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

Sunlight, mast cells, and photosensitivity: rethinking disease mechanisms in solar urticaria. 阳光、肥大细胞和光敏性：重新思考日光性荨麻疹的发病机制。

IF 2.8 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2026-10-01 Epub Date: 2026-08-26 DOI: 10.1097/ACI.0000000000001191

Yesha Kothari, Joanna Jacków-Malinowska, Christos Tziotzios, Sheila Mary McSweeney

{"title":"Sunlight, mast cells, and photosensitivity: rethinking disease mechanisms in solar urticaria.","authors":"Yesha Kothari, Joanna Jacków-Malinowska, Christos Tziotzios, Sheila Mary McSweeney","doi":"10.1097/ACI.0000000000001191","DOIUrl":"10.1097/ACI.0000000000001191","url":null,"abstract":"Purpose of review: Solar urticaria is a rare, life-altering photodermatosis caused by aberrant mast cell degranulation and cutaneous whealing following exposure to sunlight. Although mast cell degranulation is the key causal event in solar urticaria, upstream mechanisms linking sunlight exposure to mast cell activation remain unclear. This review will discuss existing evidence supporting our understanding of solar urticaria pathobiology. It will also incorporate evidence regarding interactions between sunlight, skin, and cutaneous mast cells to highlight a novel range of potential pathomechanisms.Recent findings: Current understanding of solar urticaria is dominated by a photo-allergy model, whereby cutaneous chromophore(s) are modified by solar radiation and cause mast cell activation. Wavebands now known to frequently trigger solar urticaria, e.g., visible light, could help to highlight key disease chromophores. The occasional occurrence of solar urticaria-like reactions in cutaneous porphyrias could also suggest shared pathomechanisms mediated by reactive oxygen species. Evidence of suppressed immunoglobulin E-dependent mast cell activation following ultraviolet radiation and/or visible light exposure suggests a role for other factors, e.g., alterations in the cutaneous microenvironment, in priming mast cells towards activation in solar urticaria.Summary: A diverse range of complex or complementary mechanisms may contribute to solar urticaria pathogenesis.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"395-401"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789246","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

Anaphylaxis: from reaction-centered medicine to patient-centered susceptibility. 过敏反应：从以反应为中心的药物到以患者为中心的药敏。

IF 2.8 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2026-10-01 Epub Date: 2026-08-26 DOI: 10.1097/ACI.0000000000001194

Gianenrico Senna, Marco Caminati, Mariana Castells

引用次数: 0

Safety of allergen immunotherapy: real-world evidence. 过敏原免疫疗法的安全性：真实世界的证据。

IF 2.8 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2026-08-06 DOI: 10.1097/ACI.0000000000001190

Julijana Asllani, Eleni Anastasiou, Nikolaos G Papadopoulos

{"title":"Safety of allergen immunotherapy: real-world evidence.","authors":"Julijana Asllani, Eleni Anastasiou, Nikolaos G Papadopoulos","doi":"10.1097/ACI.0000000000001190","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001190","url":null,"abstract":"Purpose of review: Allergen immunotherapy (AIT) remains the only disease-modifying treatment for respiratory allergic diseases and the only intervention capable of preventing systemic sting reactions in patients with venom allergy (VA). This review summarizes recent real-world evidence on the safety of AIT.Recent findings: Randomized controlled trials (RCTs) have consistently established the safety of licensed AIT products; however, real-world data are needed to comprehensively evaluate the frequency and severity of adverse events (AEs) and identify risk factors in routine practice. Safety data collection through registries and prospective or retrospective cohorts has confirmed that AIT is generally well tolerated across larger and heterogeneous populations, healthcare settings, and AIT practices. However, rare systemic reactions (SRs) and exceptionally fatal reactions (FRs) continue to occur. Careful pretreatment evaluation and close monitoring remain crucial, particularly during subcutaneous immunotherapy due to the higher risk of systemic reactions. Data on sublingual immunotherapy support a more favourable safety profile, with infrequent systemic reactions and no fatal reactions reported to date. In venom allergy, new evidence on clonal mast cell disorders, hereditary α-tryptasemia and detection of KIT p. D816V in peripheral blood is refining risk stratification.Summary: Systemic and severe adverse events associated with AIT are infrequent. Careful risk stratification and evaluation before initiating immunotherapy can help identify high-risk patients and optimize the benefit-risk balance.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688613","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

Drug-induced anaphylaxis in pregnant women: a call for correct labeling antibiotic allergies. 孕妇药物性过敏反应：对正确标记抗生素过敏的呼吁。

IF 2.8 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2026-08-01 Epub Date: 2026-06-08 DOI: 10.1097/ACI.0000000000001174

Cintia Bassani, Pascal Demoly, Luciana Kase Tanno

{"title":"Drug-induced anaphylaxis in pregnant women: a call for correct labeling antibiotic allergies.","authors":"Cintia Bassani, Pascal Demoly, Luciana Kase Tanno","doi":"10.1097/ACI.0000000000001174","DOIUrl":"10.1097/ACI.0000000000001174","url":null,"abstract":"Purpose of review: Drug-induced anaphylaxis during pregnancy, although uncommon, represent potentially serious clinical situation with significant maternal-fetal impact and relevant therapeutic implications. This topic is particularly timely given the need for guidance of health professionals dealing with this challenge and correct labelling patients with drug allergy/hypersensitivity.Recent findings: Recent studies report a high prevalence of self-reported β-lactam allergy during pregnancy, with poor correlation with true allergy, underscoring the value of structured, safe, and effective diagnostic evaluation for appropriate delabeling.Summary: These findings highlight the need for a systematic approach to drug-induced anaphylaxis in pregnancy, including accurate diagnosis and protocol-based management. Incorporating allergological evaluation into prenatal care can reduce unnecessary risks, optimize maternal and fetal outcomes, and promote rational medication use. Important knowledge gaps remain, emphasizing the need for prospective studies with standardized methodologies and expanded immunological assessment.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"274-280"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239069","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

Probiotics in allergic disease: from adjunct supplement to immune-modifying strategy (2026 update). 过敏性疾病中的益生菌：从辅助补充到免疫修饰策略（2026年更新）。

IF 2.8 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2026-08-01 Epub Date: 2026-06-09 DOI: 10.1097/ACI.0000000000001171

Giorgio S Raho

{"title":"Probiotics in allergic disease: from adjunct supplement to immune-modifying strategy (2026 update).","authors":"Giorgio S Raho","doi":"10.1097/ACI.0000000000001171","DOIUrl":"10.1097/ACI.0000000000001171","url":null,"abstract":"Purpose of review: Allergic diseases continue to increase globally, and accumulating evidence implicates early-life microbial exposures as central determinants of immune tolerance. This review synthesizes advances from 2024 to 2026 regarding probiotic-mediated immune modulation and their translational implications in allergy prevention and therapy.Recent findings: Recent studies confirm strain-specific expansion of Foxp3+ regulatory T cells, suppression of Th2 polarization, reinforcement of epithelial barrier integrity, and durable epigenetic stabilization mediated by short-chain fatty acids such as butyrate. Clinical trials demonstrate benefit in perinatal prevention of atopic dermatitis, modulation of allergic rhinitis symptoms, early-life asthma risk reduction, and probiotic-adjuvanted oral immunotherapy.Summary: Probiotics are evolving from adjunctive supplements to biologically active immune modulators with disease-modifying potential. Integration with allergen immunotherapy and precision microbiome profiling may redefine preventive and therapeutic strategies in allergic disease.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"313-320"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239136","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

Beta-lactam de-labelling as a core antimicrobial stewardship strategy in the era of the antimicrobial resistance pandemic: a narrative review. β -内酰胺去标签作为抗菌素耐药性大流行时代的核心抗菌素管理战略：叙述性回顾

IF 2.8 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2026-08-01 Epub Date: 2026-06-09 DOI: 10.1097/ACI.0000000000001179

Sudip Bhattacharya, Soumi Kundu

{"title":"Beta-lactam de-labelling as a core antimicrobial stewardship strategy in the era of the antimicrobial resistance pandemic: a narrative review.","authors":"Sudip Bhattacharya, Soumi Kundu","doi":"10.1097/ACI.0000000000001179","DOIUrl":"10.1097/ACI.0000000000001179","url":null,"abstract":"Purpose of review: Antimicrobial resistance (AMR) is increasingly recognised as a global public health emergency that threatens the foundations of modern medicine. While much attention has focused on antimicrobial overuse, under-emphasised drivers such as inaccurate drug allergy labels continue to undermine antibiotic stewardship efforts. Beta-lactam allergy (BLA) labels, particularly penicillin allergy labels, are among the most prevalent and most consequential of these inaccuracies. Mounting evidence demonstrates that the vast majority of individuals labelled as beta-lactam allergic are not truly allergic, yet these labels persist across healthcare systems and generations, driving the use of broader-spectrum, less effective, more toxic and resistance-promoting antibiotics. In this timely review, we argue that beta-lactam de-labelling should no longer be viewed as a niche allergy intervention but as a core antimicrobial stewardship strategy and an ethical obligation in the era of the AMR pandemic.Recent findings: Drawing on emerging inpatient and outpatient evidence, including recent paediatric inpatient de-labelling studies, we examine clinical, behavioural, system-level and ethical barriers to de-labelling and propose a reframing of beta-lactam de-labelling as a public health intervention essential for preserving antibiotic effectiveness.Summary: We conclude by outlining policy-relevant recommendations for embedding de-labelling into routine care pathways, particularly in low and middle-income countries (LMICs), where the consequences of AMR are likely to be most severe.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"294-299"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239055","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 insights into the diagnosis and management of patients with cutaneous drug hypersensitivity. 皮肤药物过敏的诊断和治疗的新见解。

IF 2.8 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2026-08-01 Epub Date: 2026-05-14 DOI: 10.1097/ACI.0000000000001166

Yiwei Liu, Lichen Li, Yonghu Sun

{"title":"New insights into the diagnosis and management of patients with cutaneous drug hypersensitivity.","authors":"Yiwei Liu, Lichen Li, Yonghu Sun","doi":"10.1097/ACI.0000000000001166","DOIUrl":"10.1097/ACI.0000000000001166","url":null,"abstract":"Purpose of review: Cutaneous drug hypersensitivity reactions (CDHRs) are immune-mediated adverse events with significant morbidity and mortality. Their diverse clinical presentations, complex pathophysiology, and growing list of causative agents pose considerable diagnostic and therapeutic challenges. This review summarizes recent advances aimed at improving the identification and management of CDHRs.Recent findings: A multi-dimensional diagnostic approach is now recommended, integrating detailed clinical phenotyping, validated causality assessment scales, and objective testing - including skin tests, in-vitro assays (e.g. LTT, ELISpot), and pharmacogenomic screening for high-risk HLA alleles. Innovations in test methodology have enhanced diagnostic accuracy. Concurrently, insights into immune mechanisms have driven the development of targeted therapies, such as TNF-α inhibitors, JAK inhibitors, and interleukin antagonists, offering new options for severe or refractory cases.Summary: The integration of optimized diagnostic tools enables more precise identification of culprit drugs. Furthermore, the advent of mechanism-based biologics and small-molecule agents, alongside proactive HLA screening, is shifting the management paradigm from reactive treatment toward precision medicine and primary prevention. These advances collectively aim to reduce the burden of CDHRs, improve patient outcomes, and guide safer prescribing practices.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"256-263"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155709","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

Immediate allergic reactions to penicillins: unanswered questions. 青霉素的直接过敏反应：未解之谜。

IF 2.8 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2026-08-01 Epub Date: 2026-05-14 DOI: 10.1097/ACI.0000000000001162

Miguel Blanca, Javier Fernandez, Ana Fernandez-Barragan, Natalia Blanca-Lopez

{"title":"Immediate allergic reactions to penicillins: unanswered questions.","authors":"Miguel Blanca, Javier Fernandez, Ana Fernandez-Barragan, Natalia Blanca-Lopez","doi":"10.1097/ACI.0000000000001162","DOIUrl":"10.1097/ACI.0000000000001162","url":null,"abstract":"Purpose of review: Penicillins and other beta-lactam antibiotics are the most frequent drugs involved in allergic drug reactions. Our aim was to outline major questions regarding immediate hypersensitivity reactions with a special focus on amoxicillin, a drug that can induce selective responses, and on the common determinants shared by all penicillins, the structure formed by the beta-lactam ring bound to proteins. This review analyzes recent research and contextualizes the findings in relation to the previous literature, which we define as the classical model. This includes an analysis of antibiotic prescription patterns, clinical entities induced by specific immunoglobulin E antibodies, other proposed mechanisms involved in immediate reactions, and the value of diagnostic tests including drug provocation.Recent findings: Amoxicillin, alone or in combination with the beta-lactamase inhibitor clavulanic acid, is the most frequent penicillin involved in hypersensitivity drug reactions in many countries. Early reports of this pattern from Spain have been and continue to be confirmed by other groups. Analysis of the recent literature shows the complexity of this area, notwithstanding the findings of earlier studies, which mainly focused on allergy to penicillin based on the classical concept of major and minor determinants of benzyl penicillin.Summary: The amoxicillin model, together with other drugs in the penicillin group, provides relevant information about what is known and what questions must be addressed in future research on beta-lactam allergies.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"237-244"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155725","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

Immediate hypersensitivity to herbal medicine: from diagnosis to policies. 对草药立即过敏：从诊断到政策。

IF 2.8 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2026-08-01 Epub Date: 2026-05-14 DOI: 10.1097/ACI.0000000000001168

Chester Yan-Jie Ng, Linda L D Zhong, Bernard Yu-Hor Thong

{"title":"Immediate hypersensitivity to herbal medicine: from diagnosis to policies.","authors":"Chester Yan-Jie Ng, Linda L D Zhong, Bernard Yu-Hor Thong","doi":"10.1097/ACI.0000000000001168","DOIUrl":"10.1097/ACI.0000000000001168","url":null,"abstract":"Purpose of review: In recent years, the global consumption of herbal medicines has been increasing, accompanied by increasing reports of immediate hypersensitivity reactions (IHRs). Given the potential impact on patient safety, there is an increasing need to tighten regulations on herbal medicine use to reduce the incidence of herbal medicine-induced IHRs. Hence, this review consolidates current evidence on the pathophysiological mechanisms, clinical manifestations, and regulatory responses related to IHRs caused by herbal medicines, before providing perspectives for future research in diagnosis, pharmacovigilance, and policymaking.Recent findings: Immunoglobulin E (IgE)-mediated and non-IgE-mediated mechanisms are implicated in IHRs. Bioactive constituents and impurities in herbal medicines have been identified as possible causes of IHRs. Clinically, herbal-induced IHRs present with cutaneous, respiratory, and systemic symptoms that may progress to anaphylaxis. Regulatory bodies worldwide have implemented regulatory frameworks and pharmacovigilance systems, however there is still room for improvement.Summary: IHRs to herbal medicines represent a growing safety concern in integrative healthcare. Future research should emphasize mechanistic characterization, improved pharmacovigilance, and well-planned regulation on herbal medicines. Strengthening clinician awareness and adverse-event reporting will be critical to safeguarding patients and ensuring the evidence-based integration of herbal medicines into modern medical practice.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"287-293"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155732","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

Updates on drug-induced anaphylaxis in children. 儿童药物性过敏反应的最新进展。

IF 2.8 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2026-08-01 Epub Date: 2026-06-09 DOI: 10.1097/ACI.0000000000001180

Tiago Pereira, Maria Luís Marques, Eva Gomes

{"title":"Updates on drug-induced anaphylaxis in children.","authors":"Tiago Pereira, Maria Luís Marques, Eva Gomes","doi":"10.1097/ACI.0000000000001180","DOIUrl":"10.1097/ACI.0000000000001180","url":null,"abstract":"Purpose of review: Data on pediatric drug-induced anaphylaxis (DIA) are scarce, as drugs are less common triggers of anaphylaxis in children; however, drugs are associated with more severe reactions and unusual presentations. This review summarizes evidence on pediatric DIA, covering epidemiology, clinical manifestations, triggers, and management focusing on pediatric specificities.Recent findings: Available data shows that drugs are responsible for up to one-third of childhood anaphylaxis. Approximately half of DIA cases occur in healthcare facilities and triggers vary according to settings. In addition to beta-lactams and NSAIDs, other medications raise concerns in specific populations. Age-dependent and trigger-dependent differences regarding symptoms have been reported. Undertreatment remains a major problem.Summary: The importance of DIA in children increases with age. Boys appear more frequently affected. Diagnosis is clinical but challenging especially in younger age groups and in perioperative settings. Elevated tryptase supports diagnosis but lacks sensitivity. Antibiotics and NSAIDs are major culprits, but in hospitalized patients, anesthetics and chemotherapeutic drugs are also relevant. Vaccines, biologicals, and immunotherapy extracts may be important in pediatric allergy practice. Immediate treatment is adrenaline, largely underused in children, even in hospital settings. All patients with DIA should undergo allergy evaluation to prevent recurrences and overlabeling of drug allergy.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"281-286"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239117","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