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

{"title":"Asthma Control Before and After Changing Gas Stoves to Electric Stoves","authors":"Ashwini R. Sehgal MD,&nbsp;Pam Schuellerman BA,&nbsp;Jacqueline Dolata MBA,&nbsp;Douglas D. Gunzler PhD,&nbsp;Kevin M. Lockett MA,&nbsp;Maeve G. MacMurdo MBChB, MPH,&nbsp;Ther W. Aung PhD","doi":"10.1016/j.jaip.2026.06.039","DOIUrl":"10.1016/j.jaip.2026.06.039","url":null,"abstract":"<div><h3>Background</h3><div>Cooking on natural gas stoves is a major source of indoor nitrogen dioxide (NO₂) exposure and may contribute to asthma exacerbations.</div></div><div><h3>Objective</h3><div>To assess asthma control before and after changing gas stoves to electric stoves.</div></div><div><h3>Methods</h3><div>We replaced gas stoves with electric stoves in the homes of 85 individuals with poorly controlled asthma (Asthma Control Questionnaire [ACQ] score ≥ 1.5) and determined changes in ACQ score from baseline (1-4 weeks before stove change) to follow-up (2-3 months after change). Changes in emergency room visits or hospitalizations for asthma, missed work or school days because of asthma, and NO₂ levels were also examined.</div></div><div><h3>Results</h3><div>ACQ score improved from 2.6 to 1.5 after the stove change (difference –1.1, 95% confidence interval [CI]: –1.3 to –0.8). At baseline, 10 individuals (11.8%) had an emergency room visit or hospitalization in the past 4 weeks. At follow-up, 3 individuals (3.5%) had an emergency room visit or hospitalization in the past 4 weeks (absolute difference –8.2%, 95% CI: –16.2% to –3.4%). There were also significant improvements in missed work or school days. Indoor NO₂ levels decreased from 21.0 to 6.3 ppb (change –14.7, 95% CI: –20.8 to –8.7).</div></div><div><h3>Conclusions</h3><div>Asthma control appeared to improve in the follow-up period after electric stove installation compared with the baseline period with a gas stove. People with poorly controlled asthma may consider transitioning away from gas stoves depending on their resources and circumstances. A controlled clinical trial is needed to confirm these findings and to assess long-term outcomes.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2341-2347"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383254","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":"Familial Mediterranean fever is associated with higher atopic morbidity: Evidence from a countrywide case-control study","authors":"Adi Ovadia MD,&nbsp;Revital Perlov Gavze RD, MPH,&nbsp;Liat Lev Shalem MSW,&nbsp;Keren Armoni Domany MD,&nbsp;Anat Oron MD,&nbsp;Dorit Lev MD,&nbsp;Ilan Dalal MD,&nbsp;Diana Tasher MD,&nbsp;Marina Michelson MD","doi":"10.1016/j.jaip.2026.07.018","DOIUrl":"10.1016/j.jaip.2026.07.018","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2411-2413"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581071","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":"Geographic Barriers to Subspecialty Care Access for Patients With Primary Immune Disorders in the United States","authors":"Jacob A. Blaukovitch MA,&nbsp;Caitlin P. Blaukovitch DO,&nbsp;Monica G. Lawrence MD,&nbsp;Nicholas L. Rider DO","doi":"10.1016/j.jaip.2026.07.020","DOIUrl":"10.1016/j.jaip.2026.07.020","url":null,"abstract":"<div><h3>Background</h3><div>Primary immune disorders, also known as inborn errors of immunity, are associated with substantial diagnostic delays and limited access to rural subspecialty and infusion care. This study measures disparities in access to expert clinical immunologists (ECIs) or infusion centers (ICs) relative to primary care resources in the United States.</div></div><div><h3>Objective</h3><div>To evaluate geographic access quantitatively to ECIs, ICs, and federally qualified health centers (FQHCs) across rural and nonrural regions of the United States.</div></div><div><h3>Methods</h3><div>We analyzed publicly available national datasets. Expert clinical immunologists and FQHCs were identified nationally whereas ICs were evaluated in six states and territories. Rurality was characterized using Rural-Urban Commuting Area (RUCA) codes and population density. Chi-square test with <em>post hoc</em> adjusted Pearson residuals (<em>r</em>) assessed associations between facility type and rurality nationally and within the six-state and territory sample. Geographic information system mapping visualized facilities and 2-hour service radii for ECIs.</div></div><div><h3>Results</h3><div>Federally qualified health centers were overrepresented in rural regions, comprising approximately 30% of US FQHCs despite only 20% of the population residing rurally. In contrast, ECIs were underrepresented nationally in rural spaces, and both ECIs and ICs were rurally underrepresented in the six-state and territory sample (ECIs RUCA: <em>r</em> = –2.68; ICs RUCA: <em>r</em> = –2.91). Geographic information system mapping revealed rural ECI coverage in only six states. Findings were consistent across rurality definitions, with RUCA codes demonstrating a balanced characterization of rurality.</div></div><div><h3>Conclusions</h3><div>Rural patients with primary immune disorders, or inborn errors of immunity, face substantial geographic barriers to diagnostic and therapeutic care despite adequate distribution of primary care. Targeted efforts to improve rural subspecialty access are urgently needed.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2389-2396"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585993","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":"Colorado Asthma-Friendly Schools: An On-Ramp to Implementation Science","authors":"Stanley J. Szefler MD,&nbsp;Melanie C. Gleason MS, PA-C,&nbsp;Arthur E. McFarlane II MS,&nbsp;Christy Haas-Howard MPH, BSN, RN, NCSN, AE-C,&nbsp;Ana Kim RN, BSN, AE-C,&nbsp;Heather H. De Keyser MD, MSCS","doi":"10.1016/j.jaip.2026.07.043","DOIUrl":"10.1016/j.jaip.2026.07.043","url":null,"abstract":"<div><div>Schools are a key point of intervention for child health. Children spend most of their days in school, and school nurses are well trained in the acute management of many childhood chronic diseases. The approach to asthma has changed significantly over time, with updates to inhaled corticosteroid use, the use of single inhalers for both relievers and controllers, and the increasing use of asthma biologics for managing severe asthma. Asthma specialists can play an important role in providing timely updates for school nurses about ongoing changes in overall asthma management. The purpose of this review is to summarize the evolution of our urban-centered school-based asthma program to one that has expanded into many school districts across Colorado, including rural communities, by applying principles of implementation science. We will share steps that we took to grow and scale this program as well as lessons learned during dissemination to additional school districts in Colorado. An effective school nurse-clinician interaction sets up a strong infrastructure for identifying children and adolescents who are not receiving optimal chronic disease care. Such efforts can leverage existing partnerships between schools and the health care system to improve the network of care for children with poorly controlled asthma.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2211-2219"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708489","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":"Combined Large and Small Airway Obstruction Is Associated With Increased Exacerbation Frequency and Poorer Symptom Control in Persistent Asthma","authors":"Samruddhi Lele,&nbsp;Anu Pillai,&nbsp;Musab Quayum,&nbsp;Michael E. Wechsler MD,&nbsp;Praveen Akuthota MD,&nbsp;Ronald J. Dandurand MD,&nbsp;Richard Hammond MBChB,&nbsp;Atanu Bhattacharjee PhD,&nbsp;Francesco Menzella MD,&nbsp;Remo Poto MD, PhD,&nbsp;Pasquale Comberiati MD,&nbsp;Alvise Berti MD, PhD,&nbsp;Carlo Lombardi MD,&nbsp;Stanley P. Galant MD,&nbsp;Ophir Freund MD, PhD,&nbsp;Laura Ventura PhD,&nbsp;Andrea Portacci MD,&nbsp;Giovanna Elisiana Carpagnano MD, PhD,&nbsp;Valeria Ortolani MD,&nbsp;Brian Lipworth MD,&nbsp;Rory Chan PhD","doi":"10.1016/j.jaip.2026.06.041","DOIUrl":"10.1016/j.jaip.2026.06.041","url":null,"abstract":"<div><h3>Background</h3><div>Spirometry remains central to the assessment of asthma but may fail to detect small airways dysfunction (SAD), which contributes to considerable symptoms and exacerbation risk.</div></div><div><h3>Objective</h3><div>We investigated whether integrating oscillometry with spirometry improves physiological phenotyping and risk stratification in asthma.</div></div><div><h3>Methods</h3><div>In this retrospective, multicenter study, data from 1497 adults with asthma were analyzed from the Oscillometry Asthma Registry. SAD was defined using the ratio of resistance heterogeneity between 5 and 20 Hz to resistance at 5 Hz ≥19% and airflow obstruction as forced expiratory volume in 1 second/forced vital capacity (FEV₁/FVC) &lt;70%. Participants were categorized into 4 mutually exclusive groups: (1) group 1—normal oscillometry and normal spirometry, (2) group 2—abnormal oscillometry with normal spirometry, (3) group 3—normal oscillometry with abnormal spirometry, and (4) group 4—abnormal oscillometry and abnormal spirometry. Associations with symptom control, exacerbations, and type 2 inflammatory biomarkers were assessed using multivariable logistic regression.</div></div><div><h3>Results</h3><div>For ≥1 exacerbation, the adjusted odds ratios (aORs) (95% confidence intervals) for group 4 were as follows: versus group 1, 3.19 (2.31, 4.42); versus group 2, 1.99 (1.46, 2.74); and versus group 3, 1.59 (1.07, 2.37). Corresponding aOR values for group 3 were as follows: versus group 2, 1.26 (0.85, 1.86), and versus group 1, 2.01 (1.37, 2.94). The aOR for ≥1 exacerbation for group 2 versus group 1 was 1.60 (1.18, 2.16). Results were similar when using FEV₁/FVC &lt;lower limit of normal instead of traditional predicted values.</div></div><div><h3>Conclusions</h3><div>The combined use of oscillometry and spirometry identifies distinct physiological phenotypes of asthma with clinically meaningful differences in symptom burden and exacerbation risk.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2348-2355.e3"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406836","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":"Performance of the PEN-FAST clinical decision rule in older adults, immunocompromised patients and delayed penicillin allergy","authors":"Morgan T. Rose PhD,&nbsp;Sara Vogrin MBiostat,&nbsp;Elizabeth J. Phillips PhD,&nbsp;Jason A. Trubiano PhD","doi":"10.1016/j.jaip.2026.07.016","DOIUrl":"10.1016/j.jaip.2026.07.016","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2414-2416"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563809","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":"Protein content of glycerinated extracts and commercial food products for priority allergens relevant to sublingual immunotherapy","authors":"Brock A. Williams PhD,&nbsp;Yigong Guo PhD,&nbsp;Lianne Soller PhD,&nbsp;Edmond S. Chan MD,&nbsp;Anubhav Pratap-Singh PhD","doi":"10.1016/j.jaip.2026.06.031","DOIUrl":"10.1016/j.jaip.2026.06.031","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2420-2422"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370690","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":"Beyond the label: Methodological considerations for a target trial emulation of antihistamine use and dementia risk","authors":"Chun-Tse Hung MS, PharmD,&nbsp;Chung-Hsuen Wu PhD","doi":"10.1016/j.jaip.2026.07.034","DOIUrl":"10.1016/j.jaip.2026.07.034","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2438-2439"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096167","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":"Biologic eligibility does not necessarily mean clinical appropriateness in obesity-associated asthma","authors":"Ercan Yılmaz MD,&nbsp;Nezihe Koker Özer MD, PhD,&nbsp;Erdem Topal MD","doi":"10.1016/j.jaip.2026.07.027","DOIUrl":"10.1016/j.jaip.2026.07.027","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2435-2436"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096564","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 “Biologic eligibility does not necessarily mean clinical appropriateness in obesity-associated Asthma”","authors":"Dinah Foer MD,&nbsp;Ayobami Akenroye MBChB, MPH, PhD","doi":"10.1016/j.jaip.2026.07.028","DOIUrl":"10.1016/j.jaip.2026.07.028","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2436-2437"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096565","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}