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 : 2025-08-01 Epub Date: 2025-06-12 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":"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":"230-236"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","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

Editorial: pharmacotherapy and evidence-based medicine in allergy and clinical immunology-2025 updates and perspectives. 社论：过敏和临床免疫学的药物治疗和循证医学-2025更新和展望。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-08-01 Epub Date: 2025-06-26 DOI: 10.1097/ACI.0000000000001087

Giovanni Paoletti, Edoardo Cavaglià, Andrea Di Biase, Danilo Di Bona

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 : 2025-08-01 Epub Date: 2025-06-05 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":"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":"277-292"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","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

Hypereosinophilia: clinical and therapeutic approach in 2025. 嗜酸性粒细胞增多症：2025年的临床和治疗方法。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-08-01 Epub Date: 2025-05-21 DOI: 10.1097/ACI.0000000000001078

Giusi Taurisano, Maria Clara Ruffi, Silvia Canalis, Giulia Anna Maria Luigia Costanzo

{"title":"Hypereosinophilia: clinical and therapeutic approach in 2025.","authors":"Giusi Taurisano, Maria Clara Ruffi, Silvia Canalis, Giulia Anna Maria Luigia Costanzo","doi":"10.1097/ACI.0000000000001078","DOIUrl":"10.1097/ACI.0000000000001078","url":null,"abstract":"Purpose of review: This review addresses the clinical and biological complexities of hypereosinophilia (HE) and hypereosinophilic syndrome (HES), highlighting the need for improved diagnostic frameworks and therapeutic strategies. Due to the increasing recognition of HE and its potential for severe multiorgan involvement, a structured, multidisciplinary approach to diagnosis and management is essential for optimizing patient outcomes.Recent findings: Recent literature categorizes HE into hereditary, reactive, and neoplastic forms, with significant advancements in defining associated conditions and their pathophysiological mechanisms. Clinical manifestations range from asymptomatic eosinophilia to life-threatening complications involving the skin, lungs, gastrointestinal tract, heart, and nervous system. Corticosteroids remain the first-line treatment across most subtypes. Imatinib has shown high efficacy, particularly in patients with FIP1L1::PDGFRA fusion. However, therapeutic resistance and relapse still occur. Biologic therapies targeting interleukin (IL)-5 or its receptor, such as mepolizumab and benralizumab, have demonstrated promise in reducing eosinophils counts and preventing flare-ups. Additional agents under investigation include dupilumab and lirentelimab.Summary: The findings highlight the importance of accurate classification and tailored management of HE and HES, which are crucial for preventing organ damage and improving quality of life. Ongoing clinical trials and research will expand therapeutic options, clarify underlying mechanisms, and address current unmet needs.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"258-268"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110026","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

Tailoring the treatment of type-2 related chronic rhinosinusitis with or without nasal polyps: a comparative analysis of medical and surgical approaches. 有或无鼻息肉的2型相关慢性鼻窦炎的治疗：内科和外科方法的比较分析

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-08-01 Epub Date: 2024-12-24 DOI: 10.1097/ACI.0000000000001057

Francesco Giombi, Giuseppe Mercante, Emanuele Nappi, Valentina Marzio, Luca Malvezzi

{"title":"Tailoring the treatment of type-2 related chronic rhinosinusitis with or without nasal polyps: a comparative analysis of medical and surgical approaches.","authors":"Francesco Giombi, Giuseppe Mercante, Emanuele Nappi, Valentina Marzio, Luca Malvezzi","doi":"10.1097/ACI.0000000000001057","DOIUrl":"10.1097/ACI.0000000000001057","url":null,"abstract":"Purpose of review: Advances in understanding the molecular pathways underlying nasal epithelial inflammation have ushered in the era of personalized medicine for chronic rhinosinusitis with nasal polyps (CRSwNP). Research progress has led to the approval of several monoclonal antibodies (mAbs) for severe CRSwNP, demonstrating promising outcomes in both clinical trials and real-world settings. Similarly, evolution in surgical techniques has enhanced progression-free survival due to the development of novel approaches. This narrative review summarizes current evidence comparing medical and surgical options for CRSwNP.Recent findings: There is general consensus that surgery is most effective in reducing nasal polyp size (NPS), while mAbs appears to provide greater benefits in terms of quality-of-life measures and olfactory function. Overall, surgery has shown higher long-term cost-effectiveness, although this could change with the upcoming patent expirations of mAbs. Additionally, head-to-head trials will allow for a direct comparison of the effectiveness of different mAbs in disease-specific outcomes.Summary: The high heterogeneity among studies has limited the ability to draw definitive conclusions through meta-analyses. To date, endoscopic sinus surgery remains the preferred option for surgery-naive patients, while individuals with recalcitrant CRSwNP and confirmed type-2 inflammation should be considered for mAb treatment.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"293-299"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869409","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 : 2025-08-01 Epub Date: 2025-06-13 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":"269-276"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","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

Algorithms for the classification of patients with a β-lactam allergy label: a systematic review. β-内酰胺过敏标签患者的分类算法：系统综述。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-08-01 Epub Date: 2025-06-20 DOI: 10.1097/ACI.0000000000001086

Joana Sousa, Joana Balseiro, Mariana Barreto, Francisca Mendes, Ana Margarida Pereira, Inês Ribeiro-Vaz, Ricardo Cruz-Correia, Bernardo Sousa-Pinto

{"title":"Algorithms for the classification of patients with a β-lactam allergy label: a systematic review.","authors":"Joana Sousa, Joana Balseiro, Mariana Barreto, Francisca Mendes, Ana Margarida Pereira, Inês Ribeiro-Vaz, Ricardo Cruz-Correia, Bernardo Sousa-Pinto","doi":"10.1097/ACI.0000000000001086","DOIUrl":"10.1097/ACI.0000000000001086","url":null,"abstract":"Purpose of review: Beta-lactam allergy is frequently reported, but only a minority of cases correspond to true allergies. Tools to stratify the risk of a real allergic reaction can possibly help delabeling patients. We aimed to retrieve evidence on algorithms for risk stratification of patients with a beta-lactam allergy label.Recent findings: We performed a systematic review, searching three databases and included 28 studies. Most of the applied tools involved the assessment of the presence of rash/hives/other exanthemas ( n = 24), angioedema/localized swelling ( n = 23), bronchospasm/wheezing/dyspnea ( n = 22) and gastrointestinal symptoms ( n = 21). Seventeen studies classified participants into different categories according to their risk of having a penicillin allergy; three studies presented algorithms indicating management approaches to be followed; six studies applied predictive models. Most studies had a high risk of bias, particularly concerning the reference standard and lack of external validation.Summary: Existing algorithms for beta-lactam allergy risk stratification are very heterogeneous and most of them lack validation.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"247-257"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332627","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

Management of patients with tuberculosis medication-induced drug reaction with eosinophilia and systemic symptoms. 伴有嗜酸性粒细胞增多和全身性症状的结核病患者药物致药物反应的处理。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-08-01 Epub Date: 2025-06-20 DOI: 10.1097/ACI.0000000000001084

Jonny Peter, Helen Hoenck, Rannakoe Lehloenya

{"title":"Management of patients with tuberculosis medication-induced drug reaction with eosinophilia and systemic symptoms.","authors":"Jonny Peter, Helen Hoenck, Rannakoe Lehloenya","doi":"10.1097/ACI.0000000000001084","DOIUrl":"10.1097/ACI.0000000000001084","url":null,"abstract":"Purpose of review: Tuberculosis (TB) incidence is rising globally, and TB medication-associated drug reaction with eosinophilia and systemic symptoms (DRESS) presents a significant clinical challenge, particularly in people living with HIV (PLH). Treatment interruption during active TB, especially with comorbid immunosuppression can be detrimental. This review highlights global variations in management practices and emphasizes the need for a more personalized approach to care.Recent findings: Timely cessation of the suspected medication, supportive care, and topical corticosteroids remain central to DRESS management. However, the routine use of systemic corticosteroids remains debated, as good outcomes from topical steroids alone have been observed, especially in TB/HIV co-infected patients. Efforts to reduce TB treatment interruption have driven interest in the use of shortened TB regimens, sequential additive drug challenge (SADC) with stat dose intravenous corticosteroids to limit positive drug challenge morbidity, and even desensitization protocols. Although not yet widely adopted, these strategies show promise in reintroducing first-line TB drugs, limiting treatment interruptions. Management remains complex, with prolonged hospital stays and high healthcare costs continuing to drive innovation.Summary: The findings support a move towards personalized approaches to TB-DRESS management, with future efforts focused on integrating clinical, genomic, and in-vitro tools to guide risk-stratified reintroduction of TB medications.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"237-244"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332628","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 role of regulatory T cells in preventing the development of drug hypersensitivity reactions. 调节性T细胞在预防药物超敏反应发展中的作用。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-08-01 Epub Date: 2025-06-11 DOI: 10.1097/ACI.0000000000001083

Lonnie MacDonald, Megan Mitchell, Paul Thomson

{"title":"The role of regulatory T cells in preventing the development of drug hypersensitivity reactions.","authors":"Lonnie MacDonald, Megan Mitchell, Paul Thomson","doi":"10.1097/ACI.0000000000001083","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001083","url":null,"abstract":"Purpose of review: T-cell-mediated drug hypersensitivity reactions represent a major impediment to the drug discovery process whilst presenting a significant burden to the healthcare sector. These reactions are predominantly facilitated by the adaptive immune system, yet the equilibrium of immune tolerance appears to be a significant determinant in whether an individual will experience a hypersensitivity reaction to a therapeutic.Recent findings: Indeed, regulatory T cells (Tregs) play a significant part in diminishing an immune response by CD4+ and CD8+ T cells and preventing autoimmunity by keeping an immune response in check. These cell subsets have been observed to be upregulated in times of immune activation, and unsurprisingly, their impairment has been associated in tandem with dysregulated immune responses contributing to the sliding scale of drug hypersensitivity.Summary: It is becoming increasingly evident that the fine balance of immune regulation significantly impacts on drug hypersensitivity reactions. As the area progresses, it will be interesting to assess whether therapies targeting Tregs hold the key to maintaining the synergy required to prevent the onset of drug hypersensitivity reactions.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":"25 4","pages":"221-229"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495070","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

Hymenoptera anaphylaxis and mast cell activation disorders. 膜翅目过敏反应和肥大细胞活化障碍。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-07-08 DOI: 10.1097/ACI.0000000000001088

David González-de-Olano, Iván Álvarez-Twose

引用次数: 0