IgE and mast cells play a pivotal role in various allergic diseases, including asthma, allergic rhinitis, and urticaria. Treatment with omalizumab, a monoclonal anti-IgE antibody, has significantly improved control of these allergic diseases and introduced a new era for the management of severe allergic conditions. About 10 years of experience with omalizumab treatment for severe allergic asthma confirmed its effectiveness and safety, reducing symptoms, frequency of reliever use, and severe exacerbations in patients with intractable conditions. Omalizumab is particularly useful in childhood asthma, where atopic conditions often determine clinical courses of asthma. Recently, omalizumab is approved for the treatment of chronic spontaneous urticaria (CSU) with the fixed dose of 300 mg. Although the mechanisms underlying the actions of omalizumab in CSU are not fully clarified, nearly 90% of patients with CSU showed a complete or a partial response to omalizumab treatment. Furthermore, omalizumab is just approved for the treatment of severe Japanese cedar pollinosis (JC) based on the successful results of an add-on study of omalizumab for inadequately controlled severe pollinosis despite antihistamines and nasal corticosteroids. For proper use of omalizumab to treat severe JC, co-administration of antihistamines is necessary, while patients should meet the criteria including strong sensitization to Japanese cedar pollen (≥class 3) and poor control under standard treatment. In the management of severe allergic diseases using omalizumab, issues including cost and concerns about relapse after its discontinuation should be overcome. At the same time, possibilities for application to other intractable allergic diseases should be considered.

Focusing on the components of fine particulate matter, i.e., PM_2.5, we have analyzed the factors that led to the high concentrations of each chemical component in PM_2.5 during our observations in Fukuoka, Japan in spring 2020. The backward trajectory showed that air masses reached Fukuoka via the Yellow Sea and the southern part of South Korea when PM_2.5 and each chemical component were high in concentrations. On the other hand, diurnal variations in ozone were also observed, suggesting that both transboundary and local air pollution are involved. Air masses reached the southern part of the Kyushu region when only sulfate concentrations were high. A volcano eruption led the high sulfate concentration. When only polycyclic aromatic hydrocarbons (PAHs) concentrations were high, air masses often reached the northern part of Kyushu, indicating that there may be a specific local source for PAHs.

Background: Childhood asthma is a major risk for low lung function in later adulthood, but what factors in asthma are associated with the poor lung function during childhood is not known. Objective: To identify clinical factors in children with asthma associated with low or declining lung function during the treatment. Methods: We enrolled children with asthma who had been treated throughout three age periods, i.e., 6–9, 10–12, and 13–15 years old, at seven specialized hospitals in Japan. Clinical information and lung function measurements were retrieved from the electronic chart systems. To characterize the lung function trajectories during each age period, we evaluated the forced expiratory volume 1 (FEV1) with % predicted values and individual changes by the slope (S) from linear regression. We defined four trajectory patterns: normal (Group N) and low (Group L), showing %FEV1 ≥80% or <80% throughout all three periods; upward (Group U) and downward (Group D), showing S ≥ 0 or S < 0%. Logistic regression analysis was performed to compare factors associated with the unfavorable (D/L) versus favorable (N/U) groups. Results: Among 273 eligible patients, 197 (72%) were classified into Group N (n = 150)/U (n = 47), while 76 (28%) were in Group D (n = 66)/L (n = 10). A history of poor asthma control, long-acting beta2 agonist use, and a lower height Z-score during 13–15 years were associated with an unfavorable outcome (Group D/L). Conversely, inhaled corticosteroid (ICS) use during 10–12 years and high-dose ICS use during 13–15 years were associated with a favorable outcome (Group N/U). Conclusion: We identified several factors that are associated with unfavorable lung function changes in pediatric asthma. Attention should be paid to the possible relationship between yearly changes in lung function and poor asthma control, use of ICS (and its dose) and use of LABA.

(1) Background: To date, little research has epidemiologically examined whether the concentration of particulate matter (PM) 2.5 and its ionic components is related to the prevalence of skin symptom exacerbations. Therefore, this study aimed to clarify this association in patients with allergic diseases. (2) Methods: From 1 February to 31 May 2020, we evaluated the daily prevalence of skin symptoms in outpatients with allergic diseases being treated at Fukuoka National Hospital, Fukuoka, Japan, and measured the concentration of PM2.5 and its ionic components. (3) Results: Univariate analysis showed a statistically significant association between skin symptoms and the concentration of PM2.5 and the ionic components SO₄²⁻, NH₄⁺, K⁺, and Mg²⁺; multivariate analysis showed a statistically significant association between the daily prevalence of skin symptom and the concentration of the ionic components SO₄²⁻ or Mg²⁺. (4) Conclusions: Our findings indicate that the concentration of some PM2.5 ionic components may affect skin symptom in patients with allergic diseases.

To clarify different effects of Asian dust (AD), long-range transported from Asian continent, on total suspended particles (TSP) and polycyclic aromatic hydrocarbons (PAHs) in Japan, TSP were simultaneously collected during AD periods (from 1 March to 31 May 2020 and 2021) in Fukuoka and Kanazawa. During AD days, decided by Light Detection and Ranging and Japan Meteorological Agency, TSP concentrations increased significantly (p < 0.001) at two sampling sites. PAH concentrations increased in Kanazawa (p < 0.001) but not in Fukuoka on AD days. Correlation coefficients (r) between daily TSP and total PAHs concentrations were weak in Kanazawa: 0.521 (non-AD) and 0.526 (AD) (p < 0.01), and in Fukuoka: 0.321 (non-AD) and 0.059 (AD). However, correlation between seasonal (average monthly) TSP and total PAH concentrations were stronger: 0.680 (Kanazawa) and 0.751 (Fukuoka). The reasons might be that seasonal variations of TSP and total PAHs in two cities depend equally on planetary scale westerly, while daily TSP and total PAHs variations in each city varied by different transportation distances from AD and PAHs sources in the Asian continent to Japan. Different local sources and meteorological conditions were considered. These results are important for elucidating the causes of chronic and acute respiratory diseases.