Annals of Allergy Asthma & Immunology最新文献

{"title":"Basic Mechanisms of Itch and Advances in Clinical Management.","authors":"Giulia Coscarella, Elise Edwards, Gil Yosipovitch","doi":"10.1016/j.anai.2025.09.014","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.014","url":null,"abstract":"<p><p>Chronic pruritus requires comprehensive assessment and management due to its profound impact on quality of life. The etiologies of pruritus are diverse, encompassing dermatologic, neuropathic, systemic, psychogenic, and mixed causes. Pruritogens activate C and Aδ fibers through histaminergic and non-histaminergic pathways. Increasing evidence highlights the role of Th2 cytokines, particularly interleukin (IL)-4, IL-13, and IL-31, which directly stimulate sensory neurons and perpetuate the itch-scratch cycle. Itch perception arises from dynamic interactions between the immune system and the peripheral and central nervous systems. Signals transmitted by sensory fibers are processed in the dorsal horn and relayed to thalamic and cortical centers, reinforcing chronicity. Diagnostic evaluation begins with detailed history and examination, complemented by laboratory testing such as complete blood count, kidney, liver, glucose, and thyroid function tests to uncover systemic or neurologic contributors. For dermatologic conditions, topical immunomodulators-including corticosteroids, calcineurin inhibitors, and PDE4 inhibitors- are first-line options for localized itch. Extensive itch may require systemic immunosuppressants or phototherapy. Biologic agents targeting IL-4/IL-13 and IL-31 pathways have revolutionized treatment for atopic dermatitis and prurigo nodularis, while JAK-STAT inhibitors also offer significant antipruritic effect in atopic dermatitis and beyond. Neuropathic itch may respond to topical anesthetics: menthol, pramoxine, capsaicin, or compounded ketamine-amitriptyline-lidocaine formulations, as well as systemic gabapentinoids and antidepressants. Systemic or intractable pruritus may benefit from kappa opioid receptor agonists. New drugs targeting the mast cell such as BTK inhibitors, c-KIT inhibitors, and MRGPRX2 antagonists have robust anti-pruritic effects in mast cell-mediated diseases. Supportive measures, including psychosocial interventions, remain integral to long-term management.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228289","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":"Beyond availability in campus subcutaneous immunotherapy delivery","authors":"Tsai Ling Ting BS, RN ,&nbsp;Yuan-Ti Lee MD, PhD","doi":"10.1016/j.anai.2025.05.034","DOIUrl":"10.1016/j.anai.2025.05.034","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Page 460"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183755","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 tralokinumab on moderate-to-severe atopic dermatitis in patients with atopic comorbidities","authors":"Amy S. Paller MD ,&nbsp;Weily Soong MD ,&nbsp;Mark Boguniewicz MD ,&nbsp;Bob Geng MD ,&nbsp;Jacob P. Thyssen MD, PhD ,&nbsp;Niels Bennike MD, PhD ,&nbsp;Shannon Schneider PhD ,&nbsp;Andreas Wollenberg MD","doi":"10.1016/j.anai.2025.06.022","DOIUrl":"10.1016/j.anai.2025.06.022","url":null,"abstract":"<div><h3>Background</h3><div>Atopic dermatitis (AD) is known to be associated with other atopic comorbidities that all involve type 2 immune dysregulation. Tralokinumab is a monoclonal antibody that specifically targets interleukin-13. As comorbid atopic disease could indicate a more severe AD phenotype, it is important to assess the effect of tralokinumab treatment in patients with these comorbidities.</div></div><div><h3>Objective</h3><div>To assess the efficacy and safety of tralokinumab treatment for AD in adult and adolescent patients with moderate-to-severe AD with and without a patient-reported history of atopic comorbidities at baseline, using data from the placebo-controlled trials (ECZema TRAlokinumab) ECZTRA 1, ECZTRA 2, ECZTRA 3, and ECZTRA 6.</div></div><div><h3>Methods</h3><div>In this post hoc analysis, subgroups were defined by a history of patient-reported asthma, food allergy, hay fever, and/or allergic conjunctivitis. End points included greater than or equal to 75% improvement in Eczema Area and Severity Index–75, Investigator's Global Assessment score of 0 or 1, and adverse events at week 16.</div></div><div><h3>Results</h3><div>At baseline, patients with a history of at least 1 atopic comorbidity exhibited more severe disease than patients with no atopic comorbidities. At week 16, higher proportions of adult and adolescent patients receiving tralokinumab vs placebo achieved Eczema Area and Severity Index–75 and Investigator's Global Assessment score of 0 or 1, regardless of the presence of atopic comorbidities at baseline. Most adverse events were of mild or moderate severity.</div></div><div><h3>Conclusion</h3><div>Regardless of the presence or number of self-reported atopic comorbidities, 16 weeks of tralokinumab treatment improved AD severity in adults and adolescents.</div></div><div><h3>Trial Registration</h3><div>ClinicalTrials.gov Identifiers: ECZTRA 1 (NCT03131648); ECZTRA 2 (NCT03160885); ECZTRA 3 (NCT03363854); and ECZTRA 6 (NCT03526861).</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 425-433.e4"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486825","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":"Managing anaphylaxis in patients on β-blockers","authors":"Dayna Miyashiro MD,&nbsp;Edsel M. Abud MD, PhD,&nbsp;Kevin A. Cook MD,&nbsp;Andrew A. White MD","doi":"10.1016/j.anai.2025.06.031","DOIUrl":"10.1016/j.anai.2025.06.031","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 452-453"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602170","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":"Information for Readers","authors":"","doi":"10.1016/S1081-1206(25)00434-X","DOIUrl":"10.1016/S1081-1206(25)00434-X","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Page A4"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183790","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":"Mediation of pediatric atopic dermatitis in emotional and behavioral outcomes by sleep disturbance","authors":"Aaron Bao BA ,&nbsp;Patrick G. Sockler MD ,&nbsp;Cyd K. Eaton PhD ,&nbsp;Sarah Radtke PhD ,&nbsp;Adam P. Spira PhD ,&nbsp;Joy Wan MD, MSCE","doi":"10.1016/j.anai.2025.05.026","DOIUrl":"10.1016/j.anai.2025.05.026","url":null,"abstract":"<div><h3>Background</h3><div>Atopic dermatitis (AD) is associated with increased risk of emotional and behavioral problems in children, but the mechanisms underlying this relationship are not fully understood.</div></div><div><h3>Objective</h3><div>To evaluate sleep disturbance and sleep duration as potential mediators between AD and emotional/behavioral problems in children across childhood.</div></div><div><h3>Methods</h3><div><span>We performed mediation analyses at 3 timepoints using data from the Avon Longitudinal Study of Parents and </span>Children birth<span> cohort in the United Kingdom. The exposure was child's AD status, categorized as no AD, inactive AD, mild active AD, or moderate/severe active AD. Mediators were maternal-reported child sleep disturbances and total 24-hour sleep duration. Outcomes were emotional and behavioral problems assessed through the parent-reported Strengths and Difficulties Questionnaire (SDQ) and depressive symptoms through the Short Moods and Feelings Questionnaire. Analyses were adjusted for sociodemographic factors.</span></div></div><div><h3>Results</h3><div>More active/severe AD was associated with greater sleep disturbance and higher levels of emotional/behavioral problems across all timepoints. Mediation models revealed significant direct effects of active AD on SDQ total difficulties. Indirect effects mediated by sleep duration were minimal (&lt;1% of total effect), whereas those mediated by sleep disturbance were significant across AD severity strata for SDQ (6.5%-26.7% of total effect) and Short Moods and Feelings Questionnaire (10.9%-14.0% of total effect). Bedtime refusal and early awakenings were most strongly associated with clinically concerning SDQ scores.</div></div><div><h3>Conclusion</h3><div>Sleep disturbance significantly mediates the association between AD and emotional/behavioral problems in children. Interventions targeting sleep may be 1 approach to reducing the psychological burden of AD in pediatric populations.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 434-442"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210147","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":"Update on desensitization to chemotherapeutics and biologicals","authors":"Joana Caiado MD, PhD ,&nbsp;Mariana C. Castells MD, PhD","doi":"10.1016/j.anai.2025.07.018","DOIUrl":"10.1016/j.anai.2025.07.018","url":null,"abstract":"<div><div>Hypersensitivity reactions to chemotherapeutics and biologicals are increasing, which can affect the prognosis of the underlying disease. Purpose of review: The goal of this review is to provide recent advancements in the diagnosis and management of hypersensitivity reactions based on current data. Recent findings: Multiple studies have provided evidence of the safety and efficacy of rapid drug desensitizations. The knowledge of recently described phenotypes (type I, cytokine release syndrome, and mixed reactions) and current biomarkers (tryptase, interleukin-6, skin testing, basophil activation, and specific IgE) allows a correct risk stratification, critical to guide the desensitization planning. Personalized protocols and premedications have been successfully used to decrease the number and severity of breakthrough reactions. Summary: Rapid drug desensitization allows patients to be treated with best therapies, increasing the quality of life and life expectancy.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 374-382"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719079","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":"From the pages of AllergyWatch","authors":"Stanley M. Fineman MD ,&nbsp;Gerald Lee MD ,&nbsp;Shyam R. Joshi MD ,&nbsp;Iris Otani MD","doi":"10.1016/j.anai.2025.06.035","DOIUrl":"10.1016/j.anai.2025.06.035","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 462-463"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610250","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":"Implications of removing race from spirometry reference equations in children with asthma","authors":"Lina Z. Mahmood MD ,&nbsp;Tamara T. Perry MD ,&nbsp;Akilah A. Jefferson MD, MSc ,&nbsp;Ariel Berlinski MD","doi":"10.1016/j.anai.2025.07.003","DOIUrl":"10.1016/j.anai.2025.07.003","url":null,"abstract":"<div><h3>Background</h3><div>The Global Lung Initiative (GLI) recently developed a race-neutral reference equation in 2022 (GLI-2022); however, the implications of its use in children with asthma, especially Latino children, have not been extensively studied.</div></div><div><h3>Objective</h3><div>To assess the difference in spirometry results, asthma severity, and airway obstruction classification for African American (AA), Latino, and White children with asthma after implementing GLI-2022.</div></div><div><h3>Methods</h3><div>This retrospective cross-sectional study evaluated the first spirometry performed by children with asthma aged 5 to 17 years between January 1, 2018, and December 31, 2023. z-Scores and percent-predicted (pp) values for forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), and FEV₁/FVC were calculated using GLI-2022 and race-adjusted GLI-2012 equations.</div></div><div><h3>Results</h3><div>A total of 7138 children (3543 AA, 2795 White, and 800 Latino) were included (median age = 10.3 years). FEV₁ z-score median difference was −0.872, −0.360, and +0.267 in AA, Latino, and White children, respectively (<em>P</em> &lt; .0001) after implementing GLI-2022. FVC z-scores, ppFEV₁, and ppFVC values demonstrated similar patterns. Adopting GLI-2022 worsened asthma severity (based on ppFEV₁) and degree of airway obstruction (based on FEV₁ z-score) classifications in AA children, improved them in White children, and did not affect Latino children.</div></div><div><h3>Conclusion</h3><div>Implementing GLI-2022 affected asthma severity and airway obstruction classifications and resulted in a lower FVC and FEV₁ in AA and Latino children and greater values in White children. Using GLI-2022 may uncover more cases of underdiagnosed asthma in AA and Latino children, which may contribute to alleviating disparate asthma outcomes.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 385-392.e5"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621098","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":"Protease-activated receptor 2 and interleukin-13 receptor α1 activation is linked to eosinophilic chronic rhinosinusitis","authors":"En-Chih Liao PhD ,&nbsp;Huai-Pao Lee MD ,&nbsp;Ching-Chih Lee MD, PhD","doi":"10.1016/j.anai.2025.02.025","DOIUrl":"10.1016/j.anai.2025.02.025","url":null,"abstract":"<div><h3>Background</h3><div>Protease-activated receptor 2 (PAR-2) and interleukin (IL)-13 receptor α1 (Rα1) play major roles in type 2 inflammation. However, most of the literature was limited to allergic asthma.</div></div><div><h3>Objective</h3><div><span>To evaluate ways these receptors contribute to upper respiratory tract inflammation<span> and to explore potential therapeutic targets in patients with eosinophilic </span></span>chronic rhinosinusitis.</div></div><div><h3>Methods</h3><div>Using protein interaction analysis, animal experiments, and human tissue samples, we assessed the effects of exposure to house dust mite allergen<span> on PAR-2 and IL-13Rα1 activation and inflammatory markers, and the impact of the PAR-2 antagonist GB88. A fluorescent multiplex staining kit was used, along with specific antibodies, to label and detect proteins in the immunofluorescence tissue samples.</span></div></div><div><h3>Results</h3><div><span>A close relationship among PAR-2 (coagulation factor II<span> receptor-like 1), SPI-1, IL-13Rα1, and RNASE2 (eosinophil-derived neurotoxin) was noted in protein interaction analysis. House dust mite exposure significantly activated PAR-2 and IL-13Rα1 in nasal epithelial cells, leading to T</span></span>_H<span><span><span>2 cytokine release (IL-25, IL-33, and thymic stromal lymphopoietin) and elevation of </span>eosinophil<span> proteins (eosinophil cationic protein and eosinophil-derived neurotoxin) that intensify upper respiratory tract inflammation. The PAR-2 antagonist GB88 reduced house dust mite allergen-induced PAR-2 and IL-13Rα1 expression, </span></span>signal transducer and activator of transcription 6<span><span> phosphorylation, and eosinophil infiltration, and decreased inflammatory markers. PAR-2/SPI-1/IL-13Rα1 was validated in </span>immunohistochemistry<span> and immunofluorescence analysis of human chronic rhinosinusitis specimens.</span></span></span></div></div><div><h3>Conclusion</h3><div><span>The PAR-2/IL-13Rα1 pathway is a promising target for treating upper respiratory tract inflammation. PAR-2 inhibitors could reduce inflammation and improve the outcomes of upper </span>respiratory tract diseases, such as eosinophilic chronic rhinosinusitis.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 412-418.e1"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617754","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}