Background:Polysensitization occurs in 80% of allergic patients. Allergen immunotherapy (AIT) formulations with multiple allergens remain debated for polysensitized patients. Objective:This study aims to evaluate the clinical effectiveness and safety profile of multiallergen AIT in polysensitized allergic rhinitis (AR) patients. Methods:We searched for polysensitized AR patients treated with multiple allergens in immunotherapy in PubMed, Embase, Web of Science and Cochrane Library until June 5, 2025. Results:Seven randomized clinical trials and 7 nonrandomized studies were included. Multiallergen immunotherapy significantly reduced combined symptom and medication scores versus placebo from baseline (SMD: -3.75, 95% CI (-5.85, -1.65; p < 0.001)). Compared to single-allergen AIT, symptom score changes were no difference (SMD: -0.34, 95% CI -1.21, 0.52; p = 0.44), while medication scores showed slight superiority (SMD: -1.36, 95% CI -2.44, -0.28; p = 0.01). But both scores at the last follow-up were significantly reduced compared with single-allergen treatment (SMD: -1.75, p = 0.01; SMD: -1.30, p = 0.007). Systematic review highlighted superior outcomes with dual-allergen AIT in some studies. The multiallergen group had a safer profile in randomized studies (OR 0.58, 95% CI 0.35, 0.96, p = 0.03). No significant differences were found in adverse events due to AIT treatment among non-randomized studies (OR 0.86, 95% CI 0.64, 1.15, p = 0.3). Multiallergen AIT demonstrated enhanced immune tolerance and modulation of the type 2 immune response similar to single-allergen treatment. Conclusion:Based on current evidence, multiallergen AIT demonstrates no significant difference in efficacy, a comparable safety profile, and equivalent immunological modulation compared to single-allergen AIT for the treatment of polysensitized allergic rhinitis. Dual-allergen approaches may optimize benefits in clinically relevant cases, though study heterogeneity necessitates standardized trials.

Objective This study compares the efficacy of monthly subcutaneous injections of 150 mg versus 300 mg omalizumab in patients with seasonal allergic rhinitis (AR) caused by cypress pollen allergy and with total immunoglobulin E (IgE) levels below 100 IU/ml, aiming to provide a basis for individualized treatment in the population with low total IgE. Methods This single-center, randomized, double-blind, placebo-controlled trial enrolled 60 patients with seasonal allergic rhinitis induced by cypress pollen and total IgE levels below 100 IU/mL. Participants were randomly assigned (1:1) to receive a single subcutaneous injection of either 300 mg omalizumab or 150 mg omalizumab plus placebo within 5 days prior to the pollen season onset. The endpoints included daily symptom and medication scores (dSS, dMS, CSMS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score, Allergic Rhinitis Control Test (ARCT) score, and nasal resistance. Results Among the 54 patients ultimately included in the analysis (27 in each group), the 300 mg group demonstrated significantly better outcomes than the 150 mg group in the CSMS (1.1 ± 0.1 vs 1.6 ± 0.1, P = 0.007), dSS (0.6 ± 0.1 vs 0.8 ± 0.1, P = 0.016), and ocular symptom score (0.5 ± 0.1 vs 0.7 ± 0.1, P = 0.003). The total RQLQ score in the 300 mg group was significantly lower than that in the 150 mg group during both the peak and late phases of the pollen season (P < 0.05). Furthermore, the ARCT score during the peak phase was significantly better in the 300 mg group (P = 0.011), and nasal resistance was significantly reduced (P = 0.020). No drug-related adverse reactions occurred in either group. Conclusions In patients with seasonal AR and total IgE levels of less than 100 IU/ml, a monthly dose of 300 mg omalizumab provided greater improvement in symptoms, quality of life, and nasal ventilation function compared with the 150 mg dose. This suggests that a higher individualized dosing strategy should be considered for such patients. Trial registration National Medical Research Registration and Filing Information System (MR-11-25-016855), registered 27 February 2025.

To evaluate the effectiveness of outdoor field-based teaching in improving the ability of clinical medical postgraduates and visiting trainees to identify allergenic plants, and to provide evidence for optimizing standardized training curricula for allergy specialists. A single-group pre- and post-test design was employed. A two-hour outdoor practical teaching session was conducted at the National Botanical Garden for clinical medical postgraduates and visiting trainees from Peking Union Medical College Hospital. The course was jointly delivered by instructors in botany and allergy, using on-site explanations of representative plant species, analysis of key morphological features, real-time question-and-answer interactions, and guided discussions. Participants completed plant identification tests before and after the course, and a post-course questionnaire was administered to collect student feedback on learning experience and satisfaction. Sixteen students participated in the course. Post-course test scores 90.0 (80.0, 100.0) were significantly higher than pre-course scores 60.0 (42.5, 70.0), with a median improvement of 30 points (P < 0.001). The magnitude of score improvement was negatively correlated with baseline knowledge (ρ = -0.674, P = 0.004). After the course, plant identification accuracy exceeded 80

Background:Alternaria alternata is a major fungal allergen, yet standardized skin prick test (SPT) extracts are lacking in China, hindering the use of this simple, first-line diagnostic tool. Objective:This study aimed to clinically evaluate a novel, domestically developed A. alternata extract for SPT and establish a diagnostic cutoff in a Chinese population. Patients and Methods:In this prospective, single-center study, 910 patients with allergic diseases were consecutively enrolled. All underwent SPT with the in-house A. alternata extract (Alt a 1: 25.7-34.8 µg/mL). Serum-specific IgE (sIgE) (ImmunoCAP™) served as the reference standard. Diagnostic accuracy was analyzed using receiver operating characteristic (ROC) curves. Safety was assessed by monitoring adverse events. Results:The per-protocol set included 610 subjects. The area under the ROC curve was 0.868 (95% CI: 0.839-0.897). The optimal diagnostic cutoff was a mean wheal diameter of 3.25 mm, yielding a sensitivity of 81.10% (95% CI: 76.76%-85.24%) and specificity of 79.32% (95% CI: 74.46%-84.18%). To achieve 95% specificity, the cutoff increased to 4.25 mm. No adverse events were reported among all 910 participants. Conclusion:The novel A. alternata SPT extract demonstrates high diagnostic accuracy for detecting Alternaria alternata sensitization and an excellent safety profile. The established cutoff of 3.25 mm provides a population-optimized threshold for identifying sensitized individuals in China. This study addresses a critical gap in allergen standardization and supports the use of SPT as a reliable first-line tool for assessing fungal sensitization in clinical practice. Trial Registration:ChiCTR ChiCTR1800014899. Registered 13 February 2018 (retrospectively registered).

BACKGROUND:In China, therapeutic options are limited by the narrow availability of allergen preparations, with house dust mite (HDM) allergen immunotherapy (AIT) as the main choice for most patients. However, polysensitization is highly prevalent, and the benefit of HDM AIT in such patients remains uncertain. The study aims to evaluate the effectiveness of single-allergen HDM AIT on both perennial and coexisting allergen-specific symptoms in polysensitised allergic rhinitis (AR) patients and to explore predictors of treatment response. METHODS:We performed a multicenter retrospective cohort study including 81 patients with AR who were polysensitised to HDM and at least one other inhalant allergen (e.g., pollens, mould or animal dander). All participants received HDM subcutaneous immunotherapy (SCIT) for 12 to 36 months. Baseline characteristics, including serum allergen-specific IgE (sIgE) levels and comorbidities, were collected. Symptom severity was assessed using the Visual Analog Scale (VAS), and treatment response was defined as a ≥ 30% reduction in VAS scores from baseline. Statistical comparisons between responders and non-responders were conducted using Fisher's exact test for categorical variables and Mann-Whitney U tests for continuous data. Firth logistic regression was used to identify predictors of treatment response. RESULTS:The overall response rate for perennial symptoms was 68.8%, and varied in patients with co-existing allergies: 72.7% for moulds, 70.0% for animal dander, 65.5% for tree pollen, 70.2% for weed pollens. Allergen-specific symptom response rates varied across allergens: 68.2% for moulds, 30.0% for animal dander, 56.7% for tree pollens, 74.5% for weed pollens. Higher sIgE levels to HDM and mould were significantly associated with lower response rates in patients co-sensitised to both. A predictive model incorporating both sIgEs showed good specificity. CONCLUSION:Single-allergen HDM AIT is effective in many polysensitised AR patients; however, its efficacy varies by coexisting allergen type and sIgE level. Patients co-sensitised to mould with high HDM and mould sIgE appeared to have poorer outcomes. These preliminary findings require confirmation in larger prospective studies to guide tailored AIT strategies.

Purpose:Yin-hua Li-shi Decoction (YLD), a traditional Chinese medicine formulation, has been employed as a complementary therapy for atopic dermatitis (AD). Nevertheless, its precise therapeutic mechanisms remained unexplored. Methods:YLD components were identified by LC-MS, and quality control was performed using HPLC. In vitro, flow cytometry was used to assess YLD toxicity and its effect on inhibiting pro-inflammatory macrophages. In vivo, AD mice model was induced by daily topical MC903 application on mice ears for 15 days. Mice received oral YLD (1.50, 3.00, or 6.00 g/mL) once daily for 14 days. Disease progression was tracked by measuring skin thickness in mice. ELISA, western blot, and immunohistochemistry were used to analyze YLD ability to regulate inflammatory factors and restore skin barrier proteins. Flow cytometry was additionally used to investigate YLD modulatory effects on type I, II, and III adaptive immune responses. Results:YLD could inhibit the differentiation of macrophages into M1 phenotype in vitro. In the AD-like mice, YLD ameliorated epidermal hyperkeratosis and skin lesions, decreased the severity scoring of AD, and suppressed the inflammation of the skin in a dose-dependent manner. Moreover, YLD downregulated pro-inflammatory factors such as IL-4/13, TNF-α, TSLP, and IgE antibodies, restored the expression of barrier proteins in the skin, decreased the infiltration of CD4+ T cells in AD skin, and reestablished the balance of Th1/ Th2/ Th17 cells. Conclusion:YLD alleviated AD by regulating the adaptive immune response through modulation of T cell differentiation and cytokine production, and by restoring skin barrier function. The study revealed the therapeutic mechanism of YLD and provided experimental evidence supporting its application in AD treatment.

BACKGROUND:Anti-IgE therapy can serve as an option for inadequately controlled seasonal allergic rhinitis (SAR) patients. LP-003, a novel anti-IgE antibody, is being tested as an add-on treatment for SAR. This trial aimed to evaluate whether LP-003 is effective and safe for SAR. METHODS:This placebo-controlled double-blind phase 2 randomized clinical trial was conducted in 17 hospitals in China. SAR patients whose symptoms were inadequately controlled despite first-line treatment (nasal corticosteroids with or without oral antihistamine) in the previous two seasons were enrolled between July 6, 2023 and August 7, 2023. Participants were randomized in a ratio of 2:4:3 to receive subcutaneous injections of 100 mg LP-003, 200 mg LP-003 or placebo every 4 weeks for 2 doses. All patients received fluticasone propionate as standard-of-care (SoC). The main outcome was the mean total nasal symptom score (TNSS) during the peak pollen period (PPP). Secondary endpoints included a series of symptom and medication scores, quality of life assessments during PPP and pollen period (PP), immunogenicity and safety. RESULTS:A total of 180 participants were randomly assigned. The LP-003 + SoC treatment achieved a significantly lower TNSS compared with placebo + SoC (3.31 vs. 4.06, intergroup difference = -0.74, p = 0.0464). For key secondary outcomes, the LP-003 group also achieved significantly lower daily nasal symptom and rescue medication use scores (3.54 vs. 4.42, intergroup difference = -0.88, p = 0.0352), and daily ocular symptom and rescue medication use scores (1.66 vs. 2.19, intergroup difference = -0.54, p = 0.0245) compared to the placebo group. The suppression of free IgE was prevalent and persistent. There was no statistically significant difference in adverse events and severe adverse events between LP-003 and placebo groups. CONCLUSIONS:These findings support LP-003 as a promising add-on option to the SoC for patients with moderate to severe SAR. Fixed dosage regimen and extensive suppression of free-IgE render it a cutting-edge advantage.

Background: Allergic rhinitis (AR) is a significant global health issue, with pollen allergens being a major cause of seasonal AR and asthma. In northern China, the prevalence of pollen-related allergies is notably higher than in the south due to higher pollen levels. Over the past few decades, climate change and urbanization have considerably transformed pollen profile in northern China. Summary: Northern China experiences two annual pollen peaks: a spring peak (March to May) dominated by tree pollens (e.g., Cupressaceae, Ulmaceae) and a summer/autumn peak (August to September) dominated by weed pollens, particularly from Artemisia, Humulus, and Chenopodiaceae. Climate change has accelerated the onset of flowering periods, increased pollen production, and extended pollen seasons, with extreme weather events and air pollution further exacerbating pollen production and sensitization. Urbanization has increased tree pollens, resulting in spring peak pollen levels gradually exceeding those of summer/autumn in most northern regions. As ecological construction concepts have advanced, the selection of plant species for the shelterbelt and ornamental trees in cities has evolved, leads to changes in the dominant pollens in the north and northeast. Artemisia has been extensively planted in the Northwest for windbreak and sand fixation purposes, resulting in a significant rise in Artemisia pollen levels and sensitization rate with a widespread influence across northern China. Key Messages: Pollen allergens in northern China are a major driver of AR and asthma, with two distinct seasonal peaks. Changes in pollen profiles are influenced by natural factors such as geographical location and climate change, as well as social factors, including urbanization, national policies, and urban planning. In northern China, Spring pollen is predominantly composed of tree pollens, significantly influenced by urban planning across different regions. In contrast, summer and autumn pollen is primarily dominated by weed and grass pollens, with weed pollens exhibiting strong allergenic potential and widespread dispersal. The Northwest region is a major potential source for these weed pollens. .

Allergic cross-reactivity among different fungal species appears to be widely existing. Fungus-related foods, such as edible mushrooms, mycoprotein, and fermented foods by fungi, can often induce to fungus food allergy syndrome (FFAS) by allergic cross-reactivity with airborne fungi. This article presents a case study of an individual with mold allergy who experienced anaphylaxis after consuming seafood mushrooms. This study indicated that Alt a 1 mediating cross-allergy between Alternaria alternata and Hypsizygus marmoreus, which has not been documented in the literature concerning the FFAS. Mushrooms tend to induce anaphylaxis in patients with mold-allergy and warrants clinicians' attention.

Peanut allergy is a chronic IgE-mediated disease with potentially life-threatening consequences. While several immunotherapeutic strategies have emerged, including oral immunotherapy (OIT), omalizumab (OMA)-based therapies, and probiotic and peanut oral immunotherapy (PPOIT), the comparative effectiveness of these interventions remains unclear. This study aimed to evaluate the relative efficacy and safety of combined and standalone oral immunotherapies for peanut allergy using a Bayesian network meta-analysis (NMA). A systematic literature search was conducted in PubMed, EMBASE, and Web of Science up to March 2025. We included randomized controlled trials (RCTs) involving patients with IgE-mediated peanut allergy who received OIT + OMA, OMA monotherapy, OIT alone, or PPOIT. Outcomes included low-dose and high-dose desensitization, sustained unresponsiveness (SU), and safety outcomes (adverse events, AEs). The risk of bias was assessed using RoB 2. Analyses were performed using R software (version 4.4.3) with Bayesian NMA methods. Nineteen RCTs involving 2040 participants were included. Based on Probability Scores (P-scores), OIT + OMA demonstrated the highest efficacy for both low- (P-score: 97.20

PURPOSE:Subcutaneous immunotherapy (SCIT) can trigger systemic reactions (SRs) that pose potential life-threatening risks. To date, no cluster analysis has been conducted to delineate sub-phenotypes of SRs. This study aims to identify and characterize diverse SR phenotypes during SCIT for house dust mite (HDM) allergies in China. METHODS:This large retrospective real-world study enrolled patients diagnosed with HDM-sensitized allergic rhinitis (AR) and/or asthma who underwent SCIT (Alutard SQ; ALK) between February 2013 and July 2024 at five allergy centers in China. Data on demographic profiles and SRs were collected, followed by a cluster analysis among SR patients. RESULTS:A total of 3,126 patients received 107,588 injections, with SRs observed in 354 patients (11.32%) and 1,056 injections (0.98%). A higher incidence of SRs was noted in younger patients (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.88-0.92; P < 0.001), those with asthma (OR, 2.12; 95% CI, 1.69-2.66; P < 0.001), those with longer disease duration (OR, 1.08; 95% CI, 1.04-1.12; P < 0.001), those with high sensitization (OR, 3.84; 95% CI, 1.66-8.88; P = 0.002), and those with polysensitization (OR, 1.69; 95% CI, 1.30-2.20; P < 0.001). Four distinct clusters of SRs were identified: Cluster 1 (16.5%) primarily comprised relatively older females with lower specific immunoglobulin E (sIgE) levels, predominantly cutaneous involvement, fewer SRs overall but with grade 4 SR; Cluster 2 (29.9%) mainly included AR patients without asthma, mostly exhibiting grade 1 SR; Cluster 3 (34.0%) predominantly consisted of asthma patients with monosensitization, higher injection doses, and mostly grade 2 SR; Cluster 4 (19.6%) mainly featured younger males with higher sIgE levels, polysensitization, lower injection doses, the highest number of SRs, and more grade 3 SR. CONCLUSIONS:Asthma, disease duration, high sensitization, and polysensitization emerge as independent risk factors for SRs. Our cluster analysis delineates distinct clinical phenotypes of SRs, offering tailored interventions for the personalized management of patients experiencing SRs.

Background: Allergic rhinitis (AR) represents a significant global health concern that can give rise to numerous diseases and result in labor productivity. T regulatory (Treg) cells are pivotal players in the pathogenesis of AR, and their deficiencies are closely related to Prostaglandin E2 (PGE2). However, the downstream mechanisms of this relationship remain poorly understood. Objective: This study aims to investigate the inhibitory mechanisms through which PGE2 impacts the differentiation of Treg cells. Methods: We compared the differentiation of Treg cells from na & iuml;ve CD4+ T cells of AR patients and healthy controls, with or without the presence of PGE2 by flow cytometry. Intracellular cAMP concentration, mRNA and protein levels of cyclic-AMP dependent protein kinase A (PKA), as well as their downstream target, Peroxisome Proliferator-Activated Receptor-gamma (PPAR-gamma) were examined in Treg cells from AR and healthy donors. AR mouse model was established by pollen administration. Results: PGE2 suppressed the differentiation of Treg cells from human na & iuml;ve CD4+ T cells through the EP4 receptor. Furthermore, in AR patients and AR mouse, the expression of EP4 receptor were observed enhanced. The PGE2-EP4 signal was carried out by activating cAMP-PKA signaling pathway. Subsequently, phospholated PKA would suppress PPAR-gamma expression. Treatment of Pioglitazone, a PPAR-gamma agonist, was demonstrated to rescue the differentiation of Treg and help alleviate inflammation in the AR mouse model. Conclusion: In AR disease, the PGE2-EP4 signaling exerts an inhibitory effect on Treg differentiation by influencing the cAMP-PKA pathway and its downstream target PPAR-gamma.

Background and Aims Elevated total IgE levels are traditionally associated with allergic conditions; however, their potential role as biomarker for mortality risk beyond allergic diseases has not been extensively explored. Recent studies have suggested that IgE is associated with cardiovascular (CV) disease. We aimed to investigate the association between total IgE levels and the risk of all-cause and cause-specific mortality, as well as to explore the potential mediating role of vitamin status in these associations. Methods and Results The association between IgE and mortality risk was examined in the National Health and Examination Survey 2005-2006. Weighted multivariable Cox proportional hazards model was employed. We further performed restricted cubic spline analysis to assess dose-response relationships and conducted mediation analysis to explore the influence of vitamins on IgE-related mortality risk. Individuals in the highest total IgE quantile (>107.0 kU/L) exhibited a 32% increased risk of all-cause mortality (95% CI: 1.07-1.64) and a 98% elevated risk of CV mortality (95% CI: 1.28-3.07) compared to the lowest quantile (<14.5 kU/L). Heterogeneity exists in the dose-response relationship and threshold effects among individuals with and without allergic diseases. Vitamin deficiency is associated with elevated total IgE levels, and vitamins mediated the relationship of the IgE-related all-cause mortality with the proportion of mediation ranging from 4.68 to 12.71%. Conclusions Our findings introduce a novel dimension to the understanding of IgE as a biomarker for mortality beyond its traditional role in allergic diseases, challenging the current paradigm that elevated IgE levels without overt allergic symptoms are benign.

BACKGROUND:This study aimed to analyze the risk signals of iodinated and gadolinium-based contrast media associated with anaphylaxis. RESEARCH DESIGN AND METHODS:Data from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) were retrospectively reviewed from January 2004 to September 2022. Disproportionality and Bayesian analyses were used in data mining to screen for suspected anaphylaxis using contrast media. RESULTS:A total of 1240 reports of anaphylaxis associated with contrast media were identified (464 men, 37.4%). The average age of anaphylaxis associated with iodinated contrast media (ICM) and gadolinium-based contrast media (GBCM) was 56.8 ± 17.2 and 50.9 ± 18.0 years old, respectively (p < .001). Among ICM, iopamidol showed the highest reporting odds ratio (ROR) (29.0), and amidotrizoate showed the lowest ROR (7.4). Among low-osmolality ICM, iopamidol had the highest ROR (29.0), and iopromide had the lowest ROR (8.8). Among the macrocyclic agents, gadoteridol had the highest ROR (37.3), while gadoterate meglumine had the lowest (10.4). Among the linear agents, gadobenate dimeglumine had the highest ROR (28.8), and gadodiamide had the lowest (1.4). The mortality rate in ICM was significantly higher than that in GBCM (p < 0.001). CONCLUSIONS:This study provides clinicians and pharmacists evidence for risk signals of anaphylactic reactions among contrast agents.

Hymenoptera venom-sensitized patients may experience systemic reactions,and severe patients may even present life-threatening symptoms such as collapse and syncope.Here we report a case of anaphylaxis triggered by multiple sensitization with Hymenoptera venom.Clinical diagnosis and in vitro allergen testing showed that the patient developed anaphylaxis to wasp and/or fire ant venom.In clinical practice,allergen testing of patients with anaphylaxis to Hymenoptera venom aims to clarify the sensitizing proteins and lay a foundation for future research on immunotherapy for Hymenoptera venom in China.For Hymenoptera-allergic patients,daily outdoor protection is crucial,and an epinephrine syringe can be carried with them if necessary.

Pollen-food allergy syndrome is an IgE-mediated allergic reaction arising from cross-reactive homologous allergens found in both food and pollen. Allergens, such as pathogenesis-related protein class 10 and profilin, usually trigger oropharyngeal itching and numbness in patients, whereas lipid transfer proteins tend to induce anaphylaxis. This article presents a case study of an individual with Artemisia pollen allergy who experienced anaphylaxis after consuming red fruit ginseng, a perennial herb belonging to the Campanulaceae family. This study revealed a novel allergen component mediating cross-allergy between Artemisia pollen and food, fructose-bisphosphate aldolase, which has not been documented in the literature concerning the pollen-food allergy syndrome. Fructose-bisphosphate aldolase tends to induce anaphylaxis in patients with Artemisia pollen-allergy and warrants clinicians' attention.

BackgroundAllergic rhinitis (AR) is a common nasal inflammatory disorder that severely affects an individual's quality of life (QoL) and poses a heavy financial burden. In addition to routine treatments, probiotic intervention has emerged as a promising strategy for preventing and alleviating allergic diseases. The main objective of this study was to determine the effect of a novel multi-strain probiotic mixture on AR symptoms and investigate potential targets underlying the probiotic intervention.MethodsA randomized, double-blind, placebo-controlled clinical study was conducted on AR patients who were allergic to autumnal pollens (n = 31). Placebo or a novel probiotic mixture, composed of Lactobacillus rhamnosus (L. rhamnosus) HN001, L. acidophilus NCFM, Bifidobacterium lactis (B. lactis) Bi-07, L. paracasei LPC-37, and L. reuteri LE16, was administered after 2 months. The therapeutic efficacy was evaluated by a symptom assessment scale. Before and during the pollen season, blood samples were collected, and peripheral blood mononuclear cells (PBMCs) were isolated for further tandem mass tags (TMTs)-based quantitative proteomic analyses. Potential targets and underlying pathological pathways were explored using bioinformatics methods.ResultsDuring the pollen season, the rhinoconjunctivitis symptom score of participants who were administered probiotics (probiotic group, n = 15) was significantly lower than those administered placebo (placebo group, n = 15) (P = 0.037). The proteomic analyses identified 60 differentially expressed proteins (DEPs) in the placebo group, and subsequent enrichment analyses enriched a series of pathways and biological processes, including signaling pathways of inflammation, coagulation cascade, lipid, carbohydrate and amino acid metabolic pathways, and transcription and translation processes. Least Absolute Shrinkage and Selection Operator (LASSO) regression extracted five main elements, namely, GSTO1, ATP2A2, MCM7, PROS1, and TRIM58, as signature proteins. A total of 17 DEPs were identified in the probiotic group, and there was no pathway enriched. Comparison of DEPs in the two groups revealed that the expression levels of the high-mobility group nucleosome-binding domain-containing protein 2 (HMGN2) and Histone H1.2 presented an opposite trend with different interventions.ConclusionOur data showed that AR symptoms alleviated after treatment with the novel multi-strain probiotic mixture, and the proteomic analyses suggested that HMGN2 and Histone H1.2 might be targets of probiotic intervention for seasonal AR.

过敏性哮喘是一种由变应原诱发的以气道高反应性、IgE升高、气道慢性炎症为特征的疾病.固有免疫和适应性免疫均在过敏性哮喘的免疫调节机制中发挥作用.支气管上皮细胞活化并释放的IL-25、IL-33和TSLP驱动Th2型免疫应答,最终导致Th2型炎症反应.近年来研究发现细胞外囊泡和微生物组学在过敏性哮喘发生发展中起到重要作用.随着新型生物治疗方法的发展,常规治疗无效的过敏性哮喘患者可以选择以IgE、IL-4/IL-13、IL-5等为靶点的生物制剂以改善哮喘症状.本文对过敏性哮喘发病过程中免疫调节机制相关研究进展进行综述.