Clinical and Translational Allergy最新文献

{"title":"Patient-Reported Outcome Measures as Predictive Tools for Disease Control in Chronic Rhinosinusitis With Nasal Polyps: A Prospective Study","authors":"Chen Zhang,&nbsp;Qianqian Zhang,&nbsp;Jiani Chen,&nbsp;Fuying Cheng,&nbsp;Yizhang Wang,&nbsp;Shirui Xue,&nbsp;Yufei Yang,&nbsp;Wenwen Guo,&nbsp;Juan Liu,&nbsp;Dehui Wang,&nbsp;Li Hu,&nbsp;Xicai Sun,&nbsp;Huan Wang,&nbsp;Quan Liu","doi":"10.1002/clt2.70119","DOIUrl":"10.1002/clt2.70119","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic rhinosinusitis with nasal polyps (CRSwNP) significantly impairs the quality of life, and disease control is now considered the primary treatment goal. Although patient-reported outcome measures (PROMs) such as the 22-item Sinonasal Outcome Test (SNOT-22) and CRS-PRO are widely used, their utility in predicting long-term postoperative disease control remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective follow-up study aimed to evaluate postoperative recovery and identify the predictors of suboptimal disease control in patients with CRSwNP by integrating preoperative PROMs with objective clinical features. A total of 102 patients with CRSwNP undergoing functional endoscopic sinus surgery (FESS) were enrolled, of whom 89 completed at least 12 months of follow-up. Preoperative and postoperative PROMs were compared across disease control groups classified based on the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 criteria. Least absolute shrinkage and selection operator regression was applied to select objective clinical predictors, which were then combined with either CRS-PRO or SNOT-22 item scores to develop and compare the nine machine learning models. Model performance was assessed using area under the curve (AUC), decision curve analysis, sensitivity, specificity, and other metrics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eosinophil and neutrophil counts were identified as key objective predictors of suboptimal disease control after FESS. Among all models, logistic regression incorporating CRS-PRO scores and selected clinical features achieved the best performance, yielding an AUC of 0.866, accuracy of 83.3%, sensitivity of 72.7%, specificity of 89.5%, and F1-score of 76.2%. This model demonstrated a strong discriminatory ability and potential utility in individualized clinical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Integrating preoperative CRS-PRO item scores with selected objective clinical parameters enables the accurate prediction of suboptimal disease control in patients with CRSwNP following FESS. This approach supports personalized risk stratification and postoperative management strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 11","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12584042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437726","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":"Which Is the Best Biologic for Nasal Polyps: An Updated Network Meta-Analysis","authors":"Xi Xu,&nbsp;Jinting Lin,&nbsp;Minting Luo,&nbsp;Qingwu Wu","doi":"10.1002/clt2.70114","DOIUrl":"https://doi.org/10.1002/clt2.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Direct comparative efficacy data for biologics in chronic rhinosinusitis with nasal polyps (CRSwNP) remain limited, particularly for novel agents like tezepelumab, underscoring the need to identify optimal therapies for precision management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To rank the comparative efficacy and safety of dupilumab, tezepelumab, omalizumab, and mepolizumab versus placebo for CRSwNP using network meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Embase, Web of Science, and Cochrane Library were searched from inception through April 1, 2025. Randomized controlled trials (RCTs) in adults with CRSwNP comparing biologics against placebo were eligible. PRISMA-NMA guidelines were followed. GRADE methodology was employed for evidence certainty assessment. Two investigators independently extracted data. Fixed-effect model network meta-analysis was performed, with treatments ranked via surface under the cumulative ranking curve (SUCRA). The primary outcomes were Nasal Polyp Score (NPS) and safety metrics (proportion of participants with ≥ 1 adverse event). Secondary outcomes included Sino-Nasal Outcome Test-22 (SNOT-22), University of Pennsylvania Smell Identification Test (UPSIT), and Nasal Congestion Score (NCS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirteen RCTs (<i>n</i> = 2304) evaluating four biologics versus placebo were included. Compared to placebo, NPS was significantly improved by dupilumab (WMD: −2.16, 95% CI [−2.44, −1.89]), omalizumab (WMD: 1.25, 95% CI [−1.52, −0.97]), mepolizumab (WMD: 0.90, 95% CI [−1.19, −0.62]), and tezepelumab (WMD: −1.50, 95% CI [−1.81, −1.19]). Dupilumab ranked first in efficacy outcomes (NPS, SNOT-22, UPSIT, and NCS, SUCRA ≥ 0.900, respectively). Tezepelumab ranked second in NPS (SUCRA: 0.720) and UPSIT (SUCRA: 0.749), while omalizumab ranked first in safety (SUCRA of adverse events: 0.064). GRADE assessments indicated that the certainty of the evidence was predominantly high for these key efficacy comparisons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Dupilumab demonstrated the highest efficacy and safety profile. Tezepelumab showed comparable efficacy in NPS with omalizumab.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 11","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426107","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":"Digital Innovation in Asthma Management in Italy: Results From the “Confronting Asthma Survey”","authors":"Manuela Latorre,&nbsp;Pierluigi Paggiaro,&nbsp;Cristina Cardini,&nbsp;Giovanni Paoletti,&nbsp;Emanuele Nappi,&nbsp;Mario Di Gioacchino,&nbsp;Enrico Heffler,&nbsp;Francesco Blasi,&nbsp;Giorgio Walter Canonica,&nbsp;Francesca Puggioni,&nbsp;SANI Network","doi":"10.1002/clt2.70109","DOIUrl":"10.1002/clt2.70109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The rapid digital transformation has significantly impacted healthcare, particularly through eHealth solutions that offer great potential for managing chronic respiratory conditions such as asthma. This study explores the impact, attitudes, and acceptance of digital technologies in asthma management in Italy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A structured 34-item survey, developed in two versions for patients and physicians, was administered independently and anonymously to adult asthma patients and to specialists in pulmonology and allergology. The questionnaires collected data on demographics, professional background, digital habits (for work and leisure), use of digital tools such as apps and smart inhalers, doctor–patient digital communication, familiarity with online health resources, and perceived barriers to digital adoption. Data were collected anonymously via REDCap, with oversight from the Severe Asthma Network in Italy (SANI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 134 patients and 180 doctors participated. Findings revealed a predominantly positive attitude toward digital tools, with 85% of physicians and 74.4% of patients embracing a “digital mindset.” Nevertheless, digital innovations remain underutilized in clinical practice. While 85.6% of patients reported regularly using digital tools in their daily lives, 91.5% stated that their doctors had never recommended apps or websites for asthma self-management. Digital solutions such as mobile apps, wearable spirometers, and telemedicine are recognized for their potential benefits—clinicians highlighted symptoms self-tracking (17.2%), improved adherence (22.7%), and enhanced clinical interventions (11.7%) as key advantages. However, adoption is hindered by concerns such as information technology (IT) compliance (62.5%), legal risks (11.5%), and skepticism about the reliability of remote data (40.6%). Furthermore, 59.9% of clinicians and 66.8% of patients recognized a knowledge gap regarding the potential benefits of smart inhalers and digital therapeutics in respiratory care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study highlights a positive attitude toward digital tools in asthma management but reveals limited adoption in clinical practice. Key barriers include IT compliance concerns and knowledge gaps. Addressing these challenges through education and regulatory support could enhance digital integration, improving asthma care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 10","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307311","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":"ST2+ Erythroid Progenitors Suppress Allergic Asthma by Scavenging IL-33 in Young Mice","authors":"Chang Li,&nbsp;Jie Liu,&nbsp;Xiaoshi Li,&nbsp;Wenlong Chen,&nbsp;Ying Zhang,&nbsp;Heng Sun,&nbsp;Cunni Zheng,&nbsp;Quan Liu","doi":"10.1002/clt2.70111","DOIUrl":"10.1002/clt2.70111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although IL-33/ST2 signaling has been implicated in adult asthma, its contribution to early-onset allergic asthma remains poorly understood. Here, we examined the postnatal dynamics of IL-33 and its regulation by splenic ST2⁺ erythroid progenitors (EPs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Plasma IL-33 levels were measured in neonatal and young mice. Wild Type (WT) and <i>Il33</i>^−/− mice were exposed to house dust mite (HDM) to assess airway inflammation and asthma. ST2⁺ EPs were analyzed for IL-33 responsiveness, transcriptomic/epigenomic profiles, and IL-33 scavenging capacity. EP depletion was performed to evaluate their role in HDM-induced inflammation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Plasma IL-33 levels fluctuated during the postnatal period, peaking at postnatal day 7 (PND7). WT mice exhibited more severe HDM-induced airway inflammation than <i>Il33</i>^−/− mice. Splenic ST2⁺ EPs, abundant in early life but absent by PND28, displayed minimal IL-33–induced signaling or transcriptomic/epigenomic alterations, yet efficiently scavenged IL-33. Depletion of EPs exacerbated HDM-induced inflammation, accompanied by increased T follicular helper cells (Tfh) and IgE⁺ B cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ST2⁺ EPs function as transient IL-33 scavengers during early life, attenuating its pro-asthmatic effects and preserving immune homeostasis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 10","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312581","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":"A Novel Cell Culture System to Improve MRGPRX2 Research in Human Skin Mast Cells","authors":"Zhuoran Li,&nbsp;Jean Schneikert,&nbsp;Anja Wegner,&nbsp;Torsten Zuberbier,&nbsp;Magda Babina","doi":"10.1002/clt2.70112","DOIUrl":"10.1002/clt2.70112","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>MRGPRX2, a receptor central to mast cell (MC) activation and related skin diseases, is selectively expressed in skin MCs but downregulated during culture by stem cell factor (SCF) and interleukin-4 (IL-4).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify culture conditions that preserve MC viability while restoring MRGPRX2 expression and function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Human skin MCs were cultured in standard or serum-free Accell medium (both with SCF). After 3 days, MRGPRX2 expression was assessed by flow cytometry, degranulation by mediator release assays, and signaling by Western blotting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Accell medium increased MRGPRX2 expression to ~1.7-fold and enhanced degranulation to Substance P and codeine. It also promoted stronger and more sustained ERK and AKT phosphorylation, while FcεRI-mediated responses were largely unaffected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Short-term incubation in serum-free Accell medium restores MRGPRX2 expression and signaling in cultured skin MCs without impairing viability. This simple adjustment yields a practical and reliable model for MRGPRX2-focused studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 10","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299115","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":"Next Generation Sequencing of Genes With Epigenetic Alterations in Mastocytosis","authors":"Aleksandra Górska,&nbsp;Thierry van De Wetering,&nbsp;Marta Sobalska-Kwapis,&nbsp;Bogusław Nedoszytko,&nbsp;Danuta Gutowska-Owsiak,&nbsp;Marek Niedoszytko","doi":"10.1002/clt2.70106","DOIUrl":"10.1002/clt2.70106","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Mastocytosis is a neoplastic disease of the bone marrow associated with the risk of frequent and severe allergic reactions. However, the genetic predisposition is not fully understood, and the crucial element in pathogenesis is the presence of the oncogenic KIT p. D816 V gene mutation. The epigenetic mechanism has also been suggested as playing a role in mastocytosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Based on our previous epigenetic studies, we have selected 110 candidate genes which were sequenced by next generation sequencing (NGS) to identify somatic mutations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The study group consisted of 32 patients with mastocytosis (16 females and 16 males) plus 16 controls (8 females and 8 males). Whole peripheral blood was collected from all the subjects and genotyped by NGS on the Illumina platform (targeted sequencing).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We analysed 4272 genetic variations in the pre-selected candidate genes and found five regions that showed a significant difference between the patient and control group. Two of them were found in the <i>TET2</i> gene located on chromosome 4 and the other three alterations were found in the genes <i>DNMT3A</i>, <i>SETD2</i> and <i>BRD4</i> located on chromosomes 2, 3 and 19, respectively. Two out of the five genetic variants have not been previously reported, despite the fact that all four genes have been described to be associated with mastocytosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results align with our previous findings, which determined <i>TET2</i>, <i>DNMT3A</i>, <i>SETD2</i> and <i>BRD4</i> genes as promising candidates for further analysis, warranting future study in a larger cohort of mastocytosis patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 10","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198492","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":"Digital Monitoring of Symptoms and Lung Function During Birch Pollen Season in Pediatric Patients","authors":"Tiina Helena Tanninen,&nbsp;Paula Hannele Reiterä,&nbsp;Annika Saarto,&nbsp;Janne Burman,&nbsp;Anna Susanna Pelkonen,&nbsp;Mika Juhani Mäkelä","doi":"10.1002/clt2.70101","DOIUrl":"10.1002/clt2.70101","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mobile health (mHealth) applications for asthma and allergic rhinitis (AR) may guide patients in following medication use, symptoms, and lung function supporting self-management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The primary study objective was to investigate the objective effect of birch pollen on asthma and AR symptoms and medicine use in pediatric patients with varying levels of birch-specific immunoglobulin E (IgE) during the 2022 birch pollen season using digital tools. The secondary objectives were to determine the effect of birch pollen on Asthma Control Test scores, and to record the subjective benefits in self-management while using the application.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Altogether, 48 pediatric participants were categorized into three groups based on their birch-specific IgE levels. Participants continued their existing asthma control therapy. For allergic rhinitis and conjunctivitis, antihistamines, intranasal corticosteroids (INCS) or a combination of INCS and intranasal antihistamines, and cromoglicates or local antihistamines were prescribed. The study involved daily asthma and allergic rhinitis symptom and medication reporting via the mHealth application (KAMU Health, Finland) combined with microspirometry during the birch pollen season in Helsinki, Finland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The patients preferred oral AR treatment. However, the low birch pollen levels may have contributed to moderate adherence to AR treatment. A low birch pollen load does not significantly impair lung function in young patients receiving anti-asthmatic treatment regularly. The majority of patients perceived this digital approach as beneficial, irrespective of their level of birch-specific sensitization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Digital tools support asthma and AR care by enabling disease monitoring, patient engagement, and provide real-world insights for clinicians.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 10","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191299","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":"Improving Diagnostic Accuracy in Respiratory Allergy: Monocentric Reevaluation of the GA2LEN Panel in Germany","authors":"Caroline Beutner,&nbsp;Christian Meyer,&nbsp;Moritz Maximilian Hollstein,&nbsp;Katharina Klara Hahn,&nbsp;Michael Peter Schön,&nbsp;Timo Buhl","doi":"10.1002/clt2.70102","DOIUrl":"https://doi.org/10.1002/clt2.70102","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>European guidelines recommend using a standardized baseline series of skin prick test (SPT) allergens for the diagnosis of airway allergies. In addition, local adaptation and/or extension of test panels according to regional exposure and sensitization patterns are increasingly being discussed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Regional sensitization rates according to SPTs based on the most recent GA²LEN baseline series in Central Germany were retrospectively analyzed for 960 consecutive patients with respiratory symptoms at our university outpatient clinic. Additional SPT allergens of interest were further analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>High sensitization rates to the baseline SPT series were observed in our highly selected study cohort. The positivity rates were particularly high for olive pollen (30.8%) and plantain pollen (33.4%). Positive olive and birch pollen SPTs were found in 98.5% of olive-ash-birch pollen tested patients. High SPT positivity rates (98.1%) for plane tree and olive tree pollen were found, whereas only six patients (1.9%) were diagnosed with exclusive cypress pollen sensitization. Subgroup analysis of SPTs for palm tree pollen revealed that 92% of patients with palm tree positivity showed polysensitization, and all but one patient had concomitant grass pollen sensitization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Regular evaluations of SPT series may be necessary because of climate change, extract production, and increasing population mobility. Ash and cypress pollen extracts could currently be removed from the baseline SPT panel without significantly decreasing diagnostic accuracy. Positive SPTs to non-native palm tree pollen may indicate the presence of IgE to cross-reacting panallergens, which may help to differentiate primary sensitization from cross-reactivity directly. Limitations include the retrospective monocentric design and lack of molecular IgE confirmation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 10","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129346","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":"Identifying Genetic Variants in Patients With Cefaclor-Induced Anaphylaxis Using Human Leukocyte Antigen Typing and Whole-Exome Sequencing","authors":"Sung-Ryeol Kim,&nbsp;Da Eun Lee,&nbsp;Hyun Young Jung,&nbsp;In-Wha Kim,&nbsp;Hye-Ryun Kang,&nbsp;Kyung Hee Park,&nbsp;Jung-Won Park,&nbsp;Jung-Mi Oh,&nbsp;Jae-Hyun Lee","doi":"10.1002/clt2.70103","DOIUrl":"10.1002/clt2.70103","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cefaclor is a commonly prescribed β-lactam antibiotic and a known major cause of immediate-type drug hypersensitivity in Korea. However, its genetic risk factors remain poorly understood. We aimed to identify genetic variants associated with cefaclor-induced anaphylaxis and evaluate their potential clinical implications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Whole-exome sequencing and HLA genotyping were performed in 33 patients with cefaclor-induced anaphylaxis and 41 drug-tolerant controls. Associations were assessed using logistic regression. Selected variants were validated in an independent Korean population. Gene set enrichment analysis (GSEA) was performed using association statistics from all variants to investigate relevant biological pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A rare missense variant, rs765144578 in <i>TPSAB1</i> was strongly associated with anaphylaxis and remained significant in the validation control group. It was found in 90.91% of patients with hypotension, suggesting a link to reaction severity. Rs192498095 in HLA-DRB5 showed a significant association in the discovery cohort. However, it was not detected in the replication set, likely due to its rarity and polymorphic nature. Co-occurrence of rs765144578 in <i>TPSAB1</i> and rs192498095 in <i>HLA-DRB5</i> markedly increased risk. GSEA revealed significant enrichment of the TNF-α signaling via NF-κB pathway, reflecting pathway-level immune activation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Genetic variants in <i>TPSAB1</i> and <i>HLA-DRB5</i> may contribute to the risk of cefaclor-induced anaphylaxis, and <i>TPSAB1</i> may also be associated with severity. These findings may support the development of future screening strategies or individualized risk prediction models in β-lactam allergy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 9","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091199","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":"Reference Values and Determinants of Fractional Exhaled Nitric Oxide in a Representative Adult Population in Western Sweden","authors":"Reshed Abohalaka,&nbsp;Selin Ercan,&nbsp;Lauri Lehtimäki,&nbsp;Saliha Selin Özuygur Ermis,&nbsp;Daniil Lisik,&nbsp;Muwada Bashir Awad Bashir,&nbsp;Radhika Jadhav,&nbsp;Linda Ekerljung,&nbsp;Göran Wennergren,&nbsp;Jan Lötvall,&nbsp;Teet Pullerits,&nbsp;Helena Backman,&nbsp;Madeleine Rådinger,&nbsp;Bright I. Nwaru,&nbsp;Hannu Kankaanranta","doi":"10.1002/clt2.70107","DOIUrl":"10.1002/clt2.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Fractional exhaled nitric oxide (FE_NO) is used to differentiate asthma inflammatory phenotypes and guide its management. However, data on FE_NO reference values in a representative adult population is limited. We aim to derive reference values and determinants of FE_NO in a representative adult population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The West Sweden Asthma Study is a clinical-epidemiological population-representative study of randomly selected adults in Western Sweden. From this cohort, 943 subjects participated in comprehensive clinical investigations, including skin prick testing (SPT), specific immunoglobulin E (sIgE) analysis, and FE_NO measurement. Clinical allergy was defined as co-occurrence of atopy (positivity to SPT or sIgE) and self-reported allergic symptoms to the same allergen family. FE_NO levels were analysed in relation to the presence or absence of clinical allergy, asthma, and other factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 95^th percentile of FE_NO ranged from 34 parts per billion (ppb) in those between 30 and 40 years old to 52 ppb in those ≤ 30 years old in the entire sample (<i>N</i> = 943), and from 26 to 37 ppb in those without clinical allergy, asthma, or chronic obstructive pulmonary disease (COPD) (<i>n</i> = 587), depending on age. Sex, smoking, clinical allergy, atopy, asthma, and hypertension influenced FE_NO levels, meanwhile, age, asthma, clinical allergy, and reversibility-related variables were significant determinants of FE_NO levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The 95^th percentile (upper normal limit) for FE_NO ranges from 34 to 52 ppb overall, and from 26 to 37 ppb in those without clinical allergy, asthma, or COPD, depending on age. These findings provide a guide for interpreting FE_NO in the general population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 9","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085100","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}