Allergy Asthma and Clinical Immunology最新文献

{"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182072/pdf/","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":"OA","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":"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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317369/pdf/","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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13289448/pdf/","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":"OA","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":"10.1186/s13223-026-01037-x","url":null,"abstract":"<p><p>BACKGROUND: Tezepelumab is the most recent human monoclonal antibody in the therapeutic arsenal of patients with severe uncontrolled asthma. It neutralizes thymic stromal lymphopoietin (TSLP). Phase 2 and phase 3 studies showed a significant reduction in asthma exacerbations in the severe asthma population, with the greatest effects seen in patients with a type 2 (T2) phenotype. TSLP is in close relation with the epithelium which is believed to be the starting point of the inflammatory cascade. Hence, blocking TSLP is expected to fully control type 2 inflammation and its actors such as interleukin 4 (IL-4), IL-13, IL-5 and eosinophils. This case report describes asthma patient cases with uncontrolled T2 inflammation on tezepelumab and explores the potential evasion mechanisms of TSLP blockage. CASES PRESENTATION: We report four patients who developed symptomatic uncontrolled T2 inflammation following the initiation to tezepelumab. All cases were biologic-experienced and achieved best asthma control with benralizumab. Several hypotheses have been proposed to explain this phenomenon. One possibility is an immune-driven process within the spectrum of eosinophilic granulomatosis with polyangiitis (EGPA). In EGPA, eosinophils act as immunoregulatory cells and have a critical role in promoting the T2 response, which truly sanction the disease as an eosinophilic immune dysfunction disorder. With such process, targeting upstream signals, such as TSLP may prove ineffective in controlling the self-sustained eosinophilic process. Additionally, local airway immunity, even in the absence of EGPA, could influence the suboptimal response to anti-TSLP therapy by exacerbating the in situ T2 response. CONCLUSION: Tezepelumab is not the optimal treatment for all asthma patients requiring biologic therapy. A non-epithelial derived source of inflammation might explain the suboptimal response. These cases stress the importance of phenotyping and individualisation of therapy as essential steps of the severe asthma care. </p>","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255355/pdf/","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":"OA","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":"10.1186/s13223-026-01035-z","url":null,"abstract":"<p><p>BACKGROUND: The prevalence of IgE-mediated cow’s milk allergy in Canada has been increasing and is recognized as the leading cause of fatal anaphylaxis in school aged children. Experts are unable to predict which individuals will have spontaneous resolution of cow’s milk allergy and who will have a persistent phenotype, therefore primary prevention is key. OBJECTIVE: The aim of this study was to identify risk factors leading to the development of an IgE mediated cow’s milk allergy. METHODS: A 54-item survey was provided to parents of children aged 0–4 years with an allergist diagnosed IgE mediated cow’s milk allergy. RESULTS: Out of the 24 participants who completed the survey, 21 were used in the analysis. All infants were term and 57% of participants reported intermittent exposure to cow’s milk formula. Of the infants with intermittent cow’s milk exposure, majority (75%) experienced the exposure prior to hospital discharge. Infants with both atopic dermatitis and intermittent exposure to cow’s milk formula had more severe reactions. CONCLUSION: This is the first study to our knowledge that found an association between reaction severity and having multiple risk factors- atopic dermatitis and intermittent exposure to cow’s milk formula. Majority of the intermittent cow’s milk exposure occurs prior to discharge from hospital. Further research in the area is required, however policy changes to mitigate associated risk could include use of donor breast milk or extensively hydrolyzed formula for supplementation, or recommendations to continue regular cow’s milk formula following introduction. </p>","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":"10.1186/s13223-026-01027-z","url":null,"abstract":"<p><p>BACKGROUND: The post-acute respiratory consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in individuals with asthma remain incompletely understood. While early coronavirus disease 2019 (COVID-19) research focused on acute infection severity, less is known about asthma control and exacerbation risk following recovery, particularly beyond the acute phase. OBJECTIVES: To systematically evaluate asthma control and exacerbation risk following SARS-CoV-2 infection in the post-acute COVID-19 phase among pediatric and adult populations. METHODS: We conducted a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and a prospectively registered PROSPERO protocol (CRD420261290371). PubMed, Embase, CINAHL, Scopus, and Web of Science were searched from 1 January 2020 to 21 January 2026. Observational studies evaluating asthma control or exacerbation outcomes assessed ≥ 4 weeks after confirmed SARS-CoV-2 infection were included. Comparators comprised uninfected asthma controls, within-individual pre–post analyses, or population-level controls. Data were synthesised narratively due to substantial clinical and methodological heterogeneity. RESULTS: Eleven observational studies involving children and adults with asthma met the eligibility criteria. Evidence regarding post-acute asthma control was heterogeneous. Several studies reported short-term worsening of asthma control following SARS-CoV-2 infection, particularly within the first one to three months, whereas larger longitudinal and registry-based studies generally demonstrated stability or recovery of asthma control over longer follow-up. In contrast, asthma exacerbation risk showed a more consistent pattern, with large population-based studies demonstrating approximately a two- to five-fold increase in post-acute exacerbation risk among individuals hospitalised with COVID-19 (adjusted hazard ratios ranging from 2.78 to 5.12), while risk was lower and more variable among non-hospitalised cases (hazard ratios approximately 1.8–2.1). Findings were more variable and often null among patients with mild infection. No consistent evidence of sustained deterioration in asthma control was observed across longer-term follow-up. CONCLUSION: Post-acute asthma outcomes following SARS-CoV-2 infection are heterogeneous and appear to vary according to acute COVID-19 severity, follow-up duration, and study design. While transient worsening of asthma control may occur, particularly after more severe infection, the available evidence does not consistently demonstrate sustained deterioration in asthma control. These findings suggest that post-COVID asthma management may benefit from consideration of infection severity, while highlighting the need for high-quality longitudinal research to better define long-term outcomes. </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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13220527/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13214350/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13214098/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}