Iranian Journal of Allergy, Asthma and Immunology

Alternaria Alternata Sensitization in Asthma: A Cross-sectional Study of Prevalence and Demographic Risk Factors

2026-04-19T11:46:10+00:00

Alternaria alternata is one of the most potent fungal allergens associated with allergic respiratory diseases, particularly asthma. Sensitization to A alternata has been linked to poor asthma control and increased morbidity, yet its prevalence varies widely across populations due to environmental and methodological differences. This study aimed to determine the prevalence and demographic predictors of A alternata sensitization among patients with moderate to severe asthma. A cross-sectional study was conducted from March to September 2024 among 80 patients with physician-diagnosed moderate or severe asthma in Shiraz, Iran. Participants underwent skin prick testing (SPT) for A. alternata. Demographic and clinical data were collected and analyzed using descriptive statistics, χ2 tests, and logistic regression. Among the 80 patients (mean age 29.03 ± 20.45 years; 53.8% male), 28.8% tested positive for Alternaria sensitization. Sensitization was significantly more prevalent in patients younger than 18 years (44.1%) compared to adults (17.4%). No significant difference was observed based on sex. Although sensitization was more frequent in patients with severe asthma (40.6%) than moderate asthma (20.8%), this trend was not statistically significant. Logistic regression identified younger age as the only independent predictor of sensitization. Alternaria alternata sensitization is common among individuals with moderate to severe asthma, particularly in younger patients. These findings underscore the importance of routine fungal allergen screening in asthmatics, especially children, to inform targeted management strategies and potentially reduce asthma-related morbidity.

Allergies and Lung Cancer: Exploring the Association with Allergic Rhinitis

2026-04-19T11:46:09+00:00

Allergy and lung cancer are two distinct health concerns. While allergies are typically associated with heightened immune activity, such immune responses may also influence the tumor microenvironment. This study aimed to investigate a potential link between allergic conditions and the risk of lung cancer. We conducted a case-control study analyzing 82 histologically confirmed lung cancer patients and 82 healthy controls from 2019 to 2022. Data were collected through structured questionnaires assessing asthma, allergic rhinitis (AR), food/drug allergies, and chronic urticaria. Statistical analyses included independent samples t-tests and chi-square tests, with significance set at a predetermined threshold. We observed a significant inverse association between AR and lung cancer (8.54% vs 47.56% in controls; OR=0.14, 95% CI: 0.06–0.32). No significant associations were found for asthma (7.32% vs 3.66%), chronic urticaria (3.66% vs 3.66%), drug allergy (4.88% vs 1.22%), or food allergy (2.44% vs 6.10%). The association between AR and lung cancer remained robust after adjustment for demographic factors. AR demonstrated a strong negative association with lung cancer, suggesting potential protective mechanisms distinct from other allergic conditions. These findings support the growing evidence for allergy-cancer immunomodulatory interactions and highlight the need for mechanistic studies on AR-specific pathways in oncogenesis

The Elevated Eosinophil Counts and Neutrophils/Lymphocytes Ratio as Predicting Biomarkers in Non-responders, Chronic Spontaneous Urticarial Patients to Cetirizine/Famotidine Treatment

2026-04-19T11:46:08+00:00

The responses of patients with chronic spontaneous urticaria (CSU) to regular therapeuticoptions vary. While these methods are effective for some patients, many do not respondsuccessfully. Despite several studies conducted to identify immunologic and inflammatorybiomarkers in patients that can predict response, our current knowledge is insufficient. This studyaimed to identify biomarkers that may predict therapeutic response.The present interventional study evaluated 61 moderate-to-severe CSU patients aged 20 to 50years who presented to our clinic from January 2024 to January 2025. Peripheral blood samples,serum, and plasma were collected to measure inflammatory and immunological variables, and wereanalyzed at a reference laboratory. Subsequently, patients were treated with cetirizine 10 mg every12 hours and famotidine 40 mg every night. After 1month, urticarial severity was reassessed usingthe same questionnaire. Severity scores were compared between patients with elevated biomarkersand those with normal levels.Sixty-one patients with chronic spontaneous urticaria were enrolled; 77% female and 23% male.Forty-one patients experienced a good response to treatment, while 20 patients did not. The average(Urticaria Activity Score) UAS7 scores before and after treatment were 27.72 and 12.67, respectively.Among the serum biomarkers evaluated, only the neutrophil-to-lymphocyte ratio (NLR) and serumeosinophil count showed a significant relationship with treatment response.To conclude, a high eosinophil count and NLR may serve as predictors of a poor clinical responseto antihistamine therapy. However, further clinical trials are needed to confirm these findings.

Modeling Post-cholecystitis Complication Risk from Perioperative Liver Function and Immune-inflammation Indicators

2026-04-19T11:46:07+00:00

Acute calculous cholecystitis (ACC) often triggers transient perioperative elevations in liver enzymes and systemic inflammation, yet existing complication-prediction tools seldom incorporate dynamic biomarker changes. Our goal was to establish and develop, using internal validation, a multivariable risk model that incorporates perioperative variations in liver function tests (LFTs) and the Systemic Immune-Inflammation Index (SII) in order to predict Clavien–Dindo grade ≥II complications following cholecystectomy for ACC. In this retrospective cohort study at a tertiary academic center (January 2022–December 2024), we analyzed 260 adult patients undergoing laparoscopic or open cholecystectomy for ACC. We calculated Δ-values (day 1 minus baseline) for alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, and SII (platelet×neutrophil/lymphocyte). Multivariable logistic regression with backward stepwise selection was used to derive the final model, which included ΔALT, ΔAST, Δbilirubin, ΔSII, age, American Society of Anesthesiologists (ASA) status, and operative duration. Internal validation employed 1 000 bootstrap replications. The model demonstrated good discrimination (optimism-corrected area under the curve, 0.82; 95% CI, 0.77–0.87) and excellent calibration (slope, 0.95; intercept, –0.02). Significant predictors included ΔALT, ΔAST, Δbilirubin, and ΔSII, along with age, ASA III status, and longer operative duration. The decision-curve analysis demonstrated net benefit across threshold probabilities of 5% to 40%, with 15 additional true positives per 1 000 at the 20% threshold. Integrating dynamic perioperative changes in LFTs and SII with key clinical factors yields a robust risk prediction model for postoperative complications after ACC surgery.

Exploring the Efficacy of Immunotherapy in Combination with Surgical Resection in High-risk Muscle-invasive Bladder Cancer

2026-04-19T11:46:06+00:00

Traditional radical cystectomy has a high recurrence rate, a high probability of metastasis, and a reduced quality of life for patients. This study aimed to explore the efficacy of combining immunotherapy and surgical resection for high-risk muscle-invasive bladder cancer. In a retrospective study, 231 patients with high-risk muscle-invasive bladder cancer admitted to Yueyang People’s Hospital between January 2019 and May 2024 were selected. After exclusions, 200 cases were analyzed and divided into two groups according to the treatment modality: the control group (surgical resection alone, n=100) and the intervention group (combination of immunotherapy and surgical resection, n=100). The cellular immune function indexes (CD3+, CD4+/CD8+, and natural killer cell levels), tumor markers (carcinoembryonic antigen, carbohydrate antigen 125, cytokeratin 21-1, and neuron-specific enolase), serum cytokines (basic fibroblast growth factor, vascular endothelial growth factor, and tumor necrosis factor-α), pathological complete remission (pCR), 1-year survival, and Functional Assessment of Cancer Therapy-Bladder (FACT-BL) quality-of-life scores were assessed in the two groups. After 1 year of treatment, the indicators of the two groups of patients were statistically significant in comparison with each other. Patients in the intervention group had substantial improvements in immune function indexes, pCR, 1-year survival rate, and FACT-BL scores in comparison with the control group. Tumor markers and serum cytokines were lower than those in the control group. The combination of immunotherapy and surgical resection can enhance clinical efficacy, providing a scientific basis for optimizing the clinical treatment plan.

Comparative Study of Dexmedetomidine Administration Routes in Pediatric Patients Receiving Endoscopic Low-temperature Plasma Adenotonsillar Ablation

2026-04-19T11:46:04+00:00

This study aimed to explore the effects of different dexmedetomidine (DEX) administrationroutes on anesthesia quality in pediatric patients undergoing endoscopic low-temperature plasmaadenotonsillar ablation.We selected 120 children with obstructive sleep apnea hypopnea syndrome scheduled forsurgery between May and December 2023. Participants were divided into four groups (n=30 each):a control group (Group S) receiving standard anesthesia without DEX; a local anesthesia group(Group L) receiving ropivacaine infiltration with 0.3 μg·kg−1 DEX; an intravenous group (Group T)receiving 0.6 μg·kg−1 DEX infusion post-induction; and a nasal drip group (Group N) receiving 0.6μg·kg−1 DEX intranasally upon room entry. We compared operation/extubation/recovery times,and scores from the Observer Assessment of Alertness and Sedation (OAA/S), Objective PainScale (OPS), and Pediatric Anesthesia Emergence Delirium (PAED) scales. Rescue sedation andsafety were also assessed.Group T showed lower heart rates at specific timepoints, while Group L had lower bloodpressures. Recovery time (Steward score ≥4) was longer in Groups L and T compared to Group S,but not in Group N. Groups T and N showed increased OAA/S scores post-awakening, withGroup N having the highest scores. OPS and PAED scores decreased in all DEX groups, withGroup N demonstrating the lowest scores, followed by Group L and then Group T. No significantdifferences were found in operation time, extubation time, or the incidence of rescuesedation/complications among groups.Intranasal DEX emerged as the optimal route, providing effective analgesia and sedationwithout prolonging recovery time.

Diagnostic Value of the Combination of Serum TH1/TH2 Cytokines, Procalcitonin, and High-sensitivity C-reactive Protein for Predicting the Severity of Pneumonia

2026-04-19T11:46:03+00:00

T helper 1 (TH1) and T helper 2 (TH2) cells can secrete various proinflammatory and anti-inflammatory factors, which can serve as indicators for predicting the severity of pneumonia.However, they are rarely used in combination with procalcitonin (PCT) and high-sensitivity C-reactive protein (hsCRP) detection to predict the severity of pneumonia. The purpose of this studyis to investigate the combination of serum TH1/TH2 cytokines, PCT, and hsCRP for predicting theseverity of community-acquired pneumonia (CAP).This study observed 58 inpatients with CAP. Analyses were conducted on the serum levels ofTH1/TH2 cytokines, PCT, and hsCRP; imaging examination results; underlying diseases; pathogens;and the pneumonia severity index (PSI).The severe pneumonia group showed significantly higher PSI scores, age, and complicationrates. Serum IL-2 was notably elevated in severe cases, while a combination of PCT, IL-4, TNF-α,and IFN-γ effectively predicted severe pneumonia, with an AUC of 0.712. Specific alterations incytokines and biomarkers were identified as risk factors for higher PSI, complications, andprolonged hospitalization.The combined detection of PCT, IL-4, TNF-α, and IFN-γ provides a potential tool forpredicting severe CAP, and distinct biomarker profiles are associated with different clinicaloutcomes

Effects of Combination Therapy with Empagliflozin and Metformin on Interleukin-1β and Interleukin-6 Secretion in Type 2 Diabetes Patients

2026-04-19T11:46:02+00:00

Type 2 diabetes (T2D) is defined by persistent inflammatory processes. This study evaluated the anti-inflammatory properties of empagliflozin in combination with metformin therapy in patients with T2D. In this prospective cohort study, 50 individuals with type 2 diabetes were non-randomly assigned to receive metformin (MTF, n=25) or empagliflozin (10 mg/day) and metformin (EMPA+MTF, n=25) and followed for 6 months. Fasting blood glucose (FPG), HbA1c, body mass index (BMI), glomerular filtration rate (GFR), and urinary albumin were measured at baseline and then 6 months later. Interleukin-1beta (IL-1β) and interleukin-6 (IL-6) secretion from isolated and stimulated peripheral blood mononuclear cells were measured using ELISA and compared in the different study groups. The MTF+EMPA group showed significantly decreased levels of FPG, HbA1C, and body mass index compared to the baseline. FPG and HbA1c in the MTF+EMPA group showed a significant decrease six months after treatment versus the MTF group. A significant reduction in IL-1β levels was observed at the six months post-treatment compared to baseline and in relation to the MTF group after six months. The levels of IL-6 exhibited no significant differences, both within and between the study groups. Significant direct correlations were observed between IL-1β levels and FPG as well as HbA1c within the MTF+EMPA group following six months of treatment. Incorporating empagliflozin (10 mg/day) into metformin treatment markedly enhanced glycemic regulation and lowered IL-1β secretions, indicating a possible anti-inflammatory benefit in overweight individuals with T2D following six months of treatment.

Construction of a Prognostic Model for Hepatocellular Carcinoma Based on Cell Death-related Genes and Characterization of Immune Microenvironment

2026-04-19T11:46:01+00:00

Hepatocellular carcinoma (HCC) is the predominant type of primary liver cancer. This study aimed to elucidate the involvement of genes associated with 25 cell-death modalities in HCC development and progression. HCC transcriptomic datasets were integrated with curated cell death-related genes. Candidate genes were screened by differential expression analysis and protein– protein interaction network construction. Prognostic genes were identified using univariate Cox regression, proportional hazards assumption testing, and stepwise multivariate Cox regression. A risk score model and a nomogram were established, followed by risk stratification and analyses of immune infiltration, immune checkpoints, somatic mutations, and in silico drug sensitivity. Single-cell RNA sequencing was used to identify key cell types, infer temporal dynamics, and characterize intercellular communication, and findings were validated by quantitative real-time PCR (qRT-PCR). MAPT, CDKN2A, NQO1, CHGA, SERPINE1, and RET were identified as prognostic genes, and the risk model and nomogram showed good prognostic performance. Immune profiling revealed significant differences in multiple immune cell subsets between risk groups, including activated CD4+ T cells. Notably, CDKN2A correlated with activated CD4+ T cells, NQO1 with natural killer cells, RET with CD4+ central memory cells, and SERPINE1 with activated dendritic cells; RET also showed the strongest positive correlation with HAVCR2. Mutation spectra differed across risk groups, and ten drugs displayed significant predicted IC50 differences; all six genes were negatively correlated with KIN001.135. Single-cell analyses highlighted hepatocytes as a key cell type with strong hepatocyte–epithelial communication. qRT-PCR confirmed higher MAPT, CDKN2A, NQO1, and SERPINE1 expression in HCC tissues than in normal tissues.

Comprehensive Analysis of Core Genes, Key Pathways, and Immune Infiltration in Intervertebral Disc Degeneration Using Machine Learning and Experimental Validation

2026-04-19T11:45:59+00:00

This study integrated and analyzed two sets of gene expression data related to intervertebral disc degeneration (IVDD) to elucidate its key molecular mechanisms. Through screening and enrichment analysis of differentially expressed genes (DEGs), 112 DEGs were identified, primarily involved in extracellular matrix remodeling, cytoplasmic translation, and signaling pathways such as PI3K-Akt. A protein-protein interaction network combined with LASSO and SVM-RFE machine learning algorithms identified 13 hub genes. Immune infiltration analysis revealed reduced infiltration of suppressor cells and monocytes in IVDD samples. In an IL-1β-induced human nucleus pulposus cell degeneration model, qPCR and Western blot experiments confirmed significant downregulation of ADM, ITGB5, RTN4, SLPI, and CSNK1E expression. This study systematically reveals the potential molecular networks and immune characteristics of IVDD, providing new candidate biomarkers and therapeutic insights for subsequent targeted drug development.

Observation on the Therapeutic Effect and Mechanism of Activated Polyethylene Glycol on Allergic Rhinitis Animal Models

2026-04-19T11:45:59+00:00

Allergic rhinitis (AR), as a chronic disease, seriously affects the quality of life of patients while concurrently exerting a significant economic and healthcare burden on the medical system. However, the existing treatment methods have certain limitations, and more effective treatment strategies are needed. To this end, we proposed an ovalbumin-induced guinea pig model of AR to investigate the potential impact of activated polyethylene glycol (PEG) with varying molecular weights and concentrations in local nasal treatment. The therapeutic effect was evaluated by behavioral score, serological detection, and histopathological observation. The behavioral assessment demonstrated significant alleviation of sneezing frequency, nasal pruritus, and clear nasal discharge in the activated PEG-600 treatment groups relative to the sham group. However, statistical analysis revealed no appreciable intergroup differences between the activated PEG-3400 treatment groups and the sham group. Histopathological evaluation disclosed a marked reduction in eosinophilic infiltration in the activated PEG-600 group, accompanied by preservation of nasal mucosal structural integrity and notable attenuation of inflammatory infiltration. In contrast, the activated PEG-3400 group exhibited comparatively limited therapeutic efficacy, demonstrating only a subtle reduction in inflammatory cell counts and more pronounced disorganization of mucosal epithelial architecture compared to the PEG-600-treated group. Serum immunological profiling indicated that while local inflammatory markers showed evidence of mitigation, systemic immune parameters remained unaffected by either activated PEG formulation. These findings underscore the differential efficacy profile between PEG-600 and PEG-3400 derivatives in ameliorating AR symptoms, among which PEG-600 exhibits superior anti- inflammatory effects.

Identification of Immune-related Diagnostic Genes and Subtypes of Active Ulcerative Colitis

2026-04-19T11:45:58+00:00

Ulcerative colitis (UC) is a chronic immune-mediated disease with a growing global burden. In this study, bioinformatics analysis and machine learning methods were employed to screen the potential immune microenvironment-related feature genes. We identified 4 immune-related genes that are consistently dysregulated in UC and correlate with immune infiltration, including APOBEC3B (Apolipoprotein B mRNA Editing Enzyme Catalytic Subunit 3B), CXCL11, PLA2G2A, and TMEM173. Their diagnostic performance was verified in an external cohort and in our clinical samples. Then, the proportion of ambiguous clustering (PAC) successfully classified UC patients into 2 molecular subtypes, including subtype 1 (metabolism-related subtype) and subtype 2 (immune- related subtype). The single sample gene set enrichment analysis (ssGSEA) algorithm revealed that subtype 2, with a higher score, of the majority of immune cells presented a worse inflammatory response. In addition, we assessed scores of partial novel drugs querying the cMAP database and found that the efficacy of clinical small-molecule compounds presented different results across UC subtypes. These findings identify biomarkers, establish a concise immune-based classification of UC, and support subtype-guided therapy.

Hsa-miR-23a-5p: A Potential Prognostic Biomarker in Diffuse Large B-cell Lymphoma

2026-04-19T11:45:56+00:00

This study aimed to identify a novel microRNA (miRNA)-related circulating biomarker that is easily accessible for clinical use and can dynamically monitor the biological characteristics of diffuse large B-cell lymphoma (DLBCL). We analyzed miRNA expression profiles in DLBCL from the Gene Expression Omnibus (GEO) (GSE171272 and GSE173080) and The Cancer Genome Atlas (TCGA). The immune microenvironment and immune-related gene differences associated with hsa-miR-23a-5p were assessed through the single-sample gene set enrichment analysis and CIBERSORT. Gene set enrichment analysis identified expression trends related to hsa-miR-23a-5p. The 50% inhibitory concentration of chemotherapy agents was estimated for hsa-miR-23a-5p. Potential miRNA targets were identified using TargetScan, miRWalk, and RNA22, and validated with miRTarBase, DIANA- TarBase, and NPInter. Gene functions and associated pathways were analyzed through Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes. Protein-Protein Interaction networks were built using Cytoscape. SNRPD1-related analysis was conducted using TCGA and GEO data. Hsa-miR-23a-5p was significantly overexpressed in the tumor tissues and serum exosomes of patients with DLBCL. The expression levels of hsa-miR-23a-5p were associated with distinct prognostic outcomes, immune landscapes, chemoresistance, and biological processes, serving as potential risk factors. The target gene SNRPD1 was an independent prognostic factor significantly associated with patient survival. This study identifies hsa-miR-23a-5p and its target SNRPD1 as potential prognostic factors for DLBCL. Specifically, the overexpression of hsa-miR-23a-5p in serum exosomes of patients with DLBCL suggests that it could serve as a convenient, non-invasive biomarker for clinical evaluation of DLBCL. However, further research and validation are necessary to confirm these findings

Phenotypic Diversity of Chronic Granulomatous Disease within a Family Carrying the Same NCF1 Gene Mutation

2026-04-19T11:45:55+00:00

Chronic Granulomatous Disease (CGD) is a defect or abnormality in the immune system thatproduces severe and persistent signs and symptoms in affected individuals.Phenotypic diversity and genetic heterogeneity exist among patients with inborn errors ofimmunity (IEI). Symptoms may vary even when the mutations are identical; conversely, patientswith different mutations may have similar clinical features. The expression of phenotype may bedetermined by the gene sequence, epigenetic changes, and sometimes environmental factors. Someof these outcomes are influenced by the individual’s past immunological exposure.This study discusses two CGD cases, a father and son; after the diagnosis of CGD in the childand confirmation of the genetic mutation, the same mutation was also identified in the father.Therefore, physicians should have more awareness that a single genetic mutation can havedifferent clinical manifestations.