Journal of Asthma and Allergy最新文献

{"title":"Associations Between Social Determinants of Health and Adherence to Biologic Therapies in Patients with Severe Asthma: Real-World Evidence from a Large US Claims Analysis.","authors":"Justin Kwiatek, Arijita Deb, Guillaume Germain, François Laliberté, Malena Mahendran, Patrick Gravelle, Annalise Hilts, Rohit K Katial, Diego J Maselli","doi":"10.2147/JAA.S608891","DOIUrl":"10.2147/JAA.S608891","url":null,"abstract":"<p><strong>Purpose: </strong>This study describes factors associated with biologic initiation and adherence, and impacts of adherence on exacerbations among US patients with severe asthma.</p><p><strong>Patients and methods: </strong>This retrospective cohort study defined two populations, biologic-eligible patients and biologic users, using the Komodo Research Database of healthcare claims (2016-2024). The biologic-eligible cohort was defined as patients with severe asthma who had ≥2 exacerbations within 12 months, after the severe asthma index date. Severe asthma was defined as ≥3 month medium-to-high-dose inhaled corticosteroid use with ≥1 overlapping supply with controller therapy. The severe asthma index date was the first day of overlapping treatment supply. Biologic users were defined as patients with ≥2 dispensings of the same biologic and ≥2 asthma diagnoses in the year prior to biologic initiation. In the biologic-eligible cohort, biologic initiation was evaluated and compared between less- and more-favored social determinants of health (SDOH) areas (based on census-level quartiles). Adherence (assessed based on refills and treatment gaps) and exacerbations were assessed among biologic users in the 12 months following biologic initiation and compared between less- and more-favored SDOH areas.</p><p><strong>Results: </strong>Overall 29,652 patients had ≥2 years of follow-up in the biologic-eligible cohort. Of these, 11.3% (n=3362) initiated biologics. In total, 16,336 patients were included in the biologic-user cohort, among whom 62.6% were adherent, 12.1% partially adherent, 3.1% minimally adherent, and 22.3% discontinued treatment. Biologic initiation and adherence were lower in less- versus more-favored SDOH areas. Compared with adherent patients, those who were partially/minimally adherent or discontinued treatment in the 12 months following biologic initiation had significantly more exacerbations post-landmark period (+18% overall and +28% hospitalization-defined exacerbations).</p><p><strong>Conclusion: </strong>Disparities in biologic initiation and adherence exist between severe asthma populations with different characteristics and SDOH. Biologic adherence is associated with fewer exacerbations compared with partial adherence, minimal adherence, and treatment discontinuation.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"608891"},"PeriodicalIF":3.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351983","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":"Expression of miR-185-5p, miR-146b-5p, miR-320b, and miR-21-5p in Eosinophil Subtypes in Allergic Asthma Patients.","authors":"Eglė Vasylė, Andrius Januskevicius, Paulina Malakauskaitė, Airidas Rimkūnas, Jolita Palacionyte, Kęstutis Malakauskas","doi":"10.2147/JAA.S534454","DOIUrl":"10.2147/JAA.S534454","url":null,"abstract":"<p><strong>Background: </strong>Allergic asthma (AA) is a common type 2 eosinophilic asthma phenotype. Inflammatory (iEOS) and lung-resident (rEOS) eosinophil subtypes may contribute to its underlying inflammatory processes. The biological functions of these eosinophils are tightly regulated by gene expression, with micro ribonucleic acids (miRNAs) emerging as key modulators and potential biomarkers.</p><p><strong>Purpose: </strong>To investigate the expression of miR-185-5p, miR-146b-5p, miR-320b, and miR-21-5p in eosinophil subtypes and relate with their plasma levels in AA patients.</p><p><strong>Patients and methods: </strong>The study included 13 AA patients and 16 healthy subjects (HS). All AA patients underwent bronchial allergen challenge (BAC) with <i>Dermatophagoides pteronyssinus</i> and blood samples were re-taken after 24 hours. Total blood eosinophils were isolated by high-density centrifugation and magnetic separation, phenotyped using CD62L-conjugated magnetic beads. miRNAs expression quantified by reverse transcription-quantitative polymerase chain reaction (RT-qPCR).</p><p><strong>Results: </strong>Before BAC, miR-185-5p and miR-146b-5p expression were elevated in both eosinophil subtypes relative to HS, with miR-185-5p showing higher expression in iEOS-like cells than in rEOS-like cells within the AA group. miR-320b was elevated only in iEOS-like cells relative to HS and remained higher than in rEOS-like cells within the AA group, whereas miR-21-5p was decreased only in iEOS-like cells and remained lower than in rEOS-like cells. After BAC, miR-146b-5p expression decreased in iEOS-like cells but increased in rEOS-like cells. Plasma analysis revealed elevated levels of all investigated miRNAs in AA patients relative to HS before BAC. However, after BAC, miR-185-5p and miR-146b-5p remained elevated, whereas miR-320b and miR-21-5p decreased to levels not significantly different from HS.</p><p><strong>Conclusion: </strong>Elevated miR-185-5p and miR-320b expression in iEOS-like cells compared to rEOS-like cells from AA patients highlights differences in their biological properties. Following the BAC, miR-146b-5p expression decreased in iEOS-like cells but increased in rEOS-like cells. Moreover, miR-185-5p and miR-146b-5p remained elevated in plasma, suggesting their potential to reflect chronic inflammation rather than acute response to allergen.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"534454"},"PeriodicalIF":3.3,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345344","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":"Allergen Sensitization Profiles and Co-Sensitization Networks in Children with Allergic Rhinitis and Asthma: A Propensity Score-Matched Retrospective Study.","authors":"Pinli Zou, Yinghong Fan, Cheng Xie, Wanmin Xia, Yanru Liu, Pei Tao, Yijie Huang, Li Wang, Tao Ai","doi":"10.2147/JAA.S620785","DOIUrl":"10.2147/JAA.S620785","url":null,"abstract":"<p><strong>Background: </strong>The sensitization mechanisms driving allergic airway disease progression from allergic rhinitis (AR) to asthma (AS) in children remain incompletely understood. This study investigated age-related patterns and topological network heterogeneity of allergen sensitization between these airway phenotypes.</p><p><strong>Methods: </strong>In this retrospective cross-sectional study, 2193 children with AR or AS were enrolled. Propensity score matching (PSM) was utilized to control for age, yielding a 1:1 matched cohort of 1206 patients. The topological architecture of allergen co-sensitization was reconstructed using an Ising probability graphical model. Independent risk factors for lower airway involvement were identified via multivariable logistic regression.</p><p><strong>Results: </strong>House dust mites mix (41%), cat dander (17%), and tree pollen mix (9.5%) dominated inhalant sensitizations. Egg white (22%), cow's milk (20%), and lamb (19%) were the most prevalent food sensitizations. While inhalant sensitization exhibited homogenous age-dependent increases in both groups, foodborne immune tolerance showed profound heterogeneity. By adolescence (≥12 years), the risk of sensitization to milk and egg white was 5.64-fold (OR = 5.64, 95% CI: 1.47-21.69, <i>p</i> = 0.010) and 3.40-fold (OR = 3.40, 95% CI: 1.07-10.07, <i>p</i> = 0.029) higher than in the AR group. Ising network analysis revealed a highly compartmentalized modular structure in AR, whereas the AS network exhibited significant complexity and deep cross-system connectivity, with peanut acting as a topological hub bridging core indoor inhalants. Multivariable regression demonstrated cockroach (aOR: 2.70; 95% CI: 1.11-7.57; p=0.039) and peanut (aOR: 1.86; 95% CI: 1.02-3.47; p=0.046) sensitizations were independent risk factors for lower airway involvement.</p><p><strong>Conclusion: </strong>Children with AS demonstrate a more complex cross-sensitization network than those with AR, rather than simply a higher burden of inhalant allergies. The delayed resolution of food sensitizations serves as a critical differentiator for the AS phenotype, highlighting the necessity of monitoring food allergies in pediatric airway disease management.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"620785"},"PeriodicalIF":3.3,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301759","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":"Development and Internal Evaluation of a Clinical-Physiological Model for Predicting Methacholine-Defined Airway Hyperresponsiveness in Children Aged 0-3 Years.","authors":"Jiangjiao Qin, Sha Liu, Ying Lin, Xia Wang, Jing Zhao, Fangjun Liu","doi":"10.2147/JAA.S602340","DOIUrl":"10.2147/JAA.S602340","url":null,"abstract":"<p><strong>Purpose: </strong>Assessing airway hyperresponsiveness (AHR) in children aged 0-3 years is crucial for early asthma diagnosis but is clinically challenging due to the safety risks and technical complexity of the methacholine challenge test (MCT). This study aimed to develop and internally evaluate a non-invasive, multidimensional nomogram to predict current methacholine-defined AHR in children aged 0-3 years with suspected asthma.</p><p><strong>Patients and methods: </strong>We conducted a retrospective cohort study of children aged 0-3 years with suspected asthma who underwent same-day tidal breathing pulmonary function testing, fractional exhaled nitric oxide (FeNO) measurement, and MCT. Clinical symptoms and atopic history were extracted from electronic medical records. Multivariable logistic regression was used to identify independent predictors of AHR. The model was internally evaluated using a single 70/30 random split into training and evaluation cohorts. Model performance was assessed by discrimination, calibration, and decision curve analysis and compared with machine-learning approaches.</p><p><strong>Results: </strong>Seven independent predictors were identified: family history of asthma (OR = 3.90), presence of wheeze (OR = 3.85), history of allergy (OR = 2.34), history of rhinitis (OR = 1.69), FeNO (OR = 1.03), age (OR = 0.96), and TPTEF/TE (OR = 0.97). The model achieved an AUC of 0.81 (95% CI: 0.77-0.85) in the training cohort and 0.76 (95% CI: 0.69-0.84) in the evaluation cohort. At the optimal cutoff, the PPV and NPV were 0.89 and 0.39, respectively, in the evaluation cohort. SHAP analysis identified family history of asthma, wheeze, and FeNO as the most influential predictors.</p><p><strong>Conclusion: </strong>We developed a clinical-physiological nomogram for predicting methacholine-defined AHR in children aged 0-3 years. It serves as an adjunctive tool in tertiary care to identify patients with a high probability of AHR.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"602340"},"PeriodicalIF":3.3,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13284878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308202","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":"Comorbidity of Allergic Asthma and Rhinitis and High Allergen-Specific IgE are Risk Factors for Systemic Reactions to House Dust Mite Immunotherapy in Children.","authors":"Qin Wang, Xiaoyan Dong, Siyu Zhu, Lang Yuan, Haojie Wang, Ran Zhao, Na Dong","doi":"10.2147/JAA.S614236","DOIUrl":"10.2147/JAA.S614236","url":null,"abstract":"<p><strong>Objective: </strong>To observe the adverse reactions during standardized dust mite allergen subcutaneous immunotherapy (SCIT) in children with allergic asthma (AA) and/or allergic rhinitis (AR), and to analyze the clinical characteristics and potential risk factors.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included 250 children with allergic diseases who received house dust mite (HDM) SCIT treatment at our hospital from July 2022 to July 2025. The participants were divided into a systemic reactions (SRs) group and a non-SRs group. Differences in baseline clinical data and laboratory indicators between the two groups were compared, and independent risk factors for SRs were analyzed using the generalized estimating equation (GEE) method.</p><p><strong>Results: </strong>Among 250 children (9,244 injections), 114 (45.6%) experienced SRs, with an incidence of 3.47% per injection. SRs were predominantly characterized by immediate, mild grade I reactions, with only 2 cases of grade III reactions and no fatal or serious adverse events. The incidence of SRs during the maintenance period was higher than during the up-dosing period. Univariate analysis showed that the occurrence of SRs was associated with age 5-9 years, AR combined with AA, elevated total immunoglobulin E (IgE), and high Dermatophagoides pteronyssinus (Der.p) specific IgE (sIgE) levels (P < 0.05). Multivariate GEE analysis showed that AR+AA comorbidity (compared to AA alone, odds ratio [OR] = 2.219, 95% confidence interval [CI]: 1.061-4.638, <i>P</i>=0.034) and baseline Der.p.sIgE ≥ 17.5 IU/mL (OR = 2.233, 95% CI: 1.216-4.099, <i>P</i>=0.01) were independent risk factors for SRs.</p><p><strong>Conclusion: </strong>HDM SCIT in children demonstrates a favorable safety profile, with SRs being predominantly mild and dose-dependent. The presence of AR+AA comorbidity (compared to AA alone) and a baseline Der.p.sIgE ≥ 17.5 IU/mL are key predictors of SR risk. These findings support pre-treatment risk stratification and suggest that children with these risk factors may benefit from a more individualized and monitored SCIT protocol to enhance safety.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"614236"},"PeriodicalIF":3.3,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295113","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":"Implementation of an Institutional Asthma Care Guideline in Hospitalized Children: Effects on Clinical Outcomes and Healthcare Resource Utilization.","authors":"Supawadee Intusup, Kanokpan Ruangnapa, Wanaporn Anuntaseree, Kantara Saelim, Pharsai Prasertsan, Kantisa Sirianansopa","doi":"10.2147/JAA.S605374","DOIUrl":"10.2147/JAA.S605374","url":null,"abstract":"<p><strong>Background: </strong>Acute asthma exacerbations are a major cause of pediatric hospitalization and healthcare utilization. Despite the availability of standard guidelines, variability in inpatient management persists and may affect both clinical outcomes and resource use.</p><p><strong>Objective: </strong>To evaluate the impact of an institutional inpatient asthma care guideline on treatment processes, clinical outcomes, and hospitalization costs in children.</p><p><strong>Methods: </strong>This retrospective quality improvement cohort study included children aged 1-15 years hospitalized for acute asthma between 2016 and 2024. Patients were categorized into three phases: pre-implementation, post-implementation, and post-revision. The institutional guideline standardized bronchodilator escalation, respiratory support, and discharge planning, and was implemented using Plan-Do-Study-Act (PDSA) cycles.</p><p><strong>Results: </strong>A total of 220 children were included. Compared across the three phases, time to first bronchodilator decreased significantly (117 vs 104 vs 70 minutes, P < 0.001), with increased use of selected interventions, including nebulized steroids and high-flow nasal cannula (both P < 0.001). Differences in 24-hour clinical respiratory score reduction were observed across study phases, with adjusted analyses demonstrating greater improvement following guideline implementation. However, resource utilization increased after implementation, with longer hospital length of stay (47.5 vs 58.6 vs 67.3 h, P = 0.004) and higher hospitalization costs (249.7 vs 460.6 vs 447.0 USD, P < 0.001).</p><p><strong>Conclusion: </strong>Implementation of an institutional asthma care guideline was associated with improved treatment timeliness and early clinical improvement but was also associated with increased length of stay and hospitalization costs, suggesting a trade-off between clinical management and resource utilization.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"605374"},"PeriodicalIF":3.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295137","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":"Salivary Cortisol versus Serum Cortisol Levels in Asthmatic Children Treated with Inhaled Corticosteroid Alone or in Combination with Montelukast.","authors":"Atqah AbdulWahab, Rasha Abdeldaim Ali Alsiddig, Amal Al-Naimi, Mona Maarafiya, Ahmed Abushahin, Yahya Hani, Rajvir Singh, Jayakumar Jerobin, Ilham Bettahi, Mutasim Abu-Hasan","doi":"10.2147/JAA.S600420","DOIUrl":"10.2147/JAA.S600420","url":null,"abstract":"<p><strong>Objective: </strong>Inhaled corticosteroids (ICS) is the mainstay therapy of childhood asthma, but side effects related to hypothalamic-pituitary-adrenal (HPA) axis suppression is a concern, especially when combined with Montelukast. HPA suppression is assessed by morning measuring serum cortisol level, which is invasive and inconvenient in children. Salivary cortisol is a non-invasive alternative. We aim to correlate serum with salivary cortisol levels in asthmatic children, and assess the effect of treatment with ICS alone or ICS with Montelukast.</p><p><strong>Methods: </strong>Morning serum and salivary cortisol levels were measured in asthmatic children (7-12 years) who were treated with either ICS (IC group) or ICS plus Montelukast (ICM group). Salivary cortisol was also measured in age-matched healthy children (control group). We used Pearson coefficient to correlate between serum and salivary cortisol levels, and Student's <i>t</i>-test or ANOVA for group comparisons as appropriate. We used multivariate regression analysis to evaluate predictors of salivary and serum cortisol levels.</p><p><strong>Results: </strong>A total of 150 children were recruited, 50 children in each study group. There was no difference between IC, ICM and control groups in age or BMI. Asthma groups had higher percentage of males (P= 0.01). We found positive correlation between serum and salivary cortisol levels (r = 0.29, p = 0.01). There was no difference in salivary cortisol levels between the 3 groups (7.30 ± 5.99 vs. 10.04 ± 11.6 vs. 10.7 ± 9.8, p = 0.76). There was no difference in serum cortisol levels between IC and ICM groups (249.03 ± 117.8 vs. 277.5 ± 123.9, p = 0.24). Age, gender, BMI, ICS dose and asthma severity did not affect serum or salivary cortisol levels.</p><p><strong>Conclusion: </strong>Salivary cortisol level correlates with serum cortisol in asthmatic children, but not different from level in controls, and not affected by treatment with ICS alone or with Montelukast.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"600420"},"PeriodicalIF":3.3,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13271143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271549","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":"Intranasal Corticosteroids Versus Second-Generation Antihistamines for Allergic Rhinitis in Adolescents: A Prospective Cohort Study of Quality of Life and School Attendance.","authors":"Siraç Irmak, Serkan Dedeoglu, Serdar Ferit Toprak, Enes Sırma, Serhat Samancı, Günay Kozan","doi":"10.2147/JAA.S606463","DOIUrl":"10.2147/JAA.S606463","url":null,"abstract":"<p><strong>Purpose: </strong>Allergic rhinitis (AR) in adolescents can negatively affect daily functioning, sleep, and school performance. This observational, non-randomized prospective cohort study compared the real-world effectiveness of intranasal corticosteroids (INCS) and second-generation oral antihistamines (OAH) on disease-specific quality of life and school attendance.</p><p><strong>Patients and methods: </strong>This observational, non-randomized prospective cohort study included 80 adolescents aged 12-18 years with moderate-to-severe allergic rhinitis who were followed for one school term. Participants received either INCS monotherapy or OAH monotherapy according to routine clinical practice; treatment allocation was not randomized. Specific drug selection within each treatment class was determined by the treating clinician and was not fully standardized, reflecting real-world treatment heterogeneity. Primary outcomes were changes in Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) scores and school absenteeism. Secondary outcomes included classroom productivity, sleep quality (Pittsburgh Sleep Quality Index), daytime sleepiness (Epworth Sleepiness Scale), adherence, and adverse events. Between-group comparisons and multivariable analyses were performed.</p><p><strong>Results: </strong>Both treatments were associated with improvement, but the magnitude of improvement was greater in the INCS group. Mean PRQLQ scores decreased by -1.0±0.4 in the INCS group and -0.6±0.5 in the OAH group; the between-group difference in mean change was -0.4 (95% confidence interval [CI], -0.7 to -0.1; p = 0.01). Clinically meaningful QoL improvement (≥0.5 reduction) occurred in 65.0% of INCS users versus 37.5% of OAH users (p = 0.02). Median school absenteeism decreased in the INCS group (change, -2 days) but not in the OAH group (change, 0 days; between-group p = 0.03). INCS users also reported greater improvements in classroom productivity and sleep quality, and fewer participants had ESS scores ≥10 at follow-up (3% vs 18%).</p><p><strong>Conclusion: </strong>In this real-world adolescent cohort, INCS use was associated with greater short-term improvement in quality-of-life and school-attendance outcomes than OAH use. However, because the study was observational and non-randomized, and because treatment heterogeneity existed within both treatment groups, these findings should be interpreted as associations rather than definitive causal effects.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"606463"},"PeriodicalIF":3.3,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13267838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264527","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":"Formaldehyde Allergy Presenting with Anaphylaxis Due to Prolonged Immediate-Type Reaction.","authors":"Hinako Masumitsu, Chiyako Oshikata, Sachiko Takaoka, Takuya Nakashima, Kaho Matsunaga, Yuka Kodama, Kosuke Terada, Yuga Yamashita, Atsushi Miyasaka, Tatsuya Muraoka, Nami Masumoto, Takeshi Kaneko, Naomi Tsurikisawa","doi":"10.2147/JAA.S608431","DOIUrl":"10.2147/JAA.S608431","url":null,"abstract":"<p><p>Formaldehyde is a low-molecular-weight chemical used as a disinfectant and in some dental materials. Although formaldehyde is a well-known cause of allergic contact dermatitis, systemic allergic reactions related to dental treatment are rare and may be overlooked, particularly when symptoms are delayed or overlap with pre-existing allergic diseases. Here we present the case of a 36-year-old woman with a history of allergic rhinoconjunctivitis, atopic bronchial asthma, and eosinophilic gastroenteritis who presented with recurrent systemic allergic symptoms after root canal treatment. Eight years earlier, she had experienced nausea and diarrhea during endodontic therapy, which were attributed to eosinophilic gastroenteritis. During subsequent dental procedures, she developed delayed-onset abdominal pain, watery diarrhea, facial edema, generalized urticaria, dyspnea, and impaired consciousness. She was diagnosed with anaphylaxis and successfully treated with epinephrine. Extensive allergological evaluations, including oral drug challenge tests and skin prick and intracutaneous tests for aspirin, antibiotics, local anesthetics, and multiple dental materials, were negative. In contrast, skin prick testing with formaldehyde-containing dental agents was positive, and serum formaldehyde-specific IgE antibodies were detected, leading to the diagnosis of formaldehyde-induced anaphylaxis. This case highlights formaldehyde-containing dental materials as an under-recognized cause of anaphylaxis. Delayed symptom onset and overlapping manifestations with underlying allergic diseases may contribute to diagnostic delay. Awareness of formaldehyde allergy is essential in patients with unexplained or recurrent allergic reactions after dental treatment.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"608431"},"PeriodicalIF":3.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251671","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":"Racial and Socioeconomic Differences in Real-World Use of Biologic Therapy for Asthma.","authors":"Monica Littlejohn, Autumn D Zuckerman, Nicolas Gargurevich, Leena Choi, Robert Lubwama, Richard H Stanford, Caresse Campbell, Manuel Nunez, Natalia Petruski-Ivleva, Anne-Laure Tardy, Katie Cruchelow","doi":"10.2147/JAA.S587574","DOIUrl":"10.2147/JAA.S587574","url":null,"abstract":"<p><strong>Purpose: </strong>Determine if there is a difference in race, socioeconomic factors and baseline asthma severity at the time of biologic initiation and whether those characteristics are associated with response to therapy within 18 months of initiation. Additionally, evaluate racial differences in clinic engagement, healthcare utilization, and biologic adherence.</p><p><strong>Patients and methods: </strong>Retrospective review of patients initiating biologic therapy for moderate-severe asthma from January 1, 2019-June 30, 2022. Multiple linear regression analyses were performed to examine whether race and socioeconomic status were associated with race-neutral percent predicted forced expiratory volume in one second (ppFEV1) prior to biologic prescription and within 18 months post biologic initiation. Differences in clinic engagement and healthcare utilization by race were assessed using Wilcoxon rank sum tests. Adherence was calculated using proportion of days covered (PDC).</p><p><strong>Results: </strong>Patients (N=215) were White (69%) or Black or African American (27%). Most had commercial (54%) or Medicare (22%) insurance. At the time of biologic initiation, Black or African American/Other patients were estimated to have a 6.9% lower ppFEV1 than White patients (<i>p</i>=0.057), had a higher percentage of no-show appointments (<i>p</i><0.001), and there was a significant difference in distribution of percentage of appointments cancelled between White and Black or African American/Other patients (<i>p</i> = 0.0038). No significant differences in healthcare utilization were found by race. At follow-up, racial differences in ppFEV1 were 0.6% after adjusting for covariates and baseline ppFEV1 (<i>p</i>=0.893). Median PDC of biologic therapy was 0.96 (IQR 0.88-1.00), with no significant difference between race. Socioeconomic status was similar between the cohorts.</p><p><strong>Conclusion: </strong>Although not statistically significant, our findings suggest a possible trend where Black or African American/Other patients had lower ppFEV1 at the time of biologic initiation, indicating an opportunity for earlier interventions.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"587574"},"PeriodicalIF":3.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13248965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217185","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}