical trials and SYRCLE for animal models and in vitro studies; evidence was graded using the GRADE system. Results: Twenty-nine eligible studies reported that GATA-3 is a key regulator of Th2 and ILC2 differentiation, promoting the production of IL-4, IL-5, and IL-13. Animal models and in vitro studies demonstrated its role in exacerbating allergic inflammation and highlighted the promise of targeting strategies such as DNAzymes and nanocapsules. Clinical trials showed that targeting GATA-3, particularly with DNAzymes, can reduce allergic responses in asthma. Conclusions: GATA-3’s role in driving allergic inflammation through Th2 and ILC2 pathways suggests it as a promising therapeutic target. Understanding its broader regulatory mechanisms is imperative for designing effective GATA-3 targeting-based therapies. Full article

Aeromycoflora present in the library environment is known to play a significant role in triggering allergies and contributing to the deterioration of both cellulosic and non-cellulosic materials within the intramural setting of the Midnapore College Library. Fungal spores not only accelerate the aging and degradation of books but also pose considerable health risks to students, library visitors, and staff. In total, 480 fungal colonies belonging to 15 genera and 28 species were recorded using the culture plate exposure method. The predominant taxa included Aspergillus/Penicillium, Alternaria alternata, Alternaria solani, Cladosporium cladosporioides, Curvularia lunata, Penicillium oxalicum, Epicoccum sp., Fusarium solanii, Fusarium oxysporum, Periconia sp., Rhizopus sp., and other Penicillium species. Many of these fungi are well-documented allergens and have been reported to cause adverse health manifestations—such as respiratory discomfort and skin irritation—among students, teaching staff, and book handlers exposed to airborne mycobiota. The present study aimed to investigate the aeromycological diversity within the Midnapore College Library and to conduct immuno-clinical assessments to identify specific serum IgE using both in vivo and in vitro diagnostic techniques. Individuals frequently visiting the library reported symptoms including eye irritation, headaches, itchy skin, sore throat, and severe asthma. Spearman’s rank correlation analysis revealed a significant association between total and dominant spore concentrations and the health status of affected individuals. Clinico-immunological evaluations confirmed the allergenicity of Aspergillus fumigatus, with 39.5% of atopic individuals showing positive reactions in skin prick tests (SPT). Additionally, three novel sero-reactive proteins were identified, offering valuable insights for local clinicians in diagnosing and managing fungal-induced allergic conditions. Full article

Vitamin D deficiency is associated with the risk of atopic diseases and respiratory infections. The activated vitamin D receptor (VDR) forms a dimer with the retinoid X receptor alpha (RXRA) and binds to VDR/RXRA composite elements (CEs) in enhancers of target genes. However, VDR/RXRA CEs are identified in only 11.5% of cases in ChIP-Seq peaks. Our hypothesis was that VDR could form a VDR-Partner complex with transcription factor for which CEs have not yet been identified. We utilized Web-MCOT to search for novel VDR/Partner CEs in regulatory DNA. The potential formation of the VDR-Partner protein complex was assessed using the AlphaFold machine learning model. Through real-time RT-PCR, we measured the expression of immune system genes in a culture of U937 macrophage-like cells incubated with the active metabolite of vitamin D, calcitriol. We have predicted novel VDR/NR2C2 and VDR/PPARG CEs in the regulatory regions of immune system genes. We found potential synergism of VDR/NR2C2 and VDR/RXRA CEs in relation to the IRF5 gene, as well as potential synergism of VDR/PPARG and VDR/RXRA CEs for MAPK13. Predicting new regulatory relationships through the identification of new potential VDR/Partner CEs may provide insight into the deep mechanisms of vitamin D involvement in the pathogenesis of atopic dermatitis, bronchial asthma, allergic rhinitis, and pulmonary infections. Full article

Atopic eczema and asthma frequently co-occur, forming a distinct complex phenotype that likely arises from shared genetic pathways and early-life environmental influences. We aimed to investigate whether variants in TNS1 and NRXN1—previously identified in a genome-wide interaction study—influence susceptibility to atopic eczema and the asthma–eczema phenotype and whether early-life environmental tobacco smoke (ETS) exposure modifies these genetic effects. A total of 188 Caucasian children under 2 years at recruitment were prospectively followed up to 6 years of age. Eligibility of all participants for the study or control group was based on a questionnaire and a physician-confirmed diagnosis of eczema and asthma. Early-life ETS exposure was assessed by parental questionnaire. All participants were genotyped for TNS1 and NRXN1 SNPs. The TNS1 rs918949 [T] allele was associated with the combined asthma–eczema phenotype but not with eczema alone. Synergistic gene–environment interactions were identified for both TNS1 and NRXN1, with the highest risk of the combined asthma–eczema phenotype observed among ETS-exposed carriers of risk alleles. Our findings provide the first independent replication of evidence suggesting that TNS1 and NRXN1 may contribute to the asthma–eczema comorbidity through mechanisms that could be substantially modified by early-life ETS exposure. Full article

Background/Objectives: Tissue eosinophilia plays a central role in chronic rhinosinusitis with nasal polyposis (CRSwNP), yet the spectrum of disease, particularly central compartment atopic disease (CCAD), remains underexplored. This study aimed to classify CRSwNP into three distinct phenotypes, eosinophilic CRSwNP (ECRSwNP), non-eosinophilic CRSwNP (NECRSwNP), and CCAD, based on radiologic and endoscopic features. It also proposes a novel severity-based staging system to guide clinical decision-making. Methods: A cross-sectional observational study was conducted in a single private clinic between January 2019 and August 2025. Patients were assessed using clinical history, paranasal sinus computed tomography (CT), and intranasal endoscopy. Key variables included symptom clusters, comorbidities, hematologic and atopy profiles, radiologic and endoscopic findings, histopathology, and pre-treatment SNOT-22 scores. Results: A total of 2060 patients (mean age: 29.8 ± 11 years; 51.8% male) were included. Asthma was the most frequent comorbidity (23.5%). Classification into ECRSwNP, NECRSwNP, and CCAD was achieved using integrated clinical, radiologic, and histopathologic criteria. Conclusions: This study presents a phenotype- and severity-based classification system for CRSwNP that incorporates endoscopic and radiologic features. This framework may enhance diagnostic accuracy and enable more tailored therapeutic strategies. Full article

Background: Atopic dermatitis (AD) is a common pediatric skin disease that is associated with other atopic comorbidities, all of which correlate with higher rates of neurocognitive alterations such as developmental delays and ADHD. Methods: We conducted a retrospective chart review from January 2022 through January 2024 and identified 79 children aged 0–5 years who were prescribed dupilumab in the Massachusetts General Brigham healthcare system. We defined the patient population (including demographics, atopic comorbidities, and neurocognitive burden), and assessed whether time to treatment access varied by patient or prescriber characteristics. Results: The mean age at dupilumab initiation was 3.4 years, and 62.0% of patients were male. The cohort was diverse (48.1% White, 25.3% Black, 16.5% Hispanic/Latino, 10.1% Asian/other), with 48.1% publicly insured. Atopic comorbidities were common: 64.6% had food allergies, 34.2% had asthma, and 10.1% had eosinophilic esophagitis (EOE); 73.4% had two or more atopic diagnoses. Neurodevelopmental disorders affected 43.0% of patients, with speech and language delay most frequent (25.3%) and higher rates among those with EOE (87.5% vs. 38.0%, p < 0.01). The mean time to dupilumab approval was 20.9 days, with dermatologists achieving faster approvals than other specialists (10.6 vs. 51.9 days, p < 0.001). Conclusions: Our findings reveal infrequently reported high rates of atopic and neurologic comorbidities in young children with AD and underscore the importance of coordinated inter-specialty collaboration to ensure timely access to dupilumab for these patients. Full article

Background and Objectives: Parental beliefs strongly influence treatment adherence in pediatric allergic diseases. Concerns about corticosteroid therapy—known as corticophobia—may disrupt disease control and compromise child well-being. This study aimed to evaluate parental knowledge, beliefs, and concerns regarding topical, inhaled, and intranasal corticosteroid use in children, and to identify sociodemographic factors associated with corticophobia. Materials and Methods: This prospective survey was conducted in a tertiary pediatric allergy and immunology clinic. A structured questionnaire was anonymously completed by 110 parents of children receiving corticosteroid therapy. The survey assessed demographics, family history of atopy, corticosteroid use, perceived disease severity, knowledge level, concerns, and sources of information. Descriptive statistics and chi-square tests were applied (p < 0.05 significant). Results: The most frequent concerns were growth retardation, hormonal imbalance, and long-term side effects. Corticophobia was significantly more prevalent among university-educated parents (p = 0.043) and those with a family history of atopy (p = 0.017). Despite generally high adherence to prescribed regimens, nearly 60% of parents sought additional information, highlighting the impact of knowledge gaps on health-related parenting practices. Conclusions: Corticophobia remains a common parental concern in pediatric allergy care, with implications for adherence, family decision-making, and child well-being. Addressing misinformation and providing family-centered, tailored educational strategies—particularly for highly educated parents and those with an atopic background—may reduce fears, strengthen trust, and promote sustainable healthy behaviors. Full article

Atopic eczema is the most prevalent chronic dermatitis in childhood, characterised by relapsing pruritic lesions and significant heterogeneity in clinical expression and immunological profile. The disease impacts quality of life and healthcare systems, especially when persistent into adulthood. Epidemiological data from the International Study of Asthma and Allergies in Childhood (ISAAC) demonstrate significant geographic and temporal variability in the prevalence of atopic eczema, with an overall upward trend observed in paediatric populations across most regions. A systematic literature search was conducted in PubMed, ScienceDirect, and the Cochrane Library to identify relevant studies published between 1990 and 2025. Seven studies met the inclusion criteria—six cross-sectional and one prospective—conducted in the urban centres of Athens, Thessaloniki, and Patras. Sample sizes ranged from 517 to 3076 participants, encompassing children and adolescents aged 6 to 17. Prevalence rates ranged from 4.5% to 16.1% in children and 8.9% in adolescents, with notable geographic and temporal variability. Male sex, younger age, environmental exposures, and a family history of atopic diseases were identified as key risk factors. Comparative data from European studies reflect similar trends, with increasing atopic eczema prevalence and plateauing asthma rates suggesting distinct etiological pathways. The psychosocial and economic burden of atopic eczema remains substantial, highlighting the need for early recognition and effective management. Despite methodological variability and limitations in study design, findings indicate an underestimation of atopic eczema prevalence in Greece and underscore the importance of standardised epidemiologic surveillance. Full article

Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by itching, redness, and dryness, significantly impacting the quality of life of affected individuals. With a rising prevalence across diverse demographics, understanding AD is crucial due to its systemic nature and association with comorbidities such as asthma and allergic rhinitis, as well as its psychosocial implications. The pathophysiology of AD involves a complex interplay of genetic predispositions and environmental triggers, leading to dysbiosis and increased susceptibility to superinfection. Clinically, AD manifests variably across age groups, with distinct presentations in pediatric and adult populations. Diagnosis is primarily based on clinical assessment criteria, supplemented by differential diagnoses and, when necessary, skin tests for allergies. Current management strategies encompass topical therapies, including moisturizers, corticosteroids, and calcineurin inhibitors, alongside systemic treatments such as antihistamines, immunosuppressants, and biologics. Lifestyle modifications, including trigger avoidance and effective skin care routines, are essential components of comprehensive care. Emerging novel therapies targeting specific biomarkers are currently under investigation in clinical trials, offering promising avenues for more effective management. However, challenges remain in optimizing treatment protocols and addressing the multifaceted nature of AD. In conclusion, this review highlights the need for continued research and awareness regarding atopic dermatitis. A multidisciplinary approach to management is essential to enhance patient outcomes and address the complexities of this prevalent and impactful condition. Full article

Ultra-processed foods (UPFs) are increasingly consumed worldwide, particularly during childhood, raising growing concerns for health. Although UPFs have been associated with obesity and cardiometabolic disorders, emerging evidence suggests a potential role also in respiratory and allergic diseases. This review critically examines the epidemiological evidence and biological mechanisms linking UPF consumption to respiratory and allergic outcomes in children. To this end, a structured literature search was conducted in the PubMed database, including articles published between 2006 and 2025, selected based on their relevance to the association between UPF consumption and asthma, wheezing, or food allergies in the pediatric population. Four cohort studies on asthma and wheezing, conducted mainly in Brazil and Spain, and two cross-sectional studies—including one global multicenter study—were identified. In addition, four pediatric studies on food allergies from Europe and South America were found, consisting of two cohort studies and two cross-sectional studies. The proposed mechanisms include disruption of the gut barrier, microbiota dysbiosis, chronic inflammation through the AGE–RAGE axis, skewing of immune responses toward a Th2 profile, and indirect effects through obesity and micronutrient deficiencies. Similar pathways may promote allergic sensitization and the development of food allergies. Although current evidence supports the potential role of UPFs in pediatric respiratory and allergic diseases, further longitudinal and interventional studies are needed. Meanwhile, promoting fresh and minimally processed dietary patterns may help protect children’s respiratory and immune health. Full article

Atopic dermatitis (AD) and asthma are key manifestations of the atopic march, characterized by a progressive development of allergic diseases from early skin inflammation to later respiratory involvement. Emerging evidence highlights the role of gut microbiota in modulating immune responses. However, the therapeutic potential of specific probiotic strains in preventing or mitigating the atopic march remains underexplored. This study aimed to evaluate the immunomodulatory and therapeutic effects of selected probiotic strains in a murine model of ovalbumin (OVA)-induced AD and asthma. Mice received oral administration of B. plebeiu, B. ovatus, F. duncaniae, F. taiwanense, and F. prausnitzii for four weeks before being exposed to OVA to induce AD and, later, asthma. Skin reactions were assessed after OVA application, and asthma was induced via aerosolized OVA. Afterward, blood and lung fluid samples were collected to evaluate immune markers such as total IgE, OVA-specific IgE, and IL-4. The results showed that B. plebeius improved skin histology in AD, while B. ovatus initially induced AD symptoms but later reduced them significantly between days 40 and 54. B. plebeius and B. ovatus reduced serum total IgE in asthma. B. plebeiu, B. ovatus, F. duncaniae, F. taiwanense, and F. prausnitzii significantly lowered OVA-IgE levels in serum and IL-4 levels in lung fluid (p < 0.05). These selected probiotic strains helped reduce allergic skin responses and, later, asthma by decreasing inflammation, particularly IL-4. These findings support the potential of these probiotics to prevent or mitigate the progression from AD to asthma and offer promising insight into targeted probiotic interventions for allergic diseases. Full article

Background/Objectives: Eosinophilic esophagitis (EoE) is a T2-mediated disease characterized by dysphagia and food impaction. It is often associated with other atopic disorders and is considered a late manifestation of the “atopic march”. In clinical practice, allergic comorbidities are frequently underdiagnosed and primarily based on self-reporting, potentially underestimating the true burden of T2-related pathology. To address this, a multidisciplinary task force was established at our tertiary center to systematically evaluate newly diagnosed patients with EoE. Methods: This cross-sectional observational study included patients referred for EoE evaluation from January 2022. Clinical history was collected prospectively, with systematic assessment for T2 comorbidities. All patients underwent an esophagogastroduodenoscopy with esophageal biopsies. Following EoE diagnosis, patients were referred to dermatology, ENT, immunology, and respiratory specialists. Results: A total of 43 patients were enrolled. Anamnestic T2 comorbidities were reported by 88% of patients. Rhinitis was the most common, while at baseline, no patients reported chronic rhinosinusitis with nasal polyps (CRSwNP). After specialist evaluation, diagnoses of asthma, food allergy, and atopic dermatitis remained stable, while eight patients previously reporting rhinitis were newly diagnosed with CRSwNP. Overall, 65% of patients had ≥2 T2 comorbidities in addition to EoE, and 25% had ≥3. Conclusions: Our findings support a multidisciplinary approach to assess T2 comorbidities in patients with EoE, with a high overall prevalence (95.3%) and frequent coexistence of multiple atopic conditions. CRSwNP was frequently underdiagnosed and only identified after rhinofibroscopy. Although our data needs to be confirmed in larger multicenter studies, our results suggest that relying solely on patient-reported history or single-specialty evaluation risks underestimating the systemic nature of the T2 inflammatory pathway in EoE. Full article

In recent years, the role of sexual hormones in the pathogenesis and progression of various diseases has progressively being established, which attempts to explain immune dimorphism. Whether physiological or pathological, variations in hormones influence the inflammatory response and adaptive systems to control increased productions of reactive oxygen species, reactive nitrogen species, and free radicals. Primary allergic respiratory and skin diseases were taken into consideration, and possible biomarkers of oxidative stress related to sex differences in the onset and development of atopic diseases were analyzed. Understanding how these variables interact with each other, and evaluating the possible common targets, lays the foundation for the development of tailored therapies with an eye to precision medicine. Full article

Background/Objectives: Atopic dermatitis (AD) is a prevalent chronic inflammatory skin disease, but its relationship with gastric cancer (GC) remains unclear. This study aimed to investigate the association between AD and GC using a nationwide Korean database. Methods: Using the Korean National Health Insurance Service-National Sample Cohort, we conducted a nested case–control study including 10,174 GC patients and 40,696 matched controls (1:4 by age, sex, income, and region). Overlap propensity score weighting was used to control for confounders. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated via logistic regression. Results: AD was significantly associated with an increased risk of GC (adjusted OR = 1.08; 95% CI: 1.01–1.15). Subgroup analyses revealed stronger associations among individuals aged ≥ 65 years (OR = 1.12), men (OR = 1.10), rural residents (OR = 1.14), and those without comorbidities (CCI = 0, OR = 1.15). Higher risks were also observed in participants with non-allergic rhinitis (OR = 1.43) or no asthma (OR = 1.12). Conclusions: AD may be associated with an increased risk of GC in the Korean population. These findings may highlight the importance of considering dermatological conditions in the context of systemic cancer risk. Full article