Clinical and Translational Allergy最新文献

{"title":"The Role of Air Pollution in the Pathogenesis of Atopic Dermatitis, With a Focus on Oxidative Stress","authors":"Chen-Xi Liu,&nbsp;Li Li,&nbsp;Yue-Ping Zeng","doi":"10.1002/clt2.70104","DOIUrl":"10.1002/clt2.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atopic Dermatitis (AD) is a chronic inflammatory skin condition characterized by intensely itchy eczematous lesions and dryness. Recent epidemiological studies have indicated a notable increase in the prevalence of AD in industrialized countries, suggesting that air pollution may significantly influence the onset and progression of AD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Body</h3>\u0000 \u0000 <p>This review primarily describes the mechanistic roles of major air pollutants in the pathogenesis of AD, focusing particularly on oxidative stress, skin barrier dysfunction, and immune dysregulation. Moreover, the potential of targeting these pathways to prevent and manage AD is discussed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Air pollution contributes to the pathogenesis of AD by inducing oxidative stress, skin barrier dysfunction, and immune dysregulation through pathways such as AhR and NF-κB. Mitigating its impact necessitates both personal protective measures and public health policies. Future research should investigate pollutant-climate interactions and develop novel therapies targeting these mechanisms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 9","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069160","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":"Persistent Off-Season Dysregulation of Memory B Cell Subsets in Allergic Rhinitis","authors":"Maryam Jafari,&nbsp;Eric Hjalmarsson,&nbsp;Laila Hellkvist,&nbsp;Eirini Paziou,&nbsp;Agnetha Karlsson,&nbsp;Susanna Kumlien Georén,&nbsp;Lars-Olaf Cardell","doi":"10.1002/clt2.70100","DOIUrl":"https://doi.org/10.1002/clt2.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Allergic rhinitis (AR) is a common allergic airway disease. Although B cells play essential roles in AR pathogenesis, their subset distribution outside the allergen exposure period remains poorly characterized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To profile peripheral blood B cell subsets in AR patients during the pollen-free season and compare them with healthy controls (HC), aiming to identify persistent immunological alterations and potential biomarkers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Peripheral blood mononuclear cells (PBMCs) were collected from a total of 28 participants, 14 patients with allergic rhinitis (AR) and 14 healthy controls (HC) during the off-season. B cell subsets were identified using flow cytometry based on IgD and CD27 expression, classifying cells as naïve (IgD⁺CD27⁻), unswitched memory (IgD⁺CD27⁺), switched/conventional memory (IgD⁻CD27⁺), and unconventional memory B cells (IgD⁻CD27⁻). CD38 and CD24 were utilized to further distinguish transitional, naïve, memory, and plasma cell phenotypes. Immunoglobulin isotypes (IgG1-4, IgA1⁺/IgA2⁺) were assessed specifically within conventional memory B cells, while CD86 expression was evaluated on IgM⁺ memory-like and naïve B cells. Additionally, kappa (<i>κ</i>) and lambda (<i>λ</i>) light chain usage was analyzed to assess light chain distribution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AR patients displayed lower frequencies of IgG1⁺, IgG2⁺, and IgA1⁺/IgA2⁺ memory B cells, along with elevated frequencies of IgG4⁺ and κ⁺ B cells. Additionally, CD86⁺IgM⁺ memory-like B cells were significantly reduced in AR, suggesting altered activation dynamics. No significant differences were observed in CD24/CD38 profiling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Even outside allergen exposure, AR patients exhibit systemic B cell dysregulation, characterized by skewed class switching, altered subset distribution, and reduced activation markers expression. These findings underscore persistent immune imbalance in AR, identify potential off-season biomarkers of allergic inflammation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 9","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038056","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":"Sputum Eosinophil and Macrophage Changes After Aspirin Challenge in Patients With Nonsteroidal Anti-Inflammatory Drug–Exacerbated Respiratory Disease","authors":"Gabriela Trąd-Wójcik,&nbsp;Piotr Szatkowski,&nbsp;Adam Ćmiel,&nbsp;Radosław Kacorzyk,&nbsp;Adam Stępień,&nbsp;Lucyna Mastalerz","doi":"10.1002/clt2.70079","DOIUrl":"https://doi.org/10.1002/clt2.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Induced sputum cell count is crucial for assessing airway inflammatory phenotypes. This study investigated how aspirin-induced bronchospasm affects sputum cell counts in patients with nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD), comparing systemic versus local aspirin administration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy-eight patients with N-ERD and 39 with aspirin-tolerant asthma (ATA) participated. In the N-ERD group, induced sputum was collected before aspirin challenge and during aspirin-induced bronchospasm. We assessed changes in the percentages of eosinophils, neutrophils, lymphocytes, and macrophages, and airway inflammatory phenotypes classified by sputum cells into: (A) eosinophilic, neutrophilic, paucigranulocytic, and mixed; and (B) eosinophilic and noneosinophilic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline sputum neutrophil percentage was lower in the N-ERD than in the ATA (32.9% ± 20.8% vs. 41.6% ± 22.5%; <i>p</i> = 0.02). Inflammatory phenotypes at baseline differed between groups in both classifications (A: <i>p</i> = 0.041; B: <i>p</i> = 0.044). In the N-ERD group, sputum eosinophil percentage decreased after both oral (8.9% ± 11.6% vs. 6.1% ± 8.9%, <i>p</i> = 0.009) and inhaled (10.4% ± 16.1% vs. 4.8% ± 6.3%, <i>p</i> = 0.045) challenges, without altering inflammatory phenotypes. The ATA group showed no changes. Sputum macrophage percentage dropped after oral challenge in both groups (N-ERD: 40.5% ± 18.5% vs. 35.6% ± 21.5%; <i>p</i> = 0.004; ATA: 36.5% ± 23.6% vs. 26.7% ± 20.4%; <i>p</i> = 0.0003). In the N-ERD group, baseline sputum lymphocyte and eosinophil percentages were inversely correlated with the provocative dose of aspirin that resulted in a 20% decrease in baseline forced expiratory volume in 1 s following oral aspirin challenge (<i>R</i> = −0.31, <i>p</i> = 0.02 and <i>R</i> = −0.33, <i>p</i> = 0.02, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In N-ERD, sputum eosinophil percentage decreased after aspirin challenge regardless of administration route. In both N-ERD and ATA, sputum macrophage percentage decreased after oral aspirin challenge.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 9","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145021827","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":"Innovative Strategies to Reduce Exposure and Expression of the Major Cat Allergen Fel d 1","authors":"Simone Colosimo,&nbsp;Cristiana Indolfi,&nbsp;Vittoria Frattolillo,&nbsp;Gianluca Mondillo,&nbsp;Alessandra Perrotta,&nbsp;Mariapia Masino,&nbsp;Fabio Decimo,&nbsp;Michele Miraglia del Giudice","doi":"10.1002/clt2.70098","DOIUrl":"https://doi.org/10.1002/clt2.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Fel d 1, the primary allergen produced by cats, is a glycoprotein found mainly in their salivary and sebaceous glands. Due to its small size and stability, it easily becomes airborne and adheres to surfaces, posing a persistent problem for allergic individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This article reviews innovative strategies aimed at reducing Fel d 1 expression and exposure and mitigating its allergic effects on humans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A key approach involves dietary supplementation with chicken egg-derived IgY antibodies specific to Fel d 1. These antibodies neutralize the allergen in the saliva, significantly reducing its transfer to the fur and environmental presence, with clinical studies showing a notable decrease in nasal symptoms among allergic individuals. Additional dietary factors, such as omega-3 fatty acids, polyphenols, and low-glycemic index foods, may further modulate allergen production via hormonal and sebaceous pathways. Immunotherapy options include the Fel-CuMV vaccine for cats and human-targeted treatments with monoclonal antibodies like REGN1908-1909, both of which demonstrate significant reductions in allergic symptoms. Genetic modification and hormonal manipulation (e.g., neutering) offer further avenues to lower Fel d 1 expression. Environmental strategies, including HEPA filters and protease treatments, can also help reduce allergen load in households.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Together, these approaches form a multifaceted framework for managing cat allergies, potentially allowing allergic individuals to coexist with their pets. Future research should aim to optimize these interventions and explore synergistic combinations to achieve more effective and personalized allergy management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Message</h3>\u0000 \u0000 <p>This review summarizes innovative methods for reducing Fel d 1 production in cats, including genetic, immunological and dietary approaches, with potential implications for allergy prevention in humans.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 9","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012656","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":"Early Changes in House Dust Mite Component Specific Immunoglobulin Levels Predict the One-Year Efficacy of Allergen Immunotherapy in Patients With Allergic Rhinitis","authors":"Shuying Li,&nbsp;Yue Ma,&nbsp;Jiaying Li,&nbsp;Xian Feng,&nbsp;Fang Xiong,&nbsp;Miaomiao Han,&nbsp;Huabin Li,&nbsp;Hongfei Lou","doi":"10.1002/clt2.70099","DOIUrl":"https://doi.org/10.1002/clt2.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The efficacy of subcutaneous immunotherapy (SCIT) in allergic rhinitis (AR) patients varies. Component-resolved diagnostics (CRD) may serve as a useful tool to predict therapeutic responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-three house dust mite (HDM)-sensitized AR patients undergoing SCIT were enrolled. Clinical data and serum samples were collected at baseline (V1), 15 weeks (V2), and 1 year (V3). The levels of specific immunoglobulin E (sIgE) and sIgG4 to nine HDM components were measured, and a predictive model was established. An independent prospective cohort of 23 patients was used for validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The most prevalent sensitizing components were <i>Dermatophagoides pteronyssinus</i> (Der p) 1<i>, Dermatophagoides farinae</i> (Der f) 1, Der p 2, Der f 2, and Der p 23. The responders had a significantly higher Combined Symptom and Medication Score (CSMS) at baseline than did the nonresponders. At V2, the responders showed a greater increase in serum levels of Der f 1 sIgE, higher levels of Der p 23 sIgG4, and greater incremental changes in Der p 23 sIgG4 levels. A composite model based on V1 CSMS, ∆_15w Der f 1 sIgE, and ∆_15w Der p 23 sIgG4 achieved an area under the receiver operating characteristic curve (AUC) of 0.896 (cutoff: 0.455), with 83.3% sensitivity and 84.0% specificity. In the validation cohort, the model showed a 75.0% positive predictive value, 86.7% negative predictive value, and 82.6% overall accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A composite biomarker model based on HDM component responses enabled early prediction of SCIT efficacy, supporting more personalized treatment strategies for AR management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 9","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012228","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":"Subcutaneous Allergen-Specific Immunotherapy for Allergic Rhinitis: Divergent IgA Responses in Nasal Mucosa and Blood With Validation of B Cell Class-Switching in Lymph Nodes and Blood","authors":"Maryam Jafari,&nbsp;Marianne Petro,&nbsp;Eirini Paziou,&nbsp;Eric Hjalmarsson,&nbsp;Agnetha Karlsson,&nbsp;Monika Ezerskyte,&nbsp;Laila Hellkvist,&nbsp;Susanna Kumlien Georén,&nbsp;Eduardo I. Cardenas,&nbsp;Lars-Olaf Cardell","doi":"10.1002/clt2.70097","DOIUrl":"https://doi.org/10.1002/clt2.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Subcutaneous immunotherapy (SCIT) has been a cornerstone treatment for allergic rhinitis (AR) for over 50 years, consistently demonstrating symptom reduction and modulation of immune responses. Despite this, the underlying mechanisms responsible for the efficacy of SCIT remain incompletely understood, especially with regard to local immune responses in lymph nodes and nasal mucosa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To determine the impact of SCIT treatment on immunoglobulin production in blood and nasal mucosa, as well as B cell class-switching in blood and lymph nodes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>Blood, nasal lavage (NAL), and fine-needle aspirates (FNA) of inguinal lymph nodes were collected from 23 patients with birch and/or timothy pollen-induced AR before and after SCIT updosing. General response to SCIT was evaluated with symptom and medication scores, as well as allergen-mediated activation of basophils. Allergen-specific IgE, IgA, IgG, and IgG4 were measured in blood and NAL via ELISA. B-cell class-switching was assessed in blood and FNAs by flow cytometry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AR symptoms, medication use, and basophil sensitivity to allergens was reduced after SCIT updosing. Interestingly, the plasma levels of allergen-specific IgA, IgG, and IgG4 increased after SCIT updosing, while the levels of allergen-specific IgE and IgA decreased in NAL at this timepoint. Moreover, these results were accompanied by an increase in conventional (IgD⁻CD27⁺) and unconventional (IgD⁻CD27⁻) memory B cells in blood and lymph nodes, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the differential effects of SCIT on local and systemic immunity and identifies early immunological changes associated with treatment. However, confirmation of long-term tolerance will require extended follow-up, including in-season analyses. The local decrease in allergen-specific IgA in NAL, alongside a systemic increase in allergen-specific IgA and IgG4, underscores the importance of assessing both mucosal and systemic responses when evaluating SCIT efficacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 9","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144927676","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":"Characterization of Chronic Rhinosinusitis Patients Based on Markers of Type 2 Inflammation: Findings From the European CRS Outcome Registry (CHRINOSOR)","authors":"Carlo Cavaliere,&nbsp;Sven F. Seys,&nbsp;Joost de Kinderen,&nbsp;Giulia Bettio,&nbsp;Alexandros Andrianakis,&nbsp;Isam Alobid,&nbsp;Peter W. Hellings,&nbsp;Laura Van Gerven,&nbsp;Valérie Hox,&nbsp;Claire Hopkins,&nbsp;Anette Kjeldsen,&nbsp;Sietze Reitsma,&nbsp;Sven Schneider,&nbsp;Peter-Valentin Tomazic,&nbsp;Zuzana Diamant,&nbsp;Julia Eckl-Dorna,&nbsp;Wytske J. Fokkens,&nbsp;Clemens Holzmeister,&nbsp;Kenneth Larsen,&nbsp;Anu Laulajainen-Hongisto,&nbsp;Antonella Loperfido,&nbsp;Valerie Lund,&nbsp;Gert Mariën,&nbsp;Simonetta Masieri,&nbsp;Geoffrey Mortuaire,&nbsp;Mathilde Moyaert,&nbsp;Joaquim Mullol,&nbsp;Josje Otten,&nbsp;Camilo Rodriquez-Van Strahlen,&nbsp;Martin Wagenmann,&nbsp;Claus Bachert","doi":"10.1002/clt2.70095","DOIUrl":"https://doi.org/10.1002/clt2.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Primary chronic rhinosinusitis (CRS) can be classified based on the sinuses involved and the dominant endotype of the mucosal inflammation. Since the introduction of type 2 targeted biologics as treatment option for CRS, assessment of the inflammatory status has gained importance in CRS patients. We here aimed to characterize CRS patients with and without elevated markers of type 2 inflammation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>CRS patients who visited the outpatient ENT clinic in one of the 10 tertiary centers in 7 European countries were invited to use the Galenus Health mobile application for the monitoring of their disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CRS patients (<i>n</i> = 281) were stratified according to blood eosinophil counts or BEC (&lt; 150 cells/μL: 21.6% of patients, ≥ 150 cells/μL: 78.4%; &lt; 250 cells/μL: 36.3%, ≥ 250 cells/μL: 63.7%) and serum total IgE (&lt; 100 IU/mL: 59.9%, ≥ 100 IU/mL: 40.1%). BEC and serum total IgE did not correlate well (Spearman <i>r</i> = 0.06; <i>p</i> = 0.39). CRS patients with BEC ≥ 150 cell/μL or ≥ 250 cells/μL, respectively, showed increased NPS, SNOT-22, VAS for total CRS symptoms, loss of smell, nasal blockage, runny nose compared to patients with BEC below 150 or 250 cells/μL. CRS patients with increased serum total IgE (≥ 100 IU/mL) did not show differences in the outcome parameters compared to patients with levels below 100 IU/mL. CRS patients with asthma (58.9%) showed increased SNOT-22 and VAS loss of smell compared to patients without asthma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A significant proportion of CRS patients exhibit a type 2 endotype, characterized by blood eosinophilia (78%), increased serum total IgE (40%) and/or concomitant asthma (59%). Our results underline the usefulness of eosinophils as a marker of type 2 inflammation and severity but challenge the utility of serum total IgE since it does not correlate with any of the markers of severity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 9","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923750","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":"Evaluation of Diagnosis, Cross-Reactivity, and Risk Factors in Pediatric Patients With Macrolide Allergy","authors":"Güler Yıldırım,&nbsp;Merve Karaca Şahin,&nbsp;Nilay Çalışkan,&nbsp;Hamit Boloğur,&nbsp;Muhammed Fatih Erbay,&nbsp;Hilal Güngör,&nbsp;Şefika İlknur Kökçü Karadağ,&nbsp;Aslı Berivan Topçak,&nbsp;Deniz Özçeker","doi":"10.1002/clt2.70096","DOIUrl":"https://doi.org/10.1002/clt2.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Macrolide antibiotics are generally considered safe in children, but allergic reactions can still occur. This study aims to evaluate the sensitivity and specificity of intradermal test (IDT) used to detect macrolide allergy in pediatric patients, investigate the rate of cross-reactivity between clarithromycin and azithromycin, and identify factors influencing the development of macrolide allergy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 102 patients with suspected clarithromycin and azithromycin allergy were included in the study. Characteristics of the reactions and results of skin and drug oral provocation test (OPT) were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Clarithromycin was confirmed as the culprit drug in 8 (9%) of 88 patients, and azithromycin in 1 (7.1%) of 14 patients. The cross-reactivity between clarithromycin and azithromycin determined 11.1%. In patients with immediate-type reactions, IDT performed at a concentration of 0.05 mg/mL demonstrated a sensitivity of 33.3% (95% CI: 0.0%–66.7%) and a specificity of 92.7% (95% CI: 82.9%–100%). When a higher concentration of 0.5 mg/mL was used, sensitivity increased to 100% (95% CI: 0.0%–100%), while specificity decreased to 78.9% (95% CI: 65.8%–92.1%) respectively. According to univariate logistic regression analysis, patients with a history of previous non-macrolide drug allergy (<i>p</i>: 0.003, Odds Ratio [OR]: 41, 95% CI: 3.6–456.5) and family history of drug allergy (<i>p</i> = 0.026, OR: 5.2, 95% CI: 1.2–22.5) were at a significantly higher risk of developing macrolide allergy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although IDT at a concentration of 0.05 mg/mL showed higher specificity (92.7%) compared to 0.5 mg/mL (78.9%), given its limited sensitivity, OPT is still required to confirm the diagnosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 9","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144897245","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":"Implementation of Rapid Drug Desensitization in Antineoplastic Drug Therapy in Denmark Using One-Bag Protocols","authors":"Trine Holm Rasmussen,&nbsp;Charlotte Gotthard Mortz,&nbsp;Per Pfeiffer,&nbsp;Nina Andersen,&nbsp;David George Mawn,&nbsp;Line Kring Tannert,&nbsp;Millie Nguyen Basu,&nbsp;Helene Marlies Rasmussen,&nbsp;Carsten Bindslev-Jensen","doi":"10.1002/clt2.70093","DOIUrl":"https://doi.org/10.1002/clt2.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rapid drug desensitization (RDD) is the cornerstone of managing patients with immediate drug hypersensitivity reactions (IDHR) to antineoplastic drugs in Southern Europe and the United States. As the first in Northern Europe, an allergy treatment program that includes RDD and drug provocation testing (DPT) was implemented for Danish patients with cancer. We report the results of this allergy intervention, the number of successful treatments, the fraction, timing and severity of breakthrough reactions (BTR) and the actual treatment duration of RDD procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective observational study. Patients with IDHRs to antineoplastic drugs referred to the allergy treatment program were included. Patients were followed up until finalization of DPT and/or RDD. RDDs were performed according to one-bag RDD-protocols with drug concentrations strictly following manufacturer's instructions and infusion sets primed with flushing fluid. The outcome of DPTs and RDDs were recorded together with detailed information on BTRs and treatment duration of RDD-procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During 28 months, 72 patients were included. With DPT, a safe drug alternative was found for five drugs, hypersensitivity was ruled out for six, and one treatment was discontinued after a positive DPT. RDD was performed in 60 patients. Of 248 initiated RDD procedures, 247 were completed. BTRs were observed in 53% of patients and 27% of RDD-procedures, with most BTRs being mild to moderate. The treatment duration was below 6 hours in 96% of RDD procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The allergy treatment program, which included DPT and one-bag RDD-protocols, allowed patients to continue critical antineoplastic treatments despite IDHRs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 8","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832651","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":"The usefulness of the basophil activation test for monitoring the effectiveness of wasp venom immunotherapy in different age groups","authors":"Andrzej Bozek,&nbsp;Martyna Miodonska,&nbsp;Aleksandra Mitka,&nbsp;Dominika Sadowska,&nbsp;Janne Winterstein,&nbsp;Radosław Gawlik,&nbsp;Marita Nittner-Marszalska","doi":"10.1002/clt2.70073","DOIUrl":"https://doi.org/10.1002/clt2.70073","url":null,"abstract":"<p>To the Editor,</p><p>Allergen immunotherapy (AIT) remains a well-established and widely used approach for treating immediate type allergies including allergic rhinitis and conjunctivitis, certain forms of allergic asthma, select food allergies, and allergic reactions to Hymenoptera insect venom immunotherapy (VIT). Currently, VIT is the only causative and, in some cases, can be life-saving.<span>¹</span></p><p>AIT has been proven to be effective for most age groups, including patients over 60 years old.<span>²</span> However, limited studies have confirmed the safety and effectiveness of VIT in these populations.<span>²</span> This is particularly important in cases of anaphylactic reactions following an insect sting, which is an indication for VIT also in the oldest patients.<span>³</span></p><p>Therefore, evaluating of the effectiveness of VIT and the rate at which tolerance to the venom develops is of key importance. The basophil activation test (BAT) can be the optimal tool for such an evaluation. The BAT is a valuable tool for final qualification for VIT and often resolves doubts.<span>^{4, 5}</span> The most diagnostically valuable method for assessing the effectiveness of VIT is the live insect sting challenge (SP). However, SP has significant limitations, including the necessity of conducting it in highly specialized centers, the risk of complications, including those related to the application of the full, unfractionated dose of the allergen, and the potential risk of reactivating the allergic state. Unlike SP, the BAT for assessing VIT effectiveness is free of these limitations.<span>⁶</span></p><p>The authors would like to present an assessment of the efficacy of VIT for wasp venom after 1 year of treatment in different age groups, comparing the efficacy in young and old patients to identify potential differences. This builds of an earlier observational study, which confirmed comparable efficacy after 6 months of VIT initiation in people aged 18–35 and over 60 years in the BAT test.<span>⁷</span> These results were independent of the type of vaccine used Venomenhal (Hal Allergy) or Diater.</p><p>In the second part of observation, the study group was slightly reduced (drop-out due to patients' resignation despite the effectiveness of the treatment and the lack of adverse effects), and its final characteristics are presented in Table 1.</p><p>The methodology of the BAT assessment and the entire study protocol were described and consistent with the published first part of the study.<span>⁷</span></p><p>The effectiveness of VIT was evaluated using BAT, revealing a statistically significant decrease in CD63 reactivity in the mean of about 86%–88% from the base for older patients similarly, as in young 84%–85% (<i>p</i> &gt; 0.05) after 6 months of VIT. Similar trends were observed after next 6 months, and a comparable decrease in basophil activity was ma","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 8","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832650","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}