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

{"title":"Vaccine Strain Rubella Granuloma in a Patient With Primary Immunodeficiency.","authors":"Ayelet Ollech, Amarilla B Mandola","doi":"10.1016/j.jaip.2025.02.030","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.02.030","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634727","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":"Development and Validation of Cough Hypersensitivity Assessment Test (CHAT).","authors":"Zien Feng, Fang Yi, Wenzhi Zhan, Ruchong Chen, Wanjun Wang, Surinder S Birring, Kefang Lai","doi":"10.1016/j.jaip.2025.03.010","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.03.010","url":null,"abstract":"<p><strong>Background: </strong>Cough hypersensitivity is an important clinical and pathophysiological feature of chronic cough, which involves chemical, mechanical, thermal stimuli, and sensory dysfunction. Currently, there is lack of a comprehensive method for evaluating cough hypersensitivity.</p><p><strong>Objective: </strong>The aim of this study was to develop and validate a questionnaire to assess the degree of cough hypersensitivity.</p><p><strong>Method: </strong>The initial items of Cough Hypersensitivity Assessment Test (CHAT) were made based on literature review, experts' opinions and clinical practice, the items were reduced after investigation in patients with chronic cough. Dimensional allocation, internal reliability, test-retest reliability, construct validity, responsiveness and cut-off value were determined in the final stage.</p><p><strong>Result: </strong>The final version of CHAT on a 5-point Likert scale (0-4) includes 18 items, consisting of 3 dimensions: environmental triggers, daily life triggers and tussive symptoms with total score ranging from 0-72. There was significant difference in CHAT-18 scores between patients and healthy controls (p < 0.001). The Cronbach's alpha value for CHAT was 0.832. Intraclass correlation coefficient for CHAT was 0.884. Construct validity was demonstrated with a multitrait-multimethod matrix. There was good responsiveness post-treatment. The cut-off value of CHAT was 18 for cough hypersensitivity. There was mild-to-moderate correlation between capsaicin cough sensitivity and tussive symptoms and total score of CHAT.</p><p><strong>Conclusion: </strong>Cough Hypersensitivity Assessment Test comprehensively covers a range of cough triggers, and shows robust internal reliability, test-retest reliability, construct validity and responsiveness. This may be useful for measuring cough hypersensitivity.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639789","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":"Shared decision-making in FPIES.","authors":"Marcus Shaker, Elissa M Abrams, Matthew Greenhawt, Shyam Joshi, Jay Lieberman, S Shahzad Mustafa, Aikaterini Anagnostou","doi":"10.1016/j.jaip.2025.03.008","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.03.008","url":null,"abstract":"<p><p>Food protein induced enterocolitis syndrome (FPIES) is a non IgE-mediated food allergy presenting with profuse vomiting, lethargy and potential progression to severe dehydration and hypotension. Delayed-onset bloody diarrhea may also be a feature, though generally in neonates. FPIES can be misdiagnosed due to non-specific symptoms and the fact that there is no laboratory test specific for the disease. There is currently very limited understanding of the FPIES pathophysiology. Clinical management relies mostly on case series, case reports, uncontrolled observational studies and expert opinion rather than controlled studies and a plethora of mechanistic research. As a result, there are multiple areas in FPIES where care is preference-sensitive and dependent on patient values and preferences, given lack of high-quality trials that clearly indicate a single best course of action. While in some vain this may signify major knowledge gaps and unmet needs in research and patient care, in another sense this represents an opportunity to evolve patient care in a way that may be more tailored towards individual patient or family values and preferences through shared decision-making as the research continues to evolve. There has been increased recognition that the burden of FPIES on patients and families is substantial, and there is opportunity to take advantage of particular care options to help mitigate this burden. This rostrum wishes to discuss areas where current FPIES care can be evolved to incorporate a more contextualized, preference-sensitive approach, involving shared decision-making, to provide the optimal management to each individual patient.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639792","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":"Uncovering risk factors of premature mortality in Common Variable Immunodeficiency (CVID).","authors":"Patrick Bez, Bas Smits, Christoph Geier, Aleksandra Hirsch, Andrés Caballero de Oyteza, Michele Proietti, Bodo Grimbacher, Martin Wolkewitz, Sigune Goldacker, Klaus Warnatz","doi":"10.1016/j.jaip.2025.03.009","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.03.009","url":null,"abstract":"<p><strong>Background: </strong>Among patients with common variable immunodeficiency (CVID) patients with complications of immune dysregulation (CVIDc) have higher mortality rates compared to those with infection-only presentation (CVIDio). Therefore, identifying predictive markers of premature mortality among CVIDc patients is crucial.</p><p><strong>Objective: </strong>The purpose of this retrospective exploratory study was to describe the mortality in a large tertiary referral center and compare the clinical and laboratory characteristics of CVIDc patients who died prematurely with a group of matched living CVIDc control patients to identify potential indicators of premature death.</p><p><strong>Methods: </strong>The study included patients diagnosed with CVID according to ESID criteria and active follow-up. In a case-control analysis, we identified patients who died before the age of 70 years as cases, and then randomly selected controls who were matched for sex, age, and CVID phenotype.</p><p><strong>Results: </strong>We were able to confirm the poor prognosis of CVIDc compared to CVIDio in 497 patients, including 57 who had died. The most common causes of death were infections and neoplasia. The exploratory case-control analysis of 37 cases and 73 controls suggests that cases had a higher prevalence of severe enteropathy, hepatopathy, and neoplasia when compared with controls three years prior to death. This was associated with a higher frequency of lymphopenia, thrombocytopenia, and liver enzyme elevation.</p><p><strong>Conclusion: </strong>Hepatopathy and severe enteropathy need to be confirmed in a multicenter prospective study as the most relevant factors associated with premature mortality in CVIDc patients. Their early evaluation will hopefully allow for better and possibly more definitive treatment options.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639795","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, Irene Berrar Torre, Sophia Blackburn, Lisa Nwankwo, Tom Semple, Bhavin Rawal, Darius Armstrong-James, Pujan H Patel, Anand Shah","doi":"10.1016/j.jaip.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.03.006","url":null,"abstract":"<p><strong>Background: </strong>Allergic bronchopulmonary aspergillosis (ABPA) is characterised by a severe hypersensitivity reaction to Aspergillus 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.</p><p><strong>Objective: </strong>To assess the real-world effectiveness of biologic therapies in patients with ABPA.</p><p><strong>Methods: </strong>We performed a large retrospective single-centre analysis of patients with ABPA as defined by the modified ISHAM criteria between 2014 and 2022. Baseline characteristics were recorded. Clinical outcome was assessed at 12 months post commencement of a biologic including symptom scores, exacerbation frequency, corticosteroid use and multidisciplinary team (MDT) consensus of effectiveness.</p><p><strong>Results: </strong>74 patients received a biologic. 32% (n=24) received anti-immunoglobulin E therapy, 65% (n=48) anti-interleukin-5/5Rα therapy and 3% (n=2) anti-interleukin 4-Rα therapy. 65% (n=48) of patients were deemed to have a successful response at 12 months with a ≥50% reduction in OCS use. 35% (n=26) stopped or changed biologic during the follow-up period due to failed clinical response (n=21), side effects (n=4), or medical co-morbidities (n=1). There was a significant reduction in ACQ-6 score (p = <0.0001), exacerbation rate over 12 months (p = <0.0001) and maintenance OCS use (p = 0.0173). Univariate analysis revealed mucus plugging was associated with non-response to biologic therapy (p = 0.0189) CONCLUSION: 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. This data nevertheless increases the evidence-base for biologics in ABPA.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-03-13","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":"Impact of bronchiectasis severity on clinical outcomes in patients with allergic bronchopulmonary aspergillosis: a retrospective cohort study.","authors":"Inderpaul S Sehgal, Valliappan Muthu, Sahajal Dhooria, Kuruswamy T Prasad, Mandeep Garg, Shivaprakash M Rudramurthy, Ashutosh N Aggarwal, Arunaloke Chakrabarti, Ritesh Agarwal","doi":"10.1016/j.jaip.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.03.005","url":null,"abstract":"<p><strong>Background: </strong>The impact of bronchiectasis severity on the outcomes of patients with allergic bronchopulmonary aspergillosis (ABPA) remains uncertain.</p><p><strong>Objective: </strong>To evaluate whether bronchiectasis severity is associated with an increased risk of ABPA exacerbations.</p><p><strong>Methods: </strong>We retrospectively analyzed ABPA patients between 2007 and 2019. Patients were categorized based on the segments involved by bronchiectasis as mild (1-5), moderate (6-9), and extensive (≥10). We compared lung function and immunological markers among the groups. A multivariable Poisson regression analysis, using follow-up duration as an offset variable, assessed the association between bronchiectasis severity and ABPA exacerbations, adjusting for key confounders. We report the association as an adjusted relative rate (aRR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>We included 705 ABPA patients (mean age, 35 years). Of these, 219 (31.1%), 226 (32.1%), and 260 (36.9%) had mild, moderate, and extensive bronchiectasis. Patients with extensive bronchiectasis had poorer lung function and elevated immunological markers (serum total IgE, A.fumigatus-IgE, and -IgG) than those with mild or moderate bronchiectasis. The exacerbation frequency increased with the severity of bronchiectasis (mild: 41.5% vs. moderate: 53.4% vs. extensive: 57.7%, p=0.005). On multivariable analysis, the risk of ABPA exacerbation increased significantly with bronchiectasis severity (aRR [95% CI]; extensive:1.51 [1.09-2.08], moderate: 1.50 [1.09-2.08]). Additionally, increasing age (aRR, 0.84 [95% CI, 0.76-0.94]) and BMI (aRR, 0.97 [95% CI, 0.94-0.99]) were associated with lower exacerbation risk after adjusting for total IgE, lung function, and high-attenuation mucus.</p><p><strong>Conclusion: </strong>Moderate-to-extensive bronchiectasis is associated with worse lung function, heightened immunological severity, and an increased risk of ABPA exacerbation.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634805","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":"Long-Term Safety of Abrocitinib in Moderate-to-Severe Atopic Dermatitis: Integrated Analysis by Age.","authors":"Michael J Cork, Mette Deleuran, Bob Geng, Jonathan I Silverberg, Eric L Simpson, Linda F Stein Gold, Alan D Irvine, William Romero, Hernan Valdez, Haiyun Fan, Justine Alderfer","doi":"10.1016/j.jaip.2025.02.040","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.02.040","url":null,"abstract":"<p><strong>Background: </strong>Abrocitinib has a manageable long-term safety profile for patients with moderate-to-severe atopic dermatitis. Identifying populations at higher risk of adverse events (AEs) will help optimize dose selection.</p><p><strong>Objective: </strong>To evaluate abrocitinib long-term safety by age.</p><p><strong>Methods: </strong>Data (September 25, 2021 cutoff) from JADE clinical trials were pooled in a consistent-dose cohort (patients who received the same abrocitinib dose throughout exposure) or a variable-dose cohort (patients who received abrocitinib 200 mg [12 weeks], were randomly assigned later to receive abrocitinib 200 mg, 100 mg, or placebo [up to 40 weeks], and assigned to receive abrocitinib 200 mg or 100 mg in the long-term study). Data were stratified post hoc by age at baseline (12 to <18 years, 18 to <40 years, 40 to <65 years, and ≥65 years). Incidence rates (IRs) of treatment-emergent AEs (TEAEs) of special interest were assessed.</p><p><strong>Results: </strong>Analysis included 3802 patients (exposure: 5214 patient-years). IRs for serious AEs, TEAEs leading to study discontinuation, serious infections, herpes zoster, thrombocytopenia, lymphopenia, nonmelanoma skin cancer (NMSC), malignancies (excluding NMSC), major cardiovascular events, and venous thromboembolism were numerically higher in patients aged ≥65 years than in younger patients. Overall, adolescents had the lowest rates for TEAEs of special interest.</p><p><strong>Conclusions: </strong>Abrocitinib has a manageable long-term safety profile. TEAEs of special interest were lower in adolescents and higher in the ≥65-year age group. Risk of specific TEAEs was numerically higher in patients aged ≥65 years treated with abrocitinib 200 mg and underscores the importance of dose selection in older patients.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626675","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":"Skin testing improves predictive value of mid-range peanut specific IgE and Ara h 2 levels in the LEAP study.","authors":"Joshua S Bernstein, Thao Vu, Carolyn H Baloh, Michelle F Huffaker, George Du Toit, Stephen C Dreskin","doi":"10.1016/j.jaip.2025.02.041","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.02.041","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626684","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":"Climate Change and Allergens: Current and Future Impacts.","authors":"Allison J Burbank, Alexander J Penrice, Andrew C Rorie, Jae-Won Oh","doi":"10.1016/j.jaip.2025.02.039","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.02.039","url":null,"abstract":"<p><p>Climate change will continue to impact allergic diseases in direct and indirect ways. Rising global temperatures are contributing to increased duration of pollen seasons, altered aeroallergen production and potency of allergens, and changes in the geographic distribution of allergenic plants that drive increased human exposure to aeroallergens and increased allergic disease morbidity. Climate change is inextricably linked with air pollution, the latter of which was shown to act as an adjuvant for allergic inflammatory processes promoting allergic sensitization. Pollutant exposure is also linked with higher prevalence of childhood asthma and exacerbation of existing asthma and allergic disease. Increased exposure, or co-exposure, to aeroallergens and air pollution as a result of climate change will result in higher rates of sensitization and incident allergic disease remains uncertain. Vulnerable populations, including children, the elderly, and marginalized groups, are likely to be disproportionately affected. This review summarizes the current knowledge of the effects of climate change on aeroallergens, and by extension, allergic disease. Addressing these health challenges requires a comprehensive understanding of the interaction between climate change, allergens, pollution and public health, alongside proactive measures to mitigate these effects.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617765","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":"Fertility outcomes in women with asthma: a Danish nationwide cohort study.","authors":"Anne Vejen Hansen, Kjell Ej Håkansson, Anders P Mikkelsen, Zarqa Ali, Anja Pinborg, Øjvind Lidegaard, Charlotte Suppli Ulrik","doi":"10.1016/j.jaip.2025.02.033","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.02.033","url":null,"abstract":"<p><strong>Background: </strong>Asthma is common among women of reproductive age. Prior studies have revealed an association between asthma and fertility by reporting prolonged time to pregnancy and lower fecundability.</p><p><strong>Objective: </strong>Investigate fertility in women treated with asthma medication compared to women without asthma.</p><p><strong>Methods: </strong>All women born from 1976 to 1999, living in Denmark on their 18^th birthday, were followed 1994 to 2017. Asthma was defined as repeated fulfilment of asthma medication prescriptions and severity was classified according to the Global Initiative for Asthma guidelines (GINA). Outcome was fertility treatment in women with asthma compared to women without asthma, applying a Cox regression model adjusted for age, calendar year, and education.</p><p><strong>Results: </strong>The cohort comprised 765,606 women followed-up, starting on their 18^th birthday, for a median time of 10.8 years [IQR 5.3-17.5]. Compared to women without asthma, women with asthma had a comparable proportion giving birth during follow-up, slightly more experienced fetal loss (17.0% vs. 15.8 %) and required fertility treatment (5.6% vs. 5.0%). The risk of fertility treatment was significantly higher in women with asthma: HR 1.10 (1.07-1.14). Women on GINA treatment step 4-5 had an even higher risk of fertility treatment HR 1.59 (1.41-1.80) and, likewise, women with ≥ 3 prior exacerbations of asthma, HR 1.36 (1.17-1.58).</p><p><strong>Conclusion: </strong>Women with asthma have an increased use of fertility treatment, which correlates with asthma severity and exacerbation burden. However, asthma does not seem to affect number of live births.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588145","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}