Clinical and Experimental Allergy最新文献

{"title":"Biologic Prescription Patterns and Biomarker Determinants of First-Line Dupilumab in Danish Adult Patients With Severe Asthma and Comorbid Atopic Dermatitis.","authors":"Marianne Baastrup Soendergaard, Kjell Erik Julius Håkansson, Susanne Hansen, Anne-Sofie Bjerrum, Johannes Martin Schmid, Sofie Lock Johansson, Linda Makowska Rasmussen, Barbara Bonnesen, Roxana Vijdea, Anna von Bülow, Niels Steen Krogh, Ole Hilberg, Simon Francis Thomsen, Charlotte Suppli Ulrik, Celeste Porsbjerg","doi":"10.1111/cea.70117","DOIUrl":"https://doi.org/10.1111/cea.70117","url":null,"abstract":"<p><strong>Background: </strong>Asthma and atopic dermatitis are common type-2 (T2)-driven diseases that often coexist, although different T2 biomarkers indicate disease severity in each condition. Multiple biologics target T2 inflammation, but only dupilumab has been approved for both diseases. Little is known about patients with severe asthma and comorbid atopic dermatitis, particularly regarding how this comorbidity influences the choice of biologic for severe asthma.</p><p><strong>Methods: </strong>We utilised the nationwide Danish Severe Asthma Register to characterise patients with severe asthma and comorbid atopic dermatitis, and describe prescription patterns of biologics in patients with and without comorbid atopic dermatitis. We compared biomarker determinants of first-line dupilumab prescription between the two groups using a multivariate logistic regression model adjusting for age and sex.</p><p><strong>Results: </strong>We identified 1137 patients initiating a biologic for severe asthma, of whom 192 (17%) had comorbid atopic dermatitis. Patients with comorbid atopic dermatitis more often had childhood-onset asthma with an allergic phenotype. The prescription patterns of biologics differed according to comorbid atopic dermatitis status, and patients with comorbid atopic dermatitis were more likely to switch (OR 3.02, p < 0.001). In patients with comorbid atopic dermatitis, elevated IgE was the strongest biomarker determinant of first-line dupilumab prescription (OR 8.77, p < 0.001), whereas in patients without, it was elevated FeNO (OR 1.76, p = 0.03).</p><p><strong>Conclusion: </strong>Biologic prescription patterns in severe asthma vary according to comorbid atopic dermatitis status. In patients with comorbid atopic dermatitis, elevated IgE predicts first-line dupilumab prescription, indicating that the severity of atopic dermatitis influences treatment decisions. Additional research is needed to explore the management of coexisting T2 diseases with biological therapies.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636334","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":"Specific IgG Antibodies to Penicillin and Anaphylaxis.","authors":"Miguel Blanca, Javier Fernandez, Natalia Blanca-Lopez, Angel Esteban","doi":"10.1111/cea.70106","DOIUrl":"https://doi.org/10.1111/cea.70106","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607590","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":"Use of Allergen Immunotherapy in China: Current Status and Research Progress","authors":"Song Li,&nbsp;Zhi-Ling Zhu,&nbsp;Lei Cheng","doi":"10.1111/cea.70116","DOIUrl":"10.1111/cea.70116","url":null,"abstract":"<p>Allergic diseases, including allergic rhinitis (AR), asthma, food allergies and drug allergies, are significant health issues globally and in China. AR affects 10%–40% of the global population [<span>1</span>], and 18.6%–52.9% across regions in China [<span>2</span>]. The prevalence of asthma has kept rising to 4.2% in China by 2015 [<span>3</span>]. This rampancy is also observed in other allergic diseases, together straining the public health systems around the world.</p><p>Allergen immunotherapy (AIT) alleviates IgE-mediated allergic diseases by inducing immune tolerance through a controlled and progressive exposure to allergens. Despite its eye-catching outcomes in China, AIT still faces hurdles in its wider replication, such as lack of individualisation, poor patient compliance and inadequate understanding among clinicians and patients. This paper provides a view on the current status, progress and future directions of AIT in China.</p><p>Since its discovery in 1911, AIT has already been established as a mainstay for treating allergic diseases in Western countries. In China, AIT was first copied in the 1960s by the allergy department (established in 1956 and the only one then) at Peking Union Medical College Hospital. However, the expansion of AIT was slow until the approval of standardised allergen extracts in the late 1990s and early 2000s. In recent years, the application of AIT has been accelerated due to increasing recognition from medical professionals and demand from patients. The release of Chinese AIT guidelines has bolstered basic, clinical and translational research. PubMed data show that the number of AIT-related studies involving Chinese scholars has doubled since 2018. Hot research keywords include sublingual immunotherapy (SLIT), subcutaneous immunotherapy (SCIT), efficacy and safety, biomarkers, immunoregulation and omalizumab. Increasing research fruits have been published in top journals (Figure 1).</p><p>More recently, Chinese scholars have set out on the journey to explore new delivery routes in AIT, such as oral immunotherapy, intracervical lymphatic immunotherapy, intratonsillar immunotherapy, as well as the combined application of biologics in AIT. Mechanistical research has even turned the lens to the association of gut microbiota with AIT outcomes. The roles of follicular helper T cells and regulatory T cells in allergic diseases and AIT have also been further elucidated. In summary, Chinese scholars have caught up with the global pace in the research on AIT.</p><p>Supported by the results from mechanistical research and the experience from frontline clinicians, Chinese AIT guidelines have been released. In 2017, the first edition of the Chinese Guideline on Allergen Immunotherapy for Allergic Rhinitis [<span>4</span>] was published by the Chinese Society of Allergy (CSA) and the Chinese Allergic Rhinitis Collaborative Research Group (C²AR²G), providing evidence-based recommendations and fill","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"55 8","pages":"607-610"},"PeriodicalIF":5.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.70116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607591","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}

{"title":"Age Tolerance in Egg FPIES: Reply to Gurel Et al.","authors":"Stefano Miceli Sopo, Matteo Di Toro Mammarella, Bruno Miceli Sopo, Tecla Fontana, Giulia Bersani","doi":"10.1111/cea.70112","DOIUrl":"https://doi.org/10.1111/cea.70112","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590585","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":"Asthma and Atopic Dermatitis in Asia, 1990–2021: The Global Burden of Disease Study 2021","authors":"GBD 2021 Asia Allergic Disorders Collaborators","doi":"10.1111/cea.70024","DOIUrl":"10.1111/cea.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Given the diverse population and regional differences across Asia, a comprehensive analysis of allergic diseases is crucial for guiding healthcare planning, resource allocation, and prevention strategies. Therefore, utilising the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we aimed to thoroughly investigate the burden of allergic conditions and their attributable risk factors in Asia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Asthma and atopic dermatitis (AD) prevalence and burden estimates were calculated across various regions within Asia (Central, South, Southeast, East Asia and high-income Asia Pacific) from 1990 to 2021, covering age groups segmented into five-year intervals and analysing data separately and combined for males and females. The Bayesian meta-regression tool was employed to estimate the prevalence, incidence, and cause-specific mortality of allergic disorders. Asthma-related deaths and disability-adjusted life years (DALYs) attributable to each risk factor were estimated using relative risks, risk exposure and the theoretical minimum risk exposure level input.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 1990 to 2021, asthma in Asia showed significant declines in age-standardised prevalence, mortality, and DALYs, exceeding global trends. In 2021, an estimated 106 million (95% UI, 92–121) individuals in Asia had asthma, with age-standardised rates decreasing significantly. However, asthma-related deaths still accounted for 346,755 (278,046–464,848) cases in 2021. In contrast, the AD burden remained stable, with 68.1 million (65.4–71.0) cases in 2021, reflecting a 16.1% increase since 1990, though the age-standardised prevalence remained unchanged. AD exhibited the highest DALYs rates in high-income Asia Pacific and Central Asia, with significant gender disparities in prevalence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study showed a declining age-standardised asthma burden, mortality, and impact, along with a stable burden of AD in Asia from 1990 to 2021. This comprehensive data analysis would provide invaluable insights for making targeted health interventions and policies aimed at mitigating the burden of allergic diseases in Asia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"55 8","pages":"671-690"},"PeriodicalIF":5.2,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599579","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}

{"title":"Prevalence of Asymptomatic Bronchial Hyperresponsiveness in Indian Adolescents: Insights From the APEAL Study","authors":"Padukudru Anand Mahesh,&nbsp;Mohammed Kaleem Ullah,&nbsp;Mandya Venkateshmurthy Greeshma,&nbsp;Swapnali Patil,&nbsp;Priya Samdarshi,&nbsp;Harshitha Veerabhadraiah,&nbsp;Abdul Khayum,&nbsp;Twinkle Agrawal,&nbsp;Harish Chandra Phuleria,&nbsp;George D'Souza,&nbsp;Gregory Wellenius,&nbsp;Amruta Nori-Sarma,&nbsp;Lingambika Ponnuraj,&nbsp;Sanath Kumar Kagalavadi Mahadevaswamy,&nbsp;Sathish Chandran Mayigaiah,&nbsp;Rajesh K. Thimmulappa,&nbsp;Anant Mohan","doi":"10.1111/cea.70110","DOIUrl":"10.1111/cea.70110","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Bronchial hyperresponsiveness (BHR), often undetected in asymptomatic individuals, may represent an early marker of airway inflammation and a precursor to chronic respiratory disease (CRD). Despite its established role in asthma and COPD, BHR remains under-recognised in epidemiologic screenings, particularly in low- and middle-income countries like India, where environmental exposures are high.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study assessed the prevalence and burden of asymptomatic BHR in adolescents across four Indian cities: Mysuru, Bengaluru, Mumbai and Delhi, using objective airway reversibility measures.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This secondary analysis of the APEAL study (Air Pollution Exposure on Adolescents' Lungs) included 4141 randomly selected adolescents (11–14 years) with no reported respiratory symptoms or prior physician diagnosis of asthma. Pulmonary function tests (PFTs) assessed forced expiratory volume in 1 s (FEV&lt;sub&gt;1&lt;/sub&gt;) pre- and post-bronchodilator. BHR was defined as post-bronchodilator increase in FEV&lt;sub&gt;1&lt;/sub&gt; of ≥ 12% and ≥ 200 mL. Anthropometric, socioeconomic and environmental factors were analysed.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 165 adolescents (4.0%) met criteria for asymptomatic BHR, with site-wise variation: Mumbai (5.6%), Delhi (4.5%), Bengaluru (4.2%) and Mysuru (2.3%). Males predominated except in Delhi. Younger age was significantly associated with BHR (OR = 1.48; &lt;i&gt;p&lt;/i&gt; = 0.035). A dose-dependent association with PM&lt;sub&gt;2.5&lt;/sub&gt; was observed: 64.1–124.8 μg/m&lt;sup&gt;3&lt;/sup&gt; increased BHR risk (OR = 1.83; &lt;i&gt;p&lt;/i&gt; = 0.033), with higher risk above 124.8 μg/m&lt;sup&gt;3&lt;/sup&gt; (OR = 2.56; &lt;i&gt;p&lt;/i&gt; = 0.003). In GLM analysis, Mumbai residents had lower odds of moderate (Estimate = −1.757, &lt;i&gt;p&lt;/i&gt; = 0.048) and severe airflow limitation (Estimate = −3.200, &lt;i&gt;p&lt;/i&gt; = 0.022) than Bengaluru. Underweight status was associated with increased risk of severe airflow limitation (Estimate =2.073, &lt;i&gt;p&lt;/i&gt; = 0.048), while overweight appeared protective (Estimate = −14.357; &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Obesity had similar estimates (2.075) as underweight but was non-significant due to a smaller number of subjects.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Asymptomatic BHR affects a substantial proportion of urban Indian adolescents and is associated with age, undernutrition and PM&lt;sub&gt;2.5&lt;/sub&gt; exposure. Symptom-based scree","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"55 9","pages":"795-807"},"PeriodicalIF":5.2,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583230","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}

{"title":"Excessive Endoplasmic Reticulum Stress in B Cells Associates With the Local Immunoglobulin Production in Severe Type 2 Chronic Rhinosinusitis With Nasal Polyps.","authors":"Yanran Huang, Zhaofeng Xu, Yan Yan, Chunbo Li, Jieying Yan, Yi Wei, Jian Li, Luo Zhang, Nan Zhang, Claus Bachert, Weiping Wen","doi":"10.1111/cea.70107","DOIUrl":"https://doi.org/10.1111/cea.70107","url":null,"abstract":"<p><strong>Background: </strong>Immunoglobulin overproduction was observed in type 2 chronic rhinosinusitis with nasal polyps (CRSwNP). Endoplasmic reticulum (ER) stress is linked to aggregation in various inflammatory diseases, yet its presence and extent in nasal polyps remain to be elucidated.</p><p><strong>Objective: </strong>To assess the impact of B-cell ER stress on local immunoglobulin production in CRSwNP and investigate its correlation with disease severity.</p><p><strong>Methods: </strong>Single-cell mapped transcriptional profiles at cellular resolution. Electron microscopy revealed ultrastructural features, complemented by immunohistochemistry/immunofluorescence mapping marker localisation. Western blotting quantified protein expression, with QuantiGene Plex and Luminex enabling multiplex cytokine analysis. Bulk RNA sequencing and targeted protein expression validation in ex vivo experiments confirmed critical findings.</p><p><strong>Results: </strong>HSPA5 and HSP90B1 were found to be two major elevated ER stress markers in type 2 CRSwNP, compared to the control nasal tissue, and their expression correlated with the expression of IGHE and type 2 inflammatory markers. In CRSwNP, the ER stress signature score and increased marker expression predominantly originated from B and plasma cells. Electron microscopy revealed dilated ER and enlarged lumen in sorted B cells from nasal polyps. MZB1 exhibited co-localisation with plasma cells and mature B cells. Immunofluorescence staining demonstrated that MZB1 co-localised with HSPA5 and HSP90B1. In vitro, stimulation with MZB1 upregulated mRNA expression of ER stress markers and IgE. Increased IGHE expression was detected in response to ER stress induced in vitro. Finally, anti-IgE treatment inhibited the expression of ER stress-related genes.</p><p><strong>Conclusion: </strong>ER stress markers were significantly upregulated in CRSwNP. Specifically, ER stress levels were significantly elevated in B cells of CRSwNP compared to controls. In type 2 CRSwNP, B-cell ER stress may play a role in promoting local IgE production.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559386","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":"Preschool Oral Immunotherapy Is Associated With Improved Parental Food Allergy-Specific Anxiety and Quality of Life: A Real-World Observational Study.","authors":"Ally Baaske, Michael A Golding, Jennifer L P Protudjer, Rishma Chooniedass, Scott B Cameron, Victoria E Cook, Sandeep Kapur, Gregory Rex, Mary McHenry, Tiffany Wong, Raymond Mak, Stephanie C Erdle, Timothy K Vander Leek, Jennifer Y Tong, Edmond S Chan, Lianne Soller","doi":"10.1111/cea.70111","DOIUrl":"https://doi.org/10.1111/cea.70111","url":null,"abstract":"<p><strong>Introduction: </strong>Preschool oral immunotherapy (OIT) is safe and effective for food allergy, and may improve parental food allergy-specific anxiety (FAA) and food allergy quality of life (FAQL); however, data on these important outcomes are limited, particularly for preschoolers. Herein, we explored the relationship between OIT and parental FAA, including the subdomains: food allergy-related worries, anxiety impact, behavioural avoidance, and coping; and OIT and FAQL in parents of preschool-aged children.</p><p><strong>Methods: </strong>Parents of preschool-aged children (< 72 months) receiving OIT in Canadian allergy clinics were eligible for this observational study. The Impairment Measure for Parental Food Allergy-Associated Anxiety and Coping Tool (IMPAACT) and the Food Allergy Quality of Life-Parental Burden (FAQL-PB) questionnaire were administered to parents at four timepoints from the start of OIT to 12 months post-build-up. The relationships between OIT and total FAA, each IMPAACT subscale, and FAQL were investigated using a series of linear mixed effect models. Each model included variables related to child age, whether child was receiving OIT to some (partial OIT) or all of (complete OIT) their allergens, time to complete build-up, and two binary variables indexing whether the child experienced a reaction during build-up or maintenance.</p><p><strong>Results: </strong>Between 2021 and 2025, 788 children participated. Total IMPAACT scores decreased during OIT build-up, indicating improvement (baseline: 70.69; end of build-up: 57.36; marginal mean change: -13.33; b = -18.13; 95% CI = -27.63, -8.62, p < 0.001). IMPAACT scores significantly decreased across three subscales: Worries; anxiety impact, and behavioural avoidance. FAQL-PB scores decreased during OIT build-up (baseline: 27.35; end of build-up: 22.16; marginal mean change: -5.19; b = -7.17; 95% CI = -12.65, -1.69, p = 0.01). Child's age, partial versus complete OIT, time to complete build-up, and reactions during maintenance moderated the relationship between time and some of the outcome variables.</p><p><strong>Conclusion: </strong>Preschool OIT is associated with significant improvements in parent food allergy-specific anxiety and food allergy quality of life.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567151","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":"Efficacy of the 4 Subclasses of IgG for Interacting With CD32b/a on Human Basophils.","authors":"Donald MacGlashan, Benjamin W Spiller, Scott A Smith","doi":"10.1111/cea.70108","DOIUrl":"10.1111/cea.70108","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552488","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}

{"title":"Towards Personalised Therapy in Chronic Spontaneous Urticaria: Advancing From Endotype to Clinical Response.","authors":"Katie Ridge, Rizwan Ahmad, Barry Moran, Cliona O'Farrelly, Jean Dunne, Conor M Finlay, Alan D Irvine, Niall Conlon","doi":"10.1111/cea.70100","DOIUrl":"https://doi.org/10.1111/cea.70100","url":null,"abstract":"<p><p>Chronic spontaneous urticaria (CSU) is a skin disorder characterised by recurrent hives and swellings that has a profound effect upon quality of life. Current guidelines for the management of CSU outline sequential use of standard dosing nonsedating H1 antihistamines, fourfold dose antihistamines and the anti-IgE monoclonal antibody omalizumab. A proportion of patients will have partial response or no response to omalizumab despite uptitration of dose. Evidence suggests that nonresponders may represent a specific endotype of Type IIb autoimmune CSU and respond better to ciclosporin, a fourth line off-licence treatment. Accurate and timely classification of CSU by endotype may enable personalised medicine for patients. Current attempts to classify CSU are based on distinct autoallergic and autoimmune pathways towards mast cell activation; Type I autoallergic urticaria as evidenced by IgE autoantibodies initiating FcεR1 crosslinking and Type IIb autoimmune urticaria as evidenced by IgG autoantibodies initiating FcεR1 crosslinking. However, recent data have demonstrated that the distinction between CSU endotypes is more nuanced, with overlap between categories whereby patients with Type IIb autoimmune CSU have been found to have coexistent IgE autoantibodies. A cohort of patients do not meet criteria for either endotype. Furthermore, there is recognition that laboratory parameters currently used to stratify patients are not widely available, hampering their practical use. This review seeks to summarise data on biomarkers associated with treatment response in CSU. While previous literature has focussed upon treatment response to antihistamines, our emphasis is on predicting treatment response to third and fourth-line treatments, with further reference to emerging treatments that do not yet form part of guidelines for management of CSU. Understanding factors that influence clinical response to all agents is particularly important as treatment options for CSU rapidly expand. In the following sections, we will evaluate the biochemical and clinical parameters that have been explored in these patients as well as their potential utility in routine clinical practice.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552489","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}