Allergy Asthma and Clinical Immunology最新文献

{"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":"<p><p>In Fall 2023, the Canadian Society of Allergy and Clinical Immunology (CSACI) introduced an evidence-based, participant-informed food allergy educator program for physicians and allied health professionals working in allergy. Herein, we aimed to provide an overview and evaluation of the first four cohorts of the foundational course. The 8-weeks foundational course in food allergy, the content of which was delivered by world leaders in food allergy, included topics ranging from food allergy epidemiology, diagnosis and management to the psychosocial burden of food allergy. Learners completed a pre-test and a post-test, one week prior to the course, and one week following the course, respectively. We operationalized the passing grade for the post-test as a minimum of 75%. Data were analysed descriptively with comparisons made using a paired t-test (Stata Version 19.0, College Station, TX). To date, four cohorts, including 34 learners, have completed the foundational course. The pre-test and post-test mean scores were 72.5% (range 30.0–96.0%) and 84.5% (range 65.0–97.5%), respectively, which corresponds to a significant improvement in food allergy knowledge from the pre-test (p < 0.0001). in the first four cohorts of the CSACI Food Allergy Educator Program Foundational Course, food allergy knowledge significantly improved among learners. The foundational course will continue to be offered at least once yearly. An advanced practice course is also being developed.</p>","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191832/pdf/","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":"OA","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13154864/pdf/","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":"OA","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":"<p><p>BACKGROUND: The best practices for childhood allergy prevention are continually evolving. We do not know the optimal frequency for continued exposure of common allergenic foods after the initial introduction into a child’s diet. Home-based oral immunotherapy is a promising treatment avenue for childhood food allergies. CASE PRESENTATION: We describe the case of a child who was tolerating wheat and underwent a 2-week unintentional deprivation period wherein they were not exposed to any wheat. After this period, they experienced an anaphylactic reaction to wheat upon re-introduction. The child had a history of other allergies for which they were receiving oral immunotherapy and they now are receiving oral immunotherapy for wheat as well. CONCLUSIONS: Our case is unique as, to the best of our knowledge, there has yet to be a case published wherein a deprivation period as short as 2 weeks has resulted in an anaphylactic reaction, despite previous tolerance of the allergen. Clearer labelling of gluten free versus gluten-containing products as confusion regarding labelling contributed to the unintentional deprivation period is needed. Families should also be counselled on thorough food product label reading. Finally, further research is warranted regarding the optimal frequency of potential allergen dietary reintroduction. </p>","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}

{"title":"High total serum IgE level at diagnosis was associated with a progressive decline in lung function in asthmatic patients with allergic bronchopulmonary mycosis.","authors":"Yuka Kodama, Sachiko Takaoka, Takuya Nakashima, Kaho Matsunaga, Kosuke Terada, Yuga Yamashita, Hinako Masumitsu, Atsushi Miyasaka, Tatsuya Muraoka, Nami Masumoto, Takeshi Kaneko, Maiko Watanabe, Naomi Tsurikisawa","doi":"10.1186/s13223-026-01024-2","DOIUrl":"10.1186/s13223-026-01024-2","url":null,"abstract":"<p><strong>Background: </strong>Allergic bronchopulmonary mycosis (ABPM), including allergic bronchopulmonary aspergillosis (ABPA), is an immune-mediated lung disease characterized by high serum total IgE and eosinophilia. The serum total IgE level is a well-established diagnostic and monitoring marker for ABPM/ABPA; however, its prognostic significance has not been fully elucidated. In particular, whether serum total IgE level at diagnosis is associated with subsequent longitudinal decline in lung function is unknown. Here we evaluated whether serum total IgE level at diagnosis is predictive of lung function decline and disease exacerbation in ABPA/ABPM.</p><p><strong>Methods: </strong>We retrospectively analyzed 39 patients diagnosed with ABPA/ABPM from April 2022 through February 2025. Clinical data, lung function, exacerbation rates (no./y), and treatment were assessed at diagnosis, 1 y afterward, and at final follow-up (mean, 4.7 y). Patients were classified according to IgE level at 1 y (dichotomized to ≥ 50% IgE reduction and < 50% IgE reduction).</p><p><strong>Results: </strong>During the study period, 100% of patients received inhaled corticosteroid, 56% received systemic corticosteroids, and 23% received antifungal therapy, but none was treated with any biologic. The exacerbation rate was correlated with serum IgE level at diagnosis (p = 0.026, r = 0.36) but not with eosinophilia. The serum IgE level at diagnosis was inversely correlated with change in percent vital capacity (P = 0.0015, r = -0.68), percent forced vital capacity (%FVC; P = 0.009, r = -0.70), and percent forced expiratory volume in 1 s (%FEV₁; P = 0.038, r = - 0.48). Exacerbation rates at 1 y after diagnosis (p = 0.03) and final follow-up (p = 0.011) were lower in the IgE-decreased group than IgE-unchanged/increased group. The three patients with chronic pulmonary fibrosis were the only patients who showed consistently high serum total IgE levels and low pulmonary function (%FVC and %FEV₁) at diagnosis, as confirmed by computed tomography. In contrast, high-attenuation mucus, bronchiectasis, and mucus plugging showed no consistent relationship between serum total IgE levels and pulmonary function.</p><p><strong>Conclusion: </strong>High serum IgE levels at diagnosis may predict a decline in lung function and increased exacerbation risk in patients with ABPA/ABPM. Management of serum IgE levels may mitigate ABPA/ABPM exacerbation and help preserve pulmonary function.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13081546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379386","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}