Annals of Allergy Asthma & Immunology最新文献

{"title":"What’s new in the care of patients with asthma?","authors":"John J. Oppenheimer MD","doi":"10.1016/j.anai.2026.02.011","DOIUrl":"10.1016/j.anai.2026.02.011","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"136 5","pages":"Page 501"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826537","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":"Venom immunotherapy choices: What a cluster!","authors":"Kevin M. White MD","doi":"10.1016/j.anai.2026.01.020","DOIUrl":"10.1016/j.anai.2026.01.020","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"136 5","pages":"Pages 504-505"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826538","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 the asthma guidelines: Look under the hood, particularly in asthma considered well controlled","authors":"Vincent Hussey MD , Marcello Cottini MD , Rory Chan PhD, FRCPE , Stanley P. Galant MD","doi":"10.1016/j.anai.2025.12.008","DOIUrl":"10.1016/j.anai.2025.12.008","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"136 5","pages":"Pages 502-503"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752384","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":"Cross-reactivity between amoxicillin and piperacillin–tazobactam in patients with amoxicillin allergy: A prospective study","authors":"Adelaida Cabrera MD ,&nbsp;Esther Moreno MD, PhD ,&nbsp;Nerea Otero MD ,&nbsp;Francisco-Javier Muñoz-Bellido MD, PhD ,&nbsp;Elena Laffond MD, PhD ,&nbsp;María Teresa Gracia-Bara MD ,&nbsp;Cristina Martín MD, PhD ,&nbsp;Milagros Lázaro MD, PhD ,&nbsp;Alicia Gallardo MD ,&nbsp;Ignacio Dávila MD, PhD","doi":"10.1016/j.anai.2026.01.002","DOIUrl":"10.1016/j.anai.2026.01.002","url":null,"abstract":"<div><h3>Background</h3><div>Amoxicillin (AX) is the most frequently prescribed β-lactam antibiotic in the USA and Europe and a leading cause of drug-induced hypersensitivity. Although cross-reactivity between aminopenicillins and ureidopenicillins can be considered unlikely based on side-chain dissimilarity, clinical data remain limited.</div></div><div><h3>Objective</h3><div>To prospectively evaluate cross-reactivity to piperacillin–tazobactam (PPZ–TZB) in patients with confirmed AX hypersensitivity.</div></div><div><h3>Methods</h3><div>We conducted a prospective study of 49 patients with confirmed AX hypersensitivity. Diagnosis was established through clinical history, skin testing (ST), specific IgE testing, and drug provocation testing (DPT), where indicated. All patients were systematically tested with PPZ–TZB by ST, followed by DPT in those with negative results.</div></div><div><h3>Results</h3><div>Among 49 patients with confirmed AX hypersensitivity (mean age, 47.5 years; 61.2% female), 31 (63.3%) experienced immediate reactions and 18 (36.5%) experienced non-immediate reactions. Anaphylaxis was the most common presentation (49.9%). AX hypersensitivity was confirmed by positive ST result in 32 patients (65.3%), specific IgE in 3 (6.1%), DPT in 12 (24.5%), and clinical history in 2 (4.1%). All patients had negative results for penicillin major and minor determinants. PPZ–TZB hypersensitivity was diagnosed in 9 patients (18.4%), mostly by positive ST results (8 cases) and in 1 case by DPT, which elicited acute bronchospasm. Cross-reactivity occurred in both immediate and non-immediate groups.</div></div><div><h3>Conclusion</h3><div>In this cohort of patients with confirmed AX allergy, cross-reactivity to PPZ–TZB occurred in approximately one-fifth of cases, most frequently identified by ST. These results emphasize that systematic allergy workup—particularly ST followed by DPT when result is negative—is essential before prescribing PPZ–TZB in patients with AX hypersensitivity.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"136 5","pages":"Pages 596-601"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999560","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 learned regarding optimal use of biologics to achieve disease remission in severe asthma","authors":"Liam Michael Coyle MRCP ,&nbsp;Pamela Jane McDowell PhD ,&nbsp;Liam Gabriel Heaney MD","doi":"10.1016/j.anai.2026.02.008","DOIUrl":"10.1016/j.anai.2026.02.008","url":null,"abstract":"<div><div>Severe asthma management has changed dramatically in the last decade after the introduction of T2-directed biologic therapies. This has enabled more ambitious treatment goals, including on-treatment clinical remission in severe asthma. Definitions of clinical remission have invariably included absence of both systemic corticosteroids for disease control and asthma exacerbations but have varied regarding the level of required symptom control and optimal lung function; a single definition would allow a better understanding of the longer-term impact of achieving clinical remission in both clinical practice and research studies. Studies have revealed that a few patients with severe asthma achieve clinical remission, and key barriers have been identified, including those associated with disease-related airway damage, such as fixed airflow obstruction associated with high symptom burden, and comorbidities including those from corticosteroid toxicity, such as obesity, anxiety, and depression. Earlier intervention with biologic therapy has been proposed as a potential method to overcome these barriers, tackling the T2 inflammation before disease and corticosteroid-related damage are established. However, biologic therapy should not be considered a panacea, and appropriate patient selection remains key to ensuring their optimal use. T2 biomarker–guided therapy allows clinicians to correlate clinical manifestations to the underlying biological etiology. Biomarker-guided biologic therapy alongside treatment of non–T2-driven disease may improve clinical remission attainment rates. Conversely, the presence of ongoing T2 inflammation alongside on-treatment clinical remission raises questions regarding the long-term effect of subclinical inflammation.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"136 5","pages":"Pages 520-528"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345752","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":"Adult-onset walnut allergy immediately after a negative walnut challenge","authors":"Emma Perkins MD, BMedSci, BBiomedSci ,&nbsp;Megan Howden BSc, BMBS, FRACP ,&nbsp;Celia Zubrinich MBBS (Hons) MPhil, FRACP","doi":"10.1016/j.anai.2025.12.020","DOIUrl":"10.1016/j.anai.2025.12.020","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"136 5","pages":"Pages 606-607"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994691","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":"Relative particle size and distribution of inhaled triple therapies","authors":"Brian Lipworth MD ,&nbsp;Enrico Zambelli MSc ,&nbsp;Ruben Agazzi MSc ,&nbsp;Alessio Piraino MD","doi":"10.1016/j.anai.2025.12.016","DOIUrl":"10.1016/j.anai.2025.12.016","url":null,"abstract":"<div><h3>Background</h3><div>Many patients with asthma or chronic obstructive pulmonary disease have small airways dysfunction, the presence of which has clinical implications including poor disease control and worse health status. It is, therefore, important to evaluate the ability of an inhaled product used for the treatment of asthma or chronic obstructive pulmonary disease to penetrate the small airways.</div></div><div><h3>Objective</h3><div>To compare the aerodynamic particle size distribution of 3 triple combination inhalers: beclomethasone dipropionate/formoterol fumarate/glycopyrronium (BDP/FF/G), budesonide/formoterol fumarate/glycopyrronium (BUD/FF/G), and fluticasone furoate/vilanterol/umeclidinium (FLU/VI/UMEC).</div></div><div><h3>Methods</h3><div>Parameters evaluated via a Next Generation Impactor analysis included particle size as mass median aerodynamic diameter and extrafine particle fraction (eFPF; diameter &lt; 2 µm) calculated as a percentage of the delivered dose. The mass of each component was evaluated using high-performance liquid chromatography assays (FF as the dihydrate salt, G as the bromide salt, VI as the trifenatate salt, and UMEC as the bromide salt).</div></div><div><h3>Results</h3><div>Mass median aerodynamic diameter values for all 3 components of BDP/FF/G were consistent (1.1 µm) and were lower than BUD/FF/G (3.02-3.36 µm) and FLU/VI/UMEC (1.96-4.13 µm). Mean eFPFs of the 3 components of BDP/FF/G were also consistent (39.0%-39.9%) and were higher than those of the other 2 therapies (BUD/FF/G, 10.5%-16.2%; FLU/VI/UMEC, 6.8%-27.7%), especially for the BDP component, which was 3.8-fold higher than BUD and 5.8-fold higher than FLU.</div></div><div><h3>Conclusion</h3><div>BDP/FF/G delivers consistently smaller particles than either BUD/FF/G or FLU/VI/UMEC, translating into a commensurate higher eFPF, in turn suggesting greater potential to target the small airways.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"136 5","pages":"Pages 545-549"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821897","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":"Clustering of patients with severe asthma based on long-term percentage of forced expiratory volume in 1 second (FEV1) changes","authors":"Youngsoo Lee MD ,&nbsp;Junhyuk Chang PharmD ,&nbsp;Chungsoo Kim PharmD, PhD ,&nbsp;Eunyoung Lee PhD ,&nbsp;Jae-Hyuk Jang MD ,&nbsp;Rae Woong Park MD, PhD ,&nbsp;Hae-Sim Park MD, PhD","doi":"10.1016/j.anai.2025.12.002","DOIUrl":"10.1016/j.anai.2025.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Severe asthma is a heterogeneous disease with variable clinical manifestations and treatment responses. Long-term assessment of lung function trajectories may help define phenotypic and endotypic subgroups.</div></div><div><h3>Objective</h3><div>To identify distinct phenotypic clusters in patients with severe asthma using longitudinal changes in percentage of forced expiratory volume in 1 second (FEV₁%) and assess the associated clinical and inflammatory profiles.</div></div><div><h3>Methods</h3><div>This single-center, retrospective cohort study analyzed 10-year follow-up data from adult patients with severe asthma. Latent class mixed model analysis was performed using serial FEV₁% changes. Baseline characteristics and medication use were compared with analysis of variance and χ² tests. Linear mixed models assessed longitudinal trends in fractional exhaled nitric oxide (FeNO) levels and blood eosinophil/neutrophil counts.</div></div><div><h3>Results</h3><div>Altogether, 310 patients (mean age, 44.7 ± 14.4 years; 35.2% were males) were included. The following 3 distinct clusters were identified: group 1 (n = 45) demonstrating a progressive decline in FEV₁% despite receiving maintenance therapy (refractory to current treatments); group 2 (n = 211) maintaining stable FEV₁% (≥80%); and group 3 (n = 54) demonstrating improvement. Group 1 had higher baseline FeNO and eosinophils than group 2, with eosinophil levels comparable to group 3. Over time, group 1 exhibited persistently elevated FeNO and eosinophil levels than groups 2 and 3, whereas neutrophil and IgE trajectories had no differences. Group 1 also required higher cumulative systemic corticosteroid doses.</div></div><div><h3>Conclusion</h3><div>Three distinct FEV₁% trajectories were identified in severe asthma. The treatment-refractory group demonstrated progressive lung function decline despite higher corticosteroid use and persistent T2 inflammation, underscoring the need for biologic therapies than corticosteroid escalation.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"136 5","pages":"Pages 538-544.e2"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702426","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":"Epithelial histone deacetylase 7 (HDAC7) constitutes a negative feedback loop restraining interleukin (IL)-13–driven eosinophilic inflammation in chronic rhinosinusitis","authors":"Xiwen Sun MD ,&nbsp;Wenqin Liu MD ,&nbsp;Yueming Cui MD, PhD ,&nbsp;Haoyan Guan MD, PhD ,&nbsp;Yueqi Sun MD, PhD ,&nbsp;Rui Xu MD, PhD","doi":"10.1016/j.anai.2026.01.013","DOIUrl":"10.1016/j.anai.2026.01.013","url":null,"abstract":"<div><h3>Background</h3><div>Epithelial dysfunction is a central driver of type 2 inflammation in chronic rhinosinusitis with nasal polyps (CRSwNP). Although epigenetic mechanisms are known to regulate mucosal immunity, the specific role of histone deacetylase 7 (HDAC7) in modulating the magnitude of epithelial type 2 responses remains unclear. We hypothesized that HDAC7 functions as an inducible checkpoint to restrain excessive inflammation.</div></div><div><h3>Objective</h3><div>To explore the role of epithelial HDAC7 in restraining excessive inflammation in CRSwNP.</div></div><div><h3>Methods</h3><div>Primary human nasal epithelial cells were exposed to inflammatory stimuli to identify HDAC7 inducers. Epithelial HDAC7 expression in patient tissues was correlated with inflammatory markers and remodeling indices. Mechanistic roles were assessed using lentiviral knockdown, transcriptome sequencing, and eosinophil chemotaxis assays.</div></div><div><h3>Results</h3><div>Interleukin (IL)-13 selectively induced epithelial HDAC7 expression. In clinical tissues, lower HDAC7 expression within the CRSwNP cohort correlated with severe type 2 inflammation and mucosal remodeling. Transcriptomic analysis revealed that HDAC7-low tissues demonstrated enriched type 2 pathways, whereas high expression aligned with T_H1/T_H17 signatures. In vitro, silencing HDAC7 amplified the broader IL-13–induced transcriptional program and specifically enhanced C-C motif chemokine ligand 26 (CCL26) production, promoting C-C chemokine receptor type 3–dependent eosinophil migration. Notably, this effect appeared specific to HDAC7 loss, as broad-spectrum HDAC inhibition with trichostatin A suppressed CCL26 and did not recapitulate the knockdown phenotype.</div></div><div><h3>Conclusion</h3><div>HDAC7 appears to function as an inducible negative regulator in the nasal epithelium, attenuating IL-13–driven CCL26 production. Disruption of this feedback loop may contribute to exacerbated type 2 inflammation, suggesting epithelial HDAC7 as a potential biomarker and therapeutic target for CRSwNP.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"136 5","pages":"Pages 578-588.e3"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100973","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":"Epigenetic remodeling of the nasal epithelium in chronic rhinosinusitis: Histone deacetylase 7 (HDAC7) mediates type 2 inflammation","authors":"Cameron D. Griffiths PhD","doi":"10.1016/j.anai.2026.02.014","DOIUrl":"10.1016/j.anai.2026.02.014","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"136 5","pages":"Pages 508-509"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826540","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}