AllergyPub Date : 2025-10-11DOI: 10.1111/all.70098
Jung Yeon Han,Jea-Young Lee,Chang-Gyu Jung,Richard F Lockey,Rajesh Kumar,Dong Keon Yon,Narasaiah Kolliputi,Seong H Cho
{"title":"Genistein Reduced Eosinophilic Inflammation and Remodeling by Downregulating PAI-1 and TSLP.","authors":"Jung Yeon Han,Jea-Young Lee,Chang-Gyu Jung,Richard F Lockey,Rajesh Kumar,Dong Keon Yon,Narasaiah Kolliputi,Seong H Cho","doi":"10.1111/all.70098","DOIUrl":"https://doi.org/10.1111/all.70098","url":null,"abstract":"","PeriodicalId":122,"journal":{"name":"Allergy","volume":"38 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Sting Challenge Test: An EAACI Position Paper on Hymenoptera Venom Allergy.","authors":"Arantza Vega Castro,Christine Breynaert,Teresa Alfaya,Maria Beatrice Bilò,Filippo Fassio,Deniz Eyice Karabacak,Matteo Martini,Ümit Murat Sahiner,Berta Ruiz-León,Kymble Spriggs,Gunter Sturm,Elisa Boni","doi":"10.1111/all.70096","DOIUrl":"https://doi.org/10.1111/all.70096","url":null,"abstract":"A Sting Challenge Test (SCT) is the only reliable method to verify the effectiveness of venom immunotherapy (VIT) in patients allergic to Hymenoptera venom, a leading cause of anaphylaxis in adults. This European Academy of Allergy and Clinical Immunology (EAACI) position paper provides an in-depth analysis of the SCT's key applications, risks, and outcomes in clinical practice, focusing on its role in monitoring VIT efficacy, improving patient quality of life, and ensuring appropriate therapeutic interventions. The SCT is primarily used to assess VIT protection, adjust VIT dosage, and confirm patient safety but is not recommended for routine diagnosis due to the risk of provoking systemic allergic reactions. This position paper also offers practical considerations for performing the SCT, including insect handling, patient preparation, and risk management. While SCT is a valuable tool in personalized allergy treatment, it requires careful handling of live insects and patient preparation to ensure safety. This position paper reviews the literature and presents the expert experience of the Insect Venom Hypersensitivity Working Group of the European Academy of Allergy and Clinical Immunology.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"88 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AllergyPub Date : 2025-10-11DOI: 10.1111/all.70089
Javier Perez-Garcia,Anne K Bozack,Sheryl L Rifas-Shiman,Yanjiao Zhou,Joanne Sordillo,Brent Coull,Heike Luttmann-Gibson,Joel Schwartz,Marie-France Hivert,Emily Oken,Diane R Gold,Andres Cardenas
{"title":"The Nasal Microbiome and Associations With Environmental Exposures and Respiratory Health.","authors":"Javier Perez-Garcia,Anne K Bozack,Sheryl L Rifas-Shiman,Yanjiao Zhou,Joanne Sordillo,Brent Coull,Heike Luttmann-Gibson,Joel Schwartz,Marie-France Hivert,Emily Oken,Diane R Gold,Andres Cardenas","doi":"10.1111/all.70089","DOIUrl":"https://doi.org/10.1111/all.70089","url":null,"abstract":"BACKGROUNDThe nasal microbiome is directly in contact with the external environment and may play a role in respiratory health. This study aimed to evaluate the association of the nasal microbiome with air pollutants, meteorological conditions, and respiratory health in adolescents.METHODSWe analyzed the nasal microbiome in 416 adolescents from the Project Viva cohort (mean age 13 years and 52% female). We tested for the association of alpha diversity, nasotypes, and bacterial genera abundance with environmental exposures from the past 2 days to the past year (PM2.5, NO2, O3, temperature, humidity, residential greenness) and respiratory outcomes (asthma, hay fever, wheezing, IgE, aeroallergen sensitization, FeNO, lung function) through regression models adjusted for confounders and corrected using a false discovery rate (FDR) < 5%.RESULTSBacterial diversity was positively associated with hay fever and short-term exposure to NO2, while it was negatively correlated with temperature (FDR < 0.05). Adolescents whose nasal microbiome was dominated by Moraxella were exposed in the past week to lower O3 levels (ORs: 0.73-0.76) and higher temperature and humidity (ORs: 1.19-1.26). Staphylococcus dominance was positively associated with aeroallergen sensitization compared to Propionibacterium dominance (OR: 4.48, FDR = 0.03). Thirteen and eight bacterial genera abundance were associated with short-to-medium-term exposures (PM2.5, NO2, temperature) and respiratory outcomes (hay fever, wheezing, IgE, FeNO, lung function) (FDR < 0.05). Staphylococcus, Corynebacterium, Pelomonas, Lactococcus, Lachnospiraceae (unclassified), and Faecalibacterium abundance were associated with both environmental exposures and respiratory traits.CONCLUSIONSNasal microbiome diversity was associated with hay fever, NO2, and temperature exposure. Multiple short-to-medium-term environmental exposures and respiratory outcomes were associated with nasotypes and bacterial genera abundance in adolescents.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"11 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AllergyPub Date : 2025-10-11DOI: 10.1111/all.70093
E Da Choi,David Voehringer,Daniel Radtke
{"title":"Basophils in Skin-Mediated Sensitization Drive Subsequent Lung Inflammation in Airway-Challenged Mice.","authors":"E Da Choi,David Voehringer,Daniel Radtke","doi":"10.1111/all.70093","DOIUrl":"https://doi.org/10.1111/all.70093","url":null,"abstract":"BACKGROUNDAtopic dermatitis (AD) and asthma are observed as epidemiologically linked allergic comorbidities, both characterized by elevated systemic IgE levels and type 2 immunity. Basophils play a pivotal role in these responses by producing interleukin-4 (IL-4), which is essential for IgE synthesis and allergic inflammation. However, their specific impact on the progression from AD to asthma remains unclear.METHODSWe utilized an AD model in basophil-deficient Mcpt8Cre mice and temporarily basophil-depleted mice, where topical application of the vitamin D analog MC903 induced the alarmin TSLP, resulting in AD-like symptoms. In addition, we topically applied ovalbumin (OVA) as a model allergen to trace the allergen-specific immune response. We determined allergen-specific antibody formation by analysis of the germinal center reaction and measured serum antibody concentrations and IgE loading of basophils in the spleen and lung. We further challenged mice sensitized via the skin in anaphylaxis and allergic lung inflammation models.RESULTSOur results demonstrate that basophils promote loss of skin barrier integrity, allergen-specific IgE formation, and subsequent allergic responses. Basophil depletion selectively during sensitization significantly reduced IgE-dependent anaphylaxis and lung inflammation. In challenged lungs, reduced inflammation and eosinophilia were accompanied by lower levels of chemokines CCL17 and CCL24, which attract Th2 cells and eosinophils, respectively. Notably, Il4 and Il13 were not affected by basophil depletion during sensitization but were reduced in mice that permanently lack basophils.CONCLUSIONWe find that basophils promote IgE formation and lung sensitization to skin-encountered allergens and drive secondary allergen-induced lung inflammation. We separate the role of basophils in sensitization from their effector function during anaphylaxis or lung inflammation relevant to envision novel strategies to prevent the development of allergic comorbidities.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"75 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AllergyPub Date : 2025-10-10DOI: 10.1111/all.70092
Simon Chiang, Youn Soo Jung, William Thorley, Sophie Yu, Mitali Banerjee, Evelyn Rowe, Jonathan Zou, Jesus Mejia, Emilio Peveri, Advika Sumit, Regan Bergmark, Alice Maxfield, Rachel Roditi, Vanitha Sampath, Kari Nadeau, Stella E. Lee
{"title":"Forever Chemicals: An Exploratory, Population‐Based Analysis of Per‐ and Polyfluoroalkyl Substances Exposure and Effects on Sinonasal Health","authors":"Simon Chiang, Youn Soo Jung, William Thorley, Sophie Yu, Mitali Banerjee, Evelyn Rowe, Jonathan Zou, Jesus Mejia, Emilio Peveri, Advika Sumit, Regan Bergmark, Alice Maxfield, Rachel Roditi, Vanitha Sampath, Kari Nadeau, Stella E. Lee","doi":"10.1111/all.70092","DOIUrl":"https://doi.org/10.1111/all.70092","url":null,"abstract":"IntroductionPer‐ and Polyfluoroalkyl Substances (PFAS) are widely used chemicals, notably in nonstick coatings, fire‐fighting foams and equipment, and surfactants. These chemicals degrade slowly and accumulate in tissues and the environment, being detected in water, air, wildlife, and soil across the world. Initial studies have shown that these chemicals are associated with harmful health effects, but research in this area remains limited, especially in sinonasal diseases.MethodsThe National Health and Nutrition Examination Survey (NHANES) 2011–2014 was used to analyze the association between PFAS and taste and smell survey among adults (age ≥ 40) with complete data (<jats:italic>n</jats:italic> = 1911). The survey included self‐reported sinonasal symptoms. Multivariable logistic regression adjusted for covariates was used to describe the relationship between serum PFAS concentrations and sinonasal health. Bayesian kernel machine regression (BKMR) was performed to consider the diverse chemical properties of PFAS and how real‐life exposures involve multiple types of PFAS.ResultsThe logistic regression model found that serum PFAS levels were not significantly associated with sinonasal health outcomes, except serum Me‐PFOSA‐AcOH (OR: 1.164; 95% CI: 1.020–1.308), which significantly increased the likelihood of reporting frequent nasal congestion in the past 12 months. The BKMR model identified exposure–response relationships on olfaction of Me‐FPOSA‐AcOH and PFHxS becoming more pronounced as the concentration of PFNA within the mixture increased.ConclusionOur results explore potential relationships between PFAS and adverse sinonasal health effects. Exposure to Me‐PFOSA‐AcOH may be related to frequent nasal congestion, while other PFAS may have complex, mixture‐dependent effects on olfaction.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"18 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AllergyPub Date : 2025-10-09DOI: 10.1111/all.70073
Graham Roberts, Jocelyne Just, Hendrik Nolte, Ole Holm Hels, Andrzej Emeryk, Carmen Vidal
{"title":"SQ House Dust Mite Sublingual Immunotherapy Tablet in Children With Allergic Asthma: A Randomised Phase III Trial","authors":"Graham Roberts, Jocelyne Just, Hendrik Nolte, Ole Holm Hels, Andrzej Emeryk, Carmen Vidal","doi":"10.1111/all.70073","DOIUrl":"https://doi.org/10.1111/all.70073","url":null,"abstract":"BackgroundIn children, house dust mite (HDM) sensitisation is a contributing factor for developing allergic asthma. HDM allergen immunotherapy has demonstrated efficacy and safety in adults with allergic asthma; however, evidence for its use in children is limited. MT‐11 evaluated the efficacy and safety of the SQ HDM sublingual immunotherapy (SLIT) tablet in children (5–17 years) with HDM allergic asthma.MethodsThis phase III, randomised, double‐blind, placebo‐controlled trial randomised 533 children with a recent history of asthma exacerbations, despite treatment with inhaled corticosteroids and/or long‐acting beta‐agonists, to daily treatment with SQ HDM SLIT‐tablet or placebo for 24–30 months. The primary endpoint was the annualised rate of clinically relevant asthma exacerbations. Adverse events (AEs) were reported throughout the trial.ResultsThe rate ratio for the annualised rate of clinically relevant asthma exacerbations was 0.89 (95% CI: 0.60, 1.31), in favour of the SQ HDM‐SLIT tablet; superiority over placebo was not established. Most treatment‐related AEs (TRAEs) were of mild or moderate severity, and few subjects discontinued due to TRAEs (< 2%). The most common TRAEs were local application site reactions (oral pruritus, throat irritation, ear pruritus, and upper abdominal pain). There was no increased incidence of asthma‐related events, and no anaphylaxis or adrenaline use in the SQ HDM SLIT‐tablet group.ConclusionAs a result of the coronavirus disease 2019 pandemic, asthma exacerbation rates were much lower than expected, contributing to the primary endpoint not being met. The SQ HDM SLIT‐tablet was well tolerated in a paediatric population with inadequately controlled HDM allergic asthma.Trial Registration<jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"http://clinicaltrials.gov\">Clinicaltrials.gov</jats:ext-link> identifier: NCT03654976; EudraCT number: 2016‐004363‐39","PeriodicalId":122,"journal":{"name":"Allergy","volume":"23 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AllergyPub Date : 2025-10-09DOI: 10.1111/all.70094
Angelika Lahnsteiner,Victoria Ellmer,Mengzhen Hao,Line Kring Tannert,Serge A Versteeg,Carsten Bindslev-Jensen,Ronald van Ree,Angela Risch,Lorenz Aglas
{"title":"Genome-Wide Blood DNA Methylation Profiling in Birch Pollen Allergic Patients Undergoing Allergen-Specific Immunotherapy.","authors":"Angelika Lahnsteiner,Victoria Ellmer,Mengzhen Hao,Line Kring Tannert,Serge A Versteeg,Carsten Bindslev-Jensen,Ronald van Ree,Angela Risch,Lorenz Aglas","doi":"10.1111/all.70094","DOIUrl":"https://doi.org/10.1111/all.70094","url":null,"abstract":"BACKGROUNDUntil now, no study has investigated the impact of allergen immunotherapy (AIT) on genome-wide DNA methylation in a longitudinal set-up. Herein, we investigated whether differences in DNA methylation occur in birch pollen allergic patients undergoing 6 months of birch pollen AIT, assessed alterations in methylation-based blood cell type composition, and correlated DNA methylation to serological AIT biomarkers.METHODSWe performed genome-wide DNA-methylation analysis on bisulfite-converted DNA derived from whole blood samples of 16 birch pollen-allergic patients (pre-/post-birch pollen AIT) and 15 placebo (pre-/post-placebo treatment).RESULTSOur analysis identified cg22187251, located within a regulatory region upstream of the glucosaminyl (N-acetyl) transferase 2 (GCNT2) gene and cg22336863 upstream of the transcription start site of actin binding rho activating protein (ABRA), as hypermethylated. Functional assays revealed that these regions exhibit methylation-dependent promoter and enhancer activities. We identified differentially methylated positions within the HLA gene complex, and an AIT-specific increase of CD8+ T cell populations accompanied by a decrease in natural killer (NK) cell proportion. Strong to moderate correlations with clinical biomarkers (such as specific IgG4) were observed for 42% of the top 100 differentially methylated positions.CONCLUSIONGCNT2 and ABRA are implicated in Rho-signaling, a pathway involved in Th2 differentiation. GCNT2 modulates the SMAD-dependent TGF-β pathway, indicating a role in mediating AIT-induced immunotolerance. This is the first longitudinal study investigating DNA methylation changes induced by birch pollen AIT.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"8 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dupilumab in Children Under 6 Years With Moderate-to-Severe Atopic Dermatitis: A 16-Week Real-World Prospective Study on Efficacy, Safety, and Local-Systemic Immune Responses.","authors":"Yunxuan Zhang,Jiangshan Pi,Lingling Wang,Jingsi Chen,Qingqing Tan,Xiaoying Zhou,Jingqiu Jiang,Huan Yang,Hua Wang,Xiaoyan Luo","doi":"10.1111/all.70090","DOIUrl":"https://doi.org/10.1111/all.70090","url":null,"abstract":"BACKGROUNDReal-world data on the clinical and molecular impacts of dupilumab in young children with moderate-to-severe atopic dermatitis (AD) remain limited.OBJECTIVESTo evaluate 16-week clinical outcomes, cutaneous proteomic changes, and systemic immune responses to dupilumab in children aged 6 months to 5 years.METHODSThis prospective cohort study enrolled 110 participants, with clinical evaluations performed at weeks 2, 4, 8, 12, and 16. Longitudinal biomarker profiling included skin tape strip (STS) proteomics, flow cytometric analysis of T-cell subsets, and serum cytokine multiplex assays.RESULTSOf the 96 participants who completed the study, 70.8% achieved EASI-75, 41.7% attained IGA 0/1, and 84.4% reported a ≥ 4-point improvement in PP-NRS, with comparable outcomes and adverse events observed across age subgroups (6 months to < 2 years vs. ≥ 2 to 5 years). Marked reductions in CLA+ IL-4+/IL-13+ Th2 cells (p < 0.001) and an expansion of CLA+ Tregs (p < 0.01) were noted in peripheral blood. However, serum Th2/Th1/Th17 cytokine levels remained unchanged or were elevated posttreatment, particularly IL-4 (p < 0.001), despite declines in CCL13/17/22. STS proteomics indicated a restoration of proteins associated with the skin barrier, while markers related to epidermal hyperplasia, innate immune activation, and antimicrobial defense remained unchanged. Utilizing machine-learning algorithms, PON2 and PRDX1, both involved in anti-oxidative processes, were identified as predictive biomarkers for treatment response.CONCLUSIONSShort-term dupilumab exhibited favorable outcomes in young children with AD, primarily through the remodeling of CLA+Th2 cells and the restoration of skin barrier functions. Although circulating Th2 inflammation was not completely normalized within a 16-week period, the significant reductions in TARC and MDC indicate systemic improvement and underscore the importance of maintenance therapy.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"33 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AllergyPub Date : 2025-10-06DOI: 10.1111/all.70087
Eve Denton, Megan E Jensen, Bronwyn K Brew, Mark Hew, Vanessa E Murphy
{"title":"Asthma in Pregnancy.","authors":"Eve Denton, Megan E Jensen, Bronwyn K Brew, Mark Hew, Vanessa E Murphy","doi":"10.1111/all.70087","DOIUrl":"https://doi.org/10.1111/all.70087","url":null,"abstract":"<p><p>Asthma is one of the most common chronic diseases affecting pregnant women with variable prevalence around the world. Hormonally mediated and physical changes to the respiratory system occur during pregnancy and can impact asthma status unpredictably-some women improve, some worsen and some are stable. Increased maternal and foetal adverse outcomes are observed with uncontrolled asthma. Medication non-adherence increases in pregnancy, often because of concerns regarding the effect of medications on the developing foetus and is a major contributor to loss of asthma control. Certain comorbidities, particularly metabolic comorbidities, are more common in pregnant women with asthma and are increasingly understood to impact asthma and pregnancy outcomes. There is reassuring observational data to suggest the safety of omalizumab and dupilumab in pregnancy, but more studies are needed. This review highlights the current evidence regarding epidemiology, pregnancy-related respiratory changes, comorbidities and treatment of asthma in pregnancy.</p>","PeriodicalId":122,"journal":{"name":"Allergy","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Long-Term, Real-World Effectiveness of Allergen Immunotherapy in Children and Adolescents With Allergic Rhinitis and Asthma.","authors":"Christian Woehlk,Thomas Stranzl,Marco Contoli,Nick Freemantle,Andreas Kallsoy Slaettanes,Julie Rask Larsen,Celeste Porsbjerg,Benedikt Fritzsching","doi":"10.1111/all.70085","DOIUrl":"https://doi.org/10.1111/all.70085","url":null,"abstract":"BACKGROUNDRespiratory allergies often begin in childhood and can progress over time, leading to increased disease burden. Allergen immunotherapy (AIT) is the only causal treatment for allergic respiratory diseases with disease-modifying potential. While randomised trials support its efficacy in controlling allergic rhinitis (AR) and asthma symptoms, long-term real-world data in children remain limited.METHODSThis paediatric study (n = 11,036) was conducted within the pre-defined framework of the REACT study, based on protocol-specified objectives. Children (< 18 years) with physician-diagnosed AR, with or without pre-existing asthma, were included. AIT-treated patients were matched 1:1 to non-AIT controls. Effectiveness was assessed over 9 years by comparing AR and asthma medication prescriptions, using a public database covering all reimbursable AIT products. Relative differences were calculated across the full observation period.RESULTSAIT-treated children (mean age 11.4 years; 62.1% male) exhibited greater reductions in AR medication use than controls (additional 9% reduction beyond 61% in controls). In children with asthma, AIT was associated with additional reductions in asthma medication use (-21% beyond -48% in controls), severe exacerbations (-21% beyond -36%), and new oral corticosteroid prescriptions (-33% beyond -41%). Age stratification revealed more pronounced AR medication reductions in younger children (0-11 years) than in adolescents (12-17 years).CONCLUSIONThis large-scale, real-world study supports the long-term effectiveness of AIT in children with AR, with or without asthma. The findings reflect improved disease control and suggest a disease-modifying effect of AIT. Early intervention, particularly in younger children, may help mitigate the progression of allergic disease.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"91 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}