European annals of allergy and clinical immunology最新文献

{"title":"Clinical severity of LTP syndrome is associated with an expanded IgE repertoire, FDEIA, FDHIH, and LTP mono reactivity.","authors":"E Scala, D Abeni, V Villella, D Villalta, L Cecchi, V Pravettoni, M Giani, E Caprini, R Asero","doi":"10.23822/EurAnnACI.1764-1489.314","DOIUrl":"10.23822/EurAnnACI.1764-1489.314","url":null,"abstract":"<p><strong>Summary: </strong><b>Background.</b> Lipid transfer proteins (LTP) allergy is often a challenge for clinicians. We evaluated a multiplex diagnostic approach with diverse cofactors to stratify LTP syndrome risk. <b>Methods.</b> Of the 1,831 participants screened with 'Allergy Explorer-ALEX-2', 426 had reactions to at least one LTP. Data was gathered and recorded via an electronic database. <b>Results.</b> Reactivity to peach Pru p 3 was found in 77% of individuals with LTP allergy. Higher levels of specific IgE and concurrent sensitization to more than 5 molecules (50% of all LTP-sensitised participants, 62% of symptomatic cases) were significantly associated with an increased risk of severe reactions (p = 0.001). Several cofactors, either alone or in combination, also influenced patients' clinical outcomes. Some cofactors increased the risk of severe reactions, such as mono reactivity to LTP in 44.6% of cases (p = 0.001), Food-Dependent Exercise-Induced Anaphylaxis (FDEIA) in 10.8% of patients (p = 0.001), and Food-dependent NSAID-induced hypersensitivity (FDNIH) in 11.5% (p = 0.005). On the other hand, reactivity to PR10 (24.2%; p = 0.001), profilin hypersensitivity (10.3%; p = 0.001), and/or atopic dermatitis (16.7%; p = 0.001) had a mitigating effect on symptom severity. <b>Conclusions.</b> Clinical severity of LTP syndrome is associated with an expanded IgE repertoire in terms of the number of LTP components recognized and increased IgE levels in individual molecules. Ara h 9, Cor a 8, and Mal d 3 showed the strongest association with clinical severity. In addition, several cofactors may either exacerbate (FDEIA, FDHIH, and LTP monoreactivity) or ameliorate (atopic dermatitis and co-sensitization to profilin and/or PR10) individual patient outcomes. These factors may be utilized for the daily clinical management of LTP syndrome.</p>","PeriodicalId":11890,"journal":{"name":"European annals of allergy and clinical immunology","volume":" ","pages":"128-139"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10242276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pruritus burden assessment in severe atopic dermatitis patients under dupilumab: response predictor?","authors":"R Brás, R Limão, E Pedro, A Lopes","doi":"10.23822/EurAnnACI.1764-1489.308","DOIUrl":"10.23822/EurAnnACI.1764-1489.308","url":null,"abstract":"","PeriodicalId":11890,"journal":{"name":"European annals of allergy and clinical immunology","volume":" ","pages":"140-142"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9883828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The autologous serum skin test predicts the response to anti-IgE treatment in chronic spontaneous urticaria patients: a prospective study.","authors":"A Palladino, F Villani, E Pinter, M Visentini, R Asero","doi":"10.23822/EurAnnACI.1764-1489.337","DOIUrl":"10.23822/EurAnnACI.1764-1489.337","url":null,"abstract":"<p><strong>Summary: </strong><b>Background.</b> Chronic spontaneous urticaria (CSU), characterized by recurrent itchy wheals and angioedema for > 6 weeks, is a quite common disease that may heavily impair the quality of life. Omalizumab, an anti-IgE mAb, has much improved the management of CSU but patients' response to the drug may vary and predictive markers are still largely missing. We investigated the predictive value of the autologous serum skin test (ASST) on omalizumab response. <b>Methods.</b> 15 patients with severe CSU eligible for omalizumab treatment were prospectively studied submitting them to ASST and to complete blood count, D-dimer, anti-thyroid peroxidase antibodies, and total IgE measurement before the start of the treatment. <b>Results.</b> 14/15 (93%) responded brilliantly to omalizumab at 3 months assessment. 7 responded in less than 1 month (\"early responders\") and 7 only after multiple administrations (\"late responders\"). Of 9 patients scoring positive on ASST, 7 (78%) were late, and 2 (22%) early responders to omalizumab (p = 0.021). Of 6 patients scoring negative on ASST, 5 were early omalizumab responders and 1 did not respond. The PPV and NPV of the ASST for a \"late\" response to omalizumab were 78% and 100%, respectively. Total IgE were significantly higher in early responders. <b>Conclusions.</b> Although larger prospective studies are needed to confirm these results, this study confirms previous retrospective investigations that the positive ASST appears to predict a slow response to omalizumab in CSU patients.</p>","PeriodicalId":11890,"journal":{"name":"European annals of allergy and clinical immunology","volume":" ","pages":"115-119"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of patch testing based on clinical response to contact allergen restrictions in allergic contact dermatitis.","authors":"J Sánchez, L Álvarez, S Diez, J Miquel-Miquel, M Velásquez","doi":"10.23822/EurAnnACI.1764-1489.331","DOIUrl":"10.23822/EurAnnACI.1764-1489.331","url":null,"abstract":"<p><strong>Summary: </strong><b>Background.</b> Patch testing (PT) is used to identify substances that cause allergic contact dermatitis (ACD). However, the clinical effects of allergen restrictions following PT have not been thoroughly investigated. This study aims to assess the diagnostic accuracy of PT in patients suspected of having ACD. <b>Methods.</b> Prospective study. PT were performed in patients with clinical diagnosis of ACD. Patients with a positive PT (case group) had a strict restriction of the suspected substance for one month. In patients with negative patch testing (control group), allergen restriction was based in clinical history. Clinical reduction (CR) of at least 50% in disease activity (CR50%) after one month of allergen restriction was considered clinically relevant. Total control was defined as clinical reduction of at least 90% (CR90%). <b>Results.</b> From 400 patients, 66.2% had a positive PT. The sensitivity of PT to identify CR50% was 84%, specificity 47%, PPV 53%, and NPV 81%. Only 10.5% of patients achieved CR90%. <b>Conclusions.</b> The PT had moderate diagnostic accuracy. It could be useful as a screening, but a positive result should be confirmed with controlled allergen restriction. The low number of patients who achieved a 90% CR invites to reconsider the allergens included in PT and the mechanistic processes of the disease.</p>","PeriodicalId":11890,"journal":{"name":"European annals of allergy and clinical immunology","volume":" ","pages":"107-114"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A narrative review on allergy and exposure to domestic and non-domestic animals: favorable and unfavorable effects.","authors":"G Liccardi, M Martini, M B Bilò, L Cecchi, M Milanese, A Musarra, E Puxeddu, P Rogliani","doi":"10.23822/EurAnnACI.1764-1489.372","DOIUrl":"10.23822/EurAnnACI.1764-1489.372","url":null,"abstract":"<p><strong>Summary: </strong>The aim of this contribution was to highlight the \"favorable\" and \"unfavorable\" roles of domestic and non-domestic animals on airway sensitization processes and on the type/severity of the clinical symptoms induced by their exposure. We performed a literature research in MEDLINE for allergic manifestations and animals. Pets can be \"allergy friends\" through mechanisms related to hygiene hypothesis and translational aspects, the dual role of IgG4 antibodies for pets, and their promising role as healthcare service animals (dogs). On the contrary, animals can be \"allergy enemies\" when inducing allergic sensitization and  respiratory symptoms (sometimes leading to severe reactions), and also due to cross reactivity with other pets allergens, indirect exposure and ubiquity of their allergens, cross reactivity between Can f 5 and human prostate-specific antigen (PSA). Moreover, in some cases they can trigger anaphylaxis, induce occupational asthma, and act as pests. Finally, we must outline the modest efficacy of allergen immunotherapy (AIT) for their allergens. From a strictly allergological perspective, it is evident that the \"negative\" aspects resulting from exposure to domestic / non-domestic animals outweigh the \"positive\" aspects. As a consequence, it is up to humans to seek new ways to balance the pros and cons by exploring research areas that can allow the best possible coexistence with subjects at risk of allergy with domestic and non-domestic animals.</p>","PeriodicalId":11890,"journal":{"name":"European annals of allergy and clinical immunology","volume":" ","pages":"99-106"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaphylaxis trend before and during pandemic: COVID-19 did not affect anaphylaxis frequency.","authors":"A Sangalli, A Fasiello, V Pravettoni, D Consonni, V Melli, A Jachetti, V Longo, N Montano, F Rivolta","doi":"10.23822/EurAnnACI.1764-1489.395","DOIUrl":"https://doi.org/10.23822/EurAnnACI.1764-1489.395","url":null,"abstract":"<p><strong>Summary: </strong><b>Background</b>. Data on epidemiology of anaphylaxis are difficult to record. During the lockdown in 2020-2021 due to Coronavirus disease 2019 (COVID-19), referrals to Emergency Department (E.D.) reduced. The aims of the study are to determine anaphylaxis frequency before and during COVID-19 pandemic and risk factors for severity. <b>Methods</b>. Clinical records from a general E.D. of Milan in Italy were retrospectively evaluated before (2018-2019) and during the COVID-19 pandemic (2020-2021) analyzing demographic data, comorbidities, chronic therapies, causes, severity and adrenaline use. <b>Results</b>. The frequency of anaphylaxis remained stable (120/104129 = 0.12% in 2018-2019; 72/66720 = 0.11% in 2020-2021). No differences in the occurrence of anaphylaxis were found in sex and mean age. The main causes of anaphylaxis were food (2018-2019: 53% vs 2020-2021: 51%) and drugs (2018-2019: 27% vs 2020-2021: 33%). Hymenoptera stings had a low occurrence and unidentified trigger was about 15% in each period. The severity of anaphylaxis had a similar distribution in the two periods. Gender and cardiovascular diseases did not influence the severity, instead a positive correlation was found in age over 50 yo (p<0.001). Angiotensin II receptors blockers, β-blockers, diuretics and proton pump inhibitors were associated with increasing severity (p<0.01). Adrenaline administration was similar in the two periods. <b>Conclusions</b>. Anaphylaxis frequency was not affected by the COVID-19 pandemic. Food anaphylaxis remained the most important cause in the urban area. The severity of anaphylaxis was affected by ageing and some chronic therapies, which indirectly point out the role of chronic diseases in the clinical presentation.</p>","PeriodicalId":11890,"journal":{"name":"European annals of allergy and clinical immunology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 2-week time interval criterion may alter the spectrum of disease and patient characteristics in children diagnosed with hypereosinophilia.","authors":"I C Maslak","doi":"10.23822/EurAnnACI.1764-1489.394","DOIUrl":"https://doi.org/10.23822/EurAnnACI.1764-1489.394","url":null,"abstract":"<p><strong>Summary: </strong><b>Background.</b> Diagnostic criteria for hypereosinophilia (HE) have been revised. Accordingly, the minimum interval between the two results with an absolute eosinophil count (AEC) ≥ 1500 cells/µL has been reduced from 4 to 2 weeks. The aims of this study were to identify patients with HE according to the new diagnostic criteria in children and demonstrate the effects of the revised time interval criterion on patient characteristics and disease spectrum. <b>Methods.</b> Individuals aged ≤ 18 years admitted to a tertiary university hospital were identified using an algorithm based on old and new diagnostic criteria for HE. While patients diagnosed with HE according to old diagnostic criteria were included in group 1, patients who were diagnosed with HE according to the new diagnostic criteria but did not meet the old criteria were included in group 2. <b>Results.</b> Patients in group 1 were significantly older than patients in group 2 at the time of diagnosis of HE (p = 0.004). While the number of patients diagnosed with HE aged 1-5 years was higher in group 1 (p = 0.01), the number of patients diagnosed with HE under the age of one year was higher in group 2 (p = 0.002). The most common cause of HE in group 1 was allergic disorders (10/40, 25%), while non-parasitic infections (17/36, 47%) were the most common diagnosis in group 2. <b>Conclusions.</b> The new diagnostic criteria may change the characteristics of pediatric patients with HE and the spectrum of associated diseases.</p>","PeriodicalId":11890,"journal":{"name":"European annals of allergy and clinical immunology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transitioning from nonspecific therapy to berotralstat in hereditary angioedema type I: real world data from three patients within the same family.","authors":"D Vincent, A Ghanam","doi":"10.23822/EurAnnACI.1764-1489.391","DOIUrl":"https://doi.org/10.23822/EurAnnACI.1764-1489.391","url":null,"abstract":"","PeriodicalId":11890,"journal":{"name":"European annals of allergy and clinical immunology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IL-2 and the thymus/weight index are inversely correlated with gestational age: a sign of Th1/Th2 imbalance in preterm infants and a possible connection with atopic dermatitis.","authors":"A Kowalik, Z Kwapińska, K Węglarczyk, M Stec, M Cisowska, M Siedlar, P Kwinta","doi":"10.23822/EurAnnACI.1764-1489.393","DOIUrl":"https://doi.org/10.23822/EurAnnACI.1764-1489.393","url":null,"abstract":"<p><strong>Summary: </strong><b>Background.</b> Understanding the reason for the decrease in atopic dermatitis risk in preterm patients may be crucial for the development of prophylaxis and therapeutic measures. The hypotheses include a change in T-helper1/T-helper2/T-helper17 balance, thymus development, and intestinal colonization. This study was designed to compare these parameters between preterm and term patients.  <b>Methods.</b> The investigated population comprised 28 preterm and 19 term-born patients. On the 7^th day of life, T-helper1/T-helper2/T-helper17 cytokine concentrations were assessed, thymus ultrasonographic examination was performed, and the stool was examined for the presence of pathogenic bacteria. The last two procedures were repeated at 37 weeks of post-menstrual age in the preterm group. <b>Results.</b> There were no significant differences in the concentrations of interferon-γ, tumour necrosis factor-a (TNFa), interleukin (IL)-2, IL-6, or IL-10 after mitogen stimulation between the preterm and term groups. A negative correlation was found between IL-2 and the week of gestation at birth (r_s= -0.466, p=0.038) and thymus/weight ratio and week of gestation at birth (r_s= -0.592, p=0.006). IL-6 was negatively correlated with birth weight in preterm group (r_s -0.694, p=0.008), whereas IL-10 positively with birth weight in term group (r_s 0.775, p=0.041). Correlations of other investigated cytokines were statistically insignificant. The levels of IL-2 and interferon-γ after phytohemagglutinin stimulation were greater in the subgroup with pathogenic bacteria in the stool at birth (381.38 (148.7-727.4) vs. 13.23 (7.98-197.8) pg/ml; p=0.049; 17.49 (6.53-30.54) vs. 3.37 (1.03-9.82) pg/ml; p=0.037), whereas no significant differences were found between the levels of IL-6, IL-10 or TNFa. <b>Conclusions.</b> The observed associations may indicate an altered pattern of immunological development in preterm and term children.</p>","PeriodicalId":11890,"journal":{"name":"European annals of allergy and clinical immunology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allergists versus pediatricians: primary choice of metered-dose inhaler with spacer or nebulizer.","authors":"S Melethil, E Yousef","doi":"10.23822/EurAnnACI.1764-1489.392","DOIUrl":"https://doi.org/10.23822/EurAnnACI.1764-1489.392","url":null,"abstract":"<p><strong>Summary: </strong><b>Background.</b> Many physicians believe delivering medications for asthma exacerbation via nebulizers is more efficacious than using a metered dose inhaler (MDI) with spacer. This study aimed to evaluate pediatricians and allergists' chosen method in children under 5 years: MDI with spacer or nebulizer. <b>Methods.</b> A brief survey was sent via electronic mail to a randomly selected group of pediatricians and allergists. There was a 15.8% (430/2718) total response rate. We divided respondents into 2 groups. Group A comprised 289 primary care pediatricians, and Group B included 141 practicing allergists. <b>Results.</b> In Group A, 68.5% (196/286) respondents indicated an MDI with spacer as their method of choice to deliver bronchodilator therapy during an asthma exacerbation; 64.7% (187/289) reported an MDI with spacer is an effective method; and 48% (135/281) believe delivering medication through a nebulizer will produce increased adverse effects than MDIs with spacers. In Group B, 55% (77/140) of respondents indicated MDI with spacer as their method of choice; 48.9% (69/141) reported a nebulizer is an effective method; and 65.7% (90/137) believe delivering medication through a nebulizer will produce increased adverse effects. <b>Conclusions.</b> Contrary to evidence-based recommendations, most allergists, compared to pediatricians, are not only prescribing nebulizers as their first choice for delivering bronchodilator therapy, but also half of these asthma specialists consider nebulizers to be an effective mode of delivery. As far as safety is concerned, ironically, almost two-thirds of allergists believe more side effects are associated with delivering bronchodilator therapy through a nebulizer.</p>","PeriodicalId":11890,"journal":{"name":"European annals of allergy and clinical immunology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}