Current Opinion in Allergy and Clinical Immunology最新文献_第3页

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

The immunogenicity and safety of adenoviral-based vaccines. 腺病毒疫苗的免疫原性和安全性。

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.0000000000001167

Joshua Gardner

{"title":"The immunogenicity and safety of adenoviral-based vaccines.","authors":"Joshua Gardner","doi":"10.1097/ACI.0000000000001167","DOIUrl":"10.1097/ACI.0000000000001167","url":null,"abstract":"Purpose of review: Human adenoviruses (HAdVs) have shown promise as versatile and effective delivery vectors for vaccine development. This was highlighted during the COVID-19 pandemic, which demonstrated the importance of effective vaccines but also provided scope to explore potential limitations of current viral-vector based strategies. This review summarizes the current applications of adenoviral vectors, in addition to discussing the immunological mechanisms underpinning immunogenicity and safety of viral vector-based vaccines.Recent findings: Clinical trials involving HAdVs have been undertaken to combat a range of infectious diseases, such as SARS-CoV-2, Ebola and HIV-1. However, empirical evidence indicates that preexisting T-cell immunity to adenoviruses may occur independent of serological exposure, predominantly arising from the conserved nature of immunogenic hexon proteins. As a result, T-cell responses are frequently detectable and often demonstrate broad cross-reactivity between human and nonhuman adenovirus (AdV) serotypes. Adverse events to vaccination are rare, although thrombotic events and severe cutaneous adverse reactions have been reported.Summary: Antivector T-cell immunogenicity arising from preexisting viral exposure or T-cell cross-reactivity may influence vaccine-specific immune responses. Continuous iterative refinement within the development of new vaccine vector technologies is therefore essential to circumvent limitations associated with vector-specific T-cell responses. However, mechanistic insight on the role of T-cells within pathomechanisms of adverse events remains unclear.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"264-273"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947912","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

Fractional exhaled nitric oxide and nasal nitric oxide as biomarkers in chronic rhinosinusitis. 呼气一氧化氮和鼻腔一氧化氮作为慢性鼻窦炎的生物标志物。

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.0000000000001163

Alessandro Solinas, Ina Zalar, Giovanni Paoletti, Enrico Heffler, Nicolò Valli

{"title":"Fractional exhaled nitric oxide and nasal nitric oxide as biomarkers in chronic rhinosinusitis.","authors":"Alessandro Solinas, Ina Zalar, Giovanni Paoletti, Enrico Heffler, Nicolò Valli","doi":"10.1097/ACI.0000000000001163","DOIUrl":"10.1097/ACI.0000000000001163","url":null,"abstract":"Purpose of review: This article summarizes current evidence on the role of fractional exhaled nitric oxide (FeNO) and nasal nitric oxide (nNO) as noninvasive biomarkers in chronic rhinosinusitis with nasal polyps (CRSwNP), focusing on their potential to refine endotype-driven diagnosis and monitoring in the context of united airways disease.Recent findings: Recent studies show that nNO levels are markedly reduced in CRSwNP, especially in eosinophilic phenotypes, where they correlate inversely with radiologic severity and may reflect both ostiomeatal obstruction and epithelial nitric oxide synthase dysfunction. FeNO, conversely, is often elevated in CRSwNP, even in the absence of overt asthma, is higher than in chronic rhinosinusitis without nasal polyps, and associates with type 2 inflammatory markers, symptom burden, and extended nitric oxide parameters indicating diffuse lower airway involvement. Surgical and biologic therapies targeting type 2 inflammation rapidly modify FeNO and nNO, with postoperative nNO increases and FeNO reductions, and early parallel improvements during dupilumab treatment suggesting that both indices can serve as dynamic markers of treatment response.Summary: FeNO and nNO capture complementary aspects of CRSwNP pathophysiology, integrating information on sinonasal ventilation, epithelial function, and type 2 inflammation along the nose-lung axis, but their routine clinical use is currently limited by methodological heterogeneity, lack of validated cut-offs, and scarcity of longitudinal, combined assessments. Standardized measurement protocols and multicenter studies are needed to validate FeNO and nNO as reliable tools for endotype-based stratification, early detection of lower airway involvement, and personalized selection and monitoring of medical or surgical interventions in CRSwNP.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"300-306"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155701","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

Asthma in athletes: diagnostic challenges and management strategies. 运动员哮喘：诊断挑战和管理策略。

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.0000000000001165

Andrea Giovanni Ledda, Michele Ruggiu, Martina Bullita, Giulia Costanzo, Stefano Del Giacco

{"title":"Asthma in athletes: diagnostic challenges and management strategies.","authors":"Andrea Giovanni Ledda, Michele Ruggiu, Martina Bullita, Giulia Costanzo, Stefano Del Giacco","doi":"10.1097/ACI.0000000000001165","DOIUrl":"10.1097/ACI.0000000000001165","url":null,"abstract":"Purpose of review: Exercise-induced bronchoconstriction (EIB) and exercise-induced asthma (EIA) are common conditions among athletes and represent an important clinical issue with potential implications for both respiratory health and athletic performance. The prevalence of asthma in athletes is higher than in the general population, likely due to the combined effects of increased ventilatory demand and environmental exposures.Recent findings: The pathophysiology of EIB is multifactorial and involves osmotic and thermal mechanisms related to airway dehydration during exercise-induced hyperventilation. Although some athletes present a classical T2-high inflammatory phenotype associated with allergic sensitization, a considerable proportion develop EIB through non-T2 inflammatory pathways, including airway epithelial injury and autonomic dysregulation.Summary: Diagnosis requires objective assessment through pulmonary function testing and bronchial provocation tests. Biomarkers like fractional exhaled nitric oxide (FeNO) and blood eosinophil counts can support phenotypic characterization, but they do not replace functional testing. Management in athletes follows established asthma guidelines and includes inhaled corticosteroids as the cornerstone of therapy, combined with pharmacological and non-pharmacological strategies. Considering anti-doping regulations is also essential to ensure appropriate treatment and compliance.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"307-312"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155672","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

Reframing paucigranulocytic asthma through genetic endotyping: a hypothesis-generating focus on the 17q21 rs7216389 locus. 通过基因内分型重构少粒细胞性哮喘：对17q21 rs7216389位点的假设生成焦点

IF 2.8 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2026-08-01 Epub Date: 2026-03-27 DOI: 10.1097/ACI.0000000000001145

Remo Poto, Rory Chan, Daniela Breda, Gilda Varricchi, Samuele E Burastero

{"title":"Reframing paucigranulocytic asthma through genetic endotyping: a hypothesis-generating focus on the 17q21 rs7216389 locus.","authors":"Remo Poto, Rory Chan, Daniela Breda, Gilda Varricchi, Samuele E Burastero","doi":"10.1097/ACI.0000000000001145","DOIUrl":"10.1097/ACI.0000000000001145","url":null,"abstract":"Purpose of review: Non-T2 asthma is currently defined by missing parameters, such as low blood eosinophils and FeNO, rather than positively identifiable mechanistic features. This definition overlaps with paucigranulocytic asthma (PGA). However, T2-biomarkers fluctuate over time, especially during glucocorticoid therapy, leading to potential over-diagnosis of T2-low asthma. Advancing beyond traditional endotyping is required for precision medicine.Recent findings: Alarmin-driven asthma [interleukin (IL)-33, thymic stromal lymphopoietin (TSLP), IL-25] can drive inflammation even without high T2-markers, but these are difficult to measure clinically. Genetic testing, such as the rs7216389 SNP (17q21 locus, GSDMB/ORMDL3), offers a stable alternative. The T allele is linked to childhood-onset asthma, viral-induced alarmin release, and epithelial dysfunction. Notably, carriers of the T allele are more likely to respond to allergen immunotherapy (AIT). This genetic marker is not subjected to treatment-dependent modification and segregates with both T2-driven and alarmin-driven asthma.Summary: We propose that rs7216389 genotyping could be explored, within a treatable trait framework, to improve the mechanistic characterization of paucigranulocytic or low-biomarker asthma. While current data are associative, this one-time genetic assessment might contribute to research-driven stratification of \"hidden\" T2- or alarmin-leaning endotypes, potentially guiding the use of AIT and upstream biologics like anti-TSLP.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"331-336"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510341","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

Vascular remodeling in asthma: from mechanisms to precision medicine. 哮喘血管重构：从机制到精准医学。

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.0000000000001164

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

{"title":"Vascular remodeling in asthma: from mechanisms to precision medicine.","authors":"Remo Poto, Rory Chan, Gianluca Lagnese, Andrea Portacci, Gilda Varricchi","doi":"10.1097/ACI.0000000000001164","DOIUrl":"10.1097/ACI.0000000000001164","url":null,"abstract":"Purpose of review: Angiogenesis and lymphangiogenesis are increasingly recognized as dynamic components of airway remodeling in asthma, with potential contributions to airway wall thickening, edema, ventilation-perfusion mismatch and fixed airflow limitation. This review updates mechanistic and translational evidence from the most recent literature and positions vascular biology within precision medicine and disease-modification frameworks.Recent findings: Recent integrative concepts place epithelial barrier dysfunction and alarmin programs upstream of structural disease, providing a biologically plausible bridge between chronic airway injury, innate immune activation and endothelial plasticity across asthma endotypes. Advanced imaging is reshaping phenotyping by enabling non-invasive assessment of structure-function relationships, including airway wall abnormalities and vascular/perfusion signatures relevant to longitudinal monitoring. Long-term data on upstream biologic therapy support sustained clinical benefits over years, strengthening the rationale to test whether vascular abnormalities are modifiable endpoints rather than static consequences of past inflammation.Summary: Vascular remodeling should be considered a clinically meaningful dimension of asthma heterogeneity that may explain persistent impairment despite inflammatory control. Integrating circulating angiogenesis-related mediators with imaging-derived vascular indices could refine risk stratification, inform treatment selection and accelerate a shift from symptom control toward durable disease modification.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"321-330"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947958","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

The master regulators of delayed-type drug hypersensitivity reactions. 迟发性药物超敏反应的主要调控者。

IF 2.8 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2026-08-01 Epub Date: 2026-05-20 DOI: 10.1097/ACI.0000000000001170

Lele Sun, Hong Liu, Furen Zhang

{"title":"The master regulators of delayed-type drug hypersensitivity reactions.","authors":"Lele Sun, Hong Liu, Furen Zhang","doi":"10.1097/ACI.0000000000001170","DOIUrl":"10.1097/ACI.0000000000001170","url":null,"abstract":"Purpose of review: Delayed-type drug hypersensitivity reactions (DTHRs), ranging from benign exanthems to life-threatening severe cutaneous adverse reactions such as Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS), are mediated by drug-specific T cells and governed by complex regulatory networks. This review highlights recent advances in understanding the master regulators orchestrating DTHR pathogenesis.Recent findings: HLA-restricted T-cell activation is amplified by cytokine-driven loops, notably the tumor necrosis factor-α axis, which disrupts peripheral tolerance via VISTA inhibition and recruits effectors through CXCL10. The JAK-STAT pathway plays a pathogenic role across immune and stromal compartments. Beyond genetic risk, epigenetic modifications (e.g., DNA methylation) fine-tune immune reactivity. Emerging immunomodulatory circuits involving sensory neuropeptides (CGRP) and innate immune cells (NK cells, neutrophils) critically shape adaptive responses. Terminal epidermal damage involves convergent cell death pathways (apoptosis, ferroptosis, and necroptosis) often triggered by systemic exosomal signals.Summary: Deciphering these interconnected regulatory layers reveals novel diagnostic biomarkers and therapeutic targets, paving the way for precision medicine in DTHRs.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"245-255"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155680","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 immunogenetic landscape of systemic lupus erythematosus. 系统性红斑狼疮的免疫遗传学景观。

IF 2.6 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2026-06-11 DOI: 10.1097/ACI.0000000000001175

Chiara Lo Presti, Licia Peruzzi, Francesco Licciardi

{"title":"The immunogenetic landscape of systemic lupus erythematosus.","authors":"Chiara Lo Presti, Licia Peruzzi, Francesco Licciardi","doi":"10.1097/ACI.0000000000001175","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001175","url":null,"abstract":"Purpose of review: Systemic lupus erythematosus (SLE) is typically considered an acquired disease; nevertheless, a growing body of evidence suggests that, particularly in patients with severe disease and early onset, SLE may be due to single-gene mutations. To identify Inborn Error of Immunity genes that can cause monogenic SLE, we conducted a literature review. For each gene, we evaluated the plausibility of the reported association and defined the prevalent pathological pathway implicated in disease pathogenesis.Recent findings: In the latest International Union of Immunological Societies (IUIS) classification, SLE is mentioned as a phenotype in only a subset of the genes identified in this review as SLE-related. At least 25 additional genes included in the most recent IUIS classification have also been recently linked to SLE and should be analyzed in patients with suspected monogenic SLE.Summary: Genes related to different immunological pathways (from innate to adaptive immunity) can influence SLE development. A detailed clinical history, including previous infections, and a complete immunological evaluation should be performed in all patients with SLE at diagnosis, especially when monogenic SLE is suspected. Given the large number of genes and pathways associated with SLE, next-generation sequencing should be preferred over Sanger sequencing.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239133","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

Circadian control of innate immunity: molecular mechanisms and implications for allergic disorders. 先天免疫的昼夜节律控制：分子机制及其对过敏性疾病的影响。

IF 2.6 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2026-06-09 DOI: 10.1097/ACI.0000000000001176

Ammar Nahas, Daniel Zammit Lupi, Beatriz Nunez Colao, Keith Sacco

{"title":"Circadian control of innate immunity: molecular mechanisms and implications for allergic disorders.","authors":"Ammar Nahas, Daniel Zammit Lupi, Beatriz Nunez Colao, Keith Sacco","doi":"10.1097/ACI.0000000000001176","DOIUrl":"https://doi.org/10.1097/ACI.0000000000001176","url":null,"abstract":"Purpose of review: Circadian clocks are increasingly recognized as fundamental regulators of innate immune function, yet their relevance to allergy and clinical immunology has only recently been clarified. This review summarizes emerging evidence linking circadian regulation of innate immune cells to allergic inflammation and highlights the translational potential of circadian-informed therapeutic strategies.Recent findings: Core clock components are rhythmically expressed in macrophages, mast cells, neutrophils and innate lymphoid cells, where they regulate inflammatory signalling, immunometabolism and activation thresholds. Disruption of these rhythms exaggerates cytokine production, inflammasome activation and mast cell mediator release, contributing to diurnal patterns of allergic disease such as nocturnal asthma. Human and experimental studies demonstrate that circadian misalignment driven by shift work, irregular sleep and mistimed feeding amplifies innate inflammation and worsens allergic outcomes.Summary: Circadian regulation represents an underappreciated dimension of innate immunity in allergic disease. Aligning immunomodulatory therapies, vaccination, and lifestyle interventions with endogenous immune rhythms offers a rational approach to improving efficacy and reducing inflammatory burden. Future studies should prioritize time-stratified clinical trials and direct circadian phenotyping in allergic populations.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239141","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

Biologics for chronic rhinosinusitis with nasal polyps: from downstream cytokine blockade to upstream epithelial targets. 慢性鼻窦炎伴鼻息肉的生物制剂：从下游细胞因子阻断到上游上皮靶点。

IF 2.8 4区医学

Current Opinion in Allergy and Clinical Immunology Pub Date : 2026-06-01 Epub Date: 2026-04-04 DOI: 10.1097/ACI.0000000000001146

Farah Dayana Zahedi, Baharudin Abdullah, Pongsakorn Tantilipikorn

{"title":"Biologics for chronic rhinosinusitis with nasal polyps: from downstream cytokine blockade to upstream epithelial targets.","authors":"Farah Dayana Zahedi, Baharudin Abdullah, Pongsakorn Tantilipikorn","doi":"10.1097/ACI.0000000000001146","DOIUrl":"10.1097/ACI.0000000000001146","url":null,"abstract":"Purpose of review: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogenous inflammatory disease that often persist despite optimal medical and surgical treatment. Advances in the understanding of CRS immunopathophysiology have led to the development of biologic therapies targeting specific inflammatory pathways. This review summarizes the current knowledge on the downstream biologics and the latest update on the next generation upstream biologics therapies in CRSwNP, with focus on endotype-driven treatment selection.Recent findings: Biologic therapies targeting downstream mediators of type 2 inflammation, including immunoglobulin E and interleukins interleukin (IL)-4, IL-5 and IL-13, have demonstrated substantial clinical benefit in selected patients. Nevertheless, CRSwNP commonly involves overlapping inflammatory endotypes, which may limit treatment response. Newer biologics targeting upstream epithelial-derived cytokines offer broader approach by modulating multiple inflammatory pathways simultaneously and may address current therapeutic gaps. The development of long-acting biologics also improves treatment convenience and adherence.Summary: Biologic therapy has shifted CRSwNP management towards a more personalized, mechanism-based approach. Upstream-targeted treatments represent an important step forward, particularly for patients with refractory or mixed disease. Future research should focus on biomarker-guided therapy and long-term clinical outcomes.","PeriodicalId":10956,"journal":{"name":"Current Opinion in Allergy and Clinical Immunology","volume":" ","pages":"149-156"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632807","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