Journal of Investigational Allergology and Clinical Immunology最新文献

{"title":"Endothelial Glycocalyx Shedding Emerges as a Dual Marker for Treatment and Diagnosis in Anaphylaxis.","authors":"Lucía Palacio-García, Sergio Fernández-Bravo, Irene de María-Camacho, Irene San Sebastián-Jaraba, María José Fernández-Gómez, Óscar López-Pérez, Sandra Sanz-Andrea, Carlos Pastor-Vargas, Emilio Nuñez-Borque, José Julio Laguna, Marcela Valverde, Luis Miguel Blanco-Colio, Vanesa Esteban, Nerea Méndez-Barbero","doi":"10.18176/jiaci.1190","DOIUrl":"https://doi.org/10.18176/jiaci.1190","url":null,"abstract":"<p><strong>Background and objective: </strong>Anaphylaxis is an acute life-threatening reaction. Research into the vascular endothelium and its components may improve disease management and patient outcomes. Objective: We investigated the endothelial glycocalyx (eGCX) and its role in the pathophysiology of murine anaphylaxis, aiming to identify novel diagnostic and therapeutic targets.</p><p><strong>Methods: </strong>Active systemic anaphylaxis (ASA) was evaluated in mice. eGCX structure and N-acetylglucosamine residues in mouse aortic tissue were analyzed using transmission electron microscopy and wheat germ agglutinin staining. Endocan (ESM-1) levels in mouse aorta and plasma were determined using immunofluorescence and ELISA. Sulodexide was administered as a prophylactic treatment. Human sera from ß-lactam-induced anaphylaxis and endothelial cell (EC) secretome samples were also analyzed.</p><p><strong>Results: </strong>eGCX surface area and thickness were reduced in ASA mice. N-acetylglucosamine and ESM-1 levels decreased in aortic tissue but increased in plasma, indicating eGCX shedding. Consistently, ESM-1 secretion was enhanced in ECs exposed to acute anaphylactic sera. ESM-1 and hyaluronic acid levels differed significantly between patients with anaphylaxis and nonallergic controls. Sulodexide reduced reaction severity, increased survival, and prevented disruption of eGCX and release of ESM-1.</p><p><strong>Conclusions: </strong>eGCX shedding, particularly of ESM-1, acts as a key mediator in murine anaphylaxis. Prophylaxis with sulodexide protects against severe reactions and improves survival. Therapies based on glycosaminoglycans and proteoglycans may mitigate the severity of anaphylaxis, and monitoring of eGCX dynamics could aid diagnosis.</p>","PeriodicalId":50173,"journal":{"name":"Journal of Investigational Allergology and Clinical Immunology","volume":" ","pages":"0"},"PeriodicalIF":6.6,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety, Adherence, and Effectiveness of an Increased Dose of Pollinex Quattro Grass and/or Olive in Real-World Practice.","authors":"Diana Betancor, Ana González-Jaimez, Alicia Gómez-López, Joaquín Sastre","doi":"10.18176/jiaci.1195","DOIUrl":"https://doi.org/10.18176/jiaci.1195","url":null,"abstract":"","PeriodicalId":50173,"journal":{"name":"Journal of Investigational Allergology and Clinical Immunology","volume":" ","pages":"0"},"PeriodicalIF":6.6,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Dupilumab on Sleep Disturbance in Patients With Uncontrolled Moderate-to-Severe Asthma, Type 2 Inflammation, and Nocturnal Awakenings: The MORPHEO Randomized Controlled Trial.","authors":"Jorge F Maspero, Anil Gupta, Olaf Schmidt, Luis A Perez de Llano, Eva Martinez Moragon, Martin Knolle, Paul E Pfeffer, Fabio Lm Ricciardolo, Simone van der Sar-van der Brugge, Cristina Lopes, Mykola Ostrovskyy, Dmytro Dobrianskyi, Jeremy Cole, Andrew Wachtel, Mei Zhang, Baptiste Berthou, Rebecca Gall, Hashem Awad","doi":"10.18176/jiaci.1160","DOIUrl":"10.18176/jiaci.1160","url":null,"abstract":"<p><strong>Background: </strong>This study was performed to evaluate the effects of dupilumab on sleep disturbance in adults with uncontrolled moderateto-severe asthma in the phase 4 MORPHEO study (NCT04502862).</p><p><strong>Patients and methods: </strong>The study population comprised adults (18-65 years) with uncontrolled (Asthma Control Questionnaire [ACQ] 5 score ≥2.5), type 2 (baseline eosinophils ≥150/μL and fractional exhaled nitric oxide [FeNO] ≥25 ppb), moderate-to-severe-asthma, and frequent nocturnal awakenings (≥1/night average). Patients were randomized 1:1 to receive dupilumab 200 mg or placebo every 2 weeks for 12 weeks. The primary endpoint was change from baseline to week 12 in the Asthma Sleep Disturbance Questionnaire (ASDQ) score. Other endpoints included changes from baseline in nocturnal awakenings, sleep quality, restorative sleep, wakefulness after sleep onset (WASO), prebronchodilator forced expiratory volume in 1 second (FEV1), ACQ-7 score, and FeNO.</p><p><strong>Results: </strong>Of the 202 patients included, 185 (91.6%) completed the intervention. The primary endpoint was not met. Groups differed nonsignificantly at week 12 in terms of the improvement in the ASDQ score (least squares mean difference [standard error], -0.07 [0.107]; P=.512) and did not differ in terms of the decrease in the number of nocturnal awakenings (0.00 [0.110]; 95%CI, -0.21 to 0.22). Both arms improved in the secondary sleep-diary endpoints sleep quality (0.17 [0.211]; 95%CI, -0.24 to 0.59), restorative sleep (0.13 [0.212]; 95%CI, -0.29 to 0.54), and WASO (-4.10 [5.510]; 95%CI, -14.99 to 6.79) at week 12. Compared with placebo, dupilumab improved prebronchodilator FEV1, ACQ-7, and FeNO. The results were nominally statistically significant.</p><p><strong>Conclusion: </strong>Although most sleep outcomes improved comparably in the groups, dupilumab (vs placebo) improved asthma symptoms, lung function, and airway inflammation in adults with uncontrolled, type 2, moderate-to-severe asthma and frequent nocturnal awakenings.</p>","PeriodicalId":50173,"journal":{"name":"Journal of Investigational Allergology and Clinical Immunology","volume":" ","pages":"0"},"PeriodicalIF":6.6,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Drug Target in Allergic Diseases: Bruton Tyrosine Kinase.","authors":"Moisés Labrador-Horrillo, Bruno Cenni, Marta Ferrer Puga","doi":"10.18176/jiaci.1183","DOIUrl":"10.18176/jiaci.1183","url":null,"abstract":"<p><p>Though first recognized as a signaling molecule in B cells, Bruton tyrosine kinase (BTK) has been shown to play a crucial role in signal transduction in innate and adaptive immune cells. BTK is an attractive therapeutic target, given its diverse role in immune regulation. Development of the first-generation BTK inhibitor (BTKi), ibrutinib, revolutionized the treatment of B-cell malignancies. Since its approval, newer-generation BTKis with improved pharmacological properties have been developed, with higher selectivity for BTK and fewer off-target effects than ibrutinib. BTK is essential for IgE-driven allergic responses and may influence IgE antibody production by B cells. Activation of BTK via the high-affinity Fc receptor for IgE, FcεRI, results in mast cell and basophil degranulation and release of histamine and other inflammatory mediators. BTKis are a potential novel therapeutic option in patients with mast cell-driven autoimmune and allergic diseases. This review summarizes the current evidence for BTK in urticaria (chronic spontaneous and chronic inducible urticaria [CSU/CIndU]), asthma, food allergy, and atopic dermatitis (AD). It also highlights the efficacy of BTKis in urticaria and allergic diseases where FcεRI/IgE is the pathogenic target. Based on limited available data, BTK does not seem to have a prominent role in the pathogenesis of AD, and its role in asthma is unclear, thus necessitating further clinical research. Remibrutinib and rilzabrutinib have shown the most promise in allergic and autoimmune diseases to date; remibrutinib is approved in adults with CSU, and rilzabrutinib is approved in adults with persistent or chronic immune thrombocytopenia.</p>","PeriodicalId":50173,"journal":{"name":"Journal of Investigational Allergology and Clinical Immunology","volume":" ","pages":"170-184"},"PeriodicalIF":6.6,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Sting Challenge Test Shows High Negative Predictive Value in Patients Receiving Venom Immunotherapy.","authors":"Teresa Alfaya Arias, Arantza Vega Castro, Diana Garnica-Velandia, Jesús Macías Iglesias, Javier Pereira González, Nadine Blanco Toledano, Ana Puig Fuentes, Gemma Vicens-Novell, Miriam Bermúdez Bejarano, Aikaterini Tsopana, Lluís Marquès, David González-de-Olano, Elia Pérez-Fernández, Berta Ruiz-León","doi":"10.18176/jiaci.1086","DOIUrl":"10.18176/jiaci.1086","url":null,"abstract":"<p><strong>Background and objective: </strong>The sting challenge test (SCT) is regarded as the most reliable method for assessing the effectiveness of venom immunotherapy (VIT). However, its predictive value in patients undergoing VIT is unclear. Objective: This study aims to evaluate the predictive value of the SCT.</p><p><strong>Methods: </strong>A multicenter retrospective observational study was conducted on patients receiving VIT who underwent SCT. The study gathered data on patient demographics, diagnosis, immunotherapy details, outcomes of the SCT, and subsequent field stings.</p><p><strong>Results: </strong>A total of 261 patients were included, and 372 SCTs were recorded. Most patients (75.1%) were men. Mastocytosis was confirmed in 7.7%. The final diagnosis was allergy to Apis mellifera (48.7%), Polistes dominula (36.8%), Vespula species (2.7%), and P dominula plus Vespula species (10.7%). SCTs were performed with Apis in 61.6% overall, Polistes in 34.1%, and Vespula in 4.3%. Most of the SCT results were negative (95.7%). A total of 306 field stings were recorded for 146 patients (56.2%); of these, 95.1% were negative. Among these 146 affected patients, 137 had a negative SCT result, and 130 of these also had a subsequent negative field sting, resulting in a negative predictive value (NPV) for the SCT of 94.9%. Of the patients who experienced a field sting, 9 had a positive SCT, and only 3 had a positive field sting, resulting in a positive predictive value of 33.3%.</p><p><strong>Conclusions: </strong>SCT is safe, and the high NPV emphasizes the usefulness of this test in assessing the effectiveness of VIT.</p>","PeriodicalId":50173,"journal":{"name":"Journal of Investigational Allergology and Clinical Immunology","volume":" ","pages":"207-214"},"PeriodicalIF":4.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lanadelumab for Monoclonal Gammopathy of Angioedema-Associated Significance in Acquired C1-Esterase Inhibitor Deficiency: A Case Series.","authors":"Gerdie M de Jong, Maja Bulatović-Ćalasan, Marloes W Heijstek","doi":"10.18176/jiaci.1152","DOIUrl":"10.18176/jiaci.1152","url":null,"abstract":"","PeriodicalId":50173,"journal":{"name":"Journal of Investigational Allergology and Clinical Immunology","volume":" ","pages":"252-254"},"PeriodicalIF":4.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resolution of Food Allergy After Allogeneic Hematopoietic Cell Transplantation: A Case of Acquired Immune Tolerance.","authors":"Inés Fernández-Concha, Fiorella Adrianzen Alvarez, Carmen Gómez-Traseira, Mónica Rodríguez Álvarez, Mar Gandolfo-Cano","doi":"10.18176/jiaci.1149","DOIUrl":"10.18176/jiaci.1149","url":null,"abstract":"","PeriodicalId":50173,"journal":{"name":"Journal of Investigational Allergology and Clinical Immunology","volume":" ","pages":"247-249"},"PeriodicalIF":4.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic Hyperinflation in Patients With Moderate-Severe Asthma: Relationship With Clinical Control and Small Airway Dysfunction.","authors":"Leonardo E Saldaña-Pérez, José Serrano Pariente, Carolina Cisneros Serrano, Vicente Plaza, Ismael Ali-García, Francisco Javier Campano Lancharro, Silvia Sánchez Cuellar, Ana Isabel García Onieva, Aizea Mardones, Elena Curto Sánchez, Mariana Muñoz Esquerre, Raúl Galera-Martínez, Perla Valenzuela Reyes, Íñigo Ojanguren Arranz, María Celeste Marcos, Cristina Benito Bernáldez, Ignacio Lobato Astiárraga, Rocío Magdalena Díaz-Campos, Francisco García-Río","doi":"10.18176/jiaci.1088","DOIUrl":"10.18176/jiaci.1088","url":null,"abstract":"<p><strong>Background: </strong>Dynamic hyperinflation (DH), characterized by an abnormal increase in operative lung volumes during exercise, is associated with breathlessness and exercise intolerance. This study aimed to evaluate the relationship between DH and control of symptoms in patients with moderate-severe asthma.</p><p><strong>Methods: </strong>A cross-sectional, multicenter, observational study was conducted in patients with moderate-severe asthma. DH was defined as a decrease in inspiratory capacity after a 6-minute walk test (6MWT), and asthma control was measured using the Asthma Control Test (ACT) and Spanish Guidelines for the Management of Asthma (GEMA). Secondary variables included sensitization to aeroallergens (prick test), quality of life (miniAQLQ), anxiety or depression, dyspnea (mMRC), fatigue (Borg scale), and small airway dysfunction (oscillometry).</p><p><strong>Results: </strong>Among the 154 patients analyzed, 97 (63%) had DH. ACT scores did not differ significantly between patients with and without DH (20.8 [4.4] vs 21.7 [3.6]; P=.411). However, the percentage of patients with partially and poorly controlled asthma according to GEMA was significantly higher in the DH group than in those without DH (40.2% vs 24.6%; P=.048). Compared with patients without DH, patients with DH had higher dyspnea scores (0.9 [0.9] vs 0.5 [0.6]; P=.009), greater fatigue before the 6MWT (1.3 [1.9] vs 0.5 [1.1]; P=.004), higher respiratory reactance (0.7 [1.2] vs 0.4 [1.2] cmH2O/L/s; P=.032), higher depression scores (4.2 [3.7] vs 2.1 [2.1], P=.002), and lower sensitization to aeroallergens (45.4% vs 68.4%; P=.014).</p><p><strong>Conclusion: </strong>Although no relationship was found between DH and uncontrolled asthma via the ACT, the proportion of patients with uncontrolled asthma according to GEMA was significantly higher in the DH group.</p>","PeriodicalId":50173,"journal":{"name":"Journal of Investigational Allergology and Clinical Immunology","volume":" ","pages":"215-225"},"PeriodicalIF":6.6,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus Review: Predicting Recurrence in Chronic Rhinosinusitis With Nasal Polyps: Multidisciplinary Insights From the RELAPSE Project.","authors":"Isam Alobid, M Sandra Domínguez, Christian Calvo-Henriquez, Carlos Colás, Beatriz Fernández-Parra, Ruperto González-Pérez","doi":"10.18176/jiaci.1176","DOIUrl":"10.18176/jiaci.1176","url":null,"abstract":"<p><p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a disease with a high incidence of postoperative recurrence despite medical and surgical treatments. However, a universal definition of recurrence and its determinants is lacking. Our objective was to establish a clear definition of recurrence and reach consensus on the contributing factors. A consensus study was conducted using the Delphi method. The literature on recurrence of CRSwNP was reviewed and assessed by a multidisciplinary scientific committee. The committee designed a 2-round online Delphi questionnaire addressing recurrence in CRSwNP. As for consensus, ≥70% of panelists scored 1-3 (disagreement) or 7-9 (agreement). The survey involved 70 physicians (69 completed both rounds) with expertise in the management of CRSwNP (47 ear, nose, and throat [ENT] specialists and 22 allergists). Consensus was reached on the characteristics defining recurrence (87% overall agreement, 95% agreement among allergists, and 83% agreement among ENT specialists). Finally, a list of 10 key prognostic factors was agreed upon. The top 5 were presence of nonsteroidal anti-inflammatory drug-exacerbated respiratory disease, eosinophilic CRSwNP, asthma, extent of surgery, and eosinophils in nasal polyposis (>50/high-power field). This study identified 10 key prognostic factors for recurrence and clarified the definition of recurrence in CRSwNP as the reappearance or worsening of sinonasal symptoms (>3 points on a visual analog scale and/or ≥12 points in the 22-item Sino-Nasal Outcome Test) and/or objective evidence of inflammation (nasal polyposis grade ≥1 or other endoscopic or radiological signs of persistent mucosal inflammation) after initial postoperative improvement (baseline postoperative assessment 1 month after surgery, recurrence evaluated 6 months thereafter), excluding persistence and suboptimal surgical outcome.</p>","PeriodicalId":50173,"journal":{"name":"Journal of Investigational Allergology and Clinical Immunology","volume":" ","pages":"198-206"},"PeriodicalIF":6.6,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraperitoneal Vancomycin-Induced DRESS Syndrome in a Patient Undergoing Peritoneal Dialysis: A Case Report.","authors":"Ana Rebelo, Margarida Cunha, Leonor Leão, Irene Rosmaninho, Inês Vaz","doi":"10.18176/jiaci.1153","DOIUrl":"10.18176/jiaci.1153","url":null,"abstract":"","PeriodicalId":50173,"journal":{"name":"Journal of Investigational Allergology and Clinical Immunology","volume":" ","pages":"254-256"},"PeriodicalIF":4.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}