Allergy Asthma and Clinical Immunology最新文献

{"title":"Unrecognized ciliary motility disorders in neutrophilic severe asthma exacerbations.","authors":"Sarita Thawanaphong, Lucia Gonzalez-Bravo, Katherine Radford, Melanie Kjarsgaard, Carmen Venegas Garrido, Sergey Fedosenko, Terence Ho, Lindsey Dyment, Nadia Suray Tan, Kayla Zhang, Adil Adatia, Manali Mukherjee, Myrna Dolovich, Parameswaran Nair","doi":"10.1186/s13223-026-01041-1","DOIUrl":"https://doi.org/10.1186/s13223-026-01041-1","url":null,"abstract":"<p><strong>Background: </strong>Airway bacterial infections are frequent in severe asthma and are often under-appreciated as contributors to symptoms and exacerbations. We report our experience using integrative diagnostic methods to identify ciliary motility disorders as contributors to neutrophilic exacerbations in patients with severe asthma.</p><p><strong>Methods: </strong>Targeted exome sequencing for primary ciliary dyskinesia (PCD) was performed on 52 patients with severe asthma who met predefined criteria (≥ 3 respiratory infections or intense sputum neutrophilia, within a 2-year period, along with evidence of type 2 inflammation, including peripheral or sputum eosinophilia, elevated fractional exhaled nitric oxide (FeNO), or elevated serum immunoglobulin E), and without other obvious immunodeficiencies. A subset of patients with PCD-related gene variant(s) underwent ciliary beat frequency (CBF) analysis from nasal epithelial brushings (N = 20 with analyzable data), nasal nitric oxide (nNO) measurement (N = 15), and T1/2/17 sputum cytokine assays (N = 18).</p><p><strong>Results: </strong>Among 52 patients (mean age 54.2 ± 15.1 years; 59.6% female), 32(61.5%) had PCD-related gene variants. CBF was reduced in 19/20(95%) patients who underwent motility studies (mean CBF of 8.8 ± 2.7 Hz; normal 14.2 ± 1.0 Hz), and correlated significantly with FEV₁ (r_s=0.65, P = 0.0017) and inversely with peak sputum neutrophils (r_s=-0.62, P = 0.0097). Subnormal nNO levels (< 250 nL/min) were observed in 12/15(80%) patients; 3/15(20%) were < 77 nL/min (PCD threshold). 5 patients showed FeNO discordance (> 25 ppb). Cytokines associated with inflammasome activation were increased in sputum in majority of patients with PCD-related gene variants. Sputum-guided strategy and 7% hypertonic saline treatment enable significant inhaled corticosteroid doses reduction across the entire population and airway-eosinophilia subgroup (P = 0.0026 and P = 0.0273). Oral corticosteroid doses were reduced in 6/8(75%), and biologics were not initiated in 26/32(81.3%). FEV₁ improved by 130 ± 291mL, P = 0.0273.</p><p><strong>Conclusions: </strong>Ciliary dyskinesias are prevalent in patients with severe asthma. Identifying ciliary motility disorders can guide effective treatment and reduce unnecessary biologics use in severe asthma when symptoms are infection-driven. Even variants of uncertain significance in PCD-related genes may be associated with airway infections due to ciliary dysfunction, proven by ciliary beat frequency analysis. nNO could be a useful screening tool, but its optimal cutoff in this population needs further study.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating primary and secondary immunodeficiency intersections: how to find IEI hidden within SID.","authors":"Silvia Sánchez-Ramón, Stephen Jolles, Antonio Giovanni Solimando, Angelo Vacca","doi":"10.1186/s13223-025-01009-7","DOIUrl":"https://doi.org/10.1186/s13223-025-01009-7","url":null,"abstract":"<p><p>Primary immunodeficiencies, also known as inborn errors of immunity (IEIs), and secondary immunodeficiencies (SIDs) present a multitude of challenges for clinicians due to their overlapping clinical features and diverse underlying aetiologies. IEIs mainly arise from inherited genetic defects, while SIDs are acquired conditions. IEIs are associated with an increased risk of cancer, particularly haematological malignancies, which have been linked to SID, highlighting an area of overlap. It is being increasingly recognised that in the context of cancer, immune deficiencies initially attributed to secondary causes were in fact due to an underlying IEI. This article aims to provide a comprehensive guide for recognising the subtle, yet pivotal clues that may help identify an underlying IEI in patients with haematological malignancies. Combinations of clinical features aligned to the manifestations of IEI, laboratory markers, functional studies, IEI experienced histological assessment, and genetic studies, alongside recognition of atypical responses to therapy for autoimmune and inflammatory features of IEI, and atypical features of the malignancy and its response to therapy and recurrence, can help unmask the IEI hidden within SID. This distinction is of critical importance for patients and their families, as it alters both the treatment of the underlying IEI as well as potentially the approach to the treatment of malignancy.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low risk of ocular toxicity following topical ocular administration of epinephrine nasal spray: implications for unintentional exposure.","authors":"Anne K Ellis, David M Fleischer, Carlos A Camargo, Richard Lowenthal, Sarina Tanimoto","doi":"10.1186/s13223-026-01040-2","DOIUrl":"10.1186/s13223-026-01040-2","url":null,"abstract":"<p><strong>Introduction: </strong>Unintentional ocular exposure to epinephrine nasal spray (10 mg/mL epinephrine) is a potential safety concern. Although epinephrine is used in multiple ocular formulations, unintentional ocular administration of epinephrine nasal spray was assessed to determine tolerability and support the overall safety profile.</p><p><strong>Methods: </strong>A non-GLP ocular tolerability study was conducted using six naïve New Zealand White rabbits (3 males, 3 females). Vehicle control or epinephrine nasal spray (1 mg) was applied to the right or left eye, respectively, once on Day 1. Animals were monitored over seven days for mortality, clinical signs, body weight changes, ophthalmic findings, ocular irritation (using the Modified Hackett-McDonald Scoring System), and gross necropsy findings.</p><p><strong>Results: </strong>Epinephrine nasal spray was well tolerated with no mortality, clinical abnormalities, or changes in body weight. Ophthalmic examinations via indirect ophthalmoscopy and slit-lamp biomicroscopy revealed no signs of irritation or ocular toxicity. No gross pathological changes were noted at necropsy.</p><p><strong>Conclusion: </strong>A single topical administration of epinephrine nasal spray (10 mg/mL) in rabbit eyes was not associated with any adverse effects, indicating a low risk of ocular toxicity. These results support the safety of epinephrine nasal spray in the event of unintentional ocular exposure and taken together with epinephrine's use in other ocular formulations, suggest that no further nonclinical ocular studies are necessary.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":"22 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitudes, and practices toward food allergies among early childhood educators in Taiwan: a cross-sectional study.","authors":"Fang-Ting Lu, Chien-Che Ting, Kan-Hsuan Lin, Cheng-Han Lee, Shu-Hua Wang, Ping-Chen Wu, Shu-Yuan Zhou, Chien-Sheng Hsu, Jun-Kai Kao","doi":"10.1186/s13223-026-01039-9","DOIUrl":"https://doi.org/10.1186/s13223-026-01039-9","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of food allergies among Taiwanese children has risen to 10.4%, which is notably higher than that in many other Asian regions. However, despite this trend, Taiwan lacks specialized legislation or standardized national protocols for the management of food allergies in school settings. In this study, we assessed the knowledge, attitudes, and practices of kindergarten staff to identify key management gaps and unmet institutional needs.</p><p><strong>Methods: </strong>A cross-sectional, questionnaire-based study was conducted among 208 kindergarten staff members throughout Taiwan. Participants were categorized into major metropolitan areas (MMAs) and general urban-rural areas (GURAs) to evaluate regional disparities in resources and proficiency.</p><p><strong>Results: </strong>Although 88.0% of staff were aware of students with food allergies, there was a notable deficiency in clinical literacy. Only 13.5% recognized gluten as a trigger for severe reactions, and 82.2% were unaware of food-dependent exercise-induced anaphylaxis. Moreover, emergency preparedness was exceptionally low, with 74.0% of schools lacking formal response plans, 84.6% of staff unfamiliar with epinephrine autoinjectors, and only 2.9% of schools maintaining stocks of emergency medication. In addition, 53.4% of staff reported a refusal to administer life-saving medication due to legal anxiety. Although staff in MMAs reported higher clinical vigilance, experience, and a proactive willingness to perform on-site injections, a \"uniform lack of competence\" regarding emergency resources in both assessed regions. However, 83.6% of respondents expressed a strong willingness to pursue further training.</p><p><strong>Conclusions: </strong>The findings of this study reveal a systemic national failure in the food allergy safety policies of schools, rather than regional socioeconomic disparities. The discrepancy between high staff motivation and low clinical proficiency highlights the urgent need for mandatory, standardized professional development and hands-on emergency drills to ensure a safe educational environment.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of pre- and postnatal probiotic and ω-3 fatty acid supplementation on cytokine and chemokine responses to allergens and TLR ligands during infancy.","authors":"Cibely C Fontes-Oliveira, Amanda Nylén, Johanna Ljung, Astrid Welin, Lovisa Arvidsson, Magalí Martí, Dhanapal Govindaraj, Isabel García Martín, Camilla Janefjord, Lina Tingö, Ahmed Al-Kaabawi, Elisabet Severin, Karel Duchén, Maria C Jenmalm","doi":"10.1186/s13223-026-01036-y","DOIUrl":"10.1186/s13223-026-01036-y","url":null,"abstract":"<p><strong>Background: </strong>Reduced intensity and diversity of microbial stimulation and decreased intake of anti-inflammatory ω-3 polyunsaturated fatty acids (PUFAs) in Western diets may contribute to impaired postnatal immune development and increased allergy risk. Here, we hypothesize that early supplementation with probiotics and ω-3 PUFAs, starting during pregnancy and continuing during infancy, may promote appropriate immune maturation and thereby potentially prevent allergy development.</p><p><strong>Methods: </strong>In this study, 117 mother‒baby pairs were randomized into four groups receiving the following supplements: Limosilactobacillus reuteri (L. reuteri), ω-3 PUFA, double supplementation, or placebo. Supplementation started from gestational week 20 until 3 months of age (3 mo) for ω-3 PUFA and continued until 12 mo for L. reuteri. Peripheral blood mononuclear cells (PBMCs) from infants were isolated at birth and at 6, 12, and 24 mo, and stimulated ex vivo with several allergens and ligands of Toll-like receptors (TLRs). Cytokines and chemokines related to Th1/Th2/Th17/Treg responses were quantified.</p><p><strong>Results: </strong>Probiotic supplementation modulated the pattern of cytokine and chemokine secretion over time, whereas no clear effects were observed for ω-3 PUFA supplementation. L. reuteri supplementation led to a significant increase in Th1-associated C-X-C motif chemokine ligand 10 (CXCL10) levels induced by birch and cat allergens at 6 mo. Furthermore, L. reuteri induced more significant age-dependent changes under several types of stimulation than did the placebo, indicating enhanced immune maturation.</p><p><strong>Conclusion: </strong>Pre- and postnatal probiotic supplementation may promote immune maturation during early childhood.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":"22 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender and geographic representation in editorial boards of allergy and immunology journals.","authors":"Ranya Al Jumaily, Natalie DeGurse, M Elise Graham, Samira Jeimy","doi":"10.1186/s13223-026-01034-0","DOIUrl":"https://doi.org/10.1186/s13223-026-01034-0","url":null,"abstract":"<p><strong>Background: </strong>Editorial boards shape academic publishing, yet disparities in gender and geographic representation persist across disciplines. To date, these disparities have not been comprehensively investigated in Allergy and Immunology journals.</p><p><strong>Objective: </strong>To examine gender and geographic representation among editorial board members of Allergy and Immunology journals, highlighting disparities and identifying areas for improvement.</p><p><strong>Methods: </strong>Allergy and Immunology journals were identified using the Clarivate Journal Citation Reports database. Editorial board member data, including names, roles, and locations, were collected from journal websites. Predicted gender was determined using the genderize.io tool. Pearson correlations assessed relationships between journal metrics and editorial board characteristics.</p><p><strong>Results: </strong>A total of 36 journals comprising 1,546 editorial board members were analyzed. Women accounted for 515/1,546 (33.3%) of all editorial board members and were underrepresented in leadership roles. Specifically, only 11/47 (23.4%) of editors-in-chief and 90/244 (36.9%) of deputy/associate editors were women. Geographically, 1,318/1,546 (85.3%) of editorial board members were based in developed countries, with the United States contributing the highest proportion (348/1,546, 22.5%). Women editors constituted 423/1,318 (32.1%) of board members in developed countries and 92/228 (40.4%) in developing countries. Representation of non-binary and transgender identities could not be reliably determined using the available data.</p><p><strong>Conclusions: </strong>Gender and geographic disparities are prevalent in Allergy and Immunology journal editorial boards, with significant underrepresentation of women, particularly in leadership roles, and a concentration of editors in developed countries. Addressing these disparities is essential to fostering inclusivity and equity in academic publishing.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One size does not fit all: uncontrolled T2 inflammation on tezepelumab-a case series.","authors":"Arianne Tardif, Marie-Eve Boulay, Andréanne Côté, Krystelle Godbout","doi":"10.1186/s13223-026-01037-x","DOIUrl":"https://doi.org/10.1186/s13223-026-01037-x","url":null,"abstract":"","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond first sip: combination of intermittent cow's milk exposure and atopic dermatitis associated with severe IgE mediated cow's milk reactions-a retrospective study.","authors":"Amy Plessis, Victoria E Cook, Stephanie C Erdle, Edmond S Chan","doi":"10.1186/s13223-026-01035-z","DOIUrl":"https://doi.org/10.1186/s13223-026-01035-z","url":null,"abstract":"","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":"22 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13088481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asthma control and exacerbation risk following SARS-CoV-2 infection in the post-acute COVID-19 phase: a systematic review.","authors":"Saad Alhumaid, Zainah Sabr, Sara Mohammad Alshehri, Hassan A Alhashem, Qasim Alnajjad, Dalal Saadoun Alsaadoun, Abeer S Algrafi, Fatima A Aborshaid, Ashwag A Alsaidalani, Sundus Noorsaeed, Dawood Adnan Al Nasser, Rabab Abbas Majzoub, Ola Alkhars, Nourah Al Dossary, Shorooq Shwgi Banjar, Ibtisam Ahmed ALMuhaini, Fatimah Ali Ismail, Zainab Al Alawi, Qasem M Alalwan","doi":"10.1186/s13223-026-01027-z","DOIUrl":"https://doi.org/10.1186/s13223-026-01027-z","url":null,"abstract":"","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and severity of systemic reactions during beta-lactam skin testing in adults with immediate hypersensitivity allergy.","authors":"Patricia Letón-Cabanillas, Blanca Noguerado-Mellado, Patricia Quijada-Morales, Gema Salas-Parra, Patricia Rojas-Pérez-Ezquerra","doi":"10.1186/s13223-026-01032-2","DOIUrl":"https://doi.org/10.1186/s13223-026-01032-2","url":null,"abstract":"<p><p>Hypersensitivity to beta-lactams (BL) is the most frequent drug allergy, and skin testing (ST) remains the first-line diagnostic tool. Although generally safe, systemic reactions (SR) during ST are a concern. We conducted a 7-year ambispective study (2018-2025) including 216 adults with confirmed immediate hypersensitivity reactions (HSR) to BL, established by positive skin tests (ST) or drug challenge tests (DCT). Among them, 138 (63.9%) had positive ST, predominantly intradermal tests (IDT; 93.5%). Five patients (3.6% of ST-positive; 2.3% of the entire cohort) developed SR during ST, all after IDT following negative skin prick tests (SPT). Reactions were mostly mild (urticaria, generalized pruritus, erythema), although one anaphylaxis occurred. All were rapidly controlled with symptomatic treatment. Surprisingly, all patients with SR had urticaria-angioedema as their index reaction; none had experienced prior anaphylaxis. A significant shorter time interval between the index reaction and allergy evaluation was observed in SR patients (mean 23.6 vs. 48.8 months, p = 0.02). No significant associations were identified for age, sex, culprit BL, or specific IgE. SR during BL ST are infrequent but clinically relevant. SPT appears highly safe, whereas IDT requires particular caution, especially when performed shortly after the index reaction.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}