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[Effects and mechanisms of Jiawei Yigong San on the Th17/Treg balance in food allergy].

Objective To explore the effects and mechanisms of Jiawei Yigong San (JWYGS) on the T helper type 17 (Th17)/regulatory T (Treg) cell balance in food allergy (FA). Methods Active components, action targets of JWYGS, and FA-related targets, were screened via network pharmacology. Overlapping targets between JWYGS and FA were used to construct a protein-protein interaction (PPI) network. Gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analyses were performed to predict key signaling pathways. Molecular docking was conducted to validate the binding affinity between the main active components and the predicted targets. Mice were randomly divided into control group, model group, JWYGS low-dose, medium-dose, and high-dose groups, and dexamethasone (DXM) group. An ovalbumin (OVA)-induced FA model was established. During the OVA challenge period, mice received daily intragastric administration, after which allergy and diarrhea scores were assessed. Small intestinal pathology was evaluated by HE staining. Serum ovalbumin-specific immunoglobulin E (OVA-sIgE), interleukin 6 (IL-6), IL-17, IL-2, and IL-10 were measured by ELISA. Small intestinal IL-6, IL-17, and IL-10 protein expression was detected by immunohistochemistry. Splenic Th17 and Treg cells were quantified by flow cytometry, and the Th17/Treg ratio was calculated. The mRNA expression of IL-6, retinoic acid receptor-related orphan receptor γt (RORγt), and forkhead box protein P3 (FOXP3) in the small intestine was detected by qPCR. Results Network pharmacology identified 235 active components of JWYGS and 136 common targets. GO and KEGG enrichment analyses highlighted cytokine response and Th17 differentiation. Molecular docking confirmed stable binding between core components and targets. Compared with the control group, the model group exhibited aggravated allergy and diarrhea scores, marked small intestinal inflammation and mucosal damage, elevated serum levels of OVA-sIgE, IL-6, IL-17 and IL-2, along with increased splenic Th17 cell frequency and Th17/Treg ratio. Intestinal IL-6 and IL-17 protein levels as well as IL-6 and RORγt mRNA expression were upregulated, whereas serum IL-10 levels were decreased, and intestinal expression of IL-10 protein and FOXP3 mRNA was downregulated. After JWYGS treatment, allergy and diarrhea scores were significantly reduced. Small intestinal inflammation and mucosal damage were alleviated. Serum levels of OVA-sIgE, IL-17, IL-6 and IL-2, Th17 cell frequency and the Th17/Treg ratio, intestinal IL-6 and IL-17 protein levels were decreased. IL-6 and RORγt mRNA expression was downregulated. Serum IL-10 levels were increased and intestinal expression of IL-10 protein and FOXP3 mRNA was upregulated. Moreover, the JWYGS high-dose group demonstrated comparable efficacy to the DXM group. Conclusion JWYGS can ameliorate symptoms and reverse the Th17/Treg imbalance in FA mice, potentially by inhibiting IL-6 transcription and regulating RORγt/FOXP3 expression.

Animals

[The allergic focal reaction phenomenon. Significance for the testing, therapy and theory of clinical allergy. Study in bronchial asthma and other allergic diseases].

On the basis of examinations of 654 cases of clinical allergy (487 cases of bronchial asthma) a new allergenic phenomenon is described: "The allergic focal reaction phenomenon". It is associated with the demonstration of a regularly reproducible, clinical, allergic initiating effect of very small doses of specific antigen only on the allergically diseased tissue (focus). The findings made it possible to elaborate a new method for allergy testing and therapy without any danger, and offers quite new ideas for the interpretation of allergic mechanisms. The authors tried to integrate this phenomenon into the picture of clinical allergy, and some so far unclear problems of allergy may, on this basis, have found a probable solution."

Adolescent

The Role of In Vivo, In Vitro and Pharmacogenomic Diagnostic Approaches to Sulfonamide Allergy.

Sulfonamide antibiotics are commonly reported as a medication allergy, presenting as both immediate IgE-mediated reactions and delayed hypersensitivity reactions ranging from benign cutaneous eruptions to severe cutaneous adverse reactions. Sulfonamide antibiotics have retained importance as treatment for multiple indications and are especially relevant in immunocompromised patients wherein use is indicated for prevention of opportunistic infections. Sulfonamide antibiotic allergy labels may lead to inappropriate avoidance of other "sulfur"-containing medications, because cross-reactivity is unlikely between antibiotic and nonantimicrobial sulfonamides. In this review, we discuss the typical presentation of sulfonamide antibiotic hypersensitivity reactions. We also review risk stratification tools and current in vivo procedures and experimental in vitro evaluation methods. Lastly, we will provide an update on emerging pharmacogenomics data associated with sulfonamide medication adverse reactions.

Humans

IgE studies on respiratory tract allergies.

The IgE content was determined and specific IgE antibodies were identified in serum samples and nasal secretions of 40 control subjects, 103 patients with nasal allergy, and 37 patients with bronchial asthma using a radioimmunosorbent test an both the serum samples and nasal secretions of allergic patients. Approximately 70% of the serum samples and nasal secretions obtained from patients with positive house dust skin test results were found to contain specific IgE antibodies to mites. The results of this study proved the usefulness of the determination of IgE and specific IgE antibodies in the diagnosis and study of the pathogenesis of respiratory tract allergies. The IgE in nasal secretions was much more closely related to pathogenesis of respiratory allergies than was IgE in serum samples. However, unless more concentrated nasal secretions are assayed, the diagnostic value is limited.

Adolescent

Insulin antibodies in the pathogenesis of insulin allergy and resistance.

Insulin allergy developed in a patient treated with beef/pork insulin. Desensitization therapy led to cessation of the allergy, but it was associated with the development of diabetic ketoacidosis with apparent insulin resistance which was successfully treated with fish insulin. The patient's initial serum contained a high titer of anti-insulin immunoglobulin E (IgE) antibody directed primarily against beef insulin. Desensitization therapy with pork insulin was associated with the production of anti-insulin immunoglobulin G (IgG) antibody with highest immunologic reactivity to pork insulin. This IgG antibody may have blocked the interaction of insulin with tissue-fixed IgE antibody but, in addition, led to significant increases in total serum insulin-binding capacity and transient insulin resistance. The favorable clinical response to fish insulin was likely due to the negligible immunologic reactivity of this patient's anti-insulin antibodies with fish insulin. This report suggests that desensitization therapy for insulin allergy can lead to insulin resistance of the immune type.

Animals

Allergies of the dental pulp.

A review of publications relating to the allergies of the dental pulp is presented. The pulp--especially when inflamed--contains antigens, lymphocytes, plasmocytes, IgG, IgM, IgA, and IgE antibodies, mast cells, histamine, and possibly C3. However, no antibody-mediated allergy (hypersensitivity) of the pulp has yet been demonstrated. On the other hand, two types of cell-mediated allergy--the graft-rejection reaction and contact hypersensitivity--have been reported, as well as autoimmunity.

Animals

Lactiplantibacillus plantarum SLpl116 attenuates OVA-induced food allergy with ecological restoration of the gut microbiota and immune rebalancing.

Gut dysbiosis is increasingly recognized as a key contributor to food allergy, yet probiotic strains capable of restoring allergic microbiota and rebalancing host immunity remain limited. Here, we identified Lactiplantibacillus plantarum SLpl116 through a multi-criteria screening pipeline integrating anti-allergic activity, safety, and processing stability, and evaluated its efficacy in a prophylactic ovalbumin (OVA)-induced murine food allergy model. SLpl116 significantly attenuated allergic symptoms, including diarrhea and hypothermia, and suppressed serum IgE, IgG1, OVA-specific immunoglobulins, and mucosal mast cell protease-1. It was also associated with suppression of Th2-related responses and enhancement of systemic Th1-associated signaling, indicating restoration of Th1/Th2 immune balance. Microbiome analysis showed that SLpl116 was associated with ecological restoration of the dysbiotic gut community, including suppression of allergy-associated taxa such as Alistipes finegoldii and Bacteroides and enrichment of beneficial commensals, particularly Lachnospiraceae. Correlation analysis supported an association between microbial reconfiguration and immune rebalancing, while PICRUSt2-based functional prediction suggested enriched butyrate-associated metabolic potential in the effective strain groups. Comparative genome-informed analysis further indicated that SLpl116 possessed distinctive phenotype-linked features, providing a plausible molecular rationale for its favorable phenotype. Together, these findings identify SLpl116 as a promising strain-level probiotic candidate associated with direct immune rebalancing and microbiome-associated ecological restoration.

Journal Article

[Cross allergy between sulphonamide diuretics, probenecid, sulphamethoxazole and sulphonyl-urea compounds (author's transl)].

Typical signs and symptoms of type III allergy occurred in a 55-year-old diabetic during diabetes and diuretic treatment with glisoxepid, glibenclamide, furosemide and probenecid. Symptoms of this type of allergy unintentionally recurred with every subsequent therapeutic administration of each one of these drugs. The possibility of a cross allergy between sulphonamide diuretics, chemotherapeutic sulphonamides and sulphonyl-urea compounds has only rarely been described.

Cross Reactions

A potential diagnostic method for food allergy: clinical application and immunogenicity evaluation of an elemental diet.

The use of a simple, hypoallergenic elemental diet would appear well suited for diagnosing food allergy. Vivonex was used in 21 patients (5 to 40 years old) suspected of food allergy or those who had failed to respond to the usual management of inhalant allergy. To study immunogenicity, five New Zealand rabbits were immunized with Vivonex, milk, and egg and were evaluated for the production of precipitin and passive cutaneous anaphylactic antibodies, the latter was evaluated in three Hartley guinea pigs. The clinical study was conducted over a 2- to 3-week period with evaluation of symptom and medication scores, physical examination, and hematological and biochemical measurements made before and after the Vivonex trial, which was a minimum of 1 week. No consistent, significant improvement of allergic manifestations were seen while patients received Vivonex. On the other hand, there were no serious side effects noted either clinically or by laboratory measurements, although four patients discontinued the study because of Vivonex palatibility. Vivonex was not immunogenic by either the precipitin reaction or passive cutaneous anaphylactic response. Although Vivonex did not prove helpful in these severe, refractory allergic individuals, we were encouraged by its safety and acceptance in the outpatient setting. Further studies in young allergic children who are more likely to have clear-cut food sensitivity are being planned.

Adolescent

Frequency of atopy and allergy in an anaesthetic patient population.

Ten thousand patients presenting for anaesthesia in the British Isles were questioned about a possible history of atopic or allergic disorders. The overall percentage frequency of atopy was 8.5, comprising eczema 2.4, hay fever 3.8 and asthma 3.5. The frequency of allergies was 13.5, of which penicillin was the most common (6.2). Females had a significantly greater frequency of atopy or allergy than males. Patients with a history of atopic disorders had a higher frequency of allergies than the non-atopic group (36.2% compared with 11.4%) and vice versa.

Adolescent

In vitro histamine release from leukocytes in penicillin allergies.

The definite diagnosis of Type I allergy against penicillin is very important. The in vivo tests used for this purpose may have some disadvantages for the patient. Among the in vitro tests used for the evidence and differential diagnosis of Type I allergy against penicillin, the determination of histamine release from leukocytes and the detection of IgE by the RAST test are the most promising. We have used the test of histamine release from leukocyte in this study of 18 cases, nine of whom had Type I hypersensitivity reactions to penicillin and comprised the study group, the rest were control cases. The per cent of histamine release in the control group was "zero" while in the study group it ranged from 3.9 to 51.7 per cent. The results indicate that the method used in this study is a sensitive and reliable method for the diagnosis of Type I penicillin allergies.

Adolescent

Food sensitivity reported by patients with asthma and hay fever. A relationship between food sensitivity and birch pollen-allergy and between food sensitivity and acetylsalicylic acid intolerance.

Among adult patients with bronchial asthma and/or allergic rhinitis undergoing allergological investigation with skin test, nasal provocation test and RAST, 1129 answered a questionaire regarding food sensitivity (FS). 276 (24%) of the patients reported some kind of allergic symptoms on eating or handling various foods, of which hazel nut, apple and shell fish were the most often named. Females reported FS more often than males. A correlation was found between birch pollen allergy and FS with nuts, apple, peach, cherry, pear, plum, carrot and new potato. The higher the degree of birch pollen allergy, according to skin test, RAST or provocation test, the higher the frequency of FS. A correlation was found too between acetylsalicylic acid intolerance and FS with some foods, e.g. nuts, strawberry, almond, green pepper, hip, chocolate, egg, cabbage, milk and wine. The connection between birch pollen allergy and FS is probably explained by the structural relationship between birch pollen allergen and some allergens of the foodstuffs, whereas the high incidence of FS in acetylsalicylic acid-intolerant patients is probably explained by additives in foods as well as salicylates or benzoates naturally occurring in some food.

Adolescent

Occupational dermatitis from Lactuca sativa (lettuce) and Cichorium (endive). Simultaneous occurrence of immediate and delayed allergy as a cause of contact dermatitis.

Four patients with occupational contact dermatitis to Lactuca sativa had cross-sensitivity to Cichorium endivia. One of the patients also had contact urticaria to Lactuca and Cichorium, and another reacted positively to scratch tests with these plants as a sign of immediate allergy. In two cases such immediate allergy was considered the cause of a vesicular, intense itching eruption within a few minutes of contact with fresh leaves of Lactuca on previously eczematous skin. The severe chronic dermatitis of the hands of these patients is ascribed to combined delayed and immediate allergy.

Adult

Diagnosis of reaginic allergy with house dust, animal dander and pollen allergens in adult patients. I. A comparison between RAST, skin tests and provocation tests.

RAST analyses were performed with house dust, animal dander and eleven pollen allergens in 410 adult patients with asthma and/or rhinitis and the findings were compared with skin test and provocation test results. The overall correlation between 1,316 provocation tests and RAST was 78% and the correlation between 1,778 skin tests and RAST was 66%. The relationships between RAST and in vivo tests differed considerably from allergen to allergen. No significant differences were found between various age groups. According to the in vivo tests the RAST showed more often positive results in patients with pronounced allergy than in patients with low-grade allergy. Higher RAST classes were most often combined with positive in vivo tests. It is concluded that in cases with RAST classes 2-4, a reasonably well-established allergy diagnosis can be reached without the inclusion of additional in vivo tests. In other cases, however, application of further diagnostic methods is required.

Adolescent

Diagnosis of reaginic allergy with house dust, animal dander and pollen allergens in adult patients. V. A comparison between the enzyme-linked immunosorbent assay (ELISA), provocation tests, skin tests and RAST.

An enzyme-linked immunosorbent assay (ELISA) employing allergen adsorbed onto the internal surface of a plastic tube, and alkaline phosphatase conjugated anti-IgE was used for the determination of specific IgE antibodies to various inhalant allergens in serum samples from 255 individuals with asthma and/or allergic rhinitis. A total of 541 analyses were carried out and the results were compared with those of provocation tests, skin tests and the RAST. It was found that negative ELISA values with high probability indicated nonallergy and very high ELISA values (class greater than or equal to 5) indicated allergy. However, the proportion of positive ELISA values which did not correspond to clinical allergy was high, as were the number of intermediate, inconclusive values (class 1-2). Although significant correlations between the ELISA values and provocation test, skin test or the RAST were obtained with some allergens, it was concluded that our version of the ELISA has not advantages over currently used methods for allergy diagnosis.

Administration, Intranasal

Prevalence of childhood allergy in a subtropical environment: data from Dade County, Florida.

Other prevalence studies of allergy in school children have been limited to temperate zones only. The aims of this computerized investigation were wholly focused on South Florida, located in a subtropical climate. The occurrence of allergy in relation to marked geographic variations was surveyed to evaluate the prevalence of allergy in connection with these topographic differences.

Adolescent

Testing for food allergy: a statistical comparison of cytotoxic and intracutaneous tests.

This study presents a comparison of in vitro cytotoxic food allergy test results with those of in vivo intracutaneous food allergy testing by both objective serial dilution titration and subjective provocation. During the study the cytotoxic test was utilized as a screening device for follow-up Lee intracutaneous testing, the latter providing statistics for both noted in vivo intracutaneous tests. The study is presented in two stages. The first stage documents almost 6000 comparison test results on 300 consecutive food-allergic otolarynogology patients. Thirty-four of the more frequently offending foods were utilized. Of the cytotoxic tests, 86% resulted in positive reactions. Of the positive cytotoxic reactors, 74% were intracutaneously re-checked. Only those negative cytotoxic reactors suspected of false negativity were so challenged, affording comparison statistics for a smaller 21% of the negative reactors. Poor correlation statistics for this select negative reacting group prompted a follow-up 30-patient study on 11 foods that appeared to possess a lesser potential for hypersensitivity production. The second stage emphasizes similar test comparisons on the negative cytotoxic reactors. The study concludes that no correlation exists between in vitro cytotoxic test determinations and those of in vivo intracutaneous testing by objective serial dilution titration or subjective provocation. Because most allergic individuals have multiple food allergies, clinical success utilizing the information obtained from any or all of these procedures may rely significantly on the tests' inherent tendency to identify multiple guilty foods for ultimate treatment.

Cytotoxicity Tests, Immunologic

Nasal glands in nasal allergy.

The entire nasal mucosa from a patient with nasal allergy and hay fever was studied by the whole mount method, and the density of submucous glands was determined. Their density was essentially greater than in normal noses in all parts of the nose, especially on the conchae. This finding indicates that new-abnormal-glands form in the course of the disease, glands which also differ morphologically from the normally occurring glands. As this greatly increases the secretory capacity of the mucous membrane, there is a patho-anatomical basis for assuming that the nasal secretion in allergy is formed exclusively by the existing glands. Other sources of nasal secretion, such as exudation and transudation under normal conditions and in allergy, as well as the mode and causes of gland formation, are discussed.

Adolescent