著者
Naoko Inomata Hiroyuki Osuna Katuyuki Kawano Junko Yamaguchi Masumi Yanagimachi Setsuko Matsukura Zenro Ikezawa
出版者
Japanese Society of Allergology
雑誌
Allergology International (ISSN:13238930)
巻号頁・発行日
vol.56, no.3, pp.257-261, 2007 (Released:2007-09-13)
参考文献数
18
被引用文献数
25

Background: Allergic reactions after ingestion of fermented soybeans have rarely been reported. Fermented soybeans were recently reported to be a causative food of IgE-mediated, late-onset anaphylaxis without early phase responses. The objectives of our study are to clarify the clinical and laboratory features and to characterize the allergens in allergy due to fermented soybeans. Methods: Seven patients with suspected hypersensitivity to fermented soybeans, from whom informed consent had been obtained, underwent skin prick-prick tests with fermented soybeans and challenge test with fermented soybeans. Additionally, specific IgE against fermented soybeans and the allergens of fermented soybeans were detected by ELISA and IgE-immunoblotting, respectively. Results: Seven male patients, aged 26 to 42 years (mean age, 33.1 years), participated. All patients reported generalized urticaria and dyspnea; 5, loss of consciousness; 2, collapse; 2, vomiting; and 2, diarrhea after fermented soybean ingestion. The interval between fermented soybean ingestion and onset of symptoms was 5 to 14 hours (mean, 9.6 hours). All patients were positive on skin prick-prick tests with fermented soybeans. In 2 patients, oral challenge with fermented soybeans was positive 5.5 and 13 hours after ingestion. In ELISA, all 5 patients tested showed elevated IgE levels to the fermented soybean extract. Furthermore, IgE-immunoblotting using 5 patients' sera showed six bands, of which three bands at 38, 28, and 26-kd were bound to sera from 4 patients. Conclusions: Cases with hypersensitivity after ingestion of fermented soybeans most frequently correspond to IgE-mediated, late-onset anaphylactic reactions due to fermented soybeans.
著者
Atsuhito Nakao Yuki Nakamura
出版者
Japanese Society of Allergology
雑誌
Allergology International (ISSN:13238930)
巻号頁・発行日
vol.71, no.4, pp.425-431, 2022 (Released:2022-10-08)
参考文献数
54
被引用文献数
7

Mast cell activation is crucial to the development of allergic disease. New studies have shown that both IgE-dependent and -independent mast cell activation is temporally regulated by the circadian clock, a time-of-day-keeping system that consists of transcriptional-translational feedback loops of several clock genes. For instance, the core clock gene Clock controls the expression of the high-affinity IgE receptor (FcεRI) and interleukin-33 (IL-33) receptor ST2 on mast cells in a time-dependent manner. As a result, the threshold of IgE-dependent or IL-33-dependent mast cell activation differs between daytime and nighttime. This mechanism may underlie the observation that allergic disease shows a marked day-night change in symptom occurrence and severity. Consistent with this novel concept, environmental and lifestyle factors that disturb the normal rhythmicity of the circadian clock, such as irregular eating habits, can lead to the loss of circadian control of mast cell activation. Consequently, the degree of mast cell activation becomes equally strong at all times of day, which might clinically result in worsening allergic symptoms. Therefore, further understanding of the association between mast cell activation and the circadian clock is important to better manage patients with allergic disease in the real world, characterized by a “24/7 society” filled with environmental and lifestyle factors that disturb the circadian clock rhythmicity.
著者
Naoko Ozawa Naoki Shimojo Yoichi Suzuki Shingo Ochiai Taiji Nakano Yoshinori Morita Yuzaburo Inoue Takayasu Arima Shuichi Suzuki Yoichi Kohno
出版者
Japanese Society of Allergology
雑誌
Allergology International (ISSN:13238930)
巻号頁・発行日
vol.63, no.2, pp.261-266, 2014 (Released:2014-06-06)
参考文献数
18
被引用文献数
20

Background: There are reports that the maternal diet during pregnancy may affect development of babies' eczema. We sought to investigate the association between the maternal diet during pregnancy and the risk of eczema in infancy in Japan. Methods: A birth cohort was set up at 2 hospitals in Chiba city. Dietary habits concerning fish, butter, margarine, yogurt and natto during pregnancy was obtained from mothers just after delivery. The intake frequencies of these foods were classified into four groups: 1) daily, 2) 2-3 times a week, 3) once a week and 4) once a month or less. Diagnosis of eczema at 6 months of age was made by the presence of an itchy rash that persisted more than two months. Results: Valid data on 650 mother-baby pairs were obtained. No relationship between frequencies of the maternal intake of fish, margarine and yogurt during pregnancy and the onset rate of the babies' eczema were observed. For butter consumption, the incidence of babies' eczema was significantly higher in the group with daily intake than in those with an intake 2-3 times a week or less (p = 0.044). For natto, incidence of babies' eczema was significantly lower in the group with everyday intake than those eating it 2-3 times a week or less (p = 0.020). Conclusions: High frequency intake of natto during pregnancy possibly reduces the incidence of eczema in children at 6 months of age.
著者
Naoko Inomata Mami Miyakawa Michiko Aihara
出版者
Japanese Society of Allergology
雑誌
Allergology International (ISSN:13238930)
巻号頁・発行日
vol.67, no.3, pp.341-346, 2018 (Released:2018-07-28)
参考文献数
24
被引用文献数
21

Background: Poly(γ-glutamic acid) (PGA) is an allergen in natto, fermented soybeans, which causes late-onset anaphylaxis. We hypothesized that jellyfish stings sensitize adults to PGA because a surfer had allergies to both natto and jellyfish, whose sting contains PGA. The aim of the study was to identify behavioral factors, such as marine sports, associated with PGA sensitization.Methods: Outpatients diagnosed with food allergies based on relevant clinical history, positive skin test and/or food challenge test answered a questionnaire during a regular visit in 2016.Results: Questionnaire data from 140 outpatients were analyzed. These patients were divided into two groups: natto allergy group (13 patients, M:F = 10:3, mean age 40.6 years) and non-natto allergy group (127 patients, M:F = 46:81, mean age 44.5 years). All patients with natto allergy had positive results in skin prick test and basophil activation test with PGA. Of these, 92.3% had a marine sport hobby, especially surfing (84.6%). PGA sensitization was independently associated with marine sports (odds ratio, 278.0, 95 percent confidence interval, 36.9-6315.9, p < 0.001) adjusted for male sex and sea bathing, but not with male sex or sea bathing. In addition, although there was no significant difference in the experience of marine sports between natto and non-natto allergy groups, the natto allergy group participated significantly more frequently in marine sports than the non-natto allergy group (p < 0.001). There was no significant difference between natto consumption amount and PGA sensitization.Conclusions: Surfing is a risk factor for PGA sensitization in those with allergy to natto.
著者
Tetsuji Takabayashi Yoshimasa Imoto Masafumi Sakashita Yukinori Kato Takahiro Tokunaga Kanako Yoshida Norihiko Narita Tamotsu Ishizuka Shigeharu Fujieda
出版者
Japanese Society of Allergology
雑誌
Allergology International (ISSN:13238930)
巻号頁・発行日
vol.66, no.4, pp.594-602, 2017 (Released:2017-10-24)
参考文献数
28
被引用文献数
23

Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is often comorbid with asthma and resistant to therapeutic interventions. We recently reported that excessive fibrin deposition caused by impairment of fibrinolysis might play pivotal role in forming nasal polyp. Nattokinase (NK), a serine protease produced by Bacillus subtilis, has been reported to be a strong fibrinolytic enzyme. NK could be a promising drug candidate for use in the treatment of both CRSwNP and asthma. The objective of this study was to investigate the effects of NK on nasal polyp tissues from patients with CRSwNP. The nasal discharge from patients with CRSwNP and sputum from subjects with asthma were also used to investigate whether NK influences the viscosity of mucus.Methods: To examine the effects on NK on nasal polyp tissues, pieces of nasal polyps were incubated either with saline or NK (10–1000 FU/ml) at 37 °C for 24 h. We assessed the presence of fibrin in nasal polyp tissue incubated with NK by means of immunohistochemistry. To examine the effects of NK on nasal discharge and sputum from patients with CRSwNP and asthma, respectively, were incubated with NK solution at 37 °C for 1 h.Results: NK effectively shrinks the nasal polyp tissue through fibrin degradation. We also found that the viscosity of the nasal discharge and sputum from patients with CRSwNP and asthma, respectively, was significantly reduced by incubation with NK solution.Conclusions: NK may be an effective alternative therapeutic option in patients with CRSwNP and comorbid asthma by causing fibrin degradation.
著者
Kimihiro Okubo Satoshi Ogino Toshikazu Nagakura Takeru Ishikawa
出版者
Japanese Society of Allergology
雑誌
Allergology International (ISSN:13238930)
巻号頁・発行日
vol.55, no.4, pp.379-386, 2006 (Released:2006-12-18)
参考文献数
25
被引用文献数
79

Background: Seasonal allergic rhinitis (SAR) induced by Japanese cedar pollen is a substantial problem in Japan. Omalizumab, a novel humanized monoclonal anti-immunoglobulin E (IgE) antibody, has already been proven to reduce symptoms associated with SAR. We investigated the safety and efficacy of omalizumab in the treatment of patients with Japanese cedar pollen-induced SAR compared to placebo. Methods: A randomized, placebo-controlled, double-blind study was conducted in 100 Japanese patients with a history of moderate-to-severe SAR induced by Japanese cedar pollens. Omalizumab (150, 225, 300, or 375mg) or placebo was administered subcutaneously every 2 or 4 weeks based on serum total IgE and body weight at baseline. The primary efficacy variable was the mean of daily nasal symptom medication scores (sum of the daily nasal symptom severity score and daily nasal rescue medication score) during the treatment period. Secondary efficacy variables included the daily ocular symptom medication score and related variables. Results: Primary and all secondary efficacy variable scores were significantly lower in the omalizumab group than in the placebo group (P Conclusions: Omalizumab was effective and safe in the treatment of SAR induced by Japanese cedar pollen.
著者
Lea Gigon Shida Yousefi Alexander Karaulov Hans-Uwe Simon
出版者
Japanese Society of Allergology
雑誌
Allergology International (ISSN:13238930)
巻号頁・発行日
vol.70, no.1, pp.30-38, 2021 (Released:2021-01-09)
参考文献数
167
被引用文献数
31

Neutrophils and eosinophils are granulocytes which are characterized by the presence of granules in the cytoplasm. Granules provide a safe storage site for granule proteins that play important roles in the immune function of granulocytes. Upon granulocytes activation, diverse proteins are released from the granules into the extracellular space and contribute to the fight against infections. In this article, we describe granule proteins of both neutrophils and eosinophils able to kill pathogens and review their anticipated mechanism of antimicrobial toxicity. It should be noted that an excess of granules protein release can lead to tissue damage of the host resulting in chronic inflammation and organ dysfunction.
著者
Akihito Yokoyama Hiroshi Okazaki Naoyuki Makita Ayako Fukui Yi Piao Yoshifumi Arita Yohji Itoh Naoki Tashiro
出版者
Japanese Society of Allergology
雑誌
Allergology International (ISSN:13238930)
巻号頁・発行日
vol.71, no.1, pp.47-54, 2022 (Released:2022-01-27)
参考文献数
18
被引用文献数
7

Background: In Japan, regional differences in asthma mortality have been reported; however, regional differences in asthma exacerbations have not been studied extensively. Therefore, using a health insurance claims database, we investigated the regional differences in the incidence of asthma exacerbations in Japan.Methods: This study used data from Medi-Scope (Japan Medical Information Research Institute Inc., Japan)-a nationwide health insurance claims database. Patients with asthma at the index date (the latest date of an asthma-related prescription with an asthma diagnosis before October 1, 2018) were included in the analysis. The pre-index period was defined as 1 year before the index date, and the follow-up period as 1 year after the index date. The incidence of asthma exacerbation events was analyzed for each region.Results: The primary analysis population comprised 24,883 patients who were continuously prescribed ICS or ICS/LABA at least four times during the pre-index period. The incidence rate of asthma exacerbations with hospitalization was the highest in Chugoku (2.95/100 person-years [95% CI, 1.97-4.43]) and the lowest in Kanto (1.52/100 person-years [95% CI, 1.26-1.83]). The incidence rate of asthma exacerbations for the composite outcome of hospitalization, injectable corticosteroid prescription, and oral corticosteroid burst was the highest in Fukui (105.00/100 person-years [95% CI, 64.53-170.85]) and the lowest in Nagasaki (15.69/100 person-years [95% CI, 10.84-22.72]).Conclusions: Regional differences in the incidence of asthma exacerbations as well as their treatments were observed in Japan.
著者
Naoko Takeo Masashi Nakamura Satoshi Nakayama Osamu Okamoto Naoki Sugimoto Shinichi Sugiura Nayu Sato Susumu Harada Masao Yamaguchi Naoya Mitsui Yumiko Kubota Kayoko Suzuki Makoto Terada Akiyo Nagai Junko Sowa-Osako Yutaka Hatano Hiroshi Akiyama Akiko Yagami Sakuhei Fujiwara Kayoko Matsunaga
出版者
Japanese Society of Allergology
雑誌
Allergology International (ISSN:13238930)
巻号頁・発行日
vol.67, no.4, pp.496-505, 2018 (Released:2018-10-18)
参考文献数
48
被引用文献数
31

Background: Cochineal dye is used worldwide as a red coloring in foods, drinks, cosmetics, quasi-drugs, and drugs. The main component of the red color is carminic acid (CA). Carmine is an aluminum- or calcium-chelated product of CA. CA and carmine usually contain contaminating proteins, including a 38-kDa protein thought to be the primary allergen. Severe allergic reactions manifest as anaphylaxis. The aim of this study was to review all Japanese reported cases and propose useful diagnostic chart.Methods: All reported Japanese cases of cochineal dye-induced immediate allergy were reviewed, and newly registered cases were examined by skin prick test (SPT) with cochineal extract (CE) and measurement of CE and carmine-specific serum IgE test. Two-dimensional (2D) western blotting using patient serum was conducted to identify the antigen.Results: Twenty-two Japanese cases have been reported. SPT and the level of specific IgE test indicated that six cases should be newly registered as cochineal dye allergy. All cases were adult females, and all cases except three involved anaphylaxis; 13 cases involved past history of local symptoms associated with cosmetics use. Japanese strawberry juice and fish-meat sausage, and European processed foods (especially macarons made in France) and drinks were recent major sources of allergen. 2D western blotting showed that patient IgE reacted to the 38-kDa protein and other proteins. Serum from healthy controls also weakly reacted with these proteins.Conclusions: SPT with CE and determination of the level of CE and carmine-specific IgE test are useful methods for the diagnosis of cochineal dye allergy.
著者
Ittetsu Tanaka Mitsushi Okazawa Masami Taniguchi Kenichiroh Suzuki Ryouji Tamura Hiroki Sakakibara Susumu Suetsugu
出版者
Japanese Society of Allergology
雑誌
Allergology International (ISSN:13238930)
巻号頁・発行日
vol.49, no.4, pp.269-273, 2000 (Released:2006-03-16)
参考文献数
29
被引用文献数
2

A 49-year-old Japanese man with bronchial asthma was admitted to hospital because of acute lobar pneumonia. A diagnosis of acute tuberculous pneumonia was made based on the pathologic findings of lung biopsy specimens and bacteriologic examination. For the 5 years before the onset of pneumonia, the patient had been treated with inhaled beclomethasone dipropionate (600 µg/day) and was well controlled. Laboratory findings revealed no immunosuppressive conditions, nor had the patient used oral corticosteroids for the treatment of his asthma. A tuberculin skin test had been negative approximately 30 years ago and annual chest X-ray examination had shown no evidence of tuberculosis over the past 5 years. Fiberoptic broncoscopic examination showed no evidence of bronchial tuberculosis or perforated lymph nodes. Because acute tuberculous lobar pneumonia in the lower lung field is rare, except in patients receiving oral corticosteroids or with immunodeficiency conditions, in this patient the inhalation of corticosteroids may have predisposed him to the onset of this condition.
著者
Hideyuki Takeshima Masafumi Horie Yu Mikami Kosuke Makita Naoya Miyashita Hirotaka Matsuzaki Satoshi Noguchi Hirokazu Urushiyama Yoshihisa Hiraishi Akihisa Mitani Zea Borok Takahide Nagase Yasuhiro Yamauchi
出版者
Japanese Society of Allergology
雑誌
Allergology International (ISSN:13238930)
巻号頁・発行日
vol.68, no.1, pp.101-109, 2019 (Released:2019-01-26)
参考文献数
47
被引用文献数
14

Background: Bronchial asthma is a chronic airway disease characterized by eosinophilic airway inflammation. Lung fibroblasts activated by IL-13 serve as important sources of chemokines, such as eotaxins, contributing to persistent eosinophilic inflammation. Src-homology 2-containing protein (CISH), belonging to the suppressor of cytokine signaling (SOCS) family, acts as a negative regulator of cytokine induction. The aim of this study was to elucidate the role of CISH in the production of eosinophil chemotactic chemokines in human lung fibroblasts.Methods: Normal human lung fibroblasts were stimulated by IL-13, and global gene expression profile was assessed by cDNA microarray. Expression changes and downstream of IL-13 signaling were evaluated by quantitative RT-PCR, ELISA or western blotting. Loss- and gain-of-function analyses of CISH were performed by small interfering RNA and vector overexpression, respectively.Results: Ingenuity pathway analysis revealed that IL-13 induced chemokine signaling, including the eotaxin family, while significantly suppressing IFN-α/β signaling. Among eight SOCS family members, CISH was most strongly induced by IL-13 via phosphorylation of signal transducer and activator of transcription 6 (STAT6). Loss- and gain-of-function studies demonstrated that CISH negatively regulated the expression of CCL26.Conclusions: These findings suggest that CISH plays a key role in the eosinophilic inflammation associated with bronchial asthma by regulating IL-13-induced CCL26 production. Augmentation of CISH function could be a novel approach for treating eosinophilic inflammation in severe asthma.
著者
Yuko Chinuki Eishin Morita
出版者
Japanese Society of Allergology
雑誌
Allergology International (ISSN:13238930)
巻号頁・発行日
vol.68, no.3, pp.296-300, 2019 (Released:2019-07-12)
参考文献数
34
被引用文献数
35

Cetuximab, the IgG1 subclass chimeric mouse-human monoclonal antibody biologic that targets the epidermal growth factor receptor (EGFR), is used worldwide for the treatment of EGFR-positive unresectable progressive/recurrent colorectal cancer and head and neck cancer. Research has shown that the principal cause of cetuximab-induced anaphylaxis is anti-oligosaccharide IgE antibodies specific for galactose-α-1,3-galactose (α-Gal) oligosaccharide present on the mouse-derived Fab portion of the cetuximab heavy chain. Furthermore, it has been revealed that patients who are allergic to cetuximab also develop an allergic reaction to mammalian meat containing the same α-Gal oligosaccharide owing to cross-reactivity, and the presumed cause of sensitization is tick bites: Amblyomma in the United States, Ixodes in Australia and Europe, and Haemaphysalis in Japan. The α-Gal-specific IgE test (bovine thyroglobulin-conjugated ImmunoCAP) or CD63-expression-based basophil activation test may be useful to identify patients with IgE to α-Gal in order to predict risk for cetuximab-induced anaphylactic shock. Investigations of cetuximab-related anaphylaxis have revealed three novel findings that improve our understanding of immediate-type allergy: 1) oligosaccharide can serve as the main IgE epitope of anaphylaxis; 2) because of the oligosaccharide epitope, a wide range of cross-reactivity with mammalian meats containing α-Gal similar to cetuximab occurs; and 3) tick bites are a crucial factor of sensitization to the oligosaccharide. Nonetheless, taking a medical history of tick bites and beef allergy may be insufficient to prevent cetuximab-induced anaphylaxis, and therefore blood testing with an α-Gal-specific IgE test, with high sensitivity and specificity, is necessary to detect sensitization to α-Gal.
著者
Fukutomi Yuma Tanimoto Hidenori Yasueda Hiroshi Taniguchi Masami
出版者
一般社団法人日本アレルギー学会
雑誌
Allergology International
巻号頁・発行日
vol.65, no.1, pp.30-36, 2016
被引用文献数
37

Prompt diagnosis of allergic bronchopulmonary mycosis (ABPM) is an important clinical issue in preventing irreversible lung damage. Therefore, a good serological marker for the diagnosis of ABPM is desired in clinical practice.The measurement of IgE antibody to crude Aspergillus fumigatus allergen is considered the first step in screening asthmatic patients for allergic bronchopulmonary aspergillosis (ABPA). However, presence ofIgE to A. fumigatus does not always indicate genuine sensitization to A. fumigatus because of crossreactivity between crude extracts from different fungal sources. The application of molecular-based allergy diagnosis can solve this problem. The specificity of testing can be greatly improved by measuring the IgE antibody to Asp f 1 and f 2, specific allergen components for genuine A. fumigatus allergy.The problem of cross-reactivity between crude fungal extracts is also true for the identification of genuine causal fungi in each ABPM patient. Some patients with ABPM induced by fungi other than Aspergillus may be consistent with ABPA diagnostic criteria because current criteria depend on IgE/IgG reactivity to crude extracts. Accurate identification of genuine causal fungi for ABPM is of clinical importance, considering that clinical presentation, anti-fungal treatment strategies and disease prognosis can be influenced by different causal fungi. The diagnosis of causal fungi can be robustly validated by the confirmation of genuine sensitization to fungi after measuring IgE to specific allergen components, as well as repeated microbiological isolation of the fungi from their airway.
著者
Yuhei Hamasaki Yoichi Kohno Motohiro Ebisawa Naomi Kondo Sankei Nishima Toshiyuki Nishimuta Akihiro Morikawa Japanese Society of Allergology Japanese Society of Pediatric Allergy and Clinical Immunology
出版者
一般社団法人日本アレルギー学会
雑誌
Allergology International (ISSN:13238930)
巻号頁・発行日
vol.63, no.3, pp.335-356, 2014 (Released:2014-09-11)
参考文献数
52
被引用文献数
31

The Japanese Guideline for the Diagnosis and Treatment of Allergic Diseases 2013 (JAGL 2013) describes childhood asthma after the Japanese Pediatric Guideline for the Treatment and Management of Asthma 2012 (JPGL 2012) by the Japanese Society of Pediatric Allergy and Clinical Immunology. JAGL 2013 provides information on diagnosis by age group from infancy to puberty (0-15 years of age), treatment for acute exacerbations, long-term management by anti-inflammatory drugs, daily life guidance, and patient education to allow non-specialist physicians to refer to this guideline for routine medical treatment. JAGL differs from the Global Initiative for Asthma Guideline (GINA) in that JAGL emphasizes early diagnosis and intervention at <2 years and 2-5 years of age. A management method, including step-up or step-down of long-term management drugs based on the status of asthma control levels, as in JAGL, is easy to understand, and thus the Guideline is suitable as a frame of reference for routine medical treatment. JAGL has also introduced treatment and management using a control test on children, recommending that the physician aim at complete control by avoiding exacerbation factors and by appropriate use of anti-inflammatory drugs.
著者
Mari Maeda-Yamamoto Kaori Ema Manami Monobe Ikuo Shibuichi Yuki Shinoda Tomohiro Yamamoto Takao Fujisawa
出版者
一般社団法人日本アレルギー学会
雑誌
Allergology International (ISSN:13238930)
巻号頁・発行日
vol.58, no.3, pp.437-444, 2009 (Released:2009-09-11)
参考文献数
20
被引用文献数
27

Background: We previously reported that 'benifuuki' green tea containing O-methylated catechin significantly relieved the symptoms of perennial or seasonal rhinitis compared with a placebo green tea that did not contain O-methylated catechin in randomized double-blind clinical trials. In this study we assessed the effects of 'benifuuki' green tea on clinical symptoms of seasonal allergic rhinitis. Methods: An open-label, single-dose, randomized, parallel-group study was performed on 38 subjects with Japanese cedar pollinosis. The subjects were randomly assigned to long-term (December 27, 2006 - April 8, 2007, 1.5 months before pollen exposure) or short-term (February 15, 2007: after cedar pollen dispersal - April 8, 2007) drinking of a 'benifuuki' tea drink containing 34mg O-methylated catechin per day. Each subject recorded their daily symptom scores in a diary. The primary efficacy variable was the mean weekly nasal symptom medication score during the study period. Results: The nasal symptom medication score in the long-term intake group was significantly lower than that of the short-term intake group at the peak of pollen dispersal. The symptom scores for throat pain, nose-blowing, tears, and hindrance to activities of daily living were significantly better in the long-term group than the short-term group. In particular, the differences in the symptom scores for throat pain and nose-blowing between the 2 groups were marked. Conclusions: We conclude that drinking 'benifuuki' tea for 1.5 months prior to the cedar pollen season is effective in reducing symptom scores for Japanese cedar pollinosis.
著者
William W. Busse
出版者
Japanese Society of Allergology
雑誌
Allergology International (ISSN:13238930)
巻号頁・発行日
vol.68, no.2, pp.158-166, 2019 (Released:2019-04-17)
参考文献数
34
被引用文献数
117

Asthma is a heterogeneous disease with considerable variability noted in disease severity, patterns of airway inflammation, and achievement of disease control on current medications. An absence of disease control is most frequently noted in patients with severe asthma, and is defined as a lack of control while on high dose inhaled corticosteroids (ICS) plus a second controller medication. In part, this lack of control may relate to a diminished effect of current guideline-directed care on the existing pattern of airway inflammation in severe asthma.Airway inflammation in severe asthma has been arbitrarily divided into T (type) 2 high and T2 low. T2 high is characterized by the generation of key cytokines, interleukin (IL)-4, −5 and −13, which generate and regulate airway inflammation. Biomarkers to mark the presence of T2-high inflammation include eosinophils, fractional exhaled nitric oxide (FeNO) and immunoglobulin (Ig) E, whose presence arises from the action of IgE, IL-5, IL-4, and IL-13. In this review, treatment of severe asthma with monoclonal antibodies, i.e. biologics, which are directed against these inflammation generated pathways are reviewed. The available monoclonal antibodies include omalizumab (anti-IgE); mepolizumab, reslizumab and benralizumab (anti-IL-5 pathways), and dupilumab (anti-IL-4/IL-13).The use of these T2-high interventions has led to significant reductions in asthma symptoms, a decreased frequency of exacerbations, and improved lung function in many patients. Not only has the use of these monoclonal antibodies led to improved asthma control in patients with severe disease, their use has provided insight into mechanisms of severe asthma.