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

{"title":"Angioedema Due to Acquired C1-Inhibitor Deficiency Without Hematological Condition: A Multicenter French Cohort Study of 34 Patients","authors":"Romain Stammler MD ,&nbsp;Federica Defendi MD ,&nbsp;Magali Aubineau MD ,&nbsp;Beatrice Bibes MD ,&nbsp;Isabelle Boccon-Gibod MD ,&nbsp;Laurence Bouillet MD, PhD ,&nbsp;Yoann Crabol MD ,&nbsp;Marie Caroline Dalmas MD ,&nbsp;Claire de Moreuil MD, PhD ,&nbsp;Aurelien Delluc MD, PhD ,&nbsp;Claire Dingremont MD ,&nbsp;Aurelie Du-Thanh MD, PhD ,&nbsp;Jerome Hadjadj MD, PhD ,&nbsp;Pierre-Yves Jeandel MD, PhD ,&nbsp;Galith Kalmi MD ,&nbsp;Marion Lacoste MD ,&nbsp;Ludovic Martin MD, PhD ,&nbsp;Chloé Mc Avoy MSc ,&nbsp;Claire Blanchard-Delaunay MD ,&nbsp;Marie Caroline Taquet MD ,&nbsp;Delphine Gobert MD","doi":"10.1016/j.jaip.2024.12.027","DOIUrl":"10.1016/j.jaip.2024.12.027","url":null,"abstract":"<div><h3>Background</h3><div>Angioedema (AE) due to acquired C1-inhibitor deficiency (AAE-C1-INH) is a rare disease associating recurrent edema of the mucosa and skin. Several underlying diseases have been reported, mainly lymphoproliferative diseases and monoclonal gammopathy. However, 15% to 20% of patients never exhibit such a hematological condition.</div></div><div><h3>Objective</h3><div>To analyze specific features of patients with AAE-C1-INH without a hematological condition.</div></div><div><h3>Methods</h3><div>This is a multicenter, retrospective cohort study of patients with AAE-C1-INH without a hematological condition included from January 1999 to May 2024 in the French national CREAK (Centre de reference des angioedèmes à kinine) registry. The clinical and biological characteristics of patients were detailed and then compared with those of patients with AAE-C1-INH associated with lymphoid hemopathies or monoclonal gammopathy.</div></div><div><h3>Results</h3><div>Thirty-four patients were included. All patients displayed a functional C1-INH below 50% of the reference value, 26 (76%) also had a decreased C1-INH antigen level, and 26 (76%) displayed anti-C1-INH antibodies. After a median follow-up of 65 months, 4 (12%) patients were in spontaneous complete remission of AE; 15 (44%) were in complete response under long-term prophylactic treatment. Compared with 75 patients with lymphoma-associated AAE-C1-INH, patients with AAE-C1-INH without a hematological condition displayed a higher incidence of anti-C1-INH antibodies and received more frequently symptomatic or prophylactic treatment with a lower remission rate at last follow-up. Clinical and biological features of patients with AAE-C1-INH without a hematological condition were similar to those of 30 patients with monoclonal gammopathy–associated AAE-C1-INH.</div></div><div><h3>Conclusions</h3><div>AAE-C1-INH without a hematological condition displays a different clinical and biological presentation from lymphoma-associated AAE-C1-INH. No autoimmune disease was identified. Unlike rituximab, long-term prophylaxis seems to prevent AE attacks among these patients.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 3","pages":"Pages 542-550.e2"},"PeriodicalIF":8.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933511","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":"From statistical to clinical significance: Establishing and testing the minimal clinically important difference of the Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q).","authors":"Hugo W F Mak, Weihong Shi, Erin H C Shum, Jackie S H Yim, Elaine Lee, Dorothy L Y Lam, Philip H Li","doi":"10.1016/j.jaip.2025.02.023","DOIUrl":"10.1016/j.jaip.2025.02.023","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538076","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":"Longitudinal evaluation of the Cough Hypersensitivity Questionnaire in a cohort of chronic cough.","authors":"Mi-Yeong Kim, Hwa Young Lee, Ji-Yoon Oh, Noeul Kang, Sung-Yoon Kang, Eun-Jung Jo, Han-Ki Park, Seung-Eun Lee, Ji-Yong Moon, Youngsang Yoo, Ha-Kyeong Won, Jin An, Kyung Eun Park, Yeonhee Kim, Joon-Woo Bahn, Min-Kyung Oh, Surinder S Birring, Woo-Jung Song","doi":"10.1016/j.jaip.2025.02.025","DOIUrl":"10.1016/j.jaip.2025.02.025","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538097","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":"Chronic norovirus infection in immunodeficiency: A UK national case series.","authors":"Alexandros Grammatikos, Anisha Mangtani, Mark Ponsford, Stephen Jolles, Elizabeth McDermott, Sarah Johnston, Marina Frleta-Gilchrist, Patrick Yong, Fiona Moghaddas, Moira Thomas, Smita Patel, Caitlin Blundell, Phil Bright, Elizabeth Drewe, Suzanne Elcombe, Archana Herwadkar, Sai Murng, Da-In Kim, Mark Gompels, David Lowe","doi":"10.1016/j.jaip.2025.02.026","DOIUrl":"10.1016/j.jaip.2025.02.026","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538072","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":"Long-Term Safety of Epicutaneous Immunotherapy in Peanut-Allergic Children: An Open-Label Active Treatment (REALISE Study).","authors":"Jacqueline A Pongracic, Rémi Gagnon, Gordon Sussman, Dareen Siri, Roxanne C Oriel, Terri F Brown-Whitehorn, Sara Anvari, William E Berger, J Andrew Bird, Edmond S Chan, R Sharon Chinthrajah, Hey J Chong, Stanley M Fineman, David M Fleischer, Erika Gonzalez-Reyes, Edwin H Kim, Bruce J Lanser, Andrew MacGinnitie, Hemalini Mehta, Daniel Petroni, Ned Rupp, Lynda C Schneider, Amy M Scurlock, Lawrence D Sher, Wayne G Shreffler, Sayantani B Sindher, Robert Wood, William H Yang, Hugh A Sampson, Timothée Bois, Todd D Green, Dianne E Campbell, Katharine J Bee, Philippe Bégin","doi":"10.1016/j.jaip.2025.02.024","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.02.024","url":null,"abstract":"<p><strong>Background: </strong>Due to limited treatment options for peanut allergy, patients remain at risk for allergic reactions due to accidental exposure. Epicutaneous immunotherapy (EPIT) is a novel treatment being investigated for peanut allergy.</p><p><strong>Objective: </strong>This study assessed long-term safety of EPIT with VIASKIN® peanut patch 250 μg (VP250) via an open-label extension of the REAL Life Use and Safety of EPIT (REALISE) trial.</p><p><strong>Methods: </strong>REALISE was a phase 3 trial in peanut-allergic children aged 4 through 11 years that included a 6-month, randomized, double-blind, placebo-controlled treatment phase, followed by an open-label, single-arm, active treatment period for up to 36 months.</p><p><strong>Results: </strong>Of the 392 participants (male, 54.8%; median age, 7.2 years) who received at least 1 dose of treatment, 77.8% completed the 36-month active treatment. Mean adherence to treatment was high at 96.4%. Most participants (98.7%) experienced at least 1 treatment-emergent adverse event (TEAE); the majority were mild or moderate and decreased in frequency and severity over time. Most (94.6%) participants experienced at least 1 treatment-related TEAE. Local skin reactions were the most common treatment-related TEAE with the incidence decreasing from year 1 (87.8%) to year 3 (19.2%). Serious treatment-related TEAEs were reported in 2 participants. No specific safety signals were identified in the 14 participants enrolled with a history of severe anaphylaxis (Anaphylaxis Staging System grade 3).</p><p><strong>Conclusion: </strong>Consistent with previous phase 3 studies, long-term EPIT with VP250 was well tolerated with high adherence in peanut-allergic children aged 4 through 11 years (clinicaltrials.gov; NCT: NCT02916446).</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538106","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":"Efficacy and Safety of Maintenance Regimens for Adolescent and Adult Asthmatics With Exercise-Induced Bronchospasm: Systematic Review and Network Meta-Analysis.","authors":"Irin Vichara-Anont, Lalita Lumkul, Phichayut Phinyo, Chamard Wongsa, Torpong Thongngarm","doi":"10.1016/j.jaip.2025.02.018","DOIUrl":"10.1016/j.jaip.2025.02.018","url":null,"abstract":"<p><strong>Background: </strong>Exercise-induced bronchospasm (EIB) commonly coexists with asthma. However, the data on the efficacy of maintenance therapies for asthma with EIB are scarce.</p><p><strong>Objective: </strong>This network meta-analysis assessed the comparative efficacy and safety of maintenance regimens for asthmatics with EIB.</p><p><strong>Methods: </strong>We searched PubMed, Scopus, Embase, the Cochrane Center of Controlled Trials, and Google Scholar for randomized controlled trials (RCTs) that addressed the efficacy and safety of maintenance treatments in adolescent and adult asthmatics with EIB from inception to April 2024. The primary outcome was the change in forced expiratory volume in 1 second postexercise after maintenance therapy. The secondary outcome focused on treatment-related adverse events (AEs).</p><p><strong>Results: </strong>Eleven RCTs involving 1054 patients were included. Low-dose inhaled corticosteroid (ICS)-montelukast significantly improved EIB with a mean difference (95% confidence interval) of 14.96% (9.61, 20.31), followed by low- to medium-dose (LM-dose) ICS-salmeterol 13.7% (8.68, 18.72), high-dose ICS 13.30% (1.34, 25.26), montelukast 11.35% (5.76, 16.95), ICS-vilanterol 9.24% (4.41, 14.07), zafirlukast 8.80% (2.28, 15.32), LM-dose ICS 7.55% (3.48, 11.63), and as-needed ICS-formoterol 6.91% (2.07, 11.75). Low-dose ICS-montelukast and LM-dose ICS-salmeterol were comparably effective. There were no significant efficacy differences among ICS monotherapy, as-needed ICS-formoterol, and antileukotrienes. Antileukotrienes were inferior to ICS monotherapy in reducing asthma exacerbation. Long-acting β₂-agonist (LABA)-induced tachyphylaxis may occur despite using alongside ICS.</p><p><strong>Conclusion: </strong>Low-dose ICS and as-needed ICS-formoterol were equally effective in managing asthmatics with EIB. The addition of antileukotrienes or LABA to ICS should be considered for more severe cases, with close monitoring to assess treatment response and detect potential tachyphylaxis or AEs.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531850","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":"Sensitization is persistent in most patients with anaphylaxis to a cephalosporin at 10 years.","authors":"Jamma Li, Suran L Fernando, Benedict Krupowicz, Marc Capon, Andrew Lindberg, Anisha Kulkarni, Sarah Green","doi":"10.1016/j.jaip.2025.02.017","DOIUrl":"10.1016/j.jaip.2025.02.017","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532024","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":"Moving Beyond Desensitization to Tolerance in Food Allergy.","authors":"Julie D Flom, Wayne G Shreffler, Kirsten P Perrett","doi":"10.1016/j.jaip.2025.02.014","DOIUrl":"10.1016/j.jaip.2025.02.014","url":null,"abstract":"<p><p>Management of IgE-mediated food allergy is shifting from reactive management strategies (allergen avoidance and ready access to autoinjectable epinephrine in case of exposure) to proactive therapies. These therapies are in various stages of clinical development and implementation; the two main approaches include allergen-specific or active therapies (induce the immune system to produce a protective response to the allergen; eg, Food and Drug Administration-approved AR101/Palforzia (peanut [Arachis hypogaea] Allergen Powder-dnfp; PTAH, also known as AR101) (Aimmune Therapeutics, Inc., Brisbane, CA) for peanut allergy), and allergen-agnostic, passive therapies (provide the body with the tools needed to suppress immediate hypersensitivity reactions in a nonspecific manner; eg, Food and Drug Administration-approved omalizumab). These therapies provide a similar degree of protection, specifically desensitization (increased reaction threshold while receiving food allergy therapy, bite safety), but differ in mechanisms, dosing protocols, and side effects. The goals of therapeutics in development are shifting to sustained unresponsiveness or remission (absence of clinical reactivity after allergen and food allergy therapy avoidance, typically for weeks to months) and tolerance (no clinical reaction or free ingestion of the allergen). As the food allergy management repertoire expands, important considerations in selecting a therapy will be patient-specific and include mode of delivery, dosing regimens, side-effect profiles, and goals or outcomes. The role of shared decision making and implementation strategies to support equitable access across patient populations and clinical contexts will be critical to move an increasing number of patients beyond desensitization to tolerance, if they wish.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517224","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":"Diagnosing and managing DRESS amidst remaining uncertainty.","authors":"Erika Yue Lee, Jonny Peter","doi":"10.1016/j.jaip.2025.02.019","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.02.019","url":null,"abstract":"<p><p>Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), a severe cutaneous adverse reaction (SCAR), represents a diagnostic and therapeutic challenge due to its varied, evolving clinical presentation, complex pathophysiology, and potential for severe systemic involvement. This article explores DRESS syndrome through three illustrative cases from diverse populations and with different background co-morbidities. Cases highlight different challenges in DRESS care, including: i) the need for early diagnosis and severity scoring, ii) identification of offending drugs and risk stratification to consider a possible drug challenge, and iii) best practice management including long-term monitoring for emergent autoimmunity. Recent developments in our understanding of clinical spectrum of disease, genomic and non-genomic biomarkers, severity groupings, and pharmacological and longer-term management strategies are described. Critical gaps remain in several of these domains, particularly in vulnerable groups such as the immune-compromised. In this absence of robust evidence, we aim for this article to assist attending clinicians with current expert opinion in DRESS management. Finally, we highlight areas for further research needed to improve the clinical care and outcomes of DRESS.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525073","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":"Achieving Long-Term Control in Atopic Dermatitis: Emerging Concepts, Definitions, Flares, and Therapy.","authors":"Hywel C Williams, Eric L Simpson, Sinéad M Langan, Amanda Roberts, Kim S Thomas","doi":"10.1016/j.jaip.2025.02.013","DOIUrl":"10.1016/j.jaip.2025.02.013","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494611","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}