Annals of Allergy Asthma & Immunology最新文献

{"title":"Predictive value of ELR combined with CT scores for olfactory recovery in CRSwNP.","authors":"Liufeiyan Fan, Zhong Zheng, Haofei Bai, Silyu Jing, Chunyang Zhang, Weijia Du, Yubin Lai, Min Xu, Jian Wang, Tao Xue, Fuquan Chen","doi":"10.1016/j.anai.2025.10.009","DOIUrl":"https://doi.org/10.1016/j.anai.2025.10.009","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a debilitating inflammatory disease often complicated by olfactory dysfunction (OD). Despite surgery being a primary treatment, predicting postoperative olfactory recovery remains challenging. Eosinophilic inflammation and sinus computed tomography (CT) characteristics may serve as prognostic markers, yet their combined utility in predicting OD outcomes is underexplored.</p><p><strong>Objective: </strong>To investigate the predictive effect of eosinophil-to-lymphocyte ratio (ELR) from peripheral blood tests, combined with ethmoid sinus-to-maxillary sinus (E/M) ratio, and ethmoid sinus score minus maxillary sinus (E-M) score on olfactory recovery in CRSwNP patients.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study was conducted from January 2022 to June 2024. A total of 137 CRSwNP patients and 52 healthy controls were included. Preoperative and postoperative olfactory functions were assessed using the Sniffin' Sticks test. ELR, E/M ratio, and E-M score were calculated based on blood tests and CT scans. Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were used to identify and validate predictive factors for olfactory recovery.</p><p><strong>Results: </strong>The median preoperative TDI score was 10 (IQR 7-24), improving to 26 (IQR 15-33) at 6 months postoperatively, with a median improvement (ΔTDI) of 7 (IQR 2-14). ELR, E/M ratio, and E-M score were significantly higher in patients with poor olfactory recovery (all p < 0.05). Logistic regression analysis showed that ELR (Model 1: OR = 1.199; Model 2: OR = 1.209), E/M ratio (OR = 3.236), and E-M score (OR = 2.179) were independent risk factors for poor olfactory prognosis. ROC curve analysis showed that the Combined Index showed superior predictive performance.</p><p><strong>Conclusion: </strong>A composite model integrating ELR with CT-based E/M ratio or E-M score effectively predicts olfactory recovery in CRSwNP patients. These accessible biomarkers aid in stratifying patients for personalized treatment and postoperative monitoring.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Clinical Rotation on Resident Competency in Allergy and Clinical Immunology.","authors":"Michael Aw, Fatemah AlYaqout, Natacha Tardio, Abeer Feteih, Michael Fein","doi":"10.1016/j.anai.2025.10.011","DOIUrl":"https://doi.org/10.1016/j.anai.2025.10.011","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Supply and Demand for Allergy and Immunology Training in the United States.","authors":"Jason Silvestre, Robert J Ferdon, Charles A Reitman, Anne Maitland","doi":"10.1016/j.anai.2025.09.028","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.028","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Managers for The Risk Managers.","authors":"Sarah A Taylor-Black, Giselle Mosnaim, Aikaterini Anagnostou, Matthew Greenhawt, Marcus Shaker","doi":"10.1016/j.anai.2025.10.004","DOIUrl":"https://doi.org/10.1016/j.anai.2025.10.004","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardizing Oral Food Challenge Protocols in Food Protein-Induced Enterocolitis Syndrome (FPIES): A Call for Consensus.","authors":"Mary Grace Baker, J Andrew Bird, Terri Brown-Whitehorn, Arjola Cosper, Marion Groetch, Sierra Horak, Stephanie Leonard, Amy M Scurlock, Julia E M Upton, Pooja Varshney, Sara Anvari","doi":"10.1016/j.anai.2025.10.005","DOIUrl":"https://doi.org/10.1016/j.anai.2025.10.005","url":null,"abstract":"<p><p>Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy characterized by delayed gastrointestinal symptoms. Oral food challenges (OFCs) are essential tools for confirming the diagnosis in uncertain cases and assessing resolution, yet the optimal procedure for conducting FPIES OFCs remains unknown. Current practice lacks standardization, with OFC protocols varying significantly across institutions and regions with regard to timing, IgE testing, intravenous access, dosing strategies, observation periods, and post-challenge guidance. Recent studies are paving a path toward FPIES OFC standardization. Emerging literature supports the safety and effectiveness of low-dose OFC protocols, with evidence indicating that administering 25-33% of an age-appropriate serving size (AAS) can provoke symptoms in most individuals with persistent FPIES while reducing reaction severity. Furthermore, evidence suggests that the antiemetic ondansetron can ameliorate FPIES symptoms in some patients, potentially reducing the need for intravenous fluid (IVF) resuscitation. Current gaps in FPIES literature include how to define positive OFCs after treatment with ondansetron, reaction severity classification, the role of corticosteroids in reaction management, and considerations related to atypical FPIES in diagnosis and OFC planning. Given the evolving literature, there is need for international consensus on updated FPIES OFC protocols. Ongoing initiatives, including multicenter registries and a NIH-funded prospective trial, aim to generate the data necessary to inform these guidelines. Standardized approaches to dosing, monitoring, severity grading, and interpretation of outcomes are needed to improve comparability across studies, enhance clinical decision-making, and advance evidence-based care for patients with FPIES.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hard to Digest: The Adult Food Protein-Induced Enterocolitis (FPIES) Experience.","authors":"Rachel N Kim, Jai P Ahluwalia, Aiden C Bingemann, Anitha Shrikhande, Theresa A Bingemann","doi":"10.1016/j.anai.2025.10.003","DOIUrl":"https://doi.org/10.1016/j.anai.2025.10.003","url":null,"abstract":"<p><p>Food protein induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy that is increasingly recognized in adults. Adult FPIES is characterized by severe abdominal pain, diarrhea and possibly vomiting. Pathophysiology and management between adults and children appear to be similar. However, with the evolving literature, distinguishing characteristics from pediatric populations have been identified including gastrointestinal symptom profile, symptom severity, common food triggers, and female demographic predominance. Despite the growing body of data on adult FPIES, there remains significant challenges related to diagnosis due to the broad differential diagnosis, poor awareness and lack of confirmatory testing aside from oral food challenges. There is significant heterogeneity in the literature regarding the best protocol for oral food challenges in adult FPIES. There also remain limitations in understanding prognosis, natural history, and factors affecting tolerance. These limitations have been reflected in reported unmet needs, with consequences on quality of life for adults diagnosed with FPIES. This review focuses on the most recent literature regarding clinical presentation, epidemiology, pathophysiology, management, and unmet needs for adult FPIES, with discussion of areas requiring further investigation.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urgent Need for Collaboration in the Allergy Workforce for Infants and Toddlers.","authors":"Karen Rance, Amanda Michaud, Michael Pistiner","doi":"10.1016/j.anai.2025.09.025","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.025","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of tezepelumab on asthma exacerbations co-occurring with infection-attributed acute respiratory illnesses.","authors":"Wojciech Feleszko, Marco Caminati, James E Gern, Sebastian L Johnston, Claudio Marchese, Deborah Clarke, Christopher S Ambrose, Andrew W Lindsley","doi":"10.1016/j.anai.2025.09.015","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.015","url":null,"abstract":"<p><strong>Background: </strong>Tezepelumab, a human monoclonal antibody, blocks the activity of thymic stromal lymphopoietin (TSLP). In the phase 2b PATHWAY (NCT02054130) and phase 3 NAVIGATOR (NCT03347279) studies, tezepelumab reduced exacerbations and improved lung function, asthma control, and health-related quality of life versus placebo in patients with severe, uncontrolled asthma.</p><p><strong>Objective: </strong>This post hoc analysis of PATHWAY and NAVIGATOR evaluated the incidence of asthma exacerbations co-occurring with documented acute respiratory illnesses attributed to infections.</p><p><strong>Methods: </strong>Patients were randomized 1:1 to receive tezepelumab 210 mg subcutaneously or placebo every 4 weeks for 52 weeks. The incidence of asthma exacerbations co-occurring with respiratory illness-related adverse events (AEs) was assessed. Co-occurrence was defined as at least 1 day of overlap between a respiratory illness-related AE and the asthma exacerbation period beginning 7 days before the start of the exacerbation until the end of the asthma exacerbation.</p><p><strong>Results: </strong>Of the 1334 patients (tezepelumab, n = 665; placebo, n = 669) included, 312 experienced at least one asthma exacerbation co-occurring with a respiratory illness-related AE attributed to an infection. The incidence of asthma exacerbation co-occurring with a respiratory illness-related AE was lower in the tezepelumab group than the placebo group overall (18.2% vs 28.6%; exposure-adjusted incidence difference [EAID]: -11.1 [95% CI: -15.75, -6.41]) and among patients with perennial allergy (EAID, -11.6 [95% CI: -17.44, -5.69]) and without perennial allergy (EAID, -10.2 [95% CI: -18.16, -2.10]).</p><p><strong>Conclusion: </strong>Tezepelumab reduced asthma exacerbations attributed to respiratory infections in patients with severe, uncontrolled asthma compared with placebo, irrespective of perennial allergy status.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons from the ACAAI IEI Survey: Advancing Diagnostic and Therapeutic Strategies for the Practicing Allergist-Immunologist.","authors":"Barbara Ariue, Niraj C Patel, Joseph A Bellanti","doi":"10.1016/j.anai.2025.09.026","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.026","url":null,"abstract":"<p><strong>Background: </strong>Inborn errors of immunity (IEI) have been increasingly well characterized on the molecular and genetic levels. Their clinical recognition and management among practicing allergist-immunologists remain challenging.</p><p><strong>Objective: </strong>To evaluate the consultative practices of allergist-immunologists in diagnosing and managing IEIs by identifying subtypes encountered, current approaches, multidisciplinary collaboration, barriers, and educational needs.</p><p><strong>Methods: </strong>The American College of Allergy, Asthma, and Immunology distributed a 30-question web-based survey assessing IEI experience via SurveyMonkey to U.S.-based members over a four-week period during the spring of 2024.</p><p><strong>Results: </strong>Most IEI consultations originated from outpatient primary care settings (82%), with 56% of respondents providing both outpatient and inpatient consultations. Frequently encountered IEIs included common variable immunodeficiency (CVID) (100%), specific antibody deficiency (99%), selective IgA deficiency (97%), and C1 esterase inhibitor deficiency (90%). Less frequently encountered were Chediak-Higashi syndrome (40.5%) and type I interferonopathies (41%). The greatest need for subspecialty input was from hematology/oncology for quantitative phagocyte cell defects (89%) and ALPS-FAS (74%). Severe combined immunodeficiency (SCID) and defects of cytotoxicity (50%) most often required expert immunology consultation. The top educational priorities were genetic testing (61%) and gene therapy (60%). The major barriers were complexity and wide range of IEIs (39%) and low referral volume (36%). Comfort levels and need for knowledge varied significantly by practice type and clinician age. A major limitation of this study was the over representation of academic practitioners.</p><p><strong>Conclusion: </strong>This ACAAI study provides insight into the current consultative practices and management of allergist-immunologists engaging in IEI care. These findings highlight the critical need for enhanced training, improved access to multidisciplinary support, and targeted continuing education to optimize care for patients with these complex disorders.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I Wish Someone Said Along the Way\": Patient Perspectives on Penicillin Allergy Evaluation During Pregnancy.","authors":"Lulu R Tsao, Angela L Chang, Jennifer Z Qin, Sara L Ackerman, Roxanna A Irani, Iris M Otani","doi":"10.1016/j.anai.2025.09.023","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.023","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}