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

{"title":"Subtypes of Atypical Cold Urticaria and Recommendations for Their Diagnostic Workup","authors":"Dalia M. Ahsan MD ,&nbsp;Daniel Elieh-Ali-Komi ,&nbsp;Manuel P. Pereira MD ,&nbsp;Seda Sürmeli ,&nbsp;Mojca Bizjak MD, PhD ,&nbsp;Maxi Brockstaedt ,&nbsp;Martin Metz MD ,&nbsp;Sabine Altrichter MD ,&nbsp;Dorothea Terhorst-Molawi MD","doi":"10.1016/j.jaip.2025.07.019","DOIUrl":"10.1016/j.jaip.2025.07.019","url":null,"abstract":"<div><h3>Background</h3><div>A substantial subset of patients suffering from cold urticaria (ColdU) have atypical disease presentations and develop cold-induced wheals and/or angioedema in a real-world setting but not in response to standard cold stimulation tests. How to diagnose atypical ColdU is largely unclear, and little is known about the clinical features and treatment responses.</div></div><div><h3>Objective</h3><div>The aim of the study was to describe subtypes of atypical ColdU and provide recommendations for the diagnostic workup.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive literature search on subtypes of atypical ColdU and published testing procedures. We then developed and pilot-tested modified cold stimulation tests (mCSTs) for 8 subtypes of atypical ColdU.</div></div><div><h3>Results</h3><div>Our systematic review identified 10 subtypes of atypical ColdU—delayed ColdU, ColdU with aberrant wheals, extended exposure ColdU, generalized exposure ColdU, localized ColdU, cold-induced cholinergic urticaria, cold-dependent dermographism, water-dependent ColdU, food-dependent ColdU, and ultra-freeze ColdU. Pilot-testing of protocols for diagnostic mCSTs was successful in 8 of 8 variants. Based on these results, we generated recommendations for the diagnostic workup of known subtypes of atypical ColdU.</div></div><div><h3>Conclusions</h3><div>The mCSTs provide a more precise diagnostic confirmation in patients with suspected atypical ColdU and allow effective monitoring throughout the disease course, facilitating access to specific therapy options, and ultimately leading to improved care for this patient population.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 9","pages":"Pages 2370-2380.e2"},"PeriodicalIF":6.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709787","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":"Walnut Threshold Dose Distribution and Safe Dose in Allergic Patients (Nut CRACKER Study)","authors":"Liat Nachshon MD ,&nbsp;W. Marty Blom PhD ,&nbsp;Sabina Bijlsma PhD ,&nbsp;Michael R. Goldberg MD, PhD ,&nbsp;Noa H. Shufutinsky MD ,&nbsp;Naama Epstein-Rigbi MD ,&nbsp;Yael Koren MD ,&nbsp;Michael B. Levy MD ,&nbsp;Arnon Elizur MD","doi":"10.1016/j.jaip.2025.05.041","DOIUrl":"10.1016/j.jaip.2025.05.041","url":null,"abstract":"<div><h3>Background</h3><div>Walnut is a significant global food allergen, but data relating to population reaction thresholds are limited. This hampers the ability of industry and regulators to undertake allergen risk assessment, increases use of allergen labeling, and impairs patients’ quality of life.</div></div><div><h3>Objective</h3><div>To describe reaction eliciting doses (EDs) in a large walnut-allergic population.</div></div><div><h3>Methods</h3><div>A retrospective cohort study including all reactive walnut oral food challenges (OFCs) was performed between July 2014 and May 2023 at Shamir Medical Center. OFCs were performed for either diagnostic reasons or at the beginning of oral immunotherapy. Objective signs were used as stopping criteria. Confirmatory safe-dose OFCs with dose intervals of 90 minutes or more were also analyzed.</div></div><div><h3>Results</h3><div>Overall, 415 walnut OFCs were analyzed, with no left- or right-censored data. Corresponding estimated ED01 and ED05 (amount of protein eliciting an objective reaction in 1% and 5% of the walnut-allergic population, respectively) were 0.8 mg (range, 0.3-24) and 3.8 mg (range, 1.1-96.4) for discrete and 1.2 mg (range, 0.4-29.4) and 5.9 mg (range, 1.7-140.5) for cumulative dosing. Doses less than or equal to 1 mg elicited subjective reactions (in 12.5% of patients), but no objective reactions during the 295 safe-dose OFCs performed. Factors associated with a lower reaction threshold to walnut included a younger age, oral immunotherapy-OFC protocol, and coallergy to pecan (<em>P</em> &lt; .001 for all).</div></div><div><h3>Conclusions</h3><div>This is the largest published data set to inform EDs to walnut, with greater certainty of ED with the inclusion of safe-dose OFCs. These data address an evidence gap in the global Codex efforts to improve evidence-based allergen risk assessment for walnut.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 9","pages":"Pages 2411-2418.e5"},"PeriodicalIF":6.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200772","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":"Advancements in Novel Therapeutics for Chronic Spontaneous Urticaria","authors":"","doi":"10.1016/j.jaip.2025.08.010","DOIUrl":"10.1016/j.jaip.2025.08.010","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 9","pages":"Page 2286"},"PeriodicalIF":6.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050702","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":"Information for Readers","authors":"","doi":"10.1016/S2213-2198(25)00782-2","DOIUrl":"10.1016/S2213-2198(25)00782-2","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 9","pages":"Page A18"},"PeriodicalIF":6.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050638","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":"Practice Notes","authors":"","doi":"10.1016/S2213-2198(25)00783-4","DOIUrl":"10.1016/S2213-2198(25)00783-4","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 9","pages":"Pages A21-A22"},"PeriodicalIF":6.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050639","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 of Chronic Spontaneous Urticaria Made Practical: What Every Clinician Should Know","authors":"Emek Kocatürk MD ,&nbsp;Derek K. Chu MD ,&nbsp;Murat Türk MD ,&nbsp;Heike Röckmann MD, PhD ,&nbsp;Martijn Van Doorn MD, PhD ,&nbsp;Surapon Nochaiwong PharmD ,&nbsp;Torsten Zuberbier MD, PhD","doi":"10.1016/j.jaip.2025.07.021","DOIUrl":"10.1016/j.jaip.2025.07.021","url":null,"abstract":"<div><div>Despite its significant impact on quality of life, optimal management of chronic spontaneous urticaria remains challenging because of knowledge gaps regarding triggers, treatment response variability, and limited data for special populations. Second-generation H1-antihistamines are the first-line treatment and effective in approximately 50% of patients. For those who remain symptomatic, up-dosing up to fourfold is safe and recommended. However, prolonged ineffective antihistamine therapy should be avoided to prevent delayed disease control. In such cases, timely escalation to biologics, particularly omalizumab, is essential. Omalizumab remains the cornerstone of biologic therapy, offering rapid and sustained efficacy with an excellent safety profile. Personalized approaches involving dose escalation or interval adjustments further optimize outcomes. Cyclosporine A serves as an effective third-line option, particularly for autoimmune chronic spontaneous urticaria, but requires close monitoring because of dose-related adverse effects. Special considerations for children, pregnant individuals, and elderly people are discussed, reflecting the need for tailored approaches. Trigger avoidance, particularly nonsteroidal anti-inflammatory drugs, may aid management, although evidence is limited for many suspected exacerbating factors. Regular assessment of disease activity and control using validated tools such as the Urticaria Activity Score and Urticaria Control Test is essential for guiding treatment decisions and monitoring response. Updated international guidelines are anticipated to address emerging therapies and current knowledge gaps.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 9","pages":"Pages 2252-2269"},"PeriodicalIF":6.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856962","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":"Clinical Evaluation and Outcome Measures of Chronic Spontaneous Urticaria and Chronic Inducible Urticaria","authors":"Karsten Weller MD ,&nbsp;Indrashis Podder MD ,&nbsp;Andac Salman MD ,&nbsp;Anna Maria Gimenez-Arnau MD ,&nbsp;Sophia Neisinger MD ,&nbsp;Sabine Altrichter MD","doi":"10.1016/j.jaip.2025.07.008","DOIUrl":"10.1016/j.jaip.2025.07.008","url":null,"abstract":"<div><div>Chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU) are debilitating skin diseases characterized by recurrent itchy wheals and/or angioedema, with a considerable negative impact on the patient’s quality of life (QoL). Accurate clinical evaluation is important for diagnosis, disease monitoring, and guiding treatment. In CSU, it is primarily based on a detailed history, selected laboratory investigations, and patient-reported outcome measures (PROMs). In CIndU, objective provocation tests and critical threshold testing (CTT) are additionally useful. PROMs have emerged as indispensable tools in assessing disease activity, impact, and control from the patient’s perspective. They enhance disease monitoring, support treatment decisions, and facilitate individualized, patient-centered care, and are recommended in routine clinical care and research. Recently, digital tools such as the CRUSE (Chronic Urticaria Self Evaluation) app have further advanced PROM integration, enabling real-time disease tracking and improved clinical workflows. In CIndU, objective provocation tests and CTT help to identify specific triggers and quantify individual stimulus thresholds. A structured approach based on the \"Assess–Act–Adjust\" principle facilitates optimal management by linking PROM results, diagnostic tests (eg, CTT), and other data with therapeutic strategies. Its implementation in urticaria care supports personalized medicine, aiming to achieve complete disease control and to normalize the patient’s QoL.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 9","pages":"Pages 2229-2241"},"PeriodicalIF":6.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668939","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 efficacy of extended venom immunotherapy maintenance intervals in mastocytosis","authors":"Giovanna Sfriso MD ,&nbsp;Matteo Martini MD ,&nbsp;Maria Beatrice Bilò MD ,&nbsp;Maria Angiola Crivellaro MD ,&nbsp;Marina Mauro MD ,&nbsp;Erminia Ridolo MD ,&nbsp;Carla Lombardo MD ,&nbsp;Maria Teresa Costantino MD ,&nbsp;Marcello Cilia MD ,&nbsp;Donatella Bignardi MD ,&nbsp;Fabio Lodi Rizzini MD ,&nbsp;Irene Martignago MD ,&nbsp;Francesco Murzilli MD ,&nbsp;Elisabetta Favero MD ,&nbsp;Giovanni Marchi MD ,&nbsp;Federico Reccardini MD ,&nbsp;Elisa Boni MD ,&nbsp;Valentina Gueli MD ,&nbsp;Francesca Norelli MD ,&nbsp;Ilaria Tanasi MD ,&nbsp;Patrizia Bonadonna MD","doi":"10.1016/j.jaip.2025.05.052","DOIUrl":"10.1016/j.jaip.2025.05.052","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 9","pages":"Pages 2526-2528.e1"},"PeriodicalIF":6.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250799","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":"Weight and unplanned asthma health care utilization among disinvested, urban, and Black children","authors":"Taylor Brewer MD ,&nbsp;Rachel Margolis PhD ,&nbsp;Stephen J. Teach MD, MPH","doi":"10.1016/j.jaip.2025.05.053","DOIUrl":"10.1016/j.jaip.2025.05.053","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 9","pages":"Pages 2518-2521"},"PeriodicalIF":6.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250815","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":"Comparing allergic rhinitis treatments based on patient satisfaction: A MASK-air® study","authors":"Rafael José Vieira MD, PhD ,&nbsp;Bernardo Sousa-Pinto MD, PhD ,&nbsp;Sara Gil-Mata MD ,&nbsp;Anna Bedbrook BSc ,&nbsp;Luisa Brussino MD ,&nbsp;Antonio Francesco Maria Giuliano MD ,&nbsp;Ludger Klimek MD, PhD ,&nbsp;Violeta Kvedariene MD, PhD ,&nbsp;Marek Niedoszytko MD, PhD ,&nbsp;Oliver Pfaar MD, PhD ,&nbsp;Nhân Pham-Thi MD, PhD ,&nbsp;Boleslaw Samolinski MD, PhD ,&nbsp;Maria Teresa Ventura MD ,&nbsp;Torsten Zuberbier MD, PhD ,&nbsp;João A. Fonseca MD, PhD ,&nbsp;Jean Bousquet MD, PhD","doi":"10.1016/j.jaip.2025.05.058","DOIUrl":"10.1016/j.jaip.2025.05.058","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 9","pages":"Pages 2529-2531.e1"},"PeriodicalIF":6.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250794","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}