International Archives of Allergy and Immunology最新文献

{"title":"Impact of Processing Delays and Cryopreservation on Sensitivity and Specificity of the Lymphocyte Transformation Test.","authors":"Caspar A Heubach, Gerda Wurpts, Andreas Glässner, Lea Grewe, Diana Dubrall, Philipp Deck, Günther Weindl, Per Hoffmann, Markus Nöthen, Amir Yazdi, Bernhardt Sachs","doi":"10.1159/000551013","DOIUrl":"10.1159/000551013","url":null,"abstract":"<p><strong>Introduction: </strong>In the lymphocyte transformation test (LTT), peripheral blood mononuclear cells (PBMCs) from patients with presumed drug allergy are cultured with the implicated drug. No study has systematically investigated how delayed processing or cryopreservation of PBMCs affects the sensitivity and specificity of the LTT to detect a drug sensitization. We evaluated the impact of delayed processing or cryopreservation of PBMCs on the sensitivity and specificity of the LTT focusing on interferon-y (IFN-γ) secretion as read-out. Additionally, we investigated the impact of the respective processing methods on non-stimulated reference and TT-stimulated PBMCs.</p><p><strong>Methods: </strong>Blood from 30 patients and 30 gender-matched controls was split for paired processing: one aliquot was processed immediately as internal reference of the patient/control, the other subjected to either a 24-h delay (n = 15) or immediate processing followed by cryopreservation of the PBMCs (n = 15). Thereby, each patient and control in the respective cohort served as its own reference for the assessment of the methodical processing impact. IFN-γ concentrations in PBMC culture supernatants were measured by ELISA.</p><p><strong>Results: </strong>Cryopreservation of PBMCs resulted in a statistically non-significant trend toward higher sensitivity (45% vs. 32%) and specificity (81% vs. 79%), for detecting drug sensitization compared to delayed processing. Overall, 80% of the LTT results using cryopreserved PBMCs were consistent with those obtained from the immediately processed reference group.</p><p><strong>Conclusion: </strong>Due to the lack of statistical significance, no clear recommendation for one of the two processing methods can be made.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-11"},"PeriodicalIF":1.8,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147485753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tissue Eosinophil Count as a Novel Immune-Endotypic Prognostic Biomarker for Long-Term Outcomes of Posterior Nasal Neurectomy in Refractory Allergic Rhinitis.","authors":"Dan Su, Yonghong Ning, Song Zhang, Shun Wang, Yu Kong","doi":"10.1159/000551497","DOIUrl":"https://doi.org/10.1159/000551497","url":null,"abstract":"<p><strong>Introduction: </strong>Refractory allergic rhinitis (RAR) encompasses distinct immune-inflammatory endotypes, notably neurogenic and eosinophilic phenotypes, which may differentially respond to surgical intervention such as posterior nasal neurectomy (PNN). Identifying prognostic biomarkers to guide patient selection remains an unmet clinical need.</p><p><strong>Methods: </strong>In this retrospective cohort study, 92 patients with moderate-to-severe RAR undergoing endoscopic PNN were stratified by 1-year outcome (effective: ≥50% improvement in Total Nasal Symptom Score [TNSS]). Preoperative serum levels of neuropeptides (Substance P, SP; Vasoactive Intestinal Peptide, VIP) were measured. Postoperative histopathological tissue eosinophil (TEos) counts (cells/HPF) from resected nasal mucosa were analyzed. Patients were categorized into Low-TEos (<10/HPF) and High-TEos (≥10/HPF) groups.</p><p><strong>Results: </strong>The overall effective rate was 88.0%. The effective group exhibited significantly higher preoperative SP (56.4±12.1 vs. 38.2±9.5 pg/mL, P<0.001) and lower TEos counts (6.5±3.2 vs. 18.4±6.7 cells/HPF, P<0.001). Low TEos count strongly correlated with greater TNSS improvement (r=-0.62, P<0.001). Multivariate analysis identified High-TEos as an independent risk factor for poor outcome (OR=4.25, 95% CI: 1.56-11.58, P=0.005). ROC analysis confirmed TEos as a robust prognostic predictor (AUC=0.845, cutoff 11.5 cells/HPF).</p><p><strong>Conclusion: </strong>High tissue eosinophilia defines an immune-endotypic subset of RAR with attenuated response to PNN, whereas a neurogenic-dominant profile (high SP, low TEos) predicts excellent surgical prognosis. TEos count serves as a clinically actionable histopathological prognostic biomarker, facilitating personalized surgical management through immune-endotype stratification.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-16"},"PeriodicalIF":1.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473474","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":"Age-Related Phenotypic Divergence in NSAID Hypersensitivity: Clinical and Comorbidity Correlates.","authors":"Emrah Harman, Fatih Çölkesen, Mehmet Emin Gerek, Ferhat Sagun, Secim Kolak, Sükran Aslan Savaş, İsmail Yiğitdöl, Ümmügülsüm Yılmaz Ergün, Şevket Arslan","doi":"10.1159/000551405","DOIUrl":"10.1159/000551405","url":null,"abstract":"<p><strong>Introduction: </strong>Nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity is a heterogeneous condition with diverse clinical phenotypes. Although age-related changes in immune and inflammatory pathways have been proposed, systematic evaluations of age-associated phenotypic differences remain limited.</p><p><strong>Methods: </strong>Between 2019 and 2025, 1,363 patients evaluated for suspected drug hypersensitivity were screened, and 484 adults with clinically defined NSAID hypersensitivity were retrospectively analyzed. Patients were categorized as early-onset (<40 years) or late-onset (≥40 years). Reaction phenotypes were classified retrospectively according to EAACI/ENDA criteria. Demographic characteristics, comorbidities, reaction phenotypes, and laboratory parameters, including total IgE levels and eosinophil counts, were compared. Subgroup analyses assessed the association between chronic low-dose aspirin use and clinical features. Multivariate logistic regression was performed to identify independent predictors of late-onset hypersensitivity.</p><p><strong>Results: </strong>The median age of the cohort was 41 years, and 65.7% were female. Cutaneous reactions were most common (66.5%), followed by cutaneous-respiratory (19.0%) and systemic reactions (8.7%). Late-onset patients (n = 258) exhibited significantly higher prevalences of asthma (19.8% vs. 8.0%; p < 0.01) and cardiovascular disease (10.5% vs. 1.3%; p < 0.001). Chronic low-dose aspirin use was more frequent in late-onset cases (14.3% vs. 1.3%; p < 0.001) and was associated with increased respiratory involvement. In multivariate analysis, asthma (OR 2.48, 95% CI 1.30-4.73; p = 0.006) and low-dose aspirin use (OR 7.52, 95% CI 1.71-32.50; p = 0.008) independently predicted late-onset NSAID hypersensitivity.</p><p><strong>Conclusion: </strong>NSAID hypersensitivity exhibits distinct age-related clinical phenotypes, with a higher burden of respiratory involvement and comorbid disease in late-onset cases. Chronic low-dose aspirin use is strongly associated with this phenotype. Recognition of age-associated patterns may support improved clinical risk stratification and individualized management strategies.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-19"},"PeriodicalIF":1.8,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443550","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":"Lanadelumab's Enduring Effectiveness and Safety in the Management of Hereditary Angioedema for Patients from Puerto Rico: Data from EMPOWER.","authors":"Rafael H Zaragoza-Urdaz, Paula J Busse, Daniel Fox, Daniel N Castaner, Natalie Khutoryansky, Salomé Juethner, Tyrone McBayne","doi":"10.1159/000550883","DOIUrl":"10.1159/000550883","url":null,"abstract":"<p><strong>Introduction: </strong>Real-world data are needed to improve our understanding of hereditary angioedema (HAE) management in different geographic regions. Here, we report outcomes of patients from Puerto Rico who received lanadelumab for HAE prophylaxis in the noninterventional EMPOWER Study (NCT03845400).</p><p><strong>Methods: </strong>Eligible patients with HAE due to C1-inhibitor deficiency who initiated lanadelumab treatment were classified as newly treated or established on lanadelumab based on number of lanadelumab doses received before enrollment (<4 or ≥4, respectively). Lanadelumab exposure data were captured using electronic case report forms. Effectiveness was assessed by change in HAE attack rate before vs. after lanadelumab initiation. Safety was assessed through treatment-emergent adverse events (TEAEs).</p><p><strong>Results: </strong>The Puerto Rican site enrolled 9 patients (1 newly treated who was lanadelumab-naïve, 8 established on lanadelumab). All patients were of Hispanic/Latino ethnicity (median [range] age: 55.0 [36-73] years; female: 77.8%). Eight out of 9 patients received lanadelumab 300 mg every 2 weeks; 1 patient established on lanadelumab received dosing every 4 weeks. Average lanadelumab exposure ranged from approximately 2.3 years to >2.5 years for patients newly treated and established on lanadelumab, respectively. In the newly treated patient, the physician-reported HAE attack rate decreased by 76% (1.99 vs. 0.47 attacks/month pre- vs. post-lanadelumab initiation); most physician-reported attacks were mild (16.7%) or moderate (58.3%). In patients established on lanadelumab, the mean (95% confidence interval) physician-reported HAE attack rate was 0.26 (0.09-0.42) attacks/month; most physician-reported attacks were mild (25.7%) or moderate (56.8%). Real-world data on attack incidence reinforced the variability in presentation among patients; 2 were attack-free while on lanadelumab treatment. A total of 5 TEAEs were reported in 4 patients, none of which were serious or fatal. One patient experienced mild fatigue that was considered lanadelumab related.</p><p><strong>Conclusion: </strong>Findings from this analysis support the clinical benefits and safety of lanadelumab treatment for HAE prophylaxis in patients from Puerto Rico.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-11"},"PeriodicalIF":1.8,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allergen Sensitization in Atopic Dermatitis: Distinction from Controls and Prediction of Respiratory Allergies.","authors":"Duy-Bo Nguyen, Anh-Tuan Dinh-Xuan, Thanh Huyen Thuc, Le Nam Nguyen, Ha Phuong Vo, Thi Mai Vu, Thi Hai Yen Pham, Quynh Anh Nguyen, Thi Minh Nguyet Nguyen, Thi Minh Huong LE, Nhat Tan Tran, Van Hien Dam, Quynh Trang Tran, Thanh Nguyen Phan, Chi Hieu Chu, Timothy Craig, Sheryl Van Nunen, Van Dinh Nguyen","doi":"10.1159/000551372","DOIUrl":"https://doi.org/10.1159/000551372","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD) is a common inflammatory skin condition characterized by epidermal barrier dysfunction and immune dysregulation, affecting both children and adults.</p><p><strong>Objectives: </strong>This study aimed to determine the prevalence of common allergen sensitizations in patients with AD, compared with controls without allergic diseases, and to identify those associated with an increased risk of asthma or allergic rhinitis.</p><p><strong>Methods: </strong>We conducted a cross-sectional study including patients with atopic dermatitis and age- and sex-matched controls selected by propensity score matching from the Center of Allergy and Clinical Immunology, Vinmec Times City Hospital. Total IgE levels and specific IgE sensitization to common allergens were documented using an extract-based multiplex assay.</p><p><strong>Results: </strong>Both the AD and control groups each comprised 452 patients and were comparable in age, median (IQR, range): 7 (1-29, 0-84) and sex distribution (51.11% female). Sensitization to at least one allergen was observed in 59.51% of patients, with a mono-sensitization rate of 11.73% and a poly-sensitization rate of 47.79%. House dust mites had the highest sensitization rates among AD patients in our study, with sensitization rates for Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis at 29.65%, 26.99%, and 11.5%, respectively. Eggs and milk were the most common food allergens, with sensitizations rates of 20.58% and 12.61%, respectively. Although sensitization rates were high, the prevalence of true clinical allergy was much lower, underscoring the need for cautious interpretation of test results in conjunction with clinical symptoms. Age-related differences were evident: younger children were more often sensitized to food allergens, older children and adolescents to respiratory allergens, and elderly patients to cockroach, and Candida albicans. Additionally, sensitization to C. albicans, D. pteronyssinus, D. farinae, cat dander, dog dander, rice grain, barley flour, and rye flour was significantly more frequent in patients with AD compared to individuals with no allergic diseases. Such sensitization was also associated with a higher risk of respiratory allergic comorbidities, suggesting the potential role of these allergens as distinctive markers of atopy.</p><p><strong>Conclusion: </strong>This study highlights the importance of understanding allergen sensitization in patients with AD to optimize management strategies, particularly in Vietnam, where house dust mite sensitization is highly prevalent. Allergen avoidance and allergen-specific immunotherapy could be beneficial as add-on therapies for AD.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-23"},"PeriodicalIF":1.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389856","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":"Impact of Age and Gender on Serum Cytokine and Chemokine Levels: Analysis of 157 Healthy Subjects Across Consecutive Age Groups.","authors":"Tasuku Miwa, Yurika Shimizu, Tatsuo Ito, Naoko Inomata, Eisuke Inoue, Hirohiko Sueki","doi":"10.1159/000551338","DOIUrl":"https://doi.org/10.1159/000551338","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding the effects of age and sex on circulating cytokine and chemokine levels in healthy individuals is essential for establishing reliable reference ranges and tailoring assessments. Although previous studies have compared younger and older populations, few have systematically examined sequential age decades. This study aimed to characterize continuous age-related changes in serum cytokine and chemokine profiles across adulthood in 157 healthy individuals.</p><p><strong>Methods: </strong>Serum samples from 100 individuals aged 20s-60s (10 males and 10 females per decade) were obtained from the Japanese Red Cross Society. Additional samples from 57 individuals aged 60s-80s (17-20 per decade) were included. Concentrations of 26 cytokines and chemokines were measured using a multiplex bead-based immunoassay. Associations between analyte levels and age were assessed using the Jonckheere test and Spearman's rank correlation. Sex differences were evaluated using Student's t-test. A two-sided p value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Three distinct age-related patterns were identified. Type 1 demonstrated continuous trends from the 20s to the 80s: IL-2, IP-10, TARC, and granulysin increased significantly with age, whereas TGF-β, FGF-2, and fractalkine decreased significantly. Type 2a (IFN-γ, IL-17, and IL-15) showed significant declines from the 20s to the 60s but an overall increase from the 20s to the 80s. Type 2b included IL-12p70, TNF-α, IL-10, IL-5, and IL-7, which increased significantly from the 20s to the 80s, and IL-8, which decreased; however, no significant trends were observed between the 20s and 60s. Type 2c (IL-6 and IL-1Ra) increased significantly from the 20s to the 60s but showed no significant trend across the 20s-80s. Between the 20s and 60s, IL-15, IL-1Ra, TGF-β, and IP-10 were significantly higher in females, whereas IL-8 and granulysin were higher in males. Across the 20s-80s, only IL-1Ra and TGF-β remained higher in females, and IL-8 remained higher in males.</p><p><strong>Conclusions: </strong>Certain cytokines exhibited consistent age- and gender-related trends, whereas others varied between the 20s-60s and the 20s-80s.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-21"},"PeriodicalIF":1.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389902","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":"RPS26 Expression as a Predictive Biomarker and Functional Modulator in Sublingual Immunotherapy for Japanese Cedar Pollinosis.","authors":"Hironori Nakayoshi, Hitoshi Hirakawa, Taro Ikegami, Shogo Takeda, Hideaki Kouzaki, Ichiro Tojima, Koji Matsumoto, Atsushi Yuta, Takeshi Shimizu, Emiko Noguchi, Mikio Suzuki","doi":"10.1159/000551442","DOIUrl":"https://doi.org/10.1159/000551442","url":null,"abstract":"<p><strong>Introduction: </strong>Japanese cedar pollinosis (JCP) is highly prevalent in Japan, and sublingual immunotherapy (SLIT) remains one of the few effective disease-modifying treatments. While many patients have significant benefits, biomarkers predicting SLIT responsiveness are lacking. Single-cell RNA sequencing (scRNA-seq) of peripheral blood mononuclear cells (PBMCs) identified the ribosomal protein gene RPS26 as a candidate associated with treatment response. This study aimed to determine whether RPS26 expression contributes to SLIT efficacy and to define its involvement in T-cell dynamics, cytokine production, and epigenetic regulatory pathways.</p><p><strong>Methods: </strong>PBMCs from 35 patients with JCP were analysed before SLIT, and paired samples from seven patients were evaluated after 1 year of SLIT. scRNA-seq was performed in four responders and three non-responders. Changes in T-cell subsets and interleukin (IL)-5 and IL-10 secretion were evaluated during SLIT. Functional relevance was examined through small interfering RNA-mediated RPS26 knockdown followed by allergen stimulation. The relationship between RPS26 and the ten-eleven translocation family (TET2 and TET3) expression was assessed by quantitative PCR.</p><p><strong>Results: </strong>scRNA-seq revealed significant RPS26 upregulation in responders. Although bulk RPS26 expression did not differ between responders and non-responders, all subjects with high RPS26 expression (≥100 relative units) were responders. SLIT increased follicular regulatory and type 1 regulatory T-cells in responders, whereas IL-10 elevation occurred exclusively in high-RPS26 responders. RPS26 knockdown enhanced early apoptosis and cell death, and reduced IL-10 expression following allergen challenge. RPS26 expression was strongly correlated with the epigenetic regulators TET2 and TET3, both essential for regulatory T-cell stability.</p><p><strong>Conclusion: </strong>RPS26 appears to function as both a biomarker and a contributor to immune tolerance during SLIT. Its association with IL-10 induction, regulatory T-cell expansion, apoptosis resistance, and TET2/TET3 expression suggests a translational-epigenetic axis supporting allergen desensitization. These findings highlight ribosomal specialization as a determinant of immunotherapy responsiveness. Larger studies are needed to validate RPS26 and further define its mechanistic role in allergen-specific immunotherapy.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-21"},"PeriodicalIF":1.8,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369194","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":"Update on the efficacy of vaccination on host immunity to influenza virus infection.","authors":"Esmaeil Mortaz, Samaneh Abdolmohammadi-Vahid, Neda K Dezfuli, Farzaneh Hojjati, Hamidreza Jamaati, Mohammad Varahram, Payam Tabarsi, Ian M Adcock","doi":"10.1159/000551286","DOIUrl":"https://doi.org/10.1159/000551286","url":null,"abstract":"<p><p>Influenza, commonly known as the flu, is a contagious respiratory illness caused by influenza viruses, primarily affecting the epithelial cells of the respiratory tract. There are several strains of the virus, with influenza A and B being the most significant in terms of public health impact. The immune system's response to influenza infection plays a crucial role in determining the severity of the illness and the effectiveness of vaccination strategies. The immune system's response to the influenza virus is both complex and vital for recovery and immunity. Vaccination plays a key role in mitigating the impact of influenza, although its effectiveness can vary based on multiple factors. Continuous monitoring of circulating strains and advancements in vaccine technology are essential in improving prevention strategies and protecting public health. Ongoing research into novel vaccine strategies is crucial for achieving better efficacy and addressing vaccine hesitancy, ultimately leading to reduced morbidity and mortality associated with influenza. Key words: Influenza, TLRs, CTL, PRR, NK.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-16"},"PeriodicalIF":1.8,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365203","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":"A Narrative Review of Drug-Induced Haemophagocytic Lymphohistiocytosis: A Rare but Relevant Differential Diagnosis.","authors":"Syed B Ali, Jovanka King, Michaela Lucas","doi":"10.1159/000550922","DOIUrl":"10.1159/000550922","url":null,"abstract":"<p><strong>Introduction: </strong>Haemophagocytic lymphohistiocytosis (HLH) is a potentially life-threatening, multisystemic, hyperinflammatory disease. There is a trend towards increased reports of drug-induced HLH (diHLH), an entity that has some features akin to severe cutaneous adverse reactions (SCARs). A narrative review was conducted to summarise the literature on reported cases of diHLH.</p><p><strong>Methods: </strong>All published cases of diHLH between January 1993 and August 2023 on PubMed database were reviewed, and those with ≥5 HLH-2004 criteria and/or Hscore ≥169 were included. All potential confounding secondary causes of HLH, as well as cases attributed to immune checkpoint inhibitors, chimeric antigen receptor T-cell immunotherapy, and vaccines, were excluded from the analysis.</p><p><strong>Results: </strong>There were 39 cases identified, with a median age of 28.0 years (IQR = 7-46) and a predominance of males (57.9%). Anticonvulsants (n = 15, 38.4%), particularly lamotrigine (n = 10, 66.7%), and antimicrobials (n = 15, 38.4%) were most frequently implicated. Among the antimicrobials, beta-lactam antibiotics were the most common (n = 12, 80%). Time to latency for presentation of diHLH was 14 days (IQR = 8-21); anticonvulsants had a significantly longer latency (17 days) than antimicrobials (12.5 days; p = 0.0180). The median HLH-1994/2004 diagnostic criteria and Hscore were 5 and 227, respectively. Ten patients (25.6%) also had SCAR features at initial presentation (DRESS syndrome: n = 7 and Stevens-Johnson syndrome and/or toxic epidermal necrolysis: n = 3). Nine patients (23.1%) succumbed to the disease, who were significantly older (median age of 56 years) compared to those achieving remission (median age of 27.5 years, p = 0.0092).</p><p><strong>Conclusion: </strong>Drug induced HLH is a rare but important diagnosis sharing some similarities in its initial presentation with SCAR, including anticonvulsants and antimicrobials as culprit drugs. As diHLH mortality parallels that in other forms of secondary HLH, prompt recognition is required for culprit drug cessation and initiation of immunosuppressive treatment.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-13"},"PeriodicalIF":1.8,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Eosinophilic Esophagitis: Challenges in Treatment and Long-Term Follow-Up.","authors":"Asli Kuzu Kusakli, Samil Hizli, Burcu Berberoglu Ates, Ahmet Selmanoglu, Selcuk Kivilcim, Zeynep Sengül Emeksiz, Aysel Unlusoy Aksu, Selim Dereci, Emine Dibek Misirlioglu, Zulfikar Akelma","doi":"10.1159/000551224","DOIUrl":"https://doi.org/10.1159/000551224","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic esophagitis (EoE) is a chronic, immune-mediated esophageal disease increasingly recognized in children. Despite growing awareness, diagnostic delays, heterogeneous presentations, and variable treatment responses continue to complicate management.</p><p><strong>Objective: </strong>This study aimed to describe the real-world clinical characteristics, atopic features, treatment patterns, and long-term outcomes of children with EoE, and to identify practical challenges that may inform more effective management strategies.</p><p><strong>Methods: </strong>This retrospective study included 50 children diagnosed with EoE between October 2020 and October 2025 at a tertiary pediatric center. Demographic, clinical, endoscopic, histopathological, and allergic data were reviewed. Symptom burden and adaptive behaviors were evaluated using the Gazi Eosinophilic Esophagitis Symptom and Adaptation Scale (GaziESAS).</p><p><strong>Results: </strong>Of the 50 patients, 33 (66%) were male. The median diagnosis age of 10.5 years with an estimated diagnostic delay of 1.6 years. At least one concomitant atopic disease was present in 36 patients (72%), most commonly allergic rhinitis in 24 (48%) and asthma in 16 (32%). Food sensitization was detected in 15 of 47 evaluated patients (31.9%), and patch test positivity in 15 of 49 patients (30.6%). All patients initially received proton pump inhibitors; topical corticosteroids and/or elimination diets were added as needed. Older age at diagnosis correlated with higher total GaziESAS scores (r = 0.524, p < 0.001), mainly due to adaptive behaviors (ρ = 0.457, p = 0.001). Females showed higher peak eosinophil counts than males (82.3 ± 37.3 vs. 49.6 ± 25 eos/HPF, p = 0.001). Complete histologic remission-defined as <15 eosinophils per high-power field in all follow-up endoscopies after the diagnostic procedure-was achieved in 25 patients (50%).</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-17"},"PeriodicalIF":1.8,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321500","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}