An Overview of Environmental Risk Factors for Food Allergy

IgE-mediated food allergy is an increasing public health concern in many regions around the world. Although genetics play a role in the development of food allergy, the reported increase has occurred largely within a single generation and therefore it is unlikely that this can be accounted for by changes in the human genome. Environmental factors must play a key role. While there is strong evidence to support the early introduction of allergenic solids to prevent food allergy, this is unlikely to be sufficient to prevent all food allergy. The purpose of this review is to summarize the evidence on risk factors for food allergy with a focus the outdoor physical environment. We discuss emerging evidence of mechanisms that could explain a role for vitamin D, air pollution, environmental greenness, and pollen exposure in the development of food allergy. We also describe the recent extension of the dual allergen exposure hypothesis to potentially include the respiratory epithelial barrier in addition to the skin. Few existing studies have examined the relationship between these environmental factors with objective measures of IgE-mediated food allergy and further research in this area is needed. Future research also needs to consider the complex interplay between multiple environmental factors.

Sinonasal Hamartomas: From Nasal Chondromesenchymal Hamartoma to Respiratory Epithelial Adenomatoid Hamartoma. Report of six Cases and Review of the Literature

Sinonasal hamartomas are uncommon lesions of nasal and sinus cavities. Based on indigenous cellular components and characteristic histologic features, they are further classified into four entities: respiratory epithelial adenomatoid hamartoma (REAH), seromucinous hamartoma (SH), chondro-osseous and respiratory epithelial hamartoma (CORE), and nasal chondromesenchymal hamartoma (NCH). REAH, SH, and CORE are seen in adult patients, while NCH predominantly occurs in newborns and infants. Morphologically REAH and SH are composed of respiratory epithelium and seromucinous glands, CORE is related to REAH but with additional feature of chondroid and/or osseous tissue, and NCH is composed of chondroid and stromal elements but devoid of epithelial component. All four lesions can present as sinonasal mass lesions and with associated obstructive symptoms. Given the rarity of these lesions, diagnosis can be challenging, especially in unusual clinical scenario. In this study, we report six cases of sinonasal hamartoma, including one case of NCH, one case of CORE, two cases of SH, and two cases of REAH. All cases were from adult patients including four men and two women. We also review the literature of the clinical and pathologic features of these rare lesions.

Cell lysis analysis for respiratory viruses through simulation modeling

An ordinary system of differential equations leading to a simulation model is propose as methodological approach to analysis the incidence of infectious-contagious diseases, in this case using SARS-CoV-2 virus as pathogenic model. The dynamics of the model are drive by the interaction between susceptible cells contemplating respiratory epithelial cells and viral infection mediated by two types of lysis response. To perform the simulations, values of some variables and parameters were selected from referenced sources, considering that previous reports suggested that the viral load in the lower respiratory tract might reach its peak in the second week after the beginning of disease symptoms. The scenarios described in the simulations evidence the performance of the cell lysis response from susceptible cells that have been infected. The recommend model shows that an excess response from both the original virus and the mutated virus leads to an increase in the approximate time to control viral infection within the organism.

In-House Immunofluorescence Assay for Detection of SARS-CoV-2 Antigens in Cells from Nasopharyngeal Swabs as a Diagnostic Method for COVID-19

Immunofluorescence is a traditional diagnostic method for respiratory viruses, allowing rapid, simple and accurate diagnosis, with specific benefits of direct visualization of antigens-of-interest and quality assessment. This study aims to evaluate the potential of indirect immunofluorescence as an in-house diagnostic method for SARS-CoV-2 antigens from nasopharyngeal swabs (NPS). Three primary antibodies raised from mice were used for immunofluorescence staining, including monoclonal antibody against SARS-CoV nucleocapsid protein, and polyclonal antibodies against SARS-CoV-2 nucleocapsid protein and receptor-binding domain of SARS-CoV-2 spike protein. Smears of cells from NPS of 29 COVID-19 patients and 20 non-infected individuals, and cells from viral culture were stained by the three antibodies. Immunofluorescence microscopy was used to identify respiratory epithelial cells with positive signals. Polyclonal antibody against SARS-CoV-2 N protein had the highest sensitivity and specificity among the three antibodies tested, detecting 17 out of 29 RT-PCR-confirmed COVID-19 cases and demonstrating no cross-reactivity with other tested viruses except SARS-CoV. Detection of virus-infected cells targeting SARS-CoV-2 N protein allow identification of infected individuals, although accuracy is limited by sample quality and number of respiratory epithelial cells. The potential of immunofluorescence as a simple diagnostic method was demonstrated, which could be applied by incorporating antibodies targeting SARS-CoV-2 into multiplex immunofluorescence panels used clinically, such as for respiratory viruses, thus allowing additional routine testing for diagnosis and surveillance of SARS-CoV-2 even after the epidemic has ended with low prevalence of COVID-19.

Enhanced apoptosis as a possible mechanism to self-limit SARS-CoV-2 replication in porcine primary respiratory epithelial cells in contrast to human cells

The ability of SARS-CoV to infect different species, including humans, dogs, cats, minks, ferrets, hamsters, tigers, and deer, pose a continuous threat to human and animal health. Pigs, though closely related to humans, seem to be less susceptible to SARS-CoV-2. Former in vivo studies failed to demonstrate clinical signs and transmission between pigs, while later attempts using a higher infectious dose reported viral shedding and seroconversion. This study investigated species-specific cell susceptibility, virus dose-dependent infectivity, and infection kinetics, using primary human (HRECs) and porcine (PRECs) respiratory epithelial cells. Despite higher ACE2 expression in HRECs compared to PRECs, SARS-CoV-2 infected, and replicated in both PRECs and HRECs in a dose-dependent manner. Cytopathic effect was particularly more evident in PRECs than HRECs, showing the hallmark morphological signs of apoptosis. Further analysis confirmed an early and enhanced apoptotic mechanism driven through caspase 3/7 activation, limiting SARS-CoV-2 propagation in PRECs compared to HRECs. Our findings shed light on a possible mechanism of resistance of pigs to SARS-CoV-2 infection, and it may hold therapeutic value for the treatment of COVID-19.

Surgical ciliated cyst after a mandibular surgery: a particular case report and review of the literature

Background Surgical ciliated cyst is a rare clinicopathological lesion that appears in patients who undergo maxillofacial surgery. In this report we present a particular mandibular case and we discuss the etiopathogenesis and clinicopathological features of this pathology after reviewing the current literature, as well as the origin of its respiratory epithelial profile. Case presentation The patient is a 67-year-old male with an irregular radiolucency in a previously tooth extracted area of the mandible. The histopathological study revealed a cystic lesion with a connective wall with chronic inflammation, partially lined by a ciliated pseudostratified epithelium. PAS and CK19 stains showed the respiratory characteristics of this epithelium and confirmed the final diagnosis of mandibular surgical ciliated cyst. Conclusions Surgical ciliated cyst is an uncommon entity associated with maxillofacial surgical procedures with bone and nasal cartilage grafts. In our case, treatment with growth factors present in platelet-rich plasma could explain the respiratory changes observed in the cystic epithelial lining.”

Viral Induced Effects on a Vulnerable Epithelium; Lessons Learned From Paediatric Asthma and Eosinophilic Oesophagitis

The epithelium is integral to the protection of many different biological systems and for the maintenance of biochemical homeostasis. Emerging evidence suggests that particular children have epithelial vulnerabilities leading to dysregulated barrier function and integrity, that resultantly contributes to disease pathogenesis. These epithelial vulnerabilities likely develop in utero or in early life due to various genetic, epigenetic and environmental factors. Although various epithelia are uniquely structured with specific function, prevalent allergic-type epithelial diseases in children potentially have common or parallel disease processes. These include inflammation and immune response dysregulation stemming from atypical epithelial barrier function and integrity. Two diseases where aetiology and pathogenesis are potentially linked to epithelial vulnerabilities include Paediatric Asthma and Eosinophilic Oesophagitis (EoE). For example, rhinovirus C (RV-C) is a known risk factor for paediatric asthma development and is known to disrupt respiratory epithelial barrier function causing acute inflammation. In addition, EoE, a prevalent atopic condition of the oesophageal epithelium, is characterised by similar innate immune and epithelial responses to viral injury. This review examines the current literature and identifies the gaps in the field defining viral-induced effects on a vulnerable respiratory epithelium and resulting chronic inflammation, drawing from knowledge generated in acute wheezing illness, paediatric asthma and EoE. Besides highlighting the importance of epithelial structure and barrier function in allergic disease pathogenesis regardless of specific epithelial sub-types, this review focuses on the importance of examining other parallel allergic-type disease processes that may uncover commonalities driving disease pathogenesis. This in turn may be beneficial in the development of common therapeutics for current clinical management and disease prevention in the future.

NUDT18 catalyzes hydrolysis of active metabolites of the antivirals Remdesivir and Ribavirin

Remdesivir (GS-5734) has gained considerable interest due to its activity against replication of SARS-CoV2. Remdesivir is a broad-spectrum antiviral prodrug that is hydrolyzed intracellularly and phosphorylated by cellular kinases to its active triphosphate form (Remdesivir-TP). Here we tested Remdesivir-TP as a substrate for a panel of human hydrolases and found that NUDIX hydrolase 18 (NUDT18) catalyzes the hydrolysis of Remdesivir-TP. NUDT18 is expressed in respiratory epithelial cells suggesting that NUDT18 may limit the antiviral efficacy of Remdesivir by decreasing the intracellular concentration of its active metabolite at its intended site of action. The kcat of NUDT18 for Remdesivir-TP was determined to 2.6 s-1 and the Km value was 156 μM, suggesting that NUDT18 catalyzed hydrolysis occurs in cells. In addition, we found that the triphosphate of the antiviral Ribavirin, with broad-spectrum activity against several RNA and DNA viruses, was hydrolyzed by NUDT18, albeit with a lower efficiency compared to Remdesivir-TP. NUDT18 activity was also tested with the triphosphates of the antivirals Sofosbuvir and Aciclovir for which low activity, in comparison to activities with Remdesivir-TP and Ribavirin-TP, was detected. These results suggest that NUDT18 can act as a cellular sanitizer and may influence the antiviral efficacy of Remdesivir and Ribavirin.