Bernardo Sousa-Pinto, Elísio M Costa, Rafael José Vieira, Ludger Klimek, Wienczyslawa Czarlewski, Oliver Pfaar, Anna Bedbrook, Rita Amaral, Luisa Brussino, Violeta Kvedariene, Desiree E Larenas-Linnemann, Tomohisa Iinuma, Nhân Pham-Thi, Frederico S Regateiro, Luis Taborda-Barata, Maria Teresa Ventura, Ignacio J Ansotegui, Karl C Bergmann, G Walter Canonica, Victoria Cardona, Lorenzo Cecchi, Ivan Cherrez-Ojeda, Cemal Cingi, Alvaro A Cruz, Stefano Del Giacco, Philippe Devillier, Wytske J Fokkens, Bilun Gemicioglu, Tari Haahtela, Juan Carlos Ivancevich, Piotr Kuna, Helga Kraxner, Daniel Laune, Renaud Louis, Michael Makris, Mario Morais-Almeida, Ralph Mösges, Marek Niedoszytko, Nikolaos G Papadopoulos, Vincenzo Patella, Ana Margarida Pereira, Sietze Reitsma, Karla Robles-Velasco, Philip W Rouadi, Boleslaw Samolinski, Milan Sova, Sanna K Toppila-Salmi, Joaquin Sastre, Arunas Valiulis, Arzu Yorgancioglu, Mihaela Zidarn, Torsten Zuberbier, Joao A Fonseca, Jean Bousquet
{"title":"Adherence to Treatment in Allergic Rhinitis During the Pollen Season in Europe: A MASK-air Study.","authors":"Bernardo Sousa-Pinto, Elísio M Costa, Rafael José Vieira, Ludger Klimek, Wienczyslawa Czarlewski, Oliver Pfaar, Anna Bedbrook, Rita Amaral, Luisa Brussino, Violeta Kvedariene, Desiree E Larenas-Linnemann, Tomohisa Iinuma, Nhân Pham-Thi, Frederico S Regateiro, Luis Taborda-Barata, Maria Teresa Ventura, Ignacio J Ansotegui, Karl C Bergmann, G Walter Canonica, Victoria Cardona, Lorenzo Cecchi, Ivan Cherrez-Ojeda, Cemal Cingi, Alvaro A Cruz, Stefano Del Giacco, Philippe Devillier, Wytske J Fokkens, Bilun Gemicioglu, Tari Haahtela, Juan Carlos Ivancevich, Piotr Kuna, Helga Kraxner, Daniel Laune, Renaud Louis, Michael Makris, Mario Morais-Almeida, Ralph Mösges, Marek Niedoszytko, Nikolaos G Papadopoulos, Vincenzo Patella, Ana Margarida Pereira, Sietze Reitsma, Karla Robles-Velasco, Philip W Rouadi, Boleslaw Samolinski, Milan Sova, Sanna K Toppila-Salmi, Joaquin Sastre, Arunas Valiulis, Arzu Yorgancioglu, Mihaela Zidarn, Torsten Zuberbier, Joao A Fonseca, Jean Bousquet","doi":"10.1111/cea.70004","DOIUrl":"https://doi.org/10.1111/cea.70004","url":null,"abstract":"<p><strong>Background: </strong>Adherence to rhinitis treatment has been insufficiently assessed. We aimed to use data from the MASK-air mHealth app to assess adherence to oral antihistamines (OAH), intra-nasal corticosteroids (INCS) or azelastine-fluticasone in patients with allergic rhinitis.</p><p><strong>Methods: </strong>We included regular European MASK-air users with self-reported allergic rhinitis and reporting at least 1 day of OAH, INCS or azelastine-fluticasone. We assessed weeks during which patients answered the MASK-air questionnaire on all days. We restricted our analyses to data provided between January and June, to encompass the pollen seasons across the different assessed countries. We analysed symptoms using visual analogue scales (VASs) and the combined symptom-medication score (CSMS), performing stratified analyses by weekly adherence levels. Medication adherence was computed as the proportion of days in which patients reported rhinitis medication use. Sensitivity analyses were performed considering all weeks with at most 1 day of missing data and all months with at most 4 days of missing data.</p><p><strong>Results: </strong>We assessed 8212 complete weeks (1361 users). Adherence (use of medication > 80% days) to specific drug classes ranged from 31.7% weeks for azelastine-fluticasone to 38.5% weeks for OAH. Similar adherence to rhinitis medication was found in users with or without self-reported asthma, except for INCS (better adherence in asthma patients). VAS and CSMS levels increased from no adherence to full adherence, except for INCS. A higher proportion of days with uncontrolled symptoms was observed in weeks with higher adherence. In full adherence weeks, 41.2% days reported rhinitis co-medication. The sensitivity analyses displayed similar results.</p><p><strong>Conclusions: </strong>A high adherence was found in patients reporting regular use of MASK-air. Different adherence patterns were found for INCS compared to OAH or azelastine-fluticasone that are likely to impact guidelines.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Growth Trajectories and Body Composition in Preschoolers With Allergic Conditions: Findings From the Japan Environment and Children's Study Pilot Cohort.","authors":"Daisuke Harama, Miori Sato, Limin Yang, Yumiko Miyaji, Nathan Mise, Reiko Suga, Mayumi Tsuji, Masayuki Ochiai, Masako Oda, Maki Fukami, Shoji F Nakayama, Makiko Sekiyama, Yukihiro Ohya, Kiwako Yamamoto-Hanada","doi":"10.1111/cea.14625","DOIUrl":"https://doi.org/10.1111/cea.14625","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anet Laanesoo, Mariel Mäe, Anu Remm, Sebastian L Johnston, Alan Altraja, Grazyna Bochenek, Bogdan Jakiela, Ana Rebane
{"title":"NLRP1 Is a Prominent Inflammasome Sensor Found in Bronchial Epithelial Cells in Asthma and Can Be Activated by Rhinovirus A16.","authors":"Anet Laanesoo, Mariel Mäe, Anu Remm, Sebastian L Johnston, Alan Altraja, Grazyna Bochenek, Bogdan Jakiela, Ana Rebane","doi":"10.1111/cea.70010","DOIUrl":"https://doi.org/10.1111/cea.70010","url":null,"abstract":"<p><strong>Background: </strong>Asthma exacerbations are frequently triggered by human rhinoviruses (RVs). Among other pro-inflammatory responses, RV infection of airway epithelium promotes the activation of the inflammasome pathway, the role of which in asthma exacerbations and disease progression is still poorly understood.</p><p><strong>Methods: </strong>Bronchial brushing or biopsy specimens were collected from asthma patients and control subjects. Functional experiments were performed in cultured human bronchial epithelial cells (HBECs) using RV-A16, poly(I:C), and siRNA transfection. Gene expression was analysed by RNA-sequencing, RT-qPCR, immunofluorescence, western blot or ELISA. Caspase-1 activity was evaluated using FAM-FLICA assay.</p><p><strong>Results: </strong>The expression of NLRP1 was found to be the highest compared to other inflammasome sensors tested in brushed bronchial epithelium samples from asthma patients and control individuals, as well as in cultured primary HBECs. Additionally, we observed increased expression of CASP1 mRNA in bronchial epithelial cells from patients with neutrophilic asthma compared to those with paucigranulocytic and eosinophilic phenotypes. Changes in the expression of inflammasome pathway genes caused by RV-A16 infection were similar in HBEC cultures from asthma patients and controls, except for IL-1β, which showed increased response, and PYCARD, which exhibited decreased change in cells derived from asthma patients. Silencing of NLRP1 expression with siRNAs impeded RV-A16-induced activation of the inflammasome but had no effect on poly(I:C)-induced secretion of IL-1β and IL-18.</p><p><strong>Conclusion: </strong>NLRP1 is highly expressed inflammasome sensor in both healthy and asthmatic bronchial epithelium and can be activated by RV-A16. RV-induced changes in the expression of inflammasome pathway genes suggest that there may be differences in HBECs derived from asthma patients, which may depend on the prevailing immunological phenotype of the disease.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D Betancor, E S Castromil-Benito, J Bernaola, J Parrón-Ballesteros, C Pastor-Vargas, J Cuesta-Herranz
{"title":"Prevalence and Mite Allergen Recognition in an Area of Low Environmental Exposure.","authors":"D Betancor, E S Castromil-Benito, J Bernaola, J Parrón-Ballesteros, C Pastor-Vargas, J Cuesta-Herranz","doi":"10.1111/cea.70006","DOIUrl":"https://doi.org/10.1111/cea.70006","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R Bestwick, R Bhogal, K Kildonaviciute, B Y Ng, B Jackson, C Moriarty, C Thomas, L Savic, S A Misbah, M T Krishna, R Mujica-Mota
{"title":"An Economic Evaluation of Direct Oral Penicillin Challenge for De-Labelling Low Risk Patients With a Penicillin Allergy Label.","authors":"R Bestwick, R Bhogal, K Kildonaviciute, B Y Ng, B Jackson, C Moriarty, C Thomas, L Savic, S A Misbah, M T Krishna, R Mujica-Mota","doi":"10.1111/cea.14633","DOIUrl":"https://doi.org/10.1111/cea.14633","url":null,"abstract":"<p><strong>Background: </strong>Removing inaccurate penicillin allergy labels (PALs) can reduce unnecessary exposure to 'watch' and 'reserve' groups of antibiotics and thereby reduce antimicrobial resistance. The most efficient model for a non-allergy-specialist-led penicillin allergy de-labelling (PADL) service has not been established.</p><p><strong>Objective: </strong>To determine the costs to the UK National Health Service of a direct oral penicillin challenge (DPC) for low-risk patients with a PAL in three hospitals in England, each with a different non-allergy-specialist delivery model: pharmacist-led, nurse-led, and mixed multidisciplinary.</p><p><strong>Methods: </strong>Cost analysis of the DPC pathway, including resources related to staff time and antibiotics. The effect of de-labelling on healthcare utilisation over 5 years was modelled using data from the published literature.</p><p><strong>Results: </strong>In total, 2257 patients from the Acute Medical or Infectious Disease Unit (AMU/IDU), Pre-surgical, and Haematology-Oncology departments were screened. Subsequently, 126 underwent DPC, and 122 were de-labelled. Twenty-two of these were de-labelled in time to affect their antibiotic regimen; 6 from AMU/IDU and 16 Pre-surgery. The DPC represented 22%-23% of the pathway cost in the pharmacist-led and mixed models, and 15% in the nurse-led model. Across departments and models, the cost per de-labelled patient varied between £577 (95% Credible Interval: 370, 633) for haematology-oncology patients to £2329 (947, 19,504) for AMU/IDU patients, both under the nurse-led model. After 5 years, recouping costs was unlikely for AMU/IDU patients under any model or for all patients combined under the mixed model.</p><p><strong>Conclusions: </strong>The penicillin allergy de-labelling pathway cost was ≥ 4-fold that of the DPC alone. Costs were up to 3 times higher in an acute compared to an elective setting. No short-term cost savings were identified from proactive or opportunistic penicillin allergy de-labelling in this study.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Jing Shi Ang, Haur Yueh Lee, Chaw Su Naing, Chiara Jiamin Chong, Chujie Li, Kavitha Garuna Murthee, Ibrahim Muhammad Hanif, Vivian Tan, Zi Teng Chai, Karen Jui Lin Choo
{"title":"Outcomes of Prolonged Provocation Testing in Penicillin Allergy Evaluation.","authors":"Andrea Jing Shi Ang, Haur Yueh Lee, Chaw Su Naing, Chiara Jiamin Chong, Chujie Li, Kavitha Garuna Murthee, Ibrahim Muhammad Hanif, Vivian Tan, Zi Teng Chai, Karen Jui Lin Choo","doi":"10.1111/cea.70008","DOIUrl":"https://doi.org/10.1111/cea.70008","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Celeste M Boesjes, Lian F van der Gang, Daphne S Bakker, C F den Hartog Jager, Marlies de Graaf, Marjolein S de Bruin-Weller, Femke van Wijk, Edward F Knol
{"title":"Increased Levels of Inflammatory Proteins, Including TARC/CCL17, in Skin of AD Patients During JAK Inhibitor Treatment.","authors":"Celeste M Boesjes, Lian F van der Gang, Daphne S Bakker, C F den Hartog Jager, Marlies de Graaf, Marjolein S de Bruin-Weller, Femke van Wijk, Edward F Knol","doi":"10.1111/cea.14637","DOIUrl":"https://doi.org/10.1111/cea.14637","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Food Allergy Prevalence, Diagnosis and Impact: Unexpected Findings","authors":"Robert J. Boyle, Mohamed H. Shamji","doi":"10.1111/cea.14635","DOIUrl":"https://doi.org/10.1111/cea.14635","url":null,"abstract":"<p>In this issue, we present three studies which make important contributions to our understanding of food allergy epidemiology, food allergy diagnostics and food allergy's impact on populations. There are very few prior studies of changes in food allergy prevalence over time using robust methodology. Perhaps the only studies worldwide which have undertaken repeated, population-based assessments of confirmed food allergy prevalence are the UK Isle of Wight studies. In this issue, Carina Venter and colleagues summarise the findings of two birth cohorts on the Isle of Wight. They used these to evaluate whether a change in food allergy prevalence can be seen between a birth cohort born in 1989/90 and one born 12 years later in 2001/2 [<span>1</span>]. The significance of these years is that during this time, many reports have documented a sharp increase in hospital attendance and admission for food anaphylaxis in young children. Contrary to the popular narrative of a food allergy epidemic, Venter et al. did not identify a detectable change in food allergy overall between the two populations (Figure 1). This finding mirrors those of the US National Health and Nutrition Examination Surveys and the Australian HealthNuts and Melbourne Atopy Cohort studies, where no change in sensitisation to foods using blood specific IgE (US) or skin prick testing (Australia) to foods could be detected. Those studies compared children born in the 1970/80s with those born in the 1990s (US) and children born in 1993/4 versus 2010/11 (Australia) [<span>2, 3</span>]. The Isle of Wight findings are also consistent with a stable rate of fatal food anaphylaxis in national registry studies [<span>4</span>]. Taken together, these studies question whether food allergy has been increasing in high-income countries in recent decades.</p><p>If we look at two more studies published in this issue, we can start to understand why professionals and members of the public are convinced there is a food allergy epidemic, without good objective evidence to support that. The first issue is that food allergy diagnosis is difficult, so this health condition is susceptible to overdiagnosis. This is shown in the study of Chong et al. from Singapore, which involved evaluating the diagnostic accuracy of commonly used tests for milk, egg, wheat and peanut allergy in children [<span>5</span>]. They report poor diagnostic accuracy, especially for milk and wheat diagnostics, with the known issue of a high false positive rate for all testing modalities and allergens. Most children with food allergy do not have a supervised oral food challenge [<span>6</span>]. So, by relying on diagnostic tests and clinical history, and increasing the number of diagnostic tests performed, we may have allowed overdiagnosis to increase, fuelling a false food allergy epidemic [<span>7</span>].</p><p>The second issue is the social response to food allergy. There has been a marked increase in concern about food allergy in rec","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"55 2","pages":"108-110"},"PeriodicalIF":6.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.14635","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}