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

{"title":"Association of sleep disorders with higher incidence of mental health and learning disorders in children with atopic dermatitis.","authors":"Aaron Bao, Stephen R Hooper, Laura M Sterni, Cyd K Eaton, Sarah Radtke, Joy Wan","doi":"10.1016/j.jaip.2025.02.010","DOIUrl":"10.1016/j.jaip.2025.02.010","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473165","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 heterogeneity of food protein-induced enterocolitis syndrome in adults.","authors":"Jenny Huang, Andrew A White","doi":"10.1016/j.jaip.2025.02.007","DOIUrl":"10.1016/j.jaip.2025.02.007","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469875","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":"Severe Cutaneous Adverse Reactions Following Vaccination: A Systematic Review and Meta-analysis.","authors":"Kevin Sheng-Kai Ma, Chin-Hsuan Shen, Meng-Han Chiang, Kimberly G Blumenthal, Steven T Chen","doi":"10.1016/j.jaip.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.02.006","url":null,"abstract":"<p><strong>Background: </strong>Increasing cases of vaccine-related severe cutaneous adverse reactions (SCARs) are reported in the literature.</p><p><strong>Objectives: </strong>To provide comprehensive information regarding the clinical spectrum of vaccine-associated SCARs.</p><p><strong>Methods: </strong>This was a systematic review and meta-analysis on case reports, case series, cohort studies, case-control studies, and post-market surveillance of SCARs following vaccination. Data on demographic information, classes of vaccination, past medical history and medications, and types, manifestations, management, and prognosis of SCARs, including acute generalized exanthematous pustulosis (AGEP), drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), and generalized bullous fixed drug eruptions (GBFDE), were extracted.</p><p><strong>Results: </strong>A total of 255 cases of SCARs following vaccination were identified. 231 (91%) of the reported cases of vaccine-associated SCARs were identified as SJS/TEN. The pooled incidence of SCARs following vaccination was 1.676 per million (95% confidence interval=0.136-20.668; I² = 97%). The H1N1 vaccine (n=52), coronavirus disease 2019 (COVID-19) vaccines (n=38; 23 [61%] from mRNA vaccines), and influenza vaccine (n=33) contributed to most of these cases. AGEP and DRESS were frequently reported with COVID-19 vaccines, particularly the mRNA vaccines (57.1% [4/7] and 83.3% [5/6], respectively) and viral vector vaccines (28.6% [2/7] and 16.7% [1/6]). No SCAR was reported for protein-based COVID-19 vaccines. Six cases of fatal SJS/TEN were reported, with two cases associated with the COVID-19 vaccine.</p><p><strong>Conclusions: </strong>SCARs following vaccination were extremely rare, with a high proportion of these cases SJS/TEN. Most suspected culprits included the H1N1 vaccine, the influenza vaccine, the varicella vaccines, and COVID-19 vaccines especially mRNA vaccines. However, concurrent medication use may confound underlying attribution of SCARs to vaccines.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469872","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":"Serum Sickness-Like Reactions in Children-Is Lifelong Avoidance Indicated?","authors":"Allison E Norton, Kimberly Risma, Moshe Ben-Shoshan","doi":"10.1016/j.jaip.2025.01.041","DOIUrl":"10.1016/j.jaip.2025.01.041","url":null,"abstract":"<p><p>Serum sickness-like reactions (SSLRs) consist of urticaria or urticarial-like rashes with joint pain and variable features of fever, angioedema, and gastrointestinal distress. Allergists typically evaluate patients in the clinic for an implicated medication, such as an antibiotic or vaccine. Although SSLR may be mistaken for classical serum sickness or anaphylaxis owing to overlapping clinical features, there is minimal evidence for type I or type III hypersensitivity reactions. Despite recent studies showing antibiotic allergy is rarely verified, patients rarely undergo allergy evaluation. A difficulty is that there is no agreement about challenge procedures- multiple-day dosing protocols lead to a risk for hives and joint pain that does not occur with single-day challenges. In addition, tolerance of either challenge protocol does not fully prevent rashes and repeat episodes of SSLR in all nonallergic children who used the culprit or an unrelated antibiotic again. Owing to the distressing symptoms, lack of abortive therapies, and uncertainty with challenge, many health care professionals and families may prefer to bypass allergy evaluation and continue lifelong avoidance. However, medication allergy labels may be associated with poor health outcomes. Well-designed prospective studies are needed to provide better insight into the diagnosis, effective treatments, and true recurrence rates.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469870","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":"Factitious severe asthma: A diagnostic challenge in the era of biologics.","authors":"Camille Larhant, Albane Lassus, Capucine Morelot-Panzini, Estelle Taupinard, Pierre-Alexis Geoffroy, Camille Taillé","doi":"10.1016/j.jaip.2025.02.008","DOIUrl":"10.1016/j.jaip.2025.02.008","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469868","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":"Profiling Blood Hypereosinophilia in Patients on Dupilumab Treatment for Respiratory Conditions: A Real-Life Snapshot.","authors":"Marco Caminati, Matteo Maule, Diego Bagnasco, Bianca Beghè, Fulvio Braido, Luisa Brussino, Paolo Cameli, Maria Giulia Candeliere, Giovanna Elisiana Carpagnano, Giulia Costanzo, Claudia Crimi, Mariella D'Amato, Stefano Del Giacco, Gabriella Guarnieri, Mona-Rita Yacoub, Claudio Micheletto, Filippo Moletta, Stefania Nicola, Bianca Olivieri, Laura Pini, Michele Schiappoli, Elena Scarpieri, Rachele Vaia, Andrea Vianello, Dina Visca, Antonio Spanevello, Gianenrico Senna, Roberto Benoni","doi":"10.1016/j.jaip.2025.01.040","DOIUrl":"10.1016/j.jaip.2025.01.040","url":null,"abstract":"<p><strong>Background: </strong>A transient and usually asymptomatic increase in blood eosinophil count (BEC) associated with dupilumab treatment has been described. Predicting factors related to the increase in BEC and the occurrence of symptoms are still poorly investigated.</p><p><strong>Objective: </strong>To investigate frequency, timing, duration, clinical relevance, and potential predictors of the increase in BEC in a real-life multicenter cohort of patients affected by asthma and/or chronic rhinosinusitis with nasal polyps (CRSwNP) treated with dupilumab.</p><p><strong>Methods: </strong>BEC and clinical conditions at baseline and every 3 months after the start of dupilumab treatment were assessed. Any adverse drug reaction was also recorded. Remission of dupilumab-associated eosinophilia was defined by follow-up BEC values <0.5 × 10⁹ cells/L.</p><p><strong>Results: </strong>Overall, 108 of 195 (55%) patients experienced an increased BEC after dupilumab initiation, but only 29 of 195 (14.9%) showed hypereosinophilia. BEC peak occurred 6 months after the start of treatment and resolved after 9 months (median time). The probability of developing hypereosinophilia was 3.3 times higher in patients with the baseline BEC between 0.5 × 10⁹ and 1.5 × 10⁹ cells/L. The occurrence of symptoms during BEC peak was higher in patients with comorbidities and in patients showing any increase in BEC.</p><p><strong>Conclusions: </strong>In a real-life setting, dupilumab treatment in patients with asthma and/or CRSwNP was often associated with a transient increase in BEC, but hypereosinophilia rarely occurred. Onset of symptoms co-occurring with BEC peak was observed in a minority of subjects. BEC should not preclude dupilumab initiation or continuation but should be monitored for at least 8 months after treatment begins, particularly in the case of baseline eosinophilia/hypereosinophilia and/or comorbidities.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434326","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 Epicutaneous Immunotherapy in Peanut-Allergic Toddlers: Open-Label Extension to EPITOPE.","authors":"Matthew Greenhawt, Deborah Albright, Sara Anvari, Nicolette Arends, Peter D Arkwright, Philippe Bégin, Katharina Blümchen, Terri Brown-Whitehorn, Heather Cassell, Edmond S Chan, Christina E Ciaccio, Antoine Deschildre, Amandine Divaret-Chauveau, Stacy Dorris, Morna Dorsey, George Du Toit, Thomas Eiwegger, Michel Erlewyn-Lajeunesse, David M Fleischer, Lara S Ford, Maria Garcia-Lloret, Jonathan O'B Hourihane, Nicola Jay, Stacie M Jones, Edwin H Kim, Kirsten Kloepfer, Stephanie Leonard, Guillaume Lezmi, Jay Lieberman, Jeanne Lomas, Melanie Makhija, Michael O'Sullivan, Christopher Parrish, Jane Peake, Kirsten P Perrett, Daniel Petroni, Jacqueline A Pongracic, Patrick Quinn, Rachel G Robison, Georgiana Sanders, Lynda Schneider, Hemant Sharma, Sayantani B Sindher, Juan Trujillo, Paul J Turner, Katherine Tuttle, Julia Upton, Pooja Varshney, Brian P Vickery, Christian Vogelberg, Brynn Wainstein, Julie Wang, Robert Wood, Katharine J Bee, Dianne E Campbell, Todd D Green, Rihab Rouissi, Henry T Bahnson, Timothée Bois, Hugh A Sampson, A Wesley Burks","doi":"10.1016/j.jaip.2025.02.004","DOIUrl":"10.1016/j.jaip.2025.02.004","url":null,"abstract":"<p><strong>Background: </strong>The pivotal phase 3 EPITOPE trial, a 12-month, double-blind, placebo-controlled study of epicutaneous immunotherapy with the VIASKIN patch containing 250 μg of peanut protein (VP250), previously reported significant treatment response versus placebo in peanut-allergic toddlers aged 1 through 3 years.</p><p><strong>Objective: </strong>To assess the interim efficacy and safety of VP250 from the first year of the EPITOPE open-label extension (OLE) study.</p><p><strong>Methods: </strong>Eligible participants enrolled in the OLE study for up to 3 years of total treatment with annual double-blind, placebo-controlled food challenges (DBPCFCs) and safety assessments; here we report the first-year OLE (year 2) results.</p><p><strong>Results: </strong>A total of 266 EPITOPE participants enrolled in the OLE study; 244 underwent month 24 DBPCFC (n = 166 VP250; n = 78 placebo). After 24 months of VP250, 81.3% reached an eliciting dose (ED) ≥1000 mg, 63.8% reached an ED ≥2000 mg, and 55.9% completed the DBPCFC (cumulative dose: 3444 mg) without meeting stopping criteria. No treatment-related anaphylaxis or serious treatment-related adverse events occurred during year 2 in this treatment arm. Local application-site reactions occurred less frequently in year 2 versus year 1. In placebo-treated EPITOPE participants, outcomes after 1 year of open-label VP250 were consistent with EPITOPE treatment results: 62.7% reached an ED ≥1000 mg, 36.5% reached an ED ≥2000 mg, and 28.4% completed the DBPCFC without meeting stopping criteria; and there was 1 treatment-related anaphylaxis event.</p><p><strong>Conclusions: </strong>Two years of VP250 in young peanut-allergic children demonstrated continued increases in treatment effect without new safety signals. This supports the potential of VP250 as a safe and effective treatment for peanut allergy in young children.</p><p><strong>Clinicaltrials: </strong>GOV: NCT03859700.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434242","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":"α1-Antitrypsin Gene Variation Associates with Asthma Exacerbations and Related Health Care Utilization.","authors":"Victor E Ortega, Vickram Tejwani, Abhishek Kumar Shrivastav, Sara Pasha, Joe G Zein, Meher Boorgula, Mario Castro, Loren Denlinger, Serpil C Erzurum, John V Fahy, Elliot Israel, Nizar N Jarjour, Bruce Levy, David Mauger, Wendy C Moore, Sally E Wenzel, Prescott Woodruff, Gregory A Hawkins, Eugene R Bleecker, Deborah A Meyers","doi":"10.1016/j.jaip.2025.01.039","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.01.039","url":null,"abstract":"<p><strong>Background: </strong>α₁-antitrypsin deficiency is caused by rare pathogenic variants in SERPINA1, the strongest genetic risk factor for COPD. Few studies have evaluated the effects of SERPINA1 variation on asthma severity accounting for critical gene-by-environment interactions with smoking.</p><p><strong>Objective: </strong>To characterize the influence of SERPINA1 variation on asthma severity.</p><p><strong>Methods: </strong>DNA samples from 847 non-Hispanic whites and 446 African Americans from the Severe Asthma Research Program underwent SERPINA1 resequencing to identify rare variants. An independent population of 1,955 individuals with asthma and α₁-antitrypsin concentrations from a Cleveland Clinic Health System (CCHS) database were evaluated for severity measures.</p><p><strong>Measurements and main results: </strong>In whites, a history of minimum smoking significantly interacted with SERPINA1 low-to-rare frequency variation to determine risk for asthma-related healthcare utilization. This was attributed to PI type Z heterozygotes (MZ, N=11) who had a higher frequency of ED visits (6 [54.5%] MZ heterozygotes, OR=7.60, 95%CI=1.71-39.7, p=0.010), hospitalization (5 [45.5%], OR=16.1, 95%CI=2.64-150.4, p=0.0050) in the past year, and lifetime ICU admissions (6 [54.5%], OR=12.5, 95%CI=2.44-75.6, p=0.0032) compared to 146 individuals without SERPINA1 variants (30 [20.5%] reporting ED visits, 17 [11.6%] hospitalization, 15 [10.3%] ICU admission). SERPINA1 variant-ever smoking interactions in African Americans for ED visits (p=0.069) related to four of six compound heterozygotes reporting an ED visit. In CCHS, α₁-antitrypsin concentrations were inversely associated with moderate-to-severe asthma risk (OR=0.97 per 10 mg/dL increase in α₁-antitrypsin, 95%CI=0.94-0.99, p=0.010) and exacerbations (OR=0.84 per 10 mg/dL, 95%CI=0.76-0.94, p=0.002).</p><p><strong>Conclusions: </strong>SERPINA1 variation and α₁-antitrypsin concentrations impact asthma severity through gene-environment interactions with minimum smoking.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426670","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":"Demography and baseline characteristics of individuals planned for jack jumper ant-specific venom immunotherapy at the Victorian Insect Venom Allergy Service.","authors":"Kymble Spriggs, Elizabeth Leahy, Nicole Weibel, Emily Heke, Sara Barnes","doi":"10.1016/j.jaip.2025.01.038","DOIUrl":"10.1016/j.jaip.2025.01.038","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416102","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":"Anti-IL-5 treatment reduces infection-related adverse events: A meta-analysis of phase 3 clinical trials.","authors":"Mark E Lustberg, Brian Clark","doi":"10.1016/j.jaip.2025.01.037","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.01.037","url":null,"abstract":"<p><strong>Background: </strong>Though multiple meta-analyses have evaluated the efficacy and safety of anti-IL5 monoclonal antibody therapy, few studies have made detailed, specific assessments of adverse events and infectious diseases (ID) adverse events.</p><p><strong>Objective: </strong>To conduct a meta-analysis to evaluate the effect of anti-IL5 therapy on ID adverse events.</p><p><strong>Methods: </strong>A meta-analysis was undertaken using 27 randomized, placebo-controlled phase 3 clinical trials. Detailed information on ID events was extracted, as well as study demographics. ID events were recorded as serious events and non-serious events as they appeared in the clinical trial record in clinicaltrials.gov. ID events were then classified into clinical and microbiologic groups.</p><p><strong>Results: </strong>Anti IL-5 therapy significantly reduced serious bacterial infections [RR = 0.808, 95% CI = 0.667 - 0.978] and pneumonias [RR = 0.806, 95% CI = 0.650 - 0.998]. Anti-IL5 therapy also significantly reduced influenza infection [RR = 0.817, 95% CI = 0.674 - 0.991], sinusitis [RR = 0.807, 95% CI = 0.685 - 0.951], non-serious lower respiratory tract infections [RR = 0.787, 95 % CI = 0.656 - 0.943] and C.difficile infection (p=0.025). Non-serious gastroenteritis was increased in those on anti-IL5 therapy [RR = 1.754, 95% CI = 1.087 - 2.830].</p><p><strong>Conclusions: </strong>Anti-IL5 therapy significantly reduces adverse events categorized as serious bacterial infections, pneumonia, influenza, non-serious lower respiratory tract infections and C.difficile infection. In the population of patients receiving anti-IL5 therapy, these effects may translate into substantial decreases in healthcare utilization.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416033","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}