OBJECTIVES: To analyze the potential causal relationship between gut microbiota and food allergy (FA) using two-sample Mendelian randomization (MR) methods. METHODS: Data from genome-wide association studies on gut microbiota and FA were utilized. MR analysis was conducted employing inverse variance weighting, MR-Egger regression, and weighted median methods to assess the causal relationship between gut microbiota and FA. Cochrane's Q test was used to evaluate heterogeneity of instrumental variables, MR-PRESSO analysis was conducted to test for outliers and pleiotropy, and MR-Egger regression was employed to assess horizontal pleiotropy. The "leave-one-out" method was used to evaluate the impact of removing individual single nucleotide polymorphisms on the causal relationship. RESULTS: Inverse variance weighting analysis revealed that the phylum Verrucomicrobia, family Verrucomicrobiaceae, order Verrucomicrobiales, genus Ruminococcaceae UCG013, and genus Akkermansia were negatively associated with FA (P<0.05). Sensitivity analyses confirmed the reliability of the findings, indicating no heterogeneity or pleiotropy present. CONCLUSIONS There is a causal relationship between gut microbiota and FA, with Verrucomicrobia, Verrucomicrobiaceae, Verrucomicrobiales, Ruminococcaceae UCG013, and Akkermansia potentially reducing the risk of developing FA. These findings provide potential targets for the treatment and prevention of FA; however, further research is needed to explore the specific mechanisms by which the microbiota influence FA.
Humans ; Mendelian Randomization Analysis ; Gastrointestinal Microbiome ; Food Hypersensitivity/microbiology* ; Genome-Wide Association Study ; Polymorphism, Single Nucleotide

OBJECTIVES: To investigate the effect of interleukin-17 (IL-17) gene polymorphism on the susceptibility to cow's milk protein allergy (CMPA) in infants and its association with gut microbiota. METHODS: A prospective study was conducted involving 100 infants diagnosed with CMPA at the Women and Children's Hospital of Ningbo University from January 2022 to October 2024. A total of 100 healthy infants undergoing routine check-ups at the same hospital during the same period was enrolled as the control group. Medical information was obtained through the electronic medical record system. IL-17A (rs2275913) and IL-17F (rs1889570) polymorphisms were detected using polymerase chain reaction-restriction fragment length polymorphism method. Serum IL-17 levels were measured using enzyme-linked immunosorbent assay, and high-throughput sequencing was employed to analyze the relative abundance of Lactobacillus and Bifidobacterium. Multivariate logistic regression analysis was used to explore the influencing factors of CMPA occurrence in infants. RESULTS: The proportions of infants with a family history of allergy and those with vitamin D deficiency or insufficiency were significantly higher in the CMPA group compared to those in the control group (P<0.05). The distribution of IL-17F (rs1889570) genotypes showed significant differences between the CMPA and control groups (P<0.05), with the frequency of the A allele being significantly higher in the CMPA group (P<0.05). Multivariate logistic regression analysis revealed that a family history of allergy, vitamin D deficiency or insufficiency, and carrying the IL-17F (rs1889570) AA genotype were independent influencing factors for CMPA in infants (P<0.05). Infants in the CMPA group with the IL-17F (rs1889570) AA genotype had significantly higher serum IL-17 levels compared to those with AG/GG genotypes (P<0.05), while the relative abundance of Lactobacillus and Bifidobacterium was significantly lower (P<0.05). CONCLUSIONS IL-17F (rs1889570) gene polymorphism influences susceptibility to CMPA in infants, potentially through mechanisms involving IL-17 expression and the relative abundance of gut probiotics.
Humans ; Interleukin-17/genetics* ; Milk Hypersensitivity/microbiology* ; Female ; Infant ; Male ; Prospective Studies ; Genetic Predisposition to Disease ; Gastrointestinal Microbiome ; Polymorphism, Genetic ; Milk Proteins/immunology*

Objective:The prevalence of seasonal allergic rhinitis （AR） and its combined diseases have been increasing recently. The purpose was to investigate the clinical characteristics and treatment of seasonal AR in northern China. Methods:A cross-sectional study was conducted in AR patients. The Visual analogue scale （VAS）, combined diseases, clinical features, allergic pollen and treatments were analyzed. Results:Of the 789 AR subjects included, 54.1% had a family history of atopic disease. The mian course wa s（7.4±5.9） years. 95.4% of the subjects had moderate to severe AR. The prevalence rates of allergic conjunctivitis （AC）, allergic asthma （AA）, and pollen food allergy syndrome （PFAS） were 71.1%, 19.0%, and 39.5% respectively. Among the patients, 13.8% presented with only AR, while 39.3% had an AR combined with other disease, and 1.9% exhibited comorbidity involving five different diseases. VAS was positively correlated with the number of comorbidities（r=0.186, P<0.001）. The mugwort exhibited the highest rate of pollen sensitization （48.9%）, closely followed by cypress （48.3%）. The prevalence of mono-sensitization to pollen was 20.2%, while the positive rates for double-sensitized pollens and more than three sensitized pollens were 17.4% and 62.4%, respectively. Among the study participants, 19.9% did not receive any form of treatment, while 66.2% were administered oral medication and 27.5% underwent nasal steroid spray therapy. The proportion of individuals receiving anti-IgE monoclonal antibodies was 4.3%, and allergen immunotherapy （AIT） treatment was undergone by 11.8%. Meanwhile, 41.2% of patients undergoing anti-IgE monoclonal antibody treatment also received AIT. The distribution of therapy types among patients was as follows: 44.7% received a single type, 22.2% received two types, and 9.8% received three types of therapy. Additionally, there was a subset of patients（1%） who were undergoing five distinct forms of treatment. The VAS score exhibited a significant negative correlation with no treatment（r=-0.199, P<0.001）, while it showed a positive association with the number of treatment modalities（r=0.245, P<0.001）. Conclusion:Mugwort and cypress are the predominant allergenic pollens responsible for seasonal AR in northern China. The majority of cases present with moderate to severe AR, often accompanied by various comorbidities, necessitating consideration of diverse treatment modalities. However, the current rate of adoption for AIT remains relatively insufficient.
Humans ; China/epidemiology* ; Cross-Sectional Studies ; Rhinitis, Allergic, Seasonal/therapy* ; Pollen/immunology* ; Adult ; Male ; Female ; Young Adult ; Adolescent ; Middle Aged ; Child ; Prevalence ; Allergens/immunology* ; Asthma/epidemiology* ; Conjunctivitis, Allergic

Upper airway allergic disease in children refers to chronic non-infectious inflammatory diseases of the upper airway caused by allergic inflammation. These diseases have high prevalences and great harm. Attentions should be paid to the treatment of these diseases. Oral antihistamines play an important role in the treatment of allergic diseases. However, there are many types of antihistamines. How to select appropriate antihistamines according to the age and characteristics of children to treat upper airway allergic diseases is a concern of pediatricians. Therefore, the Pediatric Otorhinolaryngology and Head and Neck Surgery Committee of the Chinese Association for the Promotion of Human Health Science and Technology organized relevant experts to form this consensus, in order to guide the use of oral antihistamines in children with upper airway allergic diseases.
Humans ; Child ; Histamine Antagonists/administration & dosage* ; Administration, Oral ; Consensus ; Hypersensitivity/drug therapy*

Objective:To investigate the clinical characteristics and major allergens of patients with pollen-food allergy syndrome（PFAS） and their correlation with the severity of symptoms, and to provide a basis for identifying high-risk patients, optimizing the allergen testing process and developing individualized dietary management strategies. Methods:The clinical data of 166 patients with PFAS admitted to our hospital from January 2021 to July 2023 were retrospectively analyzed. The clinical symptoms, pollen types and food allergy of the patients were analyzed by questionnaire survey and serum specific IgE detection. phi coefficient, Apriori algorithm modeling and multivariate logistic regression analysis were used to evaluate the association between allergen and symptom severity. Results:Artemisia pollen was the most common allergen in this area, with a positive rate of 96.39%. Peach and mango were the most common food allergens, which caused allergic reactions in 24.10% and 22.89% of patients, respectively. Oral mucosal symptoms were the main symptoms. Correlation analysis showed that there was a correlation between pollen allergens and allergenic food. Association rule analysis showed that when the patient was allergic to the combination of peanuts and trees, the probability of high severity of symptoms was 82.35%. Multivariate analysis showed that ragweed allergy was significantly positively correlated with the severity of PFAS symptoms. Conclusion:Artemisia pollen and related food allergens play an important role in the pathogenesis of PFAS. Association rule mining and network map analysis revealed direct associations between peanut and tree combination allergy and symptom severity, as well as potential links between other inhaled allergens and specific food allergies. Ragweed and peach allergy are independent risk factors for the aggravation of PFAS symptoms, which can be used as early warning indicators. These results help to improve the screening of high-risk patients and the construction of regional allergen databases.
Humans ; Food Hypersensitivity/immunology* ; Allergens/immunology* ; Retrospective Studies ; Pollen/immunology* ; Cross Reactions ; Immunoglobulin E/blood* ; Rhinitis, Allergic, Seasonal/immunology* ; Artemisia/immunology* ; Male ; Female ; Adult ; Prunus persica/immunology* ; Arachis/immunology* ; Middle Aged ; Surveys and Questionnaires ; Oral Allergy Syndrome

Atopic dermatitis (AD) is a prevalent inflammatory skin disorder in which patients experience recurrent eczematous lesions and intense itching. The colonization of Staphylococcus aureus (S. aureus) is correlated with the severity of the disease, but its role in AD development remains elusive. Using single-cell RNA sequencing, we uncovered that keratinocytes activate a distinct immune response characterized by induction of Il24 when exposed to methicillin-resistant S. aureus (MRSA). Further experiments using animal models showed that the administration of recombinant IL-24 protein worsened AD-like pathology. Genetic ablation of Il24 or the receptor Il20rb in keratinocytes alleviated allergic inflammation and atopic march. Mechanistically, IL-24 acted through its heterodimeric receptors on keratinocytes and augmented the production of IL-33, which in turn aggravated type 2 immunity and AD-like skin conditions. Overall, these findings establish IL-24 as a critical factor for onset and progression of AD and a compelling therapeutic target.
Dermatitis, Atopic/genetics* ; Interleukins/metabolism* ; Animals ; Methicillin-Resistant Staphylococcus aureus/immunology* ; Mice ; Keratinocytes/microbiology* ; Humans ; Interleukin-33/immunology* ; Inflammation/microbiology* ; Staphylococcal Infections/microbiology* ; Disease Models, Animal ; Hypersensitivity/microbiology* ; Mice, Inbred C57BL

Humans ; Aluminum/adverse effects* ; Pruritus/etiology* ; Skin Neoplasms ; Vaccination ; Hypersensitivity

Animals ; Cattle ; Female ; Milk Hypersensitivity/therapy* ; Consensus ; Immunoglobulin E ; Milk Proteins

Vasculitis refers to the inflammation and damage of blood vessel walls. This presents as erythematous macules or palpable purpura with a predilection for dependent parts, particularly the legs. Vesicles and bullae are less common manifestations. Vasculitis can be idiopathic or associated with infections, systemic diseases, drugs, or vaccines. Vaccine-associated vasculitis has been reported in BCG, influenza, hepatitis, and more recently, COVID-19 vaccines. However, there is limited data on the adverse events associated with rabies vaccine administration.

A 53-year-old Filipino male presented with petechiae evolving into purpura and urticarial targetoid plaques with bullae on the extremities and trunk, after administration of inactivated purified Vero cell rabies vaccine (Verorab, Sanofi Pasteur) due to a Category 3 bite. There were no mucosal lesions. Nikolsky and Asboe-Hansen signs were negative. The patient had no previous reactions to drugs or vaccines.

Histopathology results confirmed the diagnosis of vasculitis. Resolution of skin lesions was achieved with administration of intravenous steroids and oral antihistamines.

Community surveys conducted in three Philippine provinces report the incidence of animal bites at 50 injuries per 1,000 population (5 percent) per year with 45 percent of patients seeking medical treatment at animal bite treatment centers.

There is limited data on adverse events associated with rabies vaccine administration. In general, allergic reactions to vaccines are rare, occurring in approximately 1 in 50,000 to 1 in 1,000,000 doses. These reactions may be due to antigens, residual media, stabilizers, preservatives, or other excipients in the vaccine.

Rash, urticaria, and pruritus have been reported, along with injection site reactions such as erythema, edema, and pain. Fever, malaise, headaches, low mood, purpura, urticaria, Stevens-Johnson Syndrome and erythema multiforme may also occur.

Adequate documentation and reporting of adverse reactions due to vaccines contributes to long-term safety studies and establishing treatment guidelines.

OBJECTIVES: To investigate the influencing factors for asthma management and asthma control level in children. METHODS: A total of 202 children with a confirmed diagnosis of asthma were enrolled. The questionnaire of asthma control level and family management was used to investigate the influencing factors for asthma control level and the indicators of family management. The awareness of childhood asthma and its management was analyzed among the parents, as well as the influence on asthma control level in children, and the association between them was analyzed. RESULTS: Compared with the non-complete control group, the complete control group had significantly longer course of asthma and treatment time (P<0.05). The proportions of asthma attacks ≥3 times and aerosol treatment for asthma attacks >3 times in one year in the complete control group were significantly lower than those in the non-complete control group (P<0.05). The complete control group had a significantly lower proportion of children with frequent respiratory infection, wheezing during respiratory infection, or a family history of allergic diseases (P<0.05). The parents in the complete control group had significantly stronger awareness of short-term escalation to asthma medication after respiratory infection and significantly enhanced management of maintenance medication (P<0.05). Compared with the complete control group, the non-complete control group had a significantly higher proportion of children with abnormal pulmonary function at the initial stage (P<0.05). The level of asthma control in children was associated with short-term escalation to asthma medication during respiratory infection and initial lung function (P<0.05). CONCLUSIONS The level of asthma control in children is closely associated with the severity of asthma and the comprehensive management of childhood asthma. Early treatment and family management, especially escalation to asthma medication during the early stage of respiratory infection, are of great importance in asthma control. Citation:Chinese Journal of Contemporary Pediatrics, 2023, 25(1): 73-79.
Child ; Humans ; Asthma/diagnosis* ; Hypersensitivity/diagnosis* ; Lung ; Respiratory Tract Infections ; Parents ; Respiratory Sounds