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

{"title":"Hereditary Angioedema with Normal C1 Inhibitor: A Quarter Century of Forward Progress and Persisting Obstacles.","authors":"Sandra C Christiansen, Aleena Banerji, Jonathan A Bernstein, Paula J Busse, Timothy Craig, H Henry Li, Mark Davis-Lorton, William R Lumry, Marc A Riedl, Bruce L Zuraw","doi":"10.1016/j.jaip.2025.02.036","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.02.036","url":null,"abstract":"<p><p>Hereditary angioedema with normal C1 inhibitor (HAE-nl-C1INH) was initially described almost a quarter century ago. Considerable progress towards unraveling the mysteries of this complex disease has been made during the intervening years. The ability to diagnose, classify, and treat HAE-nl-C1INH, however, continue to present daunting clinical challenges. In the following article we have attempted to summarize current areas of scientific consensus as well as provide some insights envisioned to assist physicians caring for affected individuals. Coherently describing the field of HAE-nl-C1INH in many ways embodies a precarious balance between assertions anchored by data versus conjecture. In this Rostrum we have tried to encapsulate the numerous scientific developments over the past 25 years into a proposed classification schema intended to facilitate decisions when evaluating patients with recurrent angioedema. Founded upon an accurate diagnosis in conjunction with an appreciation of the underlying pathomechanism, targeted patient treatment strategies can be appropriately designed. It is hoped that this approach will lay the groundwork for future advances in our understanding of HAE-nl-C1INH while bringing patients ever closer to the goal of leading a normal life.</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":"143588147","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":"Cardiovascular Risk of the Use of Long-acting Bronchodilators in Patients with Asthma: A Meta-analysis of 22 Randomized Controlled Trials.","authors":"Le Bai, Tingyuan Li, Dongwei Zhu, Qi Zhao, Yong Xu, Xianmei Zhou","doi":"10.1016/j.jaip.2025.02.035","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.02.035","url":null,"abstract":"<p><strong>Background: </strong>Long-acting bronchodilators can improve the control of asthma when added to inhaled corticosteroids (ICS). However, the cardiovascular safety of these drugs in patients with asthma has never been comprehensively evaluated. Notably, growing evidence have indicated a positive association between asthma and cardiovascular diseases.</p><p><strong>Objective: </strong>To evaluate the cardiovascular safety of addition of long-acting bronchodilators in patients with asthma.</p><p><strong>Methods: </strong>After a comprehensive retrieval in PubMed, Embase, Cochrane Library and Web of Science, we included randomized controlled trials that assessed the cardiovascular safety of long-acting bronchodilators in patients with asthma. The primary outcome was the comparation of incidence of total cardiovascular AEs. Secondary outcomes included drug-related AEs, AEs leading to discontinuation, serious AEs and fatal AEs.</p><p><strong>Results: </strong>A total of 22 trials with 62,915 patients were included. The use of long-acting bronchodilators significantly increased the incidence of cardiovascular AEs leading to discontinuation (IRR: 3.05, 95% CI: 1.07-8.48). The incidences of total cardiovascular AEs, drug-related AEs, serious AEs and fatal AEs were higher in patients treated with long-acting bronchodilators, but the differences were not significant. The certainty of evidence was low for comparations of total cardiovascular AEs and fatal AEs. The certainty of evidence was very low for comparations of drug-related AEs, AEs leading to discontinuation and serious AEs.</p><p><strong>Conclusion: </strong>The incidence of cardiovascular AEs was quite low in patients with asthma, and only the risk of AEs leading to discontinuation significantly increased compared with those not exposure to long-acting bronchodilators. More studies are required to confirm the present findings in consideration of the potential reporting bias.</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":"143588143","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":"Life stressors, resilience resources, and asthma among adults in the Hispanic Community Health Study/ Study of Latinos (HCHS/SOL).","authors":"Yueh-Ying Han, Kristina Gaietto, Wei Chen, Krista M Perreira, Eyal Oren, Amber Pirzada, Olga Garcia-Bedoya, Robert Kaplan, Carmen R Isasi, Juan C Celedón","doi":"10.1016/j.jaip.2025.02.031","DOIUrl":"10.1016/j.jaip.2025.02.031","url":null,"abstract":"<p><strong>Background: </strong>Whether life stressors and resiliency interact on asthma risk in adults is largely unknown.</p><p><strong>Objective: </strong>To examine life stressors, resiliency, and asthma in Hispanic/Latino adults.</p><p><strong>Methods: </strong>Cross-sectional study of 4,747 adults aged 18-74 years in the Sociocultural Ancillary Study of the Hispanic Community Health Study/Study of Latinos. Participants completed questionnaires on life stressors (adverse childhood experiences [ACE], traumatic stress exposure (TSE), and chronic stressors [for >6 months]) and resilience resources (family cohesion, perceived social support, and spiritual well-being). Logistic regression was used for the multivariable analyses of current asthma and current asthma symptoms.</p><p><strong>Results: </strong>Any ACE and any chronic stressor were associated with 54%-69% increased odds of asthma and asthma symptoms in all individuals, with stronger associations for ACE in men and for chronic stressors in women. In a separate analysis, high family cohesion and high spiritual well-being were each associated with 35%-36% reduced odds of asthma symptoms. There was suggestive evidence of interactions: any TSE was associated with increased odds of asthma in adults with low family cohesion (adjusted odds ratio [aOR]=2.40, 95% CI=1.01-5.73) but not in others, and any chronic stressor was associated with increased odds of asthma symptoms in adults with low spiritual well-being (aOR=2.24, 95% CI=1.20-4.20) but not in others.</p><p><strong>Conclusion: </strong>In Hispanic/Latino adults, ACE and chronic stress were associated with higher odds of asthma or asthma symptoms, while family cohesion and spiritual well-being were linked to lower odds of asthma or asthma symptoms. Further, resiliency may interact with life stressors on asthma.</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":"143588148","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":"Labeling barriers to delabeling penicillin allergy: an intersectional case study of gender identity, race, and syphilis.","authors":"Olive Ochuba, Samantha Novotny, Katelyn H Wong, Joseph Canarie, Daniel F Sarpong, Ami P Belmont","doi":"10.1016/j.jaip.2025.02.038","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.02.038","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574566","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":"Social Determinants and Quality of Life in Food Allergy Management and Treatment.","authors":"Jennifer L P Protudjer, Carla M Davis, Ruchi S Gupta, Tamara T Perry","doi":"10.1016/j.jaip.2025.02.016","DOIUrl":"10.1016/j.jaip.2025.02.016","url":null,"abstract":"<p><p>Food allergies (FA) significantly affect the quality of life (QOL) and health-related QOL of patients and families managing this chronic condition. Social determinants of health (SDOH) are pivotal nonmedical factors that influence health outcomes and exacerbate disparities in FA diagnosis, treatment, and management. The five domains of SDOH (economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context) shape the lived experiences of individuals with FA. Challenges such as food insecurity, limited access to specialty care, and the high cost of allergen-free foods disproportionately burden under-resourced and marginalized populations, leading to gaps in care and adverse outcomes. This report explores the interplay between SDOH and FA management, focusing on the economic, emotional, and social barriers to optimal care. Furthermore, it highlights the importance of understanding domain-specific QOL, emphasizing tailored interventions to address inequities. Future research must prioritize inclusive representation in clinical trials, innovative strategies to overcome economic and systemic barriers, and tools to measure the unique QOL impacts of FA across diverse populations. Addressing these challenges is critical to promoting health equity and improving outcomes for all individuals affected by FA.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568782","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":"Exploring the Barriers and Benefits of Stock Inhaler Programs in Urban School Settings: Perspectives of Chicago School Nurses and Administrators.","authors":"Danita Hingston, Caroline Youssef, Semmy Adeleke, Paige Hardy, TaShunda Green Shelton, Jeanette White, Lynn B Gerald, Andrea A Pappalardo","doi":"10.1016/j.jaip.2025.02.029","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.02.029","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568781","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":"Prospective Piperacillin Lymphocyte Transformation Testing in Patients With Cystic Fibrosis Receiving Regular and Desensitization Courses of Piperacillin-Tazobactam","authors":"Paul Whitaker MD ,&nbsp;Andrew Gibson PhD ,&nbsp;John Farrell MSc ,&nbsp;Lindsey Gillgrass BSN ,&nbsp;Xiaoli Meng PhD ,&nbsp;Daniel Peckham DM ,&nbsp;Dean John Naisbitt PhD","doi":"10.1016/j.jaip.2024.12.003","DOIUrl":"10.1016/j.jaip.2024.12.003","url":null,"abstract":"<div><h3>Background</h3><div>Piperacillin-tazobactam is used in patients with cystic fibrosis to treat recurrent respiratory infections. Exposure is associated with a high frequency of nonimmediate hypersensitivity.</div></div><div><h3>Objective</h3><div>To assess the applicability of the lymphocyte transformation test (LTT) for the diagnosis of piperacillin hypersensitivity and the influence of desensitization on piperacillin-specific T-cell responses.</div></div><div><h3>Methods</h3><div>Study arm 1 was an analysis of LTT responses from 58 naive/baseline tolerant patients with samples collected over a 3-year interventional phase. In study arm 2, 17 hypersensitive patients were recruited and LTTs were conducted before and after desensitization. Clinical hypersensitivity reactions in both arms were monitored over an 8-year observational period.</div></div><div><h3>Results</h3><div>In study arm 1, 58 patients received 611 piperacillin-tazobactam courses (range, 2-40; mean ± SD, 10.5 ± 8.1) during the interventional phase; 11 patients developed hypersensitivity. The patients who remained tolerant received 236 piperacillin-tazobactam courses in the observational period, 9 of whom developed hypersensitivity. Ten of 11 interventional phase hypersensitive patients had a positive LTT whereas one remained negative. We recorded 136 negative LTTs with 39 tolerant patients, whereas eight patients had a positive LTT and four developed hypersensitivity during the observational period. Ten LTT-positive patients in study arm 2 underwent piperacillin-tazobactam desensitization, with seven tolerating the drug. The strength of the LTT decreased during desensitization, and negative results were recorded for a minimum of 14 days. During follow-up, eight patients tolerated 62 piperacillin-tazobactam courses through desensitization.</div></div><div><h3>Conclusions</h3><div>The LTT is a sensitive marker of drug sensitization that could be used to inform future patient management. Desensitization is associated with attenuation of the piperacillin-specific T-cell response.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 3","pages":"Pages 594-609.e8"},"PeriodicalIF":8.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Psychosocial Burden of Pediatric Food Allergy in the United States: A Population-Based Survey","authors":"Melissa L. Engel PhD ,&nbsp;Christopher M. Warren PhD ,&nbsp;Linda J. Herbert PhD ,&nbsp;Andrea A. Pappalardo PhD ,&nbsp;Ashley Ramos PhD ,&nbsp;Ruchi S. Gupta MD, MPH","doi":"10.1016/j.jaip.2024.12.007","DOIUrl":"10.1016/j.jaip.2024.12.007","url":null,"abstract":"<div><h3>Background</h3><div>Food allergy (FA) affects approximately 1 in 12 US children, with prevalence increasing. Aside from considerable health care utilization, accumulating research suggests heightened psychosocial burden among this population.</div></div><div><h3>Objective</h3><div>To characterize FA-related psychosocial burden among a large, nationally representative pediatric sample, and its correlates, including sociodemographic characteristics, comorbid conditions, allergy severity, allergic symptoms, number and type of allergens, and health care utilization.</div></div><div><h3>Methods</h3><div>A survey was administered between October 2015 and September 2016 to a nationally representative sample of US households. Survey constructs included the Food Allergy Independent Measure (FAIM), which was developed to quantify adverse impacts of living with FA on psychosocial burden (range, 1-7; higher scores indicate greater burden). FAIM responses were analyzed from caregivers reporting current FA in their child (N = 4734). Linear regression models examined associations with sociodemographic and FA characteristics.</div></div><div><h3>Results</h3><div>The overall estimated mean caregiver-proxy FAIM scores for the US pediatric population were 2.79 (SE, 0.03) for reported FA, 2.96 (SE, 0.04) for convincing FA, and 3.21 (SE, 0.05) for physician-confirmed, convincing FA. Significant differences in caregiver-reported burden (<em>P</em> &lt; .05) were found for sociodemographic (ie, household income, birth country, child age) and clinical (ie, FA severity, physician diagnosis, specific allergens) factors.</div></div><div><h3>Conclusions</h3><div>Although heterogeneous to a degree, the psychosocial burden of children with FA was substantial irrespective of sociodemographic and clinical characteristics. FAIM norms can be used clinically, as well as be leveraged by other economic, epidemiological, and health efforts to understand the public health impact of FA.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 3","pages":"Pages 630-638.e4"},"PeriodicalIF":8.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866159","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":"Preimplantation genetic testing for hereditary angioedema as a potential dominant cost-effective intervention","authors":"Willem Roosens MD ,&nbsp;Lore Lannoo MD, PhD ,&nbsp;Ellen Denayer MD, PhD ,&nbsp;Liesbeth Gilissen PharmD, PhD ,&nbsp;Karen Peeraer MD, PhD ,&nbsp;Eftychia Dimitriadou PhD ,&nbsp;Jeroen Luyten PhD ,&nbsp;Kristel Van Calsteren MD, PhD ,&nbsp;Rik Schrijvers MD, PhD","doi":"10.1016/j.jaip.2024.12.023","DOIUrl":"10.1016/j.jaip.2024.12.023","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 3","pages":"Pages 711-714.e3"},"PeriodicalIF":8.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900240","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":"Nonpharmacological Approaches to Chronic Cough","authors":"","doi":"10.1016/j.jaip.2025.01.028","DOIUrl":"10.1016/j.jaip.2025.01.028","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 3","pages":"Page 489"},"PeriodicalIF":8.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549082","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}