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

{"title":"Reply to “Early nutrition and the infant microbiome: implications for atopy”","authors":"Emily Robbins DO, Jack Koueik MD, Anne Marie Singh MD, Pamela A. Frischmeyer-Guerrerio MD, Suchitra K. Hourigan MD","doi":"10.1016/j.jaip.2026.07.030","DOIUrl":"10.1016/j.jaip.2026.07.030","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2437-2438"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096493","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":"Heart Rate Variability Patterns Differentiate Between Positive and Negative Oral Food Challenges in Children With Food Allergy","authors":"Na’ama Epstein-Rigbi MD,&nbsp;Yael Koren MD,&nbsp;Limor Ben-Nun Toledano MD,&nbsp;Rotem Blauground MD,&nbsp;Matan Elkan MD,&nbsp;Liat Nachshon MD,&nbsp;Arnon Elizur MD,&nbsp;Itamar Noham MA","doi":"10.1016/j.jaip.2026.08.009","DOIUrl":"10.1016/j.jaip.2026.08.009","url":null,"abstract":"<div><h3>Background</h3><div>Subjective complaints as well as mild symptoms during oral food challenges (OFCs) present a clinical dilemma and may result in false-positive OFCs.</div></div><div><h3>Objective</h3><div>To examine whether heart rate variability (HRV) patterns can help differentiate between patients with and without an objective allergic reaction during an OFC.</div></div><div><h3>Methods</h3><div>In this comparative cohort study, we examined the HRV patterns of children undergoing OFCs using a smart wristband device that continuously measured heart rate values. Comparison between cohorts was performed retrospectively using the derivative modified cardiac sympathetic index (CSI).</div></div><div><h3>Results</h3><div>Data from 104 pediatric patients were analyzed. Of these, 57 had a positive OFC (developed an allergic reaction), whereas 47 had a negative OFC. The baseline modified CSI scores (pre-OFC) were comparable between patients from both cohorts (<em>P</em> = .48). The HRV patterns throughout the OFCs were significantly different between positive and negative challenges (<em>P</em> &lt; .001). Patients with subjective complaints who had a negative OFC had a significantly lower modified CSI compared with patients with a positive challenge (<em>P</em> = .005). The scores of positive OFCs were not affected by reaction severity as measured by the Sampson score (Sampson score 2 vs Sampson scores 3 and 4) (<em>P</em> = .93). When comparing patients with a perioral rash with a positive versus a negative OFC, there were significantly higher scores in the positive OFC cohort (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>HRV patterns differentiate between positive and negative OFCs, regardless of the presence of subjective complaints. With further investigation, HRV monitoring may have the potential to serve as an objective adjunctive tool.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2379-2388.e2"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762499","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":"Effectiveness of Treatment With Tezepelumab in Patients With Severe Asthma, Smoking Asthmatics and Patients With Severe Asthma and COPD: A Real-World Cohort Study","authors":"Nora Drick MD,&nbsp;Christina Valtin MSc,&nbsp;Jan Fuge PhD","doi":"10.1016/j.jaip.2026.06.029","DOIUrl":"10.1016/j.jaip.2026.06.029","url":null,"abstract":"<div><h3>Background</h3><div>Severe asthma often coexists with chronic obstructive pulmonary disease (COPD), yet patients with overlapping conditions are frequently excluded from clinical trials. Consequently, evidence on the effectiveness of biologics such as tezepelumab in smokers or patients with concomitant COPD remains limited.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of tezepelumab in patients with severe asthma with concomitant COPD/emphysema or a smoking history compared with patients with asthma-only.</div></div><div><h3>Methods</h3><div>In this retrospective study, pulmonary function, exacerbations, oral corticosteroid use, asthma control, and quality of life were assessed at baseline and after at least 6 months of tezepelumab treatment in patients with different severe asthma phenotypes.</div></div><div><h3>Results</h3><div>Overall, 186 tezepelumab-treated patients (asthma-only n = 68; asthma with smoking history n = 56; asthma with COPD/emphysema n = 62) with a median treatment duration of 12 (interquartile range, 7-13) months were included. FEV₁ (% predicted) improved significantly in all groups (asthma-only: 71% to 75% [<em>P</em> = .014]; asthma with smoking history: 61% to 67% [<em>P</em> = .036]; asthma with COPD/emphysema: 44% to 45% [<em>P</em> = .035]). Asthma Control Test scores improved significantly (asthma-only: 13 to 16 [<em>P</em> = .003]; asthma with smoking history: 13 to 17 [<em>P</em> = .001]; asthma with COPD/emphysema: 12 to 15 [<em>P</em> &lt; .001]). Similar improvements across groups were observed for quality of life, oral corticosteroid dose reduction, and annualized exacerbation rates. Remission rates were comparable between groups.</div></div><div><h3>Conclusions</h3><div>Tezepelumab was associated with clinically meaningful improvements in lung function, asthma control, quality of life, and reduction in exacerbation rates in patients with severe asthma, irrespective of smoking history or comorbid COPD/emphysema, supporting its use in these underrepresented populations.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2334-2340"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370740","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":"Time to Complete Delabeling Among Eventual Completers","authors":"Fatih Kaplan MD","doi":"10.1016/j.jaip.2026.08.015","DOIUrl":"10.1016/j.jaip.2026.08.015","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Page 2444"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149094316","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":"Sustained low disease activity during long-term mepolizumab treatment in FIP1L1::PDGFRA-negative hypereosinophilic syndrome: a multicenter real-world study.","authors":"Kevin Chevalier, François Barde, Stanislas Faguer, Nathalie Freymond, Zakaria Lahmar, Arnaud Bourdin, Dorine Canu, Antoine Neel, Lucile Grange, Camille Taille, Alpha Oumar Diallo, Divi Cornec, Daniele Belgodere, Bernard Bonnotte, Pascal Chanez, Camille Ravaiau, Sébastien Trouiller, Julien Seneschal, Félix Ackermann, Ibrahim Marroun, Emmanuel Ledoult, Julien Rohmer, Guillaume Lefevre, Matthieu Groh, Jean-Emmanuel Kahn","doi":"10.1016/j.jaip.2026.09.021","DOIUrl":"https://doi.org/10.1016/j.jaip.2026.09.021","url":null,"abstract":"<p><strong>Background: </strong>Mepolizumab reduces relapses and glucocorticoid exposure in hypereosinophilic syndrome (HES), but evidence on long-term effectiveness remains limited. Growing consensus emphasizes sustained low disease activity over single-timepoint response in chronic inflammatory diseases.</p><p><strong>Objective: </strong>To evaluate the long-term safety and effectiveness of mepolizumab in HES using a pragmatic definition of Eosinophilic Low Disease Activity State (EoLDAS).</p><p><strong>Methods: </strong>We conducted a retrospective multicenter study of 67 patients with glucocorticoid-responsive FIP1L1::PDGFRA-negative HES treated with mepolizumab between 2003 and 2022 through clinical trials or compassionate use programs. Clinical manifestations, blood eosinophil counts, treatments, and serious adverse events were assessed at three-month intervals. EoLDAS was defined as absence of relapse, an absolute eosinophil count <0.5×10⁹/L (complete hematologic response, [CHR]), and a prednisone dose ≤5 mg/day.</p><p><strong>Results: </strong>After a median follow-up of 51 months, 12 patients (18%) relapsed and CHR was maintained during a median of 93% of visits. Patients spent a median of 79% (IQR, 40-88) of follow-up visits in EoLDAS, and 51% maintained EoLDAS for at least 75% of visits. Poor EoLDAS attainment (<25% of visits; n=11) was associated with lymphocytic HES and more prior treatment lines. Extending mepolizumab dosing intervals was associated with modest increases in eosinophil counts, but not with relapse or increased glucocorticoid exposure. No serious adverse event was considered related to mepolizumab.</p><p><strong>Conclusion: </strong>Mepolizumab provided sustained long-term disease control with low glucocorticoid exposure in FIP1L1::PDGFRA-negative HES. EoLDAS offers a pragmatic measure of longitudinal disease control that warrants prospective validation and may inform future treat-to-target strategies.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118037","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":"Understanding and Leveraging Implementation Science Within a Clinical Informatics Framework for Allergy/Immunology","authors":"","doi":"10.1016/j.jaip.2026.08.033","DOIUrl":"10.1016/j.jaip.2026.08.033","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2198-2199"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096169","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":"Managing Obesity to Improve Asthma Control","authors":"Christine M. Panganiban MD, MS,&nbsp;Dinah Foer MD","doi":"10.1016/j.jaip.2026.07.048","DOIUrl":"10.1016/j.jaip.2026.07.048","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2429-2430.e16"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096170","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 “Beyond the label: Methodological considerations for a target trial emulation of antihistamine use and dementia risk”","authors":"Henning Olbrich MD,&nbsp;Pavel Kolkhir MD,&nbsp;Torsten Zuberbier MD,&nbsp;Ralf J. Ludwig MD,&nbsp;Martin Metz MD","doi":"10.1016/j.jaip.2026.07.035","DOIUrl":"10.1016/j.jaip.2026.07.035","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2439-2440"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096168","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 patient positioning be addressed in intranasal epinephrine use?","authors":"Pasquale Comberiati MD,&nbsp;Gian Luigi Marseglia MD","doi":"10.1016/j.jaip.2026.07.023","DOIUrl":"10.1016/j.jaip.2026.07.023","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Page 2432"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096377","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 “Should patient positioning be addressed in intranasal epinephrine use?”","authors":"Motohiro Ebisawa MD, PhD,&nbsp;Kyohei Takahashi MD, MPH, PhD,&nbsp;Sarina Tanimoto MD, PhD","doi":"10.1016/j.jaip.2026.07.024","DOIUrl":"10.1016/j.jaip.2026.07.024","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2432-2433"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096378","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}