International Archives of Allergy and Immunology最新文献

{"title":"The Role of Allergy Testing in Treatment Selection of Pediatric Eosinophilic Esophagitis.","authors":"Müge Selin Ensari, Ezgi Ulusoy Severcan, Zülfikar Akelma, Ferda Özbay Hosnut, Seda Sirin","doi":"10.1159/iaa/adfag039","DOIUrl":"https://doi.org/10.1159/iaa/adfag039","url":null,"abstract":"<p><strong>Introduction: </strong>Eosinophilic Esophagitis (EoE) is a chronic and recurrent disease characterized by symptoms associated with esophageal dysfunction and histopathologically by eosinophil-predominant inflammation. Our study aims to evaluate the role of diagnostic allergy tests in the selection of food elimination diets in EoE using real-world data and to compare the efficacy of medical treatment alone versus medical treatment with dietary intervention.</p><p><strong>Methods: </strong>This retrospective cohort study included 53 patients with complete data who were followed with a diagnosis of EoE at the Pediatric Allergy and Immunology Clinic between October 2022 and December 2025. All patients were evaluated with food and aeroallergen skin prick tests (SPT) and specific IgE (sIgE) measurement, and with atopy patch testing where indicated. Treatment response was assessed by combined clinical, endoscopic and histological evaluation 12 weeks after the start of treatment. Predictors of response were examined by univariable analysis and by multivariable binary logistic regression.</p><p><strong>Results: </strong>Thirty-three of the 53 patients (62.3%) responded to treatment. Medical treatment alone was administered to 52.8% of the cases, while 47.2% received dietary therapy in addition to medical treatment. Response was achieved in 47.4% of patients treated with a proton pump inhibitor (PPI) alone and in 70.6% of those who received a topical steroid and/or an elimination diet in addition to a PPI (p=0.140). Among the patients treated with an elimination diet, the response rate was 76.9% when at least one trigger food had been identified by an allergy test and 50.0% when all allergy tests were negative and the diet was empiric (p=0.226). Treatment response was significantly less frequent in patients sensitized to aeroallergens (42.1% vs. 73.5%; p=0.038). In multivariable logistic regression, aeroallergen sIgE positivity was independently associated with a lower probability of response (adjusted odds ratio [aOR] 0.12, 95% confidence interval [CI] 0.02-0.58; p=0.008) and food sIgE positivity with a higher probability of response (aOR 7.07, 95% CI 1.20-41.64; p=0.031). Symptoms began earlier in children with a past history of food allergy (p=0.004).</p><p><strong>Conclusion: </strong>In this cohort, allergy testing didn't identify a subgroup in which a test-directed elimination diet outperformed an empiric one, which supports current guideline recommendations to start elimination empirically. The aeroallergen sensitization was independently associated with a lower likelihood of treatment response. Treatment success in eosinophilic esophagitis may therefore be optimized through personalized approaches that consider the whole allergic phenotype of the patient rather than food test results alone.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223969","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":"Optimizing emergency management of anaphylaxis in dentistry: a systematic review of current practices.","authors":"Huamin Li, Siyu Zhong, Zhujun Yu, Beibei Ma, Dandan Li, Jianli Wang","doi":"10.1159/iaa/adfag037","DOIUrl":"https://doi.org/10.1159/iaa/adfag037","url":null,"abstract":"<p><strong>Introduction: </strong>This review characterizes anaphylaxis in dental practice, including patient demographics, clinical presentations, implicated allergens, diagnostic approaches and emergency management, to provide actionable guidance for safer dentistry.</p><p><strong>Methods: </strong>A systematic search was conducted across PubMed/Medline, Embase, and Web of Science for case reports of dental-related anaphylaxis published between 2000 and 2025.</p><p><strong>Results: </strong>Fifty-five cases from 44 studies were analyzed. Patients were predominantly male (63.64%), with a median age of 43 years. Most anaphylaxis (76.36%) occurred within 30 minutes, primarily during oral/maxillofacial surgery, endodontic treatments, and extractions. Dental materials (34.55%, mainly formaldehyde) were the leading triggers, followed by combined anesthesia (18.18%), antibiotics (10.91%), chlorhexidine (9.09%) and lidocaine (5.45%). Prior exposure was notable for dental materials (36.84%) and lidocaine (100%). Initial presentation patterns were trigger-specific: cutaneous symptoms dominated for dental materials and lidocaine; hypotension for combined anesthesia and antibiotics; and gastrointestinal distress for chlorhexidine. Alarmingly, epinephrine was administered in only 56.36% of cases, with the recommended intramuscular route utilized in merely 7.72%. Diagnosis relied primarily on skin prick and sIgE testing, supplemented by drug provocation.</p><p><strong>Conclusion: </strong>Anaphylaxis remains a persistent risk in dentistry. Enhancing dentist training, standardizing allergen testing, and increasing vigilance for atypical symptoms are critical to mitigating risks and improving patient outcomes.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206998","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":"Postoperative Recurrence of Chronic Rhinosinusitis with Nasal Polyps: Endotype Mechanisms, Predictive Models, and Novel Strategies for Precision Treatment.","authors":"Xingjian Chen, Yufen Guo","doi":"10.1159/iaa/adfag013","DOIUrl":"https://doi.org/10.1159/iaa/adfag013","url":null,"abstract":"<p><strong>Background: </strong>Postoperative recurrence of chronic rhinosinusitis with nasal polyps (CRSwNP) represents a significant clinical challenge. Traditional phenotype-based classifications have proven inadequate for predicting recurrence and guiding individualized management, while advances in immune endotype research are revealing the molecular mechanisms driving recurrence.</p><p><strong>Summary: </strong>This review systematically examines the endotype-specific mechanisms, predictive models, and treatment strategies for postoperative recurrence of CRSwNP. It highlights five core controversies: whether type 2 inflammation is truly the strongest recurrence driver, given evidence that mixed type 1/3 inflammation may lead to earlier relapse; the absence of head-to-head comparative evidence for biologic selection; the questionable operability of endotyping in routine practice; the persistent lack of effective therapies for non-type 2 and mixed endotypes; and the lack of prospective evidence for endotype-driven surgical strategies. The review further critiques the translational barriers facing current predictive models, including inconsistent recurrence definitions, insufficient external validation, and poor accessibility of input variables. Pharmacological treatments, biologics, and surgical strategies tailored to specific endotypes are also summarized.</p><p><strong>Key messages: </strong>(1) Type 2 inflammation remains central to recurrence, but mixed endotypes may drive earlier and more refractory relapse. (2) Current predictive models lack external validation and calibration data, limiting their clinical utility. (3) Biologics targeting type 2 pathways have transformed treatment, yet evidence for non-type 2 patients is absent. (4) Endotype-guided precision management-integrating prediction, pharmacotherapy, biologics, and surgery-requires prospective validation in multicenter trials.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193298","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":"Montelukast combined with ICS/LABA improves clinical outcomes in moderate-to-severe persistent asthma by modulating T lymphocyte subset-related cytokine profiles.","authors":"Wanlong Cai, Yinghua Cao, Li Wang, Shengli Zhou, Qixing Ge, Mingming Zhao, Haipeng Yan","doi":"10.1159/iaa/adfag023","DOIUrl":"https://doi.org/10.1159/iaa/adfag023","url":null,"abstract":"<p><strong>Background: </strong>Glucocorticoids and montelukast, an anti-leukotriene agent, target different inflammatory pathways. This study aims to investigate the immunological synergy of their combination.</p><p><strong>Methods: </strong>A prospective, randomized, controlled, open-label study was conducted. Two hundred and third-four patients were randomly assigned to two groups for a 12-week treatment period. Control group [ICS+long-acting beta₂-agonist (LABA)]; n = 118): Budesonide 400 µg/day (200 µg twice daily) + formoterol 18 µg/day (9 µg twice daily). Combination group (n = 116): Same ICS+LABA regimen + Montelukast 10 mg orally once daily.</p><p><strong>Results: </strong>At Week 12, the ICS+LABA+Mon group demonstrated significantly greater improvements in pre-bronchodilator FEV₁ compared with the ICS+LABA group (mean change: +239.0 ± 70.5 mL vs. +141.2 ± 47.9 mL; between-group difference 97.8 mL; 95% CI: 82.4 to 113.2; P < 0.001). Asthma control improved more substantially with combination therapy, as shown by greater ACQ-6 score reductions, with the mean score in the combination group approaching the well-controlled threshold. Immunologically, combination therapy produced a significantly greater increase in IFN-γ and Treg cytokines IL-10 and TGF-β, alongside more pronounced suppression of T helper 2 (Th2) cytokines (IL-4, IL-5, and IL-13) and the Th17 cytokine IL-17.</p><p><strong>Conclusions: </strong>The addition of montelukast to ICS+LABA therapy significantly enhances pulmonary function, asthma control, and suppression of eosinophilic airway inflammation in moderate-to-severe persistent asthma via a favorable immunological shift characterized by enhanced Th1 and Treg responses and more potent suppression of Th2 and Th17 pathways.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193377","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":"Relapse Rates, Time-to-Flare, and Biomarker Predictors Following Omalizumab Gradual De-escalation versus Abrupt Discontinuation in Controlled Chronic Spontaneous Urticaria: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Observational Cohorts.","authors":"Muhammed Sah Dogan, Sezgin Yildiz, Ruhat Tunç","doi":"10.1159/iaa/adfag017","DOIUrl":"https://doi.org/10.1159/iaa/adfag017","url":null,"abstract":"<p><strong>Background: </strong>How best to discontinue omalizumab once chronic spontaneous urticaria (CSU) is well controlled remains unsettled, and whether to taper gradually or to stop abruptly is a recurring source of clinical uncertainty.</p><p><strong>Objective: </strong>We set out to quantify relapse rates, time-to-flare kinetics, and biomarker predictors following gradual omalizumab de-escalation as opposed to abrupt discontinuation.</p><p><strong>Methods: </strong>PubMed, Embase, and Cochrane CENTRAL were searched systematically through April 2026. A random-effects proportion meta-analysis (DerSimonian-Laird) spanned 13 independent study arms (N = 1,382 patients contributing to the relapse-proportion analysis, drawn from 5,130 patients reviewed across 11 studies). Shared control groups within multi-arm trials were weighted a priori. Prespecified subgroups contrasted gradual de-escalation-whether achieved by interval extension (IE) or dose reduction (DR)-with abrupt discontinuation, and the certainty of evidence was appraised using GRADE.</p><p><strong>Results: </strong>Across all studies, the pooled relapse rate was 39.5% (95% CI, 30.1%-49.7%). Gradual de-escalation was associated with a significantly lower relapse rate than abrupt discontinuation (31.2% [95% CI, 20.3%-44.7%] vs. 48.9% [95% CI, 37.0%-61.0%]; Qb = 8.12; P = .004), and dose reduction to 150 mg every 4 weeks yielded the lowest rate of all (23.3%; 95% CI, 9.2%-47.6%; I² = 50.4%). Several baseline features independently predicted relapse: a high total IgE (>90 IU/mL, P = .005; or ≥341 kU/L, Cox P < .001), blood eosinophils >0.15 × 10⁹/L (P = .043), concomitant angioedema (OR, 2.40; P = .004), and disease duration exceeding 2 years (HR, 0.81 for successful drug survival; P = .03). Although Egger's test fell short of conventional significance (reported P = .109), the large negative intercept-coupled with the well-recognized unreliability of this test in proportion meta-analyses-meant that small-study effects could not be excluded with confidence. A sensitivity analysis confined to homogeneous cohorts followed for at least 6 months reaffirmed the superiority of de-escalation (P = .008).</p><p><strong>Conclusion: </strong>Gradual de-escalation of omalizumab is associated with an almost two-fold reduction in the risk of post-discontinuation relapse relative to abrupt stopping. Baseline total IgE and blood eosinophils emerge as pivotal, endotype-specific biomarkers for judging which patients are ready to stop.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206977","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":"Evaluation of Suspected Hypersensitivity Reactions to Oral Iron Preparations in Children.","authors":"Deniz Yilmaz, Ahmet Selmanoglu, Zeynep Sengül Emeksiz, Emine Dibek Misirlioglu","doi":"10.1159/iaa/adfag038","DOIUrl":"https://doi.org/10.1159/iaa/adfag038","url":null,"abstract":"<p><strong>Introduction: </strong>Oral iron preparations are widely used in the treatment of iron deficiency anemia globally, including children. Although adverse reactions are occasionally reported, true hypersensitivity to oral iron is considered uncommon. However, suspected reactions may lead to unnecessary discontinuation of iron therapy and referral to allergy clinics. To evaluate the clinical characteristics and diagnostic yield of drug provocation testing in children with suspected hypersensitivity reactions to oral iron preparations.</p><p><strong>Methods: </strong>This retrospective study included children referred to a tertiary pediatric allergy clinic for suspected hypersensitivity to oral iron preparations. Clinical characteristics, reaction phenotypes, timing of reactions, and drug provocation test (DPT) outcomes were analyzed. Hypersensitivity was confirmed when objective symptoms were reproduced during culprit drug provocation. Children aged 0-18 years who underwent culprit or alternative drug provocation testing were included.</p><p><strong>Results: </strong>A total of 28 children were included in the analysis. The median age at the index reaction was 2.5 years (IQR: 0.5-9.3), and 18 patients (64.3%) were female. Allergic diseases were present in 12 patients (42.9%). Maculopapular eruption was the most frequently reported index reaction (11/28, 39.3%), followed by other cutaneous rashes (6/28, 21.4%), urticaria (5/28, 17.9%), and angioedema (1/28, 3.6%) while non-cutaneous manifestations were reported in 5 patients (17.9%). The median time from drug intake to symptom onset was 6.75 hours (IQR: 4.12-9.00). Culprit drug provocation testing was performed in 14 patients, confirming hypersensitivity in 2 cases (2/14, 14.3%). Twelve patients (12/14, 85.7%) had negative provocation tests. Alternative iron provocation was performed in 14 patients; all of which were tolerated.</p><p><strong>Conclusion: </strong>True hypersensitivity to oral iron preparations appears to be uncommon in children. Appropriate allergy evaluation, including drug provocation testing when indicated, may help clarify suspected reactions and prevent unnecessary avoidance of iron therapy.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193263","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":"INNOVATIVE SYMPTOMS ASSESSMENT APPROACH USING EHEALTH TECHNOLOGIES IN PATIENTS WITH OLEA EUROPAEA POLLEN ALLERGY USING AN ENVIRONMENTAL EXPOSURE CHAMBER.","authors":"Irene García-Gutiérrez, Violeta Sánchez-García, Cristiana Solórzano-Zepeda, Irene Dueñas-Requena, Elena Ramírez-Mateo, Cristina Mato-de Prada, Lidia Caballero-Pérez, Darío Antolín-Amérigo, Belén de la Hoz-Caballer","doi":"10.1159/iaa/adfag016","DOIUrl":"https://doi.org/10.1159/iaa/adfag016","url":null,"abstract":"<p><strong>Introduction: </strong>what is the context and aim of the study? The prevalence of Olea europaea (Olea) pollinosis in large areas of southern Europe is very relevant. This study introduces and assesses a novel approach using eHealth technologies within an environmental exposure chamber (EEC) to evaluate Olea pollen allergy at Ramón y Cajal University Hospital (RyCUH) in Madrid. The primary goal was to clinically validate the safety and diagnostic performance of Olea pollen exposure in an EEC, representing the first reported use of olive pollen in this setting.</p><p><strong>Methods: </strong>what were the principal methods used? A new EEC was developed at RyCUH, ensuring reproducible pollen distribution and stable environmental conditions. The study recruited 20 volunteers: 15 Olea pollen-allergic individuals and 5 controls. REDCap, an electronic data capture tool, was used to collect patient-reported symptom scores, asthma-related data, and clinical observations before, during, and after EEC exposure. PowerBI software facilitated real-time monitoring of clinical and technical parameters to ensure patient safety.</p><p><strong>Results: </strong>What are the most important findings? The results indicated that 12 of the 15 allergic participants (80%) experienced positive reactions during the Olea pollen challenge, primarily rhinitis and conjunctivitis, with a few developing mild asthma symptoms. No symptoms were observed in the control group, confirming specificity. The use of PowerBI enabled immediate assessment of symptom severity, and all reactions were promptly managed.</p><p><strong>Conclusions: </strong>What is the most important conclusion drawn, and what is the clinical or research relevance of the results? In conclusion, this study presents the first Olea pollen challenge in an EEC, demonstrating it to be a safe and effective method for evaluating allergic patients. The integration of REDCap and PowerBI for the in an EEC, represents a significant advancement, establishing a new precision medicine tool for symptom assessment and safety monitoring in Olea pollen allergy and contributing to the digital transformation of allergology.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193322","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":"Inborn Errors of Immunity in Neonatal and Pediatric Intensive Care Units: Clinical Spectrum and Diagnostic Outcomes.","authors":"Gokcan Ozturk, Sule Haskologlu, Candan Islamoglu, Selin Sevinç, Ahmet Kara, Burak Özerdem, Hasret Erkmen, Nazli Deveci Demirbas, Avniye Kubra Baskin, Sevgi Köstel Bal, Merve Havan, Emel Okulu, Tanil Kendirli, Begüm Atasay, Figen Dogu, Aydan Ikinciogullari","doi":"10.1159/iaa/adfag035","DOIUrl":"https://doi.org/10.1159/iaa/adfag035","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Inborn errors of immunity (IEI) may manifest with infections, immune dysregulation, syndromic features, and multisystem involvement. Critically ill neonates and children admitted to intensive care units (ICUs) with severe or atypical presentations may harbor underlying IEI, posing significant diagnostic challenges. This study aimed to evaluate the clinical characteristics, consultation indications, immunological findings, warning signs, and diagnostic outcomes of patients assessed for suspected IEI in neonatal and pediatric intensive care units.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively reviewed patients from the neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) of our hospital who were referred to the Department of Pediatric Immunology and Allergy because of clinical and/or laboratory suspicion of IEI between January 2017 and September 2025. Consultation indications, final diagnoses, IEI categories, and traditional Jeffrey Modell Foundation (JMF) and additional warning signs were evaluated. The diagnostic performance of individual warning signs for confirmed IEI was assessed, and the incremental contribution of additional warning signs beyond the traditional JMF criteria was examined at the patient level.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 172 patients were referred from the NICU and PICU, corresponding to 0.8% and 2.6% of all admissions, respectively; 40 (23.3%) were diagnosed with IEI. Syndromic features with systemic involvement were the most frequent indication for consultation in the NICU, whereas severe infection/sepsis predominated in the PICU. Combined immunodeficiencies with syndromic features were most frequent in the NICU, while predominantly antibody deficiencies were most common in the PICU. Deep-seated infection/septicemia, chronic diarrhea/enteropathy, and syndromic features were significantly associated with confirmed IEI, with ORs of 2.21 (95% CI, 1.08-4.53), 2.57 (95% CI, 1.08-6.07), and 2.41 (95% CI, 1.06-5.48), respectively. Overall, 38/40 (95.0%) patients with IEI fulfilled at least one traditional JMF warning sign. Both JMF-negative patients with IEI had at least one additional warning sign; therefore, considering traditional and additional warning signs together retrospectively identified all 40 patients with IEI in this referral cohort. Mortality among patients with IEI was 32.5%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;IEI was diagnosed in 23.3% of critically ill patients referred for immunological evaluation because of suspected IEI. Deep-seated infection/septicemia, chronic diarrhea/enteropathy, and syndromic features were significantly associated with confirmed IEI. Traditional JMF warning signs identified most patients with IEI; however, additional warning signs captured two IEI patients who did not fulfill any traditional JMF criteria. These findings support considering additional non-infectious and syndromic manifestations alongside traditiona","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180786","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":"Efficacy and Safety of Sublingual versus Subcutaneous Immunotherapy for Patients with Allergic Rhinitis with Asthma: A Systematic Review and Meta-analysis.","authors":"Qian Jiang, Yaosen Shao, Qin Zheng","doi":"10.1159/iaa/adfag033","DOIUrl":"https://doi.org/10.1159/iaa/adfag033","url":null,"abstract":"<p><strong>Introduction: </strong>Allergic rhinitis (AR) and asthma are common chronic respiratory disorders that frequently coexist. Allergen immunotherapy (AIT) is a disease-modifying treatment; however, the comparative efficacy and safety of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) remain uncertain in patients with concomitant AR and asthma.</p><p><strong>Methods: </strong>PubMed/MEDLINE, Scopus, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception to March 2026. Studies directly comparing SCIT and SLIT in patients with AR and concomitant asthma were eligible. Outcomes included symptom scores, medication use, reported asthma exacerbations or worsening events, visual analog scale (VAS) scores, immunological markers, and adverse events.</p><p><strong>Results: </strong>Nine studies were included in the systematic review, seven of which contributed to the meta-analysis. SLIT was associated with fewer reported asthma exacerbations or worsening events than SCIT (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.09-0.89; moderate-certainty evidence). SCIT was associated with greater improvement in VAS scores (mean difference [MD], 1.80; 95% CI, 0.82-2.78; low-certainty evidence). No statistically significant differences were observed in the total rhinitis symptom score (TRSS; MD, 0.44; 95% CI, -0.14 to 1.02; very-low-certainty evidence), total medication score (TMS; MD, -0.48; 95% CI, -1.12 to 0.16; low-certainty evidence), or total asthma symptom score (TASS; MD, -0.24; 95% CI, -1.03 to 0.55; very-low-certainty evidence). No statistically significant differences were found in systemic reactions (OR, 0.28; 95% CI, 0.05-1.43), skin reactions (OR, 0.72; 95% CI, 0.41-1.28), nausea or vomiting (OR, 1.25; 95% CI, 0.23-6.94), or withdrawal rates (OR, 0.72; 95% CI, 0.21-2.51).</p><p><strong>Conclusion: </strong>Limited comparative evidence suggests that SLIT may be associated with fewer reported asthma-worsening events than SCIT, whereas SCIT may be associated with greater improvement in VAS scores. However, these findings were based on a small number of clinically heterogeneous studies using nonstandardized outcome definitions. No clear differences were observed in rhinitis symptoms, medication use, asthma symptom scores, or most safety outcomes. Further high-quality head-to-head randomized controlled trials are needed.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181757","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":"Luteolin alleviates neurogenic inflammation in OVA-induced combined allergic rhinitis and asthma syndrome mice through TRPV1/ERK-related signaling.","authors":"Jing Li, Firuza Mirodilova, Lei Lei","doi":"10.1159/iaa/adfag036","DOIUrl":"https://doi.org/10.1159/iaa/adfag036","url":null,"abstract":"<p><strong>Objective: </strong>Combined Allergic Rhinitis and Asthma Syndrome (CARAS), a common chronic allergic respiratory disease, involves dysregulated neuro-immune interactions and neurogenic inflammation. Luteolin (LUT) has significant anti-inflammatory and antioxidant activities. However, its effects and underlying mechanism in CARAS remain unclear. This study aims to determine the effects of LUT administration during the airway challenge phase of CARAS and its association with TRPV1/ERK signaling.</p><p><strong>Methods: </strong>BALB/C mice were used to establish an ovalbumin (OVA)-induced CARAS model and LUT was administered. The nasal symptoms were evaluated by counting the number of nasal scratching and sneezing. HE and toluidine blue staining were performed to determine the histopathological changes. Total and differential cell counts in bronchoalveolar lavage fluid (BALF) were determined. The levels of histamine, MCP-1, substance P (SP), CGRP and Th1/Th2/Th17-related cytokines were detected by ELISA kit. Besides, TRPV1 and p-ERK expression levels were measured by immunofluorescence staining and Western blotting.</p><p><strong>Results: </strong>Our study indicated that LUT administration significantly reduced sneezing frequency, nasal scratching behavior, and serum OVA-specific IgE level in CARAS mice compared to the model group. Histopathological analysis demonstrated that LUT administration reduced inflammatory cell accumulation and histological scores in the nasal mucosa and lung tissues and was associated with reduced inflammatory cell counts in BALF. In addition, LUT administration reduced mast cell density in both tissues. Serum histamine and MCP-1 levels and pulmonary levels of IL-4, IL-5, IL-13, IL-17A, and IFN-γ were also reduced following LUT administration. LUT administration also reduced serum and BALF levels of SP and CGRP. Furthermore, LUT administration reduced TRPV1 expression and p-ERK levels in the nasal mucosa and lung tissue.</p><p><strong>Conclusion: </strong>LUT administration attenuates allergic and inflammatory responses in OVA-induced CARAS mice, which may be associated with TRPV1/ERK signaling.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170301","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}