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

{"title":"Assessing protocol variability for food protein–induced enterocolitis syndrome oral food challenges","authors":"Sara Anvari MD, MS , Ankona Banerjee MS , Stephanie Leonard MD , Purificacion Gonzalez-Delgado MD, PhD , Duc T. Nguyen MD, PhD , Anna Nowak-Wegrzyn MD, PhD","doi":"10.1016/j.jaip.2024.11.001","DOIUrl":"10.1016/j.jaip.2024.11.001","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 2","pages":"Pages 437-439.e2"},"PeriodicalIF":8.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631907","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":"Asthma digital inhaler uptake among patients and providers: A scoping review","authors":"Ilziba Yusup BHSc , Samir Gupta MD, MSc, FRCPC , Andrew Kouri MD, PhD, FRCPC","doi":"10.1016/j.jaip.2024.11.012","DOIUrl":"10.1016/j.jaip.2024.11.012","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 2","pages":"Pages 427-429.e2"},"PeriodicalIF":8.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711816","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 “Exploring the link between asthma onset in pregnancy and adverse perinatal events”","authors":"Jinyu Gu BMed , Tongxin Li MSc , Yishan Ding BMed , Chun Chang MD , Siyuan Yin BMed , Yan Wang MD, PhD","doi":"10.1016/j.jaip.2024.11.023","DOIUrl":"10.1016/j.jaip.2024.11.023","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 2","pages":"Page 448"},"PeriodicalIF":8.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143319505","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":"Two Patients With Angioedema and Persistent Lower Extremity Swelling","authors":"","doi":"10.1016/j.jaip.2025.01.004","DOIUrl":"10.1016/j.jaip.2025.01.004","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 2","pages":"Page 446"},"PeriodicalIF":8.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143319506","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 Outcome of IgE-Mediated Cow’s Milk Allergy and Risk Factors for Persistence","authors":"Liat Nachshon MD ,&nbsp;Michael R. Goldberg MD, PhD ,&nbsp;Naama Epstein-Rigbi MD ,&nbsp;Yitzhak Katz MD ,&nbsp;Arnon Elizur MD","doi":"10.1016/j.jaip.2024.10.026","DOIUrl":"10.1016/j.jaip.2024.10.026","url":null,"abstract":"<div><h3>Background</h3><div>Resolution rates of IgE-mediated cow’s milk allergy (IgE-CMA) by age 5 years and risk factors for its persistence were previously described.</div></div><div><h3>Objective</h3><div>To extend follow-up until the end of adolescence.</div></div><div><h3>Methods</h3><div>This is an extension study of 23 of 54 patients diagnosed with IgE-CMA from a population-based study of 13,019 newborns, who remained allergic at age 5 years. Patients were examined at age 17 years, and their history was reviewed. Resolution was determined by regular milk consumption without adverse reactions or a negative oral food challenge (OFC). Allergy was defined by a recent objective reaction to milk and a positive skin prick test (SPT), or by sensitization ≥95% positive predictive value (PPV) to milk. Risk factors for persistence at age 17 years were examined in the entire cohort.</div></div><div><h3>Results</h3><div>Of the 23 patients followed, 8 (35%) had spontaneous resolution and 15 had persistent IgE-CMA. Overall, 39 of the 54 patients (72.2%) initially diagnosed with IgE-CMA had spontaneous resolution by age 17 years. Risk factors for IgE-CMA persistence at age 17 years included SPT &gt;6 mm at the time of diagnosis (<em>P</em> = .03), no cow’s milk formula feeding in the nursery (<em>P</em> = .008), and wheezing on diagnostic OFC/initial reaction to milk (<em>P</em> = .04). Seven patients experienced objective reactions after age 5 years. These patients had more wheezing (<em>P</em> = .045) or anaphylaxis (<em>P</em> = .02) on diagnostic OFC/initial reaction and more current asthma (<em>P</em> = .007).</div></div><div><h3>Conclusions</h3><div>Significant rate of spontaneous resolution of IgE-CMA still occurs beyond age 5 years, and few patients with IgE-CMA, mostly asthmatics, experience objective reactions by early adulthood. This should be considered in the treatment approach of patients with IgE-CMA.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 2","pages":"Pages 369-377.e3"},"PeriodicalIF":8.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565238","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 impact of smoking history on baseline characteristic in patients with severe asthma in the German Asthma Net (GAN).","authors":"Leonie Biener, Slagjana Stoshikj, Jonas Brugger, Christoph Krall, Roland Buhl, Eckard Hamelmann, Stephanie Korn, Christian Taube, Katrin Milger-Kneidinger, Christian Schulz, Hendrik Suhling, Margret Jandl, Rainer Ehmann, Olaf Schmidt, Marco Idzko, Dirk Skowasch","doi":"10.1016/j.jaip.2025.01.024","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.01.024","url":null,"abstract":"<p><strong>Background: </strong>Asthma patients with >10 pack-years are frequently excluded from asthma trials. Little is known about how smoking affects their characteristics, and therefore may impact treatment choices.</p><p><strong>Objective: </strong>To evaluate the impact of cumulative smoking history on severe asthma patients' characteristics METHODS: We analysed pulmonary function tests, asthma control, exacerbation rate and biomarkers. We compared active and ex-smokers (=ever-smokers) vs. never-smokers and performed linear models for three groups stratified by smoking history (<10 pack-years (py), 10-20 py, >20 py). Data was obtained from the severe asthma registry German Asthma Net (GAN).</p><p><strong>Results: </strong>We included 2.478 patients: 65 (2.6%) active smokers, 1.005 (40.6%) ex-smokers and 1.408 (56.8%) never-smokers. Of the 1070 ever-smokers, 529 patients (21.3%) had <10 py, 304 (12.3%) 10-20 py and 237 (9.6%) >20 py. Cumulative smoking history was associated with worse asthma control (>20 py: ACT -1.76 [-2.76; -0.77] points (p <.001); mini-AQLQ -0.31 [-0.53; -0.10] points (p=0.004)), while exacerbation rate and maintenance oral corticosteroid (OCS) doses were similar (p=.13 and p=1.0). Cumulative smoking history was associated with smoking-related lung injury e.g. DLCO (-0.37 mmol/min/kPa for 10-20 py (p=.014) respectively -0.92 for >20 py (p<.001)), but FEV1 and FEV1-reversibility were similar. Cumulative smoking history was furthermore associated 0.84- [0.73; 0.97] fold lower FeNO concentrations (p=.007) while blood eosinophil count and IgE-levels were comparable (BEC p=1.0, IgE p=.49) CONCLUSION: Cumulative smoking history in asthma patients is associated with worse disease control, lower FeNO levels and smoking-related lung-injuries. Despite these differences, key asthma characteristics like BEC, IgE, OCS dose and exacerbation rates remain similar. If thoroughly examined and selected, patients with >10 py may also qualify for targeted treatments.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124084","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":"Adverse Impacts of Corticosteroid Treatment on Osteoporosis/Osteopenia in Adult Asthmatics: A Retrospective ICARUS Cohort Study","authors":"Junhyuk Chang PharmD ,&nbsp;Hyun-Seob Jeon MD ,&nbsp;Chungsoo Kim PharmD ,&nbsp;ChulHyoung Park MD ,&nbsp;Jae-Hyuk Jang MD ,&nbsp;Youngsoo Lee MD ,&nbsp;Eunyoung Lee MS ,&nbsp;Rae Woong Park MD, PhD ,&nbsp;Hae-Sim Park MD, PhD","doi":"10.1016/j.jaip.2024.10.016","DOIUrl":"10.1016/j.jaip.2024.10.016","url":null,"abstract":"<div><h3>Background</h3><div>Inhaled corticosteroid (ICS) and oral corticosteroid (OCS) are often used in asthma management.</div></div><div><h3>Objective</h3><div>To evaluate the long-term effect of ICS/OCS on osteoporosis, osteopenia, fractures, and bone metabolism in adult patients with asthma in real-world clinical practice.</div></div><div><h3>Methods</h3><div>This is a retrospective study investigating deidentified electronic health records from Ajou University Medical Center (Korea). Adult patients with asthma receiving maintenance ICS with/without OCS for at least 1 year were enrolled. They were classified into the high/low-dose of ICS or OCS group. Primary outcomes (incidences of osteoporosis, osteopenia, and fractures) and secondary outcomes (drug prescription and laboratory values related to bone metabolism including albumin and alkaline phosphatase) were compared after 5 years of follow-up.</div></div><div><h3>Results</h3><div>After propensity score matching, both high- and low-dose OCS groups included 468 patients, and high/low-dose ICS groups each comprised 1252 patients. The risk of osteoporosis/major fracture was higher (hazard ratio [95% CI], 2.00 [1.15-3.57]/3.03 [1.04-11.11]) in the high-dose OCS group (especially in females aged ≥50 years) than in the low-dose group, although the ICS groups showed no significant differences. The high-dose ICS group showed a higher risk of osteopenia (1.92 [1.05-3.70]) than the low-dose ICS group. The linear mixed model of laboratory values showed significantly decreased serum albumin and increased alkaline phosphatase in the high-dose OCS group than in the low-dose OCS group.</div></div><div><h3>Conclusions</h3><div>The results of this study suggest that long-term use of OCS can increase the risk of osteoporosis and osteoporosis-related fractures, whereas long-term use of ICS may increase the risk of osteopenia in adult patients with asthma.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 2","pages":"Pages 310-319"},"PeriodicalIF":8.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512576","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":"An Overview of Climate Changes and Its Effects on Health: From Mechanisms to One Health","authors":"Ioana Agache MD ,&nbsp;Michelle L. Hernandez MD ,&nbsp;Jared M. Radbel MD ,&nbsp;Harald Renz MD ,&nbsp;Cezmi A. Akdis MD","doi":"10.1016/j.jaip.2024.12.025","DOIUrl":"10.1016/j.jaip.2024.12.025","url":null,"abstract":"<div><div>Human activities, primarily the burning of fossil fuels, widespread deforestation, soil erosion or machine-intensive farming methods, manufacturing, food processing, mining, construction, and the iron, cement, steel, and chemicals industries, have been the main drivers of the observed increase in Earth’s average surface temperature and climate change. Rising global temperatures, extreme weather events, ecosystems disruption, agricultural impacts, water scarcity, problems in access to good quality water, food and housing, and profound environmental disruptions such as biodiversity loss and extreme pollution are expected to steeply increase the prevalence and severity of acute and chronic diseases. Its long-term effects cannot be adequately predicted or mitigated without a comprehensive understanding of the adaptive ecosystems. Studying the complex interaction between environmental aggressors and the resilient adaptive responses requires the exposomic and the One Health approaches. The problem is broad and affects the whole ecosystem, plants, pets, and animals in addition to humans. The central role of the epithelial barrier, microbiome, and diet as key pillars for an adaptive tolerogenic immune response should be explored for increasing resilience at the individual level. A radical change in mindset worldwide, with sustainable solutions and adaptive strategies and climate resilience and health equity policies at their center, should be achieved quickly through increased awareness based on solid scientific data.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 2","pages":"Pages 253-264"},"PeriodicalIF":8.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899268","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":"Use of high-dose inhaled corticosteroids and risk of corticosteroid related adverse events in asthma -findings from the NORDSTAR cohort.","authors":"Anna von Bülow, Susanne Hansen, Patrik Sandin, Alexandra Cooper, Olivia Ernstsson, Kirk Geale, Lauri Lehtimäki, Charlotte Ulrik, Bernt Bøgvald Aarli, Pinja Ilmarinen, Sylvia Packham, Ghada Hassan, Asger Sverrild, Helena Backman, Jussi Karjalainen, Vibeke Backer, Alan Altraja, Paula Kauppi, Valentina Yasinska, Maritta Kilpeläinen, Arja Viinanen, Johannes Martin-Schmid, Apostolos Bossios, Celeste Porsbjerg, Hannu Kankaanranta, Christer Janson","doi":"10.1016/j.jaip.2025.01.023","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.01.023","url":null,"abstract":"<p><strong>Background: </strong>The link between the use of oral corticosteroids (OCS) and adverse events (AEs) in asthma is well-described. In contrast, whether the use of high-dose inhaled corticosteroids (ICS) poses a risk to these is unknown.</p><p><strong>Objective: </strong>To examine the association between ICS exposure and corticosteroid-related AEs.</p><p><strong>Methods: </strong>We conducted an observational cohort study using nationwide Swedish registry data from the NORdic Dataset for aSThmA Research (NORDSTAR) research collaboration. We included asthma patients ≥18 years between 2009 and 2019 and calculated their current ICS exposure and average daily ICS dose (budesonide eq.) in follow-up. The association between ICS exposure and CS-related AEs was analyzed using Cox proportional hazards models adjusting for age, sex, and OCS dose.</p><p><strong>Results: </strong>We included 529,203 asthma patients. Overall, we observed increased hazard ratios (HR) in those exposed to high-dose (≥800-1599 μg) and very-high-dose (≥1600μg) ICS for several AEs, including cardiovascular disease, T2DM, osteoporosis and pneumonia compared to no ICS use. HRs for the current use of high-dose ICS ranged from 1.11 (95%CI 1.06-1.16) for T2DM to 1.65 (95%CI 1.58-1.72) for pneumonia. Likewise, HRs linked to average daily high-dose ICS ranged from 1.16 (95%CI 1.02-1.33) for pneumonia to 1.70 (95%CI 1.38-2.08) for osteoporosis. Sensitivity analysis excluding patients using OCS showed that high-dose ICS still associated with an increased risk of CS-related AEs. Overall, ICS <800 μg/daily had no increased risk, except for cataract.</p><p><strong>Conclusion: </strong>High-dose ICS is associated with an increased risk of several corticosteroid-related AEs. This highlights the importance of clinicians considering this risk in patients treated with high and very high-dose ICS.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124085","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":"Safety and Low Incidence of Anaphylaxis in Performing Oral Drug and Food Challenges in Mastocytosis","authors":"Rebekka Karolin Bent MD,&nbsp;Ivana Varsanova MD,&nbsp;Valentina Faihs MD,&nbsp;Claudia Kugler RND,&nbsp;Alexander Zink MD,&nbsp;Teresa Jäger MD,&nbsp;Johannes Ring MD,&nbsp;Tilo Biedermann MD,&nbsp;Ulf Darsow MD,&nbsp;Knut Brockow MD","doi":"10.1016/j.jaip.2024.10.044","DOIUrl":"10.1016/j.jaip.2024.10.044","url":null,"abstract":"<div><h3>Background</h3><div>Patients with mastocytosis (MC) have an increased risk of severe anaphylaxis. They report hypersensitivity reactions to drugs and food, but causality often remains questionable. Most allergy centers avoid oral challenge tests (OCT) in MC patients.</div></div><div><h3>Objective</h3><div>To determine the safety of food and drug OCT in patients with MC.</div></div><div><h3>Methods</h3><div>To evaluate the safety and outcome of challenges to drugs and food including food additives retrospectively, of 126 adult MC inpatients, 83 were suspected to have food or drug hypersensitivity and 445 OCTs were performed. History, clinical data, and allergy test results highlighting OCTs were analyzed.</div></div><div><h3>Results</h3><div>Only 10 of 445 OCTs (2.2%) in nine patients resulted in anaphylaxis. Drugs elicited reactions in four of 170 patients (2.4%): two to acetylsalicylic acid (two in 39 patients tested; 5.1%), one to tramadol (one in 12; 8.3%), and one to flurbiprofen (100%). Anaphylaxis to food was recorded in six of 275 OCTs (2.2%); two of 48 (4.1%) to galactose-α-1,3-galactose, two to other foods, and two to sulfites. Flushing or diarrhea occurred owing to histamine in five of 48 patients (10.4%), but also in five of 50 placebo challenges (10.0%), strongly questioning its relevance. Patients with proven anaphylaxis had more bone marrow MC and higher basal serum tryptase (71.3 vs 44.3 μg/L; <em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Challenge-confirmed food and drug anaphylaxis was rare in MC patients. Results have to be interpreted cautiously because placebo reactions occurred. Severe anaphylaxis was infrequent but may occur and should be met by emergency preparedness.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 2","pages":"Pages 407-417"},"PeriodicalIF":8.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631994","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}