Sara Urbani, Giulio Dinardo, Maria Cristina Artesani, Alessandro Fiocchi
{"title":"Outcomes in eosinophilic esophagitis: current understanding and future directions.","authors":"Sara Urbani, Giulio Dinardo, Maria Cristina Artesani, Alessandro Fiocchi","doi":"10.1097/ACI.0000000000001071","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001071","url":null,"abstract":"<p><strong>Purpose of review: </strong>Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disorder that demands lifelong management due to its potential to progress to fibrosis and esophageal strictures. This review synthesizes current strategies for evaluating EoE outcomes and highlights emerging approaches aimed at reconciling the often discordant relationship between clinical symptoms and histologic findings. An updated synthesis is crucial to guide evolving clinical practices.</p><p><strong>Recent findings: </strong>Recent literature emphasizes the multifaceted nature of EoE, revealing limitations in traditional outcome measures. Advances in patient-reported outcomes (PROs), histologic scoring systems, and endoscopic assessments have enriched our understanding of disease activity. Furthermore, the integration of functional assessments through modalities such as high-resolution manometry and EndoFLIP, along with digital data integration, has refined disease monitoring and provided nuanced insights into treatment responses and long-term progression. Additionally, emerging evidence suggests that integrating novel biomarkers may further refine disease stratification and outcomes.</p><p><strong>Summary: </strong>A multidimensional approach that combines clinical, histologic, endoscopic, and functional data is crucial for personalized management of EoE. These insights pave the way for improved therapeutic decision-making and highlight the need for standardized, comprehensive tools in both clinical practice and future research. These additional findings advocate for a shift towards precision medicine, emphasizing multidisciplinary and patient-centric approaches.</p>","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Use of the DEFASE score in research trials.","authors":"Stefania Arasi, Lucia Lo Scalzo, Maddalena Sciannamea, Ludger Klimek, Alessandro Fiocchi","doi":"10.1097/ACI.0000000000001072","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001072","url":null,"abstract":"<p><strong>Purpose of review: </strong>To explore the potential applicability in clinical trials of the groundbreaking international consensus named DEFASE (DEfinition of Food Allergy SEverity) as the unique grading system for IgE-mediated food allergy (FA) severity embracing the different aspects of the disease in a holistic approach. Herein, we discuss its relevance in clinical trials and potential applications in research and clinical settings through a few clinical scenarios.</p><p><strong>Recent findings: </strong>The DEFASE score has been developed to be used in research settings as a comprehensive scoring system. Researchers are currently focusing on internal and external validation of the scoring system, targeting these models to various food allergenic sources, populations, and settings.</p><p><strong>Summary: </strong>Implementing the DEFASE score in clinical trials could improve patient stratification, guide therapeutic decisions, and support regulatory assessments. Future research will focus on its external validation and integration with biomarker data to refine its predictive accuracy and make this tool applicable in the near future.</p>","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aneeza W Hamizan, Salina Husain, Pongsakorn Tantilipikorn
{"title":"Local allergic rhinitis in Asia: rethinking the allergy landscape.","authors":"Aneeza W Hamizan, Salina Husain, Pongsakorn Tantilipikorn","doi":"10.1097/ACI.0000000000001069","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001069","url":null,"abstract":"<p><strong>Purpose of review: </strong>Local allergic rhinitis (LAR) is increasingly recognized as a distinct phenotype of chronic rhinitis, yet its prevalence and characteristics in Asia remain underexplored. Given the variability in reported LAR prevalence across regions, this review re-evaluates the allergy landscape in Asia, considering environmental and immunological factors, as well as study methodology that may contribute to differences from Western populations.</p><p><strong>Recent findings: </strong>There were more Asian studies which reported lower prevalence (0-20%), in contrast to higher rates in Europe, particularly Mediterranean countries. Urbanization, air pollution, and high dust mite exposure may be important factors of nonatopic rhinitis in Asia. Diagnostic approaches, including nasal-specific IgE and provocation tests, vary across studies, impacting prevalence estimates.</p><p><strong>Summary: </strong>The lower reported LAR prevalence in Asia suggests potential differences in underlying mechanisms or diagnostic limitations. Further research is needed to refine diagnostic criteria, explore environmental triggers, and assess the clinical relevance of LAR in Asian populations. A better understanding of LAR in Asia could guide targeted management strategies and improve recognition of this condition in clinical practice.</p>","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"New approaches in childhood IgE-mediated food allergy treatment.","authors":"Deniz Ilgun Gurel, Aikaterini Anagnostou, Alessandro Fiocchi, Chinthrajah Sharon, Umit Sahiner, Sayantani Sindher, Stefania Arasi","doi":"10.1097/ACI.0000000000001058","DOIUrl":"10.1097/ACI.0000000000001058","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to provide an overview of the current and future treatment options for children with food allergies (FAs), highlighting the latest research findings and the potential impact of these new approaches on improving patients' and caregivers' quality of life.</p><p><strong>Recent findings: </strong>In the last decade, many promising approaches have emerged as an alternative to the standard avoidance of the culprit food with the risk of severe accidental reactions. Desensitization through oral immunotherapy has been introduced in clinical settings as a therapeutic approach, and more recently also omalizumab. In addition, alternative routes of administration for immunotherapy, other biologics, small molecules, probiotics or prebiotics, microbiota transplantation therapy, IGNX001, and PVX108 are being investigated.</p><p><strong>Summary: </strong>The portfolio of available treatment options for food allergies is increasing but several relevant unmet needs remain. This review aims to provide a brief overview of the existing and future treatment options for IgE-mediated food allergies.</p>","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"115-122"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Occupational allergy and climate change.","authors":"Monika Raulf, Isabella Annesi-Maesano","doi":"10.1097/ACI.0000000000001060","DOIUrl":"10.1097/ACI.0000000000001060","url":null,"abstract":"<p><strong>Purpose of review: </strong>Climate change influences working conditions in various ways, affecting employee health and safety across different sectors. Climatic factors like rising temperatures, increased UV radiation, and more frequent extreme weather events pose risks to in both indoor and outdoor workers. Allergic diseases of the respiratory tract and the skin may emerge due to climate change. This review summarizes current aspects of both direct and indirect consequences of climate change and associated exposures in diverse work environments, focusing on occupational allergies.</p><p><strong>Recent findings: </strong>Outdoor workers, in particular, are increasing susceptible to ubiquitous pollen allergens. Additionally, they may experience climate-related increases in allergens typically associated with specific workplaces, such as Cryptostroma corticale . Changes in production processes, along with altered workplaces exposures, can lead to new sensitizations and trigger allergies, representing indirect consequences of climate change. Furthermore, lifestyle changes aimed to promoting climate protection and sustainability (e.g. the introduction of insects as a protein source or using enzymes), may also contribute to the emergence of new allergens.</p><p><strong>Summary: </strong>The emergence of new occupational sensitization sources from novel or modified allergen exposures must be addressed within the framework of workplace safety and health, necessitating proactive measures to safeguard workers and mitigate risks.</p>","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"83-87"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The impact of climate change in pollen food allergy syndrome.","authors":"Isabel J Skypala","doi":"10.1097/ACI.0000000000001064","DOIUrl":"10.1097/ACI.0000000000001064","url":null,"abstract":"<p><strong>Purpose of review: </strong>To evaluate the effect of climate change on pollen allergenicity, lengthening of the pollen season, and the spread of invasive species such as ragweed. To assess evidence to determine whether these effects are impacting the prevalence of pollen food syndrome (PFS).</p><p><strong>Recent findings: </strong>There is good evidence to demonstrate that markers of climate change, including rising temperatures and to some extent greenhouse gases, are responsible for a rise in the allergenicity of pollen and an increase in the duration of the pollen season, especially for trees. These changes are likely to be linked to the increase in the prevalence of seasonal allergic rhinitis (SAR), especially in children. Sensitization to pollen, especially tree pollen, is also a risk factor for the development of PFS. Thought to mainly affect adults, recent evidence suggests that there is a rise in the prevalence of PFS in children, linked to an increase in SAR.</p><p><strong>Summary: </strong>Increasing SAR due to climate change could lead to a greater number of children and adults developing PFS. Although PFS is generally considered to be a mild condition, severe reactions can occur and there might be numerous plant food triggers, which can adversely affect dietary choice and nutritional intake.</p>","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"129-133"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ivan Taietti, Francesco Catamerò, Lorenzo Lodi, Mattia Giovannini, Riccardo Castagnoli
{"title":"Inborn errors of immunity with atopic phenotypes in the allergy and immunology clinic: a practical review.","authors":"Ivan Taietti, Francesco Catamerò, Lorenzo Lodi, Mattia Giovannini, Riccardo Castagnoli","doi":"10.1097/ACI.0000000000001059","DOIUrl":"10.1097/ACI.0000000000001059","url":null,"abstract":"<p><strong>Purpose of review: </strong>Inborn errors of immunity with atopic phenotypes (IEIwA) are a subgroup of IEI that may present with severe and/or multiple atopic clinical manifestations. Because of their specific clinical management and prognosis, it is important to distinguish IEIwA from multifactorial allergic diseases. We aimed to review the main clinical manifestations associated with IEIwA and summarize the available data regarding the precision medicine approach for these conditions.</p><p><strong>Recent findings: </strong>IEIwA include more than 50 monogenic disorders marked by different immune dysregulation mechanisms such as alterations in cytokine signaling, T cell receptor function, mast cell activation, and skin barrier integrity. A critical role in diagnosis is played by advanced genetic testing. Emerging treatments include targeted monoclonal antibodies and small molecules, whereas hematopoietic stem cell transplantation (HSCT) is still a valid option for some specific disorders and may be curative also on atopic manifestations.</p><p><strong>Summary: </strong>The recognition and accurate diagnosis of IEIwA are crucial for timely and appropriate therapeutic intervention. The diagnosis should be suspected according to the presence of 'red flags' at clinical evaluation stage, such as early-onset severe atopy, recurrent/atypical infections, and autoimmunity. The diagnostic confirmation requires genetic testing. Precision medicine approaches like biological therapies and HSCT seem to provide promising results. It is worth noting that clinical and translational research in the field of IEIwA is currently paving the way for a more thorough understanding of the molecular bases of common allergic diseases.</p>","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"105-114"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current risks of byssinosis and chronic obstructive pulmonary disease in textile workers.","authors":"Asaad Ahmed Nafees, Paul Cullinan","doi":"10.1097/ACI.0000000000001053","DOIUrl":"10.1097/ACI.0000000000001053","url":null,"abstract":"<p><strong>Purpose of review: </strong>The textile manufacturing sector is a major contributor to the economies of several emergent economies in the global South. Respiratory disease, including byssinosis and chronic obstructive pulmonary disease (COPD), among textile workers appears to be common in this setting.</p><p><strong>Recent findings: </strong>Notably, little or no contemporary research has been published from countries, which are major global producers of textiles. Most recent epidemiological studies are of a cross-sectional design, with deficiencies that repeat those of research in this area over the past 20 years and do little to advance the cause of prevention. Their estimates of disease prevalence vary wildly for reasons that are unclear. An important exception was the publication of a successful, randomized trial of a low-cost intervention, the first in this field.</p><p><strong>Summary: </strong>Research into the respiratory problems of textile work needs to embrace modern approaches to the understanding of (occupational) COPD and move beyond the estimation of disease prevalence. There is an important need for cheaper and simpler techniques for workplace dust measurement. Occupational health researchers should pool their skills, resources and protocols towards the prevention of a problem that is common to many low- and middle-income economies.</p>","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"88-94"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What rationale for treatment of occupational interstitial lung diseases with the drugs approved for idiopathic pulmonary fibrosis?","authors":"Serena Bellani, Paolo Spagnolo","doi":"10.1097/ACI.0000000000001055","DOIUrl":"10.1097/ACI.0000000000001055","url":null,"abstract":"<p><strong>Purpose of review: </strong>To critically discuss the rationale for the use of drugs approved for idiopathic pulmonary fibrosis (IPF) to treat occupational interstitial lung diseases (OILDs).</p><p><strong>Recent findings: </strong>Although IPF and OILDs share several clinical, radiological and probably pathogenetic features, currently, OILDs do not have a standard of care. In recent years, our knowledge and understanding of ILDs has improved substantially. Recently, the progressive pulmonary fibrosis (PPF) phenotype, which refers to non-IPF fibrotic ILDs that progress despite appropriate treatment, has been defined. OILDs may also be progressive. Nintedanib, initially approved for treatment of IPF, is also approved in patients with PPF. On the other hand, pirfenidone is approved in IPF but not in PPF, due to the lack of robust evidence of efficacy in this patient subset.</p><p><strong>Summary: </strong>OILDs are a large and highly heterogeneous group of conditions without a proper standard of care. Nintedanib may slow functional decline and disease progression in progressive OILDs, and new clinical trials are ongoing.</p>","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"95-104"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"New mechanisms in diisocyanate-mediated allergy/toxicity: are microRNAs in play?","authors":"Chen-Chung Lin, Brandon F Law, Justin M Hettick","doi":"10.1097/ACI.0000000000001043","DOIUrl":"10.1097/ACI.0000000000001043","url":null,"abstract":"<p><strong>Purpose of review: </strong>To describe recent findings of diisocyanate-mediated mechanisms in allergy and toxicology by addressing the role of microRNA (miR) in immune responses that may contribute to the development of occupational asthma (OA).</p><p><strong>Recent findings: </strong>Studies of diisocyanate asthma have traditionally focused on the immune and inflammatory patterns associated with diisocyanate exposures; however, recognized knowledge gaps exist regarding the detailed molecular mechanism(s) of pathogenesis. Recent studies demonstrate the critical role endogenous microRNAs play as gene regulators in maintaining homeostasis of the human body, and in the pathophysiology of many diseases including asthma. Given that diisocyanate-OA shares many pathophysiological characteristics with asthma, it is likely that miR-mediated mechanisms are involved in the pathophysiology of diisocyanate-OA. Recent reports have shown that changes in expression of endogenous miRs are associated with exposure to the occupationally relevant diisocyanates, toluene diisocyanate (TDI) and methylene diphenyl diisocyanate (MDI). Continued mechanistic study of these relevant miRs may lead to the development of novel biomarkers of occupational exposure and/or provide efficacious targets for therapeutic strategies in diisocyanate asthma.</p><p><strong>Summary: </strong>The molecular mechanisms underlying diisocyanate-OA pathophysiology are heterogeneous and complicated. In this review, we highlight recent research into the roles and potential regulation of miRs in diisocyanate-OA.</p>","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"75-82"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}