Clinical and Translational Allergy最新文献

{"title":"The impact of COVID-19 on hay fever treatment in Japan: A retrospective cohort study based on the Japanese claims database","authors":"Yasutsugu Akasaki,&nbsp;Takenori Inomata,&nbsp;Masao Iwagami,&nbsp;Jaemyoung Sung,&nbsp;Ken Nagino,&nbsp;Takeya Adachi,&nbsp;Hideaki Morita,&nbsp;Mayumi Tamari,&nbsp;Keigo Kainuma,&nbsp;Keiko Kan-o,&nbsp;Hiroaki Ogata,&nbsp;Masafumi Sakashita,&nbsp;Masaki Futamura,&nbsp;Yosuke Kurashima,&nbsp;Saeko Nakajima,&nbsp;Katsunori Masaki,&nbsp;Yasushi Ogawa,&nbsp;Sakura Sato,&nbsp;Akihiro Miyagawa,&nbsp;Akie Midorikawa-Inomata,&nbsp;Keiichi Fujimoto,&nbsp;Yuichi Okumura,&nbsp;Kenta Fujio,&nbsp;Tianxiang Huang,&nbsp;Kunihiko Hirosawa,&nbsp;Yuki Morooka,&nbsp;Akira Murakami,&nbsp;Shintaro Nakao","doi":"10.1002/clt2.12394","DOIUrl":"https://doi.org/10.1002/clt2.12394","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hay fever (HF) presents with various symptoms, including allergic conjunctivitis and rhinitis, and requires cross-organ treatment. This study assessed the impact of the coronavirus disease 2019 (COVID-19) pandemic on HF treatment trends.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study utilized data from the JMDC database collected between January 2018 and May 2021. Patients with HF were identified based on the relevant International Classification of Diseases 10th Revision diagnosis codes and the prescription of HF-related medications. The treatment approaches were compared during the cedar and cypress pollen allergy season (January to May in Japan) before and during the COVID-19 pandemic (2018 and 2019, and 2020 and 2021, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 2,598,178 patients with HF. The numbers of prescribed HF-related claims in 2018, 2019, 2020, and 2021 were 3,332,854, 3,534,198, 2,774,380, and 2,786,681 times, respectively. Oral second-generation antihistamine prescriptions decreased by &gt;10% from 2019 to 2020, with a &lt;10% change in the subsequent year. Anti-allergic eye drop prescriptions also decreased by &gt;10% from 2019 to 2020 but increased by &gt;10% from 2020 to 2021. Compared with 2018, 2019, and 2020, the number of claims in the rhinitis symptoms dominant group was significantly decreased in 2021 (<i>p</i> &lt; 0.001, all). In contrast, the number of claims in the eye symptoms dominant group and the rhinitis and eye symptoms dominant group increased in 2021 compared with that in 2018, 2019, and 2020 (<i>p</i> &lt; 0.001, all).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Changes in HF treatment and related outcomes could be attributed to lifestyle modifications resulting from the COVID-19 pandemic. Measures, such as limiting outdoor activities and adopting mask-wearing practices may have influenced HF symptoms, preventive behaviors, and the overall approach to treating HF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12394","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142245070","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":"Atopic Dermatitis Activity Score 7 (ADAS7): A tool for disease activity assessment","authors":"Axel De Greef,&nbsp;Alexia Degraeuwe,&nbsp;Nina Nielens,&nbsp;Anne-Sophie Darrigade,&nbsp;Céline Bugli,&nbsp;Laurence de Montjoye,&nbsp;Marie Baeck","doi":"10.1002/clt2.12393","DOIUrl":"https://doi.org/10.1002/clt2.12393","url":null,"abstract":"&lt;p&gt;To the Editor,&lt;/p&gt;&lt;p&gt;The Harmonizing Outcome Measures for Eczema (HOME) group has established that the evaluation of patients with atopic dermatitis (AD) should measure clinical signs, patient-reported symptoms, long-term control of the disease, and patients' quality of life.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; To date, the existing scores&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; often assess only one of the aspects and are time-consuming. Furthermore, these scores assess the severity only at a certain time-point or over a maximum of seven consecutive days, and do not take into account the disease &lt;i&gt;activity&lt;/i&gt;, defined as the fluctuations of AD.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; We stated the need for a score that effectively assesses this dynamic aspect of the disease.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Preliminary results of a newly developed score, the “Atopic Dermatitis Score 7” (ADS7), inspired by the Urticaria Activity Score 7 (UAS7), showed a good correlation with the scores currently used in AD (Figure 1).&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The aims of the present study were (i) to demonstrate ADS7 correlation with SCORing Atopic Dermatitis (SCORAD) on a larger cohort, and (ii) to evaluate if ADS7 was able to highlight the &lt;i&gt;activity&lt;/i&gt; of the disease. It was therefore renamed “Atopic Dermatitis Activity Score 7” (ADAS7). We prospectively enrolled 137 patients with AD between September 2021 and August 2023 from Belgian academic and non-academic hospitals (outpatient clinics). One hundred patients completed the score daily for a period of maximum 6 months and were included for analyses (37 were lost to follow-up). Study design, statistical analyses and descriptive analysis of the patients' cohort at baseline are detailed in Supporting Information S1.&lt;/p&gt;&lt;p&gt;Intraclass correlation coefficient was 0.594, with a 95% confidence interval of [0.451–0.708] (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) when comparing ADAS7 values with SCORAD. Using a cut-off value of ≥18 (as defined and validated in the preliminary study&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt;) to detect moderate-to-severe patients, positive and negative predictive values were 88.7% and 76.3%, respectively. Sensitivity and specificity were 85.9% and 80.5%, respectively. For a subset of 40 patients for whom long-term data were available, median ± interquartile range (IQR) ADAS7 scores were calculated and presented on boxplots to illustrate disease activity over a period of 15.5 ± 15.7, [9.2–25.0] weeks (median ± IQR, [quartile [Q]1 − Q3]) (Figure 2). Patients had “active” disease when their IQR value was &gt;8.875 (median of the distribution of all patients' IQR values, used as threshold value—detailed demonstration of variability is provided in Supporting Information S1). Of these, 11/20 (55.0%) changed severity category (i.e., their IQR overlapped two categories) in contrast to 4/20 (20.0%) patients with non-active disease.&lt;/p&gt;&lt;p&gt;Effective management of AD patients and treatment adaptations must be based on reliable outcomes that reflect disease activity. With","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12393","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142230917","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":"High-risks drug adverse events associated with Cetirizine and Loratadine for the treatment of allergic diseases: A retrospective pharmacovigilance study based on the FDA adverse event reporting system database","authors":"Weili Kong,&nbsp;Yijun Dong,&nbsp;Sixi Yi,&nbsp;Wei Mo,&nbsp;Hui Yang","doi":"10.1002/clt2.12392","DOIUrl":"https://doi.org/10.1002/clt2.12392","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cetirizine and Loratadine are the two best-selling second-generation antihistamines for allergic diseases. This study aims to provide a comparative analysis of the differences in adverse drug events (ADEs) between these two medications, which can assist clinicians in making appropriate treatment decisions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>ADE reports related to Cetirizine and Loratadine obtained from the FDA adverse event reporting system (FAERS) database were analyzed using disproportionality analysis and Bayesian analysis to evaluate and compare the ADE signals of both drugs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 28,051 and 28,073 ADE reports were retrieved from the FAERS database related to Cetirizine and Loratadine, respectively, with both drugs showing a predominance of middle-aged females. Specifically, Loratadine was associated with respiratory symptoms, mainly nasal symptoms such as rhinorrhea (<i>n</i> = 326, ROR 6.75), sneezing (<i>n</i> = 251, ROR 15.24), and nasal congestion (<i>n</i> = 185, ROR 4.25), while Cetirizine did not show this association. Notably, both drugs exhibited strong signals for somnolence in the nervous and psychiatric systems, especially Cetirizine (Cetirizine, <i>n</i> = 2556, ROR 10.52 vs. Loratadine, <i>n</i> = 1200, ROR 7.76). Additionally, Cetirizine itself showed strong signals for attention disturbance (<i>n</i> = 233, ROR 3.3), while Loratadine was associated with nervousness (<i>n</i> = 145, ROR 3.3). Further exploration revealed more severe adverse reactions closely associated with Cetirizine, including hallucinations, aggression, and abnormal behavior. Importantly, Cetirizine was significantly associated with the occurrence of pericarditis (<i>n</i> = 138, ROR 8.13), potentially leading to serious adverse consequences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared to Loratadine, Cetirizine poses a greater potential risk in the nervous and psychiatric systems. Additionally, this study reveals previously underestimated potential cardiac toxicity of Cetirizine; albeit at a relatively low incidence rate, the high signal intensity warrants further attention and exploration. These findings highlight the need for enhanced patient monitoring and therapy optimization when prescribing these medications, ensuring better management of allergic diseases while minimizing risks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12392","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142170063","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":"Eczema in early childhood increases the risk of allergic multimorbidity","authors":"L. A. Miltner,&nbsp;J. M. Vonk,&nbsp;J. L. van der Velde,&nbsp;A. B. Sprikkelman","doi":"10.1002/clt2.12384","DOIUrl":"10.1002/clt2.12384","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Eczema in early childhood is associated with the development of subsequent allergic diseases, including food allergy (FA), asthma and hay fever. However, eczema has a heterogenous presentation regarding onset age and persistence, which may lead to different allergic outcomes during childhood/adolescence. Recently, sub-phenotypes of eczema have been suggested as predictors of allergic multimorbidity. Thus, we aimed to identify associations of eczema phenotypes with FA, asthma and hay fever during childhood/adolescence. Additionally, we described the trajectories of eczema, asthma and hay fever stratified by FA presence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>TRACKER (Trajectories of Allergy in Children in Real Life Databases) is a population-based cohort study of 6852 children/adolescents from the Lifelines cohort. We investigated the associations of seven eczema phenotypes, based on onset age and persistence, with FA, asthma and hay fever using logistic regression, adjusted for appropriate covariates. Disease trajectories were determined by calculating prevalence at different ages.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants who suffered from eczema throughout childhood showed higher risks of developing FA, hay fever and asthma. “Very early onset—persistent” eczema showed the strongest associations with FA, asthma and hay fever. The prevalence of eczema, asthma and hay fever at all ages was significantly higher in participants with FA, compared to those without.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>One of the largest cohort studies on this topic to date shows that (very) early onset and persistent eczema increases the risk of allergic multimorbidity. Identification of infants at risk for developing (very) early onset eczema is of utmost importance to prevent allergic multimorbidity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12384","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104932","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":"Higher prevalence of dupilumab-induced ocular adverse events in atopic dermatitis compared to asthma: A daily practice analysis","authors":"Anne R. Schlösser,&nbsp;Lotte Bult,&nbsp;John C. Thelen,&nbsp;Alberta A. H. J. Thiadens,&nbsp;Renske Schappin,&nbsp;Tamar E. C. Nijsten,&nbsp;Johannes C. C. M. in 't Veen,&nbsp;Gerrit J. Braunstahl,&nbsp;DirkJan Hijnen","doi":"10.1002/clt2.12386","DOIUrl":"https://doi.org/10.1002/clt2.12386","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dupilumab has been shown to be an effective treatment in moderate-to-severe atopic dermatitis (AD) and severe asthma (SA). However, comparative real-world analyses of adverse events (AE), particularly dupilumab-associated ocular surface disease (DAOSD), are lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This is the first real-world study to provide insight into the prevalence of AEs associated with dupilumab in AD compared with SA. Secondary objectives were to assess the prevalence, onset and therapeutic strategies of DAOSD and evaluate dupilumab discontinuation rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from two daily practice registries including AD and SA patients receiving dupilumab treatment were analyzed. Adverse events, including DAOSD, were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 322 AD and 148 SA patients were included. Headaches (23.6%), injection site reactions (10.1%), and influenza-like symptoms (13.5%) were more prevalent in SA patients. Interestingly, ocular AEs were significantly more prevalent in AD patients (62.1%, <i>p</i> &lt; 0.001), including conjunctivitis (17.1%, <i>p</i> = 0.004). 88% AD and 47% SA patients with ocular AEs received one or more ophthalmic treatment(s). Additionally, 20% of AD and 17.6% of SA patients discontinued dupilumab treatment due to ocular AEs, while only 65% of these AD and none of these SA patients were referred to an ophthalmologist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The higher incidence of DAOSD in AD patients compared with SA patients in this real-world study highlights the importance of physician awareness, especially when prescribing dupilumab to AD patients. Conversely, the findings of this study help alleviate potential concerns about ocular AEs in patients with SA who do not have comorbid AD. Furthermore, the effective management of most ocular AEs with ophthalmic treatments suggests favorable tolerability of dupilumab in daily practice, and multidisciplinary collaboration is essential to proactively manage ocular AEs before discontinuing dupilumab.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12386","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141994174","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":"Level of education, but not occupation, is differentially associated with asthma phenotypes in adults","authors":"Muwada Bashir Awad Bashir,&nbsp;Rani Basna,&nbsp;Göran Wennergren,&nbsp;Madeleine Rådinger,&nbsp;Helena Backman,&nbsp;Emma Goksör,&nbsp;Jan Lötvall,&nbsp;Linda Ekerljung,&nbsp;Hannu Kankaanranta,&nbsp;Bright I. Nwaru","doi":"10.1002/clt2.12389","DOIUrl":"10.1002/clt2.12389","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Education, but not occupation, was differentially associated with adult asthma phenotypes in the general population. Further research into socioeconomic status variation in various asthma phenotypes is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12389","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975237","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":"Can cashew nut allergy resolve spontaneously?","authors":"Tamazoust Guiddir,&nbsp;Audrey Siberil,&nbsp;Françoise Lepape,&nbsp;Marion Hacker,&nbsp;Ariane Nemni","doi":"10.1002/clt2.12385","DOIUrl":"10.1002/clt2.12385","url":null,"abstract":"<p>To the Editor</p><p>Cashew nut allergy (CNA) is increasing worldwide and is responsible for severe anaphylaxis, particularly in young children.<span>¹</span> Symptoms range from mild reactions to severe anaphylaxis. The three main allergens are storage proteins: Ana o 1, Ana o 2 (cupin superfamily) and Ana o 3 (prolamin superfamily).<span>²</span> Lifetime avoidance of cashew nut is currently recommended for those with CNA. However, little is known about the natural history of CNA.</p><p>We report a cohort of five children with severe anaphylaxis to cashew nut who recovered and were able to eat cashew nut after a successful oral food challenge (Table 1). They all presented severe anaphylaxis according to the ordinal food allergy severity score (oFAAS-5)<span>³</span> (grade 3 to grade 5) at diagnosis at a mean age of 3 years [1.5–4]. Two patients had no atopy, one had a personal and familial atopic history and two others had only personal atopy. They all had no allergies or sensitizations to peanuts or tree nuts. Three patients consumed native cashew (between one and three cashew units) during the first reaction and two patients consumed cashew in cooked meals (unknown quantity). Allergology explorations were performed a mean 1.1 years [0.15–5] after the first reaction. All patients were sensitized to pistachio, but only two had a confirmed food allergy to pistachio. Skin prick tests (SPTs) were performed with commercial extract (ALK-Abello) and were deemed positive when wheal size was ≥ 3 mm. Cashew SPTs were positive for four children (mean 6 mm, range [3–20]). Cashew-specific IgEs (ImmunoCap® by Phadia 1000 System, Thermo Fisher Scientific) were positive for all patients, with a mean of 1 KU/L [0.36–2.49]. The recombinant Ana o 3 was not tested for at diagnosis for three patients and was positive for two of them (0.63 and 1.97 KU/L). After the reaction, they all observed strict avoidance of cashew and pistachio in their diet, without any recurrence. During a mean follow-up of 2.4 years (range [1–4]), the SPT and the cashew-specific IgEs became negative (Figure 1) and all patients tested negative for recombinant Ana o 3. An oral food challenge in four patients was successful at a cashew nut cumulated dose of 7800 mg. One patient refused the challenge, but after a successful pistachio challenge, he ate one cashew unit at home without any reaction.</p><p>We reported the cases of five children who presented severe anaphylaxis to cashew nut and who spontaneously recovered after a mean follow-up of 2.4 years [1–4]. As for peanut, ingestion of cashew is associated with a high rate of severe anaphylactic reactions,<span>⁴</span> but in our cohort it seemed not to be correlated with persistence of the allergy. Oral immunotherapy (OIT) may help develop tolerance to cashew, as reported by Elizur et al.<span>⁵</span> in a cohort of 50 children aged &gt;4 years, who presented severe clinical reactio","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12385","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975174","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":"Milk ladder versus early oral immunotherapy in infants with cow's milk protein allergy","authors":"Yurika Matsumoto,&nbsp;Mayumi Fujita,&nbsp;Tsukahara Ayumi,&nbsp;Tetsuya Takamasu,&nbsp;Chisato Inuo","doi":"10.1002/clt2.12388","DOIUrl":"10.1002/clt2.12388","url":null,"abstract":"<p>Cow's milk protein allergy (CMPA) significantly decreases the quality of life of infants and their families, necessitating effective management. Avoidance of cow's milk protein (CMP) has been the primary approach, awaiting the development of a natural tolerance.<span>¹</span></p><p>Oral immunotherapy (OIT) for CMPA gradually increases the use of pure CMP, such as milk, to enhance tolerance. A previous study demonstrated the efficacy and safety of early OIT (E-OIT) for infants with CMPA.<span>²</span> The Milk Ladder (ML) method modifies the OIT strategy and enhances CMP tolerance through stepwise exposure to milk-containing foods.<span>^{1, 3-5}</span> Despite growing adoption, ML lacks extensive validation and requires further research.<span>⁴</span> To the best of our knowledge, there have been no comparative studies of E-OIT and ML in infants with CMPA. This study aimed to compare the efficacy and safety of ML and E-OIT in infants with CMPA.</p><p>We retrospectively analyzed infants younger than 2 years who started intervention for CMPA at the Department of Allergy at Kanagawa Children's Medical Center from April 2016 to March 2022, with a treatment protocol shift in April 2018 from E-OIT to ML. Inclusion criteria included a CMPA diagnosis based on parent-reported immediate allergic reaction to CMP ingestion or a serum milk-specific IgE level greater than 5 kU_A/L.<span>³</span> Patients with only gastrointestinal symptoms were excluded due to different CMPA types. The ML protocol started with baked milk (BM), advancing toward less processed forms, while E-OIT began with controlled doses of milk or yogurt. For detailed protocols, see the Supplementary materials in Supporting Information S1.</p><p>CMP tolerance was defined as the ability to consume 100 mL of milk or an equivalent amount of approximately 3300 mg of CMP daily without experiencing symptoms. Low dairy tolerance for processed foods was defined as the ability to consume processed foods. Products high in dairy ingredients, such as cheese, yogurt, and pizza were excluded. These were confirmed through repeated intake at home. All patients underwent treatment review and assessment through interviews approximately every 3 months to assess progress and adjust care, as necessary.</p><p>This study conformed to the guidelines established by the Declaration of Helsinki and was approved by the Kanagawa Children's Medical Center Research Ethics Committee (approval no. 2105-4). Informed consent was obtained from the parents of all patients.</p><p>The analyses were performed according to the intention-to-treat principle (ITT) 2 years post intervention. The Mann–Whitney <i>U</i> test was used to compare continuous variables, while the Chi-squared test or Fisher's exact test was used for categorical variables. To evaluate the progression of CMP tolerance over time, Kaplan–Meier analysis with a log-rank test was performed. Statistical s","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11309850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906086","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":"Clinical and biological characteristics associated with bronchial or pulmonary abnormalities on chest CT imaging in patients with systemic mastocytosis","authors":"Raphael Vallière,&nbsp;Cristina Bulai Livideanu,&nbsp;Thomas Villeneuve,&nbsp;Grégoire Prévot,&nbsp;Laurent L. Reber,&nbsp;Laurent Guilleminault","doi":"10.1002/clt2.12387","DOIUrl":"10.1002/clt2.12387","url":null,"abstract":"<p>To the Editor,</p><p>Mastocytosis is a heterogeneous group of diseases characterized by a numerical increase and accumulation of clonal mast cells in various organ systems. In systemic mastocytosis, the severity varies from indolent to aggressive mastocytosis, the latter being associated with a worse prognosis.<span>¹</span> Although the lungs are known to be rich in mast cells, comorbid respiratory diseases have only been sporadically suggested as associated with SM in case reports.<span>^2-4</span> To our knowledge, no data are available on chest CT scans in patients with SM.</p><p>The aim of our study is to determine clinical and biological characteristics associated with bronchial or pulmonary abnormalities on chest CT scans in patients with SM.</p><p>A retrospective observational study was carried out at Toulouse University Hospital Center from 2003 to 2022 using our mastocytosis registry. All patients with (1) a diagnosis of SM based on bone marrow biopsy according to criteria published elsewhere<span>¹</span> and (2) a CT scan image available in their medical record were included. This study was conducted in accordance with French ethics requirements (RC31/17/0095) and the guidelines of the National Commission for Data Protection and Liberties (CNIL number: 2206723 v 0).</p><p>Chest CT scans were evaluated by two physicians blinded to the patients' clinical and functional details. The two observers easily established a consensus about the predominant chest CT scan pattern according to the definitions of the Fleischner Society.<span>⁵</span></p><p>Continuous data were expressed as median and interquartile range and categorical data as number of patients and percentages. An increased risk of a predominant pattern on chest CT scan was assessed for aggressive versus indolent SM and serum tryptase ≥20 μg/L versus &lt;20 μg/L. For this analysis, we used a multivariable logistic regression with a calculation of adjusted odds ratios (aORs) with a 95% confidence interval. aORs were adjusted on the following covariates: age, sex and smoking status. We were not able to determine aOR if the CT scan abnormality was absent in the control group.</p><p>A total of 103 patients with SM were included in the study (Table 1). Of them, 60.2% were females and the median age was 54 [40–60]. Mastocytosis was indolent in 70 (73%) patients, cKit mutation was found in 91 (85%) patients and median serum tryptase was 15 [30–51] µg/l. A predominant chest CT scan pattern was observed in 36 (35.0%) patients. The lung lesions were as follows: nodules (<i>n</i> = 11), emphysema (<i>n</i> = 9), bronchiectasis (<i>n</i> = 6), bronchial wall thickening (<i>n</i> = 6) and interstitial lung diseases (<i>n</i> = 4).</p><p>According to the multivariable analysis, an increased risk of emphysema was observed for aggressive mastocytosis compared to indolent mastocytosis (aOR 5.0 [95% CI: 1.1–27.6]) (Figure 1). An increased risk of bronchi","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11303256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896927","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":"Being born in autumn or winter is associated with asthma and allergic rhinitis in Finland","authors":"Riikka Hänninen,&nbsp;Aada Murtomäki,&nbsp;Fanni Svärd,&nbsp;Aarno Dietz,&nbsp;Paulus Torkki,&nbsp;Jari Haukka,&nbsp;Mikko Nuutinen,&nbsp;Sanna Toppila-Salmi","doi":"10.1002/clt2.12383","DOIUrl":"10.1002/clt2.12383","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Our population-based study has previously shown that being born in winter or spring was associated with adult-onset asthma. The aim was to study if season of birth (SOB) is associated with airway allergy and related diseases: NSAID exacerbated respiratory disease (N-ERD), asthma, allergic rhinitis (AR), nonallergic rhinitis (NAR), chronic rhinosinusitis with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP) in Finland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A randomly sampled retrospective registry-based follow-up data (<i>n</i> = 74,868) of patients visiting Hospital District of Helsinki and Uusimaa (HUS) in Finland was used. The birth date, sex, visit date and comorbidities were collected from electronic health record data during visits from 2005 to 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean (SD, range) age of the sample was 34.53 (25.47, 0–102) years, with 48.7 % being men. We divided the whole population in four groups based on the season they were born (SOB-groups). When observing these four SOB-groups, the proportion of those having asthma was 43.1%, 42.1%, 41.1%, 42.7%, in winter, spring, summer, and autumn SOB-groups, respectively. The proportion of those having AR was 12.6%, 12.0%, 10.7%, 12.1%, respectively. When having summer as a reference, being born in any other time of year was significantly associated with AR and, being born in autumn or winter was associated with asthma. No significant association was observed in CRS or N-ERD or NAR groups in adjusted models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study suggests that early life immunological events may have a role a role in pathogenesis of asthma and AR. As no association was observed between SOB and CRSsNP, CRSwNP, N-ERD or NAR, further studies on this are warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12383","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731049","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}