Journal of Asthma and Allergy最新文献

{"title":"Assessment of Bronchodilator Responsiveness and Spirometric Patterns in Patients with Rhinitis and Suspected Asthma.","authors":"Zhouxian Pan, Xinyu Liu, Xin Li, Kai Guan, Jia Yin","doi":"10.2147/JAA.S589700","DOIUrl":"10.2147/JAA.S589700","url":null,"abstract":"<p><strong>Background: </strong>Bronchodilation testing (BDT) is routinely used to assess reversibility of airflow limitation. For patients with rhinitis who report asthma-related symptoms but often show preserved spirometry, the clinical patterns associated with bronchodilator responsiveness (BDR) are less clearly described. Understanding these patterns may help clinicians interpret lung function in real-world practice.</p><p><strong>Methods: </strong>We retrospectively analyzed 555 consecutive patients who underwent spirometry and BDT at a single tertiary allergy center. Data on clinical symptoms, allergic status, type-2 inflammatory markers, baseline spirometry results, and BDT outcomes were collected. Associations between symptoms, spirometric indices, and BDR were evaluated. Exploratory analyses examined the relationship between FEV₁ improvements below the conventional ≥12% criterion and asthma-related symptoms.</p><p><strong>Results: </strong>Among all participants, 71.9% had allergic rhinitis, and 88.6% reported asthma-related symptoms. BDR was observed across a wide range of baseline spirometry values; 47.2% of BDT-positive patients had FEV₁ ≥80% predicted. Small airway indices, especially FEF₅ ₀ % predicted, were strongly associated with BDR. Wheezing and chest tightness demonstrated clearer physiological correlations than coughing alone did. FEV₁ improvements slightly below the conventional ≥12% bronchodilator threshold were also associated with asthma-related symptoms, although these findings were exploratory and not intended as diagnostic criteria.</p><p><strong>Conclusion: </strong>In patients with rhinitis and suspected asthma, airflow variability may be present even when FEV₁ appears preserved. Small-airway parameters and symptom profiles offer a useful context for interpreting BDT results. Modest FEV₁ changes may be clinically relevant and warrant further prospective study. These findings may help clinicians judge when bronchodilation testing is informative during the routine evaluation of suspected airway disease.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"589700"},"PeriodicalIF":3.0,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723027","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":"Integrated Bioinformatics and Experimental Validation of Inflammatory Cytokine-Related Hub Genes in Pediatric Asthma.","authors":"Mi Mi Gao, Xue Wang, Li Yin, Xiao Ying Wei, Fang Li","doi":"10.2147/JAA.S577209","DOIUrl":"https://doi.org/10.2147/JAA.S577209","url":null,"abstract":"<p><strong>Background: </strong>Although pediatric asthma is closely associated with dysregulated inflammatory cytokines, integrated analyses of inflammatory cytokine-related genes and their potential diagnostic biomarkers remain limited.</p><p><strong>Methods: </strong>Gene expression datasets GSE106230 and GSE117038, containing peripheral blood samples from pediatric asthma patients and healthy pediatric controls, were used as training sets, and GSE195599 served as the validation set. Differentially expressed genes (DEGs) were identified between pediatric asthma and healthy pediatric control samples. Weighted gene co-expression network analysis (WGCNA) was performed to identify asthma-related module genes. Characteristic genes were obtained by intersecting DEGs, module genes, and inflammatory cytokine-related genes. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were conducted. Candidate hub genes were identified through protein-protein interaction (PPI) network analysis. Gene Set Enrichment Analysis (GSEA) and immune cell infiltration analysis were further performed to explore potential mechanisms involved in asthma.</p><p><strong>Results: </strong>A total of 12 characteristic genes were identified by intersecting 213 DEGs, 1,058 WGCNA module genes, and 2,001 inflammatory cytokine-related genes, with significant enrichment in the respiratory burst pathway. Among these, CD19, RELB, IL12RB1, and RETN were prioritized as candidate hub genes. GSEA suggested enrichment of herpes simplex virus 1 infection-related gene sets, although these signals likely reflect shared host-response pathways rather than evidence of actual HSV-1 infection. A nomogram based on these four genes showed favorable predictive performance for asthma, with an area under the curve (AUC) exceeding 0.8. Transcription factor (TF)-mRNA network analysis indicated that IL12RB1 was potentially regulated by the largest number of TFs, including REST. In silico compound screening and molecular docking analysis suggested potential interactions between CD19 and bisphenol A, RELB and tetrachlorodibenzodioxin, IL12RB1 and benzo(a)pyrene, and RETN and tretinoin. Additionally, three differential immune cell subtypes were identified. Significant correlations were observed between CD19 and activated B cells, as well as between CD19 and type 1 T helper cells, in both pediatric asthma and healthy control samples. In validation analyses, CD19, RELB, and IL12RB1 showed increased expression in asthma, whereas RETN showed less consistent results.</p><p><strong>Conclusion: </strong>This study identified four candidate inflammatory cytokine-related genes associated with pediatric asthma and provided an integrated transcriptomic framework for their prioritization. These findings provide preliminary insights into asthma-related immune dysregulation and warrant further validation in larger pediatric cohorts and functional studies.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"577209"},"PeriodicalIF":3.0,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13069966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673567","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":"Real-World Response to Dupilumab as Add-on Therapy in Adults and Adolescents with Type 2 Severe Asthma: A Spanish Cohort Study.","authors":"Ana Montoro Ferrer, María Del Mar Moro Moro, Fernando Miguel Parra Borreguero, Alvaro Moreno-Ancillo, Alba María Extremera Ortega, Pedro Angel Galindo-Bonilla, Mar Jiménez Lara, José Manuel Bravo Nieto, Marta Jiménez Arroyo, José Alejandro Lemus Calderón, María José Espinosa de Los Monteros Garde","doi":"10.2147/JAA.S582686","DOIUrl":"https://doi.org/10.2147/JAA.S582686","url":null,"abstract":"<p><strong>Background: </strong>Dupilumab has demonstrated efficacy in type 2 severe asthma in clinical trials. Real-world data, particularly from Spain and including patients with prior biologic failure, remains limited. This study evaluated the effectiveness and safety of dupilumab in a Spanish cohort with type 2 severe asthma over 12 months.</p><p><strong>Methods: </strong>Retrospective, multicenter observational study in adult and adolescent patients (≥12 years) with type 2 severe asthma treated with dupilumab for at least six months. Clinical data, including exacerbations, lung function (FEV₁), Asthma Control Test (ACT), quality of life (Mini-AQLQ), systemic corticosteroid use, and biomarkers (total IgE, eosinophil count, FeNO), were collected at baseline, 6, and 12 months. The EXACTO scale was used to assess response in non-oral corticosteroid (OCS)-dependent patients at 12 months. Subgroup analyses included chronic rhinosinusitis with nasal polyps (CRSwNP) and OCS-dependent patients at baseline.</p><p><strong>Results: </strong>A total of 156 patients were included; 54.5% had received prior biologic therapies. Significant improvements (p<0.005) from baseline to 12 months were observed in exacerbations (1.43 to 0.20 per year), FEV₁ (2530.10 to 2824.59 mL), ACT (15.84 to 21.31), and Mini-AQLQ (27.24 to 74.27). Total IgE and FeNO significantly decreased whereas blood eosinophilia increased. In non-OCS-dependent patients (n=78), 56.4% were good or super-responders according to the EXACTO scale. CRSwNP patients (n=66) significantly improved in asthma and nasal symptoms. Among OCS-dependent patients (n=35), 68.6% discontinued OCS by 6 months. Comparable clinical improvements in exacerbation rates, lung function and overall response were observed in biologic-naïve and biologic-pretreated patients, consistent with similar EXACTO scores (4.92 ± 1.29 vs. 4.55 ± 1.37, respectively; <i>p</i>=0.166). No new safety signals were identified.</p><p><strong>Conclusion: </strong>This Spanish real-world study confirms sustained effectiveness and acceptable safety of dupilumab in type 2 severe asthma, including patients with prior biologic failure and comorbid CRSwNP, supporting its use in routine clinical practice.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"582686"},"PeriodicalIF":3.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13055851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638997","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":"Differential Metabolites Before and After Allergen Specific Immunotherapy in Children with Allergic Asthma.","authors":"Yinyan Yue, Menghong Sang, Shuyan Zhang, Shengang Hu, Yinan Zhang, Suqin Zhang","doi":"10.2147/JAA.S578876","DOIUrl":"https://doi.org/10.2147/JAA.S578876","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Asthma is the most common chronic respiratory disease in children. Although conventional treatments such as inhaled corticosteroids and long-acting β2-receptor agonists can effectively control symptoms, some children still face the problem of frequent attacks and drug side effects. As a potential etiological treatment, allergen-specific immunotherapy (AIT) aims to induce immune tolerance by gradually increasing exposure to specific allergens, thereby relieving asthma symptoms in the long term. This study aimed to investigate the differential metabolites in children with allergic asthma before and after subcutaneous allergen-specific immunotherapy (SCIT) using a non-targeted metabolomics approach, to gain deeper insight into the potential mechanisms of AIT and its systemic effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 30 children were enrolled, including 15 healthy controls and 15 children with asthma (prior to AIT and after one year of AIT). Serum samples were analyzed using LC-MS to identify differential metabolites and their associated metabolic pathways.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;AIT could reverse the lung function of patients with allergic asthma. There were six pathways that had difference among the control group, pre-AIT group and post-AIT group. These six pathways were the PPAR signaling pathway (impact = 0.6000), the GABAergic synapse (impact =0.5882), the alanine, aspartate and glutamate metabolism (impact =0.4290), the central carbon metabolism in cancer (impact =0.3019), the arginine biosynthesis (impact =0.2956) and the linoleic acid metabolism (impact =0.2368). There were 24 metabolites that had difference among these three groups. During them, there were 5 metabolites (9,12,13-TriHOME; 9,10-Epoxyoctadecenoic acid; Isocitrate; L-Arginine; Succinic acid semialdehyde) of the pre-AIT patients reversed by AIT compared to the control group. The levels of the 5 metabolites were increased of the pre-AIT compared to the control group. After one year of usage of AIT, the levels of the 5 metabolites were decreased. Comparing of the pre-AIT group and post-AIT group revealed additional pathways: the intestinal immune network for IgA production (impact = 0.5) and aldosterone-regulated sodium reabsorption (impact = 0.4). Key metabolites included all-trans-retinoic acid, cortisol, and cortisone.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study demonstrates for the first time the impact of one-year AIT on the metabolic profile of children with allergic asthma receiving long-term inhaled glucocorticoid therapy. Children with asthma mainly exhibited six pathways which including 24 metabolites disturbances compared to healthy peers, 5 of which were reversed following AIT. AIT may synergistically enhance the therapeutic effects of glucocorticoids while also introducing novel regulatory mechanisms. The persistence of these metabolic changes over a one-year period supports their validity as stable therapeutic outco","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"578876"},"PeriodicalIF":3.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13055859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639008","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":"Knowledge, Attitudes, and Practices Towards Atopic Dermatitis Among Parents of Children with Atopic Dermatitis: A Cross-Sectional Study.","authors":"Huiwen Zheng, Chen Shen, Dan Xu, Chai Ji, Jia Feng, Sha Zhou, Yin Li","doi":"10.2147/JAA.S571448","DOIUrl":"10.2147/JAA.S571448","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD) is a common chronic inflammatory skin disease in childhood that imposes substantial physical and psychosocial burdens on children and their families. However, limited evidence is available regarding parents' knowledge, attitudes, and practices (KAP) toward AD management. This study aimed to investigate the KAP towards AD among parents of children with AD.</p><p><strong>Methods: </strong>A web-based, cross-sectional study was conducted at a tertiary children's hospital in China between 17/01/2023 and 30/08/2023. Parents of children diagnosed with AD completed a self-administered questionnaire covering demographics and KAP-related domains. Of 451 valid responses, data were analyzed using descriptive statistics, correlation analysis, and structural equation modeling to examine KAP associations and influencing factors.</p><p><strong>Results: </strong>Among participants, 364 respondents (80.71%) were women, and 357 (79.16%) of parents had a history of allergic diseases. The mean knowledge, attitude, and practice scores were 12.29±5.67 (possible range: 0-24), 30.70±3.33 (possible range: 9-45), and 57.02±8.31 (possible range: 14-70), respectively. Correlation analysis revealed positive associations between knowledge and practices (r = 0.328, P < 0.001) and between attitudes and practices (r = 0.175, P < 0.001). Structural equation modeling results indicated that higher education level, higher monthly per capita income, and longer time since the child's diagnosis were positively associated with better knowledge. The number of children in the household was negatively associated with attitudes. Better knowledge, more positive attitudes, higher income, and fewer children in the household were positively associated with more proactive practices.</p><p><strong>Conclusion: </strong>Parents demonstrated insufficient knowledge, generally positive attitudes, and relatively proactive practices, though many scored below adequacy thresholds. Given the modest strength of the observed associations, these findings should be interpreted cautiously. Efforts may be directed toward enhancing parental education and supporting positive attitudes to potentially improve AD management, while future longitudinal studies are warranted to further clarify causal relationships.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"571448"},"PeriodicalIF":3.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633470","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":"Thunderstorm-Associated Asthma in Shenzhen, China: A Retrospective Case-Control Study of Risk Factors, Clinical Characteristics, and Management Approaches.","authors":"Xubin Shang, Yonggang Yang, Wangsheng Deng","doi":"10.2147/JAA.S584545","DOIUrl":"https://doi.org/10.2147/JAA.S584545","url":null,"abstract":"<p><strong>Objective: </strong>To identify risk factors, clinical characteristics, and management approaches associated with thunderstorm-associated asthma (TA) in Shenzhen, China, comparing it with general asthma (GA).</p><p><strong>Methods: </strong>A retrospective case-control study was conducted, including 42 patients with TA who presented with asthma exacerbations following thunderstorms and 361 patients with GA. Demographic variables and inflammatory biomarkers, including absolute eosinophil count (AEC), absolute neutrophil count, and C-reactive protein were evaluated. Logistic regression and receiver operating characteristic analyses were applied to determine discriminative factors.</p><p><strong>Results: </strong>Patients with TA were younger than those with GA (median 49 vs 57 years, <i>p</i> = 0.003) and demonstrated a higher prevalence of allergic rhinitis (73.8% vs 41.0%, <i>p</i> < 0.001). Eosinophil counts were significantly elevated among patients with TA (0.74×10⁹/L vs 0.42×10⁹/L, <i>p</i> < 0.001). An AEC ≥ 0.71×10⁹/L effectively differentiated TA from GA (area under the curve [AUC] = 0.843). The combined model incorporating age, allergic rhinitis history, and AEC yielded improved diagnostic performance (AUC = 0.880). Hospitalization rates were lower in the TA group (16.7% vs 68.4%, <i>p</i> = 0.041), although all individuals received oxygen therapy.</p><p><strong>Conclusion: </strong>TA in Shenzhen affects younger atopic individuals with eosinophilic inflammation. AEC ≥0.71×10⁹/L may aid screening during meteorological alerts, guiding acute management with oxygen, bronchodilators, and corticosteroids while avoiding unnecessary antibiotics.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"584545"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673597","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":"Eosinophil-Derived Neurotoxin: A Potential Biomarker for Allergic Bronchopulmonary Aspergillosis.","authors":"Minfang Zou, Yun Pan, Yan Yang, Xiaofei Liu, Rong Zeng, Liang Dong","doi":"10.2147/JAA.S587227","DOIUrl":"https://doi.org/10.2147/JAA.S587227","url":null,"abstract":"<p><strong>Objective: </strong>Eosinophil-derived neurotoxin (EDN) has emerged as a potential biomarker in asthma. Allergic bronchopulmonary aspergillosis (ABPA) is a severe complication of asthma. This study aimed to investigate serum EDN levels in ABPA and assess the diagnostic utility of serum EDN in distinguishing ABPA from <i>Aspergillus fumigatus</i>-sensitized asthma (ASA).</p><p><strong>Methods: </strong>This is a single-center retrospective analysis of data from patients initially diagnosed with ABPA and asthma between 2021 and 2023. Eighteen patients with ABPA, 11 with unsensitized asthma (UA), 10 with ASA, and 18 healthy controls were enrolled. Serum EDN levels were measured by enzyme-linked immunosorbent assay (ELISA). Comparisons among groups were performed using Mann-Whitney <i>U</i>-test with Bonferroni correction for multiple comparisons. Correlations between EDN and clinical parameters were assessed using Spearman rank correlation analysis. Receiver operating characteristic (ROC) curve analysis was used to evaluate diagnostic performance.</p><p><strong>Results: </strong>Serum EDN levels were significantly higher in ABPA patients (median 132.8 ng/mL, IQR: 106.1-256.4) compared to healthy controls (39.7 ng/mL, IQR: 26.6-53.5), UA (59.4 ng/mL, IQR: 48.9-70.1), and ASA (67.6 ng/mL, IQR: 33.3-104.0) after Bonferroni correction (all <i>p</i> < 0.0083). EDN strongly correlated with eosinophil counts (<i>ρ</i>= 0.73, <i>p</i> < 0.01) and <i>A. fumigatus</i>-specific IgE (<i>ρ</i>= 0.70, <i>p</i> < 0.01), and moderately with total IgE (<i>ρ</i>= 0.45, <i>p</i> < 0.05) and bronchiectasis (<i>ρ</i>= 0.40, <i>p</i> < 0.05). ROC analysis showed that EDN (AUC = 0.844, 95% CI: 0.693-0.996) had comparable diagnostic performance to total IgE (AUC = 0.833, 95% CI: 0.668-0.999) in differentiating ABPA from ASA, with sensitivity of 83.3% (95% CI: 0.608 to 0.942) and specificity of 80.0% (95% CI: 0.490 to 0.965) at a cutoff of 96.26 ng/mL.</p><p><strong>Conclusion: </strong>EDN levels are significantly elevated in ABPA and correlates with key disease markers, including eosinophil counts, <i>A. fumigatus</i>-specific IgE and bronchiectasis on chest CT. EDN demonstrates diagnostic potential comparable to total IgE in distinguishing ABPA from other asthma phenotypes. These findings suggest EDN may serve as a useful biomarker for ABPA, though validation in larger, multi-center cohorts is warranted.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"587227"},"PeriodicalIF":3.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622947","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":"Characteristics of Patients with Severe Uncontrolled Asthma in Saudi Arabia: A Cross-Sectional Study.","authors":"Riyad O Al-Lehebi, Rana A Saleh, Abdalla M Alasiri, Bader J Alghamdi, Hajer Y Almudaiheem, Ahmed H Al-Jedai, Eid A Almutairi, Haifa Aldakhil, Khaulah A Alokili, Fahad Zuriqan, Adeeb A Bulkhi","doi":"10.2147/JAA.S570574","DOIUrl":"10.2147/JAA.S570574","url":null,"abstract":"<p><strong>Background: </strong>Severe asthma poses significant morbidity and healthcare burden, with the eosinophilic phenotype being particularly prevalent. This study aims to characterize the demographic and clinical profiles of severe eosinophilic asthma patients in a Saudi Arabian cohort involving multiple centers in the country.</p><p><strong>Methods: </strong>A cross-sectional analysis of a prospective cohort of 268 patients with severe eosinophilic asthma, eligible for benralizumab treatment, was analyzed from the Saudi Arabian Ministry of Health database. Demographic data, biomarker profiles, and historic disease and medication burden were examined and stratified by various parameters including city/region, eosinophil count, and type 2 inflammatory comorbidities.</p><p><strong>Results: </strong>Patients were predominantly female (66.4%), with an average age of 45.3 years, and had a median BMI of 27.7 kg/m2. The majority were never smokers, and about one-third had type 2 inflammatory comorbidities. High exacerbation rates (median of 5 exacerbations per year) and frequent healthcare utilization were noted despite high-dose inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) treatment. Nearly 20% of patients were on maintenance oral corticosteroids. The median blood eosinophil count was 656 cells/μL, indicating a high prevalence of severe eosinophilic asthma (defined as a blood eosinophil count ≥ 150 cells/μL.</p><p><strong>Conclusion: </strong>This study confirms the substantial burden of severe eosinophilic asthma in the Saudi population, with significant exacerbation rates and healthcare resource use despite conventional therapy. The data suggest a potential role for benralizumab in improving disease outcomes for severe eosinophilic asthma. Further research is needed to evaluate the efficacy and cost-effectiveness of benralizumab in these patients.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"570574"},"PeriodicalIF":3.0,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592323","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":"Feasibility of a 50% Dosing Interval Extension of Anti-IL-5 Biologics in Patients with Severe Asthma in Clinical Remission: A Real-World Validation Study.","authors":"Mirna Vergles, Grgur Salai, Neven Tudorić, Ivona Kovačević, Domagoj Kifer, Kristina Lalić, Marija Gomerčić Palčić, Andrea Vukić Dugac","doi":"10.2147/JAA.S567136","DOIUrl":"10.2147/JAA.S567136","url":null,"abstract":"<p><strong>Background: </strong>Initiation criteria for biologic therapies for severe asthma are well established, but guidance on dose reduction or discontinuation remains limited. Sustained clinical remission presents an opportunity to evaluate biologic dose tapering strategies.</p><p><strong>Objective: </strong>To validate a down-titration algorithm by assessing the feasibility and safety of extending the dosing interval of anti-IL-5 biologics (mepolizumab, benralizumab) by 50% in patients with severe asthma in clinical remission.</p><p><strong>Methods: </strong>In this single-center, real-world, longitudinal study, 31 patients with severe asthma and sustained four-component remission for >12 months were enrolled. The biologic dosing interval was extended by 25% at baseline and by 50% at 6 months if four-component remission was maintained. Remission was assessed at 26 and 52 weeks using established three- and four-component criteria. Bayesian logistic and mixed-effects models were used to evaluate clinical and biomarker outcomes.</p><p><strong>Results: </strong>Over the 12-month study period, a 50% dose interval extension was successfully achieved in 28 out of 31 patients (90%). At study end, 18 patients (58%) remained in four-component remission, while 25 (81%) met three-component remission criteria. Acute exacerbations occurred in 3 patients (10%). Comparison between benralizumab and mepolizumab showed no significant differences. While peripheral eosinophil counts increased slightly, mean levels remained below 300 cells/μL. FeNO levels showed no significant change.</p><p><strong>Conclusion: </strong>Following a 50% extension of anti-IL-5 biologic dosing intervals, full four-component clinical remission was maintained in 58% of patients, while 81% preserved three-component remission with a low exacerbation rate. These findings indicate that a uniform 50% interval extension cannot be applied universally without risk of partial loss of disease control. However, the high proportion of patients maintaining clinically meaningful 3-component remission supports the feasibility of a structured, stepwise dosing-interval extension strategy in selected patients with severe asthma, emphasizing the need for individualized implementation.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"567136"},"PeriodicalIF":3.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581274","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":"Eosinophilic Organ Complications Associated with Dupilumab Therapy - Narrative Review and Current Evidence.","authors":"Philipp Suter, Vanessa Alexandra Buetler, Nina Graf, Nikolay Pavlov","doi":"10.2147/JAA.S588165","DOIUrl":"10.2147/JAA.S588165","url":null,"abstract":"<p><strong>Background: </strong>Dupilumab is a monoclonal antibody targeting the interleukin (IL) 4 receptor alpha subunit. By inhibiting IL-4 and IL-13 signaling, it has shown efficacy in treating type 2 high inflammatory diseases. While generally well-tolerated, rare eosinophilic adverse events have been reported.</p><p><strong>Methods: </strong>A narrative literature search was conducted using MEDLINE, Google Scholar, and Cochrane Central Register of Controlled Trials databases up to September 6, 2025. We searched for published cases of dupilumab-induced hypereosinophilia with organ involvement. Furthermore, we present data from the WHO Global Pharmacovigilance Database, VigiBase, using information component (IC) metrics.</p><p><strong>Results: </strong>A 64-year-old woman with severe asthma, aspirin-exacerbated respiratory disease, and chronic rhinosinusitis with nasal polyposis developed nine months after dupilumab initiation recurrent eosinophilic pleural effusions (EPE), accompanied by peripheral eosinophilia (2520 cells/μL). Symptoms resolved only after dupilumab discontinuation. Our review includes 52 cases of dupilumab-associated eosinophilic adverse events. Most presented within three months of treatment initiation. Eosinophilic pneumonia (EP), eosinophilic granulomatosis with polyangiitis (EGPA) and hypereosinophilic syndrome (HES) were the most frequent reported manifestations. Although most patients recovered with dupilumab withdrawal and oral corticosteroids, clinical outcomes varied, and re-challenge was associated with a high recurrence rate. Analysis of VigiBase revealed significant values for a disproportionate frequency of reports of several eosinophilic adverse events (EGPA: IC025 +3.4; HES: IC025 +2.8; EP: IC025 +2.6, EPE: IC025 +2.2) in association with dupilumab.</p><p><strong>Conclusion: </strong>Clinically significant eosinophilic adverse events during dupilumab therapy, though rare, can occur even after prolonged treatment periods. Long-term vigilance for eosinophil-mediated organ damage is important and for individualized risk-benefit assessments in patients receiving IL-4/IL-13 blockade is needed. Enhanced awareness and further studies are required to better define predictive markers, pathophysiological mechanisms, and management strategies.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"588165"},"PeriodicalIF":3.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581295","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}