International Archives of Allergy and Immunology最新文献

{"title":"Neuronal Regulation of Inflammation in Atopic Dermatitis.","authors":"Chen YiYu Zhang, Yong Mei Jin, Rui Feng Liu, Ying Wang","doi":"10.1159/000548517","DOIUrl":"https://doi.org/10.1159/000548517","url":null,"abstract":"<p><p>Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by impaired barrier function, immune dysregulation, and severe pruritus. Recent studies have highlighted the pivotal role of neuronal regulation in modulating inflammation within the skin. Neuroimmune interactions, particularly between sensory neurons and immune cells, such as macrophages and mast cells, contribute significantly to the pathophysiology of AD. Additionally, neuropeptides and neurotrophins, including substance P and neurotrophin-4, have been implicated in amplifying inflammation and promoting skin barrier dysfunction. This review explores the complex mechanisms underlying neuronal regulation of inflammation in AD, emphasizing the bidirectional communication between the nervous and immune systems. The review further emphasize that pruritus is a primary driver of disease burden and should be a co-primary therapeutic target alongside inflammation control. The review also discusses emerging therapeutic strategies targeting neuroimmune circuits, including biologic agents against pruritogenic cytokines, kinase inhibitors, and neuropeptide antagonists. Finally, we address the role of adjunctive topical strategies, such as moisturizers containing topical anesthetics and calming botanical agents, which act to dampen neuronal excitability and support barrier repair. Collectively, these approaches offer novel and multifaceted strategies for managing both pruritus and inflammation in AD. Understanding these neuroimmune pathways is crucial for developing more effective, targeted treatments for this debilitating condition.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-24"},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238610","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":"Monocyte-derived dendritic cells drive skin inflammation: cellular energy metabolism and microenvironmental regulation.","authors":"Cuie Gao, Ying Zhao, Zhiqiang Song","doi":"10.1159/000547871","DOIUrl":"https://doi.org/10.1159/000547871","url":null,"abstract":"<p><p>Dendritic cells (DCs) represent a heterogeneous subpopulation of antigen-presenting cells that bridge the innate and acquired immune responses. Studies have reported that cellular metabolic reprogramming regulates the biological function of DCs, with distinct metabolic profiles characterizing different DC subsets and activation state. Particularly, blood monocyte-derived dendritic cells (mo-DCs) drive the skin inflammation. The differentiation, maturation, metabolism and function of mo-DCs are influenced by microenvironmental factors including pH, mechanical force, and temperature. The paper briefly reviewed the biological role of mo-DCs in skin diseases, focusing on their differentiation and phenotype, disease-associated metabolic adaptations, and the microenvironmental factors that influence their maturation, energy metabolism and function. Future researchers should explore the impact of the skin microenvironment on the metabolism and function of mo-DCs and identify specific targets, which may pave the way for precision medicine methods for treating refractory inflammatory skin diseases.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-16"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206488","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":"Eosinophil-derived neurotoxin is an asthma biomarker linked to wheezing severity in preschool children.","authors":"Taiga Kobori, Niclas Rydell, Mizuho Nagao, Robert Movérare, Masahiro Watanabe, Reiko Tokuda, Helena Ekoff, Anders Sjölander, Magnus P Borres, Takao Fujisawa","doi":"10.1159/000548237","DOIUrl":"https://doi.org/10.1159/000548237","url":null,"abstract":"<p><p>Background Novel biomarkers are needed for understanding the clinical characteristics of children with acute wheeze (AW) and for optimizing management strategies. This study investigated serum eosinophil-derived neurotoxin (EDN) and blood eosinophil count (B-Eos) in Japanese pre-school children with current asthma (CA) and/or AW. Methods Two cohorts of Japanese children under 6 years of age were screened for allergy and asthma symptoms using the ISAAC questionnaire and tested for EDN, B-Eos and specific IgE. Cohort 1 included 16 children with CA, 45 with other allergies (OA), e.g. eczema or rhinitis, and 34 healthy controls (HC). Optimal cut-offs (receiver operating characteristic analysis) for EDN and B-Eos were determined for CA vs HC. Cohort 2 included 87 children with AW grouped according to symptom severity, high (EDN-H, B-Eos-H) or low (EDN-L, B-Eos-L) EDN and B-Eos (using the optimal cut-offs) and were followed up during recovery. Results Children with CA or OA had higher EDN vs HC (p<0.01). The B-Eos was higher in CA vs HC (p<0.05). The optimal cut-offs for EDN and B-Eos were 26.5 µg/L and 235 cells/µL, respectively. EDN was higher in wheezing children with severe vs mild or moderate symptoms (p<0.05). Conversely, B-Eos were higher in children with mild vs moderate symptoms (p<0.01). EDN decreased in the EDN-H group between AW and recovery (p<0.001). Higher EDN, and to a lesser extent, B-Eos were associated with IgE sensitization. Conclusion Serum EDN is a promising exploratory biomarker for CA and AW in pre-school children associated with wheezing severity and recovery after treatment.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-20"},"PeriodicalIF":1.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191550","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":"Beyond the Rash: How Omalizumab Shapes Mental Health Outcomes in Chronic Spontaneous Urticaria.","authors":"Tugba Kiratli Yolcu, Volkan Bozkurt, Sedat Demirsoy, Dilan Sirin, Cengiz Kirmaz","doi":"10.1159/000548659","DOIUrl":"https://doi.org/10.1159/000548659","url":null,"abstract":"<p><p>Introduction Chronic spontaneous urticaria (CSU) is defined as urticaria lasting at least six weeks. Its symptoms (itching, redness, wheals, etc.) significantly impair quality of life and psychological wellbeing. This study aimed to assess the effect of omalizumab on anxiety, depression, and stress in CSU patients Method This study prospectively evaluated patients diagnosed with chronic spontaneous urticaria who were treated with six doses of omalizumab. A series of assessments were conducted prior to and following the administration of treatment. These included the Perceived Stress Scale (PSS), the Hospital Anxiety and Depression Scale (HADS: HADS-A [anxiety] and HADS-D [depression]), the Urticaria Activity Score (UAS7) and the Urticaria Control Test (UCT). The results for HADS-A and HADS-D were further classified as normal, borderline, or abnormal. Results A total of 34 patients (8 males, 26 females) with a mean age of 38.5 ± 9.9 years were included in the study. Following treatment, 31 of 34 patients (91%) achieved notable reduction in the UAS7 score, aligning with the minimal clinically important difference (MCID: 9.5-10.5) criteria. A significant decrease was observed in HADS and PSS scores, while a significant increase was noted in UCT scores (p < 0.001 for all parameters). A significant decrease in the UAS7 score was observed in all subcategories of the HADS-A and HADS-D assessments at the six-month evaluation period. However, no significant change was observed between subcategories. Conclusion The omalizumab treatment has positive impact on urticaria activity, psychological parameters and stress condition in CSU patients. The presence of anxiety and depression at baseline does not impact the efficacy of the treatment. Nevertheless, patients exhibiting elevated psychological stress or anxiety/depression scores in the absence of urticaria control should be referred for further psychiatric evaluation.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-13"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149007","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":"Prevalence of NSAID-ERD among Patients with Chronic Rhinosinusitis with Nasal Polyps in the Global AROMA Registry.","authors":"Martin Desrosiers, Tanya M Laidlaw, Andrew A White, Eugenio De Corso, Changming Xia, Scott Nash, Micah Johnson, Mark Corbett, Lucia De Prado Gomez, Juby A Jacob-Nara, Amr Radwan","doi":"10.1159/000548186","DOIUrl":"https://doi.org/10.1159/000548186","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a predominantly type 2 inflammatory disease associated with severe symptom burden and reduced quality of life. Non- steroidal anti inflammatory drug-exacerbated respiratory disease (NSAID-ERD) is a common coexisting condition, associated with more severe sinus disease and increased corticosteroid use.</p><p><strong>Purpose: </strong>To describe baseline characteristics and disease burden in patients with CRSwNP with coexisting NSAID-ERD in the Global AROMA registry.</p><p><strong>Methods: </strong>AROMA is a prospective global registry study recruiting adult patients with severe CRSwNP who initiate dupilumab and following them for up to 36 months. Baseline demographics and disease characteristics were assessed for all patients entering the registry.</p><p><strong>Results: </strong>As of February 2023, the study had recruited 303 patients; 77 (25.4%) had coexisting NSAID ERD. Of these patients, 11 (14.3%) had undergone a confirmatory aspirin challenge and 11 (14.3%) had undergone an aspirin desensitization. The rate of previous sinonasal surgery was 64.9% in the coexisting NSAID-ERD group and 60.6% in the group without NSAID ERD. The mean (SD) loss of smell score in patients with coexisting NSAID-ERD was 2.4 (0.85) versus 2.1 (1.16) in patients without (p = 0.0085). Leukotriene receptor antagonist use at baseline was 45.5% in patients with coexisting NSAID-ERD and 29.2% in patients without.</p><p><strong>Conclusions: </strong>One-quarter of adults with CRSwNP in AROMA have coexisting NSAID-ERD, and most have not undergone a confirmatory aspirin challenge or desensitization. Patients with CRSwNP with coexisting NSAID-ERD report more severe smell loss at baseline and are more likely to have undergone sinonasal surgery.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149005","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":"Perioperative Hypersensitivity Reactions: An Analysis of Affected Patients, Responsible Agents, and Conducted Diagnostics at a Tertiary Allergology University Center in Switzerland.","authors":"Selina Steiger, Milad Ameri, Nick Li, Danielle Fehr, Lukas Binder, Philipp Bardelli, Clément Tschopp, Peter Schmid-Grendelmeier, Marie-Charlotte Brüggen","doi":"10.1159/000548446","DOIUrl":"https://doi.org/10.1159/000548446","url":null,"abstract":"<p><strong>Introduction: </strong>Perioperative hypersensitivity reactions (POH) are rare occurrences, but they can lead to life-threatening complications. The culprits for POH vary between countries. In about 25% of the cases, the causative agent of POH remains unknown.</p><p><strong>Objective: </strong>Data on POH and its causes in Switzerland are sparse. The aim of this study was to address this gap and provide insights into POH in Switzerland.</p><p><strong>Methods: </strong>In this retrospective monocentric study, we analyzed data from 106 patients referred for POH evaluation to a tertiary Allergology University Center in Switzerland. We analyzed data about clinical characteristics, culprit drugs, and performed diagnostic tests (specific IgEs, basophil activation tests, skin tests, provocation tests).</p><p><strong>Results: </strong>The majority of POH patients were female (56.6%, n=60). Allergic comorbidities were frequently present (68.9%, n=73), a previous episode of POH was reported in 16.0% (n=17). A trigger was diagnostically confirmed or strongly suspected in 76.4% (n=81) of the cases. The most common confirmed or suspected triggers were neuromuscular blocking agents (NMBA) and antibiotics (predominantly cephalosporins), each accounting for 26.5% (n=27) of the reactions. This was followed by antiseptics (9.8%, n=10) and opioids (9.8%, n=10). Latex accounted for less than three percent of the reactions. For the confirmed triggers, identification primarily relied on positive skin test results (73.0%, n=46), although different tests sometimes yielded varying results.</p><p><strong>Conclusions: </strong>In Switzerland, antibiotics (mostly cephalosporins), and NMBA are among the most common triggers of POH. By combining skin tests and in vitro diagnostics, culprit drugs of POH could be identified in more than 75.0% of the cases.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-24"},"PeriodicalIF":1.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091682","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":"Persistent Benefit of Two-Year Artemisia annua Sublingual Immunotherapy for Seasonal Allergic Rhinoconjunctivitis.","authors":"Yang Liu, Kaili Zheng, Tianfei Lan, Jingyi Liu, Yuxuan Wu, Xueyan Wang, Tingting Ma","doi":"10.1159/000548444","DOIUrl":"https://doi.org/10.1159/000548444","url":null,"abstract":"<p><p>Introduction：Artemisia pollen is a major aeroallergen source in Northern China that can cause multiple kinds of common allergic diseases. China's first Artemisia annua sublingual drops for Artemisia pollen-induced seasonal allergic rhinitis were launched in 2021. This study aimed to evaluate the efficacy and safety of a two-year course of sublingual immunotherapy (SLIT) using Artemisia annua allergen extract in patients with seasonal allergic rhinoconjunctivitis (SARC). Additionally, it sought to assess the sustained clinical efficacy of this therapy one year post-treatment. Methods：Fifty patients (aged 4-60 years) with SARC and confirmed Artemisia annua pollen allergy were enrolled in this study. In accordance with their preferences, the subjects were assigned to either the SLIT group (n=25, receiving SLIT plus symptomatic treatment) or the control group (n=25, receiving symptomatic treatment alone) at a ratio of 1:1. The entire study lasted for 3 years, initiating a two-year treatment phase (2022 and 2023 pollen seasons) followed by a one-year post-discontinuation follow-up period (2024 pollen season), with 2021 pollen season regarded as baseline. The total rhinoconjunctivitis symptom score (TRSS), total medication score (TMS), combined score of medication and rhinoconjunctivitis symptoms (CSMRS), and visual analogue scale (VAS) were compared between the two groups for clinical efficacy. In addition, the rhinoconjunctivitis quality of life questionnaire (RQLQ) was used to assess the impact of the Artemisia annua SLIT on the quality of life of patients. Safety was evaluated based on adverse events (AEs). Results：A total of 41 patients completed the study (SLIT: n=21, Control: n=20). There were no significant differences between the two groups during 2021 pollen season (baseline). However, the scores of TRSS (all P < 0.001), CSMRS (all P < 0.001), VAS (2022: P < 0.01; 2023: P < 0.001; 2024: P < 0.001), and RQLQ scores (2022: P < 0.01; 2023: P < 0.001; 2024: P < 0.001) were significantly lower than the control group during the 2 year SLIT treatment period and 1 year follow-up period. For TMS scores, although no statistically significant differences were found in 2022 and 2023 pollen seasons (P > 0.05), the SLIT group showed a decreasing trend. And TMS of SLIT group was significantly lower than that of the control group during 2024 pollen season (P < 0.05). In addition, RQLQ scores correlated positively with CSMRS and VAS (all P < 0.001). Conclusions：A two-year course of SLIT with Artemisia annua allergen extract significantly alleviated symptoms and reduced medication use in SARC patients, with clinical benefits persisting for at least one year post-treatment phase.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-18"},"PeriodicalIF":1.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069346","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":"Clinical and Laboratory Characteristics of Patients with Chronic Spontaneous Urticaria in a Vietnamese population.","authors":"My Nguyen Thi Tra, My Le Huyen, Minh Vu Nguyet, Katrine Baumann, Per Stahl Skov, Doanh Le Huu","doi":"10.1159/000548391","DOIUrl":"https://doi.org/10.1159/000548391","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to investigate the clinical and laboratory characteristics of patients with type IIb autoimmune Chronic Spontaneous Urticaria (CSU) in a Vietnamese population and how this correlate with results of the Basophil Histamine Release Assay (BHRA).</p><p><strong>Methods: </strong>A cross-sectional, single-center study was conducted with 388 CSU patients aged 16 years or older at the Vietnam National Dermatology and Venereology Hospital, from June 2023 to March 2024. Clinical data were collected, and laboratory tests were performed. Patients also underwent the Autologous Serum Skin Test (ASST) and BHRA. A multivariate logistic regression model was performed to identify factors associated with a positive BHRA.</p><p><strong>Results: </strong>Of the 388 CSU patients, 60.3% had new onset symptoms, 34.0% had angioedema, and 12.6% had comorbid dermographism. Laboratory results indicated that 11.4%, 5.9%, and 1.8% of patients had elevated CRP levels, low total serum IgE levels, and basopenia, respectively. Additionally, elevated IgG anti-TPO levels, positive ANA, and positive ASST were found in 10.6%, 11.4%, and 57.2% of patients, respectively. There were 9.5% who tested positive for BHRA. Multivariate logistic regression identified UAS7 score (OR=1.047, p=0.017), low basophil levels (OR=6.749, p=0.027), and low total serum IgE (OR=3.391, p=0.039) as significant predictors of BHRA positivity.</p><p><strong>Conclusion: </strong>Our results identified key clinical and laboratory characteristics associated with type IIb autoimmune CSU in Vietnamese patients. Higher UAS7 scores, basopenia, and low IgE levels were significant predictors of BHRA positivity.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-18"},"PeriodicalIF":1.8,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058368","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":"Title: Efficacy and safety of oral immunotherapy for Peanut Allergy A Grade assessed systematic review and meta analysis of randomised controlled trials.","authors":"Naveed Ahmed Khan, Furqan Ahmad Sethi, Muhammad Shaheer, Mustafa Zuhair Arshad, Muhammad Khalid Afridi, Umama Alam, Humam Shah, Zaryab Bacha, Muhammad Abdullah Ali, Abdul Rafay, Afiyat Ahmad, Aaima Zain, Ali Hasan, Raheel Ahmed","doi":"10.1159/000548282","DOIUrl":"https://doi.org/10.1159/000548282","url":null,"abstract":"<p><strong>Introduction: </strong>Peanut allergy is a common and potentially life-threatening condition affecting up to 2% of children in Western countries. Management traditionally relied on avoidance, but in 2020, the FDA approved peanut oral immunotherapy (pOIT) to induce desensitization. This meta-analysis evaluates the efficacy and safety of pOIT versus placebo by incorporating newly published trials to inform clinical decision-making.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed PRISMA guidelines and Cochrane methodology, with registration number . Randomized controlled trials comparing peanut oral immunotherapy (pOIT) to placebo in IgE-mediated peanut allergy were included. Primary outcomes were gastrointestinal disorders and wheezing. Data were pooled using a random-effects model in RevMan 5.4.1, and evidence certainty was assessed using the GRADE approach.</p><p><strong>Results: </strong>This meta-analysis included 15 RCTs with 1530 patients (1014 pOIT, 516 placebo). pOIT significantly increased gastrointestinal disorders (RR = 1.90; 95% CI: 1.25-2.89; p = 0.003) and epinephrine use (RR = 2.29; 95% CI: 1.43-3.67; p = 0.0006). No significant differences were observed in wheezing, eczema, respiratory disorders, respiratory symptoms, or vomiting. Heterogeneity ranged from low to high across outcomes. Certainty of evidence was rated high for gastrointestinal disorders, epinephrine use, and respiratory symptoms; moderate for wheezing, eczema, and vomiting. Heterogeneity was primarily driven by specific outlier studies, as identified through sensitivity analyses.</p><p><strong>Conclusion: </strong>Peanut oral immunotherapy (pOIT) increases desensitization in patients with peanut allergy but is associated with a significantly higher risk of gastrointestinal side effects and epinephrine use, reflecting an increased rate of systemic allergic reactions. While outcomes such as wheezing, eczema, and respiratory symptoms showed no significant differences, variability in study design and adverse event reporting limits broad generalizability. These findings emphasize the need for careful patient selection, pre-treatment counseling, and close monitoring. Future research should focus on protocol standardization, long-term outcomes, and strategies to minimize adverse effects while maintaining efficacy.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-27"},"PeriodicalIF":1.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145052880","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":"Comparative Effectiveness and Safety of Second-Generation Antihistamines Treatments for Chronic Urticaria: A Network Meta Analysis.","authors":"Han-Ying Tian, Chao Xu, Cheng-Jiang Liu, Yu-Zhen Li","doi":"10.1159/000548019","DOIUrl":"https://doi.org/10.1159/000548019","url":null,"abstract":"<p><p>Background The latest international joint guideline supports the use of second-generation H1 antihistamines(sgAHs) as the first-line treatment for chronic spontaneous urticaria. Objective To compare the efficacy and safety of various sgAHs on Chronic Spontaneous Urticaria (CSU) through direct or indirect evidence. Methods PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched for randomized controlled trials of various types of sgAHs in the treatment of CSU up to March 2025.For efficacy, the primary outcome was the change from baseline in the total symptom score, while the secondary outcomes were pruritus score and wheal score.For safety, the total numbers of all withdrawals due to adverse events and common adverse effects were extracted for each treatment, which included central nervous system side effects and anticholinergic side effects. Results We identified and included 24 randomized clinical trials (RCTs) involving 5172 patients. Ebastine ranked first in the total symptom score(standardized mean difference(SMD) -2.80[95% confidence interval(CI):-5.12 to -0.47]) and pruritus score (SMD -1.10[95%CI: -2.06 to -0.13]), while olopatadine ranked first in the wheal score (SMD -0.84 [95%CI :-1.37 to -0.32]).Bepotastine besilate had a significantly lower incidence of somnolence in adverse events (odds ratio(OR) 0.15[95%CI: 0.03 to 0.69]) than other sgAHs. Conclusions Both ebastine and olopatadine showed promising efficacy and no significant differences were found in acceptability and safety compared with placebo. There are no meaningful differences in safety risks between different second-generation antihistamines. Keywords: second-generation antihistamines; Chronic urticaria; Total symptom score; Adverse events; Network meta-analysis.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-27"},"PeriodicalIF":1.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145052857","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}