Journal of Allergy and Clinical Immunology-In Practice最新文献

{"title":"Sticking With It: The Continued Benefits of 2 Years of Peanut Epicutaneous Immunotherapy in Young Children","authors":"Michelle F. Huffaker MD","doi":"10.1016/j.jaip.2025.02.037","DOIUrl":"10.1016/j.jaip.2025.02.037","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 5","pages":"Pages 1188-1189"},"PeriodicalIF":8.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Guide to Pediatric Antibiotic Allergy Testing: A Report From the US Drug Allergy Registry","authors":"John J.O. Accarino MD ,&nbsp;Timothy G. Chow MD ,&nbsp;Allison Ramsey MD ,&nbsp;Christine R.F. Rukasin MD ,&nbsp;Alexei Gonzalez-Estrada MD ,&nbsp;Anne Y. Liu MD ,&nbsp;David A. Khan MD ,&nbsp;Kimberly G. Blumenthal MD, MSc ,&nbsp;US Drug Allergy Registry Study Team","doi":"10.1016/j.jaip.2024.12.036","DOIUrl":"10.1016/j.jaip.2024.12.036","url":null,"abstract":"<div><div>Pediatric antibiotic labels are common, and unnecessary antibiotic avoidance is associated with negative personal and public health outcomes; as a result, there is an increasing emphasis on the importance of pediatric antibiotic allergy evaluations. Different testing strategies have been advised, including skin testing and challenge testing with varied doses and duration. Established consensus testing protocols are lacking. The US Drug Allergy Registry Pediatrics (USDAR-Peds) is a multisite prospective study designed for epidemiology and outcome evaluations of pediatric drug hypersensitivity reactions. Interpretation of multisite data requires a uniform clinical approach, and the USDAR-Peds standardized protocols were developed in response to this need. This rostrum aims to provide a rationale and framework for standardization for pediatric antibiotic allergy protocols and assessment of positive reactions through a pediatric-specific adaptation of the USDAR immediate reaction grading scale to create consistency for multisite research collaboration efforts such as USDAR-Peds.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 5","pages":"Pages 1018-1026.e1"},"PeriodicalIF":8.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Effectiveness of Biologic Therapy in Allergic Bronchopulmonary Aspergillosis","authors":"Charlotte Carter MBChB ,&nbsp;Irene Berrar Torre MSc ,&nbsp;Sophia Blackburn MSc ,&nbsp;Lisa Nwankwo MSc, BPharm Hons ,&nbsp;Tom Semple MDRes ,&nbsp;Bhavin Rawal MDRes ,&nbsp;Darius Armstrong-James PhD ,&nbsp;Pujan H. Patel MD ,&nbsp;Anand Shah PhD","doi":"10.1016/j.jaip.2025.03.006","DOIUrl":"10.1016/j.jaip.2025.03.006","url":null,"abstract":"<div><h3>Background</h3><div>Allergic bronchopulmonary aspergillosis (ABPA) is characterized by a severe hypersensitivity reaction to <em>Aspergillus</em> species. Current treatment relies on oral corticosteroids (OCS) and triazole antifungal therapy, but there is increasing evidence of the benefits of biologic therapies targeting type 2 inflammatory pathways.</div></div><div><h3>Objective</h3><div>To assess the real-world effectiveness of biologic therapies in patients with ABPA.</div></div><div><h3>Methods</h3><div>We performed a large retrospective single-center analysis of patients with ABPA as defined by the modified International Society for Human and Animal Mycology (ISHAM) criteria between 2014 and 2022. Baseline characteristics were recorded. Clinical outcomes were assessed at 12 months after commencement of a biologic including symptom scores, exacerbation frequency, corticosteroid use, and multidisciplinary team consensus of effectiveness.</div></div><div><h3>Results</h3><div>A total of 74 patients received a biologic, of whom 32% (n = 24) received anti-IgE therapy, 65% (n = 48) anti-IL5/5Rα therapy, and 3% (n = 2) anti-IL4-Rα therapy. Of the total, 65% (n = 48) patients were deemed to have a successful response at 12 months with a ≥50% reduction in OCS use and 35% (n = 26) stopped or changed biologic during the follow-up period because of failed clinical response (n = 21), side effects (n = 4), or medical comorbidities (n = 1). There was a significant reduction in the 6-item Asthma Control Questionnaire score (<em>P</em> &lt; .0001), exacerbation rate over 12 months (<em>P</em> &lt; .0001), and maintenance OCS use (<em>P</em> = .0173). Univariate analysis revealed that mucus plugging was associated with nonresponse to biologic therapy (<em>P</em> = .0189).</div></div><div><h3>Conclusion</h3><div>Biologic therapies are effective in a number of patients with ABPA. However, further prospective clinical trials are required to determine the effectiveness and which phenotypes likely to respond. These data nevertheless increase the evidence base for biologics in ABPA.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 5","pages":"Pages 1094-1102.e1"},"PeriodicalIF":8.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mucus Plug Score Predicts Clinical and Pulmonary Function Response to Biologic Therapy in Patients With Severe Asthma","authors":"Jeremias Götschke MD ,&nbsp;Julia Walter PhD ,&nbsp;Gabriele Leuschner MD, PhD ,&nbsp;Michael Gerckens MD ,&nbsp;Melanie Götschke MD ,&nbsp;Pontus Mertsch MD ,&nbsp;Carlo Mümmler MD ,&nbsp;Alexandra Lenoir MD ,&nbsp;Michaela Barnikel MD ,&nbsp;Julien Dinkel MD ,&nbsp;Jürgen Behr MD ,&nbsp;Nikolaus Kneidinger MD, PhD ,&nbsp;Judith Eva Spiro MD ,&nbsp;Katrin Milger MD","doi":"10.1016/j.jaip.2025.01.010","DOIUrl":"10.1016/j.jaip.2025.01.010","url":null,"abstract":"<div><h3>Background</h3><div>Mucus plugging has been identified as an important feature of severe asthma contributing to airway obstruction and disease severity. Recently, improvement in mucus plugging has been found on treatment with several biologic therapies.</div></div><div><h3>Objectives</h3><div>To analyze associations of baseline characteristic with the mucus plugging score (MPS) and to determine whether the MPS at baseline predicts the clinical and functional response to biologic treatment in patients with severe asthma.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed biologic-naive patients with a suitable computed tomography scan available at baseline. We calculated the MPS and analyzed correlations with baseline parameters and improvements in biomarkers, pulmonary function, and clinical parameters after 4 months of biologic therapy.</div></div><div><h3>Results</h3><div>We included 113 patients in the baseline cohort, 101 patients of whom had sufficient data after 4 months of biologic therapy for the follow-up analysis. Computed tomography showed mucus plugging in 77% of patients (median MPS, 4). Multivariate regression analysis showed a correlation of MPS with lower FEV₁ (ρ = –0.24; <em>P</em> = .009) and diffusing capacity for carbon monoxide (ρ = –0.26; <em>P</em> = .01), and higher FeNO (ρ = .36; <em>P</em> = .0003) at baseline. Patients received treatment with anti-IgE (8.8%), anti-IL-5 (27.4%), anti-IL-5R (37.2%), anti-IL-4R (25.7%), and anti-thymic stromal lymphopoietin (0.9%) in clinical routine. Baseline MPS correlated with improvements in FEV₁ (β = 0.72; <em>P</em> = .01) and Asthma Control Test (β = 0.24; <em>P</em> = .001) in multivariate regression analysis.</div></div><div><h3>Conclusion</h3><div>Our study suggests that a higher MPS correlates with worse pulmonary function at baseline but also predicts a larger clinical and pulmonary function response to biologic therapies in severe asthma.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 5","pages":"Pages 1110-1122.e1"},"PeriodicalIF":8.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum sickness–like reactions in children taking antibiotics represent a distressing form of infection-associated urticaria and may recur unpredictably in susceptible children","authors":"Edward Fernandez MD ,&nbsp;Matthew Robson MD ,&nbsp;Grayson Summar RN ,&nbsp;Patricia Earl RN ,&nbsp;Trisha Wendling APRN ,&nbsp;Michelle Wessels RN ,&nbsp;Allison E. Norton MD ,&nbsp;Kimberly Risma MD PhD","doi":"10.1016/j.jaip.2025.01.018","DOIUrl":"10.1016/j.jaip.2025.01.018","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 5","pages":"Pages 1214-1216.e3"},"PeriodicalIF":8.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From statistical to clinical significance: Establishing and testing the minimal clinically important difference of the Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q)","authors":"Hugo W.F. Mak MBBS, MRes[Med] ,&nbsp;Weihong Shi MBBS ,&nbsp;Erin H.C. Shum MBBS ,&nbsp;Jackie S.H. Yim MS ,&nbsp;Elaine Lee MS ,&nbsp;Dorothy L.Y. Lam MS ,&nbsp;Philip H. Li MBBS, MD","doi":"10.1016/j.jaip.2025.02.023","DOIUrl":"10.1016/j.jaip.2025.02.023","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 5","pages":"Pages 1221-1223.e1"},"PeriodicalIF":8.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to “Direct challenge in children with β-lactam allergies: Consensus is reached, but now it is time for accurate results”","authors":"Michaela Lucas MD, DrMed ,&nbsp;Britta S. von Ungern-Sternberg MD, DrMed, PhD ,&nbsp;Annabelle Arnold DipHE ,&nbsp;Michelle Trevenen PhD ,&nbsp;Susan Herrmann PhD ,&nbsp;Laure Braconnier PhD ,&nbsp;Syed Ali MD ,&nbsp;Catherine Jepp MD ,&nbsp;David Sommerfield MD ,&nbsp;Kevin Murray PhD ,&nbsp;Kristina Rueter MD, DrMed, PhD","doi":"10.1016/j.jaip.2025.01.034","DOIUrl":"10.1016/j.jaip.2025.01.034","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 5","pages":"Pages 1239-1240"},"PeriodicalIF":8.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Original Article Highlights From This Issue","authors":"","doi":"10.1016/S2213-2198(25)00322-8","DOIUrl":"10.1016/S2213-2198(25)00322-8","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 5","pages":"Pages A11-A14"},"PeriodicalIF":8.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management and Prevention of Hypersensitivity Reactions to Radiocontrast Media: A Consensus Statement From the American College of Radiology and the American Academy of Allergy, Asthma, & Immunology","authors":"Carolyn Wang MD ,&nbsp;Allison Ramsey MD ,&nbsp;David Lang MD ,&nbsp;Ana Maria Copaescu MD, FRCPC ,&nbsp;Pranay Krishnan MD ,&nbsp;Merin Kuruvilla MD ,&nbsp;Benjamin Mervak MD ,&nbsp;Jeffrey Newhouse MD ,&nbsp;Alisa Sumkin MD ,&nbsp;Rebecca Saff MD, PhD","doi":"10.1016/j.jaip.2025.01.042","DOIUrl":"10.1016/j.jaip.2025.01.042","url":null,"abstract":"<div><div>Intravenous iodinated contrast media (ICM) is widely used in the United States, and it is imperative to provide guidance on the management of adverse reactions to ICM as well as the preparation, planning, and potential premedication for patients with previous reactions. Currently there is a discordance between the American College of Radiology Contrast Manual, which recommends premedication to prevent repeat hypersensitivity reactions to ICM, and the Anaphylaxis 2020 Practice Parameters Update, which recommends against routine administration of glucocorticoids and/or antihistamines to prevent anaphylaxis with prior ICM hypersensitivity reactions. A task force of experts from radiology who are also members of the American College of Radiology Committee on Drugs and Contrast Media and expert allergists/immunologists including members of the Adverse Reactions to Drugs, Biologics and Latex Committee of American Academy of Allergy, Asthma &amp; Immunology evaluated the scientific evidence to develop consensus recommendations that are endorsed by both organizations. The task force took into account the strength of evidence and balanced the potential risks of recurrent reactions with those of premedication and product avoidance when making these recommendations to improve and standardize the care of patients who experience or have a history of reaction to ICM.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 5","pages":"Pages 1029-1047"},"PeriodicalIF":8.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Models of Inpatient Antibiotic Allergy Management in Health Care","authors":"Neil Powell MS ,&nbsp;Elise Mitri BPharm ,&nbsp;Anna R. Wolfson MD ,&nbsp;Mary L. Staicu PharmD","doi":"10.1016/j.jaip.2025.01.020","DOIUrl":"10.1016/j.jaip.2025.01.020","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 5","pages":"Pages 1000-1003"},"PeriodicalIF":8.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}