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

{"title":"Yao syndrome in a child with C2 deficiency","authors":"Samantha Cresoe-Ortiz MD , Geoffrey Hall DO , Rachel L. Randell MD, MSCR , Monica G. Lawrence MD , Aarat Patel MD , Christina Peroutka MD , Qingping Yao MD, PhD , Talal Mousallem MD","doi":"10.1016/j.jaip.2024.08.018","DOIUrl":"10.1016/j.jaip.2024.08.018","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"12 11","pages":"Pages 3159-3162"},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996924","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":"Inhaled Steroid Effects in Occupational-Specific Inhalation Challenges for Asthma","authors":"Susan M. Tarlo MBBS, FRCPC","doi":"10.1016/j.jaip.2024.08.020","DOIUrl":"10.1016/j.jaip.2024.08.020","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"12 11","pages":"Pages 2983-2984"},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632191","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":"Consultation for Chronic Rhinosinusitis With Nasal Polyps and Asthma: Clinical Presentation, Diagnostic Workup, and Treatment Options","authors":"","doi":"10.1016/j.jaip.2024.10.002","DOIUrl":"10.1016/j.jaip.2024.10.002","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"12 11","pages":"Page 2906"},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662910","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":"Difficult Cases in Mast Cell Disorders","authors":"","doi":"10.1016/j.jaip.2024.10.004","DOIUrl":"10.1016/j.jaip.2024.10.004","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"12 11","pages":"Page 3171"},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663225","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":"Breath of Inequality: How Socioeconomic Factors Shape Asthma Outcomes","authors":"Ekta Perera MD , Bridgette L. Jones MD, MS , Mahboobeh Mahdavinia MD, PhD","doi":"10.1016/j.jaip.2024.08.049","DOIUrl":"10.1016/j.jaip.2024.08.049","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"12 11","pages":"Pages 2975-2976"},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632122","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 Outcome of IgE-Mediated Cow's Milk Allergy and Risk Factors for Persistence.","authors":"Liat Nachshon, Michael R Goldberg, Naama Epstein-Rigbi, Yitzhak Katz, Arnon Elizur","doi":"10.1016/j.jaip.2024.10.026","DOIUrl":"10.1016/j.jaip.2024.10.026","url":null,"abstract":"<p><strong>Background: </strong>Resolution rates of IgE-mediated cow's milk allergy (IgE-CMA) by age 5 years and risk factors for its persistence were previously described.</p><p><strong>Objective: </strong>To extend follow-up until the end of adolescence.</p><p><strong>Methods: </strong>This is an extension study of 23 of 54 patients diagnosed with IgE-CMA from a population-based study of 13,019 newborns, who remained allergic at age 5 years. Patients were examined at age 17 years, and their history was reviewed. Resolution was determined by regular milk consumption without adverse reactions or a negative oral food challenge (OFC). Allergy was defined by a recent objective reaction to milk and a positive skin prick test (SPT), or by sensitization ≥95% positive predictive value (PPV) to milk. Risk factors for persistence at age 17 years were examined in the entire cohort.</p><p><strong>Results: </strong>Of the 23 patients followed, 8 (35%) had spontaneous resolution and 15 had persistent IgE-CMA. Overall, 39 of the 54 patients (72.2%) initially diagnosed with IgE-CMA had spontaneous resolution by age 17 years. Risk factors for IgE-CMA persistence at age 17 years included SPT >6 mm at the time of diagnosis (P = .03), no cow's milk formula feeding in the nursery (P = .008), and wheezing on diagnostic OFC/initial reaction to milk (P = .04). Seven patients experienced objective reactions after age 5 years. These patients had more wheezing (P = .045) or anaphylaxis (P = .02) on diagnostic OFC/initial reaction and more current asthma (P = .007).</p><p><strong>Conclusions: </strong>Significant rate of spontaneous resolution of IgE-CMA still occurs beyond age 5 years, and few patients with IgE-CMA, mostly asthmatics, experience objective reactions by early adulthood. This should be considered in the treatment approach of patients with IgE-CMA.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565238","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":"Emergency visits for childhood asthma exacerbations are linked to socioeconomic factors.","authors":"Bruno Mahut, Jeanne Pergeline, Plamen Bokov, Nicole Beydon, Aurélie Bourmaud, Christophe Delclaux","doi":"10.1016/j.jaip.2024.10.028","DOIUrl":"https://doi.org/10.1016/j.jaip.2024.10.028","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565236","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 Assessment of Glucocorticoid Toxicity Reduction in Patients With Severe Asthma Treated With Biologic Therapies.","authors":"P Jane McDowell, John Busby, John H Stone, Claire A Butler, Liam G Heaney","doi":"10.1016/j.jaip.2024.10.024","DOIUrl":"10.1016/j.jaip.2024.10.024","url":null,"abstract":"<p><strong>Background: </strong>Toxicities associated with oral corticosteroids (OCS) are well described. Targeted biologics for severe asthma (SA) substantially reduce OCS exposure with the potential to reduce cumulative OCS-related toxicities. The Glucocorticoid Toxicity Index (GTI) systematically assesses OCS-related toxicity; the GTI Aggregate Improvement Score (AIS) is a bidirectional measure of total toxicity change with a minimal clinically important difference (MCID) of ≤-10.</p><p><strong>Objective: </strong>This study was a longitudinal assessment of patients with SA treated with biologic therapies to assess the trajectory of OCS-related toxicity and predictors of toxicity improvement.</p><p><strong>Methods: </strong>A total of 89 patients with SA had GTI assessments at baseline and after 1 and 3 years of biologic therapy.</p><p><strong>Results: </strong>At 3 years, daily prednisolone use continued to decrease (6.9 mg/day [4.0, 9.4] year 1 vs 0.8 mg/day [0.0, 3.7] year 3, P < .001), OCS-related toxicity continued to decline (AIS at 3 years -36 [-94, 19]), and 61% (54 of 89) met the AIS MCID. There was a significant positive correlation between toxicity outcomes at years 1 and 3 (ρ 0.65, P < .001). Nearly half (49%) met the AIS MCID at both years 1 and 3, but 29% of the cohort did not meet the AIS MCID at either time point. Toxicity change at year 1 was predictive of toxicity change at year 3 for 79%. Toxicity reduction was not proportional to OCS reduction; there were no prebiologic characteristics that predicted toxicity reduction.</p><p><strong>Conclusions: </strong>After 3 years of biologic treatment, 61% of patients with SA had clinically significant toxicity improvement. Individual toxicity outcomes at year 1 are associated with longitudinal outcomes, suggesting that for some, additional interventions are needed alongside OCS reduction to decrease morbidity.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548776","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":"Patient-Reported Burden of Indolent Systemic Mastocytosis in a Managed Care Organization.","authors":"Robert S Zeiger, Kevin Y Tse, Qiaowu Li, Mary Saparudin, Sahar S Al-Salman, Eric J Puttock, Kerri Miller, Dakota Powell, Benjamin Lampson, Erin Sullivan, Wansu Chen","doi":"10.1016/j.jaip.2024.10.021","DOIUrl":"10.1016/j.jaip.2024.10.021","url":null,"abstract":"<p><strong>Background: </strong>Indolent systemic mastocytosis (ISM), the most frequent subtype of systemic mastocytosis, requires better understanding.</p><p><strong>Objective: </strong>To better understand the diagnostic journey, symptom severity, impact on quality of life and work/activities, and health care utilization of ISM.</p><p><strong>Methods: </strong>Survey data were collected from 40 adults with documented ISM meeting World Health Organization 2016 criteria, including validated questionnaires (ISM Symptom Assessment Form [ISM-SAF] and Short Form Quality of Life Survey [SF-12v1]). Spearman correlation coefficients determined the associations between the ISM-SAF Total Symptom Score (TSS) and SF-12v1 scores. ISM burden was compared based on moderate/severe compared with mild TSS scores using Kruskal-Wallis and Fisher exact tests.</p><p><strong>Results: </strong>Patients were aged 56.0 ± 13.0 years, 65.0% female, 62.5% White, and 22.5% Hispanic patients. ISM diagnosis took >2 years in 40%, required ≥6 visits in 47.5%, and was considered moderately/extremely difficult in 50% of patients. Nearly half experienced symptoms daily and rated severity somewhat/significantly worsened since diagnosis. The overall TSS was 27.4 ± 16.2 (mean ± standard deviation). SF-12 Physical Component Summary (PCS) (46.7 ± 11.4) and Mental Component Summary (MCS) (47.6 ± 10.2) scores were lower than the general population score of 50. Moderate correlations (P < .001) were found between TSS and the PCS (ρ = -0.6406; P < .001) and MCS (ρ = -0.5104; P < .001). Compared with patients with mild severity (TSS < 28; n = 21), patients with moderate/severe severity (TSS ≥ 28; n = 19) evidenced significantly higher skin and gastrointestinal symptom scores (both, P ≤ .001). ISM's impact on ability to work for pay was associated with TSS (P = .004). Symptom-directed treatment had limited effect.</p><p><strong>Conclusion: </strong>ISM was self-reported as a burdensome condition in half the patients that markedly affected daily living.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548790","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":"Adverse impacts of corticosteroid treatment on osteoporosis/osteopenia in adult asthmatics: A retrospective ICARUS cohort study.","authors":"Junhyuk Chang, Hyun-Seob Jeon, Chungsoo Kim, ChulHyoung Park, Jae-Hyuk Jang, Youngsoo Lee, Eunyoung Lee, Rae Woong Park, Hae-Sim Park","doi":"10.1016/j.jaip.2024.10.016","DOIUrl":"https://doi.org/10.1016/j.jaip.2024.10.016","url":null,"abstract":"<p><strong>Background and objectives: </strong>Inhaled corticosteroid (ICS) and oral corticosteroid (OCS) are often used in asthma management. This study evaluated the long-term effect of ICS/OCS on osteoporosis, osteopenia, fractures, and bone metabolism in adult asthmatics in real-world clinical practice.</p><p><strong>Methods: </strong>This is a retrospective study investigating de-identified electronic health records from Ajou University Medical Center (Korea). Adult asthmatics receiving maintenance ICS with/without OCS for at least 1 year were enrolled. They were classified into the high/low-dose of ICS or OCS groups. Primary outcomes (incidences of osteoporosis, osteopenia, and fractures) and secondary outcomes (drug prescription and laboratory values related to bone metabolism including albumin and alkaline phosphatase [ALP]) were compared after 5 years of follow-up.</p><p><strong>Results: </strong>After propensity score matching, both high- and low-dose OCS groups included 468 patients, and high/low-dose ICS groups each comprised 1,252 patients. The risk of osteoporosis/major fracture was higher (hazard ratio [95% CI]; 2.00 [1.15-3.57]/3.03 [1.04-11.11]) in the high-dose OCS group (especially in females aged ≥50 years) than in the low-dose group, although the ICS groups showed no significant differences. The high-dose ICS group showed a higher risk of osteopenia (1.92 [1.05-3.70]) than the low-dose ICS group. The linear mixed model of laboratory values showed significantly decreased serum albumin and increased ALP in the high-dose OCS group than in the low-dose OCS group.</p><p><strong>Conclusions: </strong>The results of this study suggest that long-term use of OCS can increase the risk of osteoporosis and osteoporosis-related fractures, while long-term use of ICS may increase the risk of osteopenia in adult asthmatics.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512576","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}