Clinical and Experimental Allergy最新文献

{"title":"Oral Immunotherapy Should Play a Key Role in Preschool Food Allergy Management","authors":"Lianne Soller,&nbsp;Edmond S. Chan,&nbsp;Scott B. Cameron,&nbsp;Elissa M. Abrams,&nbsp;Sandeep Kapur,&nbsp;Stuart N. Carr,&nbsp;Timothy K. Vander Leek","doi":"10.1111/cea.70013","DOIUrl":"10.1111/cea.70013","url":null,"abstract":"<p>Food allergies pose significant challenges including the risk for severe allergic reactions. This review article highlights the advantages and disadvantages of the historic standard management approach—avoidance and carrying epinephrine in case of accidental ingestion—and argues, based on accumulating evidence, that oral immunotherapy (OIT) should play a key role in preschool food allergy management. Firstly, our review will highlight pitfalls with the ‘wait-and-see’ approach to natural resolution of food allergies, with recent data pointing to lower resolution than previously thought. For those who do not outgrow their allergies, waiting until school age to offer OIT means missing the window of opportunity where OIT is safest, and prolongs unnecessary dietary restrictions. For those who do outgrow their allergies, research indicates they may not reintroduce the food due to fear and aversion and can become re-sensitised, putting them at risk of severe reactions. Secondly, the risks associated with allergen avoidance are higher than previously believed. Allergen avoidance is imperfect and carries an increased risk of severe reactions when compared with the risk of severe reactions while on OIT, particularly in preschoolers. Although an allergic reaction can be stressful, it is preferable to have this occur during OIT where caregivers are vigilant following a scheduled dose, rather than having this occur at a potentially unexpected time following an accidental exposure. Lastly, there is a growing body of evidence supporting favourable safety and effectiveness of OIT in preschoolers, and preliminary data suggesting higher likelihood of remission in infants. OIT has the potential to significantly improve quality of life, and future research is needed to answer this important question in preschoolers. In summary, while ongoing research will further clarify cost-effectiveness, long-term adherence and psychosocial impacts of OIT, this review suggests that OIT should play a key role in preschool food allergy management.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"55 4","pages":"294-306"},"PeriodicalIF":6.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555960","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":"Hereditary Angioedema (HAE) in China: Advancing Awareness, Access, Advocacy and Alliances From the Greater Bay Area to the Global HAE Community.","authors":"Philip H Li, Jin-Xian Huang, Can-Tian Wang, Jane C Y Wong, Hao Chen, Bao Chai, Liang Chen, He Lai, Shuo Li, Yan-Hua Liang, Yun-Sheng Liang, Ning Liu, Bing Lu, Bao-Qing Sun, Qin-Tai Yang, Fei Ye, Jiang-Lin Zhang, Shu-Chen Zhang, Zuo-Tao Zhao, Min Zhou, Xian-Biao Zou, Guang-Hui Liu, Kai Guan","doi":"10.1111/cea.70014","DOIUrl":"https://doi.org/10.1111/cea.70014","url":null,"abstract":"<p><p>The article offers an overview of the progress in managing Hereditary Angioedema (HAE) in China, with a specific focus on the Greater Bay Area (GBA). Through the '4As' framework-Awareness, Access, Advocacy and Alliance-the article explores the challenges and advancements in HAE care. In terms of collaborative initiatives such as the HAE-ASIA (Angioedema Screening In Asia) collaboration and the GBA HAE Alliance \"Hub-and-Spoke model\" aim to bridge the gap between East and West, providing optimal patient care and advancing HAE management. By bridging the gap between East and West, the GBA aims to deliver optimal patient care and advance HAE management. Moving forward, it will be essential to persist in nurturing national and international collaborations, not only within China but also extending beyond its borders. These partnerships encourage the exchange of knowledge, research, and best practices, all of which are critical in propelling forward the care of HAE. By uniting as a worldwide community, we can significantly advance efforts to improve the quality of life for those affected by HAE across the globe.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555958","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":"Exploring Treatment Adherence in Allergic Rhinitis, Inflammasome Mechanisms in Asthma, and Chronic Cough: Insights From Recent Studies","authors":"Mohamed H. Shamji,&nbsp;Robert J. Boyle","doi":"10.1111/cea.70023","DOIUrl":"10.1111/cea.70023","url":null,"abstract":"<p>\u0000 \u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"55 3","pages":"210-212"},"PeriodicalIF":6.3,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536675","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":"Efficacy and Safety of Dupilumab Treatment for Adult Allergic Bronchopulmonary Aspergillosis: A Real-World Analysis of 16 Cases in China.","authors":"Xu Li, Peng Jin, Na Liu, Tingting Gao, Yanfei Li, Lili Zhi","doi":"10.1111/cea.70020","DOIUrl":"https://doi.org/10.1111/cea.70020","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522609","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":"The Conversation on Oral Immunotherapy for Preschool Children Must Continue","authors":"Paxton Loke","doi":"10.1111/cea.70027","DOIUrl":"10.1111/cea.70027","url":null,"abstract":"&lt;p&gt;There is an ongoing impetus for oral immunotherapy (OIT) for the treatment of food allergies even prior to the US Food and Drug Administration approval of a peanut OIT product (Palforzia) for the treatment of peanut allergy [&lt;span&gt;1&lt;/span&gt;]. Almost contemporaneously, there is a shift trending towards commencing OIT in earlier age groups. Even so, debates continue among experts regarding the measurement of treatment outcomes, including effectiveness, safety and tolerability together with patient-reported outcomes such as health-related quality of life. Through the Core Outcome Measures for Food Allergy (COMFA) initiative, ‘allergic symptoms’ and ‘quality of life’ (QoL) were identified as the two core outcomes recommended to be measured in all food allergy trials in addition to mandatory reporting of adverse events [&lt;span&gt;2&lt;/span&gt;]. Interestingly, while the clinical outcomes of desensitisation or remission did not meet the pre-defined inclusion criteria by the COMFA consortium, these were also considered important to some of the stakeholder groups [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In this issue, Soller and colleagues propose a case for OIT as a key role in the management of food allergy for pre-schoolers, where there may be a window of opportunity for OIT in early life. This proposition adds an element of urgency to both research and clinical practice in this area. Hence, it is imperative that the evidence is continuously evaluated for OIT in this younger age group as compared to older children. Using the lens of the core outcomes, there is a lack of randomised controlled trial (RCT) information on the effects of OIT in infants or toddlers on QoL, and as such Level I or II evidence is lacking in addressing a core outcome. Although there have been separate RCTs for peanut OIT conducted at different ages and populations with much heterogeneity in regimen and definition of clinical outcomes, harmonisation and consensus have not been possible even if real-world studies are included. The closest arguably, if separate RCTs using Palforzia were compared for their primary efficacy outcome, the desensitisation rates did not show a dramatic difference for tolerating ≥ 600 mg peanut protein at the exit challenge (73.5% active vs. 6.3% placebo in children age 1 to &lt; 4 compared to 67.2% active vs. 4% placebo in children 4–17 years, respectively) whereas the secondary outcome of tolerating ≥ 1000 mg may infer a difference (68.4% active vs. 4.2% placebo (age 1 to &lt; 4 years) compared to 50.3% active vs. 2.4% placebo (age 4–17 years)) [&lt;span&gt;3, 4&lt;/span&gt;]. This suggests that the relative impact of age on OIT outcome may vary according to outcome definitions. Furthermore, looking descriptively at the probiotic peanut OIT (PPOIT-003) study where a priori stratification into 1–5 years vs. 6–10 years may imply a higher desensitisation and remission rates for the younger age groups (desensitisation and remission rates for both active arms combined of 83% and 58% for age 1","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"55 4","pages":"288-290"},"PeriodicalIF":6.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522723","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":"Omalizumab Plus House Dust Mite Immunotherapy for Asthma: A Randomised, 5-Arm, Non-Blinded, Non-Placebo-Controlled, Multicentre, Interventional Trial","authors":"Andrzej Bożek,&nbsp;Alicja Grzanka,&nbsp;Giorgio W. Canonica","doi":"10.1111/cea.70021","DOIUrl":"10.1111/cea.70021","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"55 3","pages":"278-280"},"PeriodicalIF":6.3,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481828","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 With Fixed Obstruction Displays a Similar Small Airway Dysfunction to That Observed in Asthma–COPD Overlap","authors":"Toshihiro Shirai,&nbsp;Keita Hirai,&nbsp;Yasuhiro Gon","doi":"10.1111/cea.70018","DOIUrl":"10.1111/cea.70018","url":null,"abstract":"<div>\u0000 \u0000 <p>The clinical characteristics of asthma patients with fixed airflow obstruction were compared with those with asthma–COPD overlap. Asthma patients with fixed airflow obstruction had comparable small airway dysfunction to asthma–COPD overlap patients.</p>\u0000 </div>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"55 6","pages":"511-513"},"PeriodicalIF":6.3,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481745","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":"Dupilumab Efficacy and Safety in Patients With Persistent Asthma: Asia-Pacific Region.","authors":"Qingling Zhang, Nanshan Zhong, Sahajal Dhooria, Xiuhua Fu, Haohui Fang, Jie Lin, Shuyang Zhu, Elizabeth Laws, Yi Wang, Vivian Li, Chih-Chi Hu, Jennifer Maloney, Raolat M Abdulai, Lacey B Robinson","doi":"10.1111/cea.70005","DOIUrl":"https://doi.org/10.1111/cea.70005","url":null,"abstract":"<p><strong>Background: </strong>Asthma prevalence is increasing in the Asia-Pacific region. China and India account for > 35% of the world's population and are often underrepresented in clinical studies. This phase 3 study (NCT03782532) evaluated efficacy and safety of dupilumab, a monoclonal antibody blocking interleukin-4/13 signalling, in patients with persistent asthma from China and India.</p><p><strong>Methods: </strong>Patients (≥ 12 years) were randomised 1:1 to dupilumab 200 mg or matched placebo every 2 weeks for 24 weeks (primary analysis population: blood eosinophils ≥ 150 cells/μL or fractional exhaled nitric oxide ≥ 25 parts per billion without maintenance oral corticosteroid [OCS]; OCS maintenance population: 300 mg OCS).</p><p><strong>Primary endpoint: </strong>change from baseline to week 12 in forced expiratory volume in 1 s (FEV₁). Secondary endpoints: change from baseline to week 24 in 5-item Asthma Control Questionnaire (ACQ-5/7) scores, annualised severe exacerbation rate, and safety.</p><p><strong>Results: </strong>In the primary analysis population (n = 414), change in FEV₁ by week 12 was significantly greater for dupilumab versus placebo (least squares mean difference: 0.31 L [95% CI: 0.23-0.39]; p < 0.0001). At week 24, greater reductions in ACQ-5 score were seen for dupilumab versus placebo (least squares mean difference: -0.20 [95% CI: -0.35 to -0.05]; p = 0.0097). Dupilumab reduced severe exacerbation risk by 62% versus placebo during the treatment period (relative risk: 0.38 [95% CI: 0.21-0.70]; nominal p = 0.002). Safety was similar between treatment arms; injection-site reactions were more common with dupilumab treatment (5.0%) than with placebo (1.2%). The OCS maintenance population showed similar outcomes.</p><p><strong>Conclusion: </strong>Dupilumab significantly improved lung function and asthma control, numerically reduced asthma exacerbations, and was well tolerated in patients from China and India with persistent asthma and evidence of either type 2 inflammation or OCS maintenance.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT03782532.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481827","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":"Clinical Presentation and Nutrition Management of Non-IgE-Mediated Food Allergy in Children","authors":"Marion Groetch,&nbsp;Carina Venter,&nbsp;Rosan Meyer","doi":"10.1111/cea.70012","DOIUrl":"10.1111/cea.70012","url":null,"abstract":"<div>\u0000 \u0000 <p>Non-IgE-mediated food allergy encompasses a wide spectrum of allergic disorders ranging from mild to severe presentations, including food protein-induced allergic proctocolitis, food protein-induced enterocolitis syndrome, and food protein-induced enteropathy. Other gastrointestinal symptoms such as constipation and gastroesophageal reflux disease have not previously been recognised as symptoms of non-IgE-mediated food allergy in food allergy guideline publications. Recently, two new consensus documents from the European Academy of Allergy, Asthma and Immunology address a potential role of food allergens in these disorders, where standard treatment has failed, and provide guidance for diagnosis and management of these conditions. Additional updates include the World Allergy Organisation guidance on the diagnosis and management of cow's milk allergy, the most commonly implicated food in non-IgE-mediated food allergy. These documents all help practitioners to distinguish between common manifestations in infancy that are not pathologic and non-IgE-mediated food allergy. Understanding diagnostic criteria is vital to prevent overdiagnosis, limit unnecessary elimination diets and preserve breastfeeding. Conversely, proper diagnosis may reduce symptoms in infants who are affected. Therefore, the first step in management of non-IgE-mediated food allergy is establishing a correct diagnosis, which requires understanding the clinical presentations and if needed, applying an appropriate short-term diagnostic elimination diet to observe for symptom resolution, followed by food reintroduction to assess for symptom recurrence. Once diagnosed, treatment requires removal of the trigger food, most commonly cow's milk, which is not without burden and nutrition risk. Non-IgE-mediated food allergies typically resolve early in childhood with some disorders resolving in infancy therefore early reassessment for tolerance is vital. Management of non-IgE-mediated food allergy entails following diagnostic algorithms, developing an individualised dietary plan, and timely assessment of tolerance development to reduce burden and nutrition risk.</p>\u0000 </div>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"55 3","pages":"213-225"},"PeriodicalIF":6.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467152","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":"Prevalence and Clinical Symptoms of Wheat Allergy in Adults and Adolescents in Central Europe","authors":"A. Neyer,&nbsp;S. Dölle-Bierke,&nbsp;V. Höfer,&nbsp;J. Grünhagen,&nbsp;K. Beyer,&nbsp;M. Worm","doi":"10.1111/cea.70017","DOIUrl":"10.1111/cea.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Wheat is a well-known elicitor of food allergy, but epidemiological data are limited. The aim of this study was to investigate the prevalence of wheat allergy in an unselected population of adults and adolescents and to characterise the clinical features of this cohort, as well as those of patients who experienced wheat-induced anaphylaxis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A population-based cross-sectional study was conducted. Fifteen thousand individuals aged 12–80 years were randomly selected, and a standardised questionnaire was applied. If symptoms after wheat consumption were reported, telephone interviews were conducted. In the case of suspected type 1 wheat allergy, a skin prick test, specific immunoglobulin E (sIgE) and oral food challenge (OFC) were performed. The prevalence of self-reported wheat sensitivity and wheat allergy was determined after data extrapolation. For the assessment of severe wheat allergy-associated symptoms, a cohort from the European Anaphylaxis Registry was analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The questionnaire was answered by 1770 individuals, of whom 13.1% reported symptoms due to the consumption of foods containing wheat. Following telephone interviews (<i>n</i> = 105) and clinical diagnostics (<i>n</i> = 22), type 1 sensitisation to wheat was confirmed in 8 individuals, and 2 subjects were finally diagnosed with an IgE-mediated wheat allergy. After extrapolation, the prevalence of confirmed wheat allergy in the German population reached 0.25% [95% CI 0.08–0.9]. Self-reported wheat sensitivity was predominantly seen in females (71%), with local gastrointestinal and non-specific symptoms. This contrasted with wheat-induced anaphylaxis, where less than half occurred in females, and symptoms were mainly skin, cardiovascular or respiratory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a population with widespread wheat consumption, self-reported wheat sensitivity was common in adults and adolescents, but confirmed wheat allergy was rare. The distinct symptom profiles allow physicians to easily differentiate these entities. Dissemination of our findings may help to improve knowledge of the low prevalence of wheat allergy and may support the reduction of unnecessary dietary restrictions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"55 4","pages":"319-329"},"PeriodicalIF":6.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456969","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}