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

{"title":"Correction to \"Nutritional intervention with a partially hydrolyzed formula during the first 6 months of life may reduce the risk of food allergy and atopic dermatitis up to the age of 5 years\".","authors":"","doi":"10.1111/pai.70494","DOIUrl":"https://doi.org/10.1111/pai.70494","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 10","pages":"e70494"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171087","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":"Evidence of eosinophilic airway inflammation in children with allergic rhinitis without asthma.","authors":"Ana Vitória Soares, Mónica Rodrigues, Francisca Castro Mendes, André Moreira","doi":"10.1111/pai.70519","DOIUrl":"10.1111/pai.70519","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 10","pages":"e70519"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149130231","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":"Short-term early exposure to cow's milk formula increases the risk of cow's milk allergy: A critical window in early life.","authors":"Ayse Pakel, Handan Duman Senol, Ezgi Topyildiz, Mehmet Geyik, Hatice Ceren Eser, Figen Gulen, Esen Demir","doi":"10.1111/pai.70497","DOIUrl":"https://doi.org/10.1111/pai.70497","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether the timing and continuity of neonatal cow's milk formula (CMF) exposure influence the risk of IgE-mediated cow's milk protein allergy (CMPA).</p><p><strong>Methods: </strong>This retrospective case-control study included 376 children (182 with CMPA and 194 healthy controls). Early feeding patterns-including timing of CMF initiation and duration of exposure-were evaluated. Multivariable logistic regression analyses were performed to assess independent risk factors while adjusting for potential confounders.</p><p><strong>Results: </strong>Among infants exposed to cow's milk formula within the first 72 h, discontinuation within 14 days was associated with higher odds of CMPA than continued exposure for ≥15 days (aOR: 8.07; 95% CI: 3.20-20.36; p < .001). In contrast, continuous exposure (≥15 days) was associated with substantially lower odds of CMPA, independent of delivery mode.</p><p><strong>Conclusion: </strong>Not early exposure per se, but brief and discontinuous exposure appears to drive sensitization. These findings highlight a critical \"window of vulnerability\" in early life, suggesting that unnecessary short-term formula supplementation should be avoided, while continuous exposure-if initiated-may support oral tolerance development and may have immediate implications for neonatal feeding practices and allergy prevention strategies.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 10","pages":"e70497"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122320","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 predictors of persistent childhood asthma and allergic rhinitis: A machine learning study using post-hoc explainability.","authors":"Frederikke Rosenvinge Skov, Mario Lovrić, Tamo Sultan, Klaus Bønnelykke, Bo Chawes, Jakob Stokholm, Jonathan Thorsen, Morten Arendt Rasmussen, Ann-Marie Malby Schoos","doi":"10.1111/pai.70498","DOIUrl":"10.1111/pai.70498","url":null,"abstract":"<p><strong>Background: </strong>Asthma and allergic rhinitis (AR) follow heterogeneous childhood trajectories, and reliable early prediction of persistence or remission remains challenging. We investigated whether machine learning models applied to early-life data could predict long-term asthma and AR outcomes.</p><p><strong>Methods: </strong>We analyzed data from 411 children in the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC₂₀₀₀) cohort using 113 early-life clinical, genetic, environmental, immunological, and lung function features. Five machine learning models were trained to predict four outcomes: persistent asthma versus controls, persistent asthma versus asthma in remission, persistent AR versus controls, and teen-onset AR versus controls. Model interpretability was assessed using SHapley Additive exPlanations (SHAP).</p><p><strong>Results: </strong>Predictive performance was limited across all outcomes, and no model achieved an AUROC above 0.65. The highest performance was observed for persistent AR versus controls, where the tree-based models performed similarly, with AUROCs around 0.63. For persistent asthma versus controls, Random Forest and XGBoost both achieved an AUROC of 0.59. Performance was weak for distinguishing persistent asthma from asthma in remission and for predicting teen-onset AR, with the best models reaching AUROCs of 0.60 and 0.59, respectively. SHAP analyses of the best-performing models identified biologically plausible features, including aeroallergen sensitization and genetic predisposition for persistent asthma, and familial, immunological, and growth-related features for persistent AR, but these signals did not translate into strong discriminative performance.</p><p><strong>Conclusion: </strong>In this deeply phenotyped high-risk birth cohort, early-life data analyzed using machine learning did not reliably predict long-term asthma or AR outcomes. These findings suggest that early-life data alone may be insufficient for individual prognostic stratification and that repeated measurements later in childhood may be needed to improve prediction.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 10","pages":"e70498"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140405","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":"Inhibition studies to direct oral immunotherapy in walnut-hazelnut co-allergic patients (nut CRACKER study).","authors":"Yael Koren, Michael Y Appel, Matan Elkan, Liat Nachshon, Lars Mattsson, Jonas Lidholm, Michael B Levy, Arnon Elizur, Michael R Goldberg","doi":"10.1111/pai.70500","DOIUrl":"https://doi.org/10.1111/pai.70500","url":null,"abstract":"<p><strong>Background: </strong>Walnut OIT has been observed to induce cross-desensitization to hazelnut, but predictors of this response remain unclear. We sought to identify molecular predictors of hazelnut cross-desensitization following walnut OIT, to help guide treatment decisions in these co-allergic patients.</p><p><strong>Methods: </strong>Patients with confirmed IgE-mediated walnut and hazelnut allergy underwent walnut OIT. Patients achieving full walnut desensitization to 4 g of walnut protein were re-challenged to 4-grams hazelnut protein after 6 months. Baseline sera were obtained and competitive ELISA inhibition assays performed to evaluate serum IgE cross-recognition of total walnut, total hazelnut and hazelnut component-specific IgE. Results were compared between patients fully (4-grams protein) or clinically (≥30-fold ED increase or mild reaction at full dose) cross-desensitized to hazelnut and those who remained hazelnut allergic following walnut OIT.</p><p><strong>Results: </strong>Overall, 12/22 (54.5%) patients were fully cross-desensitized and 14/22 (63.6%) patients were clinically cross-desensitized to hazelnut following walnut OIT. Among the latter, walnut inhibited total hazelnut-specific IgE binding by a median of 95%, compared to 55% in those who remained hazelnut allergic (p < .01). Similarly, walnut extract competed for IgE binding to hazelnut components Cor a 9 (p = .003) and Cor a 16 (p = .023) in the cross-desensitized group following walnut OIT, but not in the persistent hazelnut allergic group. A ≥70% inhibition threshold accurately predicted cross-desensitization in 93% of cases (p < .001).</p><p><strong>Conclusion: </strong>Walnut OIT can induce clinical cross-desensitization to hazelnut in >60% of co-allergic individuals. Competitive ELISA inhibition is a promising predictive tool, with potential to guide targeted and efficient OIT strategies in walnut-hazelnut co-allergic patients.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 10","pages":"e70500"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123027","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":"Phenotypic patterns of allergic comorbidity and associated health outcomes in children and adolescents: A population-based latent class study.","authors":"Wenqian Zhang, Che Li, Xiaoqian Wang, Fangjieyi Zheng, Zhixin Zhang, Wenquan Niu","doi":"10.1111/pai.70501","DOIUrl":"https://doi.org/10.1111/pai.70501","url":null,"abstract":"<p><strong>Purpose: </strong>Childhood allergic diseases often coexist, but phenotype-based evidence that includes food and drug allergy remains limited. The study aimed to derive potential allergic comorbidity phenotypes across five allergic diseases (eczema, rhinitis, asthma, food allergy, and drug allergy) and examine associations between identified phenotypic clusters and associated health outcomes in children and adolescents.</p><p><strong>Methods: </strong>In this population-based cross-sectional study, 18,371 children and adolescents aged 3-14 years were enrolled from Beijing and Tangshan. Parent-reported physician diagnoses of eczema, rhinitis, and asthma, together with questionnaire-based food and drug allergy, were analyzed using latent class analysis (LCA). Multinomial and binary logistic regression models were used to identify factors associated with allergic phenotype membership and to assess associations between phenotype membership and related health outcomes, respectively.</p><p><strong>Results: </strong>Three phenotypes were identified via LCA: low-allergy (13,505, 73.5%), rhinitis-dominant (3147, 17.1%), and multi-allergic (1719, 9.4%). Female sex, higher maternal education, middle household income, and shorter outdoor time were associated with significantly higher odds of both rhinitis-dominant and multi-allergic phenotypes. Early-life factors were mainly associated with the rhinitis-dominant phenotype. Longer sitting time and 1-2/week fast-food intake were associated with the multi-allergic phenotype. Compared with the low-allergy phenotype, rhinitis-dominant and multi-allergic phenotypes showed higher odds of upper respiratory infections (adjusted odds ratio: 4.40 and 3.48) and lower respiratory infections (2.49 and 2.57). Associations with dental caries were relatively weak. Sensitivity analyses supported the respiratory infection findings.</p><p><strong>Conclusions: </strong>Three distinct allergic comorbidity phenotypes were identified in Chinese children aged 3-14 years, with two adverse phenotypes (rhinitis-dominant and multi-allergic) sharing lifestyle correlates yet differing in early-life exposure associations. Importantly, both phenotypes were independently associated with a higher likelihood of respiratory infections.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 10","pages":"e70501"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123050","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":"International survey of parental and patient perspectives on emerging adrenaline devices for community-based management of anaphylaxis: An EAACI task force report.","authors":"M F Gonzalez-Matamala, N Patel, D Kahn-Santoro, R Knibb, G Roberts, P J Turner, A Kazie, N Atzert, J Bartra, K Chetty, A Deschildre, F A Dumitru, W Feleszko, J Gerdts, M H Gowland, T T M Le, H Pité, C Ozdemir, K Papadopoulou, M Podestà, C Raviolo, M Ruano-Zaragoza, H O Skjerven, B Stoilov, L D Valderrama, C Venter, C Woehlk, G H Yonamine, M Vazquez-Ortiz","doi":"10.1111/pai.70507","DOIUrl":"10.1111/pai.70507","url":null,"abstract":"<p><strong>Introduction: </strong>Intranasal adrenaline has been approved in multiple countries for anaphylaxis treatment, based primarily on pharmacokinetic/pharmacodynamic comparisons to adrenaline autoinjectors (AAIs).</p><p><strong>Aim: </strong>To assess patient and caregiver perspectives regarding emerging non-injectable adrenaline routes.</p><p><strong>Methods: </strong>Online survey of adults and caregivers of children with food allergy prescribed AAIs, with international dissemination supported by the European Academy of Allergy and Clinical Immunology (February-April 2025).</p><p><strong>Results: </strong>We analyzed 542 responses from caregivers and 224 from adults with food allergy. Effectiveness of adrenaline nasal spray (ANS) compared to AAI was rated \"extremely important\" by 78% of caregivers and 71% of adults. 48% of caregivers and 42% of adults were \"extremely worried\" that ANS may not work as well as AAI, and 50% and 44% (respectively) that it may not work well enough. Compared with AAI, respondents were less worried about ANS being painful or difficult to carry, and about fear/embarrassment around use, but more worried about side effects and knowing how to use it. Most anticipated being more comfortable using ANS than AAI, and over half anticipated earlier use during anaphylaxis. Only 17.2% of caregivers and 23.2% of adults preferred to be prescribed ANS only. There was interest in sublingual adrenaline due to portability and reduced needle-related burden, but confidence depended on comparable speed/effectiveness and feasibility during reactions.</p><p><strong>Conclusions: </strong>Non-injectable adrenaline is attractive to caregivers and adults, and may improve willingness to carry and use adrenaline. However, demand for evidence of effectiveness, safety, and real-world feasibility is high, highlighting important information needs for shared decision-making.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 10","pages":"e70507"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186894","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":"Comment on Distinct oesophageal microbiota is associated with paediatric eosinophilic oesophagitis.","authors":"Christos Zavos","doi":"10.1111/pai.70516","DOIUrl":"10.1111/pai.70516","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 10","pages":"e70516"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169440","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":"Feeding characteristics in young children with IgE-mediated food allergies: A cross-sectional observational study.","authors":"Jennifer Kefford, Elizabeth C Ward, Rebecca L Packer, Merryn Netting, Shruti Swamy, Lara S Ford, Jeanne Marshall","doi":"10.1111/pai.70508","DOIUrl":"10.1111/pai.70508","url":null,"abstract":"<p><strong>Background: </strong>Research is limited regarding the intersection between Immunoglobulin-E (IgE)-mediated food allergies and paediatric feeding Disorder (PFD). The impact on caregivers managing a child with both conditions also remains poorly understood.</p><p><strong>Objective: </strong>This study aimed to explore feeding characteristics in young children with IgE-mediated food allergies to identify the proportion of children who may be at risk of PFD, and to examine associations between risk of PFD and caregiver-reported stress and feeding-related quality of life.</p><p><strong>Methods: </strong>A cross-sectional cohort (N = 107) of caregivers of children aged 0;6-4;11 years, with at least one diagnosed IgE-mediated food allergy, was recruited from three paediatric allergy clinics. Validated caregiver-reported questionnaires were used to assess feeding behaviours, caregiver stress and feeding-related quality of life.</p><p><strong>Results: </strong>Seventeen (16%) children were identified as being at risk of PFD based on the Behavioural Pediatric Feeding Assessment Scale-Total Frequency Score (BPFAS-TFS). Across the cohort, caregiver stress fell within the expected range. However, caregivers of children at risk of PFD reported significantly higher levels of stress on the Parental Stress Scale (PSS) (p < .001) and poorer feeding-related quality of life on the Feeding Swallowing-Impact Scale (FS-IS) (p < .001).</p><p><strong>Conclusion: </strong>Sixteen percent of children with IgE-mediated food allergies screened as being at risk of PFD, suggesting that screening and assessment of PFD are valuable in this population. More frequent difficult mealtime behaviours were associated with increased caregiver stress and lower feeding-related quality of life. Health services must recognise the compounded stressors of managing both food allergies and feeding behaviours/PFD to deliver holistic, family-centred care.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 10","pages":"e70508"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149130260","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":"Machine learning-based prediction of food sensitization in infants and toddlers with atopic dermatitis.","authors":"Rıza Yıldırım, Ece Şenbaykal Yiğit, İkbal Nur Şafak, Hatemi Esam Demirtaş, Ayşe Pakel, Seda Tunca, Sanem Eren Akarcan, İdil Akay Hacı, İlke Taşkırdı, Tuba Tuncel","doi":"10.1111/pai.70518","DOIUrl":"https://doi.org/10.1111/pai.70518","url":null,"abstract":"<p><strong>Background: </strong>Food sensitization (FS) is a common comorbidity in children with atopic dermatitis (AD), often leading to the atopic march. Identifying high-risk patients in primary care is crucial to prioritize specialist referrals and prevent unnecessary elimination diets.</p><p><strong>Objective: </strong>To develop and validate a machine learning (ML) based clinical decision support tool to predict IgE-mediated FS risk in infants and toddlers (0-3 years) diagnosed with AD using routine clinical and laboratory parameters.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of children diagnosed with AD. Patients were classified as FS positive or FS negative based on specific IgE levels and skin prick tests. Ten ML algorithms were trained and compared using 5-fold stratified cross-validation. Feature importance was analyzed, and an interactive web-based tool was developed for clinical application.</p><p><strong>Results: </strong>Among 340 patients, 156 (45.8%) had IgE-mediated FS. Key independent predictors of FS included higher total IgE levels, younger age at presentation, elevated eosinophil counts, and breastfeeding at the time of symptom onset. Boosting-based models achieved superior performance; specifically, the AdaBoost model demonstrated high stability and discrimination (ROC AUC: 0.815 in CV and 0.819 in the held-out test set). By optimizing the probability threshold to 0.40, the model achieved a recall of 92% and an F1-score of 0.75, effectively minimizing false negatives.</p><p><strong>Conclusion: </strong>The ML model may serve as a screening and risk-stratification tool for IgE-mediated FS in children with AD. By utilizing routine laboratory data, this web-integrated tool can support primary care physicians in risk stratification, ensuring timely referral for high-risk cases while reducing unnecessary testing in low-risk infants.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 10","pages":"e70518"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149130263","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}