Tongwei and Wuxi represent a rural county in western China and an industrialized city in the east, respectively. The study compared breast milk and the corresponding infant gut microbiota from 35 healthy mothers in Tongwei and 28 in Wuxi, uncovering significant differences in microbial alpha and beta diversity. A unique strain, Lactiplantibacillus plantarum FN029, characteristically transmitted from breast milk to the infant gut in Tongwei, was identified. Oral administration of FN029 to weaned BALB/c mice significantly alleviated atopic dermatitis severity caused by calcipotriol and ovalbumin. This reduction was paralleled by a decrease in mast cells and eosinophils in ear tissue and reduced levels of IL-4, IL-12, IL-33, IFN-γ, the IL-4/IFN-γ ratio, and IgE in plasma, along with an upsurge in regulatory T cells in the spleen. RNA sequencing revealed that FN029 activated the retinol metabolism pathway and the Wnt signaling pathway, enhancing immature dendritic cells and regulatory T cells. Metabolomics analysis indicated an increase in retinyl beta-glucuronide, a biomarker of vitamin A reserves. The mRNA expression of retinol-metabolizing enzymes was inversely related to the IL-4/IFN-γ ratio. FN029 also altered ileum microbiota without a direct link to atopic dermatitis improvement. In conclusion, L. plantarum FN029, a probiotic from Tongwei breast milk, fostered T regulatory cell conversion and immune balance by activating the retinol pathway, thereby improving severe atopic dermatitis in mice.

Asthma and allergies have emerged as some of the most common chronic diseases, particularly in developed countries. Epidemiological studies have consistently demonstrated that children growing up in farming/rural environments are less likely to develop these conditions. Over the past three decades, China has experienced unprecedented economic development and urbanisation, accompanied by a rapid rise in the prevalence of allergic disorders. Despite the substantial number of affected individuals, allergy management in China remains inconsistent and often inadequate, compounded by variations in diagnostic criteria and limited healthcare access in less developed regions. Furthermore, the vast population, regional disparities, and methodological inconsistencies in data collection have hindered the acquisition of comprehensive, large-scale epidemiological data. This review examines the factors contributing to asthma and allergies from their early origins, focusing on modifiable factors from a specific perspective of China. Factors related to traditional lifestyle, such as early-life exposure to agricultural farming and poultry, diverse dietary patterns, and early introduction of allergenic foods, appear to offer protection against allergies. Conversely, exposure to open-fire cooking, incense burning, tobacco smoke, as well as early-life antibiotic use and perinatal factors like Caesarean section delivery and prematurity may represent potential risks. A clear understanding of the role of these factors would pave the way for developing effective interventions to mitigate the substantial health and socioeconomic burdens associated with asthma and allergies.

While much of the evidence linking the rapid urbanization and the increasing prevalence of allergen sensitization, but little is known regarding rural-to-urban migrants. The aim of this study was to identify the disparities in allergy, the gut microbiome and factors among native urban, migrating, and native rural Chinese.

We redesigned the dataset of the China Alliance of Research on Respiratory Allergic Disease secondary survey, and after stratified sampling, a subsample of 2422 subjects were enrolled for the analysis of a questionnaire, skin prick tests (SPT), and specific immunoglobulin E (sIgE) titer measurements against 8 common allergens. Fecal microbiotal composition was also sequenced by 16S rRNA and regression-based analyses with covariate adjustment applied.

From urban to migrant and rural populations, IgE sensitization was predominantly directed against Dermatophagoides pteronyssinus (Der p). The titers of Der p-sIgE decreased sequentially across the 3 respective populations and co-sensitization to other allergens also showed a sequential decrease. Rural-to-urban migrants showed a low prevalence of Der p-SPT and Der p-sIgE initially, but developed substantial IgE titers and their gut microbiotal diversity, as well as species richness, appeared to change along with residential time spent in the urban area. High-fat diet, using a mattress, an SPT wheal size from Der p ≥ 6 mm, and duration of immigration >5 years were significantly associated with sIgE positivity in the migrants.

The Der p-sIgE responses and the composition of gut microbiota differs synchronously with extended living time in an urban area. Studies in immigrants provide a unique opportunities to evaluate the effects of environmental factors in the pathogenesis of allergic disorders.

Upper respiratory tract infections (URTIs) are a significant global health burden, and understanding the immune response is crucial for developing effective diagnostic tools and treatment strategies.

This study investigated the levels of specific biomarkers in 188 patients with URTIs and their association with demographic factors, comorbidities, and clinical outcomes. Immunoglobulin A (IgA), immunoglobulin E (IgE), neutrophils, serum iron, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured.

The median age of the patients was 5 years, with 46% being female and 63% from urban areas. Adenoiditis (37%), otitis (25%), and rhinitis (20%) were the most common diagnoses. While most biomarkers did not vary significantly by gender, neutrophil levels were significantly higher in females (p = 0.020). IgE levels were significantly elevated in rural patients compared to urban counterparts (p = 0.034).

ESR was significantly associated with rhinitis diagnosis, and IgE and ESR were predictive of otitis in multivariate models. However, many biomarkers did not significantly correlate with other diagnoses, contradicting previous research focusing on individual biomarkers. This study highlights the complexity of immune responses in URTIs and the need for more effective diagnostic tools. The findings can inform the development of tailored treatment strategies based on gender, area of origin, and infection type.

Allergic rhinitis (AR) poses a significant global health burden, with the potential to progress to asthma, thereby impacting patients' quality of life. Immunotherapy has demonstrated effectiveness in mitigating clinical symptoms by altering the underlying disease mechanisms of AR. This article provides a thorough review of the current state of immunotherapy for AR, encompassing various facets of immunotherapeutic strategies, elucidating their mechanisms and clinical implications. By presenting a nuanced understanding of the present landscape of immunotherapy for AR, this review aims to serve as a valuable reference for informing clinical treatment strategies. The subsequent analysis of diverse immunotherapeutic pathways offers a comprehensive understanding of their mechanisms and clinical implications. A meticulous examination is conducted on subcutaneous immunotherapy, sublingual immunotherapy, oral immunotherapy, intralymphatic immunotherapy, and innovative intravenous gold-induced autologous serum injection therapy. Each pathway is systematically elucidated, with its distinctive features and potential contributions to managing AR emphasized. In conclusion, synthesizing epidemiological insights, immunotherapeutic nuances, and pathway-specific analyses encapsulates a profound understanding of immunotherapy for AR.

Background: In the past two decades, the prevalence of asthma, eczema, and allergic rhinitis has increased among school-aged children in the Central Black Sea region of Turkey. This increase is consistent with national and international data, reflecting the impact and temporal changes of allergic diseases on the community. A similar increasing trend is also observed worldwide. This study aims to contribute to the development of health policies related to allergic diseases among Turkish children in the Central Black Sea region. Materials and Methods: This study compares the results of two cross-sectional surveys conducted in schools in and around Samsun, Turkey, between the years 2006 and 2022, examining changes in the prevalence of specific allergic diseases such as asthma, allergic rhinitis, and atopic eczema. Utilizing the Turkish translation of the International Study of Asthma and Allergies in Childhood protocol, the research encompassed a total of 1,310 and 3,219 children, respectively. Results: In the recent study conducted in 2022, the prevalence of asthma and allergic bronchitis diagnosed by physicians was found to be 10.5% and 4.6%, respectively. In addition, the prevalence of allergic rhinitis was determined to be 3.1% and the prevalence of atopic dermatitis was 2.5%. Moreover, previously unidentified rates of food allergy were determined to be 2.5%, and drug allergy was found to be 2.4%. Furthermore, a comparison with a cross-sectional study conducted in the same region 20 years ago revealed a statistically significant increase in the prevalence of physician-diagnosed asthma and allergic bronchitis (with P-values of 0.0375 and 0.0107, respectively). Discussion: The findings of this study suggest a similar trend of increasing prevalence of allergic diseases when compared with similar studies at national and global levels. Consistent with trends identified in the international literature, Turkey is also affected by the rising prevalence of allergic diseases.

The increase in the prevalence of food allergy has been considered as the second wave in the allergy epidemic following the first wave of increase in asthma and allergic rhinitis. It is well known that the prevalence of allergic conditions would follow economic development and urbanization in many countries or regions. In developed countries, one in three children suffered from at least one allergic disorder and these conditions include food allergy, eczema, allergic rhinitis and asthma. Food allergy is very often the first allergic manifestation affecting infants and young children. The exact etiologies are not known. The clinical manifestations ranged from a simple rash or an itch around the mouth, to the more severe manifestations of angioedema and potentially fatal anaphylaxis. Among all cases of childhood anaphylaxis, food is the most common cause. The common allergens resulting in food allergies in developed countries include egg, milk, fish, wheat, peanuts and tree nuts. However, there are marked variations in the patterns of food allergens in developing countries. In line with the epidemiology of asthma, food allergy is also much less common in rural areas. Clear understanding of reasons explaining the disparity of food allergies between urban and rural population would pave the way to the development of effective primary prevention for food allergy.

Growing up on traditional farms protects children from the development of asthma and allergies. However, we have identified distinct asthma-protective factors, such as poultry exposure. This study aims to examine the biological effect of rural exposure in China.

We recruited 67 rural children (7.4 ± 0.9 years) and 79 urban children (6.8 ± 0.6 years). Depending on the personal history of exposure to domestic poultry (DP), rural children were further divided into those with DP exposure (DP+ , n = 30) and those without (DP- , n = 37). Blood samples were collected to assess differential cell counts and expression of immune-related genes. Dust samples were collected from poultry stables inside rural households. In vivo activities of nasal administration of DP dust extracts were tested in an ovalbumin-induced asthma model.

There was a stepwise increase in the percentage of eosinophils (%) from rural DP+ children (median = 1.65, IQR = [1.28, 3.75]) to rural DP- children (3.40, [1.70, 6.50]; DP+ vs. DP- , p = .087) and to the highest of their urban counterparts (4.00, [2.00, 7.25]; urban vs. DP+ , p = .017). Similarly, rural children exhibited reduced mRNA expression of immune markers, both at baseline and following lipopolysaccharide (LPS) stimulation. Whereas LPS stimulation induced increased secretion of Th1 and proinflammatory cytokines in rural DP+ children compared to rural DP- children and urban children. Bronchoalveolar lavage of mice with intranasal instillation of dust extracts from DP household showed a significant decrease in eosinophils as compared to those of control mice (p < .05). Furthermore, DP dust strongly inhibited gene expression of Th2 signature cytokines and induced IL-17 expression in the murine asthma model.

Immune responses of rural children were dampened compared to urban children and those exposed to DP had further downregulated immune responsiveness. DP dust extracts ameliorated Th2-driven allergic airway inflammation in mice. Determining active protective components in the rural environment may provide directions for the development of primary prevention of asthma.

Allergen immunotherapy (AIT) is an etiological treatment strategy that involves administering escalating doses of clinically relevant allergens to desensitize the immune system. It has shown encouraging results in reducing allergy symptoms and enhancing patients' quality of life. In this review, we offer a thorough overview of AIT in China, examining its efficacy, safety, current practices, and prospects. We further underscore the progress made in AIT research and clinical applications, as well as the distinct challenges and opportunities that China faces in this area.

Many potential environmental risk factors, protective factors, and biomarkers of AR have been published, but so far, the strength and consistency of their evidence are unclear. We conducted a comprehensive review of environmental risk, protective factors, and biomarkers for AR to establish the evidence hierarchy. We systematically searched Embase, PubMed, Cochrane Library, and Web of Science electronic database from inception to December 31, 2022. We calculated summary effect estimate (odds ratio (OR), relative risk (RR), hazard ratio (HR), and standardized mean difference (SMD)), 95% confidence interval, random effects p value, I2 statistic, 95% prediction interval, small study effects, and excess significance biases, and stratification of the level of evidence. Methodological quality was assessed by AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews 2). We retrieved 4478 articles, of which 43 met the inclusion criteria. The 43 eligible articles identified 31 potential environmental risk factors (10,806,206 total population, two study not reported), 11 potential environmental protective factors (823,883 total population), and 34 potential biomarkers (158,716 total population) for meta-analyses. The credibility of evidence was convincing (class I) for tic disorders (OR = 2.89, 95% CI 2.11-3.95); and highly suggestive (class II) for early-life antibiotic use (OR = 3.73, 95% CI 3.06-4.55), exposure to indoor dampness (OR = 1.49, 95% CI 1.27-1.75), acetaminophen exposure (OR = 1.54, 95% CI 1.41-1.69), childhood acid suppressant use (OR = 1.40, 95% CI 1.23-1.59), exposure to indoor mold (OR = 1.66, 95% CI 1.26-2.18), coronavirus disease 2019 (OR = 0.11, 95% CI 0.06-0.22), and prolonged breastfeeding (OR = 0.72, 95% CI 0.65-0.79). This study is registered in PROSPERO (CRD42022384320).