Annals of Allergy Asthma & Immunology最新文献

{"title":"Hereditary angioedema: Patient health care experiences within underrepresented racial and ethnic groups in the United States.","authors":"Timothy Craig, Alan P Baptist, John Anderson, Rafael H Zaragoza-Urdaz, Autumn F Burnette, Theodore E Kelbel, Marc A Riedl, Alejandro Vanegas, Kimberly Boyle, Jennifer L Bartsch, Christina Darden, T Michelle Brown, Bob G Schultz, Christopher Blair, Krystal Sing, Daniel Fox, Salomé Juethner","doi":"10.1016/j.anai.2025.01.007","DOIUrl":"10.1016/j.anai.2025.01.007","url":null,"abstract":"<p><strong>Background: </strong>Hereditary angioedema (HAE) is a rare disorder in which unpredictable angioedema attacks significantly affect patient quality of life. Information on patient experiences and perspectives of HAE management within underrepresented racial and ethnic groups is limited.</p><p><strong>Objective: </strong>To gain insight into the experiences and perspectives of medical care and treatment of HAE among underrepresented racial and ethnic groups in the United States.</p><p><strong>Methods: </strong>Adult patients diagnosed with having HAE who self-identified as members of an underrepresented racial and/or ethnic group were recruited to participate in a noninterventional, observational, web-based patient survey. The questionnaire included questions on medical history, current and past treatments, resource utilization, and perceived disease severity. The patient-perceived impact of HAE on the quality of life was also measured.</p><p><strong>Results: </strong>Overall, 139 patients participated in the survey; 33.1% were identified solely as \"African American or Black\" and 30.2% solely as \"Hispanic, Latin American, Latin, or Latine, or Latinx.\" Before the diagnosis, 12.3% of the patients were satisfied with their HAE-related health care experiences. Many participants experienced difficulties obtaining an HAE diagnosis. Barriers to treatment include insufficient provider knowledge of HAE and misdiagnoses. More than 90% of the patients were satisfied with their care; however, patients reported 6 HAE attacks (median) in the past year and only 10.4% of the patients were attack free. Furthermore, 38.1% found it difficult or very difficult to cover the monthly out-of-pocket costs for HAE-related treatments and 24.6% felt that their provider sometimes/rarely/never considered their individual background when making medical decisions.</p><p><strong>Conclusion: </strong>Barriers to HAE diagnosis and effective treatment persist among US patients from underrepresented racial and ethnic groups.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025693","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":"Integrated phase I pharmacokinetics and pharmacodynamics of epinephrine administered through sublingual film, autoinjector, or manual injection.","authors":"Carl N Kraus, Steve Wargacki, David Golden, Jay Lieberman, Matthew Greenhawt, Carlos A Camargo","doi":"10.1016/j.anai.2025.01.006","DOIUrl":"10.1016/j.anai.2025.01.006","url":null,"abstract":"<p><strong>Background: </strong>Epinephrine is the first-line treatment for anaphylaxis and is administered through intramuscular or subcutaneous injection. AQST-109, a sublingual film containing the prodrug epinephrine, was developed as an alternative delivery method for treating severe allergic reactions, including anaphylaxis.</p><p><strong>Objective: </strong>To compare the pharmacokinetics (PK) and pharmacodynamics (PD) of epinephrine after the administration of AQST-109 with those of epinephrine delivered by manual intramuscular injection and epinephrine autoinjectors.</p><p><strong>Methods: </strong>Data were integrated from 2 randomized, open-label, phase I crossover trials that evaluated the PK and PD of epinephrine in 54 healthy volunteers. They had no previous medical conditions and were delivered either AQST-109 12 mg or 0.3 mg EpiPen, 0.3 mg generic EpiPen, 0.3 mg Auvi-Q, and 0.3 mg manual intramuscular injection.</p><p><strong>Results: </strong>AQST-109 yielded comparable epinephrine PK and exposure to both manual intramuscular injections and epinephrine autoinjectors. The median time to maximum concentration (Tmax) for AQST-109 was 15 minutes, compared with EpiPen (10 minutes), generic EpiPen (15 minutes), Auvi-Q (30 minutes), and manual intramuscular injection (50 minutes). There was also an early, rapid, and consistent increase in systolic blood pressure, diastolic blood pressure, and heart rate after the administration of AQST-109.</p><p><strong>Conclusion: </strong>AQST-109 delivered epinephrine with PK and PD results within the bracketed range of approved intramuscular products. AQST-109 has promise as an innovative, needle-free, nondevice, portable, and orally delivered alternative for first-line treatment of type I allergic reactions, including anaphylaxis.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015750","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":"Highly accurate, noninvasive early identification of infants with a filaggrin loss-of-function mutation by in vivo Raman spectroscopy, followed from birth to 12 months.","authors":"Gerwin J Puppels, Jonathan O'B Hourihane, Claudio Nico, Carol Ni Chaoimh, Colin Wong, John E Common, Peter J Caspers, Alan D Irvine","doi":"10.1016/j.anai.2025.01.010","DOIUrl":"10.1016/j.anai.2025.01.010","url":null,"abstract":"<p><strong>Background: </strong>Loss-of-function FLG mutation (FLGmut) carriers are at an increased risk of developing atopic dermatitis (AD), characterized by earlier onset and more severe disease. AD is driven by a complex interplay between skin barrier function, T_H2 and T_H2-dominant immune dysregulation, and dysbiosis. Results from the Short-Term Topical Application for Prevention of Atopic Dermatitis study suggest 2 early initiating AD pathogenetic pathways: an FLGmut-related skin barrier deficiency pathway and an immune function-related inflammatory pathway. The Short-Term Topical Application for Prevention of Atopic Dermatitis study suggested that early preventative intervention with specialized emollients for barrier function augmentation may benefit newborns with FLGmut. This requires early identification of FLGmut carriers, for which noninvasive Raman spectroscopic determination of natural moisturizing factor (NMF) levels in the stratum corneum of the thenar eminence provides a surrogate marker.</p><p><strong>Objective: </strong>To identify strategies for early identification of infants with FLGmut.</p><p><strong>Methods: </strong>FLG sequencing was performed on 253 infants, and NMF concentrations were measured in the stratum corneum of the palmar eminence (pSC-NMF) using noninvasive Raman spectroscopy at 6 time points after birth. Furthermore, the pSC-NMF concentrations were obtained from both parents of 150 infants.</p><p><strong>Results: </strong>Babies are born with little to no NMF. In the first days after birth, NMF levels rapidly increase and 65% of newborns with FLG wild type already reach pSC-NMF concentrations, which excludes them as FLGmut carriers with high specificity. At 2 weeks of age, FLGmut carriers could be distinguished from newborns with FLG wild type with high sensitivity (97%) and specificity (97%). In addition, parent pSC-NMF concentrations offer the possibility to exclude their newborn as FLGmut carriers with high specificity.</p><p><strong>Conclusion: </strong>Noninvasive Raman spectroscopy enables the accurate early identification of infants with FLGmut.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015780","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":"Small airway dysfunction mediates the relationship between Fractional Exhaled Nitric Oxide and asthma control.","authors":"Marcello Cottini, Laura Ventura, Carlo Lombardi, Massimo Landi, Gianluca Imeri, Fabiano Di Marco, Pasquale Comberiati, Alvise Berti","doi":"10.1016/j.anai.2025.01.003","DOIUrl":"10.1016/j.anai.2025.01.003","url":null,"abstract":"<p><strong>Background: </strong>Most physiological production of Fractional exhaled Nitric Oxide (FeNO) occurs in the small airways, but studies on the relationship between FeNO and small airway dysfunction (SAD) in asthma are scant.</p><p><strong>Objective: </strong>To investigate the relationship between asthma control, changes of FeNO in relation to airway bronchodilation (BD), and SAD.</p><p><strong>Methods: </strong>Baseline conventional spirometry, impulse oscillometry, and FeNO pre- and post-BD (salbutamol 400 μg) were tested on consecutive community-treated adult patients with asthma. Results were stratified by FeNO response (change in FeNO [ΔFeNO]), being FeNO \"responder\" if the increase is greater than 10% post-BD compared with the basal values and \"nonresponder\" if less than or equal to 10%.</p><p><strong>Results: </strong>When measured, post-BD FeNO greater than 25 parts per billion was found in an additional 31.5% of patients. Of the 92 patients included, 61% were classified as FeNO \"responders\" and 39% as \"nonresponders.\" A significant moderate-to-strong correlation was observed between ΔFeNO and R5R20, a functional marker of SAD (R = 0.52, P < .0001), whereas the correlations between spirometry markers and ΔFeNO were not significant (P > .05). Both R5R20 and ΔFeNO inversely correlated with asthma control (P < .0001). Using causal mediation analysis modeling, the effect of asthma control on ΔFeNO was mediated by SAD, with a strong indirect effect of asthma control on ΔFeNO mediated by SAD (β value: -7.04, 95% CI: -11.80 to -3.53, P < .0001), without a significant direct effect (β value: -4.96, 95% CI: -9.15 to 0.11, P = .056).</p><p><strong>Conclusion: </strong>Changes in FeNO values pre-/post-BD can improve the identification of patients with \"T_H2 high\" asthma. The relationship between ΔFeNO and asthma control is mainly mediated by SAD, highlighting its contribution to asthma control.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015760","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":"Metabolomic profiles in allergic rhinitis: A systematic review and meta-analysis.","authors":"Qin-Dong Liu, Guang-Xia Pan, Ya-Jie Yan, Jing-Wei Li, Jia-Jun Zhang, Hao-Lan Liu, Chun-Qiao Li, Yu Meng, Yuan-Xian Liu, Yan Ruan","doi":"10.1016/j.anai.2024.12.022","DOIUrl":"10.1016/j.anai.2024.12.022","url":null,"abstract":"<p><strong>Background: </strong>Allergic rhinitis (AR) is a prevalent chronic inflammatory condition that significantly affects patient quality of life and poses a substantial public health burden. Recent advancements in metabolomics have facilitated a deeper understanding of the metabolic pathways involved in AR, offering potential for new biomarkers and therapeutic targets.</p><p><strong>Objective: </strong>To conduct a systematic review and meta-analysis of clinical studies summarizing the metabolomic profiles of AR to gain deeper insights into the metabolic changes and pathologic processes underlying AR.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across PubMed, Embase, Scopus, and Web of Science databases up to October 2024. A qualitative review of the screened studies was performed, followed by meta-analyses of metabolites reported in at least 2 studies. High-impact targets, pathways, and their associations were identified using bioinformatic analyses.</p><p><strong>Results: </strong>A total of 21 studies, encompassing 84 metabolites associated with AR, met the inclusion criteria. There were 7 metabolites that consistently exhibited up-regulation in AR across multiple studies and were included in the meta-analysis. Pathway enrichment analyses revealed significant involvement of pathways such as \"valine, leucine, and isoleucine biosynthesis\" and \"linoleic acid metabolism\" in AR pathogenesis. The metabolite-pathway-gene network analysis highlighted key functional connections between metabolites, pathways, and immune response genes.</p><p><strong>Conclusion: </strong>This comprehensive analysis indicates that differential metabolites may play pivotal roles in AR pathogenesis, offering potential biomarkers and therapeutic targets. Further studies are necessary to validate these findings and elucidate the complex metabolic pathways involved in AR.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015754","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":"Desensitization with telemedicine: A novel protocol using remote monitoring for oral immunotherapy for alpha-gal syndrome.","authors":"Albert G Wu, Malina C Patel, Manish Ramesh","doi":"10.1016/j.anai.2025.01.001","DOIUrl":"10.1016/j.anai.2025.01.001","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015776","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":"Mepolizumab real-world effectiveness in severe asthma with an eosinophilic phenotype and overlapping severe allergic asthma.","authors":"Jason K Lee, Stephen J Pollard, Mark C Liu, Florence Schleich, Girolamo Pelaia, Carlos Almonacid, Liam G Heaney, Rekha Chaudhuri, Rafael Alfonso-Cristancho, Lingjiao Zhang, Aoife Maxwell, Peter Howarth","doi":"10.1016/j.anai.2025.01.002","DOIUrl":"https://doi.org/10.1016/j.anai.2025.01.002","url":null,"abstract":"<p><strong>Background: </strong>Some patients with severe asthma have overlapping allergic and eosinophilic phenotypes and may be eligible for anti-eosinophilic or anti-IgE biologics.</p><p><strong>Objective: </strong>This post hoc sub-analysis assessed real-world mepolizumab effectiveness in patients with overlapping allergic and eosinophilic phenotypes, using 1-year data from the international, prospective REALITI-A study.</p><p><strong>Methods: </strong>The clinically significant asthma exacerbation (CSE) rate was assessed 1 year prior to (pre-treatment) and following (follow-up) mepolizumab treatment, stratified by baseline total IgE levels (tIgE; <60, 60-<190, 190-<550, and ≥550 kU/L), atopic status (yes/no/unknown), prior omalizumab use (yes/no), geographic baseline omalizumab eligibility (eligible/non-eligible), and baseline tIgE level and blood eosinophil count (BEC) threshold combinations (<81 or ≥81 kU/L and <300 or ≥300 cells/µL).</p><p><strong>Results: </strong>Overall, 822 patients were included. CSEs occurred in 760 (93%) patients pre-treatment and 398 (49%) during follow-up. CSE rate (RR[95% CI]) was reduced in follow-up across all tIgE subgroups (<60 [n=173]: 0.31[0.25, 0.37]; 60-<190 [n=176]: 0.30[0.25, 0.36]; 190-<550 [n=170]: 0.26[0.20, 0.33]; ≥550 kU/L [n=155]: 0.28[0.23, 0.35]) and irrespective of atopic status (yes [n=422]: 0.29[0.26, 0.33]; no [n=52]: 0.33[0.23, 0.47]; unknown [n=348]: 0.28[0.24, 0.32]), prior omalizumab use (yes [n=151]: 0.37[0.30, 0.45]; no [n=671]: 0.27[0.24, 0.30]) or eligibility (eligible (n=349): 0.29[0.25, 0.34]; non-eligible [n=191]: 0.32[0.27, 0.38]). Furthermore, the CSE rate was reduced across all tIgE (kU/L) and BEC (cells/µL) combinations (<81/<300 [n=53]: 0.34[0.24, 0.47], <81/≥300 [n=103]: 0.33[0.26, 0.41], ≥81/<300 [n=98]: 0.36[0.28, 0.47], ≥81/≥300 [n=249]: 0.26[0.22, 0.31]).</p><p><strong>Conclusion: </strong>Mepolizumab demonstrates real-world effectiveness in reducing exacerbations in patients with severe asthma and an eosinophilic phenotype, regardless of any overlapping allergic phenotype.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980586","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":"Identifying super-responders","authors":"Samuel Mailhot-Larouche MD, MSc ,&nbsp;Carlos Celis-Preciado MD, MSc ,&nbsp;Liam G. Heaney MD ,&nbsp;Simon Couillard MD, MSc","doi":"10.1016/j.anai.2024.09.023","DOIUrl":"10.1016/j.anai.2024.09.023","url":null,"abstract":"<div><div>Asthma is a chronic respiratory disease marked by heterogeneity and variable clinical outcomes. Recent therapeutic advances have highlighted patients achieving optimal outcomes, termed “remission” or “super-response.” This review evaluates the various definitions of these terms and explores how disease burden impedes the attainment of remission. We assessed multiple studies, including a recent systematic review and meta-analysis, on biologic treatments for asthma remission. Our review highlights that type 2 inflammation may be the strongest predictor of biologic response. Key comorbidities (eg, obesity and mood disorders) and behavioral factors (eg, poor adherence, improper inhalation technique, and smoking) were identified as dominant traits limiting remission. In addition, asthma burden and longer disease duration significantly restrict the potential for remission in patients with severe asthma under the current treatment paradigm. We review the potential for a “predict-and-prevent” approach, which focuses on early identification of high-risk patients with type 2 inflammation and aggressive treatment to improve long-term asthma outcomes. In conclusion, this scoping review highlights the following unmet needs in asthma remission: (1) a harmonized global definition, with better defined lung function parameters; (2) integration of nonbiologic therapies into remission strategies; and (3) a clinical trial of early biologic intervention in patients with remission-prone, very type 2-high, moderately severe asthma with clinical remission as a predefined primary end point.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 1","pages":"Pages 31-45"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The next frontier","authors":"Elena Zidan MD ,&nbsp;Gabriella Wilson MD ,&nbsp;Junghee Jenny Shin MD, PhD ,&nbsp;Geoffrey Chupp MD","doi":"10.1016/j.anai.2024.10.013","DOIUrl":"10.1016/j.anai.2024.10.013","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 1","pages":"Pages 3-4"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479913","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;Iris Otani MD ,&nbsp;Shyam R. Joshi MD ,&nbsp;Timothy Chow MD","doi":"10.1016/j.anai.2024.08.013","DOIUrl":"10.1016/j.anai.2024.08.013","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 1","pages":"Pages 105-106"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047461","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}