Current Opinion in Allergy and Clinical Immunology最新文献

Immune phenotyping impacts on management of severe cutaneous adverse reaction. 免疫表型对严重皮肤不良反应处理的影响。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-06-13 DOI: 10.1097/ACI.0000000000001082

Ryota Hayashi, Riichiro Abe

{"title":"Immune phenotyping impacts on management of severe cutaneous adverse reaction.","authors":"Ryota Hayashi, Riichiro Abe","doi":"10.1097/ACI.0000000000001082","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001082","url":null,"abstract":"Purpose of review: Pathogenesis of severe cutaneous adverse reaction (SCAR) including Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) and drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS) has been identified by recent studies. This review provides recent understanding of pathomechanisms of SCAR and how to manage the patients with SCAR.Recent findings: Recent studies, including single-cell data, identified key signaling pathways and immune phenotypes in SCAR. These studies have highlighted potential treatments, such as TNF-α inhibitors and JAK inhibitors. Moreover, severity score of DIHS/DRESS and many biomarkers for SCAR are provided.Summary: The pathogenesis of SCAR remains unclear, and most effective therapeutic strategy has not yet been established. However, the pathogenesis of keratinocyte cell death in SJS/TEN, which is the most critical phenomenon, has been established. The difference of immune profile between early and late stage have been suggested in DIHS/DRESS. Although new therapeutic options have been identified by resent studies, there is a lack of trial data for the efficiency of them. Further trials and studies of SCAR is expected to lead to the development of general effective treatment options for SCAR.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274378","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}

引用次数: 0

New treatments for systemic mastocytosis in 2025. 2025年系统性肥大细胞增多症的新疗法。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-06-06 DOI: 10.1097/ACI.0000000000001079

Giovanni Costanzo, Valentina Marzio, Edoardo Cavaglià, Giovanni Paoletti, Enrico Heffler

{"title":"New treatments for systemic mastocytosis in 2025.","authors":"Giovanni Costanzo, Valentina Marzio, Edoardo Cavaglià, Giovanni Paoletti, Enrico Heffler","doi":"10.1097/ACI.0000000000001079","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001079","url":null,"abstract":"Purpose of review: To provide an accessible, comprehensive overview of past, present, imminent, and future therapies for systemic mastocytosis.Recent findings: Based on recent trials, the Food and Drug Administration (FDA) and European Medicines Agency (EMA) have approved two drugs for treating advanced systemic mastocytosis: avapritinib and midostaurin. The FDA also approved imatinib for selected cases of aggressive systemic mastocytosis without the D816V c-Kit mutation. Moreover, for the first time, a cytoreductive molecule, avapritinib, has been approved for patients with indolent systemic mastocytosis.Summary: Despite the considerable therapeutic progress in recent years, systemic mastocytosis is an incurable disease. In the last 20 years, the management of systemic mastocytosis has transformed from a one-size-fits-all approach, characterized by nonspecific cytoreductive drugs, to a tailored strategy focused on increasingly precise molecular targets, with the most notable example being the KIT inhibitors. Recently, the FDA and EMA have approved two drugs for treating systemic mastocytosis: avapritinib and midostaurin. Moreover, numerous trials are currently assessing the efficacy of new molecules: most are testing new-generation KIT inhibitors (ripretinib, bezuclastinib, elenestinib, masitinib, nintedanib), others focusing on Bruton's kinase (TL-895), interleukin-6 (sarilumab), sialic acid-binding immunoglobulin-like lectin-8 (lirentelimab), mTOR and CD33, among others. Real-life data are needed to confirm preliminary preclinical results.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224655","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}

引用次数: 0

Advancing precision medicine for asthma by focusing on type 2 cytokines and alarmins. 通过关注2型细胞因子和警报器推进哮喘的精准医学。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-06-05 DOI: 10.1097/ACI.0000000000001081

Remo Poto, Andrea Portacci, Rory Chan, Gianluca Lagnese, Mattia Giovannini, Gilda Varricchi

{"title":"Advancing precision medicine for asthma by focusing on type 2 cytokines and alarmins.","authors":"Remo Poto, Andrea Portacci, Rory Chan, Gianluca Lagnese, Mattia Giovannini, Gilda Varricchi","doi":"10.1097/ACI.0000000000001081","DOIUrl":"10.1097/ACI.0000000000001081","url":null,"abstract":"Purpose of review: Asthma is a heterogeneous disease encompassing distinct phenotypes and endotypes. Advances in elucidating the pathogenic role of type 2 (T2) cytokines and epithelial-derived alarmins have profoundly reshaped our understanding of airway inflammation in asthma. This review provides an updated perspective on how these mediators contribute to asthma pathobiology and examines their integration into emerging precision medicine strategies.Recent findings: Biologic agents targeting T2 cytokines (IL-4, IL-5, and IL-13) and alarmins (TSLP and IL-33) have demonstrated efficacy across a broad spectrum of severe asthma phenotypes. Recent evidence underscores the central role of alarmins in orchestrating both innate and adaptive immune responses within the airways. In parallel, the development of alarmin-associated molecular and clinical biomarkers is expanding patient stratification beyond traditional eosinophilic and allergic profiles.Summary: Advancing our understanding of alarmins and T2 cytokines offers new opportunities to refine asthma endotyping, personalize therapeutic decisions, and pursue sustained disease remission. Future directions include the integration of multiomics, real-world evidence, and novel biomarker platforms to consolidate the next phase of precision medicine in asthma and optimize long-term disease modification strategies.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215208","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}

引用次数: 0

The allergenic potential of enolases: physiological and pathophysiological insights. 烯醇化酶的致敏潜能：生理学和病理生理学的见解。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-06-01 Epub Date: 2025-03-26 DOI: 10.1097/ACI.0000000000001068

Sandra Pfeiffer, Ines Swoboda

{"title":"The allergenic potential of enolases: physiological and pathophysiological insights.","authors":"Sandra Pfeiffer, Ines Swoboda","doi":"10.1097/ACI.0000000000001068","DOIUrl":"10.1097/ACI.0000000000001068","url":null,"abstract":"Purpose of review: This review gives an overview on the current knowledge of the physiological and pathophysiological features of enolases and how these features might contribute to the enzymes' allergenic properties. It summarizes the most recent literature on allergenic enolases and raises questions that need to be answered in the future to gain a better understanding of the role of enolases in allergic diseases.Recent findings: The recent identification of two novel allergenic enolases, from London plane tree and whiff, further supports the uniqueness of this allergen family: the occurrence of enolases in the three major kingdoms of life and the capability to induce allergic symptoms via inhalation, ingestion, and skin contact.Summary: The importance and uniqueness of enolases as allergenic molecules is widely accepted. However, studies linking the biochemical and physiological features of enolases with their potential to induce allergies are still needed. This would contribute to a better understanding about the role of enolases in the induction of allergic diseases, to improve specificity and sensitivity of allergy diagnosis and to further enable the development of patient-tailored prophylactic and therapeutic approaches.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"212-219"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708991","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}

引用次数: 0

Standardizing outcomes in food allergy research: aligning clinical trials with patient priorities. 标准化食物过敏研究的结果：使临床试验与患者的优先级保持一致。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-06-01 Epub Date: 2025-04-21 DOI: 10.1097/ACI.0000000000001074

Daniel Munblit, Christian Apfelbacher, Anastasia Demidova, Audrey DunnGalvin, Robert J Boyle

{"title":"Standardizing outcomes in food allergy research: aligning clinical trials with patient priorities.","authors":"Daniel Munblit, Christian Apfelbacher, Anastasia Demidova, Audrey DunnGalvin, Robert J Boyle","doi":"10.1097/ACI.0000000000001074","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001074","url":null,"abstract":"Purpose of review: This review explores the clinical outcomes used in immunoglobulin E (IgE)-mediated food allergy (FA) intervention studies, emphasizing unmet need for patient-centred outcomes. Standardizing outcome measurement is critical as research into FA treatments, particularly food immunotherapy, expands. Here we discuss how outcomes should reflect the multidimensional impact of FA on people's lives.Recent findings: Current evidence reveals a discrepancy between clinical trial outcomes and those most valued by patients and carers. While trials often prioritize changes in reactivity thresholds or immunological markers, patients and carers emphasize need in reducing severe reactions, improving quality of life, and enhancing confidence in disease management. This disparity highlights importance of harmonization efforts to guide FA research.The Core Outcome Measures for Food Allergy (COMFA) initiative recently identified two core outcomes - 'allergic symptoms' and 'quality of life' - through an international consensus process involving patients, caregivers, clinicians, and researchers. Outcomes like 'desensitization' and 'remission/sustained unresponsiveness' were considered important but were not seen as the most critical.Summary: Developing and implementing a COS for FA intervention studies is essential to align research with patient priorities, ensuring meaningful improvements in routine clinical care. Standardized outcome measurement will generate robust evidence, inform clinical practice, and empower patients and caregivers in decision-making about FA management.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":"25 3","pages":"172-184"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062645","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}

引用次数: 0

Doxycycline: lights and shadows of a mysterious treatment for chronic rhinosinusitis. 强力霉素：慢性鼻炎神秘疗法的光与影。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-06-01 Epub Date: 2025-02-12 DOI: 10.1097/ACI.0000000000001065

Minh P Hoang, Kachorn Seresirikachorn, Kornkiat Snidvongs

{"title":"Doxycycline: lights and shadows of a mysterious treatment for chronic rhinosinusitis.","authors":"Minh P Hoang, Kachorn Seresirikachorn, Kornkiat Snidvongs","doi":"10.1097/ACI.0000000000001065","DOIUrl":"10.1097/ACI.0000000000001065","url":null,"abstract":"Purpose of review: Chronic rhinosinusitis (CRS) is a diverse condition, including different underlying pathophysiologies. Tailoring the treatment for CRS depends on the individual's specific endotype and phenotype rather than using a universal approach. The emergence of biologics in recent years has raised questions about the role of antibiotics, particularly doxycycline, in CRS management. Insights from existing research on the mechanisms and appropriate use of doxycycline therapy may guide physicians in selecting the right treatment target.Recent findings: CRS with nasal polyps (CRSwNP) is frequently associated with type 2 inflammation and characterized by tissue remodeling process that can result in recalcitrant condition. Doxycycline therapy (100 mg daily) improves CRSwNP by exerting antitissue remodeling effects through matrix metalloproteinase inhibition. Doxycycline seems to provide benefits when used alongside adequate medicine treatment.Summary: Current evidence on the use of doxycycline therapy is limited to a small number of high-quality studies. Further research is needed to explore the duration and factors of success of doxycycline in treating CRS. Like other antibiotics, doxycycline has limitations related to side effects and the potential for antibiotic resistance. Therefore, treatment decisions should be made with caution, especially when doxycycline is used in combination with other pharmacologic therapies.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"151-156"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398554","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}

引用次数: 0

Nasal allergen provocation test: updated indications and diagnostic accuracy. 鼻过敏原激发试验：最新适应症和诊断准确性。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-06-01 Epub Date: 2025-03-06 DOI: 10.1097/ACI.0000000000001066

Dichapong Kanjanawasee, Apinat Wattanaphichet, Pongsakorn Tantilipikorn, Bannawat Tantikun

{"title":"Nasal allergen provocation test: updated indications and diagnostic accuracy.","authors":"Dichapong Kanjanawasee, Apinat Wattanaphichet, Pongsakorn Tantilipikorn, Bannawat Tantikun","doi":"10.1097/ACI.0000000000001066","DOIUrl":"10.1097/ACI.0000000000001066","url":null,"abstract":"Purpose of review: The Nasal Allergen Provocation Test (NAPT) is a valuable diagnostic tool for allergic rhinitis, particularly in cases where conventional tests, such as the skin prick test (SPT) and serum-specific IgE (sIgE), yield inconclusive results. By replicating real-life allergen exposure in a controlled setting, NAPT enables the assessment of allergen-specific nasal reactivity. This article aims to review the current knowledge of NAPT.Recent findings: Recent studies have reinforced NAPT as the gold standard for confirming nasal allergic responses. In the past, test protocols, allergen dosages, and outcome measurements varied widely. However, advancements in allergen standardization, the combination of objective and subjective measurements, and metered nasal allergen application have led to an improved and more reliable test method, with ongoing efforts to establish a universal protocol for clinical testing.Summary: This review summarizes current knowledge on NAPT, including its clinical applications, indications, methodology, and recent advancements. Additionally, we compare NAPT with SPT and sIgE in terms of diagnostic accuracy. The protocols, allergen types and doses, test methodologies, and outcome measures of these studies were analyzed and compared.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"157-168"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572432","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}

引用次数: 0

Editorial introductions. 编辑介绍。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-06-01 Epub Date: 2025-05-01 DOI: 10.1097/ACI.0000000000001070

引用次数: 0

Outcomes in eosinophilic esophagitis: current understanding and future directions. 嗜酸性粒细胞性食管炎的结局：目前的认识和未来的方向。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-06-01 Epub Date: 2025-04-08 DOI: 10.1097/ACI.0000000000001071

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":"10.1097/ACI.0000000000001071","url":null,"abstract":"Purpose of review: 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.Recent findings: 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.Summary: 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.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"205-211"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","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}

引用次数: 0

From one biologic to another: the rationale and evidence behind switching therapies in chronic rhinosinusitis. 从一种生物到另一种：慢性鼻窦炎转换治疗的基本原理和证据。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-06-01 Epub Date: 2025-02-27 DOI: 10.1097/ACI.0000000000001067

Baharudin Abdullah, Farah Dayana Zahedi, Pongsakorn Tantilipikorn

{"title":"From one biologic to another: the rationale and evidence behind switching therapies in chronic rhinosinusitis.","authors":"Baharudin Abdullah, Farah Dayana Zahedi, Pongsakorn Tantilipikorn","doi":"10.1097/ACI.0000000000001067","DOIUrl":"10.1097/ACI.0000000000001067","url":null,"abstract":"Purpose of review: Although biologics had been used to treat CRSwNP, not all patients respond favourably, necessitating the use of other biologics. As there are currently no guidelines available, the process and rationale for switching biologic therapy in the treatment of CRSwNP are examined in this review.Recent findings: Due to the heterogeneity of diseases, biologic therapies may efficiently control CRSwNP but give inadequate control for asthma, or vice versa . Changing an ineffective first-line biologic to a second-line treatment or others is generally referred to as switching. The most common reasons for switching biologics are poor symptom management or ineffectiveness, and undesirable adverse effects. The ineffectiveness was largely due to the use of omalizumab or mepolizumab, whereas the adverse effects were due to dupilumab.Summary: Switching biologics is a nuanced process influenced by a variety of patient-specific and clinical factors. Biologics that effectively treat upper and lower airway diseases are recommended for optimal control in CRSwNP patients with concurrent asthma. There was no difference in outcomes between switching biologics with and without a washout period. Switching between biologics in the same class is generally not recommended. Dupilumab serves as an effective treatment option for refractory cases particularly aspirin-exacerbated respiratory disease.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"144-150"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514982","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}

引用次数: 0