Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology最新文献

{"title":"Reply to Dr. Muhammad Zarrar.","authors":"Regina Nakiranda, Linda Malan, Hannah Ricci, Arista Nienaber, Cecile Cooke, Cristian Ricci, Mieke Faber, Cornelius M Smuts","doi":"10.1111/pai.70120","DOIUrl":"https://doi.org/10.1111/pai.70120","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70120"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The psychological impact of vernal keratoconjunctivitis on families: An investigation on quality of life and psychological wellbeing.","authors":"Ludovica Natali, Valentina Cardi, Fabiano Cavarzeran, Andrea Leonardi","doi":"10.1111/pai.70141","DOIUrl":"https://doi.org/10.1111/pai.70141","url":null,"abstract":"<p><strong>Background: </strong>Vernal keratoconjunctivitis (VKC) is a chronic allergic eye disease that affects children and adolescents. While its physical burden is well documented, little research has explored its psychological impact on patients and their families. This study examined the impact of VKC on quality of life (QoL) and psychological wellbeing in children (as reported by their parents) and their parents.</p><p><strong>Methods: </strong>Forty parents of children with VKC (aged 4-17 years) attending the Ocular Allergy and Immunology Service at the University of Padova completed online questionnaires. Measures included parental depressive (PHQ-9) and anxiety symptoms (GAD-7), perceived social support, family QoL (FROM-16), child emotional and behavioral difficulties (SDQ), and the impact of VKC on child QoL (QUICK). Clinical data on VKC severity and treatment history were also collected.</p><p><strong>Results: </strong>One-third of parents reported mild depressive symptoms, and 53% had mild to severe anxiety. Higher parental distress was linked to greater family QoL disruption, while greater perceived support was associated with less disruption. Most children showed emotional and behavioral difficulties within the normal range. However, those with more emotional difficulties and the perennial form of VKC experienced greater QoL impairment. Interestingly, higher QoL disruption in children correlated with more frequent prosocial behaviors.</p><p><strong>Conclusion: </strong>These findings highlight the psychological impact of VKC on both children and parents. Integrated care approaches that address both physical and psychological aspects of the disease are essential to improve outcomes for affected families.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70141"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical diagnosis and management of drug reaction with eosinophilia and systemic symptoms (DRESS) in children: An EAACI position paper.","authors":"Semanur Kuyucu, Natalia Blanca-Lopez, Jean-Christoph Caubet, Luis Moral, Bernardo Sousa-Pinto, Ozge Yılmaz Topal, Francesca Mori, Marina Atanaskovic Markovic, Eva Gomes","doi":"10.1111/pai.70103","DOIUrl":"10.1111/pai.70103","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare but severe cutaneous adverse drug reaction encountered in both adults and children with a significant mortality rate. A number of guidelines or consensus reports have been published for optimal diagnosis and treatment of DRESS in adults, but none specifically for children. It is increasingly evident that there are significant differences in drug pharmacokinetics, metabolism, co-occurring infections, comorbidities, clinical manifestations, and severity of drug allergies between children and adults, as well as across different pediatric age groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This position paper aimed to evaluate and compare all the available data related to clinical features, diagnosis, and treatment of DRESS in adults and children in an attempt to identify the differences and gaps, and produce recommendations on diagnosis and treatment of this fatal disorder in children.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A search of MEDLINE (via PubMed) and Web of Science from 2000 to 2024, including studies that assessed children with DRESS syndrome, was performed. In the absence of pediatric-specific data, studies involving adults or mixed populations (both adults and children) were also analyzed. Among a total of retrieved 5264 records, following duplicate removal and full-text assessment, a total of 493 manuscripts related to DRESS were included in the report and recommendation generation. The recommendations for the clinical diagnosis and treatment of DRESS in children were formulated in accordance with the directionality and strength guidelines suggested by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group and related research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among retrieved records, there was only one randomized controlled trial, one meta-analysis, one systematic review, six retrospective comparative studies on treatment, and one systematic review on the accuracy of skin tests in DRESS. All of these studies were conducted in adults, rarely involving children, and none were exclusively performed in pediatric populations. Comparison of systematic case reviews revealed that some aspects of clinical features, prognosis, and mortality in children differed from those in adults. The diagnosis of DRESS is based on several clinical and laboratory criteria, which have been developed for adult patients but have not been validated for children. Causality assessment tools, in vivo skin tests, and in vitro tests have been used widely in adults to identify the culprit drugs in DRESS, while these tools are more rarely employed or reported in children. Adult guidelines or consensus reports recommend a severity-based, stepwise treatment approach for DRESS, whereas no such severity classification or treatment algorithms exist exclusively for children, leading to inconsistent management with numerous instances of overtre","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70103"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories of allergic diseases in children: Destination unknown?","authors":"Birgit Kalb, Ekaterina Khaleva, Mattia Giovannini, Karine Adel-Patient, Flore Amat, Stefania Arasi, Susanne Lau, Antonio Nieto, Bianca Schaub, Marie Standl, Jonathan O'B Hourihane, Philippe Eigenmann, Antoine Deschildre","doi":"10.1111/pai.70131","DOIUrl":"10.1111/pai.70131","url":null,"abstract":"<p><p>The trajectories of allergic diseases represent one of the most currently debated topics both when referred to childhood and likewise adulthood. Data from cohorts show their heterogeneity as well as the key role of genetic and environmental factors. More insight has been recently provided in the pathophysiological mechanisms underlying the development and amplification of T2 (hyper)inflammation. Recent data support the hypothesis of associated allergic diseases (multimorbidity) reflecting, at a given time and in given organ(s)/tissue(s), the expression of the same favorable predisposition. In particular, the impairment of the epithelial barrier, especially in subjects genetically predisposed, and the dysregulation of the host's microbiome promote the onset of allergic diseases and multimorbidity, their persistence and/or severity. These findings challenge the classical theory of the atopic march with a temporal sequence characterized by the transition from one disease (eczema) to another (food allergy, airway allergic diseases). A better understanding of the diversity of disease trajectories and the underpinning mechanisms is crucial for prevention and identification of children at risk of a \"unfavorable trajectory\" (early intervention, i.e., early primary or secondary prevention), for a personalized therapeutic approach based on identification of specific endotypes, and, therefore, addressing specific pathophysiological pathways (treat to target strategies). In the perspective of the so-called \"remission\" and \"treatment-induced-remission\", the whole spectrum of the long-term consequences of the disease(s) including their treatment has to be considered. The concept of disease modifying treatment able to interfere with their trajectories and overall long-term induced morbidity is emerging.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70131"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atopic dermatitis in children: Untargeted proteomics highlights the interaction between barrier dysfunction and immune dysregulation as key pathways.","authors":"Sean Wee, Anna de Beer, Hiromi Wl Koh, Jocelyn Ong, Jing Hui Low, Yan Ting Lim, Shi Mei Wang, Radoslaw M Sobota, Elena Goleva, Donald Y M Leung, Wen Chin Chiang, Mei Chien Chua, Anand Kumar Andiappan","doi":"10.1111/pai.70142","DOIUrl":"https://doi.org/10.1111/pai.70142","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70142"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-life allergic sensitization and respiratory infection-Two hits on lung function?","authors":"Vikas Wadhwa, Shyamali C Dharmage, Danielle Wurzel, Peter D Sly, Cecilie Svanes, Adrian J Lowe, N Sabrina Idrose, Nilakshi Waidyatillake, Caroline Lodge, Melissa Russell","doi":"10.1111/pai.70115","DOIUrl":"10.1111/pai.70115","url":null,"abstract":"<p><strong>Background: </strong>Allergic sensitization and respiratory infections commonly occur in childhood. Interplay between them in asthma development is known as the 'two-hit' hypothesis. There has been no previous investigation of this hypothesis on adult lung function.</p><p><strong>Objective: </strong>In a birth cohort at high risk for allergic diseases, we investigated interactions between these two factors and lung function outcomes into adulthood.</p><p><strong>Methods: </strong>Allergic sensitization was assessed at age 24 months by skin prick testing to aero and food allergens. Respiratory infection was defined as cough, rattle or wheeze measured by frequent questionnaires up to age 24 months. Regression models were utilized to identify interactions between these exposures and associations with lung function at ages 12, 18 and 25 years.</p><p><strong>Results: </strong>At age 25 years, those sensitized at age 2 years(n = 118) demonstrated reductions in pre-bronchodilator FEV₁ of 0.06(95% CI: -0.12, 0.00, z-score units, p = .055) for each additional month of respiratory infections. Those not sensitized (n = 120) had increases in pre-bronchodilator FEV₁ of 0.07 (95% CI: 0.02, 0.13, z-score units, p = .012) for each additional month of respiratory infection(p_interaction = .012). Similar findings were noted for FEV₁/FVC ratio(p_interaction = .011), FEF_25-75(p_interaction = .007) and absolute change in pre and post bronchodilator lung function. At 18 years, findings were similar; however, there was less evidence for interactions at 12 years.</p><p><strong>Conclusion: </strong>Our study findings support the 'two-hit' hypothesis of interactions between early-life allergic sensitization and increasing respiratory infections, and impairment in lung function up to age 25 years. Early childhood respiratory infections however had different impacts on lung function depending upon the presence or absence of allergic sensitization.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 6","pages":"e70115"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental factors shaping atopic dermatitis: Lessons from longitudinal cohort studies.","authors":"Eun Lee, Song-I Yang, Dong In Suh, Hyo-Bin Kim, So-Yeon Lee, Sung Ok Kwon, Soo-Jong Hong","doi":"10.1111/pai.70130","DOIUrl":"https://doi.org/10.1111/pai.70130","url":null,"abstract":"<p><p>Atopic dermatitis (AD) is a prevalent chronic inflammatory skin disease arising from a multifaceted interplay between genetic susceptibility and environmental exposures. Longitudinal cohort studies have been instrumental in elucidating the contribution of environmental factors to both the onset and persistence of AD. This review synthesizes evidence from such studies to delineate key environmental determinants across various domains. Early-life exposures, including delivery mode and antibiotic exposure, modulate microbial composition and function, thereby influencing immune development and predisposing individuals to AD. Both outdoor and indoor air pollutants, such as particulate matter and volatile organic compounds, have been shown to impair skin barrier integrity and dysregulate immune responses, facilitating the initiation and progression of AD. Nutritional factors, encompassing maternal and infant dietary patterns, shape gut microbiota and metabolite profiles and systemic immune activity, further modulating AD risk. Moreover, psychological stress during the prenatal and postnatal periods has been associated with alterations in immune function and epigenetic programming, which may heighten susceptibility to AD. Environmental influences also appear to vary by AD phenotype and trajectory, underscoring the need for individualized prevention strategies. Advances in exposome research, encompassing both external and internal environmental components, have enhanced mechanistic understanding and facilitated the identification of candidate biomarkers. Collectively, current evidence supports the notion that early-life environmental exposures act not as isolated determinants but in concert with genetic, microbial, and immunologic factors to shape AD pathogenesis. A comprehensive framework integrating exposomics and multiomics may ultimately inform the development of targeted preventive and therapeutic strategies for children with AD.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 6","pages":"e70130"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on Wei Zou, et al.","authors":"Siyi Huang, Ye Xu, Fangfang Tao","doi":"10.1111/pai.70124","DOIUrl":"https://doi.org/10.1111/pai.70124","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 6","pages":"e70124"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial comment on \"food allergy-related bullying: Risk factors and psychosocial functioning\".","authors":"Laura Polloni, Ömer Kalayci, Philippe Eigenmann","doi":"10.1111/pai.70125","DOIUrl":"https://doi.org/10.1111/pai.70125","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 6","pages":"e70125"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal BCG vaccination to prevent asthma: Results from the MIS BAIR randomized controlled trial.","authors":"Laure F Pittet, Emily K Forbes, Susan Donath, Kate L Francis, Kaya Gardiner, Katie L Flanagan, Anne-Louise Ponsonby, Roy Robins-Browne, Frank Shann, Mike South, Peter Vuillermin, Dan Casalaz, Nigel Curtis, Nicole L Messina","doi":"10.1111/pai.70110","DOIUrl":"10.1111/pai.70110","url":null,"abstract":"<p><strong>Background: </strong>Asthma has a significant impact worldwide, but prevention strategies remain limited. We aimed to evaluate the efficacy of neonatal BCG vaccination in preventing asthma by modulating early-life immunity.</p><p><strong>Methods: </strong>The Melbourne Infant Study: BCG for Allergy and Infection Reduction (MIS BAIR) was a phase 3 multicentre randomized controlled trial in Victoria, Australia. Infants were randomly assigned to receive the BCG-Denmark vaccine or no intervention within 10 days of birth. The incidence of asthma at 5 years of age was estimated using the International Study of Asthma and Allergies in Childhood questions.</p><p><strong>Clinicaltrial: </strong>gov (NCT01906853).</p><p><strong>Results: </strong>A total of 1272 infants were randomized. The adjusted incidence of asthma was 14.4% in the BCG group compared to 16.0% in the control group (adjusted risk difference [aRD] -1.7 percentage points; 95%CI -7.4, 3.9). Secondary outcomes, including severe asthma and use of preventer medication, showed similar trends, with an aRD of -3.9 (95%CI -7.7, 0.0), and -5.6 (95%CI -10.9, -0.4), respectively, favoring the BCG group. Among participants with one or both parents asthmatic, the rate of asthma was also lower in the BCG group (17.6%) compared with the control group (24.7%; aRD -7.2; 95%CI -15.9, 1.5), although a test for interaction was not significant (p = .07).</p><p><strong>Conclusions: </strong>While the point estimates suggested BCG vaccination might protect against asthma, the wide uncertainty around the estimates means further studies with larger sample sizes are needed to evaluate the long-term benefits of BCG vaccination beyond its primary indication.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 6","pages":"e70110"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}