Journal of Allergy and Clinical Immunology-In Practice最新文献_第6页

Poor agreement among asthma specialists on the choice and timing of initiation of a biologic treatment for severe asthma patients.

IF 8.2 1区医学

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-01-24 DOI: 10.1016/j.jaip.2025.01.017

Andréanne Côté, Rosalie Beaulé, Marie-Ève Boulay, Jakie Guertin, Louis-Philippe Boulet, Krystelle Godbout, David Price

{"title":"Poor agreement among asthma specialists on the choice and timing of initiation of a biologic treatment for severe asthma patients.","authors":"Andréanne Côté, Rosalie Beaulé, Marie-Ève Boulay, Jakie Guertin, Louis-Philippe Boulet, Krystelle Godbout, David Price","doi":"10.1016/j.jaip.2025.01.017","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.01.017","url":null,"abstract":"Background: As the number of monoclonal antibodies available for severe asthma is growing, specialists currently choose without clear guidelines. Despite increasing knowledge on treatment response to these monoclonal antibodies, making the optimal choice for each individual patient remains a challenge. However, evidence of this daily challenge is lacking.Objective: To evaluate inter-observer agreement on the choice of biologic therapy in severe asthma patients among severe asthma specialists, based on clinical cases.Methods: This two-phase study included a pilot local study and an international validation study. Asthma specialists were presented 7 real-life asthma cases managed with a monoclonal antibody. Based on the clinical information provided in the cases, they were asked if they would have initiated a monoclonal antibody and, if so, their treatment of choice between a) Omalizumab, b) Mepolizumab, c) Reslizumab, d) Benralizumab and e) Dupilumab. Interobserver agreement for each question was assessed using Gwet's AC1.Results: Sixteen physicians from the Province of Quebec (Canada) completed the pilot survey, and 70 physicians from 26 countries completed the international survey. Gwet's AC1 for the decision to initiate a biological therapy was 0.48 in the pilot survey and 0.33 in the international survey. For the choice of therapy, agreement was 0.33 and 0.26, respectively.Conclusions: The inter-observer agreement among asthma specialists in both the decision to initiate a biological treatment in patients with severe asthma and in the selection of treatment is weak. These results highlight the need for studies seeking reliable predictors for optimal response to biological therapies.","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048779","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}

引用次数: 0

Models of inpatient antibiotic allergy management in healthcare.

IF 8.2 1区医学

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-01-24 DOI: 10.1016/j.jaip.2025.01.020

Neil Powell, Elise Mitri, Anna R Wolfson, Mary L Staicu

引用次数: 0

Evaluation of Mast Cell Disease in Women: A Case Study of Delayed Diagnosis of Systemic Mastocytosis.

IF 8.2 1区医学

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-01-24 DOI: 10.1016/j.jaip.2025.01.019

Vishaka R Hatcher, Veronica C Alix, Tasha S Hellu, Meredith M Schuldt, Karla E Adams

引用次数: 0

Serum Sickness-Like Reactions in children taking antibiotics represent a distressing form of infection- associated urticaria and may recur unpredictably in susceptible children.

IF 8.2 1区医学

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-01-22 DOI: 10.1016/j.jaip.2025.01.018

Edward Fernandez, Matthew Robson, Grayson Summar, Patricia Earl, Trisha Wendling, Michelle Wessels, Allison E Norton, Kimberly Risma

引用次数: 0

The Non-Food-Specific Dynamics for Tolerance Acquisition in Acute Food Protein-Induced Enterocolitis Syndrome.

IF 8.2 1区医学

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-01-22 DOI: 10.1016/j.jaip.2025.01.015

Satoshi Hayano, Osamu Natsume, Ryuhei Yasuoka, Yukiko Katoh, Yusuke Inuzuka, Masaki Koda

引用次数: 0

The role of IgE sensitisation in acute FPIES: A systematic review and meta-analysis.

IF 8.2 1区医学

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-01-22 DOI: 10.1016/j.jaip.2025.01.016

A Phelan, S Infante, S Barni, U Nurmatov, Rj Boyle, M Vazquez-Ortiz

{"title":"The role of IgE sensitisation in acute FPIES: A systematic review and meta-analysis.","authors":"A Phelan, S Infante, S Barni, U Nurmatov, Rj Boyle, M Vazquez-Ortiz","doi":"10.1016/j.jaip.2025.01.016","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.01.016","url":null,"abstract":"Background: Evidence on the role of IgE sensitisation in acute Food Protein-Induced Enterocolitis Syndrome ('atypical FPIES') is limited. Initial reports claimed association with persistent disease, however recent studies have not replicated this.Objective: To systematically review the relationship between sensitisation to the culprit food(s) in acute FPIES and the outcome of follow-up oral food challenges. To assess rates of sensitisation, seroconversion (i.e. switch from negative tests to sensitisation) and phenotype switch to IgE-mediated food allergy over time in individuals with acute FPIES.Methods: Systematic review searching 10 databases. Studies of children and adults with acute FPIES diagnosis assessing IgE sensitisation to culprit food at onset or follow-up measured by skin prick or serological test were included.Results: Of 1830 studies identified, 53 were eligible including 3514 participants. Ten studies had an analytical design assessing whether sensitisation was associated with disease persistence, with 4 showing an association and 6 showing no association. In individuals with acute FPIES, the sensitisation rate was 9.8% (95% CI: 7.4-12.1%; 34 studies, 2587 participants, I2 = 82%); the frequency of seroconversion was 1.1% (95% CI: 0.1-2.1%; 9 studies, 673 participants, I2=32%); and phenotype switch occurred in 1.1% (95% CI: 0.4-1.7%; 14 studies, 935 participants, I2 =0%) and 13% (95% CI: 5.5-20.5%, 12 studies, 93 participants; I2=18%) of sensitised participants.Conclusion: We did not find consistent evidence for the relationship between IgE sensitisation and FPIES persistence. We found phenotype switch to IgE-mediated food allergy is uncommon in acute FPIES. IgE-sensitisation in FPIES does not have a clear relationship with clinical outcomes.","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043058","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}

引用次数: 0

Severity Trend of Recurrence in Pediatric Food Protein-Induced Enterocolitis Syndrome. 儿童食物蛋白性小肠结肠炎综合征（FPIES）复发的严重程度趋势。

IF 8.2 1区医学

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-01-17 DOI: 10.1016/j.jaip.2025.01.011

Mariannita Gelsomino, Simona Barni, Francesco Mastellone, Giulia Bersani, Marta Barbato, Chiara Condemi, Francesca Mori, Marta Vazquez-Ortiz, Giovanni Cosimo Indirli, Bruno Miceli Sopo, Giovanni Simeone, Stefano Miceli Sopo

{"title":"Severity Trend of Recurrence in Pediatric Food Protein-Induced Enterocolitis Syndrome.","authors":"Mariannita Gelsomino, Simona Barni, Francesco Mastellone, Giulia Bersani, Marta Barbato, Chiara Condemi, Francesca Mori, Marta Vazquez-Ortiz, Giovanni Cosimo Indirli, Bruno Miceli Sopo, Giovanni Simeone, Stefano Miceli Sopo","doi":"10.1016/j.jaip.2025.01.011","DOIUrl":"10.1016/j.jaip.2025.01.011","url":null,"abstract":"Background: Reintroduction of the offending food in pediatric patients affected by food protein-induced enterocolitis syndrome (FPIES) is carried out in hospitals with an oral food challenge (OFC), which leads to a long waiting time and increases the societal burden of medical cost and human resources.Objective: To assess the severity trend of acute FPIES adverse reactions over time in the same patient for possible outpatient or home reintroduction of the offending food.Methods: All children (aged <18 years) with a diagnosis of acute FPIES referred to two Italian pediatric allergy clinics were retrospectively enrolled. To determine whether home or outpatient clinic reintroduction of trigger food was possible, a risk of severe reactions of 5% or less was arbitrarily considered acceptable.Results: Of202 patients enrolled, 23 (11.4%) had increasing severity from mild to moderate up to severe episodes. No variables analyzed in these patients (sex, age at onset, and the interval between the first and severe episodes) had a statistically significant influence on the risk of more severe reactions. Of all patients who initially presented with mild or moderate episodes, 15.2% and 13.9% later manifested severe episodes over time, respectively. Of patients with cow's milk FPIES that started with a mild episode, 5.5% later experienced a severe episode.Conclusions: Performing OFC for acute FPIES is not safe enough at home because the probability of severe adverse reaction is greater than 5%. However, it could be considered to perform OFC in an outpatient clinic in patients with cow's milk FPIES who started with a mild episode and if a rapid transfer plan to emergency department is available.","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015979","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}

引用次数: 0

Barriers and Enablers of Dietary Reintroduction Following Negative Oral Food Challenge: A Scoping Review. 负面口腔食物挑战后饮食重新引入的障碍和推动因素：范围审查。

IF 8.2 1区医学

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-01-17 DOI: 10.1016/j.jaip.2025.01.012

Victoria Gibson, Amanda Ullman, Mari Takashima, Jennifer Koplin

{"title":"Barriers and Enablers of Dietary Reintroduction Following Negative Oral Food Challenge: A Scoping Review.","authors":"Victoria Gibson, Amanda Ullman, Mari Takashima, Jennifer Koplin","doi":"10.1016/j.jaip.2025.01.012","DOIUrl":"10.1016/j.jaip.2025.01.012","url":null,"abstract":"Background: After a negative oral food challenge (OFC), it is recommended for the individual to continue to consume the historical allergen regularly. However, the proportions of families achieving sustained reintroduction, and enablers and barriers for reintroduction, are currently unclear.Objective: To understand the frequency and definitions of optimal food reintroduction in children and adolescents after a negative OFC, and associated barriers and enablers.Method: We conducted a scoping review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews of four databases (PubMed, Embase, CINAHL, and Web of Science) from 2000 until the present. Medical Subject Headings guided our systematic search, and dual screening and extraction were performed. We applied descriptive analysis to examine key themes aligned with our research questions.Results: In total, 2,270 articles were screened and 22 studies were included across nine countries. Peanuts were the most studied food (17 studies; 749 OFCs), followed by cow's milk (12 studies; 625 OFCs), hazelnut (four studies; 361 OFCs) and hen's egg (11 studies; 340 OFCs). What was considered to be a successful reintroduction was poorly and inconsistently described. Successful reintroduction (as defined by the authors) ranged from 14% to 86%, with failed reintroduction up to 50%. Nineteen studies (86%) examined barriers or enablers of reintroduction. Primary barriers were fear and anxiety as well as symptoms with reintroduction and aversion to or refusal of the food, whereas younger age, male sex, and guidance from clinicians were commonly reported enablers.Conclusion: The number of families who do not reintroduce foods after OFC remains high, and clinicians need high-quality data to support families better.","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015958","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}

引用次数: 0

Mucus Plug Score predicts clinical and pulmonary function response to biologic therapy in patients with severe Asthma. 黏液堵塞评分预测严重哮喘患者对生物治疗的临床和肺功能反应。

IF 8.2 1区医学

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-01-16 DOI: 10.1016/j.jaip.2025.01.010

Jeremias Götschke, Julia Walter, Gabriele Leuschner, Michael Gerckens, Melanie Götschke, Pontus Mertsch, Carlo Mümmler, Alexandra Lenoir, Michaela Barnikel, Julien Dinkel, Jürgen Behr, Nikolaus Kneidinger, Judith Spiro, Katrin Milger

{"title":"Mucus Plug Score predicts clinical and pulmonary function response to biologic therapy in patients with severe Asthma.","authors":"Jeremias Götschke, Julia Walter, Gabriele Leuschner, Michael Gerckens, Melanie Götschke, Pontus Mertsch, Carlo Mümmler, Alexandra Lenoir, Michaela Barnikel, Julien Dinkel, Jürgen Behr, Nikolaus Kneidinger, Judith Spiro, Katrin Milger","doi":"10.1016/j.jaip.2025.01.010","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.01.010","url":null,"abstract":"Background: Mucus plugging has been identified as an important feature of severe asthma contributing to airway obstruction and disease severity. Recently, improvement of mucus plugging has been found upon treatment with several biologic therapies.Objective: We aimed to analyze associations of baseline characteristic with mucus plugging score (MPS) and asked whether MPS at baseline predicts the clinical and functional response to biologic treatment in patients with severe asthma.Methods: We retrospectively analyzed biologic-naïve patients with a suitable CT scan available at baseline. We calculated the MPS and analyzed correlations with baseline parameters and improvements of biomarkers, pulmonary function and clinical parameters after 4 months of biologic therapy.Results: We included n=113 patients in the baseline cohort, hereof n=101 patients with sufficient data after 4-months of biologic therapy for the follow-up analysis. CT showed mucus plugging in 77% of patients with a median MPS of 4. Multivariate regression analysis showed correlation of MPS with lower FEV1 (rho= -0.24, p=0.009) and DLCO (rho=-0.26 , p= 0.01), and higher FeNO (rho=0.36 p=0.0003) at baseline. Patients received treatment with anti-IgE (8.8%), anti-IL5 (27.4%), anti-IL5R (37.2%), anti-IL4R (25.7%) and anti-TSLP (0,9%) in clinical routine. Baseline MPS correlated with improvements of FEV1 (beta=0.72; p=0.01) and ACT (beta= 0.24; p= 0.001) in multivariate regression analysis.Conclusion: Our study suggests that higher MPS correlates with worse pulmonary function at baseline, but also predicts a larger clinical and pulmonary function response to biologic therapies in severe asthma.","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015966","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}

引用次数: 0

Resensitization - Should repeat testing be performed in patients undergoing penicillin allergy evaluations? A Pro-Con Debate. 再致敏——在接受青霉素过敏评估的患者中是否应该进行重复测试？一场支持反对者的辩论。

IF 8.2 1区医学

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-01-16 DOI: 10.1016/j.jaip.2024.12.043

Ami P Belmont, Roland Solensky, Inmaculada Doña, María Salas, María José Torres

引用次数: 0