Annals of Allergy Asthma & Immunology最新文献

{"title":"Want to help your patients with food allergy anxiety? Do proximity challenges!","authors":"Katherine K Dahlsgaard, Megan O Lewis","doi":"10.1016/j.anai.2025.02.020","DOIUrl":"10.1016/j.anai.2025.02.020","url":null,"abstract":"<p><p>Excessive anxiety regarding the potential for accidental and fatal cross-contamination is very common among patients and families with food allergy and contributes significantly to burden, reduced quality of life, and poorer management. In their landmark paper published nearly a decade ago, Dr Chitra Dinakar and colleagues recommended that food allergists incorporate proximity food challenges such as smelling or touching an allergen into regular clinical practice to improve patient knowledge regarding safety and relative risk and reduce anxiety. Such proximity challenges are akin to the exposure tasks routinely used to treat anxiety in cognitive-behavioral therapy, the first-line psychosocial intervention for anxiety disorders. Exposure is a highly evidence-based therapy technique in which patients-guided and encouraged by their providers-directly and strategically confront a feared object, situation, or activity. Anxiety eventually diminishes and erroneous beliefs are corrected when exposures happen repeatedly in the absence of the feared negative outcome. Following a summary of the history and evidence base for exposure in both the psychiatric and food allergy literature, we review several considerations related to conducting in-office proximity challenges. Topics include in-office assessment of food allergy anxiety and medically unnecessary avoidance; choosing appropriate, individualized proximity challenges based on patient presentation; and practical considerations in carrying out in-office proximity challenges to maximize benefits to anxious patients.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634593","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":"How We Treat Severe Atopic Dermatitis.","authors":"Ellen Chinchilli, Anna De Benedetto, Lisa A Beck","doi":"10.1016/j.anai.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.anai.2025.03.005","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634474","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":"Do not wait to challenge children: Results of a standard operating procedure for low-risk antibiotic challenges.","authors":"Grace Koo, Anjali Sundar, Kimberly B Woodward, Cosby A Stone, Allison E Norton","doi":"10.1016/j.anai.2025.03.006","DOIUrl":"10.1016/j.anai.2025.03.006","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634209","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":"What the clinician should know when ordering a mast cell tryptase test: A review article for the North American practicing clinician.","authors":"Moïse Michel, Delphine Giusti, Caroline Klingebiel, Bach-Nga Pham, Joana Vitte","doi":"10.1016/j.anai.2025.03.003","DOIUrl":"10.1016/j.anai.2025.03.003","url":null,"abstract":"<p><p>Tryptase is currently the most specific mast cell biomarker available in clinical laboratories. Tryptase levels in the peripheral blood contribute to the diagnostic, prognostic, and therapeutic evaluation of the following 3 clinical categories: (1) immediate hypersensitivity reactions, including the life-threatening systemic form known as anaphylaxis; (2) clonal mast cell diseases and other myeloid malignancies, also as a biomarker for efficacy of chemotherapeutic agents targeting mast cell survival; and (3) hereditary α-tryptasemia, a genetic trait found in 4% to 8% of general population associated to increased risk of severe immediate hypersensitivity reactions. Rapidly evolving pathophysiology knowledge and management guidelines affect tryptase use in clinical practice, explaining the need for frequent updates. Such updates often lack context on the pathophysiology and methods regarding mast cells and tryptase, thus hampering the practicing clinician's ability to get the full picture from tryptase test results. Here, we provide the practicing physician with the 2025 state-of-the-art recommendations on tryptase use and interpretation in clinical practice, also exposing their basic, clinical, and technical foundations. Successive additions to mast cell and tryptase research are summarized and revisited in light of today's knowledge. The review sections are titled to reflect matter-of-fact questions arising in clinical practice. Currently unmet needs of tryptase use and selected lines of ongoing research expected to influence clinical practice in the near future are also presented.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617761","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, Huai-Pao Lee, Ching-Chih Lee","doi":"10.1016/j.anai.2025.02.025","DOIUrl":"10.1016/j.anai.2025.02.025","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>To evaluate ways these receptors contribute to upper respiratory tract inflammation and to explore potential therapeutic targets in patients with eosinophilic chronic rhinosinusitis.</p><p><strong>Methods: </strong>Using protein interaction analysis, animal experiments, and human tissue samples, we assessed the effects of exposure to house dust mite allergen 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.</p><p><strong>Results: </strong>A close relationship among PAR-2 (coagulation factor II 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_H2 cytokine release (IL-25, IL-33, and thymic stromal lymphopoietin) and elevation of eosinophil 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, signal transducer and activator of transcription 6 phosphorylation, and eosinophil infiltration, and decreased inflammatory markers. PAR-2/SPI-1/IL-13Rα1 was validated in immunohistochemistry and immunofluorescence analysis of human chronic rhinosinusitis specimens.</p><p><strong>Conclusion: </strong>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 respiratory tract diseases, such as eosinophilic chronic rhinosinusitis.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-10","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}

{"title":"Factors associated with the development of severe asthma: A nationwide study (FINASTHMA).","authors":"Arja Viinanen, Pinja Ilmarinen, Juha Mehtälä, Juulia Jylhävä, Tero Ylisaukko-Oja, Juhana J Idänpään-Heikkilä, Hannu Kankaanranta, Lauri Lehtimäki","doi":"10.1016/j.anai.2025.03.002","DOIUrl":"10.1016/j.anai.2025.03.002","url":null,"abstract":"<p><strong>Background: </strong>Severe asthma presents a major challenge to health care and negatively affects the quality of life of patients. Understanding the factors predicting the development of severe asthma is limited.</p><p><strong>Objective: </strong>To characterize patients with severe asthma and establish risk factors for the development of severe asthma in a Finnish sample with a nationwide coverage of population, health care, and drug register data.</p><p><strong>Methods: </strong>We used data between January 1, 2014 and December 31, 2020. Pooled data over the years were used to identify characteristics of patients with severe asthma. Annual data were used in machine learning methods and logistic regression to identify factors predicting the development of severe asthma.</p><p><strong>Results: </strong>Analysis of pooled data including 242,164 individuals revealed that patients with severe asthma were more often women, slightly older, multimorbid, and had higher body mass index values compared with patients with nonsevere asthma. They also had higher use of nonasthma-related medications, manifesting as polypharmacy. Annual data from 6908 patients revealed that the most significant predictors of the development of severe asthma were being aged 51 to 60 years (odds ratio [OR] 3.90 [95% CI: 3.42-4.47]), chronic sinusitis (OR 2.48 [95% CI: 2.12-2.89]), and higher blood eosinophil counts (≥600 cells/μL, OR 2.10 [95% CI: 1.56-2.28]). Increases in all medications (nonasthma and asthma medications) were observed in the year before the onset of severe asthma.</p><p><strong>Conclusion: </strong>The results provide a clinically relevant risk factor profile for early identification of the patients at risk of developing severe asthma.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606380","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":"Incidence of food allergic reactions among adolescents engaged in food allergy management.","authors":"Roxanne Dupuis, Jonathan M Spergel, Terri F Brown-Whitehorn, Andrea B Troxel, Erica L Kenney, Jason P Block, Rachel Feuerstein-Simon, Xochitl Luna Marti, Cynthia J Mollen, Zachary F Meisel, Kevin G Volpp, Steven L Gortmaker, Carolyn C Cannuscio","doi":"10.1016/j.anai.2025.02.023","DOIUrl":"10.1016/j.anai.2025.02.023","url":null,"abstract":"<p><strong>Background: </strong>Although fatal food-induced anaphylaxis is rare, adolescence is the period of highest risk. However, we lack strong estimates of the incidence of food allergic reactions among adolescents.</p><p><strong>Objective: </strong>To estimate the incidence of food allergic and anaphylactic reactions among adolescents with food allergy who have a prescription for epinephrine.</p><p><strong>Methods: </strong>As part of a cohort study that was embedded in a randomized trial to promote safe food allergy management, we followed adolescents aged 15 to 19 years with food allergy and a current prescription for epinephrine for a period of 15 months in 2019 to 2020. At monthly intervals, participants were asked, through text message check-ins, whether they had experienced a food allergic reaction due to accidental exposure to food allergens in the past month.</p><p><strong>Results: </strong>Among the cohort of 131 adolescents, 112 answered at least 1 of the 15 monthly check-ins. Together, these respondents contributed 742 person-months of follow-up data of a total possible 1680 person-months. In the 15-month study period, the incidence of food allergic reactions among adolescents with food allergy was 34.0 events per 100 person-years (95% CI: 21.0-51.9). The incidence of food allergic reactions meeting the criteria for anaphylaxis was 16.2 events per 100 person-years (95% CI: 7.8-29.7).</p><p><strong>Conclusion: </strong>Data on the incidence of food allergic reactions can help set expectations for safe food allergy management for adolescents and their families, and can help inform discussions between patients, families, and physicians regarding different treatment options available and their associated risks and benefits.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03284372.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606381","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":"Gene therapy for inborn errors of immunity: Current clinical progress.","authors":"Sathi Wijeyesinghe, Javier Chinen","doi":"10.1016/j.anai.2025.02.026","DOIUrl":"10.1016/j.anai.2025.02.026","url":null,"abstract":"<p><p>Hematopoietic stem cell transplant has been the single curative treatment for inborn errors of immunity (IEI) and is recommended for the most severe IEI conditions, such as severe combined immunodeficiency. However, adverse outcomes primarily due to histocompatibility differences between the donor and the patient are still of concern. Progress in genetic and molecular mechanisms, including new technology to insert DNA sequences in cell genomes, has allowed the development of strategies to treat genetic diseases by correcting gene defect in patients' cells. This technology is named gene therapy. Gene therapy approaches being developed for IEI are mediated by gene insertion, using a retroviral vector, or by gene editing, using a combination of a nuclease and a DNA template. After the unexpected occurrence of oncogenesis associated with the initial retroviral vector designs, significant advances have led to successful gene therapy clinical trials for 3 forms of severe combined immunodeficiency, which demonstrated the safety and efficacy of this approach. Active preclinical and clinical studies are ongoing for diverse IEI, including chronic granulomatous disease, leukocyte adhesion deficiency, severe congenital neutropenia, Wiskott-Aldrich syndrome, X-linked agammaglobulinemia, and familial forms of hemophagocytic lymphohistiocytosis.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587933","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":"The use of grocery-sourced real-food solutions in sublingual immunotherapy for food allergies.","authors":"Brock A Williams, Ally Baaske, Lianne Soller, Stephanie C Erdle, Tiffany Wong, Raymond Mak, Nikhila D Schroeder, Edmond S Chan","doi":"10.1016/j.anai.2025.03.001","DOIUrl":"10.1016/j.anai.2025.03.001","url":null,"abstract":"<p><strong>Background: </strong>Sublingual immunotherapy (SLIT) is a safe, effective therapy for the treatment of food allergy. Studies demonstrating SLIT efficacy have primarily used pharmaceutical glycerinated food extracts for the administration of food allergens, which may limit accessibility due to extract cost and availability.</p><p><strong>Objective: </strong>To develop novel sample protocols and resources for the preparation of grocery-sourced real-food SLIT solutions, which could help more clinicians incorporate food SLIT into their practice and increase accessibility to this treatment. Second, to describe our site's experience with real-food SLIT implementation.</p><p><strong>Methods: </strong>Three- and five-dose build-up protocols were developed using powdered- or liquid-based forms of food allergens, with a maintenance dose of 2 to 4 mg protein/d. Patient adherence and satisfaction data were collected through online surveys. After 1 to 2 years of daily real-food SLIT maintenance dosing, patients were offered a low-dose oral food challenge (cumulative dose, 330-340 mg protein).</p><p><strong>Results: </strong>Sample protocols for real-food SLIT were developed for 31 foods, including peanut, cow's milk, cashew, egg, and sesame. At our site, 305 patients have undergone or are currently undergoing real-food SLIT. Of 162 satisfaction survey respondents, 99% (n = 160) were satisfied or very satisfied with their care. Adherence surveys revealed that 82% of the respondents (n = 105/128) reported consistently taking their SLIT dose. Among a subset of 33 patients, 57 low-dose oral food challenges were performed, of which 70.1% (n = 40) were successful.</p><p><strong>Conclusion: </strong>Grocery-sourced real-food SLIT solutions present another food SLIT option that may expand the feasibility and accessibility of this safe and effective food allergy immunotherapy.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597144","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":"Dupilumab efficacy in relation to changes in club cell secretory protein 16.","authors":"Yui Murai, Toshiyuki Koya, Hiroki Koda, Wakana Uji, Moe Tanaka, Masahiro Endo, Kyoichiro Oshima, Takahiro Matsuda, Hiroshi Ueno, Ami Aoki, Kenjiro Shima, Yosuke Kimura, Toshiaki Kikuchi","doi":"10.1016/j.anai.2025.02.019","DOIUrl":"10.1016/j.anai.2025.02.019","url":null,"abstract":"<p><strong>Background: </strong>Although the performance of dupilumab in severe asthma has been evaluated, the detailed mechanism underlying its effect remains unclear.</p><p><strong>Objective: </strong>To analyze the effect of dupilumab on serum club cell secretory protein 16 (CC16).</p><p><strong>Methods: </strong>A total of 25 patients who were administered dupilumab and underwent computed tomography before and approximately 4 months after the introduction of dupilumab were included. Clinical and computed tomography parameters before and after dupilumab administration, such as mucus plug score and wall area measurement, were compared along with serum CC16 levels. The correlation between the clinical background and treatment effects was also evaluated.</p><p><strong>Results: </strong>The number of mucus plugs and airway wall area decreased significantly after dupilumab introduction. The number of mucus plugs was positively correlated with both age and serum IgE levels. The number of mucus plugs and airway wall area was inversely correlated with percent of predicted forced expiratory volume in 1 second (FEV₁) and maximal mid-expiratory flow. Dupilumab treatment resulted in a significant increase in serum CC16 levels and led to a significant improvement in asthma symptoms, quality-of-life scores, FEV₁, and exacerbation frequency. In addition, changes in CC16 were significantly correlated with changes in the fraction of exhaled nitric oxide, IgE, quality-of-life score, FEV₁, maximal mid-expiratory flow, and mucus plug score.</p><p><strong>Conclusion: </strong>These data suggest that dupilumab improves symptoms and respiratory functions by altering the airway epithelial environment.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568686","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}