Allergologie select最新文献

{"title":"In-hospital sting challenge during venom immunotherapy has a high negative predictive value for subsequent sting reactions.","authors":"Nicola Wagner, Eva Oppel, Jarmila Gloning, Annett Walker, Sophia Czell, Franziska Ruëff","doi":"10.5414/ALX02652E","DOIUrl":"10.5414/ALX02652E","url":null,"abstract":"<p><strong>Aims: </strong>Hymenoptera venom allergy is the most frequent elicitor of anaphylaxis in adults. Biomarkers predicting success of venom immunotherapy (VIT) are lacking. Only a re-sting may help to detect insufficiently protected individuals. The aim of the study was to investigate the prognostic value of a tolerated sting challenge with regard to future field stings.</p><p><strong>Materials and methods: </strong>A retrospective study included 585 consecutive patients of the AllergieZentrum Munich, Germany, who had tolerated a sting challenge test during VIT. Patients who were still on VIT were examined with a questionnaire evaluating the outcome of later field stings during ongoing VIT.</p><p><strong>Results: </strong>439 of 585 patients (75%) could be evaluated. Of the 439 patients, 74/102 (75.2%) had tolerated a sting challenge with bee, 288/401 (74.1%) with yellow jacket, and 67/82 (81.7%) with both insects. In the follow-up time, 24.6% (108) had experienced at least 1 field sting. 104 of 108 patients (96.2%) had tolerated the sting without any reaction. Four patients (3.8%) reported systemic symptoms, 2 of whom experienced mild allergic immediate-type symptoms (1.9%).</p><p><strong>Conclusion: </strong>In patients on ongoing VIT a tolerated in-hospital sting provocation has a high negative predictive value (98.2%) in relation to the outcome of later field stings. The majority of these patients will subsequently not develop systemic reactions.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"10 ","pages":"280-284"},"PeriodicalIF":5.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Spanish clinical perspective on national regularization of allergen immunotherapy products.","authors":"Ruperto González-Pérez, Paloma Poza-Guedes, Inmaculada Sánchez-Machín","doi":"10.5414/ALX400671","DOIUrl":"10.5414/ALX400671","url":null,"abstract":"","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"10 ","pages":"259-261"},"PeriodicalIF":5.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between as-needed versus regular treatment for allergic rhinitis: Protocol for a systematic review.","authors":"Catarina Ferreira, Vítor Henrique Duarte, Nicky Akbarian, Antonio Bognanni, Sara Gil-Mata, Ana Margarida Pereira, Manuel Marques-Cruz, Torsten Zuberbier, Holger J Schünemann, João A Fonseca, Jean Bousquet, Rafael José Vieira, Bernardo Sousa-Pinto","doi":"10.5414/ALX02654E","DOIUrl":"10.5414/ALX02654E","url":null,"abstract":"<p><strong>Background: </strong>Allergic rhinitis (AR) impairs quality of life. While most trials assess regular regimen medication use, mobile-Health (mHealth) data suggest that most patients use treatments on an as-needed basis.</p><p><strong>Objectives: </strong>Protocol for a systematic review comparing as-needed versus regular AR treatment regimens regarding efficacy and safety.</p><p><strong>Materials and methods: </strong>We will conduct a systematic review and network meta-analysis (NMA) of randomized controlled trials involving patients of any age with perennial or seasonal AR. Oral and intranasal drugs will be compared in an as-needed regimen versus a regular regimen or placebo. Primary outcomes will be the Total Nasal Symptom Score, the Total Ocular Symptom Score, and the Rhinoconjunctivitis Quality-of-Life Questionnaire.</p><p><strong>Conclusion: </strong>This review will evaluate the efficacy and safety of two different strategies for AR management. The findings of this review will inform the Allergic Rhinitis and its Impact on Asthma (ARIA) 2024-2025 guidelines.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"10 ","pages":"296-302"},"PeriodicalIF":5.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fixed drug eruption to propofol: Case series and clinical implications.","authors":"Carole Guillet, Elisabeth Gössinger, Lukas Joerg, Barbara Ballmer-Weber, Felicitas Bellutti-Enders, Valentina N S Hongler, Hazem A Juratli, Karin Hartmann, Thierry Girard, Anne Leuppi-Taegtmeyer, Kathrin Scherer, Minaya Beigi, Esther Helen Steveling-Klein","doi":"10.5414/ALX02645E","DOIUrl":"10.5414/ALX02645E","url":null,"abstract":"<p><strong>Background: </strong>Fixed drug eruption (FDE) is a type IV delayed hypersensitivity reaction characterized by recurrent lesions at the same site upon drug re-exposure. Propofol-induced FDE is extremely rare.</p><p><strong>Case report: </strong>We report four cases of FDE following propofol administration, presenting with erythematous or bullous lesions at fixed sites, sometimes with mucosal involvement. Standard skin tests and lymphocyte transformation tests were frequently negative, particularly when performed outside previously affected areas. Diagnosis was confirmed by controlled intravenous provocation in one adult case. Histology supported the diagnosis when available.</p><p><strong>Discussion: </strong>FDE to propofol is likely under-recognized due to delayed onset of lesions. Diagnostic testing can be challenging, and controlled re-exposure may be required. Awareness of this rare reaction is important given propofol's widespread use and limited alternative anaesthetic options. Reporting such cases improves recognition and guides safe management.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"10 ","pages":"262-267"},"PeriodicalIF":5.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dupilumab improves long-term asthma control in German patients with severe asthma: Real-world data.","authors":"Andreas Renner, Slagjana Stoshikj, Eckard Hamelmann, Dirk Skowasch, Christian Schulz, Margret Jandl, Olaf Schmidt, Katrin Milger, Rainer Ehmann, Christian Taube, Stephanie Korn, Roland Buhl, Marco Idzko","doi":"10.5414/ALX02646E","DOIUrl":"10.5414/ALX02646E","url":null,"abstract":"<p><strong>Background: </strong>Dupilumab has proven effective in severe asthma, but there is only sparse evidence on its impact on asthma control in a real-world setting.</p><p><strong>Materials and methods: </strong>All patients from the German Asthma Net (GAN) severe asthma registry who initiated dupilumab after inclusion into the registry were analyzed. Clinical effectiveness was evaluated in those with at least 2 follow-up visits, with a maximum follow-up time of 3 years.</p><p><strong>Results: </strong>A total of 481 patients with severe asthma initiated dupilumab. At baseline, median blood eosinophil count was 174 cells/µL (IQR 61.2 - 436); 184 (38.3%) were former smokers with median 9.6 pack-years (IQR 4.3 - 23.3). Clinical effectiveness was evaluated in 235 patients. The FEV₁ increase from baseline was maintained over the whole study period (+300 mL at 4 months and 1 year, +200 mL at 2 and 3 years, all p < 0.0001). The frequency of exacerbations decreased, and the Asthma Control Test score increased from baseline clinically significantly at all timepoints (+4.3 at 4 months, +4.9 points at 1 year, +5.3 points at 2 years, and +4.6 points at 3 years, all p < 0.0001). Dupilumab was well tolerated; < 10% of patients reported adverse events or discontinued dupilumab treatment. The only adverse events recorded in more than 1 patient were conjunctivitis (4 patients), joint pain (3 patients), and flu-like symptoms (2 patients).</p><p><strong>Conclusion: </strong>In this large real-life study of dupilumab in patients with severe asthma dupilumab showed long-term clinical effectiveness for up to 3 years, with results consistent with prior randomized controlled trials.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"10 ","pages":"268-279"},"PeriodicalIF":5.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Species-specific outcomes in wasp sting challenges during venom immunotherapy and their respective follow-up.","authors":"Eva Oppel, Felix V Weber, Benjamin Kendziora, Bernhard G Weiss, Paul Severin Wiggenhauser, Friedrich Ihler, Maya Bertlich, Nora Aszodi-Pump, Jennifer Lee Spiegel, Lars E French, Saskia Freytag, Mattis Bertlich","doi":"10.5414/ALX02653E","DOIUrl":"10.5414/ALX02653E","url":null,"abstract":"<p><strong>Background: </strong>Insect venom allergy is a major cause of life-threatening anaphylaxis, with venom immunotherapy (VIT) being the gold standard for prevention. Sting challenges (SC) are used to assess immune tolerance and VIT efficacy, but factors influencing outcomes remain unclear. This study examined whether the stinging insect species affects SC outcomes during VIT and evaluated outcomes during long-term follow-up.</p><p><strong>Materials and methods: </strong>A retrospective analysis of 1,163 patients undergoing SC during wasp venom VIT was performed. The stinging species was entomologically confirmed. Associations between SC tolerance and species, skin prick test (SPT) results, venom-specific IgE levels, and treatment duration were analyzed using multivariable logistic regression adjusted for demographics. Follow-up assessed subsequent field stings and systemic reactions.</p><p><strong>Results: </strong>SCs were conducted with <i>Vespula vulgaris</i> (n = 479), <i>Vespula germanica</i> (n = 615), <i>Dolichovespula media</i> (n = 40), and <i>Dolichovespula saxonica</i> (n = 29). SC was tolerated without systemic reaction in 1,141 patients (98.1%). <i>Vespula spp.</i> were associated with a significantly higher likelihood of tolerance (odds ratio (OR) 7.69, 95% CI 2.66 - 20.43) compared with <i>Dolichovespula spp.</i> A decline in SPT positivity occurred after VIT, and conversion from positive to negative at 10 µg/mL showed a trend toward improved sting tolerance (OR 2.26, 95% CI 0.68 - 11.53). During follow-up (mean 53.2 ± 38.5 months), 167 patients experienced field stings; 6 developed systemic reactions, none of whom had been challenged with <i>Dolichovespula spp</i>.</p><p><strong>Conclusion: </strong>Species-specific differences influence sting challenge outcomes, suggesting incomplete cross-protection of <i>Vespula</i> VIT against <i>Dolichovespula spp.</i> Declining SPT reactivity may predict sting tolerance. SCs remain a reliable indicator of post-therapy protection against anaphylaxis.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"10 ","pages":"285-295"},"PeriodicalIF":5.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"S2k-Guideline - Standardized application of the nasal and conjunctival provocation test on allergic diseases of the upper airways : of the German Society for Allergology and Clinical Immunology (DGAKI), German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (DGHNO-KHC), German Dermatological Society (DDG), German Society of Pediatrics and Adolescent Medicine (DGKJ), German Society of Ophthalmology (DOG), German Respiratory Society (DGP), German Society for Occupational and Environmental Medicine (DGAUM), German Society for Pediatric Allergology and Environmental Medicine (GPA), German Society for Pediatric Pulmonology (GPP), Ärzteverband Deutscher Allergologen (AeDA), and German Professional Association of Otorhinolaryngologists (BVHNO).","authors":"Ulrike Förster-Ruhrmann, Tobias Ankermann, Sven Becker, Petra Bubel, Mandy Cuevas, Moritz Gröger, Ludger Klimek, Lars Lange, Katrin Milger, Philip Maier, Norbert Muelleneisen, Dennis Nowak, Heidi Olze, Uwe Pleyer, Wolfgang Schlenter, Sebastian Schmidt, Antje Schuster, Martin Wagenmann, Bettina Wedi, Oliver Pfaar","doi":"10.5414/ALX02647E","DOIUrl":"10.5414/ALX02647E","url":null,"abstract":"<p><p>Broad evidence confirms that AR (ICD J30.3) is a chronic disease with high prevalence among children and adults worldwide. Its consequences, both from a public health perspective and at the level of the individual patient, are often underestimated, and the condition is inadequately treated. In addition, AR is often related to comorbidities with additional impact on diseases-severity. Allergen provocation of the easily accessible nasal (nasal allergen provocation test: NPT) or conjunctival mucosa (conjunctival allergen provocation test: CPT) reproduces the allergen-dependent, IgE-mediated allergic reaction under controlled and standardized conditions. These measures are regarded as the diagnostic gold standard, particularly in cases of unclear results in primary allergological tests, enabling clinically relevant identification of the causative allergen. Approved test allergens are critical for ensuring the methodological quality of the NPT. However, their availability is increasingly limited, although adequate quantities of allergen solutions remain indispensable for high-quality nasal allergen testing. Unilateral allergen provocation has been established in the clinical routine for decades in Germany. However, scientific evidence for unilateral application of the test allergen is pending. International position papers differ from this recommendation. The CPT is a simple, safe, and well-tolerated measure. It is primarily used in perennial and, in selected cases, seasonal allergic conjunctivitis. This method is less commonly applied for vernal keratoconjunctivitis and atopic keratoconjunctivitis. It is primarily used to confirm the underlying allergen, particularly when establishing the indication for allergen immunotherapy (AIT). It can also be employed to monitor treatment effects such as e.g., AIT or pharmacotherapy. Although highly sensitive, the procedure of nasal ASA provocation remains a time-consuming procedure. While challenging in children, NPT provides clinically relevant additional diagnostic information on the causes of the allergic symptoms. Allergological diagnostic work-up also includes pulmonary assessment, particularly in patients with established asthma or symptoms suggestive of asthma. Both AAR and PNIF are applied as standard procedures for assessing the outcome of NPT in Germany. In individual cases, other rhinometric methods may also be used.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"10 ","pages":"234-258"},"PeriodicalIF":5.1,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The involvement of human breastmilk-derived extracellular vesicles in the development of infant atopic sensitization.","authors":"Tinevimbo Weidner Baricholo, Amiq Gazdhar, Matthias V Kopp, Emilie Seydoux","doi":"10.5414/ALX02651E","DOIUrl":"10.5414/ALX02651E","url":null,"abstract":"<p><p>Breastmilk, with its unique biological components, is the optimal source of neonatal nutrition, and WHO global feeding guidance recommends that all infants are exclusively breastfed for the first 6 months. The composition of human milk depends on multiple factors such as maternal diet, exposure to pathogens, metabolic or autoimmune disorders, smoking, mental health, and genetics. Breastfeeding not only transfers nutrients to the child, but it also influences the infant immune function, through the transfer of immune cells, antibodies, microbiota from the mother, cytokines, or growth factors. Among these, human milk-derived extracellular vesicles (hMEVs) are emerging as key yet understudied elements in neonatal growth, development, and immunity. This review explores their structure, formation, uptake, and roles in supporting development, modulating immune responses during early life, and influencing allergic outcomes, highlighting their potential significance in infant health.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"10 ","pages":"219-225"},"PeriodicalIF":5.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Olfactory dysfunction in children is associated with atopic dermatitis and allergic rhinitis, but not bronchial asthma.","authors":"Elisabeth C Lohrer, Janine Gellrich, M Antonia Hinkelmann, Rene F Drosdek, Christian Vogelberg, Valentin A Schriever","doi":"10.5414/ALX02644E","DOIUrl":"10.5414/ALX02644E","url":null,"abstract":"<p><strong>Aims: </strong>To investigate associations between olfactory dysfunction and atopic dermatitis (AD), allergic rhinitis (AR), and bronchial asthma (BA) in children.</p><p><strong>Materials and methods: </strong>In a prospective study, 250 children (6 - 17 years) with AD, AR, BA, combined atopy, or healthy controls (n = 50 each) were assessed using olfactory tests (\"Sniffin' Sticks\", \"U-Sniff\"), questionnaires, prick tests, and spirometry.</p><p><strong>Results: </strong>Atopic patients showed poorer odor identification than controls. Children with AD had impaired odor identification. AR patients displayed more hyposmia in threshold testing, but mean scores did not differ significantly. BA patients showed no significant impairment, though lung function correlated positively with olfactory performance.</p><p><strong>Conclusion: </strong>Pediatric AD and AR are associated with specific olfactory dysfunctions, whereas BA is not. Awareness of olfactory deficits in these groups is warranted; further studies should assess neurodevelopmental aspects in AD.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"10 ","pages":"226-233"},"PeriodicalIF":5.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro diagnostics of drug hypersensitivity reactions.","authors":"Christian Möbs, Sophie C Hermann Lang, Valerie Härtel, Wolfgang Pfützner","doi":"10.5414/ALX02627E","DOIUrl":"10.5414/ALX02627E","url":null,"abstract":"<p><p>In vitro diagnostics of drug hypersensitivity reactions comprises different tests that can add important information for identifying the culprit drug. Depending on the patients' clinical history and underlying immune mechanisms, these tests can be classified into immediate-type and late-type in vitro assays. While they are currently mostly not part of routine diagnostics, knowledge of when to apply which test and what distinct benefits and specific limitations each assay carries, can be helpful when considering the referral of patients with adverse drug reactions for appropriate further testing to specialized centers.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"10 ","pages":"209-218"},"PeriodicalIF":5.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}