Clinical and Experimental Allergy最新文献

{"title":"Cluster Analysis Identifies Patients With Severe Eosinophilic Asthma Who Achieve Super-Response and Remission With Mepolizumab.","authors":"Danilo Di Bona, Massimo Bilancia, Claudia Crimi, Michelina Daddato, Alida Benfante, Maria Filomena Caiaffa, Cecilia Calabrese, Raffaele Campisi, Santi Nolasco, Giovanna Elisiana Carpagnano, Maria D'Amato, Corrado Pelaia, Girolamo Pelaia, Angelantonio Maglio, Nicola Scichilone, Giulia Scioscia, Giuseppe Spadaro, Massimo Triggiani, Isabella Carrieri, Giuseppe Valenti, Alessandro Vatrella, Luigi Macchia, Nunzio Crimi","doi":"10.1111/cea.14584","DOIUrl":"https://doi.org/10.1111/cea.14584","url":null,"abstract":"<p><p>This study identifies two distinct subgroups of patients with severe eosinophilic asthma who respond differently to mepolizumab. Cluster analysis reveals that patients with a family history of asthma, positive skin prick tests and higher baseline lung function have better treatment outcomes, highlighting the value of personalised treatment strategies.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399574","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":"Anaphylaxis Management in Paediatric Patients Undergoing Milk Oral Immunotherapy.","authors":"Dimitry Buyansky, Roy Khalaf, Sofianne Gabrielli, Julia Upton, Eyal Grunebaum, Edmond S Chan, Ingrid Baerg, Liane Beaudette, Danbing Ke, Bruce Mazer, Christine McCusker, Duncan Lejtenyi, Moshe Ben-Shoshan","doi":"10.1111/cea.14582","DOIUrl":"https://doi.org/10.1111/cea.14582","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388510","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":"Adrenaline Auto-Injectors for Preventing Fatal Anaphylaxis.","authors":"Marcus Sim, Vibha Sharma, Karen Li, Mary H Gowland, Tomaz Garcez, Cassandra Shilladay, Richard Pumphrey, Nandinee Patel, Paul J Turner, Robert J Boyle","doi":"10.1111/cea.14565","DOIUrl":"https://doi.org/10.1111/cea.14565","url":null,"abstract":"<p><p>Anaphylaxis affects up to 5% of people during their lifetime. Although anaphylaxis usually resolves without long-term physical consequences, it can result in anxiety and quality of life impairment. Rarely and unpredictably, community anaphylaxis can cause rapid physiological decompensation and death. Adrenaline (epinephrine) is the cornerstone of anaphylaxis treatment, and provision of adrenaline autoinjectors (AAI) has become a standard of care for people at risk of anaphylaxis in the community. In this article, we explore the effectiveness of AAIs for preventing fatal outcomes in anaphylaxis, using information drawn from animal and human in vivo studies and epidemiology. We find that data support the effectiveness of intravenous adrenaline infusions for reversing physiological features of anaphylaxis, typically at doses from 0.05 to 0.5 μg/kg/min for 1-2 h, or ~ 10 μg/kg total dose. Intramuscular injection of doses approximating 10 μg/kg in humans can result in similar peak plasma adrenaline levels to intravenous infusions, at 100-500 pg/mL. However, these levels are typically short-lived following intramuscular adrenaline, and pharmacokinetic and pharmacodynamic outcomes can be unpredictable. Epidemiological data do not support an association between increasing AAI prescriptions and reduced fatal anaphylaxis, although carriage and activation rates remain low. Taken together, these data suggest that current AAIs have little impact on rates of fatal anaphylaxis, perhaps due to a lack of sustained and sufficient plasma adrenaline concentration. Effects of AAI prescription on quality of life may be variable. There is a need to consider alternatives, which can safely deliver a sustained adrenaline infusion via an appropriate route.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388509","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":"Diagnostic Accuracy of Skin Prick Test, Food-Specific IgE and Component Testing for IgE-Mediated Peanut, Egg, Milk and Wheat Allergy.","authors":"Kok Wee Chong, R Sultana, May Ping Lee, Lynette Liling Tan, Anne Goh, Si Hui Goh, Wenyin Loh","doi":"10.1111/cea.14578","DOIUrl":"https://doi.org/10.1111/cea.14578","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388513","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":"British Society for Allergy and Immunology Abstracts From the 2024 Annual Conference","authors":"","doi":"10.1111/cea.14576","DOIUrl":"10.1111/cea.14576","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"54 10","pages":"781-847"},"PeriodicalIF":6.3,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388511","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":"Allergen Immunotherapy for the Prevention and Treatment of Asthma.","authors":"Thierry Batard, Camille Taillé, Laurent Guilleminault, Andrzej Bozek, Véronique Bordas-Le Floch, Oliver Pfaar, Walter G Canonica, Cezmi Akdis, Mohamed H Shamji, Laurent Mascarell","doi":"10.1111/cea.14575","DOIUrl":"https://doi.org/10.1111/cea.14575","url":null,"abstract":"<p><p>Allergic asthma is the predominant phenotype among asthmatics. Although conventional pharmacotherapy is a central component in the management of asthma, it does not enable control of asthma symptoms in all patients. In recent decades, some uncontrolled asthmatic patients, especially those with allergic asthma, have benefited from biological therapies. However, biologics do not address all the unmet needs left by conventional pharmacotherapy. Furthermore, it is noteworthy that neither conventional pharmacotherapy nor biological therapies have disease-modifying properties. In this context, allergen immunotherapy (AIT) represents an indispensable component of the therapeutic arsenal against allergic asthma, due to its disease-modifying immunological effects. In this review article, funded by an AIT manufacturer, we find clinical trials support AIT as the only treatment option able both to improve allergic asthma symptoms and to prevent the onset and worsening of the condition. For patients with severe asthma or other safety concerns, the combination of AIT and biologics offers very promising new treatment modalities for the management of allergic asthma. Trial Registration: clinicaltrials.gov identifier: NCT06027073.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371132","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":"Enhancing Asthma Pharmacogenetics Through Subtype-Specific Associations.","authors":"Shraddha Piparia, Julian Hecker, Upasna Srivastava, Rinku Sharma, Manaswitha Khare, Alvin Kho, Scott T Weiss, Michael McGeachie, Kelan Tantisira","doi":"10.1111/cea.14573","DOIUrl":"10.1111/cea.14573","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364617","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":"Timing of Onset of Garadacimab for Preventing Hereditary Angioedema Attacks","authors":"Petra Staubach,&nbsp;Raffi Tachdjian,&nbsp;H. Henry Li,&nbsp;Roman Hakl,&nbsp;Emel Aygören-Pürsün,&nbsp;Lolis Wieman,&nbsp;John-Philip Lawo,&nbsp;Timothy J. Craig","doi":"10.1111/cea.14568","DOIUrl":"10.1111/cea.14568","url":null,"abstract":"&lt;p&gt;Hereditary angioedema (HAE) is a rare, autosomal dominant disease characterised by recurrent, unpredictable, painful, debilitating and potentially life-threatening attacks [&lt;span&gt;1-3&lt;/span&gt;]. HAE imparts a substantial disease burden that impacts daily activities and extends beyond symptoms directly attributable to HAE attacks, encompassing mental health (anxiety and depression) and psychosocial impacts associated with unpredictable attack recurrence [&lt;span&gt;1, 3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Per World Allergy Organization (WAO)/European Academy of Allergy and Clinical Immunology (EAACI) guidelines, the goal of HAE treatment is complete disease control and normalisation of patients' lives [&lt;span&gt;2&lt;/span&gt;]. This can only be achieved with effective long-term prophylactic (LTP) therapy [&lt;span&gt;2&lt;/span&gt;]. Early onset of efficacy and durability of protection are critical attributes of LTP therapies to optimise HAE disease control and establish clinician and patient confidence in the treatment. Despite the availability of approved LTP therapies, there is still an unmet need for treatments with a rapid onset and improved durability of protection against HAE attacks [&lt;span&gt;2, 4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Activated factor XII (FXIIa) is the principal initiator of the kallikrein–kinin system, leading to production of bradykinin, the key inflammatory mediator responsible for vasodilation and vascular permeability [&lt;span&gt;2, 5, 6&lt;/span&gt;]. C1 inhibitor (C1INH) regulates FXIIa in healthy individuals [&lt;span&gt;5, 6&lt;/span&gt;]. In HAE, most patients have C1INH deficiency (HAE-C1INH-Type1) or dysfunction (HAE-C1INH-Type2), leading to uncontrolled activation of FXII. The subsequent dysregulation of the kallikrein–kinin system results in overproduction of bradykinin, ultimately leading to HAE attacks [&lt;span&gt;2, 5, 6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Garadacimab is a first-in-class, fully human, potent, anti-activated FXII monoclonal antibody under clinical evaluation as an LTP therapy for HAE attacks [&lt;span&gt;7, 8&lt;/span&gt;]. Garadacimab has high affinity and specificity for FXIIa, with in vitro data demonstrating decreased bradykinin production [&lt;span&gt;8&lt;/span&gt;]. In the 6-month pivotal Phase 3 (VANGUARD) study (NCT04656418), patients aged ≥ 12 years with HAE with C1INH deficiency or dysfunction and an average attack rate of ≥ 3 attacks in the 3 months preceding study initiation were randomised (3:2) to receive garadacimab 200 mg subcutaneous once monthly after an initial 400 mg loading dose (&lt;i&gt;n&lt;/i&gt; = 39) or volume-matched placebo (&lt;i&gt;n&lt;/i&gt; = 25). Garadacimab significantly reduced monthly number of attacks versus placebo (mean: 0.27 vs. 2.01, respectively; &lt;i&gt;p&lt;/i&gt; &lt; 0.0001 and median [interquartile range] 0.00 [0.00–0.31] vs. 1.35 [1.00–3.20], respectively). Throughout the study, 62% of patients treated with garadacimab remained attack free, demonstrating durable protection against HAE attacks [&lt;span&gt;7&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In this post hoc analysis of the pivotal Phase 3 (VANGUARD) study, the onset of protection against HAE","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"54 12","pages":"1020-1023"},"PeriodicalIF":6.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364619","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":"Rethinking Blood Biomarkers in Autoimmune Urticaria: A Response to Recent Findings","authors":"Sukhdeep Singh,&nbsp;Hitaishi Mehta,&nbsp;Muthu Sendhil Kumaran","doi":"10.1111/cea.14571","DOIUrl":"10.1111/cea.14571","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"54 12","pages":"1027-1028"},"PeriodicalIF":6.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364618","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":"Whole Exome Sequencing Identifies Epithelial and Immune Dysfunction-Related Biomarkers in Food Protein-Induced Enterocolitis Syndrome","authors":"Alba Camino-Mera,&nbsp;Jacobo Pardo-Seco,&nbsp;Xabier Bello,&nbsp;Laura Argiz,&nbsp;Robert J. Boyle,&nbsp;Adnan Custovic,&nbsp;Jethro Herberg,&nbsp;Myrsini Kaforou,&nbsp;Stefania Arasi,&nbsp;Alessandro Fiocchi,&nbsp;Valentina Pecora,&nbsp;Simona Barni,&nbsp;Francesca Mori,&nbsp;Teresa Bracamonte,&nbsp;Luis Echeverria,&nbsp;Virginia O'Valle-Aísa,&nbsp;Noelia Lara Hernández-Martínez,&nbsp;Iria Carballeira,&nbsp;Emilio García,&nbsp;Carlos Garcia-Magan,&nbsp;José Domingo Moure-González,&nbsp;Purificación Gonzalez-Delgado,&nbsp;Teresa Garriga-Baraut,&nbsp;Sonsoles Infante,&nbsp;Gabriela Zambrano-Ibarra,&nbsp;Margarita Tomás-Pérez,&nbsp;Adrianna Machinena,&nbsp;Mariona Pascal,&nbsp;Ana Prieto,&nbsp;Sonia Vázquez-Cortes,&nbsp;Montserrat Fernández-Rivas,&nbsp;Leticia Vila,&nbsp;Laia Alsina,&nbsp;María José Torres,&nbsp;Giusi Mangone,&nbsp;Santiago Quirce,&nbsp;Federico Martinón-Torres,&nbsp;Marta Vázquez-Ortiz,&nbsp;Alberto Gómez-Carballa,&nbsp;Antonio Salas","doi":"10.1111/cea.14564","DOIUrl":"10.1111/cea.14564","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Food protein-induced enterocolitis syndrome (FPIES) is a food allergy primarily affecting infants, often leading to vomiting and shock. Due to its poorly understood pathophysiology and lack of specific biomarkers, diagnosis is frequently delayed. Understanding FPIES genetics can shed light on disease susceptibility and pathophysiology—key to developing diagnostic, prognostic, preventive and therapeutic strategies. Using a well-characterised cohort of patients we explored the potential genome-wide susceptibility factors underlying FPIES.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Blood samples from 41 patients with oral food challenge-proven FPIES were collected for a comprehensive whole exome sequencing association study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Notable genetic variants, including rs872786 (<i>RBM8A</i>), rs2241880 (<i>ATG16L1</i>) and rs2289477 (<i>ATG16L1</i>), were identified as significant findings in FPIES. A weighted SKAT model identified six other associated genes including <i>DGKZ</i> and <i>SIRPA</i>. DGKZ induces TGF-β signalling, crucial for epithelial barrier integrity and IgA production; <i>RBM8A</i> is associated with thrombocytopenia absent radius syndrome, frequently associated with cow's milk allergy; <i>SIRPA</i> is associated with increased neutrophils/monocytes in inflamed tissues as often observed in FPIES; <i>ATG16L1</i> is associated with inflammatory bowel disease. Coexpression correlation analysis revealed a functional correlation between <i>RBM8A</i> and filaggrin gene (<i>FLG</i>) in stomach and intestine tissue, with filaggrin being a known key pathogenic and risk factor for IgE-mediated food allergy. A transcriptome-wide association study suggested genetic variability in patients impacted gene expression of <i>RBM8A</i> (stomach and pancreas) and <i>ATG16L1</i> (transverse colon).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study represents the first case–control exome association study of FPIES patients and marks a crucial step towards unravelling genetic susceptibility factors underpinning the syndrome. Our findings highlight potential factors and pathways contributing to FPIES, including epithelial barrier dysfunction and immune dysregulation. While these results are novel, they are preliminary and need further validation in a second cohort of patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"54 11","pages":"919-929"},"PeriodicalIF":6.3,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.14564","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342723","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}