AllergyPub Date : 2025-06-12DOI: 10.1111/all.16623
D Loli-Ausejo, M F Gonzalez-Matamala, D Martí, M Ruano-Zaragoza, P Mir-Ihara, K Solis-Ynga, R Lara, J Bartra, M Pascal, R Muñoz-Cano
{"title":"Basal Serum Tryptase Outperforms Hereditary Alpha Tryptasemia as a Biomarker of Food Allergy Severity.","authors":"D Loli-Ausejo, M F Gonzalez-Matamala, D Martí, M Ruano-Zaragoza, P Mir-Ihara, K Solis-Ynga, R Lara, J Bartra, M Pascal, R Muñoz-Cano","doi":"10.1111/all.16623","DOIUrl":"https://doi.org/10.1111/all.16623","url":null,"abstract":"","PeriodicalId":122,"journal":{"name":"Allergy","volume":" ","pages":""},"PeriodicalIF":12.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273754","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 : 2025-06-12DOI: 10.1111/all.16607
Mariona Pascal, Jitesh Chauhan, Edward Knol, Rodolfo Bianchini, Mariana Castells, Leticia De Las Vecillas, Karin Hartmann, Elena Izquierdo, Uta Jappe, Teodorikez-Wilfox Jimenez-Rodriguez, Francesca Levi-Schaffer, Cristobalina Mayorga, Aurélie Poli, Frank Redegeld, Alexandra F Santos, Erika Jensen-Jarolim, Christoph Bergmann, Sophia N Karagiannis, Heather J Bax
{"title":"Basophil Activation Test: Bridging Allergy and Oncology for Diagnostic, Therapeutic and Prognostic Applications in AllergoOncology: An EAACI Position Paper.","authors":"Mariona Pascal, Jitesh Chauhan, Edward Knol, Rodolfo Bianchini, Mariana Castells, Leticia De Las Vecillas, Karin Hartmann, Elena Izquierdo, Uta Jappe, Teodorikez-Wilfox Jimenez-Rodriguez, Francesca Levi-Schaffer, Cristobalina Mayorga, Aurélie Poli, Frank Redegeld, Alexandra F Santos, Erika Jensen-Jarolim, Christoph Bergmann, Sophia N Karagiannis, Heather J Bax","doi":"10.1111/all.16607","DOIUrl":"https://doi.org/10.1111/all.16607","url":null,"abstract":"<p><p>The basophil activation test (BAT) is gaining increasing relevance as an ex vivo functional assay in allergy to evaluate IgE-mediated hypersensitivity reactions to food allergens, venoms, and drugs and to monitor tolerance induction. Establishing universal standard operating protocols has been difficult, due to several challenges including variable activation markers, positive control selection, the need for processing fresh blood samples, and the existence of non-releasing individuals. In oncology, BAT is also an emerging promising diagnostic and management tool to assess hypersensitivity reactions to biologics and chemotherapy agents, monitor drug tolerance in desensitisation, and predict and address the safety of novel anti-cancer IgE-based therapeutics. This position paper highlights the emerging significance of BAT in AllergoOncology, in facilitating therapy monitoring, biomarker discovery, and risk stratification. Capitalising on long-acquired expertise in the development of BAT for allergy, we propose research directions and routes to clinical applications of this highly promising tool in AllergoOncology. We advocate the need for enhanced focus on addressing standardisation challenges and leveraging outputs for precision medicine. By linking allergy and oncology, the key remaining limitations can be addressed, with the aim of realising the significant promise of BAT as a robust tool to enhance personalised care in allergy and AllergoOncology.</p>","PeriodicalId":122,"journal":{"name":"Allergy","volume":" ","pages":""},"PeriodicalIF":12.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273755","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 : 2025-06-12DOI: 10.1111/all.16624
Ozge Ardicli, Juan Felipe Lopez, Margot E Starrenburg, Laura Buergi, Tayfun K Carli, Cezmi A Akdis, Mübeccel Akdis, Willem van de Veen
{"title":"Strategies for Flow Cytometric Profiling of BCR IgH Isotypes: A Comparative Assessment of FcR Blocking Agents.","authors":"Ozge Ardicli, Juan Felipe Lopez, Margot E Starrenburg, Laura Buergi, Tayfun K Carli, Cezmi A Akdis, Mübeccel Akdis, Willem van de Veen","doi":"10.1111/all.16624","DOIUrl":"https://doi.org/10.1111/all.16624","url":null,"abstract":"","PeriodicalId":122,"journal":{"name":"Allergy","volume":" ","pages":""},"PeriodicalIF":12.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273757","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 : 2025-06-12DOI: 10.1111/all.16617
Alex Cucco, Angela Simpson, Sadia Haider, Clare Murray, Stephen Turner, Paul Cullinan, Sarah Filippi, Sara Fontanella, Adnan Custovic, STELAR/UNICORN Investigators
{"title":"Patterns of Respiratory Symptoms and Asthma Diagnosis in School-Age Children: Three Birth Cohorts","authors":"Alex Cucco, Angela Simpson, Sadia Haider, Clare Murray, Stephen Turner, Paul Cullinan, Sarah Filippi, Sara Fontanella, Adnan Custovic, STELAR/UNICORN Investigators","doi":"10.1111/all.16617","DOIUrl":"10.1111/all.16617","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many studies used information on wheeze presence/absence to determine asthma-related phenotypes. We investigated whether clinically intuitive asthma subtypes can be identified by applying data-driven semi-supervised techniques to information on frequency and triggers of different respiratory symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Partitioning Around Medoids clustering was applied to data on multiple symptoms and their triggers in school-age children from three birth cohorts: MAAS (<i>n</i> = 947, age 8 years), SEATON (<i>n</i> = 763, age 10) and ASHFORD (<i>n</i> = 584, age 8). ‘Guided’ clustering, incorporating asthma diagnosis, was used to select the optimal number of clusters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five-cluster solution was optimal. Based on their clinical characteristics, including frequency of asthma diagnosis, we interpreted one cluster as ‘Healthy’. Two clusters were characterised by high asthma prevalence (95.89% and 78.13%). We assigned children with asthma in these two clusters as ‘persistent, multiple-trigger, more severe’ (PMTS) and ‘persistent, triggered by infection, milder’ (PIM). Children with asthma in the remaining two clusters were assigned as ‘mild-remitting wheeze’ (MRW) and ‘post-bronchiolitis resolving asthma’ (PBRA). PBRA was associated with RSV bronchiolitis in infancy. In most children with asthma in this cluster wheezing resolved by age 5–6, and predominant symptoms were shortness of breath and chest tightness. Children in PBRA had the highest hospitalisation rates and wheeze exacerbations in infancy. From age 8 years (cluster derivation) to early adulthood (18–20 years), lung function was significantly lower, and FeNO and airway hyperreactivity significantly higher in PMTS compared to all other clusters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patterns of coexisting symptoms identified by semi-supervised data-driven methods may reflect pathophysiological mechanisms of distinct subtypes of childhood wheezing disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":122,"journal":{"name":"Allergy","volume":"80 7","pages":"1923-1934"},"PeriodicalIF":12.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/all.16617","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AllergyPub Date : 2025-06-12DOI: 10.1111/all.16621
Kelly Shibuya, Sadhana Balasubramanyam, Divya Verma, Kristen E. Holm, Lakshmi Gopalakrishnan Nair, Erika Manczak, Anne P. DePrince, Rafeul Alam, Eileen Wang
{"title":"Uncontrolled Asthma, Intimate Partner Violence, and Inflammatory Pathways: Surprising Insights From Cytokine Profiles","authors":"Kelly Shibuya, Sadhana Balasubramanyam, Divya Verma, Kristen E. Holm, Lakshmi Gopalakrishnan Nair, Erika Manczak, Anne P. DePrince, Rafeul Alam, Eileen Wang","doi":"10.1111/all.16621","DOIUrl":"10.1111/all.16621","url":null,"abstract":"","PeriodicalId":122,"journal":{"name":"Allergy","volume":"80 7","pages":"2084-2087"},"PeriodicalIF":12.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273758","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 : 2025-06-10DOI: 10.1111/all.16538
Chia-Ling Tsao, Shu-Yen Chan, Meng-Hsun Lee, Tina Yi Jin Hsieh, Wanda Phipatanakul, Hana B. Ruran, Kevin Sheng-Kai Ma
{"title":"Adverse Outcomes Associated With Short-Acting Beta-Agonist Overuse in Asthma: A Systematic Review and Meta-Analysis","authors":"Chia-Ling Tsao, Shu-Yen Chan, Meng-Hsun Lee, Tina Yi Jin Hsieh, Wanda Phipatanakul, Hana B. Ruran, Kevin Sheng-Kai Ma","doi":"10.1111/all.16538","DOIUrl":"10.1111/all.16538","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The 2019 Global Initiative for Asthma (GINA) report no longer recommended short-acting beta-agonists (SABA) monotherapy due to associated complications and a lack of anti-inflammatory properties. This systematic review and meta-analysis aimed to evaluate adverse outcomes associated with SABA overuse in patients with asthma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Cochrane Library, EMBASE, and Web of Science databases were searched for studies on SABA overuse (≥ 3 SABA canisters/year) in patients with asthma, from 1981 to November 2023. Randomized controlled trials (RCTs), cohort studies, and cross-sectional studies were included. Pooled risk ratios (RRs) were calculated for dichotomous measures of all-cause mortality and acute exacerbations using random-effects models and Mantel-Haenszel weighting. Subgroup analyses were conducted based on study design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 626 records, 27 studies (2 RCTs, 1 prospective cohort study, 12 retrospective cohort studies, and 12 cross-sectional studies) were included. SABA overuse (≥ 3 SABA canisters/year) was associated with significantly higher mortality (2743 of 130,629 in the overuse group versus 3534 of 300,451 in controls; RR = 2.04, 95% confidence interval, CI = 1.37–3.04; <i>p</i> < 0.001) and a significantly higher rate of acute exacerbations (60,320 of 165,271 in the overuse group versus 84,439 of 376,845 in controls; RR = 1.93, 95% CI = 1.24–3.03; <i>p</i> < 0.001). An increased risk of acute exacerbations was observed in retrospective cohort studies (RR = 1.88, 95% CI = 1.43–2.47; <i>p</i> < 0.001) and cross-sectional studies (RR = 2.23, 95% CI = 1.04–4.77; <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SABA overuse was associated with increased rates of mortality and acute exacerbations in patients with asthma, supporting guidelines that advise against SABA monotherapy in asthma management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":122,"journal":{"name":"Allergy","volume":"80 6","pages":"1629-1646"},"PeriodicalIF":12.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/all.16538","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AllergyPub Date : 2025-06-10DOI: 10.1111/all.16599
Xintong Feng, Yue Xue, Rujuan Bao, Si Chen, Han Yang, Fangfang Xie, Jiayuan Sun, Xiao Su
{"title":"Disruption of the Vagal TRPA1-Pulmonary Neuroendocrine Cell Axis Reduces Asthma Severity","authors":"Xintong Feng, Yue Xue, Rujuan Bao, Si Chen, Han Yang, Fangfang Xie, Jiayuan Sun, Xiao Su","doi":"10.1111/all.16599","DOIUrl":"10.1111/all.16599","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pulmonary neuroendocrine cells (PNECs) are adjacent to the vagus nerve, which innervates the lungs, and have been implicated in asthma pathogenesis. However, the neuroimmunomodulatory role of vagal-PNEC signaling in asthma remains poorly understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed an asthma model of C-fiber photoactivation and vagotomy to investigate the changes in PNECs. RNA sequencing (RNA-seq) was performed on flow cytometry-sorted PNECs to explore how vagus nerve C fibers affect the function of PNECs, with further validation in an in vitro cell model. Single-nucleus RNA sequencing (snRNA-seq) was conducted on airway samples of patients before and after bronchial thermoplasty (BT) treatment, and the changes of neural signals in different airway cell types and their crosstalk with PNEC after BT were analyzed in depth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Vagotomy reduced photoactivated TRPA1-mediated PNEC activation and allergic inflammation, inhibited the number and function of PNEC, and attenuated PNEC-mediated asthma response. PNEC RNA-seq results showed that photoactivation of TRPA1 in lung could promote the migration, aggregation, and synaptic transmission of PNECs and increase the synthesis and secretion of neuropeptides, which could also be activated by α7 nAChR of PNECs. BT therapy significantly reduced or interrupted NRG1-ERBB signaling between PNECs and other cells by interfering with PNEC secretion, synapse formation, and signaling, thereby alleviating the condition of asthma patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We found that the vagal TRPA1-PNEC axis contributes to asthma severity. BT can disrupt this pathway through NRG1-ERBB signaling between PNECs and other cells to attenuate the inflammatory response in asthma.</p>\u0000 </section>\u0000 </div>","PeriodicalId":122,"journal":{"name":"Allergy","volume":"80 6","pages":"1715-1736"},"PeriodicalIF":12.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256836","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 : 2025-06-10DOI: 10.1111/all.16610
Andrea Portacci, Remo Poto, Gilda Varricchi, Giovanna Elisiana Carpagnano
{"title":"Dupilumab and Blood Eosinophilia: A Disease-Specific Phenomenon?","authors":"Andrea Portacci, Remo Poto, Gilda Varricchi, Giovanna Elisiana Carpagnano","doi":"10.1111/all.16610","DOIUrl":"10.1111/all.16610","url":null,"abstract":"<p>Dupilumab, a fully human monoclonal antibody that targets the interleukin (IL)-4 receptor alpha subunit (IL-4Rα) blocking IL-4 and IL-13 signaling, has revolutionized the treatment landscape for several type 2 (T2) inflammatory diseases, including severe asthma, chronic rhinosinusitis with nasal polyposis (CRSwNP), atopic dermatitis (AD), and eosinophilic esophagitis (EoE) [<span>1</span>]. Despite its therapeutic efficacy, the occurrence of transient blood eosinophilia during dupilumab treatment across different T2 diseases remains poorly understood. This phenomenon is generally not associated with clinical symptoms or impact on efficacy, occurs in the first few weeks, and returns to baseline or lower by the end of the treatment period. As reported by Wechsler et al. in a post hoc analysis of dupilumab trials involving patients with severe asthma, CRSwNP, and AD, transient blood eosinophilia occurs in a subset of individuals. This finding suggests that transient blood eosinophilia may be linked to a specific endotype of T2 inflammation that predisposes individuals to this response [<span>2</span>]. Nevertheless, while several molecular mechanisms have been proposed to explain the presence of blood eosinophilia during the blockage of the IL-4/IL-13 axis in patients with severe asthma, CRSwNP, and AD, the absence of this phenomenon in chronic obstructive pulmonary disease (COPD) and EoE remains elusive. This discrepancy raises key questions about whether blood eosinophilia is primarily driven by dupilumab mechanisms of action or by underlying disease-specific immune pathways. Moreover, understanding these differences could have practical implications for clinical management, particularly in terms of monitoring adverse effects and tailoring treatment strategies.</p><p>The rise in blood eosinophils observed during dupilumab treatment has been attributed to multiple mechanisms, highlighting the role of cytokine dynamics and eosinophil trafficking. One hypothesis suggests that dupilumab-induced eosinophilia results from altered vascular cell adhesion molecule-1 (VCAM-1) expression, a key molecule mediating eosinophil adhesion to endothelial cells. Blocking IL-4/IL-13 reduces VCAM-1 expression, leading to decreased eosinophil migration from circulation into tissues, thereby increasing eosinophil counts in the blood [<span>3, 4</span>]. However, the expression of VCAM-1 differs across diseases. Patients with COPD could exhibit a higher expression of VCAM-1, especially those with increased cardiovascular risk [<span>5</span>]. This augmented VCAM-1 expression could facilitate eosinophil retention within tissues, thereby preventing their accumulation in the bloodstream despite IL-4/IL-13 axis blockade (Figure 1). Similarly, in patients with EoE, VCAM-1 is highly expressed on the esophageal vascular endothelium, eosinophils, and mast cells [<span>6</span>]. In EoE, VCAM-1 expression is primarily driven by IL-18, a cytokine involved in some aspects of bo","PeriodicalId":122,"journal":{"name":"Allergy","volume":"80 6","pages":"1811-1814"},"PeriodicalIF":12.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/all.16610","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AllergyPub Date : 2025-06-10DOI: 10.1111/all.16611
Ioana Agache, Josefina Salazar, Yesenia Rodriguez-Tanta, Fiorella Karina Fernandez Saenz, Tari Haahtela, Claudia Traidl-Hoffmann, Athanasios Damialis, de las Letizia Vecillas, Mattia Giovannini, Kari C. Nadeau, Isabella Pali-Schöll, Oscar Palomares, Harald Renz, Jurgen Schwarze, Bernardo Sousa Pinto, Marilyn Urrutia-Pereira, Carina Venter, Donata Vercelli, Tonia Winders, Ivan Sola-Arnau, Pablo Alonso-Coello, Carlos Canelo-Aybar, Marek Jutel, Cezmi A. Akdis
{"title":"The Impact of Rhinovirus, Syncytial Respiratory Virus and Helminth Infection on the Risk of New-Onset Asthma and Other Allergic Conditions—A Systematic Review for the EAACI Guidelines on Environmental Science for Allergic Diseases and Asthma","authors":"Ioana Agache, Josefina Salazar, Yesenia Rodriguez-Tanta, Fiorella Karina Fernandez Saenz, Tari Haahtela, Claudia Traidl-Hoffmann, Athanasios Damialis, de las Letizia Vecillas, Mattia Giovannini, Kari C. Nadeau, Isabella Pali-Schöll, Oscar Palomares, Harald Renz, Jurgen Schwarze, Bernardo Sousa Pinto, Marilyn Urrutia-Pereira, Carina Venter, Donata Vercelli, Tonia Winders, Ivan Sola-Arnau, Pablo Alonso-Coello, Carlos Canelo-Aybar, Marek Jutel, Cezmi A. Akdis","doi":"10.1111/all.16611","DOIUrl":"10.1111/all.16611","url":null,"abstract":"<p>This systematic review evaluated the association between lower respiratory tract infections (LRTI) in infancy with respiratory syncytial virus (RSV), rhinovirus (RV) or infestation with helminths and the risk of developing asthma and allergic diseases. The risk of bias was assessed with ROBINS-E, and the certainty of evidence (CoE) with GRADE. Meta-analysis applied a random-effects model. RSV LRTI is likely associated with an increased risk of developing asthma by age 7 (OR 3.02, 95% CI 2.23–4.09; <i>I</i><sup>2</sup> = 98%; moderate CoE). The impact on wheezing, atopic dermatitis (AD), and allergic rhinitis is uncertain. RV LRTI may be associated with increased risk of developing asthma (OR 8.40, 95% CI 2.56–27.55; <i>I</i><sup>2</sup> = 43%; low CoE). The impact on wheezing and AD is uncertain. <i>Trichuris trichiura</i> infestation might be associated with reduced risk of new-onset wheezing (OR 0.57, 95% CI 0.35–0.94; very low CoE) or AD (HR: 0.35, 95% CI 0.18–0.67; very low CoE). The association between <i>Ascaris lumbricoides</i> and hookworm infestation and the risk of developing asthma or AD is uncertain. Infestation with any helminths might be associated with reduced risk of new-onset asthma by age 5 (OR: 0.60, 95% CI 0.38–0.95; very low CoE) and wheezing (OR 0.70, 95% CI 0.51–0.95; very low CoE). More high-quality studies are needed to confirm these findings.</p>","PeriodicalId":122,"journal":{"name":"Allergy","volume":"80 7","pages":"1878-1898"},"PeriodicalIF":12.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/all.16611","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}