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

{"title":"Prospective association between psychopathological symptoms in childhood and asthma in adolescence: Results from the GINIplus and LISA birth cohort studies.","authors":"Pia-Marie Keim, Ellen Greimel, Lisa Feldmann, Charlotte Elisabeth Piechaczek, Carla P Harris, Claudia Flexeder, Dietrich Berdel, Andrea von Berg, Sibylle Koletzko, Carl-Peter Bauer, Tamara Schikowski, Gunda Herberth, Joachim Heinrich, Gerd Schulte-Körne, Marie Standl","doi":"10.1111/pai.70151","DOIUrl":"10.1111/pai.70151","url":null,"abstract":"<p><strong>Background: </strong>Although there is a high co-occurrence of psychopathological symptoms and asthma, longitudinal studies considering asthma endotypes in childhood and adolescence are scarce. Therefore, this study examined the prospective association between psychopathology in childhood and current atopic and non-atopic asthma in adolescents, considering sex and puberty-related characteristics.</p><p><strong>Methods: </strong>The study includes 3584 participants (1790 females, 1794 males) from two German birth cohort studies, GINIplus and LISA. Psychopathological symptoms at age 10 (M = 10.06, SD = .22) were assessed by parent-reported Strengths and Difficulties Questionnaire (SDQ) and current asthma at age 15 (M = 15.07, SD = .30) was defined as a positive parent-reported medical diagnosis, wheezing, and/or medical treatment against asthma (at least two criteria). Atopic asthma was characterized as current asthma and a positive specific immunoglobulin E (IgE) test (≥0.35 kU/L), non-atopic asthma as current asthma without sensitization. Data were analyzed by logistic regression and multinomial regression models, controlling for potential covariates and confounders.</p><p><strong>Results: </strong>Psychopathological symptoms at age 10 were associated with asthma at age 15 (odds ratio (OR) = 1.69, 95% confidence interval (CI) = 1.04-2.92, p = .035). When examining the endotypes, this effect was replicated only for non-atopic asthma at age 15 (relative risk ratio (RRR) = 2.92, 95% CI = 1.13-7.60, p = .028), but not for atopic asthma (p = .381). Regarding the SDQ subscales, an association between peer problems at age 10 and atopic asthma at age 15 was revealed (RRR = 2.00, 95% CI 1.01-3.97, p = .048). Furthermore, significant interaction effects of puberty onset with psychopathological symptoms (p = .020), and particularly with peer problems (p = .029), were found on atopic asthma.</p><p><strong>Conclusion: </strong>The findings highlight the importance of early recognition and treatment of psychopathological symptoms to prevent and reduce development, persistence and exacerbation of asthma endotypes, and point to the necessity for further research into hormonal mechanisms linking psychopathology with atopy.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70151"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700972","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":"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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562654","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":"Heavy metal and childhood wheezing: The Japan Environment and Children's Study.","authors":"Hajime Maeda, Koichi Hashimoto, Hajime Iwasa, Akiko Sato, Yuka Ogata, Yuichi Nagasaka, Tsuyoshi Murata, Hyo Kyozuka, Kei Ogasawara, Keiya Fujimori, Hidekazu Nishigori, Seiji Yasumura, Mitsuaki Hosoya, Hayato Go","doi":"10.1111/pai.70144","DOIUrl":"https://doi.org/10.1111/pai.70144","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":"e70144"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577621","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 Ruano-Zarogosa M.","authors":"Arzu Bakirtas, H Ilbilge Ertoy Karagol, Muserefe Nur Keles, Dilek Yapar, Bulent Elbasan, A Kubra Baskin, Hakan Ozturk, Odul Egritas Gurkan, Sinan Sari, Buket Dalgic","doi":"10.1111/pai.70139","DOIUrl":"https://doi.org/10.1111/pai.70139","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":"e70139"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629415","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":"Biologics in the management of IgE-mediated food allergy. What is new?","authors":"Deniz Ilgun Gurel, Stefania Arasi","doi":"10.1111/pai.70146","DOIUrl":"https://doi.org/10.1111/pai.70146","url":null,"abstract":"<p><p>The prevalence and the burden of food allergies (FAs) have been estimated to be increased in recent decades, particularly in urban and developed areas. In parallel, in the last decade, new treatment options have been available, including biologicals. In February 2024, the FDA approved omalizumab for IgE-mediated FA to prevent severe accidental reactions. This review provides an overview of current biologicals available on the market and the main emerging drugs under evaluation with a main focus on IgE-mediated FA. The challenge for current and near-future research in the field remains to determine the ideal candidates for each biologic treatment and to refine the therapeutic protocols.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70146"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629414","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":"Maternal dietary inflammatory index during pregnancy and the risk of offspring allergic disease.","authors":"Jonas Österlund, Stina Bodén, Gabriel Granåsen, Richard Lundberg Ulfsdotter, Magnus Domellöf, Anna Winberg, Ingegerd Johansson, Christina E West","doi":"10.1111/pai.70148","DOIUrl":"10.1111/pai.70148","url":null,"abstract":"<p><strong>Background: </strong>Maternal diet during pregnancy is considered a potential modifiable risk factor for allergic diseases in offspring. The dietary inflammatory index (DII) is a tool to assess the inflammatory potential of the diet and has been suggested to be associated with offspring allergy development. Its association with food allergy and immunoglobulin E (IgE) sensitization in children remains understudied.</p><p><strong>Methods: </strong>This study analyzed 4709 mother-partner-child triads from the NorthPop Birth Cohort in Sweden. Maternal DII scores were calculated from a food frequency questionnaire administered at gestational week 34. Allergy outcomes at 18 months included parent-reported physician-diagnosed food allergy, parent-reported eczema and atopic eczema according to UK Working Party criteria, parent-reported ever wheeze, parent-reported physician-diagnosed asthma, and IgE sensitization to food and airborne allergens. Associations between maternal DII scores (continuous and quartiles) and allergic outcomes were assessed using logistic regression, adjusting for maternal age, allergic heredity, farm living, region of birth, siblings, and education.</p><p><strong>Results: </strong>At age 18 months, 4.9% of children had physician-diagnosed food allergy, 30.6% had eczema, 11.4% had atopic eczema, 15.9% reported ever wheeze, 4.1% had physician-diagnosed asthma, and 19% were IgE sensitized. No significant associations were found between maternal DII scores and the allergic outcomes of interest.</p><p><strong>Conclusion: </strong>This large birth cohort study found no association between maternal DII during pregnancy and allergic diseases or IgE sensitization in 18-month-old children, suggesting that a proinflammatory diet during pregnancy does not influence early allergic outcomes. Further research is needed to clarify the role of maternal diet in offspring immune development.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70148"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652082","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":"Urbanization and childhood asthma.","authors":"Teresia T Pham, Yeside Akinbolagbe, Thinh H Nguyen, Wanda Phipatanakul","doi":"10.1111/pai.70137","DOIUrl":"10.1111/pai.70137","url":null,"abstract":"<p><p>Childhood asthma is one of the major public health concerns, and urbanization as well as worsening environmental factors are contributing to its increasing prevalence. Outdoor pollutants, such as PM2.5, ozone, and traffic-related air pollution or TRAP, play significant roles in exacerbating asthmatic symptoms in children as well as reducing their lung function. Climate change can further compound these effects with changing pollen patterns that increase exposure to allergens in certain geographical areas. Moreover, indoor environments in urban areas also expose children to pollutants such as nitrogen dioxide, particulate matter, and aeroallergens like cockroach or mouse allergens. Socioeconomic disparities can further amplify these effects, with children in minority or low-income households disproportionately burdened by asthma morbidity. Green infrastructure and technological innovations can offer mitigation opportunities for negative effects of urbanization but require careful implementation to address multifactorial contributors to childhood asthma. Our review highlights the need for integrated strategies regarding environmental regulation, urban planning, and targeted interventions to reduce asthma burden in the urban pediatric population.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70137"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577622","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":"Casein sIgE as the most accurate predictor for heated milk tolerance in Finnish children.","authors":"Otso Nieminen, Kati Palosuo, Mika J Mäkelä","doi":"10.1111/pai.70152","DOIUrl":"10.1111/pai.70152","url":null,"abstract":"<p><strong>Background: </strong>Up to 83% of children with cow's milk allergy (CMA) tolerate baked milk, but research on heated milk (HM) tolerance and allergen-specific IgE (sIgE) cutoff values predicting oral food challenge (OFC) outcomes are lacking. We hypothesized that casein sIgE is the best predictor for HM tolerance.</p><p><strong>Methods: </strong>Finnish children suspected of having IgE-mediated CMA were recruited. sIgE levels to milk, casein, alpha-lactalbumin, beta-lactoglobulin, and bovine serum albumin were measured alongside skin prick tests (SPT) to fresh milk (FM) and HM. The diagnosis was confirmed with an FM OFC. IgE-sensitized children with a positive FM OFC underwent an HM OFC with extensively heated milk in rice porridge. Cutoff values to predict HM OFC outcome were determined, reaction severity analyzed, and effect of age investigated.</p><p><strong>Results: </strong>Of the 158 children (median age: 2.59 years) undergoing FM OFC, 127 proceeded to an HM OFC. Of these, 77 (61%) demonstrated HM tolerance. Casein sIgE emerged as the best predictor for the HM OFC outcome (AUC 0.786), with a 95% sensitivity cutoff value of <0.54 kU/L and a 95% specificity cutoff value of >14.1 kU/L. Most HM OFC reactions were mild (66%), but reaction severity was unpredictable. Casein sIgE, milk sIgE, and HM SPT showed greater accuracy in ≤3-year-old children.</p><p><strong>Conclusion: </strong>Casein sIgE cutoffs <0.54 and >14.1 kU/L can help identify children with a high or low likelihood of HM tolerance. This approach may reduce unnecessary OFCs in high-risk patients and guide safe dietary advancement on a milk ladder in low-risk cases.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70152"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661753","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":"Guidance for healthy complementary feeding practices for allergy prevention in developed countries: An EAACI interest group report.","authors":"Berber Vlieg-Boerstra, Merryn Netting, Emilia Vassilopoulou, Imke Reese, Erika Jensen-Jarolim, Stephanie Marchand, Sylwia Smolinska, Carina Venter, Karen Wright, Alexandra F Santos, Isabel Skypala","doi":"10.1111/pai.70150","DOIUrl":"https://doi.org/10.1111/pai.70150","url":null,"abstract":"<p><p>The goals of the complementary feeding period starting from 4 to 6 months of age are to fulfill the infant's nutritional need for nutrients and expose the infant to foods of varying flavors and textures to encourage acceptance of a diverse and nutritionally complete diet. Healthy complementary feeding consists of the timely introduction of a high diversity of whole, nutrient dense, and home-cooked foods or alternatively commercially frozen meals based on whole ingredients without added sugar or salt. These meals consist of predominantly plant-based foods, such as fruits, vegetables, legumes, grains, as well as fermented foods such as yoghurt. Healthy complementary foods are rich in fiber, iron, zinc, omega-3, and low in sugar, salt, and ultra-processed ingredients. In addition, these foods are hygienically safe, properly prepared, and include the early introduction of family-adjusted and country-specific food allergens. In this way regular complementary foods contribute to taste development, age-appropriate oral motor skills, and the prevention of allergic disease, not only by early introduction of food allergens but also by its impact on a healthy and diverse gut microbial development, a healthy immune maturation, and mucosal tolerance. Thus, individualized timing and selection of appropriate foods are essential while avoiding overreliance on infant formula and commercial baby foods as well as non-recommended feeding styles. This paper provides a rationale and guidance for health care professionals on healthy choices for complementary foods beyond early introduction of common allergens in children up to 24 months of age in developed countries.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70150"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677220","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}