Allergy最新文献

{"title":"The Dual Face of Wheat and Cereal Reactivity: Molecular Divergence Between Soluble and Gluten-Derived Allergens.","authors":"Enrico Scala,Valeria Villella,Damiano Abeni,Mauro Giani,Emma Cristina Guerra,Maria Locanto,Giorgia Meneguzzi,Lia Pirrotta,Donato Quaratino,Alessandra Zaffiro,Elisabetta Caprini,Maria Barrale,Ignazio Brusca,Valerio Pravettoni,Lorenzo Cecchi,Danilo Villalta,Riccardo Asero","doi":"10.1111/all.70062","DOIUrl":"https://doi.org/10.1111/all.70062","url":null,"abstract":"BACKGROUNDCereal allergy comprises a heterogeneous spectrum of sensitization patterns directed toward water-soluble and gluten-derived proteins. The role of molecular cross-reactivity with homologous allergens from other cereals remains only partially understood.OBJECTIVETo investigate IgE reactivity to major wheat allergens (Tri a 14, Tri a 19, Tri a 30) and their homologs across cereals and pseudocereals, integrating bioinformatic, epidemiological, and clinical data.METHODSSequence homology was assessed using BLAST analysis across cereal and pseudocereal proteomes. IgE reactivity was evaluated in 17,510 patients using two multiplex platforms (ImmunoCAP ISAC and ALEX2). Clinical data were available for 7201 individuals.RESULTSTri a 14 displayed high sequence identity with multiple cereal nsLTPs, including a hitherto undefined maize-derived protein (72%), suggesting broad cross-reactivity, whereas Zea m 14 showed higher identity with Pru p 3 than with Tri a 14. Homologs of Tri a 30 and Tri a 19 were found in spelt and durum wheat. Sensitization to wheat allergens was rare (3.9%); Tri a 14 was the most frequent (64%), followed by Tri a 30 (23%) and Tri a 19 (18%). The limited cases of Tri a 14 or Tri a 19 were specifically associated with severe reactions and WDEIA. Limited co-sensitization indicated distinct IgE pathways to soluble and gluten-related proteins.CONCLUSIONSIgE profiling revealed distinct cross-reactivity patterns across cereals. Tri a 14 frequently co-sensitized with nsLTPs from both gluten-containing and gluten-free cereals, while Tri a 19 was exclusive to gluten-containing species. These findings support the need to expand molecular diagnostic panels to enhance clinical accuracy and guide dietary recommendations.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"28 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145072122","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":"Correction to \"Gene-Environment Interaction Affects Risk of Atopic Eczema: Population and In Vitro Studies\".","authors":"","doi":"10.1111/all.70059","DOIUrl":"https://doi.org/10.1111/all.70059","url":null,"abstract":"","PeriodicalId":122,"journal":{"name":"Allergy","volume":"24 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071729","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":"Predictors of Response to Biologics for Severe Asthma: A Systematic Review and Meta-Analysis.","authors":"Anna Rattu,Piers Dixey,David Charles,Chris Brightling,Kian Fan Chung,Apostolos Bossios,Arnaud Bourdin,Ratko Djukanovic,Sven-Erik Dahlén,Louise Fleming,Rekha Chaudhuri,Erik Melén,Antoine Deschildre,Charles Pilette,Gerard H Koppelman,Andrew Exley,Freja Anckers,Sarah Miller,Hanna Nielsen,Clare Williams,Ekaterina Khaleva,Graham Roberts, ","doi":"10.1111/all.70031","DOIUrl":"https://doi.org/10.1111/all.70031","url":null,"abstract":"Biologics are effective for severe asthma, but not all patients benefit equally. There is an urgent need to understand which biologic works best for which patient. We systematically searched for predictors of response to biologics (except omalizumab) for severe asthma in four bibliographic databases and two trial registries from 1990 to 2024. Two reviewers screened records, extracted data, and assessed risk of bias using a modified CASP checklist. Data were synthesized narratively, and certainty of evidence assessed using the modified GRADE framework. Comparable studies were meta-analyzed using a random-effects model. From 5853 records, 21 studies were identified investigating predictors of anti-IL5/5Rα, 4Rα, and anti-TSLP response. We found predominantly 'moderate' to 'high' quality evidence that raised blood eosinophil counts (≥ 300 cells/μL), FeNO levels (> 40 ppb), lack of or low OCS dose (< 10 mg/day), and better asthma control predict biologic response. Evidence for the predictive value of other characteristics was limited and mostly 'low' quality. Key reasons for downgrading the evidence were heterogeneous response definitions and imprecision. No data were identified for the pediatric population or biologics targeting the non-T2 pathway. Outside of traditional inflammatory and clinical variables, there is an unmet need for universally applicable predictors of biologic response for severe asthma.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"77 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068304","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":"Markers in Infants of Mothers With Asthma and Associations With Respiratory Outcomes.","authors":"Carla Rebeca Da Silva Sena,Gabriela Martins Costa Gomes,Noëmi Künstle,Olga Gorlanova,Andrea Marten,Sven Schulzke,Florian Wyler,Vanessa E Murphy,Paul D Robinson,Peter D Sly,Jakob Usemann,Benjamin Stoecklin,Ruth Steinberg,Sophie Yammine,Loretta Müller,Philipp Latzin,Pablo Sinues,Peter G Gibson,Joerg Mattes,Adam Collison,Urs Frey, ","doi":"10.1111/all.70044","DOIUrl":"https://doi.org/10.1111/all.70044","url":null,"abstract":"BACKGROUNDIn utero mechanisms related to oxidative stress response, inflammation, and extracellular matrix turnover may influence fetal lung development in the offspring of asthmatic mothers. Therefore, we aimed to determine whether levels of cord blood proteins differ between the offspring of asthmatic and nonasthmatic mothers. In addition, we aimed to examine if these proteins are associated with infant lung function, bronchiolitis hospitalization in infancy, and asthma at six years.METHODSWe compared protein levels of infants (n = 715) from the Swiss Basel-Bern Infant Lung Development and the Australian Breathing for Life Trial birth cohorts using Tobit regression and network analyses. Using adjusted linear and logistic regression, we determined their association with postnatal infant lung function, bronchiolitis hospitalization in infancy, and asthma at six years.RESULTSInfants born to asthmatic mothers had lower levels of matrix metalloproteinase-9 (MMP-9, β-coefficient [β] -0.67, 95% confidence interval [-1.07; -0.27] padj = 0.009) and Interferon gamma (IFN-γ, β -0.77 [-1.21; -0.32], padj = 0.009), and higher levels of p62 (β 1.15 [0.30; 2.00], padj = 0.030). p62 levels were inversely associated with minute ventilation (β -16.18 [-28.44; -3.91], padj = 0.032). Functional residual capacity values were inversely associated with both IFN-γ (β -1.26, [-2.41; -0.11], padj = 0.063) and MMP-9 levels (β -1.27, [-2.53; -0.01], padj = 0.063). MMP-9 levels were inversely associated with both the risk of bronchiolitis hospitalization (odds ratio 0.47, [0.29; 0.77], padj = 0.004) and the risk of asthma (aOR 0.53, 95% CI, 0.32-0.86, padj = 0.033).CONCLUSIONSProtein levels differed between offspring of asthmatic and non-asthmatic mothers. These markers were associated with postnatal lung function, bronchiolitis hospitalization, and asthma.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"24 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059070","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":"Acetylcholine From Solitary Chemosensory Cell, Not Neuron, Regulates Basal Cell Fate Driving Eosinophilic Chronic Rhinosinusitis With Nasal Polyps.","authors":"Bowen Zheng,Tao Lu,Ji Wang,Yalan Zhang,Panhui Xiong,Jieyu Zeng,Shuman Li,Yu Jiang,Yijun Liu,Longlan Shu,Yuan Chen,Yin Zhou,Yue Gu,Dayu Guan,Chenxi Li,Lei Zhao,Shujin Wang,Jie Liu,Xia Ke,Yang Shen,Yucheng Yang","doi":"10.1111/all.70048","DOIUrl":"https://doi.org/10.1111/all.70048","url":null,"abstract":"BACKGROUNDBasal cells (BCs) play a crucial role in epithelial remodeling, a hallmark of eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP). Single-cell sequencing has revealed an increased number of solitary chemosensory cells (SCCs) alongside BC hyperplasia in eCRSwNP, yet the underlying mechanism of BC hyperplasia in eCRSwNP remains unclear. This study aimed to investigate the role of SCC-derived acetylcholine (Ach) in determining BC fate.METHODSTissue samples from healthy individuals, patients with eCRSwNP, and those with non-eCRSwNP (neCRSwNP) were analyzed to investigate BC proliferation, differentiation abnormalities, and the prevalence of SCCs. The relationship between SCC-derived Ach, BC dysfunction, and disease severity was examined. Ach sources and receptor expression patterns were characterized. In vitro studies using submerged cell cultures and air-liquid interface cultures, along with in vivo murine models, were employed to elucidate the mechanisms by which Ach influences BC fate. The inhibitory effects of tiotropium bromide (TB) on Ach-driven processes were also evaluated.RESULTSOur results indicated that SCC-derived Ach, rather than by parasympathetic nerves, contributed to abnormal BC proliferation and differentiation through muscarinic acetylcholine receptors (mAChRs) and had potential impact on the development of eCRSwNP. These effects were associated with the activation of YAP and could be partially reversed both in vitro and in vivo by blocking mAChRs with TB.CONCLUSIONThese results demonstrate that SCC-derived Ach plays a critical role in eCRSwNP by regulating BC fate. This provides a potential translational framework for developing prevention and treatment strategies targeting the cholinergic pathway.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"53 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059079","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":"Adherence to Mediterranean Diet During Pregnancy, Breastfeeding, and Development of Food Allergy in the Offspring: Results From the MEDALLION Cohort Study.","authors":"Emilia Vassilopoulou,Calliope Karastogiannidou,Anna Comotti,Carlo Agostoni,Myrto-Kalliopi Maragkou,Nikolaos G Papadopoulos,Maria Pasioti,Maria Lithoxopoulou,Gavriela Feketea,Sophia Tsabouri,Gregorio Paolo Milani,Carina Venter","doi":"10.1111/all.70054","DOIUrl":"https://doi.org/10.1111/all.70054","url":null,"abstract":"BACKGROUNDPrevention is a key strategy for reducing the burden of food allergies (FA). The maternal diet during pregnancy and breastfeeding is increasingly recognized as a factor contributing to FA risk.METHODSWe analyzed data from a sub-cohort of the MEDALLION study to evaluate the association between maternal adherence to the Mediterranean Diet (MedDiet) and the development of FA in offsprings. Maternal dietary intake during pregnancy and lactation was assessed using a validated scale, i.e., the MedDiet Score, along with individual food group consumption. Multiple logistic regression models were performed.RESULTSA total of 430 mother-offspring dyads were included in the analysis. Higher maternal adherence to the MedDiet was associated with reduced odds of FA in offspring during both pregnancy (adjusted OR 0.94, 95% CI 0.89-1.00) and lactation (adjusted OR 0.94, 95% CI 0.88-1.00). Increased weekly consumption of fruits and full-fat dairy products during pregnancy, and vegetables during breastfeeding, was associated with reduced likelihood of FA in the offspring. Conversely, higher intake of poultry and red meat (> 3 servings/week) during both periods, and fish consumption during pregnancy (> 1 serving/week), were associated with increased odds of FA.CONCLUSIONSThis study points out that the MedDiet and, especially, some specific components, such as fruits, vegetables, and full-fat dairy products, may contribute to lowering the risk of FA in infants, whereas a higher intake of poultry, red meat, and fish may increase it. These findings support the potential of maternal nutrition to reduce childhood FA.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"36 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043515","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":"International Evidence-Based Guidelines for Traditional Chinese Medicine Management of Allergic Rhinitis.","authors":"Qin-Wei Fu,Peng Liu,Yan Ruan,Xin-Rong Li,Lan-Zhi Zhang,Sha-Sha Yang,Feng Chai,Ji Chen,Qiao-Yan Chen,Shu-Cheng Chen,Wen-Yong Chen,Yong-Na Chen,Hong-Bin Cheng,Lei Cheng,Lu-Jia Cui,Ke-Bin Deng,Cai-Shan Fang,Rong-Chang Feng,Li Fu,Wen-Yang Fu,Jian-Ying Gao,Hong Guo,Miao He,Ko-Hsin Hu,Chun-Jiang Huang,He-Yin Huang,Lu-Yun Jiang,Feng-Ying Qiao,Hui Leng,Yun-Ying Li,Chun-Song Liu,Da-Xin Liu,Jian-Hua Liu,Jin-Hui Liu,Jing Liu,Min Liu,Wei-Ting Liu,Yuan-Xian Liu,Yang Liu,Ying Liu,Zhi-Qing Liu,Qiu-Lan Luo,Yu Ma,De-Hong Mao,Juan Meng,Kai-Yun Pang,Shun-Lin Peng,Xuan-Fu Tong,Ji Wang,Jia-Xi Wang,Jun-Ge Wang,Ren-Zhong Wang,Shi-Zhen Wang,Ji-Yan Xia,Hui Xie,Qiang Xie,Yan Xie,Da-Jing Xiong,Zhan-Feng Yan,Hui Yang,Da-Zheng Zhang,Fu-Bing Zhang,Shi-Peng Zhang,Zhi-Cheng Zhang,Ji-Ping Zhao,Yu Zhao,Yun Zheng,Dan-Zhu Zhong,Li Zhou,Valentin Mikhailovich Knyazev,Irina Viktorovna Kostrova,Wing-Fai Yeung,Qi Wang,De-Yun Wang,Qin-Xiu Zhang","doi":"10.1111/all.70057","DOIUrl":"https://doi.org/10.1111/all.70057","url":null,"abstract":"BACKGROUNDAllergic rhinitis (AR) is a prevalent chronic condition that significantly impacts patients' quality of life and poses challenges to effective management. Traditional Chinese medicine (TCM) offers a holistic approach, emphasizing syndrome differentiation, individualized care, and natural treatment strategies.OBJECTIVETo develop comprehensive evidence-based guidelines for AR management using TCM interventions, incorporating rigorous evidence assessment and expert consensus.METHODSThe guidelines were developed using the GRADE-TCM framework, analyzing 351 randomized controlled trials (RCTs) involving 43,276 participants. Supplementary evidence from published textbooks, standardized documents, ancient literature, and TCM medical records was incorporated. Five rounds of expert consensus, involving 80 expert person-times and over 10,000 valid responses, refined the recommendations.RESULTSThe guidelines provide 32 recommendations covering four primary TCM syndromes (Deficiency-cold of Lung Qi, Spleen Qi Deficiency and Weakness, Kidney-yang Deficiency, and Latent Heat in Lung Meridian) which are mainly involved in AR. These recommendations include both internal interventions (such as herbal and patent medicines) and external therapies (such as acupuncture, moxibustion, and other acupoint-based treatment). Of these interventions, 10 received strong recommendations, while 22 were classified as weak recommendations. TCM treatments demonstrated significant efficacy in alleviating AR symptoms, reducing recurrence, and improving quality of life. Additionally, TCM can complement conventional AR treatments by reducing the need for pharmacological therapy while maintaining a favorable safety profile.CONCLUSIONThe guidelines integrate classical TCM principles with modern evidence-based methodologies, offering a structured framework for AR management. They serve as clinical references for practitioners worldwide, supporting a promising approach to AR treatment. Future updates will incorporate emerging evidence and real-world clinical data to further optimize the role of TCM in AR management.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"24 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043524","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 Prevalence of Symptomatic Dermographism: Results of the International UCARE PREVALENCE-D Study.","authors":"Kanokvalai Kulthanan,Jonathan A Bernstein,Michael Rudenko,Pascale Salameh,Chulaluk Komoltri,Esra Adışen,Salma Al Abri,Mona Al-Ahmad,Nasser Al-Ahmed,Bushra Al Hinai,Anastasiia Allenova,Saad Alshareef,Nattha Angkoolpakdeekul,Rand Arnaout,Joanna Bartosińska,Ivan Cherrez-Ojeda,Leena Chularojanamontri,Paulo Ricardo Criado,Luis Felipe Ensina,Roberta Fachini Jardim Criado,Cesar Alberto Galvan Calle,Ana Maria Giménez-Arnau,Kiran Godse,Maia Gotua,Naoko Inomata,Nuttagarn Jantanapornchai,Chang-Gyu Jung,Alicja Kasperska-Zając,Maryam Khoshkhui,Pavel Kolkhir,Dorota Krasowska,Jomgriditip Laomoleethorn,Antonina Maiorowa,Raisa Meshkova,Dragan Mijakoski,Melba Munoz,Yanisorn Nanchaipruek,Iman Nasr,Rabia Öztaş Kara,Waratchaya Panjapakkul,Teerapat Paringkarn,Indrashis Podder,Karla Robles-Velasco,Isabel Rosmaninho,Ana Rita Presa,Chuda Rujitharanawong,Phuwakorn Saengthong-Aram,Rana Tafrishi,Natasa Teovska Mitrevska,Papapit Tuchinda,Teerapat Wannawittayapa,Anushka Wilson,Young-Min Ye,Anna Zalewska-Janowska,Marcus Maurer,Torsten Zuberbier","doi":"10.1111/all.70047","DOIUrl":"https://doi.org/10.1111/all.70047","url":null,"abstract":"BACKGROUNDThe prevalence of symptomatic dermographism (SD) in the general population remains unclear. This study aimed to internationally estimate the prevalence of SD and two other dermographic subtypes-physiological red dermographism and simple urticarial dermographism-among adults worldwide.METHODSThe PREVALENCE-D (Prevalence Estimation of Dermographism) study was the largest international, cross-sectional, internet-based investigation conducted by the Urticaria Centers of Reference and Excellence of the Global Allergy and Asthma Excellence Network from 2021 to 2024. A world expert-designed questionnaire was completed by participants from 28 centers across 19 countries to diagnose SD. Participants were recruited into three age groups (18-24, 25-60, and > 60 years), with ≥ 1000 individuals per group per country. We calculated sex- and age-adjusted prevalence estimates internationally and by country, with 95% confidence intervals.RESULTSAmong 59,543 participants worldwide, those with SD had an adjusted point prevalence of 3.20% (95% confidence interval [CI] 2.68%-3.73%) and a lifetime prevalence of 5.94% (95% CI 5.32%-6.56%). The 25-60 years group presented the highest prevalence. Females had higher rates than males, with statistically significant differences across all age groups for both point and lifetime prevalence. Physiological red dermographism had an adjusted point prevalence of 10.02% (95% CI 9.48%-10.55%) and a lifetime prevalence of 33.47% (95% CI 32.01%-34.94%). Simple urticarial dermographism showed an adjusted point prevalence of 1.21% (95% CI 1.08%-1.35%) and a lifetime prevalence of 5.39% (95% CI 4.99%-5.79%).CONCLUSIONThese findings provide comprehensive international estimates of dermographism, particularly SD, and emphasize the need for appropriate healthcare resource allocation and disease recognition.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"55 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043517","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":"Diversity and Dosage Determine the Efficacy of the Probiotic SYN-53 in Allergic Rhinoconjunctivitis: A Randomized, Double-Blind, Placebo-Controlled Trial.","authors":"Karl-Christian Bergmann,Torsten Zuberbier","doi":"10.1111/all.70045","DOIUrl":"https://doi.org/10.1111/all.70045","url":null,"abstract":"SYN-53, a multi-strain probiotic food supplement, was recently shown to significantly alleviate allergic rhinoconjunctivitis (ARC) and its symptoms. The diversity and dosage of bacterial strains administered via SYN-53 have been proposed as key drivers of its efficacy. The aim of this study was to assess the role of bacterial diversity and dosage by comparing SYN-53 to a low dose variant (SYN-53-LD), a low diversity variant (SYN-4), and a placebo in the management of ARC. This double-blind, parallel-group, placebo-controlled clinical trial included subjects with moderate-to-severe grass pollen allergy. Following baseline exposure in an allergen exposure chamber (AEC), 166 subjects were randomized to undergo three weekly 3-day intake cycles of SYN-53, SYN-53-LD, SYN-4, or placebo, followed by a final allergen exposure. During AEC exposure, symptoms were continuously measured via assessment of the Total Symptom Score (TSS). SYN-53 was significantly superior in reducing TSSMAX compared with its low dose variant SYN-53-LD (∆TSSMAX [Mean ± SE]: -5.19 ± 0.80 vs. -2.27 ± 0.65; p = 0.0372), its low diversity variant SYN-4 (-3.41 ± 0.52; p = 0.0482), and placebo (-2.82 ± 0.78; p = 0.0329). No significant differences to placebo were seen for either SYN-53-LD (p = 0.7377) or SYN-4 (p = 0.5152). SYN-53 and its variants were well tolerated, and adverse events were not different from placebo. Our findings reaffirm the efficacy of SYN-53 in the management of ARC and demonstrate that the effectiveness of this multi-strain probiotic is intricately linked to the diversity of bacterial strains and dosage administered.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"33 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032012","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":"Diagnosis of Quinolone Hypersensitivity: An EAACI Position Paper.","authors":"Aslı Gelincik,Knut Brockow,Gülfem E Çelik,Semra Demir,Inmaculada Doña Diaz,Didier G Ebo,Cristobalina Mayorga,Marina Labella,Vito Sabato,María José Torres Jaén","doi":"10.1111/all.70037","DOIUrl":"https://doi.org/10.1111/all.70037","url":null,"abstract":"Hypersensitivity reactions to quinolones (QHRs) have been increasing in frequency, thus classifying them as the second most frequently implicated class of antibiotics in hypersensitivity reactions (HRs). It is noteworthy that quinolones (Qs) have been observed to predominantly trigger immediate hypersensitivity reactions (IHRs). These reactions are categorized as either IgE-mediated or non-IgE-mediated, attributable to the off-target occupation of the recently described receptor, Mas-related G-protein coupled receptor member X2 (MRGPRX2), on effector cells. The increasing trend of HRs underscores the necessity for enhanced diagnostic and management strategies. The present position paper aims to shed light on the key mechanisms involved in immediate and non-immediate QHRs. The clinical spectrum of these reactions is discussed, as well as the utility of skin tests, in vitro diagnostic tests, and drug provocation tests in diagnosis. A further focal point of this study is the analysis of cross-reactivity between various Qs. The paper concludes with the presentation of diagnostic algorithms for both immediate and non-immediate QHRs. The paper's findings aid clinical practice for QHRs and address unmet needs, which should stimulate more in-depth investigations into the mechanisms and clinical practice of QHRs.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"16 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032119","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}