Haisheng Hu

Introduction: Dermatophagoides pteronyssinus (Dp) and shrimp are common air allergens and allergenic food sources, respectively, in southern China. This study aimed to analyze the specific immunoglobulin E (sIgE) characteristics and relationships of Dp components among co-sensitized patients with Dp and shrimp. Materials and Methods: Serum samples were collected from 112 patients with Dp sensitization (61 with shrimp sensitization and 51 without) from southern China. The sIgE concentrations of Dp and shrimp crude extracts were determined by ImmunoCAP, and the sIgE of Dp allergen components (Der p 1, Der p 2, Der p 5, Der p 7, Der p 10, Der p 21, and Der p 23) was detected by protein chip. Results: Overall, in the Dp-allergic patients, Der p 1 had the highest positive rate (72.3%), followed by Der p 2 (65.2%), Der p 23 (46.4%), Der p 7 (32.14%), Der p 21 (29.46%), Der p 5 (22.32%), and Der p 10 (17.86%). Compared with that in the shrimp nonsensitized group, the positive rate of sIgE for Der p 10 (27.87% vs. 5.88%, p = 0.002) in the shrimp sensitization group was significantly higher; however, the positive rate of sIgE for Der p 7 (22.95% vs. 43.14%, p = 0.023) was significantly lower. Moreover, the concentration of sIgE for Der p 10 increased statistically in the shrimp-sensitized group. The correlation analysis also showed that shrimp sensitization was significantly correlated with Der p 10. Conclusion: Among patients with Dp sensitization, Der p 1 had the highest positive rate, followed by Der p 2 and Der p 23. Meanwhile, Der p 10 may play an important role in patients with shrimp sensitization, while Der p 7 may be the meaningful allergen component in patients with Dp sensitization alone. In general, component-resolved diagnosis technology in clinical practice can effectively guide patients with polysensitization to avoid allergic substances.

Background: Despite the increasing prevalence of allergic disease, large-scale studies to investigate allergen sensitization have rarely been conducted in the inland region of Southwest China. Objective: This study aimed to investigate the trend of allergen sensitization in mainland China from 2016 to 2017. Methods: During the 2-year study period, from 2016 to 2017, the serum samples of 7,759 allergic patients collected from 38 hospitals in Yunnan were detected the specific immunoglobulin E (sIgE) against 8 indoor and food allergens, namely, house dust mite, cockroach, dog dander, mold mix, egg white, milk, crab, and shrimp. The polysensitization patterns were analyzed through cluster analysis, and the relationship between cockroach and other indoor and food allergens was analyzed. Results: Allergen sIgE positivity was prevalent in 45.6% of the population. Cockroach was the most common allergen (27.0%), followed by house dust mite (25.6%), shrimp (18.8%) and crab (15.6%). Three polysensitization clusters were identified: cluster 1): egg white/milk; cluster 2): crab/shrimp/cockroach/house dust mite/dog dander; and cluster 3): mold mix. The sIgE levels and sensitization rates to house dust mite, crab, and shrimp increased with the level of cockroach sIgE (P < 0.05). Conclusions: Based on big data in the real world, we found that there is a new trend in common allergens in Southwest China, where house dust mite is the only available reagent of specific immunotherapy. Cockroaches may become another major allergen in mainland China in the future, and clinicians should be aware of this.

Different methods have different diagnostic value under diverse clinical conditions. This study was conducted to analyze the clinical practical value of different assays in different situations and to establish the concept of an allergen diagnosis strategy. This study used Phadia CAP, Advan Sure (AdvS), Euroline Camera (ELC), and Allergy Lateral Flow Assay (ALFA) kits to detect allergen specific immunoglobulin E (sIgE) in the sera from 30 allergic asthma patients, with Phadia CAP as the gold standard. This study found high sensitivity for Dermatophagoides pteronyssinus in AdvS (92.6%), ELC (88.9%), and ALFA (85.2%), but poor sensitivity for F. domesticus in all three assays. Furthermore, the AdvS, ELC, and ALFA assays could detect 20, 21, and 8 allergens in one panel, respectively. The combination of the results showed that 93.3% and 46.7% of patients tested positive for ≥5 and ≥10 types of allergens, respectively. All patients who were tested positive for the Marine fish mixture were positive for both Shrimp and Crab. Similarly, patients who were tested positive for Chicken also tested positive for Pork. Optimal scale analysis showed a strong connection between Peanut, Soybean, Wheat, Japanese Hop, Western ragweed, and Oak allergens (Cronbach’s α = 91.1%). The ELC assay was more suitable for use in pollen-rich areas, whereas the ALFA assay was easy to establish in areas with poor medical conditions. An allergen diagnosis strategy needs to be considered for use in clinical practice.

Background: The prevalence of allergen-induced chronic respiratory disease (CRD) is increasing annually. Objective: This study aimed to analyze the sensitization characteristics of adult Chinese CRD patients. Methods: The serum specific immunoglobulin E (sIgE) was detected via an inhalation allergy screening test. Total intmunoglobulin E (tIgE) levels were measured in 85 asthma patients, 98 chronic obstructive pulmonary disease (COPD) patients, and 69 patients with other CRDs. Results: The total positive rate of allergy screening among CRD patients was 36.1%. Asthma showed the highest rate (45.9%), followed by COPD (32.7%) and other CRDs (29.0%). The positive rate of inhalation allergy screening was significantly higher among office staff (68.9%) than among outdoor workers (42.8%) and farmers (25.0%, P < 0.05). In patients with COPD, atopy was a risk factor for dyspnea (Odds ratio = 1.22; P < 0.05). Optimal scaling analysis revealed a correlation between tIgE levels and smoking index (Cronbach's alpha = 91.1%). Up to 35.0% of GOLD III or IV patients showed low sIgE and high tIgE. Conclusion: Patients with CRD had high sensitization. Asthma patients who work indoors were more susceptible to allergies. Atopy was associated with COPD pulmonary function. It is necessary to initially screen the sensitization situation of CRD patients.

Objective: This was the first multicentre study assessing the sensitisation patterns in patients with severe asthma by different occupations as well as different regions of China, and aimed to provide evidence for the prevention of sensitised patients with severe asthma.Methods: A total of 676 adults were included and assigned to three cohorts. Cohort A was comprised of severe asthma patients without smoking (n = 454), cohort B comprised severe asthmatic patients who were ex‐smokers (n = 149), and cohort C comprised non‐asthma individuals (n = 73). All study subjects underwent testing of serum sIgE level of house dusts mix (hx2), foods mix (fx5), moulds mix (mx2), tree pollen mix (tx4) and weed pollen mix (wx5) simultaneously.Results: Overall, the positive rates of hx2, fx5, mx2, tx4 and wx5 were 37.6%, 11.9%, 16.6%, 9.0% and 9.5% in severe asthmatic patients, respectively. Comparing cohort A with cohort B, the hx2 positive rates in cohort A were higher in fulltime homemaker (30.0% vs. 0.0%) and medical staff (40.0% vs. 0.0%, P < 0.05). However, the mx2 positive rates in cohort B were higher in businessman (30.0% vs. 7.0%) and the tx4 positive rates in cohort B were higher in drivers (35.7% vs. 0.0%, P < 0.05). The optimal scale analysis showed that severe asthmatic patients who work indoor were more prone to be allergic to house dusts (Cronbach's alpha = 76.4%).Conclusion: Patients with severe asthma in different occupations exhibited different sensitisation patterns. Avoid being contact with house dust and application of indoor air purifier should be considered for severe asthma patients.

This study aimed to determine the clinical significance of Krebs von den Lungen-6 (KL-6) in patients with COVID-19, so as to find a marker with high sensitivity, specificity and easy detection to evaluate the lung injury and inflammation of COVID-19. Sixty-three COVID-19 patients and 43 non-COVID-19 patients with similar clinical phenotypes and/or imaging findings were enrolled to test the levels of KL-6 using chemiluminescent immunoassay. In addition, the blood gas, imaging and lymphocyte factors tests were collected from all participants. The data was finally analyzed using multivariate statistical analysis. The results showed KL-6 levels in COVID-19 patients were higher than those in non-COVID-19 patients (P < 0.001). Moreover, the KL-6 levels in severe and critically severe patients were significantly upregulated compared with patients with mild and common type (P < 0.05). Meanwhile, the imaging evaluation showed a significant correlation between KL-6 and pulmonary lesion area (P < 0.05). KL-6 was also found to be significantly correlated with oxygenation index and oxygen partial pressure difference of alveolar artery (PA-aDO2) (Both P < 0.01). In conclusion, KL-6 could be an indicator to evaluate the progression of COVID-19, which is parallel to the level of lung injury and inflammation in patients. Moreover, it can also reflect the pulmonary ventilation function.

Objective: The aim of this study was to analyse the level of serum matrix metalloproteinases (MMPs) in atopic and non-atopic COPD patients, providing guidance for clinical practice and theory for atopic COPD. Methods: Blood samples from 50 adult male patients with COPD, including 17 atopic and 33 non-atopic patients, were submitted for detection of MMP8, MMP9, surfactant associated protein D (SPD), noradrenaline (NE), leukotriene (LT) B4, recombinant proteoglycan (PRG4), Phadiatop sIgE, and tIgE levels. Patients’ Modified Medical Research Council Dyspnea Scale (mMRC), COPD Assessment Test (CAT), pulmonary function test results, FeNO, blood cell ratio and induced sputum were collected. Results: The level of serum tIgE in patients with atopic COPD [1876.00 kU/l (760.50, 5347.00)] was significantly higher than in patients with non-atopic COPD [377.00 kU/l (93.50, 581.50), P < 0.001]. The MMP8 levels in atopic COPD (1600 ± 1181 ng/mL) were significantly higher than in non-atopic COPD (973.3 ± 921.5 ng/mL, P = 0.0494), but there was no significant difference in MMP9, SPD, NE, LTB4, and PRG4 levels between the two groups. In atopic COPD patients, the rate of leukocyte (r_s = 0.63, P < 0.001) and neutrophil (r_s = 0.54, P < 0.05) were positively correlated with MMP8 levels, while lymphocyte rate was negatively correlated with MMP8 (r_s = − 0.70, P < 0.001) and MMP9 levels (r_s = − 0.54, P < 0.05). Optimal scale analysis showed that NE was most closely related to the basophil rate from induced sputum and FeNO levels (Cronbach’s alpha = 85.1%). Interestingly, all atopic COPD patients with mMRC ≥ 2, CAT ≥ 10, and CCQ ≥ 16 exhibited MMP8 levels > 1000 ng/mL. Conclusion: In general, tIgE and MMP8 levels were higher in atopic COPD patients than in non-atopic patients. NE levels were closely correlated with the basophil rate of induced sputum and FeNO levels, which may play an important role in the pathogenesis and development of atopic COPD.

Background and Objective: Severe chronic obstructive pulmonary disease (COPD) is the terminal stage of the disease characterized by declined lung function, malnutrition, and poor prognosis. Such patients cannot tolerate long-time sports rehabilitation owing to dyspnea and fail to achieve the desired therapeutic effect; therefore, increasing nutritional support will be an important strategy for them. The present study applied metabolomics technology to evaluate the correlation between serum concentrations of polyunsaturated fatty acid (PUFA) metabolites, nutritional status, and lung function in patients with COPD to provide a theoretical basis for accurate nutritional support. Materials and Methods: We enrolled 82 patients with stable severe COPD in our hospital. The general characteristics including height, weight, and lung function were recorded. Metabolomics was used to detect the concentrations of serum metabolites of n-3 and n-6 at baseline and at 24 and 52 weeks after enrollment. The correlations between nutrition level and pulmonary function and clinical indicators were evaluated. Results: The concentrations of n-3 and n-6 increased over time along with the progression of COPD. Body mass index (BMI) and percent of ideal body weight (IBW%) decreased with disease development, and BMI was found to be significantly correlated with FEV1% predicted and FEV1/FVC. Serum levels of n-6 metabolites such as linoleic acid (LA), γ-linoleic acid (GLA), and arachidonic acid (ARA) (all P < 0.01) and the n-3 metabolites such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (all P < 0.05) showed significant correlations with BMI and were closely correlated with FEV1% predicted and FEV1/FVC of lung function (all P< 0.05). Conclusion: This study demonstrates that malnutrition in patients with severe COPD is progressive and is positively correlated with n-3 and n-6 polyunsaturated fatty acids and lung function.

Introduction: The impact of furry animal allergens on house dust mite (HDM)-induced allergic rhinitis (AR) is unclear. Objective: We aimed to investigate the co-sensitization and cross-sensitization of furry animal allergens and assess their clinical relevance with HDM-induced AR. Methods: We enrolled 268 patients with HDM-induced AR who were diagnosed with skin prick tests positive for dogs and/or cats. Specific immunoglobulin E (sIgE) for dogs (e1) and cats (e2), their components (Can f 1–5 and Fel d 1–2), and other uncommon furry animal extracts were measured. Symptoms and quality of life were assessed with a visual analog scale (VAS). Results: The VAS scores for the AR and asthma (AS; n = 166), moderate-to-severe persistent-AR (n = 132), and e1P (positive)-e2P (n = 89) groups were higher than those for single AR (n = 102), other AR classifications, and other AR sensitization profiles, respectively. The IgE positivity rates for components such as Can f 1–3 and Fel d 2 and those for rats, sheep, mice, cows, and horses were highest in e1P-e2P patients. Can f 1–4, Fel d 1, Fel d 2, or the combined allergens were positively correlated with VAS scores. AR combined with AS and sensitization to Can f 4, Fel d 1, or mice were risk factors for HDM-induced AR with VAS scores ≥5. Conclusions: Extensive cross-sensitization or co-sensitization was found between Can f 1–3, Fel d 2, or rat, sheep, mouse, cow, and horse extracts. Higher sIgE levels for Can f 1–4 and Fel d 1–2 or a higher number of furry animal allergens lead to more severe symptoms and a reduced quality of life. Combined with AS, sensitization to Can f 4, Fel d 1, or mice were risk factors for moderate-to-severe HDM-induced AR.

Background: Moth is a common allergen in southern China. Shrimp sensitization might be related to the moth allergen. Objective: This study investigated sensitization to moth allergen in patients in southern China sensitized to shrimp and explored the effect of moth sensitization on different allergic diseases. Methods: Serum samples from 212 patients sensitized to shrimp were tested for specific immunoglobulin E (sIgE) to Dermatophagoides pteronyssinus, crab, cockroach, and moth. Results: The patients sensitized to shrimp were co-sensitized to D. pteronyssinus (88.7%), crab (85.4%), cockroach (89.2%), and moth (92.0%). Overall, 75% of the patients sensitized to shrimp tested positive to the above allergens; only four patients were sensitized to shrimp alone. The median (interquartile range [IQR]) concentrations of sIgE to shrimp (2.66 kU/L [1.02‐6.11 kU/L] versus 1.61 kU/L [0.70‐3.67 kU/L]), crab (2.35 kU/L [0.83‐4.18 kU/L] versus 1.30 kU/L [0.59‐3.14 kU/L]), cockroach (3.78 kU/L [0.98‐6.91 kU/L] versus 1.56 kU/L [0.85‐3.17 kU/L]), and moth (4.70 kU/L [2.98‐9.62 kU/L] versus 2.85 kU/L [1.16‐7.01 kU/L]) in patients with skin allergic diseases was significantly higher than in patients with respiratory allergic diseases (all p < 0.05). The median (IQR) concentration of sIgE to cockroach in the young adults (2.33 kU/L [0.86‐5.56 kU/L]) was the highest among all age groups as well as to moth (young adults: 4.14 kU/L [1.93‐8.24 kU/L]). With the increasing positive class of shrimp allergen, the sIgE concentration of moth, cockroach, and crab also increased, and the optimal scaling analysis showed that the sIgE of crab, cockroach, and moth had a strong correlation with sIgE to shrimp (Cronbach α = 93.8%). Conclusion: This study found a high rate of co-sensitization between moth, D. pteronyssinus, cockroach, and crab among patients sensitized to shrimp and a strong correlation between shrimp, moth, and cockroach. Shrimp and cockroach co-sensitization might be related to moth allergens.