International Archives of Allergy and Immunology最新文献

{"title":"From Sensitisation to Tolerance: A Retrospective Study of Tree Nut and Peanut Allergy in Pediatric Patients.","authors":"Damla Baysal Bakır, Özge Atay, Halime Yağmur, Gizem Kabadayı, Özge Kangallı Boyacıoğlu, Gizem Atakul, Suna Asilsoy, Nevin Uzuner","doi":"10.1159/000548420","DOIUrl":"https://doi.org/10.1159/000548420","url":null,"abstract":"<p><strong>Background: </strong>Tree nut/Peanut (TN/PN) allergies are among the most common pediatric food allergies, often persisting into later life and posing significant clinical risks. The likelihood of tolerance acquisition varies, and predictive factors remain inadequately defined in clinical practice.</p><p><strong>Objective: </strong>To evaluate the clinical and laboratory features associated with anaphylaxis risk and tolerance development in pediatric patients with TN/PN allergy, and to determine the role of aeroallergen sensitization, comorbid atopic diseases, and skin test reactivity.</p><p><strong>Methods: </strong>In this retrospective, cross-sectional study, 121 children (0-18 years) diagnosed with TN/PN allergy at a tertiary allergy centre between 2016 and 2024 were analyzed. Data included allergic reaction history, comorbidities, total IgE, eosinophil counts, and prick-to-prick (PTP) test wheal sizes. Tolerance acquisition was defined based on oral food challenge, absence of reactions upon re-exposure, and clinical follow-up.</p><p><strong>Results: </strong>Multiple nut allergy was present in 81% of patients, with hazelnut (67%) and pistachio (62%) being most common. IgE-mediated reactions were predominant (91%), including urticaria (79%) and anaphylaxis (36%). During follow-up, 25% of patients developed tolerance, while 13% continued to experience anaphylaxis. Aeroallergen sensitisation, particularly to pollens, was significantly associated with reduced tolerance in almond and walnut allergy (p < 0.05). Persistent multi-nut allergy correlated with higher anaphylaxis risk (p < 0.01). Strong co-sensitisation was observed between pistachio-cashew (r = 0.686) and almond-walnut (r = 0.579). Notably, smaller PTP wheal sizes predicted tolerance acquisition (p < 0.05).</p><p><strong>Conclusion: </strong>Pediatric TN/PN allergy is frequently severe and persistent. Multiple nut allergy, aeroallergen sensitization, and larger PTP wheal sizes are significant risk factors for prolonged allergy and anaphylaxis. Early identification of these markers may improve risk stratification and guide individualized follow-up strategies.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-15"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033243","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 presentation, triggers, co-morbidities and management of anaphylaxis in the elderly: A cross-sectional study.","authors":"Roy Khalaf, Rawan Saleem, Connor Prosty, Christine McCusker, Adam Bretholz, Mohammed Kaouache, Ann E Clarke, Judy Morris, Rodrick Lim, Edmond S Chan, Ran D Goldman, Andrew O' Keefe, Jennifer Gerdts, Derek K Chu, Julia E M Upton, Elana Hochstadter, Jocelyn Moisan, Xun Zhang, Jennifer L P Protudjer, Elissa Abrams, Elinor Simons, Juan Ruiz, Moshe Ben-Shoshan","doi":"10.1159/000548393","DOIUrl":"https://doi.org/10.1159/000548393","url":null,"abstract":"<p><strong>Background: </strong>Anaphylaxis is a life-threatening, systemic allergic reaction. This study aims to compare anaphylactic triggers, clinical presentation and management between elderly (≥65 years old) and non-elderly adults.</p><p><strong>Methods: </strong>Data from the Cross-Canada Anaphylaxis Registry (C-CARE) from April 2011 to May 2024 was collected, spanning five emergency departments (EDs) and one emergency medical service (EMS) across three Canadian provinces. Demographics, trigger, symptom severity, co-morbidities and medication use were assessed. Chi Square tests were used to compare categorical variables between elderly and non-elderly adults, whereas non-parametric t-tests were used for numerical variables.</p><p><strong>Results: </strong>Among 1135 anaphylaxis cases, 90 (7.9%) involved elderly patients. Drug and venom anaphylaxis triggers were more prevalent (P<0.01) in elderly adults compared to non-elderly adults, while food allergies were less common. Elderly patients were more likely to experience anaphylaxis at home (P<0.01) and had a higher intensive care unit admission rate (P=0.04). Use of epinephrine was less frequent in elderly patients (30.0%).</p><p><strong>Conclusion: </strong>Compared to younger adults, elderly patients exhibit distinct anaphylactic triggers, and have increased ICU admission and lower epinephrine use. Our findings highlight the need for improved recognition, treatment adherence and tailored management strategies in this vulnerable population.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-15"},"PeriodicalIF":1.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029749","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":"Safety and Efficacy of Remibrutinib for Chronic Spontaneous Urticaria, a Systematic Review and Meta-analysis.","authors":"Muhammad Burhan, Saad Ashraf, Ahila Ali, Iqra Shahid, Jalib Ahmed, Muhammad Shahmeer Ullah Shah, Neha Bhagwan Das, Abdulqadir J Nashwan","doi":"10.1159/000548302","DOIUrl":"https://doi.org/10.1159/000548302","url":null,"abstract":"<p><strong>Background: </strong>Chronic spontaneous urticaria (CSU) is a burdensome condition marked by recurrent wheals and/or angioedema lasting over six weeks. Despite current treatments, many patients remain symptomatic. Remibrutinib, a selective Bruton's tyrosine kinase (BTK) inhibitor, is a promising therapy targeting mast cell degranulation.</p><p><strong>Objective: </strong>To assess the efficacy and safety of remibrutinib versus placebo in CSU management.</p><p><strong>Methods: </strong>A systematic review and meta-analysis following PRISMA guidelines was conducted. PubMed, Cochrane CENTRAL, and Google Scholar were searched for randomized controlled trials (RCTs) comparing remibrutinib to placebo. The primary outcome was change in Urticaria Activity Score over 7 days (UAS7). Safety outcomes included adverse events (AEs) and serious adverse events (SAEs). Analyses were performed using Review Manager (RevMan 5.4).</p><p><strong>Results: </strong>Three RCTs were included. remibrutinib significantly reduced UAS7 scores compared to placebo (MD = -7.78, 95% CI: -10.24 to -5.32, p < 0.01) and improved disease control (RR = 2.16, 95% CI: 1.73-2.71, p < 0.00001) and absence of hives/itch (RR = 3.41, 95% CI: 2.32-5.03, p < 0.00001). No significant differences were found in overall AEs (RR = 1.05, p = 0.59) or SAEs (RR = 1.85, p = 0.37). However, infection risk was higher with remibrutinib, particularly for total infections (RR = 1.59, p < 0.00001) and upper respiratory infections (RR = 2.89, p = 0.009).</p><p><strong>Conclusion: </strong>Remibrutinib significantly improves CSU symptoms and disease control. While generally safe, it may increase infection risk, notably upper respiratory tract infections. Further long-term studies are needed to confirm these findings.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-18"},"PeriodicalIF":1.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006107","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":"Insights into Silica-Induced Lung Fibrosis: Fibrotic Gene Signatures, Pathways, and Therapeutic Opportunities.","authors":"Fahad Alsohime, Narjes Saheb Sharif-Askari, Nasser Saleh Alharbi, Mohammed Faraj Ayad Alosaimi, Rabih Halwani","doi":"10.1159/000548097","DOIUrl":"https://doi.org/10.1159/000548097","url":null,"abstract":"<p><p>Silica exposure is a significant environmental hazard linked to lung inflammation and fibrosis. This study utilized in-silico analysis of publicly available transcriptomic datasets (GSE250537 and GSE142446) from silica-exposed Fischer 344 rats to investigate molecular pathways and potential therapeutic targets. Rats were exposed to crystalline silica via inhalation, and transcriptomic data from lung and blood samples were analyzed at four post-exposure intervals (1-day, 3-month, 6-month, and 9-month). Gene set enrichment analysis (GSEA) revealed the activation of fibro-inflammatory and aging pathways in lung tissue, including TGF-beta, NLRP3, and TNF-α signaling, with limited effects in blood transcriptomes. Differential expression analysis identified 12 key fibrotic markers consistently upregulated in lung tissue, such as Cxcl6, Mmp12, and S100a9, which are involved in inflammation, tissue remodeling, and fibrosis. Temporal analysis indicated prolonged upregulation of fibrotic markers up to 9 months post-exposure. Protein-protein interaction networks highlighted clusters related to chemokine signaling, tissue remodeling, and matrix metalloproteinases. Using the open-TG gate database, 179 pharmacological agents were identified as potential treatments, with 37 targeting five or more fibrotic genes. Notable candidates include NSAIDs, captopril, and simvastatin, offering promising therapeutic avenues to mitigate silica-induced lung pathology. In vivo validation in a silica-induced murine fibrosis model further demonstrated that simvastatin treatment significantly reduced the expression of key fibro-inflammatory genes and attenuated the increase in fibrotic markers in lung tissue. These findings provide insights into silica immunopathology and potential drug repurposing strategies; however, further studies are warranted to elucidate underlying mechanisms and evaluate therapeutic efficacy in clinical settings.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-20"},"PeriodicalIF":1.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000475","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":"Interpretation of the Diagnostic Accuracy of the Nasal Allergy Test.","authors":"Fejzo Džafić, Ademir Ahmetović, Nur Čoloman, Ismail Džafić, Maida Šljivić Husejnović","doi":"10.1159/000548221","DOIUrl":"https://doi.org/10.1159/000548221","url":null,"abstract":"<p><strong>Introduction: </strong>Allergic rhinitis (AR) is a prevalent health concern. In Europe, 20-40% of the population is affected. Diagnostic methods include skin tests, measurement of serum immunoglobulin E (IgE), nasal smear for eosinophils, and inhalation provocation tests. The introduction of the nasal allergy test has simplified allergen testing for the direct determination of specific IgE on the nasal mucosa.</p><p><strong>Methods: </strong>A prospective study conducted from 2010 to 2012 included 102 participants diagnosed with AR and 60 control participants without persistent AR, based on medical history and physical examination. Participants from both groups underwent a nasal test using prepared inhalant allergy panels. Specific IgE was tested using the ELISA processor Hytec 288. The aim of the study was to interpret diagnostic accuracy measures for each allergen panel.</p><p><strong>Results: </strong>The nasal allergy test demonstrated sensitivity above 75 %, and specificity approaching 90 %. The positive predictive value (PPV) was 91.25 %, while the negative predictive value (NPV) was 71 %. The positive likelihood ratio ranged from 3.75 to 34.59, indicating that a positive result was 10.23 times more likely in patients than in controls. A negative likelihood ratio was 0.25, suggesting that participants in the control group were four times more likely to yield a negative result than allergic individuals.</p><p><strong>Conclusion: </strong>The nasal allergy test is recommended due to its simplicity, minimal risk profile compared to conventional tests, and high diagnostic reliability.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-15"},"PeriodicalIF":1.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000413","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 Safety of Baked Egg, Egg Yolk, and Egg White in Young Children with Egg Allergy.","authors":"Yuki Ohara, Yurika Matsumoto, Mayumi Fujita, Chisato Inuo","doi":"10.1159/000548298","DOIUrl":"10.1159/000548298","url":null,"abstract":"<p><strong>Introduction: </strong>Baked egg (BE) is generally well tolerated by children with egg allergy, and heated egg yolk (EY) is considered less allergenic than egg white (EW). Although these findings suggest that both BE and EY may be safer options for reintroduction, no studies have directly compared their safety with each other or with heated EW. This study aimed to compare the safety of oral food challenge (OFC) for reintroducing BE, EY, and EW in children with egg allergy.</p><p><strong>Methods: </strong>We retrospectively analyzed data from patients who underwent OFCs with BE, EY, or EW at the Department of Allergy, Kanagawa Children's Medical Center, between 2014 and 2024. Only patients with a history of acute IgE-mediated allergic reactions (within 2 h of egg ingestion), an EW-specific IgE level ≥0.35 UA/mL, and strict avoidance of egg protein at the time of OFC were eligible for inclusion.</p><p><strong>Results: </strong>Ninety-seven children under 3 years of age were enrolled (BE group, n = 47; EY group, n = 23; EW group, n = 27). The OFC positive rate was significantly lower in the BE group (0%) compared to the EY (17.4%) and EW (22.2%) groups (p = 0.0011). Although mild skin or gastrointestinal reactions were observed in the EY group, 2 patients in the EW group experienced respiratory reactions. No patient required adrenaline administration.</p><p><strong>Conclusion: </strong>OFC with a small amount of BE demonstrated a low positivity rate and could be safely performed even in children with a history of egg-induced reactions.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992431","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":"Immune-Related Comorbidities in Pediatric Familial Mediterranean Fever: A Hidden Burden Beyond Autoinflammation.","authors":"Fatih Eren, Sefika Ilknur Kokcu Karadag, Alisan Yıldıran","doi":"10.1159/000548068","DOIUrl":"https://doi.org/10.1159/000548068","url":null,"abstract":"<p><p>: Introduction: To assess the frequency and clinical-immunologic characteristics of immune-related comorbidities in children with genetically confirmed Familial Mediterranean Fever.</p><p><strong>Methods: </strong>This cohort study included 132 pediatric patients with followed at a tertiary care center. Patients were stratified into two groups based on the presence or absence of immune-related comorbidities. Clinical manifestations, laboratory parameters, MEFV mutation profiles, and treatment modalities were comparatively analyzed. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>Immune-related comorbidities were identified in 37.8% of patients, including 12 with defined inborn errors of immunities. These patients more frequently presented with atypical symptoms such as diarrhea, rash, aphthous stomatitis, and appetite loss, while classical symptoms like fever and abdominal pain were less common. Tonsillitis was significantly more frequent in the non-comorbidity group (p = 0.046). Strong ANA positivity and immunoglobulin deficiencies were significantly associated with the comorbidity group. Although MEFV mutation patterns did not differ between groups, intravenous immunoglobulin therapy was administered exclusively in patients with immune-related comorbidities (p < 0.001).</p><p><strong>Conclusion: </strong>A notable subset of pediatric Familial Mediterranean Fever patients demonstrates immune dysregulation extending beyond innate autoinflammation. These findings underscore the importance of immunologic assessment in patients with atypical features or inadequate response to colchicine. Early identification and appropriate immunomodulatory interventions may improve clinical outcomes in this distinct subgroup.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-11"},"PeriodicalIF":1.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952864","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":"Identification of ATG4B and NLRP1 as M1 Macrophage-Activating-Related Plasma Proteins in Systemic Lupus Erythematosus via Multi-Omics Approaches.","authors":"Manrong He, Lei Chen, Yongdi Zuo, Jingxue Du, Wanxin Tang","doi":"10.1159/000548167","DOIUrl":"10.1159/000548167","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to identify systemic lupus erythematosus (SLE)-associated plasma proteins, particularly those linked to M1 macrophage activation, using an integrative multi-omics approach.</p><p><strong>Methods: </strong>We performed two-sample Mendelian randomization (MR) analysis using protein quantitative trait loci data and SLE genome-wide association study (GWAS) data to assess associations between genetically predicted plasma protein levels and SLE risk. Validation was conducted using FinnGen SLE data, supplemented by single-cell RNA sequencing (scRNA-seq), Bayesian colocalization, in vitro M1 macrophage experiments of primary human peripheral blood monocytes and THP-1 cells, SLE patients' plasma sample validation, and molecular dynamics simulations.</p><p><strong>Results: </strong>By integrating MR analysis, scRNA-seq analysis, Bayesian colocalization analysis, and in vitro M1 macrophage activation experiments, this study identified ATG4B, NLRP1, and PDCD4 as important causal plasma proteins associated with M1 macrophage activation. The plasma samples of patients with SLE validated the protein expression of ATG4B and NLRP1. Phenome-wide association studies (PheWASs) found no significant links between these proteins and other complex traits. Drug target analysis, molecular docking, and molecular dynamics simulations supported the strong binding affinities and stability for the target proteins ATG4B and NLRP1 with their candidate drugs.</p><p><strong>Conclusion: </strong>Our multi-omics and molecular dynamics simulation identified ATG4B and NLRP1 as potential SLE biomarkers and therapeutic targets, with implications for M1 macrophage-driven pathogenesis.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-25"},"PeriodicalIF":1.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952814","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":"Mouse Models for Studying the Mechanisms and Therapeutic Effects of Allergic Airway Inflammation.","authors":"Buyi Zhang, Jingyun Li, Luo Zhang, Yuan Zhang","doi":"10.1159/000548101","DOIUrl":"10.1159/000548101","url":null,"abstract":"<p><strong>Background: </strong>Allergic airway inflammation, including allergic rhinitis and asthma, is a disease characterized by immunoglobulin E-mediated type I hypersensitivity reactions, with its pathophysiological features characterized by infiltration and proliferation of inflammatory cells in the airway mucosal epithelial cells. The complexity and heterogeneity of this inflammatory response, as well as the limitations of sampling from patients with allergic airway inflammation, have made animal models play a crucial role in studying the pathophysiological molecular pathways and treatment methods of allergic airway inflammation.</p><p><strong>Summary: </strong>Among the many animal models studied for allergic airway inflammation, mouse models are widely used for their diversity of genetic backgrounds, ease of experimental manipulation, and relevance to human diseases. When constructing and evaluating mouse models, many factors must be considered, including the selection of allergens, the selection of mouse species that are sensitive to allergens and have significant immune responses, the selection and feasibility of reagents and gene targets related to allergic airway inflammation, and the correlation with human natural diseases, i.e., whether the mouse model can be used to answer clinical questions about allergic airway inflammation, etc. Key Message: This review aimed to summarize the latest advances in mouse models used for allergic airway inflammation research, so as to provide further insights into the pathophysiology and treatment of allergic airway inflammation.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-10"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952926","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 Presentation and Causes of Prosthesis-Related Hypersensitivity Reactions: An Analysis of 225 Patients.","authors":"Claudia Lang, Katja Bärenfaller, Marie-Charlotte Brüggen, Tamara El Saadany, Barbara Illi, Pascal Raffael Furrer, Sandro F Fucentese, Pascal Schenk, Nick Li, Damir Zhakparov","doi":"10.1159/000547103","DOIUrl":"https://doi.org/10.1159/000547103","url":null,"abstract":"<p><strong>Introduction: </strong>Between 10% and 20% of all prosthesis patients experience implant-related complications within 1-2 years following surgery. Hypersensitivity to components within the prosthesis is a possible cause of these complications.</p><p><strong>Methods: </strong>This study aimed to investigate the characteristics of prosthesis-related hypersensitivity (PRH) and identify possible associated risk factors. A retrospective, monocentric study was conducted at the University Hospital Zurich.</p><p><strong>Results: </strong>A total of 225 patients who underwent patch testing for suspected PRH between 2011 and 2021 were included. The mean age was 72 years; 34% were male and 65% were female. Knee pain was the most commonly reported symptom (85%), followed by eczematous skin lesions and joint instability (each around 20%), as well as redness or swelling (13-16%). In 67% of the patients undergoing patch testing, an allergy was diagnosed. Nickel was the most frequently identified allergen (31.5%), followed by vanadium chloride (13.7%) and gentamycin, an antibiotic, often added to bone cement. 60% of the PRH patients had a previously known contact allergy - 25.7% to metals and 34.6% to other substances. Among the metals, nickel was the most prevalent (19.5%), followed by silver (3.1%). This prevalence was significantly higher than in patients without a metal allergy diagnosis. No significant differences were observed between the groups regarding overall or individual atopic comorbidities (present in approximately 40% of patients).</p><p><strong>Conclusion: </strong>A history of contact allergy may be an indicator of PRH. In contrast, clinical presentation and the consideration of atopic or non-atopic comorbidities in prosthesis patients with suspected PRH do not appear to provide helpful diagnostic clues. Based on our findings, PRH may represent an underestimated cause of postoperative complaints.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952909","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}