Journal of Allergy and Clinical Immunology最新文献

{"title":"LRBA functional deficiency caused by biallelic LRBA missense variants characterized by Evans syndrome or colitis.","authors":"Samuel Cc Chiang,Li Yang,Erika Owsley,Ammar Husami,Nagako Akeno,Cristina Cobb,Nicholas L Hartog,Araceli Elizalde,Christine M Seroogy,Geraldine Blanchard-Rohner,Xiao P Peng Md,Rae Brager,David Buchbinder,Eleanor Cook,Lindsay Phillips,Snezana Maricic,Tatiana Kalashnikova,Beata Derfalvi,Victoria R Dimitriades,Luis E Murguía-Favela,Maria J Gutierrez,Anitha Shrikhande,MacGregor Steele,Jo L Wilson,Nicola Am Wright,Rebecca Marsh,Jack Bleesing,Michael B Jordan,Ashish K Marwaha BMBch","doi":"10.1016/j.jaci.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.jaci.2025.04.003","url":null,"abstract":"BACKGROUNDBiallelic loss-of-function (LOF) mutations in LRBA (lipopolysaccharide-responsive and beige-like anchor) lead to a severe syndrome of early-onset immune dysregulation called LRBA deficiency. Monoallelic CTLA4 mutations lead to a similar phenotype. In both conditions, Treg CTLA-4 levels are significantly decreased. In previously reported cases of symptomatic disease associated with LRBA pathogenic variants, patients usually have severely decreased or absent LRBA protein levels.OBJECTIVEWe describe here five patients with biallelic missense variants in the LRBA gene presenting predominantly with Evans syndrome or colitis.METHODSLRBA and CTLA-4 levels were investigated in LRBA missense, \"classic\" LRBA, and CTLA-4 insufficiency samples.RESULTSSurprisingly, all five LRBA missense patients have normal expression of LRBA protein. However, CTLA-4 intracellular expression was reduced to similar levels as those seen in CTLA-4 insufficiency patients at resting state. Lower levels of surface CTLA-4 are seen upon cell activation, indicating that these LRBA variants lead to reduced CTLA-4 cell surface expression. Several of the missense variants are shared between unrelated patients in the cohort suggesting a mutational hotspot or founder effect for those with shared ancestry.CONCLUSIONHerein, we describe novel LRBA deficiency variants resulting in quantitative or qualitative LRBA defects, leading to reduced intracellular resting levels and induced surface levels of CTLA-4.","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"6 1","pages":""},"PeriodicalIF":14.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inside Job: Roles of Intracellular C3.","authors":"Behdad Afzali, Parul Singh, Md Tajmul, Claudia Kemper","doi":"10.1016/j.jaci.2025.03.024","DOIUrl":"https://doi.org/10.1016/j.jaci.2025.03.024","url":null,"abstract":"<p><p>Our understanding of the complement system continues to grow beyond that of a liver-derived systemically operative mechanism of pathogen clearance to a central orchestrator of single cell behavior and tissue biology. These expanded activities reflect the extra-hepatic and local production of complement by many, if not most, cells, and the unexpected recent finding that complement also serves important physiological intracellular roles. The complement core component C3 has emerged as a particularly critical player in basic cell functions. Here, we provide an overview of the currently known forms and functions of intracellular C3 and the mechanisms that control it. We also discuss two emerging concepts as potential key areas for future exploration: intracellular C3 as second layer of pathogen defence at host-environmental interfaces and \"C3 licensing\". We conclude by suggesting that the potential clinical implications surrounding perturbations in intracellular C3 activities should be explored better.</p>","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":11.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-Life Wheeze Trajectories Are Associated with Distinct Asthma Transcriptomes Later in Life.","authors":"Kieran J Phelan, Krishna M Roskin, Jeffrey W Burkle, Wan-Chi Chang, Lisa J Martin, Jocelyn M Biagini, Latha Satish, David B Haslam, Daniel Spagna, Seth Jenkins, Elsie Parmar, Leonard B Bacharier, Tebeb Gebretsadik, Michelle Gill, Diane R Gold, Daniel J Jackson, Christine C Johnson, Susan V Lynch, Kathryn E McCauley, Chris G McKennan, Rachel Miller, Carole Ober, Dennis R Ownby, Patrick H Ryan, Nathan Schoettler, Sweta Singh, Cynthia M Visness, Matthew C Altman, James E Gern, Gurjit K Khurana Hershey","doi":"10.1016/j.jaci.2025.03.020","DOIUrl":"https://doi.org/10.1016/j.jaci.2025.03.020","url":null,"abstract":"<p><strong>Rationale: </strong>Early childhood wheeze is characterized by heterogeneous trajectories having differential associations with later life asthma development.</p><p><strong>Methods: </strong>The Children's Respiratory Environmental Workgroup (CREW) is a collective of 12 birth cohorts, 7 of which conducted an additional visit with a nasal lavage collected and subjected to bulk RNA-sequencing. Early-life wheeze trajectories were defined using latent class analysis of longitudinal early-life wheezing data. Weighted gene correlation network analysis was utilized to associate gene expression patterns and current asthma with early-life wheeze trajectories.</p><p><strong>Results: </strong>We investigated 743 children (mean [SD] age 17 [5.1] years, 360 [48.5%] male). Four patterns of early life wheeze were identified: infrequent, transient, late-onset, persistent. Early life transient wheeze was associated with gene expression patterns related to increased antiviral response and late-onset wheeze was associated with decreased insulin signaling and glucose metabolism. Early-life persistent wheeze was associated with gene expression modules of type 2 inflammation and epithelial development, but these modules did not distinguish those with current asthma. Children who had persistent wheeze in early life and current asthma displayed a unique increase in expression of genes enriched for neuronal processes and ciliated epithelial function compared to those without asthma.</p><p><strong>Conclusions: </strong>Early-life longitudinal wheeze trajectories are associated with specific asthma transcriptomes later in life. These data suggest early-life asthma prevention strategies may be most beneficial when tailored to the specific wheeze pattern.</p>","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":11.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasal transcriptome differences preceding recurrent wheezing in infancy.","authors":"Poshmaal Dhar, Martin O'Hely, Luba Sominsky, Sarah Ashley, Sarath C Ranganathan, Peter D Sly, Fiona Collier, Mimi Lk Tang, Rachel Morgan, Toby Mansell, Richard Saffery, David Burgner, Anne-Louise Ponsonby, Peter Vuillermin","doi":"10.1016/j.jaci.2025.03.021","DOIUrl":"https://doi.org/10.1016/j.jaci.2025.03.021","url":null,"abstract":"<p><strong>Background: </strong>Mucosal immune responses and epithelial barrier function are key emerging determinants of susceptibility to wheezing illnesses in early life.</p><p><strong>Objective: </strong>We investigated the association between nasal transcriptome in healthy infants and the subsequent incidence of recurrent wheeze.</p><p><strong>Methods: </strong>In a population-derived prebirth cohort study, whole transcriptome sequencing was performed to compare the nasal transcriptome at 1 month of age from 26 infants who subsequently developed recurrent wheeze (parents' record in symptom diary) in the first year of life to 22 infants who remained recurrent wheeze-free. Differentially expressed genes (DEGs) were identified using DEseq2, followed by over-representation pathway (GO and KEGG) and upstream regulator analyses (Ingenuity Pathway Analysis).</p><p><strong>Results: </strong>202 DEGs (false discovery rate ≤ 0.1 and absolute log₂ fold change > 1; 66 upregulated and 136 downregulated) were associated with recurrent wheeze. Upregulated GO pathways associated with recurrent wheeze included chemokine-mediated signalling, eosinophil and monocyte chemotaxis. The downregulated GO included cilium organisation and cellular aldehyde metabolic process. TNF emerged as the key driver (adjusted p-value and Z-score) of DEG patterns in the recurrent wheeze group, with OSMR and IL21 identified as master regulators.</p><p><strong>Conclusion: </strong>The nasal transcriptome in early infancy is associated with subsequent recurrent wheezes, indicating upregulation of immune cell chemotaxis, decreased epithelial barrier function, and altered cilium organisation and mitochondrial function. Future studies are required to evaluate the use of nasal transcriptome in the early detection of infants at risk of recurrent wheeze and to generate new knowledge of antecedent pathways as targets for novel primary prevention strategies.</p>","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":11.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TNFα counters skin inflammation by restraining mast cell-dependent TSLP production.","authors":"Davender Redhu, Vandana Kumari, Kristin Franke, Karin Hartmann, Margitta Worm, Magda Babina","doi":"10.1016/j.jaci.2025.03.019","DOIUrl":"https://doi.org/10.1016/j.jaci.2025.03.019","url":null,"abstract":"<p><strong>Background: </strong>TNFα is an important proinflammatory cytokine, but its neutralization in the management of inflammatory skin disorders like psoriasis may trigger eczematous skin lesions as an adverse reaction.</p><p><strong>Objectives: </strong>This study aimed to elucidate whether TNF-α may protect from skin inflammation and to identify in detail the underlying mechanisms.</p><p><strong>Methods: </strong>Wildtype, TNF-α-deficient, TSLPR-deficient, mast cell (MC)-deficient, TNF-α-TSLPR-double-deficient and TNF-α-MC-double-deficient mice were subjected to a skin inflammation model and inspected by physical, clinical, histological, immunohistochemical and bioanalytical techniques.</p><p><strong>Results: </strong>TNFα deficiency promoted skin inflammation. This was accompanied by MC hyperplasia and potent TSLP production in lesional skin and serum of TNFα deficient mice. Specifically, MCs were found to be responsible for inducing high levels of TSLP in the epidermis, compromising barrier function and initiating inflammation. In contrast, the production of immunoglobulins, including IgE, was reduced in mice lacking TNFα.</p><p><strong>Conclusions: </strong>TNFα restrains MC-dependent TSLP production and the onset of eczema.</p>","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":11.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gene-by-environment interactions modulate the infant gut microbiota in asthma and atopy.","authors":"Sara A Stickley, Zhi Yi Fang, Amirthagowri Ambalavanan, Yang Zhang, Amanda M Zacharias, Charisse Petersen, Darlene Dai, Meghan B Azad, Jeffrey R Brook, Piushkumar J Mandhane, Elinor Simons, Theo J Moraes, Michael G Surette, Stuart E Turvey, Padmaja Subbarao, Qingling Duan","doi":"10.1016/j.jaci.2025.03.018","DOIUrl":"https://doi.org/10.1016/j.jaci.2025.03.018","url":null,"abstract":"<p><strong>Background: </strong>Gut microbiota has been associated with health and susceptibility to childhood diseases, including asthma and allergies. However, the genomic factors contributing to inter-individual variations in gut microbiota remain poorly understood.</p><p><strong>Objective: </strong>Our study integrates host genomics with early-life exposures to investigate main and interaction effects on gut microbiota during the first year of life. In addition, we identified gut microbes associated with childhood respiratory (asthma, wheeze) and atopic (atopic dermatitis, food/inhalant sensitization) outcomes.</p><p><strong>Methods: </strong>We leveraged microbiome data from infant stool at ages 3 months (N=779) and 1 year (N=770) from the CHILD Cohort Study. We identified microbial taxa and co-occurring network clusters associated with asthma and atopy by age 5 years. Genome-wide association studies and gene-by-environment interaction analyses determined main and interaction effects of host genomics and early-life environmental exposures (e.g., feeding practices, household pets, birth characteristics) on gut microbial features.</p><p><strong>Results: </strong>Shifts in microbial taxa and network clusters during the first year of life were associated with childhood respiratory and atopic outcomes (P<0.05), some of which were sex-specific. Additionally, some of these implicated microbes were associated with host genomics and early-life exposures. For example, Blautia obeum was associated with reduced food/inhalant sensitization and genetic variants near the MARCO gene (P=9.4E-11). Also, variants in the SMAD2 gene interact with breastfeeding to influence the green microbial network cluster (P=8.3E-10), associated with asthma.</p><p><strong>Conclusion: </strong>Our study reports main and interaction effects of genomics and exposures on early-life gut microbiota, which may contribute to childhood asthma and atopy. Improved understanding of the factors contributing to gut dysbiosis will inform on early-life biomarkers and interventions.</p>","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":11.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A molecular basis for milk allergen immune recognition in eosinophilic esophagitis","authors":"Julianna Dilollo BA ,&nbsp;Alex Hu PhD ,&nbsp;Huiqi Qu MD, PhD ,&nbsp;Karina E. Canziani PhD ,&nbsp;Rachel L. Clement BS ,&nbsp;Sam J. McCright PhD ,&nbsp;Wayne G. Shreffler MD, PhD ,&nbsp;Hakon Hakonarson MD, PhD ,&nbsp;Jonathan M. Spergel MD, PhD ,&nbsp;Karen Cerosaletti PhD ,&nbsp;David A. Hill MD, PhD","doi":"10.1016/j.jaci.2025.01.008","DOIUrl":"10.1016/j.jaci.2025.01.008","url":null,"abstract":"","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"155 4","pages":"Pages 1396-1399"},"PeriodicalIF":11.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase 2b randomized clinical trial of amlitelimab, an anti-OX40 ligand antibody, in patients with moderate-to-severe atopic dermatitis","authors":"Stephan Weidinger MD, PhD ,&nbsp;Andrew Blauvelt MD, MBA ,&nbsp;Kim A. Papp MD, PhD ,&nbsp;Adam Reich MD, PhD ,&nbsp;Chih-Hung Lee MD, PhD ,&nbsp;Margitta Worm MD ,&nbsp;Charles Lynde MD ,&nbsp;Yoko Kataoka MD ,&nbsp;Peter Foley MD ,&nbsp;Xiaodan Wei PhD ,&nbsp;Wanling Wong PhD ,&nbsp;Anne-Catherine Solente MSc ,&nbsp;Christine Weber MD ,&nbsp;Samuel Adelman MD ,&nbsp;Sonya Davey MD ,&nbsp;Fabrice Hurbin PharmD ,&nbsp;Natalie Rynkiewicz PhD ,&nbsp;Karl Yen MD ,&nbsp;John T. O’Malley MD, PhD ,&nbsp;Charlotte Bernigaud MD, PhD","doi":"10.1016/j.jaci.2024.10.031","DOIUrl":"10.1016/j.jaci.2024.10.031","url":null,"abstract":"<div><h3>Background</h3><div>Amlitelimab, a fully human nondepleting mAb targeting OX40 ligand on antigen-presenting cells, could prevent T-cell–driven inflammation seen in atopic dermatitis (AD).</div></div><div><h3>Objective</h3><div>This trial evaluated the efficacy and safety of amlitelimab in adults with AD.</div></div><div><h3>Methods</h3><div>In this 2-part, phase 2b, randomized, double-blinded placebo-controlled trial (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> identifier NCT05131477), patients received subcutaneous amlitelimab every 4 weeks at doses of 250 mg plus a 500-mg loading dose, 250 mg, 125 mg, or 62.5 mg or placebo for 24 weeks in Part 1 (1:1:1:1:1 randomization). In Part 2, clinical responders were reallocated 3:1 to stop taking amlitelimab or continue the previous dose regimen for 28 weeks. The primary end point was percentage of change in Eczema Area and Severity Index (EASI) from baseline to week 16.</div></div><div><h3>Results</h3><div>In all, 390 and 190 patients enrolled in Part 1 and Part 2, respectively. A significant percentage of change decrease in EASI was observed with amlitelimab doses versus with placebo (<em>P</em> &lt; .001). Clinical responses at week 24 (Investigator Global Assessment 0/1 and/or a 75% reduction in EASI) were maintained at week 52 in patients continuing or stopping amlitelimab. Of the patients maintaining clinical response at week 52 after no longer receiving treatment, more than 80% had serum amlitelimab concentrations less than the 4-μg/mL threshold for several weeks before week 52. Reductions in AD-related biomarkers during Part 1 were maintained through Part 2. Amlitelimab was well tolerated over 52 weeks.</div></div><div><h3>Conclusions</h3><div>Amlitelimab treatment significantly reduced clinical and biomarker responses, and was well tolerated in adults with AD through week 52. Sustained responses were observed in the majority of patients for 28 weeks after they had stopped taking amlitelimab.</div></div>","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"155 4","pages":"Pages 1264-1275"},"PeriodicalIF":11.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus of the Italian Primary Immunodeficiency Network on the use and interpretation of genetic testing for diagnosing inborn errors of immunity","authors":"Giuliana Giardino MD, PhD ,&nbsp;Gigliola Di Matteo PhD ,&nbsp;Silvia Giliani PhD ,&nbsp;Simona Ferrari PhD ,&nbsp;Vassilios Lougaris MD, PhD ,&nbsp;Raffaele Badolato MD, PhD ,&nbsp;Francesca Conti MD, PhD ,&nbsp;Roberta Romano MD, PhD ,&nbsp;Maria Pia Cicalese MD, PhD ,&nbsp;Silvia Ricci MD ,&nbsp;Federica Barzaghi MD, PhD ,&nbsp;Antonio Marzollo MD, PhD ,&nbsp;Cristina Cifaldi PhD ,&nbsp;Davide Montin MD, PhD ,&nbsp;Lorenzo Lodi MD ,&nbsp;Emilia Cirillo MD, PhD ,&nbsp;Baldassarre Martire MD ,&nbsp;Antonio Trizzino MD ,&nbsp;Mayla Sgrulletti MD ,&nbsp;Viviana Moschese MD, PhD ,&nbsp;Claudio Pignata MD, PhD","doi":"10.1016/j.jaci.2024.11.030","DOIUrl":"10.1016/j.jaci.2024.11.030","url":null,"abstract":"<div><h3>Background</h3><div>Inborn errors of immunity (IEIs) comprise more than 500 different rare congenital disorders of the immune system and are characterized by susceptibility to infection and immune dysregulation. The significant overlap of the clinical features among the different forms may lead to diagnostic delay. High-throughput sequencing techniques may allow a timely genetic definition. Guidelines for the use and the interpretation of genetic testing produced by the American College of Medical Genetics and Genomics (ACMG) and the European Society of Human Genetics (ESHG) do not cover specifics for their application to IEIs.</div></div><div><h3>Objective</h3><div>The aim of this consensus study was to define the best approach to genetic testing for IEIs.</div></div><div><h3>Methods</h3><div>A panel of experts in the context of the Italian Primary Immunodeficiency Network (IPINet) composed a list of statements that were evaluated by the Delphi method.</div></div><div><h3>Results</h3><div>The experts recommend that genetic testing for IEIs should be offered to selected patients with warning signs for IEIs and highlight the crucial role of thorough phenotyping and functional tests for the conclusive diagnosis of IEI. Comprehensive educational programs targeted to health care professionals and the public should be developed to increase IEIs awareness and reduce diagnostic delay. Ethical issues should be pondered over the diagnostic advantages of genetic tests requested for diagnostic purposes.</div></div><div><h3>Conclusion</h3><div>Adherence to guidelines on the use and interpretation of genetic tests for diagnosing IEIs should help limit the inappropriate use of these techniques, thereby reducing the risk of misdiagnosis and patient apprehension regarding inconclusive genetic results.</div></div>","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"155 4","pages":"Pages 1149-1160"},"PeriodicalIF":11.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronavirus disease 2019 (COVID-19) in children: Evolving epidemiology, immunology, symptoms, diagnostics, treatment, post–COVID-19 conditions, prevention strategies, and future directions","authors":"Juliane Wurm MD ,&nbsp;Nicole Ritz MD, PhD ,&nbsp;Petra Zimmermann MD, PhD","doi":"10.1016/j.jaci.2024.11.012","DOIUrl":"10.1016/j.jaci.2024.11.012","url":null,"abstract":"<div><div>The epidemiology of coronavirus disease 2019 (COVID-19) in children has evolved throughout the pandemic, with initially low infection rates rising significantly as a result of the emergence of the more transmissible Omicron variant. Adolescents, children from ethnic minorities and lower-income households, and those with obesity are at increased risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The immune response in children leads to milder symptoms compared to adults, with fever and cough being most frequent; tough symptoms vary by SARS-CoV-2 variant and age. Diagnostic methods to confirm current or past infection include reverse transcription PCR, rapid antigen tests, and serology. Treatment is mainly supportive, with antivirals and glucocorticoids reserved for severe cases. While serious conditions like multisystem inflammatory syndrome in children and other post–COVID-19 conditions are rare, they require careful management. Vaccination has proven effective in reducing severe disease and protecting against post–COVID-19 conditions. Continued surveillance, including wastewater monitoring and universal or pooled testing, remains crucial for controlling community spread. Key questions remain regarding the duration and quality of immunity after reinfection or vaccination, the impact of coinfections, and optimal treatment protocols for different pediatric populations.</div></div>","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"155 4","pages":"Pages 1071-1081"},"PeriodicalIF":11.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}