Yuto Hamada

Background: Anisakis allergy has been increasing, and the diagnosis of it is based on specific serum IgE detection. Recently, the IgE-crosslinking-induced luciferase expression (EXiLE) test has been proposed as convenient tool for detecting functionally specific IgE antibodies. Here, we investigated if the EXiLE test is a useful tool in the diagnosis of Anisakis allergy. Methods: HuRa-40 cells were sensitized using six serum types from three patients with Anisakis allergy at the time of the initial test and after 6–12 months. Thereafter, various concentrations of Anisakis worm protein (AWP) were reacted to measure the degree of EXiLE. The degree of EXiLE was compared with Anisakis-specific IgE antibody levels measured by the CAP-FEIA method, and the IgE-antibody-binding protein profile was examined using IgE immunoblotting. Results: The results showed a good correlation between the CAP-FEIA values and EXiLE obtained with 5 μg/mL of AWP (R = 0.91, p < 0.01), a strong response on IgE immunoblotting in the region containing proteins weighing ≥40,000 Da. In addition, after the onset of Anisakis allergy, the degree of serum EXiLE decreased in two patients whose Anisakis-specific IgE antibody levels decreased over time but increased in one patient whose specific IgE antibodies increased after repeated antigen sensitization. Conclusions: Based on these data, the AWP-induced EXiLE test seemed to be useful and convenient for the diagnosis of Anisakis allergy, supplementing specific IgE determinants. After allergy onset, the use of this method to observe changes in specific IgE levels over time may be important for predicting the risk of recurrence.

Anisakis allergy has been increasing and the diagnosis of it is based on specific serum IgE detection. Recently, IgE crosslinking-induced luciferase expression (EXiLE) test has been proposed as convenient tool for detecting the functional specific IgE antibodies. Here, we investigated if EXiLE test is a useful tool in the diagnosis of Anisakis allergy. HuRa-40 cells were sensitized using six serum types from three patients with Anisakis allergy at the time of the initial test and after 6–12 months. Thereafter, various concentrations of Anisakis worm protein (AWP) were reacted to measure the degree of EXiLE. The degree of EXiLE was compared with the Anisakis-specific IgE antibody levels measured by the CAP-FEIA method, and the IgE antibody binding protein profile was examined using IgE immunoblotting. Results showed a good correlation between the CAP-FEIA values and EXiLE obtained with 5 μg/mL of AWP (R = 0.91, p < 0.01), a strong response on IgE immunoblot in the region containing proteins weighing ≥40,000 Da. In addition, after the onset of Anisakis allergy, the degree of serum EXiLE decreased in two patients whose Anisakis-specific IgE antibody levels decreased over time but increased in one patient whose specific IgE antibodies increased after repeated antigen sensitization. Based on these data, the AWP-induced EXiLE test seemed to be useful and convenient for the diagnosis of Anisakis allergy, supplementing specific IgE determinants. After allergy onset, the use of this method to observe changes in specific IgE levels over time may be important for predicting the risk of recurrence.

Patients with severe eosinophilic asthma, characterised by a high disease burden, benefit from mepolizumab, which improves symptoms and reduces exacerbations, potentially leading to clinical remission in a subgroup. This study aimed to identify treatment response trajectories to mepolizumab for severe eosinophilic asthma and to assess the achievement of clinical remission. Data from the Australian Mepolizumab Registry were used to assess treatment responses at 3, 6, and 12 months. The treatment response trajectories were identified using a group-based trajectory model. The proportions achieving clinical remission at 12 months, which was defined as well-controlled symptoms, no exacerbations, and no oral corticosteroid (OCS) use for asthma management, were compared between trajectories, and baseline predictors of the trajectories were identified using logistic regression analysis. We identified three trajectory groups: group 1, responsive asthma with less OCS use (n=170); group 2, responsive late-onset asthma (n=58); and group 3, obstructed and less responsive asthma (n=70). Groups 1 and 2 demonstrated higher proportions achieving clinical remission at 36.5% and 25.9%, respectively, compared to group 3 with 5.7% (p 1% predicted, higher Asthma Quality of Life Questionnaire score, higher OCS dose, and nasal polyps in group 2; with group 3 as the reference. Treatment response to mepolizumab in severe eosinophilic asthma follows 3 trajectories with varying proportions achieving clinical remission and differing baseline characteristics. Treatment response variability may influence the achievement of clinical remission with mepolizumab therapy.

As a novel respiratory viral infection, coronavirus disease 2019 (COVID-19) has influenced asthma in unpredictable ways. In the post-COVID era, there is a need to review asthma care and the new challenges and opportunities that are presented. Long COVID is a new and complex syndrome that has arisen. Treatable traits (TTs) have already been developed to address complex asthma and can be adapted to manage long COVID. Consumers are seeking more information on and answers to what to expect with a dual diagnosis of asthma and COVID-19. People with asthma identify a strong need for research into COVID and asthma. Completion of a national survey (n = 593) resulted in a list of research themes. From these, participants prioritized 10 asthma research themes. Among the top 10 asthma research priorities, the theme of COVID and asthma was ranked as the second priority in the overall rank list. Addressing these issues has the potential to improve global asthma health.