International Archives of Allergy and Immunology最新文献

{"title":"Diagnostic Performance of Skin Prick Test and Specific Immunoglobulin E in Children Sensitized to Cat Allergen.","authors":"Çağrı Torun Özel, Aslı Kuzu Kuşaklı, Funda Aytekin Güvenir, Ahmet Selmanoğlu, Zeynep Sengül Emeksiz, Emine Dibek Mısırlıoğlu","doi":"10.1159/000552603","DOIUrl":"10.1159/000552603","url":null,"abstract":"<p><strong>Introduction: </strong>Cat allergen sensitization is common in childhood; however, the relationship between immunological test results and clinical symptoms remains unclear. Skin prick testing (SPT) and serum cat-specific immunoglobulin E (cat-sIgE) are widely used diagnostic tools, but their optimal cut-off values according to symptom status have not been well defined. This study aimed to evaluate cat allergen sensitization in pediatric patients, assess the diagnostic performance of SPT and cat-sIgE, and determine optimal cut-off values according to symptom status following cat exposure.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included children aged 0-18 years with cat allergen sensitization who underwent both SPT and cat-sIgE testing between January 2023 and January 2025. Patients were classified as symptomatic or asymptomatic based on documented allergic symptoms following cat exposure. Demographic characteristics, environmental exposures, comorbid allergic diseases, laboratory findings, and aeroallergen co-sensitization were analyzed. Multivariable logistic regression was used to identify factors associated with symptomatic status following cat exposure, and receiver operating characteristic (ROC) curve analysis was performed to evaluate diagnostic performance.</p><p><strong>Results: </strong>A total of 428 children were included, of whom 211 (49.3%) were asymptomatic and 217 (50.7%) were symptomatic according to clinical history following cat exposure. Cat exposure-related symptoms were predominantly nasal, followed by ocular, respiratory, and cutaneous symptoms. In the multivariable model, asthma was associated with higher odds of symptomatic status, whereas pollen sensitization, prenatal cat exposure, and longer duration of cat ownership were inversely associated with symptomatic status. ROC analysis demonstrated high diagnostic accuracy for both SPT wheal size and cat-sIgE levels, with higher cut-off showing high specificity for symptomatic status following cat exposure.</p><p><strong>Conclusion: </strong>SPT wheal size and cat-sIgE levels showed diagnostic value in pediatric cat allergen sensitization. Laboratory sensitization should be interpreted together with clinical history, and distinct cut-off values based on symptom status following cat exposure may improve diagnostic accuracy and clinical interpretation.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-10"},"PeriodicalIF":2.3,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396630","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":"Differences in Reported Anaphylaxis Associated with Common Nonsteroidal Anti-Inflammatory Drugs: A Pharmacovigilance Study.","authors":"Suwei Liu, Haoyang Yu, Yuxin Wu, Haogeng Wang, Yuxia Ma","doi":"10.1159/000552828","DOIUrl":"10.1159/000552828","url":null,"abstract":"<p><strong>Introduction: </strong>Nonsteroidal anti-inflammatory drugs (NSAIDs) are a major cause of drug hypersensitivity reactions, yet comparative real-world data on drug-specific anaphylaxis reporting remain limited. This study aimed to evaluate reporting patterns and disproportionality signals of NSAID-associated anaphylaxis in the FDA Adverse Event Reporting System (FAERS), compare severe outcomes across individual NSAIDs, and describe the indication context of these reports.</p><p><strong>Methods: </strong>In this cross-sectional pharmacovigilance study, FAERS reports from 2015Q1 to 2025Q2 were analyzed. Five NSAIDs were included: ibuprofen, diclofenac, naproxen, celecoxib, and meloxicam. Anaphylaxis was defined by 4 MedDRA preferred terms and restricted to reports listing the target NSAID as the primary suspect drug. Disproportionality was assessed using reporting odds ratio, proportional reporting ratio, empirical Bayes geometric mean, and information component.</p><p><strong>Results: </strong>Total adverse event reports were 51,837 for ibuprofen, 43,979 for diclofenac, 27,043 for naproxen, 13,085 for celecoxib, and 2,591 for meloxicam. Corresponding anaphylaxis reports were 938 (1.81%), 919 (2.09%), 320 (1.18%), 178 (1.36%), and 38 (1.47%). All 5 NSAIDs showed disproportionality signals versus all other drugs. Female predominance was observed across agents. Most reports involved adults aged 18-64 years, except meloxicam, which was concentrated in those aged 65-85 years. Diclofenac reports mainly originated outside the USA, whereas naproxen had the highest proportion of US reports. Among submitted FAERS reports of NSAID-associated anaphylaxis, the reported proportion of DE/LT outcomes varied across the 5 NSAIDs. Pain and back pain were common indications, but the broader indication patterns showed drug-specific features.</p><p><strong>Conclusion: </strong>NSAIDs showed consistent disproportionality signals for anaphylaxis in FAERS, with observable heterogeneity in reporting patterns across individual agents.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-10"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368397","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":"Association of Serum Lectin Galactoside-Binding Soluble 3-Binding Protein with Acute Exacerbation, Inflammation, and Airway Remodeling in Pediatric Asthma.","authors":"Haifeng Zhu, Qiwu Xie","doi":"10.1159/000552682","DOIUrl":"10.1159/000552682","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the association between serum LGALS3BP levels and acute exacerbations, airway inflammation, lung function, and airway remodeling in children with asthma.</p><p><strong>Methods: </strong>A total of 93 children with asthma (57 with stable condition and 36 with acute exacerbation) and 100 healthy controls were enrolled. Pulmonary function tests, markers of allergic and airway inflammation, pro-inflammatory cytokines, and airway remodeling-related biomarkers were also assessed. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed to evaluate the independent factors associated with and the diagnostic performance for acute exacerbations.</p><p><strong>Results: </strong>Serum LGALS3BP levels were significantly higher in children with asthma than in healthy controls and were further elevated during acute exacerbations (all p < 0.001). Increased LGALS3BP levels were independently associated with a higher risk of acute exacerbations (odds ratio = 1.073, 95% confidence interval: 1.003-1.147; p = 0.040). ROC analysis demonstrated strong discriminatory performance for identifying exacerbations (AUC = 0.910), with 76.3% sensitivity and 91.0% specificity. Serum LGALS3BP levels showed significant moderate negative correlations with lung function parameters and positive correlations with eosinophil counts, total immunoglobulin E, fractional exhaled nitric oxide, pro-inflammatory cytokines, and airway remodeling markers, including transforming growth factor-β1, matrix metalloproteinases-2, matrix metalloproteinases-9, and stromal cell-derived factor-1α (all p < 0.05).</p><p><strong>Conclusion: </strong>Elevated serum LGALS3BP levels are closely associated with acute exacerbations, airway inflammation, impaired lung function, and airway remodeling in pediatric asthma. These findings suggest that LGALS3BP may serve as a promising noninvasive biomarker for disease activity and exacerbation risk.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-13"},"PeriodicalIF":2.3,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360703","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":"Effectiveness of a Provincial Law to Improve Epinephrine Use for Anaphylaxis in Schools in Alberta, Canada: A Pre-Post Study.","authors":"Joseph Najem, Alexandre Ton That, Connor Prosty, Ann E Clarke, Judy Morris, Jocelyn Gravel, Rodrick Lim, Edmond S Chan, Ran D Goldman, Andrew O Apos Keefe, Jennifer Gerdts, Derek K Chu, Julia E Upton, Elana Hochstadter, Jocelyn Moisan, Adam Bretholz, Christine McCusker, Xun Zhang, Jennifer L P Protudjer, Elissa Abrams, Elinor Simons, Andrew Dixon, Moshe Ben-Shoshan","doi":"10.1159/000552127","DOIUrl":"10.1159/000552127","url":null,"abstract":"<p><strong>Introduction: </strong>The 2020 Protection of Students with Life-Threatening Allergies Act, obligates schools across Alberta, Canada to hold a common use stock of at least one epinephrine autoinjector (EAI) and to maintain a protocol for the prevention and management of anaphylaxis. Herein, we assessed the effectiveness of this policy by comparing pre-hospital EAI use before and after implementation of the act.</p><p><strong>Methods: </strong>The Cross-Canada Anaphylaxis Registry (C-CARE) enrolls patients presenting to a participating emergency department with anaphylaxis defined as the involvement of ≥2 systems and/or hypotension. Specific to this project, we extracted data on pediatric patients recruited from the Stollery Children's Hospital in Edmonton, Alberta from 2016 to 2024. Data were collected on demographics, comorbidities, symptomatology, pre- and intra-hospital management, and outcome of anaphylaxis by standardized chart review. Multivariable logistic regression was used to assess pre-hospital EAI use for cases occurring at school before versus after the enactment of the Act on January 1, 2020. Evaluating pre-hospital EAI use in Quebec and Ontario and antihistamine use pre versus post act in Alberta were used as negative controls.</p><p><strong>Result: </strong>Of the 59 cases of in-school anaphylaxis identified over the study period, 52.5% occurred post-act. The median age was 13.0 years (IQR = 9.5-15.8) and 40.7% were male. EAI use in schools was greater post-act versus pre-act (64.5% versus 35.7%, aOR = 3.82, 95% confidence interval [CI] = 1.24-11.7). There was no difference in pre-hospital EAI use pre versus post 2020 in Quebec and Ontario, that did not use the act (aOR = 0.72, 95% CI = 0.31-1.70). There was no difference in pre-hospital antihistamine use pre versus post act (aOR = 0.31, 95% CI = 0.07-1.41).</p><p><strong>Conclusion: </strong>Implementation of the provincial policy was associated with an increase in pre-hospital EAI use in cases of pediatric anaphylaxis occurring at school. These preliminary results support the effectiveness of policy interventions for anaphylaxis management.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-10"},"PeriodicalIF":2.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13446875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338484","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":"Rab27a Regulates Dendritic Cell Immune Tolerogenic Capacity.","authors":"Yang-Peng Wu, Shu-Wang Peng, Dong Hua Bin, Zhuo-Ya Wang, Qiao Liu, Yang-Dong Wu, Ke-Peng Peng, Sheng-Lan Tan, Ping-Chang Yang, Gui-Xiang Tian","doi":"10.1159/000553054","DOIUrl":"10.1159/000553054","url":null,"abstract":"<p><strong>Introduction: </strong>Dendritic cells (DCs) are known to play a crucial role in inducing immune tolerance. The major cytokine that DCs use to induce immune tolerance is IL-10. Rab27a, a small G protein, has been reported to play a significant role in the cellular output process. The aim of this study was to comprehend how Rab27a regulates the secretion of IL-10 by DCs.</p><p><strong>Methods: </strong>DCs were purified from the intestinal tissues using flow cytometry cell sorting. The enzyme-linked immunosorbent assay was used to quantify cytokines in culture supernatant.</p><p><strong>Results: </strong>Our observation was that patients with food allergy (FA) had a lower level of Rab27a activation in peripheral DCs than normal controls (NC). The immune tolerogenic ability of FA DCs was defective compared to NC DCs. The data of Rab27a activation levels and the immune tolerogenic capacity of DC were found to have a positive correlation. The activation of Rab27a in DCs was regulated by MADD in a significant way. Rab27a that was activated created a complex with IL-10, which was responsible for transporting IL-10 out of DCs. MADD and Rab27a activation were found to be lower in DCs collected from patients with FA. Re-establishment of MADD expression could restore the immune tolerogenic capacity of FA DCs.</p><p><strong>Conclusion: </strong>Activated Rab27a is required for the release of IL-10 from DCs. MADD plays a crucial role in Rab27a activation.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329357","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":"Burden of Hereditary Angioedema in Adults: Impact of Disease and Patient Characteristics.","authors":"Maureen Watt, Inmaculada Martinez Saguer, Ryan Murphy, Marie De La Cruz, Ricardo Zwiener, Mauricio Sarrazola, Anete S Grumach","doi":"10.1159/000551657","DOIUrl":"10.1159/000551657","url":null,"abstract":"<p><strong>Introduction: </strong>Hereditary angioedema (HAE) has a heterogeneous clinical presentation, and symptoms can vary in severity and frequency. The aim of this post hoc analysis was to describe the burden of disease in patients with HAE according to the impact of the disease and patient characteristics.</p><p><strong>Methods: </strong>A cross-sectional, web-based survey in 13 countries was conducted to assess the burden of disease in patients aged ≥18 years with HAE. This post hoc analysis assessed disease control, HRQoL, anxiety, depression, and work productivity by subgroups defined by sex, perception of disease control and HRQoL impairment. Patient-reported outcomes included the Angioedema Quality of Life (AE-QoL), Angioedema Control Test (AECT), Hospital Anxiety and Depression Scale (HADS), and Work Productivity and Activity Impairment: General Health (WPAI:GH) questionnaires. Descriptive statistics were used to describe the results by subgroups.</p><p><strong>Results: </strong>Of 260 respondents (189 female; 71 male) who completed the survey, 195/260 (75.0%) perceived their HAE was poorly controlled (AECT score <10) and 137/260 (52.7%) had moderate-to-large HRQoL impairment (AE-QoL score ≥39). Relative to male respondents, females reported higher HRQoL impairment (AE-QoL total score mean ± SD 46.5 ± 23.3 vs. 33.3 ± 20.1), a perception of more poorly controlled disease (AECT score 7.1 ± 3.0 vs. 8.3 ± 3.0), and a higher proportion reported moderate or severe anxiety (33.9% vs. 7.0%) and depression (12.2% vs. 5.6%) according to the HADS. Respondents who perceived their HAE was poorly controlled had a higher number of HAE attacks in the last 6 months, reported greater HRQoL impairment, higher scores on HADS anxiety and depression subscales, and greater WPAI:GH work and activity impairment than those who perceived their HAE to be well controlled (AECT ≥10). Similarly, patients reporting moderate-to-large HRQoL impairment reported more HAE attacks in the last 6 months, higher scores on HADS anxiety and depression subscales, and greater WPAI:GH work and activity impairment than those with an AE-QoL score <39.</p><p><strong>Conclusion: </strong>In this post hoc analysis, the burden of HAE was consistently higher in females than males, in respondents who reported their disease to be poorly controlled versus well-controlled, and in those with moderate-to-large versus minimal HRQoL impairment. Findings support the use of patient-reported outcomes to assess burden of disease in routine clinical practice to understand the broader burden of disease beyond metrics such as attack rate and to consider individual circumstances and experiences.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-13"},"PeriodicalIF":2.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329300","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":"Predictors of Treatment Response to Omalizumab in Children with Chronic Spontaneous Urticaria: A Real World Study.","authors":"Aymen Hişmioğullari, Özlem Sancakli, Soner Günder, Özgen Soyöz, Ayça Demir, Figen Çelebi Çelik, Berna Uzunoğlu, Gülçin Kaymakoğlu, Necmi Can Yüksel, Emre Firat, Canan Şule Karkiner, Demet Can","doi":"10.1159/000553219","DOIUrl":"10.1159/000553219","url":null,"abstract":"<p><strong>Introduction: </strong>Omalizumab is an effective therapy for H1-antihistamine-refractory chronic spontaneous urticaria (CSU). However, predictive biomarkers for treatment success in the pediatric population remain poorly defined. This study aimed to identify clinical and laboratory factors predicting complete disease control in children receiving omalizumab.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 44 pediatric patients (aged 12-18 years) with CSU treated with omalizumab (300 mg/4 weeks). Disease activity and control were assessed using Urticaria Activity Score (UAS7), Urticaria Control Test (UCT), and Chronic Urticaria Quality of Life Questionnaire at baseline and months 1, 3, and 6. Complete control was defined as UAS7 = 0 and UCT = 16 at month 6. Univariate and multivariate logistic regression analyses were performed to identify independent predictors.</p><p><strong>Results: </strong>Complete control was achieved in 40.9% (n = 18) of patients at month 6. In multivariate analysis, shorter symptom duration prior to omalizumab (odds ratio [OR]: 0.46; 95% confidence interval [CI]: 0.25-0.88) and higher baseline absolute eosinophil count (OR: 1.04; 95% CI: 1.00-1.06) were identified as independent predictors of complete control. In addition, early clinical response at month 1 was significantly associated with subsequent treatment success and may serve as an early on-treatment prognostic marker.</p><p><strong>Conclusion: </strong>Early initiation of omalizumab and higher baseline eosinophil counts are strong predictors of complete disease control in pediatric CSU. These findings support a biomarker-guided and timely intervention strategy to optimize clinical outcomes in children.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-10"},"PeriodicalIF":2.3,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308001","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":"Long-Term Efficacy beyond 10 Years of Subcutaneous Immunotherapy for House Dust Mite-Induced Allergic Rhinitis: A Real-World Evidence Study.","authors":"Jichao Sha, Yiting Liu, Ye Yuan, Liwei Sun, Cuida Meng, Dongdong Zhu","doi":"10.1159/000552898","DOIUrl":"10.1159/000552898","url":null,"abstract":"<p><strong>Introduction: </strong>This retrospective study evaluated real-world data on subcutaneous immunotherapy for house dust mites (HDM-SCIT) in children and adults with AR over a period exceeding 10 years and aimed to observe the long-term efficacy of HDM-SCIT lasting more than 10 years in children and adults.</p><p><strong>Methods: </strong>Sixty-six patients, including 31 children and 35 adults who were allergic to house dust mite and received SCIT, were retrospectively analysed. All patients completed an immunotherapy course lasting 2-3 years. Questionnaire data were collected before and at the end of SCIT, and telephone follow-up was conducted to evaluate the long-term efficacy after 10 years.</p><p><strong>Results: </strong>Nasal and ocular symptoms in children and adults remained better controlled 10 years after the completion of HDM-SCIT (all p < 0.05). The efficacy for nasal and ocular symptoms in children persisted after 10 years (all p < 0.05), whereas the efficacy of other related symptoms declined (p = 0.414). The efficacy for nasal symptoms in adults remained stable (p = 0.888), whereas the efficacy for ocular symptoms and ear-itching symptoms declined (all p < 0.05). No statistically significant difference between children and adults (p = 0.607, p = 0.764). No adverse reactions persisted for 10 years or more.</p><p><strong>Conclusions: </strong>Up to 10 years after completing HDM-SCIT, both children and adults continued to exhibit significant improvement in their symptoms. The safety profile during treatment for both adults and children remained excellent even 10 years later.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-8"},"PeriodicalIF":2.3,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277332","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":"Real-Life Effectiveness of Mepolizumab in Severe Type-2 Chronic Rhinosinusitis with Nasal Polyps: Clinical Outcomes and Predictors of Response.","authors":"Sante De Santis, Stefania Galassi, Jacopo Cambi","doi":"10.1159/000552667","DOIUrl":"10.1159/000552667","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to evaluate the real-life effectiveness of mepolizumab in patients with severe uncontrolled type-2 chronic rhinosinusitis with nasal polyps (CRSwNP), focusing on clinical, functional, and inflammatory outcomes.</p><p><strong>Methods: </strong>This retrospective study included 74 patients with uncontrolled type-2 CRSwNP treated with subcutaneous mepolizumab (100 mg every 4 weeks) for at least 12 months. Primary endpoints were changes in Sino-Nasal Outcome Test-22 (SNOT-22) and Nasal Polyp Score (NPS). Secondary endpoints included Sniffin' Sticks Identification Test-12 (SSIT-12), Lund-Mackay CT score (LMK-CT), blood eosinophils, total IgE, and Asthma Control Test (ACT). Outcomes were assessed at baseline and at 1, 3, 6, and 12 months.</p><p><strong>Results: </strong>Significant improvements were observed over 12 months. Mean SNOT-22 decreased from 76.2 ± 17.8 to 27.7 ± 15.6, and NPS from 6.3 ± 0.9 to 2.1 ± 0.7. LMK-CT scores improved from 17.2 ± 3.6 to 10.5 ± 4.2. Olfactory function improved, with normosmia increasing from 2.8% to 10.8%. Blood eosinophils decreased significantly (from 564 ± 62.9 to 82 ± 10.0 cells/μL), while total IgE remained stable. Asthma control improved rapidly, with all patients achieving an ACT of ≥20 within 4 weeks. Multivariate logistic regression identified higher baseline blood eosinophil counts (odds ratio [OR]: 1.42 per 100 cells/μL increase, 95% confidence interval [CI]: 1.08-1.87, p = 0.012) and lower baseline SSIT-12 scores (OR: 0.78 per point increase, 95% CI: 0.63-0.96, p = 0.021) as independent predictors of favorable response at 12 months.</p><p><strong>Conclusion: </strong>Mepolizumab provides sustained clinical and radiologic improvement in severe type-2 CRSwNP. Baseline eosinophilia and olfactory dysfunction may help identify patients more likely to benefit from anti-IL-5 therapy, supporting a personalized treatment approach.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-8"},"PeriodicalIF":2.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257792","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 Characteristics and Severity of Pediatric Anaphylaxis in the Emergency Department: A Six-Year Study Based on WAO Criteria.","authors":"Nazli Ercan, Aysun Tekeli","doi":"10.1159/000552773","DOIUrl":"10.1159/000552773","url":null,"abstract":"<p><strong>Introduction: </strong>Anaphylaxis is a potentially life-threatening systemic allergic reaction with an increasing incidence in children. The World Allergy Organization (WAO) recently introduced trigger-independent diagnostic criteria and severity grading, enabling standardized evaluation of acute systemic allergic reactions. To evaluate clinical characteristics, etiological distribution, severity patterns, and risk factors for severe reactions in children presenting with acute systemic allergic reactions and anaphylaxis using the updated WAO criteria.</p><p><strong>Methods: </strong>This retrospective study included children with acute systemic allergic reactions (WAO Grade 2-4) presenting to a tertiary university pediatric emergency department between January 2017 and December 2022. Clinical features, triggers, management, and outcomes were analyzed. Pediatric patients with confirmed anaphylaxis were divided into three subgroups based on etiology: food, drug, and other allergens. Severity was classified according to the WAO grading system, and logistic regression analysis was performed to identify independent risk factors for severe reactions.</p><p><strong>Results: </strong>Among 75 children prediagnosed with anaphylaxis, 61 (81.3%) met the WAO criteria. Food was the most common trigger (49%), followed by drugs (21.3%) and other allergens (29.5%), with food-induced reactions occurring at a younger median age. Cutaneous (60.7%) and gastrointestinal symptoms (vomiting, 41.0%) were the most frequent clinical manifestations. Cardiovascular findings distinguished severe reactions, with hypotension observed in (45%) of Grade 4 cases and none in grade 3 (p < 0.001). Nausea was more common in reactions caused by other allergens compared with food (77.8% vs. 11.1%, p < 0.05). In multivariable analysis, drug-induced and other allergen-related reactions were associated with a lower likelihood of severe reactions compared with food-induced anaphylaxis (OR = 0.061, p = 0.011 and OR = 0.143, p = 0.029, respectively). Adrenaline autoinjector were prescribed at discharge in a minority of patients, with a rate of 26.7% among food-allergic cases.</p><p><strong>Conclusion: </strong>Applying the WAO criteria, cardiovascular compromise was the main determinant of severe pediatric anaphylaxis, emphasizing the need for severity-based assessment and optimized discharge practices.</p>","PeriodicalId":13652,"journal":{"name":"International Archives of Allergy and Immunology","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257858","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}