Oliver Pfaar, Anju T. Peters, Camille Taillé, Thijs Teeling, Jared Silver, Robert Chan, Peter W. Hellings
{"title":"Chronic rhinosinusitis with nasal polyps: Key considerations in the multidisciplinary team approach","authors":"Oliver Pfaar, Anju T. Peters, Camille Taillé, Thijs Teeling, Jared Silver, Robert Chan, Peter W. Hellings","doi":"10.1002/clt2.70010","DOIUrl":"10.1002/clt2.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a recurrent inflammatory disease associated with several comorbidities and a significant disease burden for patients. Treatments include corticosteroids and sinonasal surgery, but these can be associated with the risk of adverse events and nasal polyp recurrence. Biologic treatments such as mepolizumab can be used as an add-on treatment and are effective at reducing surgery and corticosteroid use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main text</h3>\u0000 \u0000 <p>Patients with CRSwNP may be seen by a specialist in one of several different areas and often experience delayed diagnosis due to the need to see multiple physicians, as well as misdiagnosis resulting from lack of sufficient expertise within any one speciality. Multidisciplinary team (MDT) approaches have been shown to be effective in optimising the treatment and clinical management of other respiratory diseases, such as aspirin-exacerbated respiratory disease and severe asthma. In CRSwNP, an MDT approach may reduce diagnostic delays, mitigate secondary disease burden, and reduce overprescription of corticosteroids and antibiotics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This article provides an overview of the patient perspective of MDTs, existing approaches and barriers to adoption, lessons learnt from allied and rare diseases, how to address under-recognised aspects of CRSwNP, and other key considerations for developing an MDT approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963242","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}
Carl Skröder, Laila Hellkvist, Ulla Westin, Pernilla Sahlstrand-Johnsson, Kerstin Hansson, Agneta Karlsson, Åslög Dahl, Leif Bjermer, Lars Olaf Cardell
{"title":"Prednisolone versus antihistamine for allergic rhinitis: No significant difference found in randomized trial","authors":"Carl Skröder, Laila Hellkvist, Ulla Westin, Pernilla Sahlstrand-Johnsson, Kerstin Hansson, Agneta Karlsson, Åslög Dahl, Leif Bjermer, Lars Olaf Cardell","doi":"10.1002/clt2.70017","DOIUrl":"10.1002/clt2.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Seasonal allergic rhinitis (AR) impacts public health by affecting work productivity and quality of life. The Swedish tree pollen season starts in February with alder and hazel pollination, followed by birch and ends with oak in May. Systemic corticosteroids are often prescribed when topical treatments fail, despite limited evidence supporting their efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the effectiveness of prednisolone tablets versus antihistamine tablets in reducing symptoms and medication usage in patients with moderate to severe tree pollen-induced AR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This interventional single-center, double-blinded randomized trial included 34 patients. Treatment was initiated, and symptoms were registered during the tree pollen season. The two groups received either prednisolone tablets (20 mg) or ebastine tablets (20 mg) for 7 days. Treatment effects were evaluated by comparing daily symptom scores, use of topical medication, and a combined symptom-medical score between the groups. Quality of life was recorded at the start and after 3 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both interventions demonstrated efficacy in enhancing quality of life metrics. The area under the curve (AUC) for the combined symptom severity and medication usage score averaged 34.0 (SD = 19.1, 95% CI = 24.5–43.4) in the group treated with prednisolone. This was marginally lower than the control group, with an AUC of 32.6 (SD = 13.2, 95% CI = 25.6–39.7). The difference was not statistically significant (<i>p</i> = 0.80). Both groups exhibited only mild adverse events, which were statistically comparable in frequency and severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Prednisolone tablets did not show superior efficacy over antihistamine tablets in reducing symptoms or medication usage in tree pollen-induced AR. These results suggest that systemic corticosteroids may not provide additional benefits over antihistamines, and clinicians should prioritize individualized treatment based on patient preferences and tolerability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945735","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}
Wenhui Chen, Xiaofang Liu, Xiujuan Yao, Yanghe Hao, Zhuo Zhou, Chengshuo Wang, Ming Wang, Luo Zhang
{"title":"Total immunoglobulin E levels in induced sputum reflect asthma control status","authors":"Wenhui Chen, Xiaofang Liu, Xiujuan Yao, Yanghe Hao, Zhuo Zhou, Chengshuo Wang, Ming Wang, Luo Zhang","doi":"10.1002/clt2.70021","DOIUrl":"10.1002/clt2.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Most patients with severe asthma are sensitized to at least one allergen. Whether local immunoglobulin E (IgE) in induced sputum reflects asthma control status has not been investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with asthma were classified as well controlled, partly controlled, and uncontrolled asthma (UCA) according to Global Initiative for Asthma 2022 guidelines. Lung function and fractional exhaled nitric oxide (FeNO) were evaluated. Induced sputum was collected and total IgE and Phadiatop (IgE to common inhalant allergens) measurements were performed. General clinical characteristics and pulmonary inflammation indicators were analyzed between the three groups of asthmatic patients. Univariate and multifactor ordinal logistic regression were used to model the relationship between pulmonary inflammation indicators and asthma control status. The ability of sputum total IgE in identifying different levels of asthma control was assessed by receiver operating characteristic curve (ROC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with UCA had worse lung function and airway inflammation as indicated by lower levels of forced expiratory volume in 1s (FEV1)%pred, FEV1/FVC, MEF75%pred, MEF50%pred and MEF25%pred, and higher levels of FeNO and sputum eosinophil% compared with the WCA group. In addition, higher levels of total sputum IgE and Phadiatop were found in patients with UCA than in patients with WCA and PCA. Univariate and multifactor ordinal logistic regression analysis indicated that sputum total IgE was the unique significant risk factor for poor asthma control (adjusted odds ratio = 6.25; 95% CI, 1.07–36.55; <i>p</i> < 0.05) among pulmonary inflammation indicators including different indices of pulmonary function test, sputum IgE and FeNO. Sputum total IgE levels showed a significant correlation with asthma control scores (<i>r</i> = 0.53, <i>p</i> < 0.001). Moreover, ROC analysis showed that the predictive value of sputum total IgE for patients with UCA was 0.82 (95% CI, 0.74–0.9).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Sputum total IgE reflects levels of asthma control, and can be used as an indicator of UCA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930737","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}
He Zhang, Yang Cao, Haibo Jiang, Qilin Zhou, Qintai Yang, Lei Cheng
{"title":"The present and future of digital health, digital medicine, and digital therapeutics for allergic diseases","authors":"He Zhang, Yang Cao, Haibo Jiang, Qilin Zhou, Qintai Yang, Lei Cheng","doi":"10.1002/clt2.70020","DOIUrl":"10.1002/clt2.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Digital health, digital medicine, and digital therapeutics integrate advanced computer technologies into healthcare, aiming to improve efficiency and patient outcomes. These technologies offer innovative solutions for the management of allergic diseases, which affect a significant proportion of the global population and are increasing in prevalence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Body</h3>\u0000 \u0000 <p>This review examines the current progress and future potential of digital health in allergic disease management. It highlights key advancements, including telehealth, mobile health (mHealth), artificial intelligence, clinical decision support systems (CDSS), and digital biomarkers, with a focus on their relevance to allergic disease management. The role of digital tools in improving treatment adherence, enabling remote care, and integrating environmental and patient data into personalized care models is discussed. Challenges such as data privacy, interoperability, and equitable access are addressed, alongside potential strategies to overcome these barriers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Digital therapy will play an important role in allergic diseases, and the further development of digital therapies will effectively promote the development of clinical research, digital biomarkers, hypoallergenic environments and digital twins. More research is needed to support the progress of digital therapy for allergic diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926668","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}
Sophia Neisinger, Pascale Salameh, Annika Gutsche, Felix Aulenbacher, Frank Siebenhaar, Marcus Maurer
{"title":"Disease control and quality of life in chronic spontaneous urticaria and recurrent angioedema are strongly linked, but not in all patients","authors":"Sophia Neisinger, Pascale Salameh, Annika Gutsche, Felix Aulenbacher, Frank Siebenhaar, Marcus Maurer","doi":"10.1002/clt2.70026","DOIUrl":"10.1002/clt2.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patient-reported outcome measures (PROMs) help to assess disease control and quality of life (QoL) in chronic spontaneous urticaria (CSU) and recurrent angioedema (RA). This study aimed to assess the correlation between two different concepts: disease control and QoL, using disease-specific PROMs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from 445 CSU and 330 RA patients who completed both a disease control and QoL PROM as part of the clinical routine. We included the UCT and CU-Q2oL for CSU and AECT and AE-QoL for RA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In CSU and RA, disease control scores positively correlated with QoL scores (Spearman's rho correlation coefficient (CR) −0.757, −0.735; <i>p</i> < 0.001) with better disease control corresponding to better quality of life. However, 5.9% of CSU patients and 28% of RA patients with complete disease control had impaired QoL. In CSU, QoL was impaired in 69.2% of patients based on the CU-Q2oL and in 62.7% of patients based on a single numeric question from the UCT, with a mismatch in 89/445 patients. In RA, QoL was impaired in 58.5% using the AE-QoL and in 52.7% using a single numeric question from the AECT30mo, with a mismatch in 69/330 patients. Different domains of the QoL PROMs showed different degrees of influence on disease control, with “Itching/Embarrassment” showing the strongest correlation with the UCT (CR −0.804; <i>p</i> < 0.001) and “Functioning” with the AECT3mo (CR −0.824; <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although most patients with controlled disease have better quality of life, unexpectedly, quality of life remains impaired in up to one-fourth of patients with completely controlled CSU and RA. Reasons behind this should be investigated in further studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926656","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}
Jorge Sánchez, Leidy Álvarez, José Ignacio Larco, Luis Ensina, Guillermo Guidos-Fogelbach, Cesar A. Reyes-López, German D. Ramon, Karla Robles-Velasco, Ivan Cherrez-Ojeda
{"title":"Cost-of-illness analysis of chronic urticaria clinical management in five countries of Latin America","authors":"Jorge Sánchez, Leidy Álvarez, José Ignacio Larco, Luis Ensina, Guillermo Guidos-Fogelbach, Cesar A. Reyes-López, German D. Ramon, Karla Robles-Velasco, Ivan Cherrez-Ojeda","doi":"10.1002/clt2.70016","DOIUrl":"10.1002/clt2.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Chronic spontaneous urticaria (CSU) is a disease with a high impact on the quality of life of patients. There are some evaluations of the economic cost of the disease in developed countries, but there is little information about the economic cost of the disease in developing countries. Our aim was to assess the economic diagnostic and therapeutic expenses of CSU in five Latin American (LA) countries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A noninterventional multicenter cross-sectional study was conducted in five LA countries: Brazil, Colombia, Ecuador, Mexico, and Peru. To determine the frequency of medical interventions as well as clinical and sociodemographic characteristics of CSU patients, questionnaires were administered to patients, primary care physicians, allergists, and dermatologists. In each country, diagnostics and therapeutic expenses were calculated by reviewing medical records, health insurance, and interviews. The main outcome was the yearly economic burden from the healthcare insurance perspective in each country.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>According to the projected costs, Brazil had the highest urticaria cost per patient/year (7009.4 USD), followed by Mexico (3695.1 USD), Ecuador (3132.8 USD), Peru (2693.9 USD), and Colombia (2392.8 USD); the cost and the frequency of use of omalizumab and antihistamines explain the total cost differences between countries. Interventions such as medical visits and exams had similar costs between countries and represented less than 10% of total urticaria cost analysis in the five countries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The cost of the CSU in LA varies widely based on the health insurance coverage, the cost of the therapies, and the frequency of therapies used. Strengthening national health systems, as well as following the recommendations of international guidelines, seems to reduce the cost of CSU and improve the quality of patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913879","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}
Antoine Deschildre, Montserrat Alvaro-Lozano, Antonella Muraro, Marcia Podesta, Debra de Silva, Mattia Giovannini, Simona Barni, Timothy E. Dribin, Mónica Sandoval-Ruballos, Aikaterini Anagnostou, Alessandro Fiocchi, Alice Toniolo, Andrew Bird, Angel Sánchez Sanz, Anna Asarnoj, Anna Nowak-Wegrzyn, Berber Vlieg-Boerstra, Brian P. Vickery, Carina Venter, Caroline Nilsson, Cecilia Parente, Céline Demoulin, David M. Fleischer, Diola Bijlhout, Edward F. Knol, Eleanor Garrow, Emma E. Cook, Fallon Schultz, Francesca Lazzarotto, Francesca Mori, Gary Wong, Gideon Lack, Graham Roberts, Gustavo Andres Marino, H. N. G. Oude Elberink, Helen A. Brough, Hugh A. Sampson, Jay Lieberman, Jennifer Gerdts, Jing Zhao, Josefine Gradman, Julia E. M. Upton, Julie Wang, Kati Palosuo, Kirsi M. Järvinen, Kirsten Beyer, Kunling Shen, Laura Polloni, Lianne Mandelbaum, Luciana Kase Tanno, Lucy A. Bilaver, Marcus S. Shaker, Margitta Worm, Maria Said, Mary Kelly, Mary Jane Marchisotto, Michael Makris, Mikaela Odemyr, Montserrat Fernandez-Rivas, Motohiro Ebisawa, Nandinee Patel, Pablo Rodríguez del Río, Pakit Vichyanond, Paul Turner, Pete Smith, Pilar Morón Gaspar, R. Sharon Chinthrajah, Rima Rachid, Roberta Bonaguro, Ruchi Gupta, Sabine Schnadt, Sakura Sato, Stefania Arasi, Stephanie Leonard, Sung Poblete, Susanne Halken, Thuy-My Le, Guillaume Pouessel, Tracey Dunn, Victoria Cardona, Torsten Zuberbier
{"title":"Towards a common approach for managing food allergy and serious allergic reactions (anaphylaxis) at school. GA2LEN and EFA consensus statement","authors":"Antoine Deschildre, Montserrat Alvaro-Lozano, Antonella Muraro, Marcia Podesta, Debra de Silva, Mattia Giovannini, Simona Barni, Timothy E. Dribin, Mónica Sandoval-Ruballos, Aikaterini Anagnostou, Alessandro Fiocchi, Alice Toniolo, Andrew Bird, Angel Sánchez Sanz, Anna Asarnoj, Anna Nowak-Wegrzyn, Berber Vlieg-Boerstra, Brian P. Vickery, Carina Venter, Caroline Nilsson, Cecilia Parente, Céline Demoulin, David M. Fleischer, Diola Bijlhout, Edward F. Knol, Eleanor Garrow, Emma E. Cook, Fallon Schultz, Francesca Lazzarotto, Francesca Mori, Gary Wong, Gideon Lack, Graham Roberts, Gustavo Andres Marino, H. N. G. Oude Elberink, Helen A. Brough, Hugh A. Sampson, Jay Lieberman, Jennifer Gerdts, Jing Zhao, Josefine Gradman, Julia E. M. Upton, Julie Wang, Kati Palosuo, Kirsi M. Järvinen, Kirsten Beyer, Kunling Shen, Laura Polloni, Lianne Mandelbaum, Luciana Kase Tanno, Lucy A. Bilaver, Marcus S. Shaker, Margitta Worm, Maria Said, Mary Kelly, Mary Jane Marchisotto, Michael Makris, Mikaela Odemyr, Montserrat Fernandez-Rivas, Motohiro Ebisawa, Nandinee Patel, Pablo Rodríguez del Río, Pakit Vichyanond, Paul Turner, Pete Smith, Pilar Morón Gaspar, R. Sharon Chinthrajah, Rima Rachid, Roberta Bonaguro, Ruchi Gupta, Sabine Schnadt, Sakura Sato, Stefania Arasi, Stephanie Leonard, Sung Poblete, Susanne Halken, Thuy-My Le, Guillaume Pouessel, Tracey Dunn, Victoria Cardona, Torsten Zuberbier","doi":"10.1002/clt2.70013","DOIUrl":"https://doi.org/10.1002/clt2.70013","url":null,"abstract":"<p>GA<sup>2</sup>LEN and EFA propose minimum specifications for all industrialised countries/regions to work towards to support students with food allergies in educational settings. We reviewed research and legislation and gained feedback from over 100 patient and professional groups. We built shared expectations around: 1. training all school staff about what food allergy is, the symptoms of allergic reactions, what to do in an emergency, and when and how to use and store devices that laypeople can use to administer adrenaline (epinephrine). 2. preventing allergic reactions by using clear labelling on school menus and prepacked and non-prepacked foods and regular cleaning where students eat. 3. preparing for serious allergic reactions, with written emergency action plans for every student with food allergies, legislation allowing schools to store adrenaline for anyone who needs it in an emergency (not just those prescribed it), and training and legal safeguards for staff administering adrenaline. 4. including affected students by discussing food allergy in the curriculum, raising awareness among all students and caregivers and reviewing school processes regularly. It is time for national and international action at the policy level. Patient groups, education networks and professional societies all play a role in campaigning for shared next steps.</p>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143120403","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}
Ajda Demšar Luzar, Jakob Otorepec, Mitja Košnik, Peter Kopač, Julij Šelb, Peter Korošec, Matija Rijavec
{"title":"Patients with detectable KIT p.D816V in peripheral blood are at high risk for adverse systemic events during venom immunotherapy and treatment failure","authors":"Ajda Demšar Luzar, Jakob Otorepec, Mitja Košnik, Peter Kopač, Julij Šelb, Peter Korošec, Matija Rijavec","doi":"10.1002/clt2.70019","DOIUrl":"https://doi.org/10.1002/clt2.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recent studies have highlighted the importance of routine screening for the somatic missense <i>KIT</i> p.D816V variant in peripheral blood leukocytes (PBL), and its association with severe sting anaphylaxis. Our study aimed to evaluate the clinical relevance of <i>KIT</i> p.D816V detected in PBL on systemic adverse events (SAEs) and the efficacy of venom immunotherapy (VIT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 839 patients receiving VIT. The <i>KIT</i> p.D816V variant was assayed with a highly sensitive, allele-specific, quantitative PCR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p><i>KIT</i> p.D816V was detected in the PBL of 125 (15%) of 839 VIT patients. The majority (70%, 88/125) of these individuals had normal BST levels. Notably, half of the <i>KIT</i>-positive patients receiving honeybee venom immunotherapy had SAEs during treatment (48%, 18/37; <i>p</i> = 0.0136), and the <i>KIT</i> p.D816V allele burden was higher than 0.01% in the majority of those patients (61%, 11/18). Furthermore, a significant difference was observed between <i>KIT</i>-positive and <i>KIT</i>-negative patients treated with VIT in the past and who experienced a recurrent reaction to a sting after treatment termination (VIT failure). <i>KIT</i>-positive patients with VIT failure had a higher allele burden than those with successful VIT (80% vs. 40% with a <i>KIT</i> p.D816V higher than 0.01%; <i>p</i> = 0.0019). <i>KIT</i> p.D816V was a predictor of SAEs during honeybee VIT (univariate; OR = 2.43, <i>p</i> = 0.012/multivariate; OR = 2.26, <i>p</i> = 0.033) and a strong predictor of VIT failure in patients treated with wasp venom (univariate; OR = 4.1, <i>p</i> = 0.002/multivariate; OR = 3.54, <i>p</i> = 0.008).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study revealed the high clinical relevance of <i>KIT</i> p.D816V detected in PBL. <i>KIT</i> p.D816V was a significant predictor of SAEs during honeybee VIT and a significant predictor of VIT failure after completing wasp VIT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143120401","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}
Piotr Szatkowski, Anna Gielicz, Adam Stępień, Patryk Hartwich, Radosław Kacorzyk, Hanna Plutecka, Adam Ćmiel, Gabriela Trąd-Wójcik, Marek Sanak, Lucyna Mastalerz
{"title":"Unique effect of aspirin on local 15-oxo-eicosatetraenoic acid synthesis in asthma patients with aspirin hypersensitivity","authors":"Piotr Szatkowski, Anna Gielicz, Adam Stępień, Patryk Hartwich, Radosław Kacorzyk, Hanna Plutecka, Adam Ćmiel, Gabriela Trąd-Wójcik, Marek Sanak, Lucyna Mastalerz","doi":"10.1002/clt2.70004","DOIUrl":"10.1002/clt2.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nonsteroidal anti-inflammatory drugs–exacerbated respiratory disease (NSAIDs-ERD) is characterized by altered arachidonic acid (AA) metabolism. Aspirin hypersensitivity is diagnosed using aspirin challenge, while induced sputum is collected to perform cell counts and to identify local biomarkers in induced sputum supernatant (ISS). This study aimed to assess the levels of a newly identified eicosanoid, 15-oxo-eicosatetraenoic acid (15-oxo-ETE), in ISS at baseline and during aspirin-induced bronchospasm in patients with NSAIDs-ERD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Oral aspirin challenge was performed in 27 patients with NSAIDs-ERD and in 17 patients with aspirin-tolerant asthma (ATA) serving as controls. Sputum was collected before and after aspirin challenge to determine eosinophil, neutrophil, macrophage, and lymphocyte counts as well as the concentration of AA metabolites via 15-lipoxygenase-1 (15-LOX-1) and 5-LOX pathways in ISS. Chromatography–tandem mass spectrometry was used to measure ISS levels of 15-oxo-ETE, 15-hydroxyeicosatetranoic acid (15-HETE), and leukotriene E<sub>4</sub> (LTE<sub>4</sub>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At baseline, ISS levels of 15-oxo-ETE were higher in NSAIDs-ERD than in ATA (<i>p</i> = 0.04). In contrast, baseline 15-HETE levels in ISS were lower in patients with NSAIDs-ERD (<i>p</i> = 0.03). After aspirin challenge, 15-oxo-ETE levels decreased only in patients with NSAIDs-ERD (<i>p</i> = 0.001) who developed bronchospasm. In both study groups, there was a reduction in sputum macrophage count after aspirin challenge (<i>p</i> = 0.03 and <i>p</i> = 0.02, respectively) irrespective of bronchospasm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with NSAIDs-ERD are characterized by higher baseline 15-oxo-ETE levels in ISS than patients with ATA. Aspirin-induced bronchospasm inhibited the local generation of 15-oxo-ETE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 12","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892678","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":"Role of eosinophil counts in mediating the association between asthma and colon cancer","authors":"Zhi-Qing Zhan, Ze-Min Huang, Zhi-Xin Xie, Hao-Bin Zhou, Yu-Hua Luo, Pei-Zhen Chen, Tian-Ye Luo, Baoqing Sun, Zhangkai J. Cheng","doi":"10.1002/clt2.70012","DOIUrl":"10.1002/clt2.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Epidemiological findings regarding the association between asthma and the risk of colon cancer (CC) are inconsistent. The causality and potential molecular mechanisms underlying asthma, eosinophil count, and CC remain unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed Mendelian randomization (MR) analysis to investigate the causality between asthma and CC and attempted to demonstrate that asthma indirectly affects CC mediated by eosinophil count through mediation analysis. Sensitivity analyses and multivariable MR were performed to test the robustness of our findings. Multiple bioinformatics tools were applied to further investigate the underlying mechanisms related to eosinophils that contribute to the pathogenesis of both asthma and CC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MR with mediation analyses suggested that eosinophil count may play a role in the mechanism through which asthma reduces the risk of CC. Our bioinformatic analyses identified PPP1R14A as a potential therapeutic target and an eosinophil-associated biomarker for CC patients. Higher expression of PPP1R14A may be associated with a poorer prognosis in CC patients. Additionally, the lysosome pathway emerges as a shared eosinophil-related pathway in both asthma and CC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Eosinophils may contribute to a lower risk of CC in patients with asthma. PPP1R14A is a potential therapeutic target and biomarker for CC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 12","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805611","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}