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

{"title":"Development of a patient-reported outcome measure for Hypereosinophilic syndrome.","authors":"Paneez Khoury, Sana Mahmood, Alexis Berry, Dominique Mata, Miriam Kimel, Julie McCormack, Calman Prussin, Amy Klion","doi":"10.1016/j.jaip.2025.09.008","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.09.008","url":null,"abstract":"<p><strong>Background: </strong>Although a recent phase 3 double-blind, placebo-controlled registration trial of mepolizumab for HES used a patient-reported severity assessment, no patient reported outcome (PRO) measures have been formally developed for HES. Prior attempts to develop a PRO have been unsuccessful.</p><p><strong>Objective: </strong>The purpose of this study was to develop an outcome measure using accepted approaches for qualitative methods, conceptual models, and analyses to detect symptom severity and patient experience of disease activity.</p><p><strong>Methods: </strong>The study was performed using FDA guidance for development of symptom scales for outcome metrics using psychometric analysis and patient-administered questionnaires. Sixty-three Heterogeneous patients with different HES subtypes enrolled on a natural history study of eosinophilia were invited to participate. All participants provided informed consent. At baseline, patients filled out an HES Symptom Inventory (HES-SI) and indicated up to 4 of their most bothersome symptoms (HES-MBS). Symptom fluctuation was recorded over the course of 3 months, and clinical metrics (treatment changes) were assessed during the same period.</p><p><strong>Results: </strong>Across all timepoints, strong statistically significant correlations were observed for the HES-SI Total score (r=0.69 to 0.80, p < 0.0001) and HES-MBS score (r=0.71 to 0.81, p < 0.0001) with the patients' perception of disease status (PGA). The HES-SI and HES-MBS showed sensitivity to change and demonstrated test-retest reliability.</p><p><strong>Conclusion: </strong>Analyses of the HES-SI and HES-MBS scores provided strong preliminary evidence supporting the reliability and validity of these measures for use in future HES clinical trials. The ability of these scales to accurately measure changes in HES symptoms with successful treatment requires further study.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126480","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":"Preparing Allergists to Practice in 2050 Using AI.","authors":"Paneez Khoury, John Oppenheimer, Supinda Bunyavanich, Christina E Ciaccio, Jay Portnoy","doi":"10.1016/j.jaip.2025.09.012","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.09.012","url":null,"abstract":"<p><p>As artificial intelligence (AI) becomes deeply embedded in clinical practice, the field of allergy and immunology is poised for transformation by 2050. AI is expected to evolve from a decision-support tool to a collaborative partner in diagnostics, treatment personalization, and medical education. Allergy training programs will need to prepare fellows for a technologically advanced landscape by integrating AI literacy, data science, and virtual simulation into curricula. Fellowship programs will need to adopt adaptive learning platforms, high-fidelity simulations, and AI-powered clinical decision support to improve diagnostic acumen, procedural competency, and patient care. This evolution also demands attention to the ethical and legal challenges of AI implementation, including preserving patient autonomy, addressing algorithmic bias, and safeguarding data privacy. Fellows must develop skills to critically evaluate AI outputs and uphold transparent, human-centered care. AI will probably also reshape research practices through predictive analytics, digital twins, and automated trial matching, accelerating discovery in allergic and immunologic disease. Despite these advances, limitations such as the \"black box\" problem, lack of emotional intelligence, and misinformed patient self-diagnoses pose challenges. Clinicians will require new communication strategies, including brief cognitive behavioral interventions, to address AI-derived misconceptions and maintain trust. Rather than replacing allergists, AI is likely to expand their roles; freeing time for patient interaction while reinforcing their responsibility as interpreters, educators, and ethical stewards of digital tools. This review explores how graduate medical education and clinical practice in allergy and immunology must evolve to ensure that future allergists remain competent, compassionate, and technologically fluent in a dynamic AI-enhanced healthcare environment.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114685","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 participant baseline factors on exposure-adjusted incidence of treatment-related adverse events during peanut oral immunotherapy.","authors":"Melanie Lloyd, Sarah Ashley, Sarabnoor Singh Chawla, Paxton Loke, Francesca Orsini, Adriana Chebar Lozinsky, Ping Tang, Mimi L K Tang","doi":"10.1016/j.jaip.2025.09.010","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.09.010","url":null,"abstract":"<p><strong>Background: </strong>Oral immunotherapy (OIT) causes frequent treatment-related adverse events (AE), particularly during dose-escalation, which can cause treatment withdrawal.</p><p><strong>Objective: </strong>We aimed to determine whether patient characteristics influenced the frequency of treatment-related AEs during dose escalation.</p><p><strong>Methods: </strong>Data was obtained from a multicentre, randomised trial (PPOIT-003), involving 201 children aged 1-10 years who received probiotic peanut oral immunotherapy (PPOIT), peanut oral immunotherapy alone (OIT) or placebo. Frequency of AE was expressed as 'exposure-adjusted incidence rate' (EAIR). Multivariable Poisson regression models with interaction terms were used to explore whether baseline participant factors modified the effect of treatment on EAIR of treatment-related AEs during dose escalation.</p><p><strong>Results: </strong>EAIR of AE in PPOIT and OIT groups were 3-fold higher compared to placebo, with no difference between PPOIT and OIT (PPOIT vs placebo: rate ratio (RR)=3.62 [95% CI 2.92-4.48] p<0.001; OIT vs placebo: RR=3.62 [2.93-4.48] p<0.001; PPOIT vs OIT: RR=1.00 [0.90-1.10] p=0.98). Older children (≥6 years) and females had a higher EAIR in all treatment groups. Allergic sensitivity and pre-existing allergic conditions modified the effect of treatment on EAIR (likelihood ratio test all p<0.001). Children with SPT≥15mm, peanut sIgE≥40kU/L, reaction dose threshold <320mg peanut protein, or history of asthma, allergic rhinitis or anaphylaxis were more likely to report frequent treatment-related AEs when receiving PPOIT or OIT, but not placebo.</p><p><strong>Conclusion: </strong>Children with higher allergic sensitivity or allergic comorbidities are more likely to experience frequent treatment-related adverse events during peanut OIT dose escalation, and may benefit from more intensive monitoring and support to optimise treatment success.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114600","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":"Should We Consider Venom Immunotherapy When Levels of specific IgE to Insect Venom is between 0.1 and 0.34?","authors":"Taha Al-Shaikhly, David B K Golden, Timothy J Craig","doi":"10.1016/j.jaip.2025.09.005","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.09.005","url":null,"abstract":"<p><p>Venom immunotherapy (VIT) improves quality of life and is potentially lifesaving in patients with anaphylactic reactions to stinging insect venom and evidence of IgE-mediated sensitization. Sensitization is defined as either a positive skin test to insect venom or serum venom-specific IgE level that is equal to or above 0.35 kU/L. With the advent of advanced diagnostics, levels of sensitization as low as 0.1 kU/L can be appreciated; however, the approach to patients with a low level of sensitization (defined as venom-specific IgE levels between 0.1 and 0.34 kU/L) remains debatable. Additionally, when considering VIT for selected patients with large local reactions or cutaneous systemic reactions, encountering low levels of sensitization can complicate the clinical decision. In this pro/con debate, we discuss whether patients who had an anaphylactic reaction, cutaneous systemic reaction, or large local reaction to insect venom should receive VIT when diagnostic evaluation only reveals sensitization between 0.1 and 0.34 kU/L and negative skin testing. The pro position is presented by Dr. Al-Shaikhly, while the con position is discussed by Dr Craig. Dr. Golden served as moderator and fact-checker. This review is not intended to address the medical legal aspects, rather to direct research and clinical studies.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092857","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":"The Future of Allergy Management: How Artificial Intelligence Is Changing the Game.","authors":"Giovanna Cilluffo, Sakina Bajowala, Tania Elliott, Payel Gupta, Sofija Volertas, Giuliana Ferrante","doi":"10.1016/j.jaip.2025.08.033","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.08.033","url":null,"abstract":"<p><p>Allergy management is undergoing a transformative shift due to advancements in diagnostic tools, precision medicine, and digital health technologies. Artificial intelligence-driven predictive models enable more personalized and accurate diagnoses. Additionally, digital health solutions are enhancing patient monitoring and adherence to treatment protocols. The integration of these advances into clinical practice requires interdisciplinary collaboration and updated healthcare policies to ensure accessibility and affordability. While these innovations present promising opportunities, challenges such as data privacy, regulatory approval, and equitable healthcare distribution must be addressed. By embracing technological and scientific developments, the future of allergy management aims to improve patient outcomes, enhance quality of life, and reduce the overall burden of allergic diseases globally.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082400","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":"Tezepelumab in real-life practice: Characteristics of patients commenced and efficacy in a nationwide, Danish cohort of patients with severe asthma.","authors":"Marianne Baastrup Soendergaard, Kjell Erik Julius Håkansson, Susanne Hansen, Anne-Sofie Bjerrum, Johannes Martin Schmid, Sofie Lock Johansson, Linda Makowska Rasmussen, Claus Rikard Johnsen, Barbara Bonnesen, Roxana Vijdea, Anna von Bülow, Niels Steen Krogh, Ole Hilberg, Charlotte Suppli Ulrik, Celeste Porsbjerg","doi":"10.1016/j.jaip.2025.09.001","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.09.001","url":null,"abstract":"<p><strong>Background: </strong>Tezepelumab holds significant potential in severe asthma owing to its upstream target in the inflammatory cascade and could be an appropriate choice of biologic for different patient groups.</p><p><strong>Objectives: </strong>We aimed to characterise the patients prescribed tezepelumab during the first two years of the drug being available and its illuminate efficacy in a nationwide Danish cohort of patients with severe asthma.</p><p><strong>Methods: </strong>In this prospective observational study, we used data from the Danish Severe Asthma Register (DSAR). We categorised patients according to their previous biological treatment as either Biologic-naive or Switchers, compared baseline charecteristics and investigated efficacy after 12 months of treatment.</p><p><strong>Results: </strong>Of the 273 patients initiated on tezepelumab, 171 (63 %) were switchers. Biologic-naive patients had a median blood eosinophil count of 0.20 cells x 10⁹/L and fractional exhaled nitric oxide (FeNO) of 17 ppb. 172 patients were included in efficacy analyses and after 12 months of treatment, both biologic-naive patients and switchers showed significant improvements in maintenance oral corticosteroid use, symptoms and reduced exacerbations by 69 %. The majority of patients in both groups achieved a clinical response to treatment, however, a larger proportion of biologic-naïve patients achieved clinical remission (35 % vs 15 %, p=0.01).</p><p><strong>Conclusion: </strong>Most patients initiating tezepelumab in real-life clinical practice were switchers, and the biologic-naive patients initiated had relatively low type-2 inflammatory biomarkers, highlighting the complexity of patients on tezepelumab. However, both groups showed a clinical response rate to treatment, comparable to that seen in Danish patients initiated on other biologics.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058686","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":"Sex differences in childhood atopic disease and the role of sex-steroid metabolites.","authors":"Laura Marie Hesselberg, Nicklas Brustad, Rikke Bjersand Sunde, Min Kim, Julie Kyvsgaard, Ann-Marie Malby Schoos, Jakob Stokholm, Klaus Bønnelykke, Bo Chawes","doi":"10.1016/j.jaip.2025.08.031","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.08.031","url":null,"abstract":"<p><strong>Background: </strong>Studies have described sex differences in childhood asthma, allergy, and atopic dermatitis, but the development and clinical phenotype of these differences remain poorly understood.</p><p><strong>Objective: </strong>To characterize sex differences in atopic disease throughout childhood and study the potential role of sex-steroid metabolites.</p><p><strong>Methods: </strong>We examined sex differences in asthma, allergy, and atopic dermatitis using longitudinal generalized estimating equation models in the COPSAC₂₀₀₀ (n=411) and COPSAC₂₀₁₀ (n=700) birth cohorts. We further examined possible mechanisms through early-life sex-steroid metabolites.</p><p><strong>Results: </strong>In combined analyses of COPSAC₂₀₀₀ and COPSAC₂₀₁₀ until age 6 years, males had a higher prevalence of asthma compared to females (25% vs 20%): OR=1.48 (95% CI, 1.09-2.02) and experienced more asthma exacerbations: IRR=1.87 (1.37-2.55). Males had a higher prevalence of allergic sensitization (37% vs 31%): OR=1.54 (1.20-1.98), and higher blood eosinophil count: GMR=1.16 (1.07-1.27), which may indicate Type 2-inflammation. These sex differences persisted until age 18 years in COPSAC₂₀₀₀, except for asthma prevalence, whereas males had a higher prevalence of allergic rhinitis and a higher fraction of exhaled nitric oxide. During preschool-age, five of the measured sex-steroid metabolites significantly mediated parts of the sex differences in allergic sensitization (range of proportion mediated: 0.16-0.18) and/or blood eosinophils (range of proportion mediated: 0.22-0.25).</p><p><strong>Conclusion: </strong>Males had a higher prevalence of asthma, more frequent asthma exacerbations, higher prevalence of allergic sensitization, and higher blood eosinophil count than females during early childhood across two birth cohorts. These sex differences, which may indicate Type 2-inflammation, persisted into adolescence and were partly explained by sex-steroid metabolites.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034664","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":"Endoscopic Evaluation of Patients With Food Allergy for Eosinophilic Esophagitis Before Oral Immunotherapy.","authors":"Handan Duman Senol, Ezgi Topyildiz, Dogan Barut, Miray Karakoyun, Murat Sezak, Basak Doganavasargil Yakut, Funda Cetin, Figen Gulen, Esen Demir","doi":"10.1016/j.jaip.2025.08.029","DOIUrl":"10.1016/j.jaip.2025.08.029","url":null,"abstract":"<p><strong>Background: </strong>In recent years, it has been argued that eosinophilic esophagitis (EoE) seen in the early period of oral immunotherapy (OIT) may exist before OIT.</p><p><strong>Objective: </strong>We sought to evaluate the presence of EoE before initiating OIT and identify risk factors (during fetal development, infancy, and environmental exposures) for its development.</p><p><strong>Methods: </strong>A total of 48 patients who underwent endoscopic evaluation before OIT were enrolled. We scored endoscopic findings using the EoE Endoscopic Reference Score (EREFS) and histopathologic evaluation using the Eosinophilic Esophagitis Histologic Scoring System. The Index of Severity for EoE was used to evaluate disease activity.</p><p><strong>Results: </strong>There were pathologic endoscopic findings in 36 patients (75%), and the median EREFS was 2 (minimum of 0 to maximum of 7). Only seven patients (14.5%) had normal histology, 16 (33.3%) had esophageal eosinophilia (EE), and five (10.4%) had low-grade eosinophilia (5 to 15 eosinophils/hpf). Although all children were asymptomatic, only four patients (8.3%) had normal endoscopic and histopathologic findings. Furrows, total EREFS, and both inflammatory and fibrostenotic scores on the Index of Severity for EoE were statistically significantly higher in the EE group (P = .013, P = .008, P < .01, and P = .005, respectively). We found an approximately five times increased risk of EE (odds ratio = 5.444; 95% CI, 1.290-22.976; P = .021) when patients had any three risk factors combined among fetal and infant period factors (maternal fever, cesarean delivery, formula feeding, antibiotic use, and neonatal intensive care admission).</p><p><strong>Conclusion: </strong>Given the significantly increased risk of EE in children with a combination of early life risk factors, a risk-stratified approach to endoscopic evaluation may be warranted before OIT initiation.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034695","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":"Addition of Dupilumab for Patients with Aspirin-Exacerbated Respiratory Disease who have Poor Response to Aspirin Therapy After Desensitization.","authors":"Pooja M Achanta, Joel Swirnoff, Rachel E Parigian, Tanya M Laidlaw, Kathleen M Buchheit","doi":"10.1016/j.jaip.2025.08.032","DOIUrl":"10.1016/j.jaip.2025.08.032","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031155","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":"Observational analysis of biological remission as a treatment target for severe asthma: UK severe asthma registry.","authors":"McDowell P Jane, Redmond Charlene, Busby John, Patel Pujan, Jackson David J, Pfeffer Paul E, Mansur Adel H, Patel Mitesh, Brown Thomas, Burhan Hassan, Chaudhuri Rekha, Rupani Hitasha, Heaney Liam G","doi":"10.1016/j.jaip.2025.08.027","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.08.027","url":null,"abstract":"<p><strong>Background: </strong>The aim of biologic therapies in severe asthma is inhibition of T2 inflammatory pathways.</p><p><strong>Objective: </strong>We hypothesized that patients who achieve complete suppression of IL-5 & IL4/IL13 pathways with biologic therapy (FeNO <20ppb & blood eosinophil count (BEC) <0.15x10ˆ9, 'biological remission') would have better outcomes than patients with incomplete suppression of T2 biology.</p><p><strong>Methods: </strong>Retrospective analysis of severe asthma patients in the United Kingdom Severe Asthma Registry (UKSAR) who met strict national access criteria for biologics. Characteristics pre-biologic & at annual review were compared across biological remission (BR) & non-BR.</p><p><strong>Results: </strong>Of 778 patients, 148 (19%) had BR and 630 (81%) non-BR. BR did not confer additional benefit in exacerbation reduction, oral steroid exposure, lung function improvement, symptom improvement or T2-biomarker reduction. The BR cohort were less T2-high prior to commencing biologics. Long disease duration (adjOR 1.96, 95% CI 1.17 to 3.28), macrolide therapy (adjOR 2.08, 95% CI 1.17 to 3.71), & smoking history (adjOR 1.63, 95% CI 1.11 to 2.39) were positive predictors of BR, while higher-T2 biomarkers predicted non-BR. However, BEC & FeNO both had a negative correlation with lung function.</p><p><strong>Conclusion: </strong>Patients who achieve BR do not have superior outcomes compared to those who do not achieve BR. BR denotes a cohort of patients with a lower burden of T2 disease & additional factors driving disease severity. However, suppression of T2 biology is important for lung function gain. Prospective evaluation of treatment strategies that completely supress IL5 & IL4/13 pathways in T2-composite high patients is needed.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016666","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}