International Archives of Allergy and Immunology最新文献

{"title":"Eosinophilic esophagitis following oral immunotherapy- A systematic review and meta-analysis.","authors":"Roy Khalaf, Maya Fields, Eviatar Fields, Natacha Tardio, Waqqas Afif, Rilla Schneider, Moshe Ben-Shoshan","doi":"10.1159/000552457","DOIUrl":"https://doi.org/10.1159/000552457","url":null,"abstract":"<p><strong>Background: </strong>Oral immunotherapy (OIT) has become a cornerstone in the management of IgE-mediated food allergies, offering the potential for desensitization and protection against accidental allergen exposure. However, the therapy carries the risk of adverse effects, notably eosinophilic esophagitis (EoE), a chronic, Th2-mediated inflammatory disorder of the esophagus characterized by eosinophilic infiltration, dysphagia, and esophageal remodeling. This systematic review aimed to identify and summarize all published cases of EoE arising in the context of OIT, characterizing patient demographics, comorbidities, allergens, diagnostic approaches, and treatment strategies.</p><p><strong>Methods: </strong>A systematic search of MEDLINE and Embase from inception to July 1, 2025, was conducted in accordance with PRISMA and Cochrane guidelines. Eligible studies included case reports, case series, cohort studies, and clinical trials describing EoE during OIT. Study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Data extracted included patient characteristics, atopic comorbidities, allergen type, OIT regimen, latency to EoE onset, diagnostic modality, and post-diagnosis management. Given the heterogeneity in study design and outcome definitions, a descriptive synthesis was performed.</p><p><strong>Results: </strong>Thirteen studies (3 trials, 6 cohorts, 2 case series, 2 case reports) comprising 3,655 OIT patients were included. A total of 89 cases of EoE were identified, yielding an overall pooled prevalence of 1.8% (95% CI 0.87-2.79%). Prevalence varied by allergen, with peanut OIT associated with lower risk (0.82%, 95% CI 0.51-1.12%) compared with milk (6.9%, 95% CI 3.74-10.08%) and egg OIT (9.5%, 95% CI 2.78-16.13%). Males accounted for 74% of EoE cases. Diagnosis was confirmed endoscopically in nearly all patients. Most cases improved following proton pump inhibitor therapy and/or discontinuation of OIT, while fewer reports described dietary elimination or topical corticosteroids.</p><p><strong>Conclusions: </strong>EoE is an uncommon but clinically significant complication of OIT, occurring in approximately 1-2% of treated patients. Male sex, milk and egg OIT, and coexisting atopic disease may increase susceptibility. Recognition of early symptoms, routine monitoring in high-risk patients, and standardized diagnostic criteria are essential to ensure safe and effective OIT implementation. Future prospective studies are needed to clarify risk predictors and establish evidence-based management strategies for EoE in this context.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-14"},"PeriodicalIF":1.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Dose Radiation Sensitizes Human Nasal Epithelium to Viral Inflammation Despite Preserved Structural Integrity.","authors":"Yitong Liu, Yuanming Wang, Suizi Zhou, Qianmin Chen, Yueying Yang, Zhiqing He, Hsiao-Hui Ong, Keshuang Wang, Shuping Jiang, Yang Peng, Chubo Xie, Ce-Belle Chen, Vincent T Chow, Mark Thong, De-Yun Wang, Qianhui Qiu, Jing Liu","doi":"10.1159/000552427","DOIUrl":"https://doi.org/10.1159/000552427","url":null,"abstract":"<p><strong>Introduction: </strong>Patients receiving radiotherapy for nasopharyngeal carcinoma often experience prolonged nasal epithelial dysfunction and recurrent infections. However, the dose-dependent effects of radiation on epithelial integrity and antiviral immune function remain incompletely defined.</p><p><strong>Methods: </strong>Human nasal epithelial cells (hNECs) were differentiated at an air-liquid interface (ALI) and exposed to gamma irradiation (0, 1, 2, 4, 8, or 16 Gy) on ALI day 0 to define dose-dependent epithelial injury. DNA damage, epithelial cell number, and proliferative capacity were assessed after irradiation. To model post-irradiation viral challenge, cultures exposed to 1 Gy were infected with rhinovirus on ALI day 28, followed by assessment of ciliary beat frequency (CBF), transepithelial electrical resistance (TEER), immunofluorescence, cytospin analysis, and gene expression by qRT-PCR.</p><p><strong>Results: </strong>Increasing radiation doses progressively exacerbated epithelial injury. Higher doses (8-16 Gy) caused marked epithelial loss and were not pursued for detailed phenotypic analyses. At 4 Gy, hNECs exhibited impaired ciliogenesis, impaired barrier integrity, and reduced proliferative capacity, whereas 2 Gy primarily caused structural abnormalities characterized by reduced acetylated α-tubulin and MUC5AC signals and an increased cell aspect ratio. In contrast, 1 Gy induced transient DNA damage while largely preserving epithelial structure by day 28. Upon rhinovirus infection, 1 Gy-exposed hNECs exhibited enhanced antiviral and inflammatory responses, including increased type III interferons, interferon-stimulated genes, inflammatory mediators, and intercellular adhesion molecule-1 (ICAM-1) expression.</p><p><strong>Conclusion: </strong>These findings suggest that low-dose radiation may alter epithelial immune responsiveness even in the absence of overt structural damage, leading to amplified antiviral and inflammatory gene induction following rhinovirus challenge. Our results provide novel insights into how prior radiation exposure may reshape mucosal responses to viral infection and thereby contribute to persistent sinonasal inflammation after radiotherapy.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-21"},"PeriodicalIF":1.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PNEUMOCOCCAL SEROLOGICAL EVALUATION IN VACCINATED CHILDREN DIAGNOSED WITH TRANSIENT HYPOGAMMAGLOBULINEMIA OF INFANCY AND UNCLASSIFIED HYPOGAMMAGLOBULINEMIA.","authors":"Gökcan Öztürk, Filiz Orhon, Deniz Bayrakoğlu, Candan İslamoğlu, Şule Haskoloğlu, Figen Doğu, Aydan İkincioğulları","doi":"10.1159/000552296","DOIUrl":"https://doi.org/10.1159/000552296","url":null,"abstract":"<p><p>The severity and incidence of invasive pneumococcal infections increase in inborn errors of immunities. However, there are limited number of studies in the literature evaluating pneumococcal antibody levels in patients with a prediagnosis of transient hypogammaglobulinaemia (THI) and unclassified hypogammaglobulinemia (UH). The aim of our study was to serologically evaluate pneumococcal antibody levels in children aged 24-72 months with THI or UH who had completed the primary PCV schedule, and to compare these levels with those of age matched healthy control. Patients aged between 24-72 months who were admitted to the Pediatric Immunology Allergy Department Outpatient Clinic between January 2024 and July 2024 and who were considered to have transient or unclassifiable hypogammaglobulinaemia. Healthy children of similar age group, without signs of infection or chronic disease and with complete vaccination according to their age were included in the study as a healthy control group. Serum samples obtained were separated and stored at -20 C⁰ until the day anti-PNP IgG levels were studied by ELISA method. No statistically significant difference was found when anti-PCP IgG levels were compared according to the diagnosis of THI and UH in the patient group (p=0.410). It was determined that both patient groups produced similar antibody levels. There were no statistically significant differences in anti PCP IgG levels between patients and control group (p=0.427). When the correlation between the time elapsed since the last dose of PCV13 and anti-PCP IgG levels was evaluated in the patient group (both in all patients and age groups) and in the control group, no statistically significant correlation was found. In the patient group, anti-PNP IgG levels were found to be lower in the group in which both IgG and IgM values were low compared to the other groups. No statistically significant difference was found between the clinical characteristics of the patients and anti-PCP IgG levels. In conclusion, this study is one of the few to evaluate pneumococcal antibody levels in children with THI and UH who have completed the primary PCV13 vaccination series. Further prospective studies involving serotype-specific tests and different pneumococcal vaccine formulations are needed.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-23"},"PeriodicalIF":1.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food protein-induced enterocolitis syndrome (FPIES) among Canadian children living in Montreal.","authors":"Angela Mulé, Pasquale Mulé, Adnan Al Ali, Catherine Prattico, Xun Zhang, Christine McCusker, Vicky Le Blanc, Moshe Ben-Shoshan","doi":"10.1159/000552386","DOIUrl":"https://doi.org/10.1159/000552386","url":null,"abstract":"<p><strong>Background: </strong>Data on food protein induced enterocolitis syndrome (FPIES) are sparse. We aimed to evaluate sociodemographic characteristics, co-morbidities, and triggers of children presenting with FPIES. Tolerance to baked goods and resolution a year following diagnosis were also assessed.</p><p><strong>Objective: </strong>Primary objective: To evaluate the sociodemographic characteristics, comorbidities, and triggers of children presenting with FPIES.</p><p><strong>Secondary objective: </strong>To determine tolerance of baked goods for children with milk, egg, oat, and/or soy/grains induced FPIES and evaluate symptom resolution over three years.</p><p><strong>Methods: </strong>Children with physician-diagnosed FPIES were enrolled and followed at the Montreal Children's Hospital and an affiliated clinic. Families were queried on the food trigger and co-morbidities, as well as clinical characteristics of reaction and management.</p><p><strong>Results: </strong>Between November 2021 and April 2025, 87 children with a confirmed history of FPIES were enrolled. Patient ages ranged from 1 month to 13 years old, and 45% of patients were males. The most common triggers included egg, shellfish, milk, fish, peanut, oat, fruit, soy/grains, and rice. Symptoms included vomiting, lethargy, pallor, diarrhea, dehydration, and abdominal pain. Tolerance to baked forms was seen in the majority of patients. The triggers that had resolved FPIES include egg, milk, oat, soy/grains, peanut, shellfish.</p><p><strong>Conclusion: </strong>The most common food triggers are egg, milk, and shellfish. The majority of reactions are not severe and baked goods containing the culprit food are often tolerated. Resolution of FPIES was reported in most patients one year following diagnosis.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-14"},"PeriodicalIF":1.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Salt Intake Exacerbates Food Allergy Symptoms by Impairing Intestinal Barrier Function and Activating Mucosal Mast Cells.","authors":"Suzuno Ota, Hibiki Yamaguchi, Sayaka Yokoyama, Shoki Kusano, Yuna Kawase, Hana Kozai, Mamoru Tanaka","doi":"10.1159/000552247","DOIUrl":"https://doi.org/10.1159/000552247","url":null,"abstract":"<p><strong>Introduction: </strong>Recent studies have shown that dietary salt affects the differentiation and function of T helper cell subsets. However, its influence on food allergies and the underlying mechanisms remains unclear. This study aimed to clarify the influence of high salt intake on allergic responses by examining its effects on immune function and intestinal barrier integrity in a food allergy mouse model.</p><p><strong>Methods: </strong>Five-week-old female BALB/c mice were assigned to four groups: non-sensitized/normal diet (CA), non-sensitized/salt diet (CN), sensitized/normal diet (SA), and sensitized/salt diet (SN). CA and SA groups received the AIN-93G diet and water, while CN and SN groups received AIN-93G diet containing 4% NaCl and water containing 1% NaCl ad libitum. Ovalbumin (OVA) sensitization was performed in SA and SN groups on days 7 and 21. On day 28, OVA was administered orally; rectal temperature, serum, and jejunal samples were collected 30 min later. Anaphylaxis severity, OVA-specific antibody responses, serum zonulin levels, jejunal histology, and serum mMCP-1 concentrations were evaluated.</p><p><strong>Results: </strong>OVA-specific IgE, IgG1, and IgG2a were significantly elevated in sensitized mice compared with non-sensitized mice, with no additional effect of high salt intake. High salt intake caused a marked reduction in rectal temperature in sensitized mice compared with non-sensitized mice, indicating enhanced anaphylaxis. Sensitized mice fed a high-salt diet also exhibited significantly elevated serum zonulin levels and jejunal villus damage compared with control diet-fed mice. Serum mMCP-1 levels increased with sensitization and were significantly higher in sensitized mice fed a high-salt diet than in sensitized mice fed a control diet.</p><p><strong>Conclusion: </strong>High salt intake may worsen food allergy symptoms by disrupting intestinal barrier function and enhancing mucosal mast cell activation.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-23"},"PeriodicalIF":1.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence of alpha-gal IgE among patients with confirmed Lyme serology result.","authors":"Kamran Kadkhoda, Alison Schwaben, Matthew Dee","doi":"10.1159/000552320","DOIUrl":"https://doi.org/10.1159/000552320","url":null,"abstract":"<p><p>Given the significant rise in the incidence of alpha-gal syndrome alongside the geographical expansion of ticks in recent years, it is crucial to conduct studies aimed at raising awareness-particularly among patients with a history of, or current diagnosis of, Lyme disease, to improve their quality of life. Our study is unique in addressing this important intersection. Two groups composed of 200 residuals de-identified samples originally collected during the peak of tick activity season in Northeast Ohio were tested for alpha-gal IgE. The first group (n=100) was from patients with Lyme IgG western blot positive results, and the remainder were from healthy subjects only tested for immune status. Of the 200 samples, 17 tested positive for α-Gal IgE: 15 from the Lyme-positive group and 2 from the control group. A Fisher Exact Test showed strong statistical significance between the two groups (P = 0.0015). Although alpha-gal syndrome had been previously associated with a history of American lone start tick bite, this study (given its controlled design) for the first time in North America shows a strong association between α-Gal IgE positivity and exposure to Ixodes ticks. This is of paramount importance given the vast prevalence of Ixodes ticks especially in areas where the American lone start ticks are scarce.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-6"},"PeriodicalIF":1.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysregulation of fatty acid and sphingolipid metabolism is involved in abnormal nasal epithelial differentiation.","authors":"Yutong Lin, Xiaoyan Ye, Yingqian Zhong, Liyue Li, Xianxiong Huang, Hexin Chen, Qingxiang Meng, Yifang Gao, Jian Li, Jianfeng Huang, Chunwei Li","doi":"10.1159/000552208","DOIUrl":"https://doi.org/10.1159/000552208","url":null,"abstract":"<p><strong>Introduction: </strong>Aberrant epithelial remodeling, driven by a shift from ciliated to goblet cell ratio, is central to chronic nasal inflammation. Despite the known role of metabolism in normal epithelial differentiation, the specific metabolic reprogramming patterns underlying this pathological shift of nasal epithelium induced by type 2 inflammatory milieu is poorly understood. This study aimed to delineate the key metabolic pathways involved in aberrant nasal epithelial differentiation.</p><p><strong>Methods: </strong>We employed a human apical-out nasal organoid (hANO) model stimulated with IL-13. Integrated transcriptomic (RNA-seq) and untargeted metabolomic profiling was performed at undifferentiated (Day 0), mid- (Day 7), and mature (Day 18) differentiation stages.</p><p><strong>Results: </strong>The IL-13-induced hANO model successfully recapitulated the aberrant differentiation phenotype of nasal epithelium. Multi-omics analyses converged to identify lipid metabolism as the most significantly altered functional module. Specifically, aberrant differentiation featured a reprogramming of fatty acid metabolism, marked by upregulated genes for uptake and elongation (CD36, ELOVL1/5/7), downregulated β-oxidation enzymes (ACADL, ACAA2), reduced acylcarnitines, and consequent free fatty acid accumulation. This was coupled with a distinct sphingolipid signature: while de novosynthesis was constrained and the sphingomyelinase pathway suppressed, the salvage synthesis pathway was specifically and persistently activated, evidenced by upregulation of key enzymes (CERS3/5, SGPP1/2) and elevated sphingosine, culminating in increased ceramide (e.g., C16:0) levels.</p><p><strong>Conclusion: </strong>Our work elucidates a time resolved lipid metabolic program, from fatty acid anabolism to dysregulated sphingolipid salvage synthesis, as a hallmark of aberrant nasal epithelial differentiation. This metabolic signature provides a novel framework for understanding epithelial remodeling in type 2 inflammation.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-19"},"PeriodicalIF":1.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioinformatics Analysis and Animal Experiments Revealed the Potential Role of IGFBP3 in Allergic Rhinitis.","authors":"Lisha He, Xiaodan Li, Yaojie Wang, Qiuyang Wang, Jing Tian","doi":"10.1159/000551921","DOIUrl":"https://doi.org/10.1159/000551921","url":null,"abstract":"<p><p>Background：Allergic rhinitis (AR) is a prevalent chronic inflammatory disorder that severely impairs patients' quality of life. Despite the availability of therapeutic interventions, the fundamental molecular mechanisms driving AR pathogenesis remain incompletely elucidated. Notably, the contribution of hypoxia-associated genes to nasal mucosal inflammation in AR has not been fully characterized. Methods：We conducted a comprehensive bioinformatics analysis on two public gene expression datasets-GSE261239 (human-derived) and GSE171005 (mouse-derived)-to identify hypoxia-related genes with differential expression in AR. A reference panel of hypoxia-associated genes was curated using the Molecular Signatures Database (MsigDB) and GeneCards. Immune cell infiltration patterns were evaluated via the xCell tool, and protein-protein interaction (PPI) networks were constructed using the STRING database. Subsequently, we validated these in silico findings in an ovalbumin (OVA)-induced mouse model of AR. Finally, we assessed the therapeutic potential of insulin-like growth factor-binding protein 3 (IGFBP3) by treating AR mice with recombinant IGFBP3. Results：Our analysis identified 11 hypoxia-related genes with altered expression in AR, among which IGFBP3 emerged as a central hub gene and was significantly downregulated. Reduced IGFBP3 expression was negatively correlated with the infiltration of mast cells (r=-0.43, p=0.037) and Th1 cells (r=-0.44, p=0.035). Consistent with the bioinformatics results, IGFBP3 expression was markedly decreased in the nasal tissues of AR mice. Treatment with recombinant IGFBP3 significantly alleviated allergic symptoms and reduced serum IgE levels (p=0.045) in AR mice. Furthermore, IGFBP3 treatment restored the integrity of the nasal epithelial barrier and diminished inflammatory cell accumulation in the nasal mucosa. Conclusion：Our findings demonstrate that IGFBP3 acts as a key regulator in AR pathogenesis, likely by modulating the local hypoxic microenvironment and regulating immune cell activity. The successful mitigation of AR symptoms following IGFBP3 treatment highlights its potential as a novel therapeutic target for AR.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-18"},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Severe Cutaneous Adverse Drug Reactions (SCARs) clinical characteristics and comparison of causality assesment tools and severity scoring systems in relation to clinical outcomes from a single center experience.","authors":"Burcu Cil Yilmaz, Pinar Gokmirza, Sibel Kaplan Sarikavak, Erkan Cakmak, Nagehan Aslan, Cigdem Aydogmus","doi":"10.1159/000551609","DOIUrl":"https://doi.org/10.1159/000551609","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Severe cutaneous adverse reactions (SCARs) such as drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN) are rare but life-threatening in children. Pediatric data on causative drugs, immunologic features, and outcomes remain limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare clinical, laboratory, and immunologic findings, causality tools, and severity scoring systems in pediatric DRESS and SJS/TEN.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively analyzed 23 children (&lt;18 years) with SCAR at a tertiary center (December 2022-April 2025). DRESS and SJS/TEN were diagnosed using RegiSCAR and consensus criteria, respectively. Causality was evaluated by the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) and Naranjo algorithms for DRESS, and the Algorithm of Drug Causality in Epidermal Necrolysis (ALDEN) for SJS/TEN. Disease severity in DRESS was evaluated using both the Mizukawa severity score and the EAACI 2025 Pediatric Position Paper (PP) severity grading, while SJS/TEN severity was assessed using Severity-of-Illness Score for Toxic Epidermal Necrolysis (SCORTEN). Clinical features, laboratory findings, treatment strategies, and outcomes were compared.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;DRESS constituted 69.6% of cases. Antibiotics predominated in DRESS (68.7%), and antiepileptics in SJS/TEN (57.1%). Causality assessment yielded predominantly Probable classifications in DRESS (69.2%), while aromatic anticonvulsants scored Very probable in SJS/TEN by ALDEN and severity grading aligned with clinical outcomes. In DRESS patients, severity stratification by the Mizukawa score predominantly classified cases as moderate, guiding systemic corticosteroid use. When reclassified according to the EAACI 2025 PP grading, several patients with limited extra-hepatic involvement were upgraded to higher severity categories, despite favorable clinical response to corticosteroid monotherapy. In SJS/TEN, SCORTEN scores aligned with overall clinical severity but did not correlate with ocular involvement. Intravenous immunoglobulin was administered more frequently in SJS/TEN than in DRESS (85.7% vs 12.5%, p=0.001). No mortality occurred. During follow-up, immune-mediated complications were observed exclusively in the DRESS group, including autoimmune thyroiditis in one patient, autoimmune thyroiditis with concurrent autoimmune neutropenia in another, and chronic urticaria in one patient, whereas no immune-mediated sequelae were detected in the SJS/TEN group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Pediatric DRESS and SJS/TEN display distinct clinical, immunologic, and severity profiles. Early CD19⁺ B-cell lymphopenia appears characteristic of DRESS and may support severity stratification and long-term autoimmune surveillance. Comparative application of the Mizukawa score and EAACI 2025 PP grading highlights potential differences in severity classificat","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-18"},"PeriodicalIF":1.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multifaceted Role of Vitamin D in the Pathogenesis and Clinical Management of Oral Lichen Planus: Current Evidence and Research Perspectives.","authors":"Wen-Juan Xie, Li-Na Li, Si-Jia Liu, Yang Li","doi":"10.1159/000551455","DOIUrl":"https://doi.org/10.1159/000551455","url":null,"abstract":"<p><p>Oral lichen planus (OLP) is a chronic, immune-mediated inflammatory disorder of the oral mucosa, primarily involving T lymphocyte activity. It is recognized by the World Health Organization as an oral potentially malignant disorder due to its established risk for malignant transformation. Although OLP has been the subject of extensive research, its pathogenesis remain partially understood. Vitamin D, a fat-soluble hormone essential for calcium-phosphorus homeostasis and immunological regulation, has emerged as a significant factor in the onset, progression, and clinical course of OLP. This review systematically examines the association between vitamin D-related local metabolic pathways and the oral mucosal microenvironment, synthesizing epidemiological evidence from diverse geographic regions that support an association between vitamin D deficiency and the occurrence of OLP. The molecular mechanisms by which vitamin D modulates OLP are discussed within a comprehensive framework including cellular protection, immune modulation, and regulation via non-coding RNAs. In addition, recent advances in the clinical application of vitamin D is summarized, particularly in relation to its potential role in non-invasive diagnostics and as an adjunctive therapy for OLP. Unresolved questions and areas of debate in current research are critically evaluated. Based on contemporary high-quality evidence, future research directions are proposed, emphasizing the need for individualized therapeutic strategies through multicenter, large-scale randomized controlled trials. Additional exploration of the interactions among vitamin D/vitamin D receptor signaling pathways, non-coding RNA networks, and the gut microbiota is recommended to enhance mechanistic insights and optimize clinical management strategies for individuals with OLP.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-19"},"PeriodicalIF":1.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}