Allergy Asthma and Clinical Immunology最新文献

{"title":"Parent perspectives on guided self-care approaches to ensure timely access to therapy in infants with food allergy.","authors":"Anna Voia, Marie-Josée Bettez, Catherine Lord, Julie Andrews, Philippe Bégin","doi":"10.1186/s13223-026-01030-4","DOIUrl":"https://doi.org/10.1186/s13223-026-01030-4","url":null,"abstract":"<p><strong>Background: </strong>Early allergen immunotherapy (AIT), including oral immunotherapy (OIT), is increasingly recognized as a disease-modifying intervention for infants with Immunoglobulin E (IgE)-mediated food allergy. However, limited access to allergy specialists and long wait times often prevent timely initiation during the critical early-life window. Guided self-care models could offer alternative care pathways, yet parents' perspectives on such approaches remain poorly understood.</p><p><strong>Objective: </strong>To explore parents' perceptions of the acceptability, feasibility, and conditions required for guided self-care approaches to to early-life food allergen immunotherapy in infants, drawing on parental experiences managing food allergy in their children in their early years.</p><p><strong>Methods: </strong>A qualitative study was conducted using semi-structured videoconference interviews (Zoom) with 11 parents of children with food allergies in Québec, Canada, between June and August 2024. Participants were recruited through purposive sampling to capture a range of experiences. Interviews were conducted in French, transcribed verbatim, and analyzed using thematic analysis to identify key themes and constructs in French, translated into English for publication. Rigor was enhanced through independent coding by two analysts, iterative interim analyses, and team discussions to resolve discrepancies.</p><p><strong>Results: </strong>The mean age of the index child at food allergy diagnosis was 0.8 years (range 0.2-2); four participants were still parents of infants at the time of interview. Three major themes emerged: (1) acceptability of self-care driven by barriers to timely access to AIT and the perceived benefits of early intervention; (2) parental confidence in self-management shaped by experience, preparedness, and education; and (3) the necessity of professional support and clear protocols. Participants expressed strong motivation to initiate early treatment to avoid missing a critical therapeutic window, even in the absence of direct allergist supervision. However, guided self-care was consistently viewed as requiring diagnostic validation, structured protocols, and access to trained healthcare professionals for support, particularly at treatment initiation.</p><p><strong>Conclusion: </strong>Parents of children with food allergy are receptive to guided self-care approaches for early infant AIT when timely access to specialists is limited. Developing low-risk AIT modalities, standardized protocols, and training for non-allergist healthcare professionals may facilitate earlier intervention and improve outcomes for infants with food allergy.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662671","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":"Laying the foundation in food allergy education: CSACI food allergy educator program.","authors":"Jennifer L P Protudjer, Douglas P Mack, Lori Connors, Jasmin Lidington, Harold Kim","doi":"10.1186/s13223-026-01019-z","DOIUrl":"10.1186/s13223-026-01019-z","url":null,"abstract":"","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":"22 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655402","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":"A red-eye presentation concerning for vernal keratoconjunctivitis: a case report.","authors":"Lauren Wong, Samira Jeimy","doi":"10.1186/s13223-026-01029-x","DOIUrl":"https://doi.org/10.1186/s13223-026-01029-x","url":null,"abstract":"<p><strong>Background: </strong>Vernal keratoconjunctivitis (VKC) is a chronic, recurrent allergic eye disease that can significantly impair quality of life in children. Although rare in Canada and more common in hot, dry climates, VKC should be considered in persistent conjunctivitis. Diagnosis may be challenging when symptoms occur outside typical seasonal patterns or when allergy testing is inconclusive.</p><p><strong>Case presentation: </strong>An 11-year-old male presented with a six-month history of bilateral conjunctival redness and swelling with seasonal nasal and palatal pruritus and sneezing. Symptoms began atypically in February and progressed to photophobia and early vision changes. Clinical images demonstrated perilimbal Horner-Trantas dots with marked conjunctival inflammation, ecchymosis, and chemosis. Epicutaneous testing and serum IgE showed only mild sensitization to cat dander. Symptoms partially improved with olopatadine and resolved with topical loteprednol, though attempts to taper resulted in recurrence. VKC was diagnosed based on clinical features and photographic findings. The patient was transitioned to olopatadine and treated with oral rupatadine. After ophthalmology assessment and steroid taper, he remained stable on daily antihistamine therapy and later discontinued medications with only mild intermittent ocular symptoms. Repeat skin testing was negative.</p><p><strong>Conclusions: </strong>VKC is uncommon in Canada, but may lead to vision-threatening complications if a patient is not appropriately seen by an ophthalmologist and it goes unrecognized. It should be considered in cases of conjunctivitis that are unresponsive to antihistamines, even when seasonal patterns or allergen sensitization are unclear. Topical and oral antihistamine combination is effective in stabilizing VKC symptoms, with the addition of topical steroids if needed for flares. VKC treatment can require a prolonged course.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629190","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":"The shift towards lower-risk oral food challenges since the implementation of oral immunotherapy: a retrospective cohort study.","authors":"Adam P Sage, Min Jung Kim, Tiffany Wong, Raymond Mak, Stephanie C Erdle, Lianne Soller, Edmond S Chan","doi":"10.1186/s13223-026-01028-y","DOIUrl":"10.1186/s13223-026-01028-y","url":null,"abstract":"<p><p>We previously published data on the safety of oral food challenges (OFCs) at BC Children's Hospital (BCCH), which demonstrated high rates of anaphylaxis requiring epinephrine (15.6%). However, since the 2019 paper, the introduction of oral immunotherapy (OIT) for treatment of food allergies has been widely adopted at our center, resulting in significant practice changes in terms of when and for which patients to offer an OFC. As a result, we sought to compare outcomes of OFCs between the pre-OIT (2014-2017) and post-OIT (2019-2021) eras. We conducted a retrospective chart review of all OFCs completed 2019-2021 at BCCH (post-OIT, n = 590) and compared this to previously published data from OFCs between 2014-2017 (pre-OIT, n = 353). Relative to the pre-OIT cohort, we found patients undergoing OFCs to have significantly lower odds of positive OFCs (26.3% vs 32.6%, OR = 0.738, p = 0.0444). Further, OFCs completed after a period of maintenance OIT were found to have reduced odds of requiring epinephrine (8.31% vs 15.0%, OR = 0.542, p = 0.0164). We also observed a low severity in those with positive OFCs, with only 3/49 (6.10%) Grade 4 (severe) reactions. While multifactorial in etiology, we found changes in clinical practice with the adoption of OIT to be associated with a significant improvement in safety of OFCs preformed at our institution.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576125","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":"Association between changes in blood eosinophil levels and alterations in olfactory function in asthma.","authors":"Hyo-In Rhyou, Woo Yong Bae, Young-Hee Nam","doi":"10.1186/s13223-026-01025-1","DOIUrl":"10.1186/s13223-026-01025-1","url":null,"abstract":"<p><p>Olfactory dysfunction has been observed in asthma, but its underlying mechanisms are poorly understood. This prospective study assessed olfactory function using the YSK Olfactory Function Test in 30 patients with moderate to severe asthma, and compared clinical parameters according to changes in olfactory function over 6 months. Nine patients were classified into the olfactory-improvement group, 15 into the olfactory-stable group, and six into the olfactory-decline group. The change in blood eosinophil levels showed a progressive increase across the olfactory-improvement, olfactory-stable, and olfactory decline groups, while there were no significant differences in terms of the presence of upper airway diseases, use of intranasal steroids, asthma control status, and asthma treatment medications among the three groups. Eosinophilic inflammation in blood may be associated with olfactory function in asthma, and further study will be needed in the future.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576092","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":"Baseline disease duration of chronic spontaneous urticaria participants in phase III clinical trials.","authors":"Sana Gupta, Vinesh Rao, Grace Xiong, Mohannad Abu-Hilal","doi":"10.1186/s13223-026-01026-0","DOIUrl":"10.1186/s13223-026-01026-0","url":null,"abstract":"<p><p>Chronic spontaneous urticaria often follows a prolonged and variable course, yet baseline disease duration is inconsistently reported in clinical trials, limiting interpretation of treatment outcomes. Accordingly, this systematic review aimed to evaluate baseline disease duration and reporting practices in phase-III trials for chronic spontaneous urticaria. Of 36 trials identified, only 16 (44.4%) reported baseline disease duration (mean: 5.30 ± 1.81 years). Differences in average disease duration were observed by publication date and intervention of interest. Definitions of disease duration were frequently unspecified, and no trials examined efficacy stratified by disease duration. This review ultimately highlights a gap in disease duration reporting, underscoring the need for standardization and transparency in clinical trial design.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516624","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":"APDS in a 3-year-old boy presenting with EBV viremia and hodgkin lymphoma associated with a novel germline heterozygous variant in PIK3CD and with characteristic immune phenotype but no upregulation of the T cell mTOR pathway.","authors":"Devyani Bakshi, Andrew Wong-Pack, Stacey Marjerrison, Rae Brager, Manish J Butte, Timothy J Thauland, Jenny Garkaby","doi":"10.1186/s13223-026-01014-4","DOIUrl":"10.1186/s13223-026-01014-4","url":null,"abstract":"<p><strong>Background: </strong>Activated phosphoinositide 3-kinase δ syndrome (APDS) is an inborn error of immunity in the PIK3CD gene caused by an increase in phosphoinositide 3-kinase δ (PI3Kδ) activity. APDS is characterized by immune dysregulation such as senescent T cells, lymphoproliferation, and hypogammaglobulinemia. Patients present with lymphoid hyperplasia, recurrent sinopulmonary infections, recurrent viremias, and lymphomas.</p><p><strong>Case presentation: </strong>We present a case report of a patient with APDS due to a novel variant in the PIK3CD gene. Our patient was identified at 3 years of age due to persistent EBV viremia and Hodgkin lymphoma. Immune evaluation demonstrated upregulation of T follicular helper cells and CD10 + B cells were consistent with the lymphocytic phenotype present in patients with APDS. However, there was no upregulation of the T cell mTOR pathway by functional testing. The patient was found to carry a novel variant, (c.58G > A p.(Val20lle)), in the PIK3CD gene.</p><p><strong>Conclusions: </strong>We describe a 3-year-old patient with a novel variant in the PIK3CD gene (c.58G > A p.(Val20lle)) presenting with EBV viremia, Hodgkin lymphoma, upregulation T follicular helper cells and CD10 + B cells consistent with a phenotype of APDS in a 3-year-old boy. This case broadens our understanding of the genetic and phenotypic spectrum of PIK3CD gene mutations in APDS.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476309","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":"Organizing pneumonia potentially caused by infliximab in a pediatric patient with ulcerative colitis.","authors":"Brian Lee, Isaac Martin, Kevin Bax, Samira Jeimy","doi":"10.1186/s13223-026-01022-4","DOIUrl":"10.1186/s13223-026-01022-4","url":null,"abstract":"<p><strong>Background: </strong>Organizing pneumonia (OP) is a rare interstitial lung disease characterized by intra-alveolar fibroblastic plugs and chronic inflammation. Although most cases are idiopathic, OP may occur secondary to infections, autoimmune disease, or drug exposure. Pulmonary complications of tumor necrosis factor-alpha (TNF-α) inhibitors are uncommon, and infliximab-associated OP has not yet been described in the pediatric population.</p><p><strong>Case presentation: </strong>A 12-year-old girl with ulcerative colitis (UC) on infliximab presented with three weeks of dyspnea, fever, and pleuritic chest pain. Computed tomography (CT) revealed bilateral peripheral infiltrates. Microbiologic testing and bronchoalveolar lavage were negative. Wedge biopsy demonstrated fibroblastic plugs (Masson bodies), consistent with OP. Infliximab was discontinued. The patient's symptoms improved without corticosteroids, with near-complete radiologic resolution at 2 months.</p><p><strong>Conclusions: </strong>This case highlights probable infliximab-associated OP in a pediatric patient, highlighting a need for awareness of rare pulmonary toxicities from biologics. Importantly, resolution occurred without corticosteroids, suggesting that withdrawal of the offending agent may suffice in select cases.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460980","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":"Anaphylaxis and loss of wheat tolerance after two weeks of wheat deprivation.","authors":"Hannah Martin, Edmond S Chan, Raymond Mak, Angela Maccan","doi":"10.1186/s13223-026-01023-3","DOIUrl":"10.1186/s13223-026-01023-3","url":null,"abstract":"","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391645","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":"Summarizing the 2024 immunotherapy manual of the Canadian society of allergy and clinical immunology.","authors":"Aria Bruton Joe, George Cai, Samina Nazarali, Harold Kim, Godfrey Lam, Susan Waserman","doi":"10.1186/s13223-026-01020-6","DOIUrl":"10.1186/s13223-026-01020-6","url":null,"abstract":"<p><p>Allergen immunotherapy (AIT) is an essential disease-modifying therapy in the field of allergy and clinical immunology. The Immunotherapy Manual of the Canadian Society of Allergy and Clinical Immunology serves as a comprehensive guide for the safe and effective administration of immunotherapy. Its purpose is to address an educational gap in immunotherapy identified by residency training programs in Canada.This summary highlights key updates for both aeroallergen and venom immunotherapy from the latest edition of the immunotherapy manual and provides a concise, accessible resource for trainees to support their practice. The areas reviewed include principles of immunotherapy, allergen extract standardization, and safety related to immunotherapy with practical strategies for risk mitigation. Included in the original manual are practice cases that have been updated with systematic checklists to coach readers in their management of patients.The updated immunotherapy manual and its summary aim to serve as a basis for trainees as they develop competence in the provision of immunotherapy.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13085749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391660","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}