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

{"title":"The Burden of Nonsteroidal Anti-Inflammatory Drug-Exacerbated Respiratory Disease: Interplay Between Quality of Life and Economic Implications","authors":"Nicholas R. Rowan MD ,&nbsp;Claire Hopkins DM ,&nbsp;Rodney J. Schlosser MD ,&nbsp;Zachary M. Soler MD","doi":"10.1016/j.jaip.2024.06.044","DOIUrl":"10.1016/j.jaip.2024.06.044","url":null,"abstract":"<div><div>Nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (NSAID-ERD) presents a significant challenge in clinical management owing to recalcitrant disease with accompanying profound impacts on patient quality of life. Although asthma represents a significant component of this disease, quality of life disruptions are driven primarily by recalcitrant sinonasal problems, olfactory dysfunction, and the associated psychosocial and dietary implications. This review delves into specific quality of life metrics used to assess NSAID-ERD and the associated health care burden and financial implications of this disease, offering insights into the comparative challenges in chronic rhinosinusitis with nasal polyps when available. The article reviews the associated costs and cost-effectiveness of NSAID-ERD–directed therapies, including endoscopic sinus surgery, aspirin desensitization, and biologic therapy. Although some of these emerging treatment approaches show promise, they also present numerous unanswered questions, reflecting the dynamic nature of this field. As the landscape of NSAID-ERD management continues to evolve, this review provides insights into the challenges faced by clinicians and underscores the need for further research to optimize patient care and quality of life outcomes.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"12 11","pages":"Pages 2907-2913"},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560340","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":"The Challenges of Oral Tolerance Induction in a Diverse Population Advised to Introduce Allergens Early: Insights From the EarlyNuts Study","authors":"Hannah F. Marshall MBChB ,&nbsp;Helen A. Brough MBBS, PhD","doi":"10.1016/j.jaip.2024.08.028","DOIUrl":"10.1016/j.jaip.2024.08.028","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"12 11","pages":"Pages 3079-3080"},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632242","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":"Impact of Ongoing Treatment With Inhaled Corticosteroids During Specific Inhalation Challenges for Diagnosing Occupational Asthma","authors":"Gabriel Lavoie MD ,&nbsp;Catherine Lemière MD, MSc","doi":"10.1016/j.jaip.2024.07.021","DOIUrl":"10.1016/j.jaip.2024.07.021","url":null,"abstract":"<div><h3>Background</h3><div>Specific inhalation challenge (SIC) tests are still the reference test for diagnosing sensitizer-induced occupational asthma (SIOA). The European Respiratory Society recommends the cessation of inhaled corticosteroids (ICS) 72 hours before SIC.</div></div><div><h3>Objective</h3><div>To assess the effect of an ongoing ICS treatment during SIC on the maximum fall in forced expiratory volume in 1 second (FEV₁), the change in methacholine provocative concentration of methacholine inducing a 20% fall in FEV₁ (PC₂₀), and sputum eosinophil counts after exposure to the suspected agent.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis using a database of cases referred to our center for suspected SIOA from 1999 to 2022. The results of the SIC were compared between subjects treated with ICS during SIC and steroid-naïve subjects.</div></div><div><h3>Results</h3><div>Six hundred and seventy-one individuals underwent SIC in the laboratory. Three hundred and eighteen were treated with ICS, whereas 353 were steroid naïve. The proportion of subjects with a positive SIC was greater among ICS-treated subjects (39. 6%) compared with steroid-naïve subjects (27.5%, <em>P</em> &lt; .001). A treatment with ICS did not influence the outcome of the SIC. There was no difference in the change in PC₂₀ or the percentage of sputum eosinophils after SIC between steroid-treated and steroid-naïve subjects.</div></div><div><h3>Conclusions</h3><div>An ongoing ICS treatment during an SIC did not affect the occurrence of an asthmatic reaction, the change in airway responsiveness, or eosinophilic inflammation after exposure to the suspected agent in subjects who have been treated with ICS for a long period of time.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"12 11","pages":"Pages 2977-2982"},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879750","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 Skin and Serum Testing to Direct Challenge Outcomes in Children With β-Lactam Allergies","authors":"Michaela Lucas MD, DrMed ,&nbsp;Britta S. von Ungern-Sternberg MD, DrMed, PhD ,&nbsp;Annabelle Arnold DipHE ,&nbsp;Michelle Trevenen PhD ,&nbsp;Susan Herrmann PhD ,&nbsp;Laure Braconnier PhD ,&nbsp;Syed Ali MD ,&nbsp;Catherine Jepp MD ,&nbsp;David Sommerfield MD ,&nbsp;Kevin Murray PhD ,&nbsp;Kristina Rueter MD, DrMed, PhD","doi":"10.1016/j.jaip.2024.08.023","DOIUrl":"10.1016/j.jaip.2024.08.023","url":null,"abstract":"<div><h3>Background</h3><div>There is a scarcity of prospective studies investigating the relative roles of skin prick and intradermal testing, serum specific IgE, and extended oral challenges in diagnosing children with reported β-lactam allergies.</div></div><div><h3>Objective</h3><div>To determine the sensitivity and specificity of skin testing and serum specific IgE in children with β-lactam allergies, with immediate and nonimmediate historic reactions.</div></div><div><h3>Methods</h3><div>Four hundred children with parent-reported β-lactam allergies were recruited into an open-label prospective study. Detailed allergy histories were collected. Those with medically observed and documented histories of anaphylaxis, requiring epinephrine, or severe cutaneous adverse reactions were excluded. In total, 380 children underwent all testing modalities and a direct provocation test. Each child was followed up for a minimum of 3 years.</div></div><div><h3>Results</h3><div>True allergy in children was uncommon; 8.3% reacted to the direct provocation challenge or the 5-day extended oral provocation challenge. Children reporting cephalosporin allergy or a reaction within 1 year were more likely to react to direct provocation testing. The sensitivity, specificity, and positive predictive value of skin testing were 12.5%, 98.8%, and 20.0% for direct challenge outcomes, 4.76%, 99.0%, and 25.0% for extended challenge outcomes, and 6.9%, 99.0%, and 40.0% for both challenges combined, respectively. Follow-up investigations revealed that 5.7% of children had a mild repeat reaction and 2.7% continued to avoid the culprit despite successful delabeling. The relabeling rate for children readmitted to hospital was 15%, with the relabeing being unfounded.</div></div><div><h3>Conclusions</h3><div>Genuine β-lactam allergies were rare, with over 90% of children effectively delabeled. Skin and serum specific IgE testing did not aid the diagnosis of β-lactam antibiotic allergy in children, regardless of medical history. Extended oral challenges proved valuable in confirming allergies and boosted parental confidence.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"12 11","pages":"Pages 3034-3043.e20"},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037657","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":"History of Aspirin-Exacerbated Respiratory Disease: Discovery, Clinical Features, and Treatment","authors":"Donald Day Stevenson MD, FAAAAI, WSAAI (Pres. 1978), FACAAI, FACP (Retired) ,&nbsp;Ronald Alan Simon MD, FACP, FAAAAI, FAACI","doi":"10.1016/j.jaip.2024.08.027","DOIUrl":"10.1016/j.jaip.2024.08.027","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"12 11","pages":"Pages 2885-2888"},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037658","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":"Dupilumab improves pediatric type 2 asthma outcomes independent of patient baseline characteristics","authors":"Jorge F. Maspero MD ,&nbsp;Alessandro G. Fiocchi MD ,&nbsp;Antoine Deschildre MD ,&nbsp;Leonard B. Bacharier MD ,&nbsp;Arman Altincatal MS ,&nbsp;Elizabeth Laws PhD ,&nbsp;David J. Lederer MD ,&nbsp;Bolanle Akinlade MD ,&nbsp;Megan Hardin MD","doi":"10.1016/j.jaip.2024.08.010","DOIUrl":"10.1016/j.jaip.2024.08.010","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"12 11","pages":"Pages 3135-3138.e2"},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914564","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":"Associations Between Chronic Rhinosinusitis and the Development of Non–Cystic Fibrosis Bronchiectasis","authors":"So Lim Kim MD, MSCI ,&nbsp;Brian S. Schwartz MD, MS ,&nbsp;Thanh-Huyen Vu MD, PhD ,&nbsp;David B. Conley MD ,&nbsp;Leslie C. Grammer MD ,&nbsp;Amina Guo BS ,&nbsp;Atsushi Kato PhD ,&nbsp;Robert C. Kern MD ,&nbsp;Michelle H. Prickett MD ,&nbsp;Robert P. Schleimer PhD ,&nbsp;Stephanie Smith MD, MPH ,&nbsp;Whitney W. Stevens MD, PhD ,&nbsp;Lydia Suh BS ,&nbsp;Bruce K. Tan MD ,&nbsp;Kevin C. Welch MD ,&nbsp;Anju T. Peters MD, MSCI","doi":"10.1016/j.jaip.2024.07.027","DOIUrl":"10.1016/j.jaip.2024.07.027","url":null,"abstract":"<div><h3>Background</h3><div>Studies have shown an association between chronic rhinosinusitis (CRS) and non–cystic fibrosis (CF) bronchiectasis.</div></div><div><h3>Objective</h3><div>We aimed to determine whether CRS increases the risk of developing non-CF bronchiectasis.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted utilizing electronic medical records from an academic center. Patients with CRS without bronchiectasis, with at least 1 chest computed tomography (CT) scan performed after the diagnosis of CRS, were identified between January 2006 and December 2015. Charts were reviewed until May 2022. The control group was age-, sex-, and race-matched, and included patients without CRS, asthma, or chronic obstructive pulmonary disease (COPD) who had at least 1 chest CT scan. Bronchiectasis was identified by chest CT radiology reports. The odds of developing bronchiectasis were analyzed in patients with CRS without asthma or COPD (cohort 1) and patients with CRS with asthma or COPD (cohort 2).</div></div><div><h3>Results</h3><div>The odds of developing bronchiectasis were significantly higher in patients with CRS (139 of 1,594; 8.7%) than in patients in the control group (443 of 7,992; 5.5%; odds ratio OR 1.63; 95% confidence interval [95% CI] 1.34–1.99). Furthermore, the odds of developing bronchiectasis were higher in cohort 1 (63 of 863; 7.3%; OR 1.34; 05% CI 1.02–1.76) and cohort 2 (76/ of 731; 10.4%; OR 1.98; 95% CI 1.53–2.55) versus the control group. After adjusting for confounding diseases, the association was attenuated in cohort 1 (OR 1.22; 95% CI 0.92–1.61) but remained significant in cohort 2 (OR 1.78; 95% CI 1.37–2.31).</div></div><div><h3>Conclusions</h3><div>The CRS is associated with the future development of non-CF bronchiectasis. Patients with CRS, especially those with asthma or COPD, have a higher likelihood of developing bronchiectasis than patients without CRS.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"12 11","pages":"Pages 3116-3122.e2"},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903523","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":"Polycystic ovary syndrome and the risk of asthma in reproductive-age women: Insights from 2 real-world large cohorts","authors":"Battoul Fakhry MD ,&nbsp;Amy Attaway MD ,&nbsp;Hyun Jo Kim MS ,&nbsp;Zaid Yaqoob MD ,&nbsp;Sadeer G. Al-Kindi MD, PhD ,&nbsp;Celine Chedraoui MD ,&nbsp;Joelle Sleiman MD ,&nbsp;Joe G. Zein MD, PhD","doi":"10.1016/j.jaip.2024.08.009","DOIUrl":"10.1016/j.jaip.2024.08.009","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"12 11","pages":"Pages 3132-3134"},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914566","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":"Atopic Dermatitis (Eczema) Guidelines 2023: Highlights","authors":"Anna De Benedetto MD ,&nbsp;Mark Boguniewicz MD ,&nbsp;Peck Y. Ong MD ,&nbsp;Derek K. Chu MD, PhD ,&nbsp;Lynda C. Schneider MD","doi":"10.1016/j.jaip.2024.08.052","DOIUrl":"10.1016/j.jaip.2024.08.052","url":null,"abstract":"<div><div>Atopic dermatitis is a common chronic inflammatory skin disorder, with a complex pathogenesis. It is characterized by eczematous skin lesions, pruritus, and recurrent skin infections and has a negative impact on patients’ and caregivers’ quality of life. The American Academy of Allergy, Asthma &amp; Immunology/American College of Allergy, Asthma and Immunology Joint Task Force Atopic Dermatitis Guideline Panel recently released updated AD guidelines. This guideline focuses on addressing clinical questions using trustworthy guideline development standards, including mitigating the potential influence of financial and nonfinancial conflicts of interest, and Grading of Recommendations Assessment, Development, and Evaluation methodology. A multidisciplinary panel used systematic reviews and meta-analyses to inform specific recommendations addressing optimal use of topical treatments, dilute bleach bath, dietary avoidance/elimination, allergen immunotherapy, and systemic treatments. The comprehensive recommendations, emphasizing the third principle of evidence-based medicine—that evidence alone is never enough, and that patient values and preferences must be carefully considered when determining optimal treatments for patients and populations—provide a framework to support clinicians in selecting an optimal treatment plan for each patient. This review provides an overview of the guideline and discusses how those recommendations relate to current practice.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"12 11","pages":"Pages 2955-2965"},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300427","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":"Examining the Utility of Penicillin Allergy Clinical Decision Rules: How Low Will You Go?","authors":"Sara Vogrin MBiostat ,&nbsp;Kimberly G. Blumenthal MD, MSc ,&nbsp;Jason A. Trubiano MBBS, PhD","doi":"10.1016/j.jaip.2024.08.053","DOIUrl":"10.1016/j.jaip.2024.08.053","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"12 11","pages":"Pages 2994-2995"},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632076","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}