Journal of Allergy and Clinical Immunology最新文献

{"title":"Anaphylaxis definition, overview, and clinical support tool: 2024 consensus report—a GA2LEN project","authors":"Timothy E. Dribin MD ,&nbsp;Antonella Muraro MD, PhD ,&nbsp;Carlos A. Camargo Jr MD, DrPH ,&nbsp;Paul J. Turner FRCPCH, PhD ,&nbsp;Julie Wang MD ,&nbsp;Graham Roberts DM ,&nbsp;Aikaterini Anagnostou MD, PhD ,&nbsp;Susanne Halken DM, DMSc ,&nbsp;Jay Liebermann MD ,&nbsp;Margitta Worm MD ,&nbsp;Torsten Zuberbier MD ,&nbsp;Hugh A. Sampson MD","doi":"10.1016/j.jaci.2025.01.021","DOIUrl":"10.1016/j.jaci.2025.01.021","url":null,"abstract":"<div><h3>Background</h3><div>The 2006 National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network anaphylaxis criteria are widely used in clinical care and research. In 2020, the World Allergy Organization published modified criteria that have not been uniformly adopted. Different criteria contribute to inconsistent care and research outcomes.</div></div><div><h3>Objective</h3><div>We sought to develop a consensus anaphylaxis definition, overview, and clinical support tool.</div></div><div><h3>Methods</h3><div>A 12-member writing group developed draft outputs modified with input from a 46-member international expert panel, 31 medical stakeholder organizations, and 15 patient advocacy organizations. The expert panel participated in a modified Delphi process to seek consensus for the outputs using a ≥80% consensus threshold.</div></div><div><h3>Results</h3><div>The first sentence of the definition reads, “Anaphylaxis is a serious allergic (hypersensitivity) reaction that can progress rapidly and may cause death.” The definition also describes organ systems that may be involved and signs of life-threatening reactions. The overview includes details of anaphylaxis recognition and management. The clinical support tool incorporates new clinical criteria to help determine the likelihood that patients are having anaphylaxis, intramuscular epinephrine indications and dosing, and common findings from the anaphylaxis organ systems. In addition, 93.5% (43/46), 97.8% (45/46), and 93.5% (43/46) of experts agreed with the definition, overview, and clinical support tool, respectively.</div></div><div><h3>Conclusion</h3><div>The anaphylaxis overview is a novel educational tool conveying key elements of anaphylaxis recognition and management. We propose that the definition and clinical support tool should replace previous definitions and clinical criteria. The clinical support tool should facilitate improved anaphylaxis recognition and management across different clinical settings and standardize research outcomes.</div></div>","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"156 2","pages":"Pages 406-417.e6"},"PeriodicalIF":11.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065569","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":"Converging paths toward unified therapeutic approaches in atopic dermatitis, vitiligo, and alopecia areata","authors":"Lea Tordjman BS ,&nbsp;Kayla D. Mashoudy BS ,&nbsp;Tali Czarnowicki MD, MSc","doi":"10.1016/j.jaci.2025.04.016","DOIUrl":"10.1016/j.jaci.2025.04.016","url":null,"abstract":"<div><div>Emerging evidence reveals significant epidemiologic, genetic, and immunologic connections between atopic dermatitis, vitiligo, and alopecia areata, challenging previously established notions of their distinct pathogenic and molecular signatures. Exploring these commonalities not only enhances our understanding of each disease’s pathogenesis, but also supports the development of unified treatment strategies for these frequently co-occurring disorders. This review examines key immune players shared across the 3 conditions, including cytokines, immune cells, and signaling pathways. Building on these insights, we also evaluate a range of therapeutic options—ranging from treatments approved by the Food and Drug Administration to those currently in clinical trials—alongside proposed future therapeutic targets. This comprehensive approach aims to advance our management of these interconnected autoimmune and inflammatory disorders with greater precision.</div></div>","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"156 2","pages":"Pages 237-251"},"PeriodicalIF":11.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876467","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 MBI ,&nbsp;Zhi Yi Fang BSc ,&nbsp;Amirthagowri Ambalavanan PhD ,&nbsp;Yang Zhang MSc ,&nbsp;Amanda M. Zacharias MBI ,&nbsp;Charisse Petersen PhD ,&nbsp;Darlene Dai MSc ,&nbsp;Meghan B. Azad PhD ,&nbsp;Jeffrey R. Brook PhD ,&nbsp;Piushkumar J. Mandhane MD, PhD ,&nbsp;Elinor Simons MD ,&nbsp;Theo J. Moraes MD ,&nbsp;Michael G. Surette PhD ,&nbsp;Stuart E. Turvey MBBS, DPhil ,&nbsp;Padmaja Subbarao MD ,&nbsp;Qingling Duan PhD","doi":"10.1016/j.jaci.2025.03.018","DOIUrl":"10.1016/j.jaci.2025.03.018","url":null,"abstract":"<div><h3>Background</h3><div>Gut microbiota has been associated with health and susceptibility to childhood diseases, including asthma and allergies. However, the genomic factors contributing to interindividual variations in gut microbiota remain poorly understood.</div></div><div><h3>Objective</h3><div>We sought to integrate 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.</div></div><div><h3>Methods</h3><div>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 (eg, feeding practices, household pets, and birth characteristics) on gut microbial features.</div></div><div><h3>Results</h3><div>Shifts in microbial taxa and network clusters during the first year of life were associated with childhood respiratory and atopic outcomes (<em>P</em> &lt; .05), some of which were sex-specific. In addition, some of these implicated microbes were associated with host genomics and early-life exposures. For example, <em>Blautia obeum</em> was associated with reduced food/inhalant sensitization and genetic variants near the <em>MARCO</em> gene (<em>P</em> = 9.4 × 10⁻¹¹). Also, variants near the <em>SMAD2</em> gene interact with breast-feeding to influence the <em>green</em> microbial network cluster (<em>P</em> = 8.3 × 10⁻¹⁰), associated with asthma.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"156 2","pages":"Pages 433-448"},"PeriodicalIF":11.2,"publicationDate":"2025-08-01","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":"Complement factor I deficiency: Diverse phenotypes","authors":"Ruby Moreno MD ,&nbsp;Lori Broderick MD, PhD","doi":"10.1016/j.jaci.2025.03.013","DOIUrl":"10.1016/j.jaci.2025.03.013","url":null,"abstract":"","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"156 2","pages":"Pages 305-307"},"PeriodicalIF":11.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700429","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":"Anti-KIT antibody, briquilimab, induces mast cell apoptosis and depletion in non-human primates.","authors":"Song Eun Lee,Hind Bouzid,Cheryl Kwan,Ajay Sharma,Andrea R Romo,Ruiqi Huang,Iris Zhan,Christopher Banfield,Jane R Parnes,Vaughn V Smider,Mang Yu,Hye-Sook Kwon,Wendy W Pang","doi":"10.1016/j.jaci.2025.07.019","DOIUrl":"https://doi.org/10.1016/j.jaci.2025.07.019","url":null,"abstract":"BACKGROUNDMast cells (MCs) play a critical role in many allergic and inflammatory reactions in healthy and disease states. Current therapeutic strategies to treat MC-mediated diseases aim to suppress MC activation by utilizing small molecule inhibitors or antibodies targeting specific signaling receptors on MCs. However, these strategies require chronic drug exposure, which have inherent limitations including increased patient burden and potential toxicity. Moreover, the redundancy between multiple signaling pathways concomitantly regulating MC activation can lead to insufficient MC suppression.OBJECTIVETo develop a novel therapeutic strategy using an aglycosylated anti-KIT monoclonal antibody, briquilimab, to deplete MCs via KIT signaling inhibition.METHODSInhibition of KIT by briquilimab was evaluated in vitro in KIT expressing cell lines and primary human MCs. Briquilimab safety, pharmacokinetics, and MC depletion were evaluated in non-human primates (NHPs).RESULTSBriquilimab potently blocks SCF ligand binding to KIT and inhibits SCF/KIT signaling and primary MC degranulation and survival, leading to MC apoptosis via PI3K/AKT pathway in vitro. Additionally, aglycosylation of briquilimab mitigates unwanted MC activation. In NHPs, single and multi-dose high, chronic exposure of briquilimab is well-tolerated with mild to moderate, but reversible adverse effects and effectively depletes various tissue MCs, such as lung, skin, and colon, in a dose-dependent manner.CONCLUSIONSBriquilimab effectively inhibits SCF/KIT signaling and induces MC apoptosis, leading to profound and durable MC depletion in NHPs, and may provide a safe and novel therapeutic option to treat MC-mediated diseases.","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"37 1","pages":""},"PeriodicalIF":14.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769754","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":"From a study on daily steps to new wearable device–driven asthma prevention strategies","authors":"Qinhan Liu BS ,&nbsp;Jun Li MM ,&nbsp;Yaling Li MD","doi":"10.1016/j.jaci.2025.04.029","DOIUrl":"10.1016/j.jaci.2025.04.029","url":null,"abstract":"","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"156 2","pages":"Page 483"},"PeriodicalIF":11.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103748","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":"Beyond wheeze: Early-life predictors of asthma development in children","authors":"Megan Elios MD,&nbsp;Sharmilee M. Nyenhuis MD, FAAAAI","doi":"10.1016/j.jaci.2025.06.006","DOIUrl":"10.1016/j.jaci.2025.06.006","url":null,"abstract":"","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"156 2","pages":"Pages 322-323"},"PeriodicalIF":11.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478647","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":"The crucial impact of NIH funding on allergy/immunology patient care and research","authors":"Nora A. Barrett MD ,&nbsp;Anna Nowak-Wegrzyn MD, PhD ,&nbsp;Leonard B. Bacharier MD ,&nbsp;Priya Bansal MD ,&nbsp;Lynda G. Kabbash MD ,&nbsp;Jordan S. Orange MD, PhD ,&nbsp;Paul V. Williams MD ,&nbsp;Frank S. Virant MD ,&nbsp;Carla M. Davis MD ,&nbsp;Rebecca Brandt CAE ,&nbsp;Thomas A. Fleisher MD ,&nbsp;American Academy of Allergy, Asthma & Immunology Scientific Community Task Force for Allergy/Immunology Research","doi":"10.1016/j.jaci.2025.06.003","DOIUrl":"10.1016/j.jaci.2025.06.003","url":null,"abstract":"","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"156 2","pages":"Pages 320-321"},"PeriodicalIF":11.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475324","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":"Complement and fungal diseases","authors":"Jigar V. Desai PhD ,&nbsp;Michail S. Lionakis MD, ScD","doi":"10.1016/j.jaci.2025.02.003","DOIUrl":"10.1016/j.jaci.2025.02.003","url":null,"abstract":"","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"156 2","pages":"Pages 302-304"},"PeriodicalIF":11.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433031","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":"Eosinophilic esophagitis: An allergy and immunology perspective on the updated guidelines","authors":"Emily C. McGowan MD, PhD ,&nbsp;Benjamin L. Wright MD ,&nbsp;Melanie A. Ruffner MD, PhD ,&nbsp;Robert D. Pesek MD ,&nbsp;Marc E. Rothenberg MD, PHD ,&nbsp;Jonathan M. Spergel MD, PhD ,&nbsp;Evan S. Dellon MD, MPH ,&nbsp;Seema S. Aceves MD, PhD","doi":"10.1016/j.jaci.2025.04.026","DOIUrl":"10.1016/j.jaci.2025.04.026","url":null,"abstract":"<div><div>In January 2025, the American College of Gastroenterology published updated guidelines on the diagnosis and management of eosinophilic esophagitis (EoE). These new guidelines incorporated updated information on the pathophysiology, risk factors, natural history, and treatment of EoE. These guidelines were primarily intended for practicing gastroenterologists; therefore, we summarize their key recommendations for the allergy and immunology community. In addition, as the prevalence and health care burden of EoE continues to increase, the population affected primarily comprises allergic individuals, and less invasive monitoring techniques are on the horizon, we discuss the key means by which allergists can contribute to the diagnosis and management of EoE. In particular, allergists can participate in screening for subtle EoE symptoms among their allergy patients, assist in optimizing the management of other allergic comorbidities, provide education about elimination diets, and facilitate the monitoring of disease over time. Allergists are uniquely poised to treat the entire allergic individual, rather than just the allergic esophagus, and should be prepared to co-manage these patients along with gastroenterologists.</div></div>","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"156 2","pages":"Pages 252-258"},"PeriodicalIF":11.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926381","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}