Annals of Allergy Asthma & Immunology最新文献

{"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":"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":"Clinical burden, treatment, and disease control in patients with chronic spontaneous urticaria","authors":"Marc A. Riedl MD, MS ,&nbsp;Dhaval Patil MS ,&nbsp;Jonathan Rodrigues MD ,&nbsp;Merin Kuruvilla MD ,&nbsp;Tara Raftery PhD ,&nbsp;Irina Pivneva PhD ,&nbsp;Jason Doran MBA ,&nbsp;Arthur Voegel MA ,&nbsp;James Signorovitch PhD ,&nbsp;Gil Yosipovitch MD","doi":"10.1016/j.anai.2024.12.008","DOIUrl":"10.1016/j.anai.2024.12.008","url":null,"abstract":"<div><h3>Background</h3><div>Chronic spontaneous urticaria (CSU) is an unpredictable inflammatory skin condition with substantial clinical burden that affects 0.23% to 0.78% of the US population.</div></div><div><h3>Objective</h3><div>To describe the incidence and prevalence of patients with a record of CSU diagnosis, treatment patterns, disease control, and clinical and economic burden in a US cohort of patients with CSU.</div></div><div><h3>Methods</h3><div>Adults with a record of CSU diagnosis within the US HealthVerity claims database were eligible. Age- and gender-adjusted prevalence/incidence rates were calculated for January 2017 to December 2022. Clinical characteristics were described during the 1 year before CSU diagnosis (baseline) and the time after (follow-up). Proxy events representing uncontrolled CSU (any record of prescriptions for corticosteroids, biologics, or immunosuppressants [excluding all antihistamines and over-the-counter medication] or any CSU-related inpatient admissions or emergency department or urgent care visits) were used to identify patients with uncontrolled CSU. Health care resource utilization (HCRU) and health care costs were described.</div></div><div><h3>Results</h3><div>Overall, 200,298 patients were followed-up for a median of 2.3 years after diagnosis. Estimated cumulative prevalence of diagnosed CSU was 0.57% (women: 0.80%; men: 0.32%). The average annual incidence rate was 0.08%. Corticosteroids were the most prescribed treatment during follow-up among the 166,195 patients prescribed at least 1 treatment (94.3%). Proxy events were observed in 59.1% of the patients. HCRU and health care costs increased from baseline in patients with uncontrolled CSU during follow-up.</div></div><div><h3>Conclusion</h3><div>Of patients with CSU who were prescribed treatment, more than 50% experienced uncontrolled CSU, which was associated with increased HCRU and health care costs.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 3","pages":"Pages 324-332.e4"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856532","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":"Further evidence for the roles of computed tomography in managing severe asthma","authors":"Naoya Tanabe MD, PhD","doi":"10.1016/j.anai.2024.12.014","DOIUrl":"10.1016/j.anai.2024.12.014","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 3","pages":"Pages 251-252"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529834","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":"Mild asthma—What matters to patients and parents","authors":"Emma Greimann MD ,&nbsp;George E. Freigeh MD, MA ,&nbsp;Rachel P. Wettenstein BS ,&nbsp;Belinda Nelson MSW, PhD ,&nbsp;Laurie M. Carpenter MSW ,&nbsp;Arjun Mohan MBBS ,&nbsp;Alan Baptist MD, MPH","doi":"10.1016/j.anai.2024.11.017","DOIUrl":"10.1016/j.anai.2024.11.017","url":null,"abstract":"<div><h3>Background</h3><div>Mild asthma has received less attention despite accounting for most of patient with asthma. However, asthma complications including hospitalizations and progressive loss of lung function frequently occur in such patients. The priorities of patients with mild asthma are unknown, hindering the ability to advance care.</div></div><div><h3>Objective</h3><div>To identify patient and parent perspectives on the definition of mild asthma, treatment preferences, concerns and goals of care.</div></div><div><h3>Methods</h3><div>Participants with self-defined mild/intermittent asthma were recruited using emails distributed through the Allergy &amp; Asthma Network and Allergy Foundation of America. A demographic survey and measures of asthma control/quality of life were completed. Focus groups consisting of approximately 5 participants and a focus group leader were conducted.</div></div><div><h3>Results</h3><div>A total of 20 patients and 20 parents of children with mild asthma participated. Focus groups revealed significant variability in the definition and treatment preferences. Frequency of symptoms appears to be a key driver in treatment decisions for mild asthma, and those with infrequent symptoms were opposed to the addition of an inhaled corticosteroid to albuterol. Use of recommended asthma monitoring strategies such as asthma action plans or peak flow meters was low among adults. Participants desired more education from their providers regarding asthma remission and long-term complications associated with mild asthma.</div></div><div><h3>Conclusion</h3><div>There is significant heterogeneity in the definition and treatment preferences among patients and parents of those with mild asthma. Shared decision making between patients and providers is necessary to personalize medical decisions in those with mild asthma.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 3","pages":"Pages 290-295.e1"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752149","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 no harm: An ethical approach to refractory anaphylaxis to chemotherapy","authors":"Timothy M. Buckey MD, MBE","doi":"10.1016/j.anai.2024.11.024","DOIUrl":"10.1016/j.anai.2024.11.024","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 3","pages":"Pages 247-248"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774572","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":"High prevalence of eosinophilic gastrointestinal disorders in patients with atopic disease","authors":"Alexandra A. Weir MS ,&nbsp;Onyinye I. Iweala MD, PhD ,&nbsp;Evan S. Dellon MD, MPH","doi":"10.1016/j.anai.2024.12.001","DOIUrl":"10.1016/j.anai.2024.12.001","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 3","pages":"Pages 362-364"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803196","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}