Journal of Asthma and Allergy最新文献

{"title":"Prognostic Predictors of Bronchial Thermoplasty for Symptom Control in Severe Asthma.","authors":"Jia Pan, Ming-Lu Zhong, Xiao-Yi Pan, Sha-Sha He, Ying-Bo Wu, Shi-Yue Li, Zhu-Quan Su","doi":"10.2147/JAA.S585639","DOIUrl":"https://doi.org/10.2147/JAA.S585639","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the clinical biomarkers that predict therapeutic response to bronchial thermoplasty (BT) in severe asthma.</p><p><strong>Patients and methods: </strong>We prospectively recruited patients with severe asthma who completed three sessions of bronchial thermoplasty. Baseline demographics, Asthma Control Questionnaire-5 (ACQ5) scores, eosinophil counts, fractional exhaled nitric oxide (FeNO), spirometry, impulse oscillometry (IOS), endobronchial optical coherence tomography (EB-OCT), and BT activation counts were recorded. All subjects were followed for two years and classified as responders or non-responders according to ACQ5 improvement ≥0.5 points.</p><p><strong>Results: </strong>Thirty patients were included (22 responders, 8 non-responders). Compared with non-responders, responders had lower body weight, BMI, and triglycerides, along with more negative X₅ values, higher RV/TLC ratios, greater Collagen Type III (COL3) expression, and larger airway luminal areas with thinner airway walls on EB-OCT. Receiver operating characteristic (ROC) analysis demonstrated that body weight (AUC = 0.759), BMI (AUC = 0.733), triglycerides (AUC = 0.694), X₅ (AUC = 0.938), RV/TLC (AUC = 0.756), COL3 (AUC = 0.846), and EB-OCT indices including airway luminal area from the 3^rd to 6^th generation (Ai3-6), 7^th to 9^th generation (Ai7-9), and airway wall area percentage from the 3^rd to 6^th generation (Aw%3-6) showed moderate-to-good discriminatory power (AUC range: 0.761-0.830). Multivariable logistic model integrating BMI, X₅, and Ai3-6 achieved better discrimination (AUC = 0.988) in predicting response to BT.</p><p><strong>Conclusion: </strong>More negative baseline X₅, lower triglyceride levels, EB-OCT-derived thinner airway walls and larger luminal areas, and higher COL3 expression, but not BT activation number, may help identify asthma patients most likely to benefit from BT and serve as potential predictors of its long-term efficacy.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"585639"},"PeriodicalIF":3.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stability of Type 2 Inflammation in a 12-Year Adult-Onset Asthma Follow-Up Study.","authors":"Ella Flinkman, Iida Vähätalo, Leena E Tuomisto, Lauri Lehtimäki, Onni Niemelä, Madeleine Rådinger, Bright I Nwaru, Selin Ercan, Mari Hämäläinen, Eeva Moilanen, Pinja Ilmarinen, Hannu Kankaanranta","doi":"10.2147/JAA.S582305","DOIUrl":"https://doi.org/10.2147/JAA.S582305","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the stability of T2 inflammation and clinical features associated with high or low T2 markers in adult-onset asthma.</p><p><strong>Patients and methods: </strong>Seinäjoki Adult Asthma Study is a 12-year follow-up study including 256 patients diagnosed with new-onset adult asthma. Patients were grouped according to T2 marker status at baseline when steroid-naïve and at the 12-year follow-up after long-term inhaled corticosteroid (ICS) treatment. High T2 markers were defined at diagnosis by ≥1 of the following: blood eosinophils ≥0.30×10⁹/L or positive SPT, and at follow-up by ≥1 of the following: blood eosinophils ≥0.30×10⁹/L, FeNO ≥25 ppb, or specific IgE ≥0.3 ISU.</p><p><strong>Results: </strong>At diagnosis, 109 patients (66.5%) had high and 55 (33.5%) low T2 markers. Low T2 marker patients were older, had higher BMI, and higher Airway Questionnaire 20 scores. High T2 marker patients had greater reversibility of forced expiratory volume in 1 second. At follow-up, baseline low T2 marker patients had more comorbidities, non-respiratory medications and lower Asthma Control Test scores. Of patients, 76% remained in the low T2 marker group and 24% transitioned to the high T2 marker group; those who transitioned had higher BMI. Sixty-eight percent remained in the high T2 marker group and 32% transitioned to the low T2 marker group; those who transitioned were older, had more comorbidities, and more non-respiratory medications. No significant differences were observed between patients who transitioned and those remaining stable regarding lung function, asthma severity, control, exacerbations, or ICS use.</p><p><strong>Conclusion: </strong>T2 high and low markers of adult-onset asthma are largely stable over time. However, differences in comorbidities, non-respiratory medication, age, and BMI distinguish the groups significantly.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"582305"},"PeriodicalIF":3.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Remission in Patients with Severe Eosinophilic Asthma - A Single-Arm Observational Study with Benralizumab.","authors":"Nikolay Pavlov, Pierre-Olivier Bridevaux, Peter Jandus, Florian Charbonnier, Claudio Schuoler, Philipp M Wörner, Jörg D Leuppi, Thomas Rothe, Daiana Stolz","doi":"10.2147/JAA.S590200","DOIUrl":"https://doi.org/10.2147/JAA.S590200","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate clinical remission rates and its individual components in patients with severe eosinophilic asthma treated with benralizumab, and to explore predictors of clinical remission using subgroup analyses by blood eosinophils, prior exacerbations, and previous biologic treatment.</p><p><strong>Patients and methods: </strong>Data from a prospective, observational, non-interventional study (BEEPS, NCT03907137) of patients with severe eosinophilic asthma (SEA) in Switzerland were analysed post-hoc. Benralizumab 30 mg was administered at weeks 0 (baseline), 4, and 8, followed by an 8-weekly regimen until week 56. Clinical remission was defined as meeting all four of the following criteria: Asthma Control Questionnaire (ACQ-5) scores < 1.5 or ≤ 0.75, no oral corticosteroid (OCS) use, no exacerbations, and a stable lung function. Patients were categorised into three pre-planned subgroups: (1) Blood eosinophils at baseline: 300-400 cells/μL and > 400 cells/μL; (2) exacerbations in the last 12 months: <4 and ≥4 exacerbations; (3) prior biologic treatment: naïve and experienced patients.</p><p><strong>Results: </strong>At baseline, no patients met all four criteria for clinical remission. After 56 weeks of benralizumab treatment, 58.1% of patients achieved all criteria when using ACQ-5 < 1.5, and 51.6% did so with ACQ-5 ≤ 0.75. Throughout the study, each individual remission criterion improved consistently over time. Across all subgroups, asthma symptoms and annualized exacerbation rates (AER) continuously decreased over the course of treatment.</p><p><strong>Conclusion: </strong>More than 50% of patients with SEA achieved clinical remission on treatment with benralizumab. Furthermore, benralizumab demonstrated consistent clinical efficacy across all patient subgroups, providing deeper insight into the characteristics and needs of these specific populations.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"590200"},"PeriodicalIF":3.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Gap Between Suspected Local Anesthetic Allergy and Formal Diagnostic Evaluation.","authors":"Maha B Alqahtani, Ghaliah Alqarni, Joud Alansari, Nouf Alotaibi, Naif S Sannan, Mohieldin Elsayid, Abdulrahman Althubaiti, Seham Khashwayn","doi":"10.2147/JAA.S599913","DOIUrl":"https://doi.org/10.2147/JAA.S599913","url":null,"abstract":"<p><strong>Background: </strong>Local anesthetics (LAs) are widely used, but true immune-mediated allergies are rare. Most adverse events are toxic or autonomic, yet patients are frequently mislabeled as allergic. This study aims to determine the prevalence of allergy evaluation and testing following suspected reactions to LAs.</p><p><strong>Methods: </strong>A cross-sectional retrospective study was conducted with a total of 126 patients. The study collected medical records from tertiary care hospitals in Saudi Arabia from 2016 to 2022, analyzing patients with reported allergic reactions to LA. The analysis included demographics, occurrences, medical procedure type, and allergy testing history.</p><p><strong>Results: </strong>Lidocaine was the most common agent, involved in over 90% of cases. Reactions primarily followed injections, with symptoms ranging from rash and itching to anaphylactic shock. Despite these events, only 10 patients (7.94%) were referred for further investigation. Allergy testing was performed in only three patients (2.38%). Among those tested, one was negative, while two tested positive (one for lidocaine and one for a lidocaine-bupivacaine combination).</p><p><strong>Conclusion: </strong>The study highlights a low prevalence of follow-up allergy testing despite reported adverse reactions. Systematic testing is essential to confirm or rule out true LA allergies, ensuring patient safety and identifying viable anesthetic alternatives for future procedures.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"599913"},"PeriodicalIF":3.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologic Underutilization and Healthcare Burden in US Patients with Type 2 Severe Asthma.","authors":"Jihye Park, Steven Gelwicks, Loretta A Jacques, David Muccino, Justin Kwiatek, Rafael Alfonso-Cristancho, Victoria S Benson","doi":"10.2147/JAA.S580937","DOIUrl":"https://doi.org/10.2147/JAA.S580937","url":null,"abstract":"<p><strong>Background: </strong>Detailed real-world evidence on the unmet needs and economic burden of patients with type 2 severe asthma, particularly in the biologic therapy era, remains limited.</p><p><strong>Purpose: </strong>To characterize unmet treatment needs and economic burden in patients with type 2 severe asthma and a history of frequent exacerbations who could benefit from biologic therapy.</p><p><strong>Patients and methods: </strong>This retrospective cohort study used healthcare claims data from the US Optum's de-identified Clinformatics^® Data Mart database (January 1, 2018-December 31, 2021). Patients with type 2 severe asthma were included if they received Global Initiative for Asthma (GINA) step 4 (GINA 4)/5 treatment, experienced ≥2 exacerbations, and had a blood eosinophil count ≥150 cells/μL in the baseline period (ie. 12 months prior to the index date [study entry]). Analyses were descriptive.</p><p><strong>Results: </strong>Overall, 2827 patients met the study definition for type 2 severe asthma (GINA 4: n=1513; GINA 5: n=1314), with 11.9% of patients (GINA 4: 5.2%; GINA 5: 19.6%) receiving biologics at baseline. Systemic/oral steroid-defined exacerbations were most common at baseline and follow-up across GINA steps. Overall, similar proportions of patients at GINA 4 and 5 (71.6% and 70.5%, respectively) experienced ≥1 exacerbation during the follow-up period. The mean (SD) total number of exacerbations was 1.6 (1.8) at GINA 4 versus 1.7 (1.9) at GINA 5. Mean (SD) steroid-defined exacerbations were 1.3 (1.5) versus 1.4 (1.6), emergency-department (ED)-defined exacerbations were 0.2 (0.9) versus 0.2 (0.8), and hospitalization-defined exacerbations were 0.04 (0.3) and 0.06 (0.3) in the respective treatment groups. Patients at GINA step 5 receiving biologic therapies at baseline had lower asthma-related inpatient admissions costs versus those not receiving biologic therapies.</p><p><strong>Conclusion: </strong>Patients with type 2 severe asthma at GINA steps 4/5 experience similar disease burden. These findings highlight a potential unmet need for earlier phenotypic assessment in this population.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"580937"},"PeriodicalIF":3.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Knowledge, Attitudes, and Practices Towards Atopic Dermatitis Among Parents of Children with Atopic Dermatitis: A Cross-Sectional Study [Corrigendum].","authors":"","doi":"10.2147/JAA.S616879","DOIUrl":"https://doi.org/10.2147/JAA.S616879","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2147/JAA.S571448.].</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"616879"},"PeriodicalIF":3.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aeroallergen Sensitization and Its Changes in Adult Asthmatics Managed by Primary Care in the Western Yokohama, Japan.","authors":"Junko Ueno, Takahiro Tsuburai, Yuko Komase, Aya Matsushima, Satoshi Tanaka, Hiromi Muraoka, Shotaro Kaneko, Masamichi Mineshita, Takeo Inoue, Hiroki Nishine","doi":"10.2147/JAA.S581305","DOIUrl":"https://doi.org/10.2147/JAA.S581305","url":null,"abstract":"<p><strong>Background: </strong>Knowledge of aeroallergen sensitizations is important for environmental adjustment in asthma management. We investigated the allergen sensitization status of adult asthmatics managed by primary care physicians.</p><p><strong>Methods: </strong>We recruited 119 patients who measured \"IgE-CAP16 allergic asthma (LSI medience)\" three times in 2 years from patients who visited St. Marianna University Yokohama Seibu Hospital, between January 2009 and May 2018, and managed by primary care physicians.</p><p><strong>Results: </strong>Sensitization rates (IgE Class ≧ 1) were high for house dust (33.6%), Japanese cedar (54.6%), mite (34.4%), and moth (24.3%) at baseline. Frequent associations were found at baseline between house dust and mite and, between Japanese cedar and cypress, as well as among insects and among fungi. Cluster analysis classified the IgE responses into seven categories. Allergens for which 10% of subjects changed to Class ≧1 over the 2 years were house dust (20.1%), mite (12.6%), Japanese cedar (31.1%), cypress (24.3%), ragweed (10.9%), moth (18.5%), <i>Candida</i> (21.8%), and <i>Aspergillus</i> (16.8%). Thirty-five subjects (29.4%) had no changes in any sensitization levels. Allergens with a correlation coefficient (<i>R</i>) of ≧0.3 between Δspecific IgE and Δtotal IgE were with ΔIgE were Δ<i>Alternaria</i> (0.366), Δmoth (0.307), and Δalder (0.302). The degree of asthma control was not associated with changes in the ImmunoCAP IgE class.</p><p><strong>Conclusion: </strong>Aeroallergens were classified into seven clusters. Even in stable asthma managed by primary care physicians, allergen sensitization can change, so that these changes should be checked over time.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"581305"},"PeriodicalIF":3.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13098552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardizing a Four-Marker Basophil Activation Test: Influence of Storage Time, Temperature, and IgE Levels.","authors":"WeiZe Li, XuanYue Qu, LiHui Lin, Juan Wang, Jia Li, Yue Yin, YiQin Ge, JinYan Zhao, Yi Liu, Li Li, Xia Peng","doi":"10.2147/JAA.S577679","DOIUrl":"https://doi.org/10.2147/JAA.S577679","url":null,"abstract":"<p><strong>Background: </strong>Allergic diseases affect 25% of the global population, yet current diagnostics like specific IgE (sIgE) and skin prick tests lack specificity. The basophil activation test (BAT) offers high specificity but requires methodological standardization.</p><p><strong>Objective: </strong>This study develops gating strategies and pre-analytical storage conditions to develop an analytically validated BAT protocol for <i>Dermatophagoides farinae</i> (Df) allergy.</p><p><strong>Methods: </strong>Seventy-nine adults (Df-sensitized and controls) were enrolled. Basophil activation was assessed by CD63 expression following <i>Df</i> extract, anti-IgE, or fMLP stimulation. Evaluations included gating strategies, correlations with serological markers, and storage stability.</p><p><strong>Results: </strong>The three-marker gating strategy (CD123⁺CD203c⁺CD45⁺SSC^low) achieved analytical equivalence to a four-marker gating approach with 25% cost reduction, and improved phenotypic purity over a two-marker method (97.2% vs. 91.8% HLA-DR negativity). Df-induced BAT results correlated moderately with <i>Df</i> sIgE (r=0.4352) and membrane-bound IgE (mIgE) (r=0.6264-0.6659) (r²<0.4), leaving >60% of variability unexplained. Quantitatively, CD63 MFI declined significantly with storage. Qualitatively, storage at 2-8°C better preserved <i>Df</i> responsiveness up to 48-52 h, while room temperature (RT) was superior for fMLP.</p><p><strong>Conclusion: </strong>This study demonstrates that a three-marker gating strategy within a four-color BAT panel reduces costs while maintaining analytical equivalence to a four-marker gating reference. Stimulus-specific storage patterns support flexible processing for research applications, and BAT outcomes provide complementary functional information beyond IgE levels. Clinical utility requires prospective validation.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"577679"},"PeriodicalIF":3.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clonal Mast Cell Disorders and Mutation Profile in Adults Initially Presenting with Mast Cell Activation (Anaphylaxis) versus Non-Anaphylactic Presentations: A Joint Allergy-Hematology Cohort.","authors":"Patchara Pornsuthirat, Weerapat Owattanapanich, Chamard Wongsa, Torpong Thongngarm, Mongkhon Sompornrattanaphan","doi":"10.2147/JAA.S594281","DOIUrl":"https://doi.org/10.2147/JAA.S594281","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the diagnostic yield, clinical, and molecular features of clonal mast cell disorders (CMCDs) in adults presenting with mast cell activation (MCA)/anaphylaxis versus non-anaphylactic phenotypes in a joint Allergy-Hematology cohort.</p><p><strong>Patients and methods: </strong>In this single-center retrospective study, we reviewed clinician-selected adults (≥18 years) evaluated at a Thai tertiary center (2019-2024) who completed joint Allergy-Hematology evaluation and targeted 66-gene myeloid next-generation sequencing (NGS). Index presentations were classified as MCA/anaphylaxis versus non-MCA. Final diagnoses followed WHO 5th/International Consensus Classification criteria.</p><p><strong>Results: </strong>Of 24 sequenced adults, 14 (58.3%) had MCA/anaphylaxis and 10 (41.7%) had non-MCA presentations. Among sequenced MCA/anaphylaxis presentations, final diagnoses included idiopathic anaphylaxis (IA, n=11), secondary anaphylaxis (n=2), and systemic mastocytosis (SM, n=1). Conversely, all 10 non-MCA cases had CMCD (SM 6, cutaneous mastocytosis 4). Compared to non-mastocytosis cases, mastocytosis patients were older, predominantly male, with higher basal tryptase (median 22.4 vs 3.2 ng/mL). Pathogenic variants occurred in 12/24 (50%) patients: <i>KIT</i> D816V in 6/24 (25%), with heterogeneous <i>TET2</i> co-mutations, <i>DNMT3A</i> R882H, and <i>SRSF2</i> P95 hotspots clustering in SM. IA rarely harbored driver mutations.</p><p><strong>Conclusion: </strong>CMCD showed a low diagnostic yield (1/14, 7.1%) in the clinician-selected MCA/anaphylaxis subgroup escalated to marrow/NGS, but was universal in the hematologic non-MCA subset (10/10, 100%). These findings suggest that REMA-based, risk-stratified selection may be useful in this setting, but larger prospective studies are needed. While <i>TET2</i> was the most frequently mutated gene overall, the mutational profile within the SM subgroup-characterized by <i>KIT</i> D816V and frequent <i>TET2, DNMT3A</i>, and <i>SRSF2</i> co-mutations-parallels established molecular signatures in Western systemic mastocytosis cohorts, suggesting <i>KIT</i>-targeted therapies are biologically applicable in Thai patients.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"594281"},"PeriodicalIF":3.0,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchial Hyperreactivity in the COVID-19 Era: The Impact of SARS-CoV-2 Infection and COVID-19 Vaccination in Patients with Respiratory Symptoms.","authors":"Mei-Chen Yang, Chung Lee, Lun-Yu Jao, Chun-Yao Huang, Yao-Kuang Wu, Kuo-Liang Huang, Wen-Lin Su, I-Shiang Tzeng, Chou-Chin Lan","doi":"10.2147/JAA.S589394","DOIUrl":"https://doi.org/10.2147/JAA.S589394","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent respiratory symptoms are commonly reported following coronavirus disease 2019 (COVID-19). Although COVID-19 vaccines are effective, concerns remain regarding their potential impact on airway hypersensitivity. The relationship between SARS-CoV-2 infection, vaccination, and bronchial hyperresponsiveness remains unclear.</p><p><strong>Materials and methods: </strong>This retrospective study included adults aged ≥18 years who underwent methacholine provocation testing. Participants were categorized into four groups according to their history of SARS-CoV-2 infection and COVID-19 vaccination: no infection/no vaccination (NI-NV), vaccination/no infection (V-NI), no vaccination/infection (NV-I), and vaccination/infection (V-I). Airway hypersensitivity was defined as a ≥20% reduction in forced expiratory volume in one second (FEV1) following methacholine challenge. Multivariable logistic regression analysis was performed to evaluate independent associations.</p><p><strong>Results: </strong>A total of 340 participants were included (NI-NV: n=36; V-NI: n=163; NV-I: n=25; V-I: n=116). No significant differences were observed in methacholine positivity, pulmonary function parameters, or PC20 values across groups (all p>0.05). In multivariable analysis, neither prior infection (adjusted OR 0.99, 95% CI 0.63-1.55) nor vaccination (adjusted OR 1.06, 95% CI 0.60-1.88) was independently associated with bronchial hyperresponsiveness. Smoking was significantly associated with methacholine positivity (adjusted OR 3.33, 95% CI 1.43-7.77). Symptom severity differed among groups, with higher cough and sputum scores in the NI-NV group and greater dyspnea severity in the NV-I group.</p><p><strong>Conclusion: </strong>Neither prior SARS-CoV-2 infection nor COVID-19 vaccination was associated with increased airway hypersensitivity after adjustment for confounders. Despite similar objective airway responsiveness, symptom severity varied across groups, suggesting a dissociation between subjective respiratory symptoms and measurable bronchial hyperresponsiveness.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"589394"},"PeriodicalIF":3.0,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}