Journal of Allergy and Clinical Immunology最新文献

{"title":"CB2R-cAMP-Epac1 Pathway Orchestrates Epithelial-Neural-Immune Interactions in Atopic Dermatitis.","authors":"Ximin Hu,Yi Luo,Yiya Zhang,Kun Liu,Liyan Wu,Jinjun Hou,Guodun Zhao,Ting Wang,Yifei Liu,Hongyi Cheng,Xia Li,Lei Zhang,Libei Liu,Wanying Wu,Ronghua Yang,Xinyan Gao,Ji Li,Heng Xu,Jing Feng","doi":"10.1016/j.jaci.2025.08.021","DOIUrl":"https://doi.org/10.1016/j.jaci.2025.08.021","url":null,"abstract":"BACKGROUNDKeratinocytes form the skin's first line of defense, not only serving as a physical barrier but also actively communicating with immune cells and sensory neurons.OBJECTIVETo elucidate the molecular mechanisms by which keratinocytes contribute to barrier dysfunction and neuroimmune activation in atopic dermatitis (AD).METHODSCB2R expression was assessed by RNA-seq, qRT-PCR, RNAscope fluorescence, and western blot. Pharmacological activation/inhibition or keratinocyte-specific deletion of CB2R was used to determine its role in AD-associated itch and inflammation. Behavioral assays, immunofluorescence, and qRT-PCR were employed to identify downstream signaling components.RESULTSCB2R expression was upregulated in the epidermis of MC903-induced AD. CB2R activation alleviated scratching and skin pathology, whereas keratinocyte-specific CB2R deletion exacerbated both. CB2R suppressed adenylate cyclase 3 (ADCY3) activity, reducing cAMP levels and downstream Epac1 activation, thereby limiting IL-33 production. This CB2R-cAMP-Epac1-IL-33 axis regulated epidermal hyperplasia, dermal neutrophil infiltration, and chronic itch.CONCLUSIONThe keratinocyte CB2R-cAMP-Epac1 axis integrates epithelial, neural, and immune signaling to drive AD pathology, representing a potential therapeutic target for chronic itch and skin inflammation.","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"46 1","pages":""},"PeriodicalIF":14.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031963","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":"Artificial Intelligence in allergy and immunology: recent developments, implementation challenges, and the road towards clinical impact.","authors":"Merlijn van Breugel,Matt Greenhawt,Ibon Eguiluz-Gracia,Maria Jose Torres Jaen,Aikaterini Anagnostou,Gerard H Koppelman","doi":"10.1016/j.jaci.2025.08.022","DOIUrl":"https://doi.org/10.1016/j.jaci.2025.08.022","url":null,"abstract":"Artificial intelligence (AI) is increasingly recognized for its capacity to transform medicine. While publications applying AI in allergy and immunology have increased, clinical implementation substantially lags behind other specialties. By mid-2024, over 1,000 FDA-approved AI-enabled medical devices existed, but none specifically addressed allergy and immunology. This gap partly reflects our field's limited reliance on imaging, which facilitated early AI breakthroughs in radiology and pathology. This narrative review examines recent AI developments, including Large Language Models (LLMs) and AI agents, evaluating their applicability to allergy and immunology practice. We analyze current and potential applications, emphasizing those demonstrating clinical value, while identifying implementation barriers amplified by allergic diseases' unique complexities, including data privacy concerns, bias, reliability constraints, and evolving regulatory frameworks. To bridge the persistent research-to-implementation gap, we propose a 6-point roadmap: (1) prioritize impactful applications, (2) define clinically relevant benchmarks, (3) enforce rigorous governance, (4) transition to operationalization, (5) promote clinical adoption through trustworthy AI, and (6) establish lifecycle management. This roadmap builds upon established implementation frameworks while incorporating critical field-specific considerations unique to allergy and immunology. Through this approach, we aim to provide a perspective for advancing AI in allergy and immunology from academic promise to tangible clinical benefit.","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"11 1","pages":""},"PeriodicalIF":14.2,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025511","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":"Anifrolumab treatment of Singleton-Merten syndrome 2 due to a novel RIGI variant.","authors":"Evan E Hsu,Courtney E LeSon,Michael T Lam,Seigo Okada,Jian Yue,Casey A Rimland,Rachel Weng,Qing Zhou,Tal Geva,Amy E Roberts,Charmaine Ilagan,Chrystalle Katte Carreon,Mary Beth F Son,Pui Y Lee","doi":"10.1016/j.jaci.2025.08.001","DOIUrl":"https://doi.org/10.1016/j.jaci.2025.08.001","url":null,"abstract":"","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"25 1","pages":""},"PeriodicalIF":14.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003196","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":"Corrigendum.","authors":"","doi":"10.1016/j.jaci.2025.08.008","DOIUrl":"https://doi.org/10.1016/j.jaci.2025.08.008","url":null,"abstract":"","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":11.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992488","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":"Artificial Intelligence in the Detection and Management of Eosinophilic Gastrointestinal Diseases: Applications, Challenges, and Future Outlook.","authors":"Corey J Ketchem,Stanislaw J Gabryszewski,Marc E Rothenberg","doi":"10.1016/j.jaci.2025.08.020","DOIUrl":"https://doi.org/10.1016/j.jaci.2025.08.020","url":null,"abstract":"","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"26 1","pages":""},"PeriodicalIF":14.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007128","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":"Targeting the Common Pathway: IL-4/IL-13 Blockade Across the Spectrum of Primary Atopic Disorders.","authors":"David P Hoytema van Konijnenburg,Craig D Platt","doi":"10.1016/j.jaci.2025.08.019","DOIUrl":"https://doi.org/10.1016/j.jaci.2025.08.019","url":null,"abstract":"","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"189 2-3 1","pages":""},"PeriodicalIF":14.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002803","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 preschool wheeze trajectories are predominantly non-allergic with distinct biologic and microbiome traits.","authors":"Zihang Lu,Charisse Petersen,Ruixue Dai,Myrtha E Reyna,Mojtaba Ahmadiankalati,Erika Sifuentes,Darlene L Y Dai,Courtney Hoskinson,Kate L Del Bel,Kozeta Miliku,Theo J Moraes,Piush J Mandhane,Allan B Becker,Meghan B Azad,Elinor Simons,Wendy Lou,Amirthagowri Ambalavanan,Qingling Duan,Stuart E Turvey,Padmaja Subbarao","doi":"10.1016/j.jaci.2025.07.034","DOIUrl":"https://doi.org/10.1016/j.jaci.2025.07.034","url":null,"abstract":"BACKGROUNDDisentangling preschool wheezing heterogeneity in terms of clinical traits, temporal patterns, and collective healthcare burden is critical for precise and effective interventions.OBJECTIVEWe aimed to collectively define contributions and distinct characteristics of respiratory phenotypes based on longitudinal wheeze and atopic sensitization patterns in the first 5 years of life.METHODSGroup-based trajectory analysis was performed in the CHILD Cohort study to identify distinct wheeze and allergic sensitization trajectories. Trajectories were evaluated for associated risk factors, healthcare utilization, biological determinants, and clinical outcomes. Stool samples for shotgun metagenomic sequencing profiles from infant microbiomes collected at 3-months and 1-year were assessed for phenotype-specific biomarkers.RESULTSSix distinct respiratory phenotypes were identified from 2902 children that differed by temporal wheeze and allergic sensitization patterns. While allergic wheeze phenotypes (11·6% of participants) carried the highest asthma diagnosis risk, the more common non-allergic phenotypes (88·3% of participants) contributed to the majority of 5-year asthma diagnoses (61·4% of diagnoses). Most importantly, non-allergic phenotypes accounted for over 2/3 of healthcare utilization in this age group. Phenotypes differed by lung function, blood eosinophils, allergic comorbidities and weight-for-age z-score. Moreover, microbiome profiles from 1439 infants revealed largely non-overlapping microbial signatures at 1 year were associated with each phenotype.CONCLUSIONWe identified novel early childhood respiratory phenotypes to disentangle non-overlapping paths to preschool wheezing. Our findings highlight the continued clinical relevance of non-atopic wheeze phenotypes, which remain undertreated despite accounting for a substantial proportion of healthcare utilization and asthma diagnoses.","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"25 1","pages":""},"PeriodicalIF":14.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002802","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":"News beyond our pages","authors":"","doi":"10.1016/j.jaci.2025.07.008","DOIUrl":"10.1016/j.jaci.2025.07.008","url":null,"abstract":"","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"156 3","pages":"Pages 595-596"},"PeriodicalIF":11.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989400","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":"Brief Overview of This Month's JACI","authors":"","doi":"10.1016/S0091-6749(25)00810-3","DOIUrl":"10.1016/S0091-6749(25)00810-3","url":null,"abstract":"","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"156 3","pages":"Pages A1-A2"},"PeriodicalIF":11.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989402","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 drug allergy history tool (DAHT): Validation of a patient-reported survey instrument","authors":"Kimberly G. Blumenthal MD, MSc ,&nbsp;Daniel A. Gundersen PhD ,&nbsp;Liam R. Smith BS ,&nbsp;Brett Nava-Coulter MA ,&nbsp;Andrew King MS ,&nbsp;Elizabeth J. Phillips MD ,&nbsp;Alexei Gonzalez-Estrada MD ,&nbsp;Iris M. Otani MD ,&nbsp;Allison Ramsey MD ,&nbsp;Aleena Banerji MD ,&nbsp;Timothy G. Chow MD ,&nbsp;Cosby A. Stone Jr. MD, MPH ,&nbsp;Whitney A. Salinas MD ,&nbsp;David A. Khan MD","doi":"10.1016/j.jaci.2025.02.027","DOIUrl":"10.1016/j.jaci.2025.02.027","url":null,"abstract":"<div><h3>Background</h3><div>While the reaction history is critical for drug allergy<span> evaluations and is typically self-reported, there is no validated survey instrument to collect drug allergy history from patients.</span></div></div><div><h3>Objective</h3><div>We validated a survey instrument that collects patient-reported drug allergy history.</div></div><div><h3>Methods</h3><div>The drug allergy history tool (DAHT) was revised after 3 rounds of cognitive testing, assessed for reliability through test–retest comparisons, and assessed for quality and validity through a concordance analysis against electronic health record<span> allergist documentation. Participants completing testing and surveys had 1 or more drug allergies and were recruited from allergy clinics at Massachusetts General Hospital. Primary evaluative measures were percentage agreement and kappa statistic values.</span></div></div><div><h3>Results</h3><div><span>The DAHT was completed by 79 individuals (mean age, 49 [SD 17] years, 85% female, 85% White, 11% Hispanic ethnicity), 29 with single drug allergy labels and 50 with multiple drug allergy labels. The most common drug allergy labels were penicillins (77%), </span>sulfonamides<span> (32%), cephalosporins<span> (15%), and nonsteroidal anti-inflammatory drugs (8%). The DAHT achieved acceptable test–retest reliability (median κ = 0.64, median agreement = 86%). The DAHT achieved a more complete allergy history than allergist documentation in the electronic health record, with lower median item uncertainty (21% DAHT vs 79% electronic health record) with fair concordance (median κ = 0.21, median agreement = 67%) between the two data sources.</span></span></div></div><div><h3>Conclusion</h3><div>The DAHT is a reliable and valid source of patient-reported drug allergy information. This tool can be used in clinical care and clinical research to obtain standardized patient-reported drug allergy history.</div></div>","PeriodicalId":14936,"journal":{"name":"Journal of Allergy and Clinical Immunology","volume":"156 3","pages":"Pages 734-742"},"PeriodicalIF":11.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572974","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}