alternaria allergen SLIT

Sensitization to Alternaria alternata, household environmental exposure and respiratory disease control in a Mediterranean agricultural area.

Martinez Antonio Carbonell AC, Garrido Cristina Navarro CN, Zamorano Javier Carbonell JC, Diaz Javier Alcover JA et al.

Environmental fungi play an important role in allergic respiratory diseases. Alternaria alternata sensitization has been associated with more severe respiratory phenotypes and poorer asthma control. Mediterranean agricultural environments may favor environmental exposure because of their climatic conditions and intensive agricultural activity. To analyze the prevalence of sensitization to Alternaria alternata, evaluate its association with asthma control and quality of life, and describe household environmental findings in a Mediterranean agricultural population. An observational, analytical, cross-sectional study with standardized collection of clinical, allergological, and environmental data was conducted in 100 consecutive adult patients (18-65 years) with allergic rhinitis/rhinoconjunctivitis, with or without associated asthma. Sensitization to Alternaria alternata was defined by a positive skin prick test and/or molecular determination against Alt a 1 (>0.35 kUA/L). Asthma control was assessed using the Asthma Control Test (ACT), quality of life using the Mini Asthma Quality of Life Questionnaire (MiniAQLQ), and rhinitis control using the Spanish Rhinitis Questionnaire (SPRINT). Household environmental evaluation was performed in sensitized patients. Sensitization to Alternaria alternata was observed in 29% of patients (95% CI: 20.1-38.8). Skin prick testing was positive in 25 patients, whereas molecular sensitization against Alt a 1 was observed in 20 patients. Sensitized patients showed poorer asthma control and greater quality-of-life impairment than non-sensitized patients. No significant differences in the polysensitization burden were observed. Among sensitized patients, household microbiological assessment demonstrated Alternaria alternata detection in 46.4% of indoor samples and 28.6% of outdoor samples. Sensitization to Alternaria alternata was frequent in this Mediterranean agricultural population and was associated with poorer asthma control and greater quality-of-life impairment. Environmental findings support further investigation of fungal exposure in Mediterranean agricultural settings.

Has Parietaria allergen immunotherapy become an overlooked indication?

Karabacak Deniz Eyice DE

Complementary feeding routines and parental allergy follow-up behavior in early childhood.

Boyacıoğlu Özge Kangallı ÖK, Atay Özge Ö, Al Serdar S, Atakul Gizem G et al.

Early complementary feeding practices and timely allergen introduction are important components of current infant feeding recommendations. However, evidence remains limited regarding how complementary feeding routines and socioeconomic factors influence parental allergy-related healthcare-seeking behavior during early childhood.Objective: To examine the association between complementary feeding routines, early allergen introduction, socioeconomic characteristics, and parental allergy-related healthcare-seeking behavior in young children. In this cross-sectional study, parents of young children completed a structured questionnaire assessing complementary feeding routines, the timing and type of allergen introduction, allergy-related symptoms, and socioeconomic characteristics. All data were based on parental self-report and were not independently verified through clinical assessment or medical records. The primary outcome, allergy-related healthcare-seeking behavior, was operationally defined as any parent-reported healthcare contact, including at least one visit to a pediatrician or pediatric allergy clinic, due to suspected allergy-related symptoms or parental concern. Multivariable logistic regression analysis was performed to identify factors associated with allergy-related healthcare-seeking behavior. Early introduction of specific allergens, particularly egg white, was significantly associated with increased parental allergy-related healthcare-seeking behavior. The presence of allergy-related symptoms was also a strong determinant of healthcare utilization. In addition, socioeconomic factors, including household income and parental employment status, were associated with differences in healthcare-seeking patterns, likely reflecting variation in access to healthcare services and health awareness. The multivariable model demonstrated moderate sensitivity, indicating that while key factors associated with allergy-related healthcare-seeking behavior were identified, some cases could not be fully captured. Complementary feeding practices, early introduction of allergenic foods, and socioeconomic factors were associated with parental allergy-related healthcare-seeking behavior in early childhood. These findings highlight the need for targeted parental education, optimization of infant feeding recommendations with consideration of allergy risk, and improved clinical guidance for families reporting allergy-related symptoms. Prospective studies are warranted to confirm these associations and to support the development of effective preventive strategies.

Genes and cells associated with sublingual allergen immunotherapy revealed by integrated transcriptome analysis in allergic rhinitis patients.

Li Zhengqi Z, Hou Yilin Y, Li Hang H, Ji Ding D et al.

Sublingual allergen immunotherapy (SLIT) is known as an effective therapy for allergic rhinitis (AR), although its efficacy varies across different treatment duration and individuals. The factors associated with the duration and response of SLIT need to be explored. Twenty-seven AR patients undergoing SLIT and three healthy volunteers were recruited. Peripheral blood mononuclear cells were isolated for RNA sequencing, and key results were further examined by quantitative PCR (qPCR) in available PBMC samples. Time-correlated and response-associated genes were identified and analyzed using bioinformatic tools. The data were further integrated with single-cell transcriptome. We first identified 164 genes significantly correlated with SLIT duration. The expressions of genes associated with immunoregulation, nitric oxide and serotonin transportation were regulated as the treatment proceeded. qPCR validation further showed a significant positive correlation between SLC6A4 expression and SLIT duration, while SH2D1B and ARG1 showed positive trends. Then, we identified 257 up-regulated and 349 down-regulated genes in SLIT responders. Several pathways were enriched in these genes, including interferon signaling (up-regulated in responders) and granulocytes migration (down-regulated in responders). Single-cell and deconvolution analyses suggested that natural killer cell-associated signals may associate with SLIT efficacy, potentially in relation to T-cell-regulatory and eosinophil-migration-related transcriptional programs. This study revealed potential genes and cells associated with SLIT duration and response. Regulation of T cells and NK cells may play a crucial role in the successful treatment responses. Further studies are required to validate these findings and assess their clinical relevance.