Clinical and Experimental Allergy最新文献

{"title":"Rebound Pruritus and Urticaria After Discontinuation of Chronic Antihistamine Use—A Scoping Review","authors":"Jun Jie Benjamin Seng, Prawira Oka, Ngiap Chuan Tan","doi":"10.1111/cea.70291","DOIUrl":"10.1111/cea.70291","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rebound pruritus and urticaria have been increasingly reported following discontinuation of chronic antihistamines, particularly with cetirizine and levocetirizine, prompting the United States Food and Drug Administration to issue a recent safety warning for these two medications. Currently, there are significant gaps regarding the risk factors, course and optimal management of rebound pruritus and urticaria after discontinuation of chronic antihistamine use, and if this represents a class-specific adverse effect. This review aimed to map the literature related to rebound pruritus and urticaria after discontinuation of chronic antihistamine use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A scoping review was conducted across four major literature databases (PubMed, Embase, Web of Science and Cochrane database) and grey literature (GreySource, OpenGrey, Google Scholar) from inception to December 2025. Articles describing rebound pruritus following discontinuation of chronic antihistamine use in paediatric or adult populations were included. Antihistamines evaluated included all first- and second-generation histamine-1 antagonists. Non-English articles were excluded. A narrative synthesis was conducted to summarise the reported risk factors, clinical course and potential management strategies for rebound pruritus following antihistamine discontinuation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 17,346 records retrieved, two retrospective studies, one case series and one case report were included in the review. The studies were conducted in the United States (<i>n</i> = 2), the Netherlands (<i>n</i> = 1) and Singapore (<i>n</i> = 1). The main antihistamines implicated in after discontinuation rebound pruritus were cetirizine (<i>n</i> = 327), levocetirizine (<i>n</i> = 39) and, both cetirizine and levocetirizine (<i>n</i> = 2). Among these patients, 85 patients experienced concomitant urticaria after discontinuation of chronic antihistamines. No report was noted for other antihistamines. The patients' age ranged from 6 to 71 years, with a female predominance (76.1%). Antihistamine use ranged from months to years, with pruritus developing between 1 to 5 days after discontinuation. Among the common treatment strategies adopted, cetirizine or levocetirizine re-initiation was the most effective (<i>n</i> = 136 of 137, 99.2%), while antihistamine tapering had the lowest rate of symptoms resolution (<i>n</i> = 11 of 33, 33.3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Rebound pruritus following ","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"56 10","pages":"1205-1214"},"PeriodicalIF":5.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.70291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580670","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":"From Parasite to Therapy: Immunomodulatory Effects of a Trichuris trichiura Derived Recombinant Protein in Allergic Airway Disease.","authors":"Jessica Cristiane da Conceição de Andrade, Eduardo Santos da Silva, Jennifer Emily Anunciação Sousa, Jade Liz Ferreira Mendes Souza, Carolina Melo Orrico-Ferreira, Lorena Miranda Souza, Raphael Chagas Silva, Silvia Letícia Bispo Dos Santos, Antônio Márcio Santana Fernandes, João Vitor Borges Rios, Paulo Emílio Oliveira Cruz, Vítor Lima Miranda Melo, Emília Maria Medeiros de Andrade Belitardo, Luís Gustavo Carvalho Pacheco, Carina Silva Pinheiro","doi":"10.1111/cea.70374","DOIUrl":"10.1111/cea.70374","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":"1267-1269"},"PeriodicalIF":5.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293627","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":"Trajectories of Body Mass Index in the First 18 Years of Life and Eczema in Early Adulthood: A Prospective Cohort Study","authors":"Ali H. Ziyab, Wilfried Karmaus, Sayed Hasan Arshad, Susan Ewart, Hongmei Zhang","doi":"10.1111/cea.70368","DOIUrl":"10.1111/cea.70368","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"56 10","pages":"1233-1236"},"PeriodicalIF":5.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148223685","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":"Emerging Paediatric Uses of Dupilumab Beyond Approvals","authors":"Simone Foti Randazzese,&nbsp;Anna Calamita,&nbsp;Diletta D'Angelo,&nbsp;Alessia Marseglia,&nbsp;Esther Mesa Lombardero,&nbsp;Sara Pedersoli,&nbsp;Micol Tedeschi,&nbsp;Mara De Amici,&nbsp;Sara Manti,&nbsp;Valeria Brazzelli,&nbsp;Amelia Licari,&nbsp;Gian Luigi Marseglia","doi":"10.1111/cea.70381","DOIUrl":"10.1111/cea.70381","url":null,"abstract":"<p>Dupilumab is a fully human IgG4 monoclonal antibody that targets the interleukin-4 receptor alpha subunit, thereby inhibiting interleukin-4 and interleukin-13 signalling, two central drivers of type-2 (T2) inflammation. It is currently approved by both the Food and Drug Administration and the European Medicines Agency for multiple indications, including moderate-to-severe atopic dermatitis (from 6 months of age), add-on maintenance therapy for moderate-to-severe asthma with T2 inflammation (≥ 6 years), eosinophilic esophagitis (≥ 1 year and ≥ 15 kg), chronic rhinosinusitis with nasal polyps (≥ 12 years in the United States and ≥ 18 years in Europe), and chronic spontaneous urticaria (≥ 12 years in the United States and ≥ 2 years in Europe) who remains symptomatic despite antihistamine therapy. Additional adult indications include prurigo nodularis, bullous pemphigoid, and chronic obstructive pulmonary disease with an eosinophilic phenotype. Beyond these established indications, increasing evidence suggests a broader therapeutic potential for dupilumab in paediatric diseases characterized by T2 immune dysregulation. This narrative review synthesizes the emerging literature on off-label and investigational paediatric uses of dupilumab, focusing on inflammatory skin diseases, inborn errors of immunity with severe atopic phenotypes, transplant-associated immune dysregulation, selected respiratory conditions and food allergy. Although current evidence largely derives from case reports, small case series, and observational studies, reported outcomes consistently indicate significant improvements in disease severity, and quality of life, with a favourable safety profile. These findings highlight the expanding role of IL-4/IL-13 blockade in paediatrics and underscore the need for prospective studies to better define efficacy, long-term safety, and optimal patient selection in emerging indications.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"56 10","pages":"1162-1176"},"PeriodicalIF":5.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.70381","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307255","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":"National and Individual-Level Economic Burden of Local Corticosteroid Use and Concomitant Use of Multiple Local Corticosteroid Formulations—A Nationwide Cohort Study","authors":"Kjell Erik Julius Håkansson,&nbsp;Jonas Bækdal,&nbsp;Inge Raadal Skov,&nbsp;Steven Arild Wuyts Andersen,&nbsp;Zarqa Ali,&nbsp;Anders Løkke,&nbsp;Rikke Ibsen,&nbsp;Ole Hilberg,&nbsp;Howraman Meteran,&nbsp;Claus Rikard Johnsen,&nbsp;Vibeke Backer,&nbsp;Charlotte Suppli Ulrik","doi":"10.1111/cea.70351","DOIUrl":"10.1111/cea.70351","url":null,"abstract":"&lt;p&gt;Local corticosteroid treatment, including inhaled, nasal and topical formulations, is the backbone of many highly prevalent diseases such as asthma, allergic rhinitis, chronic rhinosinusitis and atopic dermatitis [&lt;span&gt;1, 2&lt;/span&gt;]. Local corticosteroids are typically well tolerated. However, prolonged high-dose local corticosteroid exposure can contribute to adverse effects typically seen with systemic corticosteroid exposure [&lt;span&gt;3, 4&lt;/span&gt;]. As some of the above-mentioned diseases share inflammatory pathways (e.g., type 2 inflammation), patients may be exposed to multiple routes of administration [&lt;span&gt;5&lt;/span&gt;]. Despite their ubiquity, the financial impact of individuals using one or more formulations of local corticosteroids has been sparsely investigated. In the present study, we aimed to quantify the healthcare and welfare burden on a societal level, as well as the loss of personal income for individuals using one or more formulations of local corticosteroids as compared to matched comparators.&lt;/p&gt;&lt;p&gt;Using the Danish national registries covering all residents of Denmark, we identified incident local corticosteroid users based on repeated pharmacy redemptions (&gt; 1 annual) or relevant ICD-10 diagnoses such as asthma or allergic rhinitis between 2002 and 2020. Excess costs compared to age-, sex-, residence- and marital status-matched comparators were calculated using national registries on healthcare utilization (direct costs e.g., hospital admission, medications), welfare transfers (e.g., sick leave) and loss of income (differences in salaried wage). Costs were estimated using generalized linear regression models (GLM) with a gamma distribution and a log link [&lt;span&gt;6&lt;/span&gt;]. Costs are reported as excess Euro (95% CI) and are adjusted for education level, comorbidity burden (Charlson comorbidity index using prescription patterns and diagnostic codes) and systemic corticosteroid-treated comorbidity (e.g., cancers, IBD). Welfare transfers were estimated for individuals in the working age (18–64). For full national financial burden estimation, the difference unadjusted crude means were used. Full cohort definitions, cost subdivisions and methods are available in an online repository (http://doi.org/10.5281/zenodo.19651707).&lt;/p&gt;&lt;p&gt;In all, 1,935,349 adults who redeemed repeated prescriptions for local corticosteroids and 3,821,720 comparators were included. Multiple administration routes were common, with 21% redeeming two concomitant formulations, and 3% redeeming three. The median age was 50 [IQR 33], 54 [30] and 55 [29] years, and 54%, 58% and 61% were female, respectively.&lt;/p&gt;&lt;p&gt;Annual excess healthcare costs exhibited a clear gradient across number of formulations. For users of one, two and three formulations the costs were 755 (95% CI 752–757), €1667 (1658–1675) and €2661 (2629–2693), respectively (Figure 1, Panel A). Outpatient care was the largest expenditure for individuals redeeming one local corticosteroid (€218 (217–219)),","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"56 10","pages":"1230-1232"},"PeriodicalIF":5.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.70351","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986936","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":"Determinants of Total and Inhaled Allergen-Specific Immunoglobulin E in the Middle-Aged and Elderly Population","authors":"M. Al Fatly,&nbsp;S. Leonard,&nbsp;P.L.A. van Daele,&nbsp;G. Helleman,&nbsp;E. Torabi-Azhandeh,&nbsp;L. Lahousse,&nbsp;S. Veenbergen,&nbsp;L. Chaker","doi":"10.1111/cea.70383","DOIUrl":"10.1111/cea.70383","url":null,"abstract":"&lt;p&gt;Immunoglobulin E (IgE) plays a key role in hypersensitivity reactions and immune responses against parasites and venom. While total IgE (tIgE) is generic, allergen-specific IgE (sIgE) can confirm allergen-specific sensitization [&lt;span&gt;1&lt;/span&gt;]. Beyond IgE's conventionally established roles, there is increasing evidence linking tIgE and sIgE to chronic non-communicable diseases, potentially through chronic inflammatory mechanisms [&lt;span&gt;1&lt;/span&gt;]. Nevertheless, determinants of tIgE and sIgE remain poorly understood, especially in the general middle-aged and elderly population, where the burden of chronic diseases is increasing.&lt;/p&gt;&lt;p&gt;Therefore, we utilized Rotterdam Study (RS) data to investigate age, sex, smoking, alcohol consumption, body mass index (BMI), season and corticosteroid use (topical, inhaled, oral) as potential determinants of tIgE and sIgE. A detailed description of the analyses, quality assurance, analytical considerations and results are available in an online repository (data availability statement).&lt;/p&gt;&lt;p&gt;The RS is a population-based cohort including middle-aged and elderly residents of Ommoord, Rotterdam, the Netherlands [&lt;span&gt;2&lt;/span&gt;]. All participants provided written informed consent. We measured tIgE and sIgE between 2023–12 and 2024–11 in serum samples stored in −80°C using NOVEOS, a fully automated chemiluminescent immunoassay system [&lt;span&gt;3&lt;/span&gt;]. The tIgE detection range was 5–5000 kU/L (kilounits/L). Serum sIgE was measured with a molecular inhalant allergen mix (SX01) in Standard Arbitrary Units (SAU). We investigated the determinants of tIgE and sIgE through multivariable linear regression analyses. We log-transformed the outcomes and evaluated nonlinearity of age using restricted cubic splines. Lastly, we used linear mixed models to investigate longitudinal changes in tIgE and sIgE, and dose–response effects of inhaled and oral corticosteroids. We quantified the associations in odds ratios with 95% confidence intervals (OR [95% CI]).&lt;/p&gt;&lt;p&gt;Cross-sectional analyses included 8679 participants (mean ± SD age 64.2 ± 9.8 years; 56.9% female), of which 478 had repeated measurements (median follow-up 5.56 years). We identified age, sex, smoking, BMI, season and topical and inhaled corticosteroid use as determinants of tIgE and/or sIgE. Figure 1 shows the cross-sectional and longitudinal relationships of age with tIgE and sIgE. Figures and effect estimates of other determinants are available in the online repository. First, age and tIgE showed a U-shaped relationship (&lt;i&gt;p&lt;/i&gt;-nonlinearity &lt; 0.001). Until approximately 70 years of age, older age was associated with lower tIgE, while after 70 years, older age was associated with higher tIgE values. For sIgE, the relationship with age was L-shaped (&lt;i&gt;p&lt;/i&gt;-nonlinearity &lt; 0.001), where older age was associated with lower sIgE levels and the association was most pronounced in younger ages. Both tIgE and sIgE decreased over time (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). Mechanistic","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"56 10","pages":"1240-1242"},"PeriodicalIF":5.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.70383","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148337960","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":"Allergic Diseases and Risk of Incident Autoimmune Diseases: Phenotype-Specific Patterns and Multimorbidity Effects in a Nationwide Cohort.","authors":"Kyung Min Kang, Jeung Min Lee, Seong Heon Kim, Seogsong Jeong, Hwamin Lee","doi":"10.1111/cea.70379","DOIUrl":"10.1111/cea.70379","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":"1273-1275"},"PeriodicalIF":5.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344060","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":"Setting National Allergy Priorities for Research in Australia: A Priority Setting Consumer Survey.","authors":"Rachel L Peters, Lauren Pikó, Janet Davies, Lisa Gamble, Jennifer J Koplin, Michaela Lucas, Sheryl van Nunen, Sally Voukelatos, Yichao Wang, Nyanhial Yang, Kirsten P Perrett","doi":"10.1111/cea.70440","DOIUrl":"10.1111/cea.70440","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104920","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":"Sublingual House Dust Mite (HDM) Immunotherapy Comes to UK Children: Equity of Access and the Unanswered Question of Asthma.","authors":"Prasad Nagakumar, Adel H Mansur, Mamidipudi Thirumala Krishna","doi":"10.1111/cea.70443","DOIUrl":"https://doi.org/10.1111/cea.70443","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080023","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":"Prespecified Margins Are Essential Before Claiming Non-Inferiority in Paediatric Egg-Ladder Follow-Up.","authors":"Ercan Yılmaz, Nezihe Koker Özer, Erdem Topal","doi":"10.1111/cea.70436","DOIUrl":"https://doi.org/10.1111/cea.70436","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079962","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}