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

{"title":"Alterations in Child Feeding Behavior: An Underrecognized Clinical Complication of Food Allergy.","authors":"Jinhee Park, Kaitlin B Proctor, Hayley H Estrem, Rohali Keesari, Scott Gillespie, Suzanne M Thoyre, William G Sharp, Brian P Vickery","doi":"10.1016/j.jaip.2024.09.014","DOIUrl":"10.1016/j.jaip.2024.09.014","url":null,"abstract":"<p><strong>Background: </strong>Food allergy (FA) affects around 5.6 million children in the United States, conferring risk for negative impacts on growth and psychosocial functioning. While evidence suggests a higher prevalence of feeding difficulties in children with FA, the link between FA and feeding dysfunction remains unclear.</p><p><strong>Objective: </strong>To investigate feeding problems in children with parent-reported IgE-mediated FA and/or pediatric feeding disorder (PFD) compared with healthy children in a community-based sample and explore factors associated with feeding problems in children with FA.</p><p><strong>Methods: </strong>A matched cross-sectional cohort study used survey data from 352 parents of children aged 6 months to 7 years who reported a diagnosed IgE-mediated FA and/or PFD (50 with FA only, 67 with FA and PFD, and 235 with PFD only). Healthy children were matched based on age, sex, race, and socioeconomic factors. Feeding problems were assessed using the Pediatric Eating Assessment Tool. Matched-pairs generalized linear regressions compared each cohort and explored factors associated with feeding problems in children with FA.</p><p><strong>Results: </strong>Children with FA exhibited significantly higher feeding problems compared with healthy children. Children with a diagnosed PFD had more severe feeding problems, irrespective of comorbid FA. Factors linked with feeding problems in children with FA included older age, non-White race, increased medical comorbidity, and limited dietary variety.</p><p><strong>Conclusions: </strong>This study adds to evidence indicating a higher prevalence of feeding problems in children with FA. Clinicians treating FA patients should routinely screen for feeding and growth concerns and consider referral to multidisciplinary feeding programs as needed.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":"176-184.e1"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332042","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 \"Higher may not be better\".","authors":"Alexei Gonzalez-Estrada, Ismael Carrillo-Martin, W Tatiana Garzon-Siatoya, Hajara Joundi, Dan Morgenstern-Kaplan, J Ross Renew, H Ross Powers, Jared D Nelson, Wendelyn Bosch, Kevin L Epps, Aurora Gonzalez-Estrada, Susan Kinate, Matthew A Rank, Christine R F Rukasin, Gerald W Volcheck, Miguel Park","doi":"10.1016/j.jaip.2024.10.043","DOIUrl":"https://doi.org/10.1016/j.jaip.2024.10.043","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 1","pages":"250-251"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958577","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":"Type-Specific Impacts of Protein Defects in Pathogenic NFKB2 Variants: Novel Clinical Findings From 138 Patients.","authors":"Jan Meissner, Manfred Fliegauf, Bodo Grimbacher, Christian Klemann","doi":"10.1016/j.jaip.2024.10.015","DOIUrl":"10.1016/j.jaip.2024.10.015","url":null,"abstract":"<p><strong>Background: </strong>The noncanonical NF-κB2 (nuclear factor kappa B subunit 2) pathway is integral in regulating immunologic responses, supervising immune function, development, and homeostasis. NFKB2 encodes the cytoplasmic precursor p100, which undergoes processing of its inhibitory C-terminal half to generate p52. Impeding C-terminal defects are well established to cause primary immunodeficiency disorder. In contrast, the mechanism of truncating N-terminal defects remains obscure.</p><p><strong>Objective: </strong>We characterized clinical phenotypes associated with 3 distinct protein-defect types: (1) early truncations: typically occurring N-terminal relative to the nuclear localization sequence and affecting the Rel homology domain, predicting p100 expression to be halved and subsequent p52 generation by processing to be diminished; (2) central truncations: mainly affecting the ARD and predicting immediate expression of p52-like proteins and a 50% reduction of p100; and (3) C-terminal phosphorylation-/ubiquitination domain defects: causing expression of nonprocessable p100 with retained IκB-like activity and subsequently reducing generation of p52.</p><p><strong>Methods: </strong>We performed literature research on PubMed, Clinvar, and Human Gene Mutation Database collecting clinical and immunologic data on NFKB2 patients, focusing on comparing protein-defect-specific impacts.</p><p><strong>Results: </strong>The highest prevalence of early-onset primary immunodeficiency disorder and antibody deficiency occurred in the CTD-defect group. In addition, endocrinological abnormalities and T-cell-mediated autoimmunity were common and frequently required immunosuppression. An extensive immunologic workup revealed patients with C-terminal defects to have pan-hypogammaglobulinemia and reduced specific antibody responses and markedly impaired B-cell differentiation, but normal to elevated T-cell counts. In contrast, pathogenic NFKB2 variants causing central or early-truncating protein defects were only partially penetrant, with ameliorated symptoms and diminished T-cell-mediated autoimmunity.</p><p><strong>Conclusions: </strong>Our work defines a clear genotype-phenotype correlation for NFKB2 mutations.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":"192-201"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512579","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":"Health-Related Quality of Life in Jack Jumper Ant Venom Allergy: Validation of the Venom-Allergy Quality of Life Questionnaire.","authors":"Kymble Spriggs, Marsus Pumar, Elizabeth Leahy, Nicole Weibel, Sara Barnes","doi":"10.1016/j.jaip.2024.11.009","DOIUrl":"10.1016/j.jaip.2024.11.009","url":null,"abstract":"<p><strong>Background: </strong>We assessed health-related quality of life (HRQoL) in patients with allergy to the venom of the jack jumper ant (JJA), Myrmecia pilosula, a Hymenoptera order species native and endemic to the Southeastern quarter of Australia. To our knowledge, this has not previously been studied despite an estimated population prevalence of generalized allergic symptoms as high as 3% in some areas.</p><p><strong>Objective: </strong>To validate the Venom Quality of Life Questionnaire (VQLQ) HRQoL instrument, which was previously validated in patients with wasp and bee venom allergy, for use in this specific ant venom-allergic population.</p><p><strong>Methods: </strong>The 14-item VQLQ survey instrument was administered to patients with clinical allergy to JJA venom presenting at the state treatment center for venom immunotherapy. Surveys were performed at different time points of the progression through visits for venom immunotherapy treatment. We performed cross-sectional and longitudinal validation against the Expectation of Outcome (EO) questionnaire by determining correlations and agreement.</p><p><strong>Results: </strong>A total of 271 individuals contributed survey data, median age 52 years (range, 3-85 years; bimodal distribution with 25% aged <18 years). Internal consistency was excellent (Cronbach α = 0.95). Cross-sectional validity was demonstrated with a positive correlation of VQLQ to EO of 0.44 (P < .001). Performance was nearly identical when stratified into adults and children (aged <18 years). Longitudinal validity was suggested as both VQLQ and EO improved over time in both adults and children, but this had paired correlation at only two time points in adults. Bland-Altman analysis demonstrated acceptable agreement between VQLQ and EO and no evidence of systematic bias.</p><p><strong>Conclusions: </strong>The VQLQ appears to offer performance of HRQoL measurement in patients with JJA venom allergy, similar to that previously demonstrated in other Hymenoptera species. In addition, this study demonstrates cross-sectional validity specifically in a pediatric population aged 3 to 18 years.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":"89-94"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696187","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":"Bee/Vespula Venom-Specific IgE Ratio Greater Than 5:1 Indicates Culprit Insect in Double-Sensitized Patients.","authors":"Simon Tischler, Axel Trautmann, Matthias Goebeler, Johanna Stoevesandt","doi":"10.1016/j.jaip.2024.10.029","DOIUrl":"10.1016/j.jaip.2024.10.029","url":null,"abstract":"<p><strong>Background: </strong>Venom-allergic patients are frequently double-sensitized to honeybee venom (BV) and Vespula venom (VV). Genuine double allergy is uncommon.</p><p><strong>Objectives: </strong>To assess whether a quantitative comparison of BV- and VV-specific IgE levels permits an identification of the culprit venom in double-sensitized patients, and to evaluate whether independent sensitization to BV- and VV-specific components corresponds to an indication for double immunotherapy.</p><p><strong>Methods: </strong>This single-center observational study evaluated 1,069 consecutive patients; 490 nonallergic controls were available for statistical comparison. The diagnosis (BV allergy, VV allergy, or double allergy) was based on a comprehensive allergological workup including patient history, IgE serology, intradermal skin test, and, when required, basophil activation testing. Quantitative allergen-specific IgE to BV, VV, rApi m 1, and rVes v 5 was retrospectively compared with the final diagnosis. The ratio of BV/VV-specific IgE levels was considered in double-sensitized venom-allergic patients.</p><p><strong>Results: </strong>Sensitization to whole-venom preparations and components was frequent in patients and asymptomatic controls, with higher specific IgE levels in the patient group. At least 5:1 dominance of the specific IgE to either BV or VV was documented in 239 of 459 double-sensitized venom-allergic patients (52.1%). Of these patients 232 (97.1%) received a diagnosis of monoallergy to only the venom to which they were dominantly sensitized.</p><p><strong>Conclusions: </strong>Dominant specific IgE at a ratio of 5:1 indicates the culprit venom in double-sensitized allergic patients. Additional component-resolved diagnostic testing can be restricted to cases with double sensitization to whole venom at a ratio of less than 5:1. Double sensitization to rApi m 1 and rVes v 5 per se does not justify double venom immunotherapy.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":"79-88.e4"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590976","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":"Effects of Sex and Gender in Immediate β-Lactam Antibiotic Allergy: A Systematic Review and Meta-Analysis.","authors":"Nisha B Patel, Gabriel Cojuc-Konigsberg, Danna Garcia-Guaqueta, Divya Shah, Darshana Balasubramaniam, Avanika Mahajan, Fnu Shakuntulla, Danielle Gerberi, Lyda Cuervo-Pardo, Miguel A Park, Thanai Pongdee, Elina Jerschow, Avni Joshi, Zhen Wang, Alexei Gonzalez-Estrada, Sergio E Chiarella","doi":"10.1016/j.jaip.2024.10.031","DOIUrl":"10.1016/j.jaip.2024.10.031","url":null,"abstract":"<p><strong>Background: </strong>β-Lactams are the most common antibiotic class reported to cause allergic drug reactions. Previous literature suggests an increased prevalence of penicillin drug allergy in female patients in both inpatient and outpatient settings. However, the effects of sex and gender have not been well characterized regarding the entire class of β-lactam antibiotics.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to identify sex- and gender-based differences in the prevalence of immediate β-lactam allergy.</p><p><strong>Methods: </strong>We performed an electronic search of Ovid MEDLINE/PubMed, Embase, Web of Science, Scopus, and the Cochrane Library between 2013 and 2023. Patients with a documented β-lactam allergy who underwent allergy testing with skin testing, oral drug challenge, or serum-specific IgE were included. We quantitatively assessed sex- and gender-based differences in β-lactam allergy with meta-analysis.</p><p><strong>Results: </strong>We included 69 primary studies assessing 53,989 participants from outpatient and inpatient cohorts. A total of 7,558 patients had a confirmed β-lactam allergy. There was no difference in the prevalence of positive β-lactam allergy test between males and females. Subgroup analysis of studies that performed oral challenges showed a higher risk of β-lactam allergy in females compared with males (relative risk = 1.40; 95% CI, 1.18-1.66; P < .001; I² = 77.8%). Finally, there was a higher proportion of females (64.8%) than males enrolled in β-lactam allergy studies.</p><p><strong>Conclusions: </strong>Our findings suggest both sex-based and gender-based differences in the prevalence of immediate β-lactam allergy. Biological factors such as sex hormones and gender-based behaviors including increased health care use may contribute to higher rates of β-lactam allergy diagnosis in females.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":"155-166.e11"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570329","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":"What's in a Clade? Clinical Impact of Rhinovirus Serotype on the Development and Severity of Asthma Exacerbations.","authors":"Larry Borish","doi":"10.1016/j.jaip.2024.10.022","DOIUrl":"https://doi.org/10.1016/j.jaip.2024.10.022","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 1","pages":"105-106"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958578","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":"Rheumatic adverse effects with biologics targeting type 2 inflammation in severe asthma: A VigiBase study.","authors":"Miranda Laux, François Montastruc, Yannick Degboe, Laurent Guilleminault","doi":"10.1016/j.jaip.2024.09.029","DOIUrl":"10.1016/j.jaip.2024.09.029","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":"225-227.e1"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382322","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":"Performance of serum amyloid A and C reactive protein for disease control assessment in familial Mediterranean fever.","authors":"Inès Elhani, Maurine Jouret, Olivier Malaise, Ai-Tien Nguyen, Marie-Nathalie Sarda, Alexandre Belot, Véronique Hentgen","doi":"10.1016/j.jaip.2024.09.035","DOIUrl":"10.1016/j.jaip.2024.09.035","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":"233-235.e2"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401847","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":"A Randomized Comparison of Bencycloquidium Bromide, Mometasone Furoate, and a Combination for Persistent Allergic Rhinitis.","authors":"Xian Li, Xueyan Wang, Qintai Yang, Jianjun Chen, Hao Tian, Meiping Lu, Tingting Ma, Yana Zhang, Yue Zhou, Jiao Xia, Lei Cheng, Yuan Zhang, Luo Zhang","doi":"10.1016/j.jaip.2024.12.035","DOIUrl":"10.1016/j.jaip.2024.12.035","url":null,"abstract":"<p><strong>Background: </strong>Moderate to severe persistent allergic rhinitis (AR) poses a substantial socioeconomic burden.</p><p><strong>Objectives: </strong>We aimed to establish the superiority of bencycloquidium bromide (BCQB) nasal spray and BCQB combined with mometasone furoate nasal spray (MFNS) over MFNS alone in adults with moderate to severe persistent AR.</p><p><strong>Methods: </strong>In this multicenter, randomized, controlled clinical trial (NCT05038202), adults with moderate to severe persistent AR were randomly assigned to receive BCQB, MFNS, or a combination treatment for 4-week periods. Mean changes from baseline in the daily reflective runny nose, nasal congestion, sneezing, nasal itching scores, total nasal symptom score (TNSS) and Rhinoconjunctivitis Quality of Life Questionnaire scores were recorded. We also assessed the exploratory end points and adverse events.</p><p><strong>Results: </strong>Bencycloquidium bromide led to a significant improvement in the mean change from baseline in daily reflective runny nose during the 4-week treatment, compared with MFNS (least-squares mean difference, -0.27; 95% CI, -0.44 to -0.09; P = .004). The BCQB combined with MFNS significantly improved runny nose, nasal congestion, sneezing, TNSS, and Rhinoconjunctivitis Quality of Life Questionnaire scores compared with MFNS alone, except for nasal itching. Bencycloquidium bromide significantly decreased the percent change in eosinophilic cationic protein, eotaxin, vasoactive intestinal peptide, and IL-6 levels. Treatment-emergent adverse events were similar among the three groups.</p><p><strong>Conclusions: </strong>Bencycloquidium bromide was superior to MFNS in reducing daily runny nose symptoms. The combination of BCQB and MFNS was superior to MFNS alone in alleviating TNSS in patients with moderate to severe persistent AR with a predominant symptom of runny nose.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924034","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}