Current Opinion in Allergy and Clinical Immunology最新文献_第2页

Chronic urticaria and autoinflammatory syndromes. 慢性荨麻疹和自身炎症综合征。

IF 2.6 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-08-01 DOI: 10.1097/ACI.0000000000001093

Mona-Rita Yacoub, Arianna Ferlito, Eustachio Nettis

{"title":"Chronic urticaria and autoinflammatory syndromes.","authors":"Mona-Rita Yacoub, Arianna Ferlito, Eustachio Nettis","doi":"10.1097/ACI.0000000000001093","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001093","url":null,"abstract":"Purpose of review: This review provides an updated overview of the association between chronic urticaria (CU) and autoinflammatory syndromes (AS), underlining the diagnostic and therapeutic implications of identifying CU as an initial manifestation of systemic autoinflammatory disorders.Recent findings: emerging evidence has reinforced the role of innate immune dysregulation in the pathogenesis of CU associated with AS, with particular involvement of the pro-inflammatory cytokines such as interleukin (IL)-1β. Several monogenic and multifactorial autoinflammatory diseases, including cryopyrin-associated periodic syndromes (CAPS), Schnitzler syndrome (SchS), Still's disease (SD), and others, may present with CU. Neutrophilic urticarial dermatosis (NUD) has been recognized as a histopathological hallmark. Early diagnosis remains challenging but is crucial, as targeted therapies, especially IL-1 inhibitors, have demonstrated significant efficacy in controlling systemic inflammation and preventing disease progression.Summary: CU refractory to conventional treatment, particularly when associated with systemic symptoms, should prompt suspicion of an underlying autoinflammatory syndrome. A comprehensive diagnostic approach, including clinical assessment, inflammatory markers evaluation, histopathological examination, and genetic testing, is essential. Recognition of the autoinflammatory nature of CU allows for timely initiation of personalized therapies, improving patient prognosis and reducing long-term morbidity.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759421","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

Update on refractory anaphylaxis. 关于难治性过敏反应的最新进展。

IF 2.6 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-08-01 DOI: 10.1097/ACI.0000000000001101

Paula Galvan-Blasco, Javier Pereira-Gonzalez, Victoria Cardona

{"title":"Update on refractory anaphylaxis.","authors":"Paula Galvan-Blasco, Javier Pereira-Gonzalez, Victoria Cardona","doi":"10.1097/ACI.0000000000001101","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001101","url":null,"abstract":"Purpose of review: The rising incidence of anaphylaxis and reports of cases unresponsive to standard epinephrine treatment highlight the relevance of refractory anaphylaxis. There is a lack of standardized management protocols, and clinicians across specialties need guidance to handle this rare but life-threatening condition.Recent findings: There is a lack of a universally accepted definition, with most studies describing it as anaphylaxis unresponsive to several doses of intramuscular epinephrine. It emphasizes the pathophysiological complexity, including potential mechanisms like delayed epinephrine absorption, atypical mediator release, or underlying comorbidities. Management relies on recommendations ranging from intravenous epinephrine to adjunctive treatments. We call attention to gaps in clinical guidelines and research, advocating for more data on incidence, risk factors, and effective interventions, especially in emergency settings.Summary: There is a need for clear protocols to help recognize and manage cases of refractory anaphylaxis. This includes awareness of when to escalate care, use intravenous epinephrine or adjunctive agents. For research, the variability in definitions and treatment approaches points to the need for standardized diagnostic criteria and prospective studies to better understand risk factors, outcomes, and optimal management strategies. Additionally, there is a strong case for exploring biomarkers and therapies that may improve early identification and treatment of high-risk cases.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759424","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

Where eye meets body part 1: uniting allergy pathways in ocular and nasal disease - IgE on the offense. 眼睛与身体接触的地方，第一部分：将眼部和鼻腔疾病的过敏途径结合起来——IgE在进攻。

IF 2.6 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-08-01 DOI: 10.1097/ACI.0000000000001096

Sebastian Borges, Victoria A Pereira, Christopher Chang, Anat Galor

{"title":"Where eye meets body part 1: uniting allergy pathways in ocular and nasal disease - IgE on the offense.","authors":"Sebastian Borges, Victoria A Pereira, Christopher Chang, Anat Galor","doi":"10.1097/ACI.0000000000001096","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001096","url":null,"abstract":"Purpose of review: This review explores the shared immunologic mechanisms and clinical distinctions between seasonal and perennial allergic rhinitis (SAR, PAR) and their ocular counterparts, seasonal and perennial allergic conjunctivitis (SAC, PAC). These IgE-mediated diseases often coexist, reflecting overlapping triggers, mast cell activation, and mucosal immune responses. By comparing their epidemiology, pathophysiology, genetics, and treatments, this review highlights how nasal and ocular allergic pathways intersect and diverge.Recent findings: SAC and SAR frequently co-occur, with up to 71% of SAR patients reporting conjunctival symptoms and 75% of SAC patients experiencing rhinitis; in children, 42% with allergic rhinitis also have PAC. Recent studies suggest possible shared genetic and metabolic contributors across these conditions. Therapeutically, oral and intranasal antihistamines remain a mainstay for SAR, while combination intranasal corticosteroid-antihistamine regimens offer enhanced control in PAR. Topical dual-action antihistamine-mast cell stabilizers are commonly used in SAC and serve as first-line therapy for PAC. Novel ocular delivery systems, such as dexamethasone intracanalicular inserts, show promise for PAC.Summary: These findings emphasize the overlap in episodic and chronic nasal and ocular allergies, with shared mechanisms, genetics, and treatment approaches, yet with site-specific nuances. Ongoing research into genetic and therapeutic differentiation remains crucial to advancing personalized allergy care.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759425","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

Human mast cells in anaphylaxis: from research to diagnosis. 过敏反应中的人肥大细胞：从研究到诊断。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-07-24 DOI: 10.1097/ACI.0000000000001092

Jessy Elst, Didier G Ebo, Vito Sabato

引用次数: 0

Age dependent differences in anaphylaxis: elderly population. 过敏反应的年龄依赖性差异：老年人群。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-07-24 DOI: 10.1097/ACI.0000000000001091

Alessandro Barone, Francesca Nicoletta, Martina Ottoni, Erminia Ridolo

{"title":"Age dependent differences in anaphylaxis: elderly population.","authors":"Alessandro Barone, Francesca Nicoletta, Martina Ottoni, Erminia Ridolo","doi":"10.1097/ACI.0000000000001091","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001091","url":null,"abstract":"Purpose of review: Anaphylaxis in elderly is a little-known topic, despite the worldwide growth of this part of the population. In this review, the main elicitors are discussed, with a particular regard for risk factors, clinical manifestation and management of anaphylaxis in people over 65 years of age.Recent findings: Available data report age-dependent differences regarding elicitors, cofactors and symptoms of anaphylaxis. In the last years, few studies have focused on anaphylaxis in the elderly, highlighting drugs and insect venom as main triggers.Summary: Drugs and insect venom represent the main triggers of anaphylaxis in individuals over 65 years of age. In addition, idiopathic anaphylaxis is seen more frequently in adults and older adults, and recent studies show an increasing rate of food-related anaphylaxis in this population.Elderly patients are at a greater risk of severe or fatal reactions because they often have multiple comorbidities requiring the concomitant use of several drugs. This may complicate anaphylaxis management, leading to poor outcomes, increased hospitalization and higher admission to intensive care unit.The clinical presentation of anaphylaxis in older adults is most often characterized by cardiovascular symptoms, with syncope as the most frequent one.The injection of adrenaline is the most important treatment of anaphylaxis at any age, and no absolute contraindications are reported. Despite this, its use still remains suboptimal.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689422","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

Skin manifestations in perioperative hypersensitivity: state of the art. 围手术期过敏的皮肤表现：最新进展。

IF 3 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-07-24 DOI: 10.1097/ACI.0000000000001094

Xin-Rong Lim, Bernard Yu-Hor Thong

{"title":"Skin manifestations in perioperative hypersensitivity: state of the art.","authors":"Xin-Rong Lim, Bernard Yu-Hor Thong","doi":"10.1097/ACI.0000000000001094","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001094","url":null,"abstract":"Purpose of review: Among the various manifestations of perioperative hypersensitivity (POH), skin reactions are often the first and most visible signs of an allergic or hypersensitivity response to drugs, antiseptics, or other agents in the perioperative setting. This review aims to examine the range and significance of skin manifestations associated with POH reactions, particularly their diagnostic value and clinical presentation in the perioperative setting.Recent findings: Cutaneous signs such as urticaria, angioedema, flushing, and erythema are common in POH and may present alone or alongside systemic symptoms. While these manifestations are frequently observed, they are not universally present, especially in life-threatening reactions like anaphylaxis. The timing, distribution, and morphology of these skin changes can provide diagnostic clues, although intraoperative factors like draping, lighting, and hypotension may hinder their identification. Cutaneous vasoconstriction signs such as pallor, piloerection, sweating, and cyanosis are strong indicators of life-threatening IgE-mediated allergic reactions compared to early vasodilation signs like erythema or urticaria.Summary: Skin manifestations play a crucial role in the early recognition and management of POH, but their absence should not lead to false reassurance. A thorough understanding of these signs is essential for accurate diagnosis and safe management in the perioperative environment.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689456","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