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

{"title":"Probiotic oral immunotherapy for egg and milk allergy induces sustained unresponsiveness.","authors":"Melanie Lloyd, Paxton Loke, Kathy Nguyen, Sigrid Pitkin, Sarah Ashley, Andy Cantlay, Julie Burns, Hugh Brown, Francesca Orsini, Mimi L K Tang, Adriana Chebar Lozinsky","doi":"10.1111/pai.70222","DOIUrl":"https://doi.org/10.1111/pai.70222","url":null,"abstract":"<p><strong>Background: </strong>High-dose rapid-escalation oral immunotherapy (OIT) with adjunct probiotic is effective at inducing sustained unresponsiveness (SU) of peanut allergy, but the efficacy of this approach for other food allergies is untested. This open-label study aimed to confirm the safety and tolerability of high-dose egg and milk oral immunotherapy (OIT) with probiotic in children.</p><p><strong>Methods: </strong>Participants aged 5-17 years with egg (n = 20) or milk (n = 20) allergy confirmed by double-blind placebo-controlled food challenge (DBPCFC) received probiotic and either egg or milk OIT for 18 months. SU was assessed by DBPCFC performed post-treatment (after 8 weeks dietary allergen exclusion). The primary outcome was the proportion completing the dose-escalation phase according to protocol. Secondary outcomes were the proportion with SU, adverse events (AE), and change in health-related quality of life (HRQL).</p><p><strong>Results: </strong>Nine (45%) egg and 7 (35%) milk participants completed the dose-escalation according to protocol, and 17 (85%) in both groups were able to reach the maintenance phase with dose modifications. Eleven (55%) egg and 10 (50%) milk participants attained SU. Treatment-related AEs were frequent, with 9 (45%) egg and 13 (65%) milk participants reporting at least one moderate or severe event. Clinically significant improvements in HRQL were observed in both groups.</p><p><strong>Conclusion: </strong>High-dose rapid-escalation OIT with adjunct probiotic is a promising treatment for egg and milk allergy, which may increase the likelihood of achieving SU and shorten the required treatment period for participants. The efficacy and safety of this approach should be confirmed in later-stage placebo-controlled randomized trials.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 10","pages":"e70222"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305270","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":"Mollusk tolerance in crustacean-allergic children: Unraveling pediatric shellfish allergy cross-reactivity patterns.","authors":"Benedetta Pessina, Paula Cabrera-Freitag, Ana Entrala, Sonsoles Infante, Alberto Alvarez-Perea","doi":"10.1111/pai.70227","DOIUrl":"https://doi.org/10.1111/pai.70227","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 10","pages":"e70227"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357578","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":"Leveraging artificial intelligence for the management of preschool wheeze: A narrative review.","authors":"Anglin Dent, Mohammad Kaviul Khan, Padmaja Subbarao","doi":"10.1111/pai.70207","DOIUrl":"10.1111/pai.70207","url":null,"abstract":"<p><p>Management of preschool wheeze is notoriously challenging given heterogeneous clinical trajectories and underlying biological mechanisms dictating therapeutic response. Data-driven approaches have highlighted the value of identifying individual wheeze phenotypes and underlying biomarkers to support a personalized management approach; however, these advancements have yet to be translated into clinical management. Here, we discuss key opportunities for Artificial Intelligence and Machine Learning to support personalized approaches to wheeze management through vast pattern-recognition capabilities. Advancements in the development of tools for objective symptom evaluation, remote symptom monitoring, and prediction of clinical trajectories are summarized. Key considerations for the responsible and successful deployment of such promising technologies in real-world clinical settings are emphasized, including prevention of algorithmic biases, promotion of prediction transparency, and establishing standards for patient data privacy and equitable access to novel technologies.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 10","pages":"e70207"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12485587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202920","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 Ying Ye et al.","authors":"Wei Zhang, Ke Ouyang","doi":"10.1111/pai.70228","DOIUrl":"https://doi.org/10.1111/pai.70228","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 10","pages":"e70228"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357602","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":"Relapse rates and associated risk factors following omalizumab treatment in adolescents with chronic spontaneous urticaria.","authors":"Canan Caka, Melike Ocak, Bahri Can Duran, Özge Soyer, Bülent Enis Sekerel, Ümit Murat Şahiner","doi":"10.1111/pai.70216","DOIUrl":"https://doi.org/10.1111/pai.70216","url":null,"abstract":"<p><strong>Background: </strong>Omalizumab is an effective treatment option for antihistamine-resistant chronic spontaneous urticaria (CSU) patients. This study aimed to evaluate relapse in patients after completing omalizumab treatment and identify associated risk factors.</p><p><strong>Methods: </strong>Patients aged 12-18 years diagnosed with CSU who received omalizumab therapy between 2015 and 2023, whose treatment ceased with complete remission by December 2024.</p><p><strong>Results: </strong>This study consisted of 59 patients with a median (interquartile) age of 14.0 (12.0-16.0) years, of whom 49.2% were female. Post-treatment relapse was observed in 47.4% (n = 28) of the patients, with a median time to relapse of 6.0 (4.0-7.5) months. Relapsed patients had an earlier onset of CSU than non-relapsed [11.9 (8.0-13.9) and 14.1 (11.5-15.9) years, p = .028]. The pre-treatment symptom duration was significantly longer in relapsed patients than in non-relapsed patients [21.0 (8.0-36.0) and 8.0 (6.0-21.0) months, p = .010]. Patients with symptoms longer than 7.5 months prior to starting omalizumab had a higher risk of relapse (AUC: 0.695, 95% CI: 0.561-0.830; p = .010; sensitivity: 82.1%, specificity: 45.2%). Pretreatment symptom duration was identified as a significant risk factor, increasing the likelihood of relapse (OR: 1.134, 95% CI: 1.011-1.272, p = .032). No significant differences were found between relapsed and non-relapsed patients in terms of other clinical and laboratory factors. Late relapse was more common in ANA-positive patients than early relapse [14 (87.5%) vs. 2 (12.5%), p = .021].</p><p><strong>Conclusion: </strong>Delayed initiation of omalizumab treatment following the onset of urticaria symptoms is associated with an increased risk of relapse. Therefore, omalizumab treatment should be initiated promptly in eligible patients.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 10","pages":"e70216"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208973","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 \"Early-life allergic sensitization and respiratory infection-Two hits on lung function?\"","authors":"Beatriz Moya, Ismael García-Moguel, Ömer Kalayci, Philippe Eigenmann","doi":"10.1111/pai.70211","DOIUrl":"https://doi.org/10.1111/pai.70211","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 10","pages":"e70211"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202861","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":"First daily carboplatin desensitization protocol in a child: A case report.","authors":"L Argiz, T Toscano, J Crespo, E Panizo, N De Amuriza, M Diaz Villapalos, J J Aristu-Mendioroz, G Gastaminza","doi":"10.1111/pai.70220","DOIUrl":"10.1111/pai.70220","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 10","pages":"e70220"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240830","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":"Dibutyl phthalate induces atopic dermatitis via semaphorin-plexin signaling and IL-5: ECHO-COCOA study.","authors":"Mi-Jin Kang, Jeonghun Yeom, Yong Joo Park, Ah-Yoon Song, Hosub Im, Yanghee Kim, Jeong-Hyun Kim, Hyun Ju Yoo, Hoon Je Seong, Seung-Hwa Lee, Hyo-Bin Kim, Song-I Yang, So-Yeon Lee, Kangmo Ahn, Kyung Won Kim, Youn Ho Shin, Dong In Suh, Eom Ji Choi, Soo-Jong Hong","doi":"10.1111/pai.70224","DOIUrl":"https://doi.org/10.1111/pai.70224","url":null,"abstract":"<p><strong>Background: </strong>Several studies have reported an association between phthalate exposure and an increased risk of atopic dermatitis (AD). However, the molecular mechanism underlying this phenomenon in children remains unknown.</p><p><strong>Objectives: </strong>In this study, we investigated the effect of dibutyl phthalate (DBP) on AD development from a birth cohort and explored the potential mechanisms using multi-omics.</p><p><strong>Methods: </strong>Urinary concentrations of mono-n-butyl phthalate (MnBP) and mono-isobutyl phthalate (MiBP) metabolites were measured in 222 children aged 7 years from the Exposome and Child Health with Omics-Cohort for Childhood of Asthma and Allergic Diseases (ECHO-COCOA) study. Physician diagnosed AD in these participants. Luminex multiplex assay, proteome, and transcriptome were performed on blood samples. The production of interleukin (IL)-5 and IL-10 was analyzed after MnBP exposure in human keratinocytes and macrophage.</p><p><strong>Results: </strong>Higher MnBP and MiBP levels increased the risk of AD development. These phthalates were positively correlated with eosinophils and IL-5. In total, 24 differentially expressed proteins (DEPs) and IL-5 were associated with MnBP and the development of AD. DEPs were predominantly enriched in the semaphorin-plexin signaling pathway. Plexin B1 was negatively correlated with IL-10 and interferon gamma and positively correlated with egg white specific immunoglobulin E. Moreover, mediation analysis indicated that IL-5 had a significantly positive mediation effect on the association between MnBP and eosinophils. The IL-5-mediated signaling pathway was enriched in the blood transcriptome. IL-10 was decreased and IL-5 was increased in a dose-dependent manner after MnBP exposure from THP-1 and HaCaT cells.</p><p><strong>Conclusion: </strong>Exposure to DBP affects childhood AD via semaphorin-plexin signaling and IL-5.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 10","pages":"e70224"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145288174","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":"Systematic review of maternal dietary patterns during pregnancy and offspring allergy.","authors":"William Tan, Shriya Amara, Manzi Venter, Laura Wang, Stina Bodén, Melina E Simonpietri Tesoro, Kaci Pickett-Nairne, Deborah Glueck, Liam O'Mahony, Anna Comotti, Carina Venter","doi":"10.1111/pai.70217","DOIUrl":"https://doi.org/10.1111/pai.70217","url":null,"abstract":"<p><p>Individual studies indicate that maternal diet during pregnancy may be associated with child allergy outcomes. We performed a systematic review to summarize the available data focusing on overall maternal dietary intake rather than single foods and nutrients. Searches included PubMed, OVID Medline, Web of Science, and Embase up to November 28, 2024. Searches were not restricted by geographical location and included studies published in English only. The ROBINS-I Cochrane tool was used to assess risk of bias. Meta-analysis was conducted when ≥2 studies examined the same dietary pattern-outcome-age combination; a fixed- or random-effects model was used based on I². When studies reported multiple effect sizes, a multilevel meta-analysis accounted for within-study clustering. We included 28 papers reporting on 29 diet patterns, indices, or diversity. Diet patterns included healthy and unhealthy diet patterns, healthy and unhealthy diet indices, and healthy and unhealthy diet diversity. Allergy outcomes were atopic dermatitis/eczema, food allergy, allergic rhinitis, asthma, and allergic sensitization/atopy. Only diet diversity during pregnancy showed a modest protective effect against food allergy (OR = 0.95 (0.92-0.99)). A pro-inflammatory diet was linked to increased asthma/wheeze risk in children under 5 (OR = 1.17 (1.04, 1.33)) and (OR = 1.18 (1.04, 1.34)) with high heterogeneity across studies. Modest evidence supports a protective role of diet diversity against food allergy and that pro-inflammatory diets may increase early asthma risk in children. The Maternal diet index is the only index significantly associated with multiple allergy outcomes, and further studies in other cohorts are required.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 10","pages":"e70217"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240796","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":"Machine learning-based early prediction of asthma in preschoolers: The COCOA birth cohort study.","authors":"Chang Hoon Han, Seok-Jae Heo, Haerin Jang, So-Yeon Lee, Ji Soo Park, Dong In Suh, Youn Ho Shin, Jihyun Kim, Kangmo Ahn, Myung Hyun Sohn, Eom Ji Choi, Sun Hee Choi, Hey-Sung Baek, Soo-Jong Hong, Kyung Won Kim, Inkyung Jung, Soo Yeon Kim","doi":"10.1111/pai.70223","DOIUrl":"10.1111/pai.70223","url":null,"abstract":"<p><strong>Background: </strong>Early prediction of asthma in preschoolers, which is crucial for timely intervention, remains challenging. This study aimed to develop a machine learning (ML)-based model and a questionnaire-based scoring tool for the prediction of asthma at age 3 years.</p><p><strong>Methods: </strong>Data from the COhort for Childhood Origin of Asthma and allergic diseases (COCOA), a comprehensive prospective birth cohort in South Korea, was used. Children with complete 3-year follow-up (n = 2007) were divided into development (n = 1472) and validation (n = 535) cohorts based on birth year. Asthma diagnosis at age 3 years was based on physician diagnosis, recurrent wheezing episodes, asthma treatment, or parental reports. Random Forest-based predictive models were developed using data collected until the age of 2 years, initially selecting features via least absolute shrinkage and selection operator (LASSO) regression. A questionnaire-based scoring tool was also developed and compared with multiple ML algorithms.</p><p><strong>Results: </strong>The ML-based prediction models showed improved performance as the data accumulated. The 6-month, 1-year, and 2-year models had area under the receiver operating characteristic curve (AUROC) values of 0.614, 0.726, and 0.774, respectively, in the validation cohort. The performance of the questionnaire-based scoring tool (AUROC, 0.790) was comparable to that of the ML-based model. Important predictors included paternal total IgE levels, maternal iron supplementation during pregnancy, parental asthma history, nut allergy history, and recent lower respiratory infections.</p><p><strong>Conclusions: </strong>Our study successfully developed robust predictive models for early asthma that demonstrated high performance. The questionnaire-based scoring tool offers particular value because of its clinical applicability. Further validation in diverse populations and investigation of the causative pathways of the identified predictors are necessary to enhance clinical utility.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 10","pages":"e70223"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12533341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310657","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}