World Allergy Organization Journal最新文献

{"title":"Obesity in severe asthma: Unveiling challenges and exploring new therapeutic options","authors":"Mona Al-Ahmad MD , Asmaa Ali MD, PhD","doi":"10.1016/j.waojou.2025.101042","DOIUrl":"10.1016/j.waojou.2025.101042","url":null,"abstract":"","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 4","pages":"Article 101042"},"PeriodicalIF":3.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allergen immunotherapy and dupilumab in atopic dermatitis: Clinical efficacy and disparities in immunological indicators","authors":"Jin Liu MM ,&nbsp;Lin Yang MD, PhD ,&nbsp;Qingxiu Xu MD ,&nbsp;Qing Jiang PhD ,&nbsp;Nan Huang MD ,&nbsp;Wenjing Li PhD ,&nbsp;Yaqi Yang MD ,&nbsp;Dongxia Ma MD ,&nbsp;Le Li MM ,&nbsp;Yangxue Fu PhD ,&nbsp;Hao Chen PhD ,&nbsp;Rongfei Zhu MD, PhD","doi":"10.1016/j.waojou.2025.101043","DOIUrl":"10.1016/j.waojou.2025.101043","url":null,"abstract":"<div><h3>Objective</h3><div>Allergen immunotherapy (AIT) and dupilumab have been confirmed to improve symptoms of atopic dermatitis (AD); however, the precise immune mechanisms underlying their efficacy and whether they can elicit synergistic immune effects remain not fully elucidated. We aimed to investigate the clinical efficacy and immunological changes in AD patients undergoing AIT, dupilumab, and a combination of AIT and dupilumab treatment.</div></div><div><h3>Methods</h3><div>Clinical data, serum samples, and peripheral blood mononuclear cells (PBMC) were collected from house dust mite (HDM)-sensitized AD patients receiving AIT and/or dupilumab at baseline and 6 months. Changes in clinical efficacy, HDM-specific IgE and IgG₄, serum cytokines, and lymphocyte subgroups were compared among the treatment groups.</div></div><div><h3>Results</h3><div>A total of 77 AD patients were included, with 39 in the AIT group, 19 in the dupilumab group, and 19 in the AIT combined dupilumab group. The SCORAD scores significantly improved in all groups after 6 months. Levels of HDM-specific IgE and total IgE remained stable in the AIT group but decreased in the dupilumab and combination groups. Levels of IgG₄ against major mite components <em>Der p1</em> and <em>Der p23</em> increased in the AIT group and combined treatment group. Serum cytokine levels showed no significant changes, except for a decrease in CCL17 in the dupilumab group. Th1/Th2 and Th17/Th2 ratios increased after dupilumab treatment. There were notable differences in T cell subpopulations when PBMCs were stimulated with HDM extracts after 6-month treatment, tSNE analysis showed the proportion of IL-4⁺IL-13⁺CRTH2⁺T cells increased in the dupilumab group but had no changes in the AIT and combination group.</div></div><div><h3>Conclusions</h3><div>AIT, dupilumab, and their combination improved clinical symptoms and quality of life in AD patients. AIT promoted allergen-specific IgG₄ production, while dupilumab modulated T cell responses and reduced allergen-specific IgE synthesis. The combination of AIT and dupilumab exhibited the immunological parameter changes characteristic of both treatments but did not result in a significantly greater improvement in AD symptoms.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 3","pages":"Article 101043"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediators of the association between allergic diseases and bronchiectasis: A bi-directional univariable and multivariable Mendelian randomization study and mediation analysis","authors":"Ping-An Zhang MD ,&nbsp;Jie-Lin Wang MD ,&nbsp;Shi-Yan Fu BD ,&nbsp;Hua-Lian Luo BD ,&nbsp;Run-Dong Qin PhD ,&nbsp;Jing Li MD","doi":"10.1016/j.waojou.2025.101038","DOIUrl":"10.1016/j.waojou.2025.101038","url":null,"abstract":"<div><h3>Background</h3><div>Emerging research indicates that bronchiectasis often coexists with a range of allergic illnesses. The pathogenesis of both conditions is highly complex, involving a variety of interconnected factors, such as immune responses, metabolic pathways, and gut microbiota. However, the precise causal relationship between bronchiectasis and allergy-related conditions remains poorly understood.</div></div><div><h3>Materials and methods</h3><div>We obtained published GWAS datasets for 5 allergic disorders (allergic asthma, allergic rhinitis, atopic conjunctivitis, atopic dermatitis, and chronic rhinosinusitis) and bronchiectasis, along with data on 731 immune cells, 91 inflammatory proteins, 1400 plasma metabolites, and 473 gut microbiotas. Using bi-directional two-sample Mendelian Randomization (TSMR), we explored causal relationships between allergic diseases and bronchiectasis and validated these findings in a replication cohort. We also applied Linkage Disequilibrium Score Regression (LDSC) to assess genetic correlations between the conditions. Additionally, the mediating effects of immune cells, inflammatory proteins, metabolites, and gut microbiota on the relationship between allergic disorders and bronchiectasis were assessed through two-step TSMR and multivariate MR analysis.</div></div><div><h3>Results</h3><div>Our study revealed that allergic asthma, allergic rhinitis, atopic conjunctivitis, and atopic dermatitis all increased the risk of developing bronchiectasis, with no causal relationship identified in the reverse direction. Additionally, positive genetic associations were observed between allergic asthma, allergic rhinitis, atopic dermatitis, and bronchiectasis, respectively. We identified a total of forty immune cells, 5 inflammatory proteins, ninety plasma metabolites, and nineteen gut microbiota species as causal factors contributing to bronchiectasis onset. In mediation analysis, we found that the metabolic ratio of Retinol (Vitamin A) to oleoyl-linoleoyl-glycerol (18:1 to 18:2) was a risk factor for allergic asthma developing bronchiectasis, while the level of CD14 on CD33dim HLA-DR + CD11b + cells was a risk factor for allergic rhinitis. Two specific metabolic ratios—the Aspartate to <em>N</em>-acetylglucosamine to <em>N</em>-acetylgalactosamine ratio and the Methionine to phosphate ratio—served as, respectively, risk and protective factors for atopic dermatitis-developing bronchiectasis.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that allergic asthma, allergic rhinitis, atopic conjunctivitis, and atopic dermatitis increase the risk of developing bronchiectasis, with no evidence of a reverse causal relationship. Specifically, 3 metabolic ratios were identified as mediators between allergic diseases and bronchiectasis. Further studies are needed to clarify the underlying mechanisms.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 3","pages":"Article 101038"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The novel house dust mite allergen Der p 39 exacerbates atopic dermatitis-like inflammation in mice by inducing skin barrier dysfunction","authors":"Shan Liu BSc ,&nbsp;Ze-Lang Cai MS ,&nbsp;Jingcheng Liu ,&nbsp;Si-Yi Que BSc ,&nbsp;Wan-Zhen Hu MS ,&nbsp;Liang Chen MS ,&nbsp;Jia-Jie Chen PhD ,&nbsp;Kunmei Ji PhD","doi":"10.1016/j.waojou.2025.101036","DOIUrl":"10.1016/j.waojou.2025.101036","url":null,"abstract":"<div><h3>Background</h3><div>House dust mite (HDM) allergens can induce or exacerbate allergic inflammation, including atopic dermatitis (AD). Substances that damage the epithelial barrier can trigger or worsen AD. The mechanism by which the novel HDM allergen Der p 39 induces allergic inflammation remains unclear. Our aim was to investigate the effects of Der p 39 on AD-like inflammation and associated mechanisms.</div></div><div><h3>Methods</h3><div>Dinitrochlorobenzene (DNCB) and Der p 39 were utilized to establish AD model mice. Inflammation severity was evaluated with physiological and morphological assays. The effects of Der p 39 on inflammatory cytokine release and skin barrier protein expression were examined in HaCaT cells (human epidermal keratinocytes). Mitogen-activated protein kinase (MAPK) activation was examined by western blots. MAPK inhibitors were employed to assess MAPK involvement in filaggrin expression.</div></div><div><h3>Results</h3><div>Der p 39 worsened allergic inflammation (tissue thickness) in murine ears pretreated with 1% DNCB. Compared to controls, Der p 39-sensitized tissues showed epidermal and dermal thickening with elevated numbers of mast cells and eosinophils in inflammatory lesions. Der p 39 increased transcription and production of pro-inflammatory interleukins (ILs), down-regulated expression of the skin barrier proteins filaggrin and loricrin, and upregulated phosphorylation of ERK, JNK and p38 in HaCaT cells. Inhibition of MAPK signaling rescued filaggrin expression in Der p 39-treated cells.</div></div><div><h3>Conclusions</h3><div>The HDM allergen Der p 39 enhances allergic inflammation and promotes MAPK pathway-mediated epidermal barrier dysfunction, suggesting that Der p 39 may possess pathogenic and clinically relevant immunomodulatory potential.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 3","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trend analysis and cross-national inequity analysis of immune-mediated inflammatory diseases in children and adolescents aged 10–24 from 1990 to 2021","authors":"Hailin Xu PhD ,&nbsp;Xiaofeng Liang MD ,&nbsp;Keai Li PhD ,&nbsp;Yangmeihui Wang MD ,&nbsp;Zhiwen Zhang PhD ,&nbsp;Ying Deng MD ,&nbsp;Bin Yang PhD","doi":"10.1016/j.waojou.2025.101033","DOIUrl":"10.1016/j.waojou.2025.101033","url":null,"abstract":"<div><h3>Introduction</h3><div>Immune-mediated inflammatory diseases (IMIDs) are chronic inflammatory diseases caused by immune system dysregulation, affecting multiple systems and organs. Children and adolescents aged 10–24 are among the high-risk groups, and the global burden is substantial.</div></div><div><h3>Methods</h3><div>Using the latest data from global burden of disease (GBD) 2021, we employed Joinpoint regression analysis, Socio-Demographic Index (SDI) correlation analysis, and cross-national equity analysis to elucidate the spatiotemporal differences in the burden of IMIDs among 10-24-year-olds from 1990 to 2021.</div></div><div><h3>Results</h3><div>The burden of IMIDs in adolescents aged 10–24, ranked by severity, includes asthma, atopic dermatitis (AD), psoriasis, diabetes, rheumatoid arthritis (RA), inflammatory bowel disease (IBD), and multiple sclerosis (MS). Among these, asthma, AD, psoriasis, RA, and MS are more prevalent in females. Compared to 1990, the incidence rates of asthma and AD decreased in 2021, while the rates of psoriasis, diabetes, and RA increased. IMIDs are more common in Western Europe and North America, with rising incidence rates in South America and Asia. Concentration indices and slope indices indicate that these diseases are primarily concentrated in high SDI regions, although the differences in incidence rates between countries are decreasing.</div></div><div><h3>Conclusion</h3><div>While focusing on high-incidence regions, we must also pay attention to the incidence of IMIDs in emerging regions such as Asia and South America. Only in this way can we effectively reduce the heavy burden that IMIDs place on younger people globally.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 3","pages":"Article 101033"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal association of allergic diseases, eosinophils, and osteoporosis: A Mendelian randomization study","authors":"Xinghai Yue PhD ,&nbsp;Hongfei Liu PhD ,&nbsp;Shangmei Yang MMed ,&nbsp;Tao Fang MMed ,&nbsp;Shaoshun Shi MD","doi":"10.1016/j.waojou.2025.101039","DOIUrl":"10.1016/j.waojou.2025.101039","url":null,"abstract":"<div><h3>Background</h3><div>The association between allergic diseases and osteoporosis remains controversial. We hypothesize that this discrepancy may be due to a mediator that plays a role in the pathogenesis of both allergic diseases and osteoporosis. To test this hypothesis, we used Mendelian randomization (MR) analysis to investigate the relationships among allergic diseases, eosinophils, and osteoporosis.</div></div><div><h3>Method</h3><div>This study utilized data from publicly available GWAS databases, including 3 allergic diseases: asthma, allergic rhinitis, and eczema. We conducted bidirectional MR analyses on the relationships between allergic diseases and eosinophils (including eosinophil counts and percentage), allergic diseases and osteoporosis, and eosinophils and osteoporosis, respectively. We conducted sensitivity analyses for results with significance, validated the findings using multivariable Mendelian randomization (MVMR) analysis to ensure the reliability of the significant results.</div></div><div><h3>Results</h3><div>Two-sample MR analysis revealed significant bidirectional causal relationships between the 3 allergic diseases and eosinophils. A unidirectional causal relationship was found between eosinophils and osteoporosis, with eosinophil counts associated with osteoporosis (OR: 1.194; 95% CI 1.064 to 1.339; Pivw &lt;0.001) and eosinophil percentage associated with osteoporosis (OR: 1.187; 95% CI 1.057 to 1.332; Pivw &lt;0.001). Sensitivity analyses indicated no pleiotropy, However, the association between eosinophil percentage and osteoporosis was no longer significant after multivariable (MVMR) analysis. Additionally, no causal effects were observed from allergic diseases to osteoporosis, from osteoporosis to allergic diseases, or from osteoporosis to eosinophils.</div></div><div><h3>Conclusions</h3><div>1.) There is a significant bidirectional potential causal relationship between the 3 allergic diseases (asthma, allergic rhinitis, eczema) and eosinophils. 2.) There is no evidence to support a causal relationship between the 3 allergic diseases and osteoporosis, and vice versa. 3.) There is a unidirectional causal relationship may exist from eosinophil counts to osteoporosis.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 3","pages":"Article 101039"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular and metabolic outcomes associated with moderate-to-severe atopic dermatitis: A systematic review and meta-analysis","authors":"Suvijak Untaaveesup MD ,&nbsp;Thipsukon Amnartpanich MD ,&nbsp;Noraworn Jirattikanwong MD ,&nbsp;Anchaya Boonsom MD ,&nbsp;Treedanuch Treemethawee MD ,&nbsp;Pornteera Srichana MD ,&nbsp;Chettha Yimkijboriharn MD ,&nbsp;Phichayut Phinyo MD, PhD ,&nbsp;Wannada Laisuan MD ,&nbsp;Torpong Thongngarm MD","doi":"10.1016/j.waojou.2025.101035","DOIUrl":"10.1016/j.waojou.2025.101035","url":null,"abstract":"<div><h3>Background</h3><div>Chronic systemic inflammation in individuals with moderate-to-severe atopic dermatitis (AD) potentially predisposes them to metabolic and cardiovascular diseases. Nevertheless, evidence with regard to such association is limited.</div></div><div><h3>Objective</h3><div>To assess the association between metabolic and cardiovascular outcomes and moderate-to-severe AD.</div></div><div><h3>Methods</h3><div>A systematic search was performed through PubMed, Scopus, EMBASE, and Cochrane for population-based studies that addressed the effects of moderate-to-severe AD on metabolic and cardiovascular outcomes compared with the general population from inception to August 31, 2023. Meta-analysis was performed using the random effects model. The pooled odds ratio (OR) and certainty of evidence for each outcome were reported.</div></div><div><h3>Results</h3><div>We included 11 studies, 4 retrospective cohorts, 1 prospective cohort, 4 cross-sectional, and 2 case-control studies involving 405,170 moderate-to-severe AD patients compared to 4,591,478 unaffected controls. Moderate-to-severe AD was associated with a higher risk of myocardial infarction with an OR (95% CI) of 1.33 (1.07, 1.65), angina 1.33 (1.06, 1.66), heart failure 1.56 (1.28, 1.90), stroke 1.45 (1.21, 1.74), hypertension 1.38 (1.18, 1.63), dyslipidemia 1.27 (1.15, 1.41), and metabolic syndrome 1.24 (1.05, 1.42) with very low certainty of evidence. No significantly increased risk of cardiovascular death with an odds ratio (95% CI) of 1.81 (0.96, 3.44) and diabetes of 1.24 (0.91, 1.68) was observed. High heterogeneity was observed in most studies for all of the outcomes.</div></div><div><h3>Conclusion</h3><div>Our meta-analysis demonstrated a modest but significant association between moderate-to-severe AD and increased susceptibility to metabolic and cardiovascular diseases. Initial assessment of cardiovascular and metabolic risk for patients with moderate-to-severe AD should be considered to enable early management strategies.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 3","pages":"Article 101035"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angiotensin-converting enzyme inhibitor-induced angioedema: Proposal for a diagnostic score","authors":"Alexis Bocquet MD ,&nbsp;Nicolas Marmion MD ,&nbsp;Isabelle Boccon-Gibod MD ,&nbsp;Laurence Bouillet MD, PhD","doi":"10.1016/j.waojou.2025.101037","DOIUrl":"10.1016/j.waojou.2025.101037","url":null,"abstract":"<div><h3>Objective</h3><div>Angiotensin-converting enzyme inhibitor (ACEI)-induced angioedema (AE-ACEI) may be life-threatening, and the treatment should therefore be discontinued. However, patients taking ACEI may also have mast cell-mediated angioedema (AE-MC). Differentiating between AE-ACEI and AE-MC in patients taking ACEI is sometimes difficult. We propose to identify the factors associated with the diagnosis of AE-ACEI in patients.</div></div><div><h3>Materials and methods</h3><div>A multicenter retrospective study was carried out at Grenoble Alpes University Hospital and University Hospital of La Réunion. All patients referred for suspected diagnosis of AE-ACEI were included in the study between January 2019 and January 2022. The final diagnosis was made by the expert physician after a minimum follow-up of 1 year and after a biological work-up ruling other bradykinin-mediated angioedema.</div></div><div><h3>Results</h3><div>A total of 93 patients were analyzed, 49 with a final diagnosis of AE-ACEI and 44 with a diagnosis of AE-MC. Multivariate analysis identified 4 factors associated with the final diagnosis of AE-ACEI: number of AE between the introduction of ACEI and the consultation ≤3 (OR: 7.93 [1.60–50.7], p = 0.017) (1 point), duration of AE strictly greater than 24 h regardless of the treatments administered (OR: 8.41[2.07–44.5], p &lt; 0.01) (1 point), hospitalization in intensive care unit (OR: 7.14[1.19–50.0], p = 0.045) (1 point) and no recurrence of AE after stopping ACEI, regardless of the delay (OR: 16.7[3.37–125], p &lt; 0.01) (2 points).</div><div>This five-point diagnostic score (AUC: 0.85 [0.75–0.95]) identifies patients with a low probability of AE-ACEI when the score is 0–2 (sensitivity: 0.93, specificity: 0.35) and a high probability when it is between 4 and 5 (sensitivity: 0.53, specificity: 0.97).</div></div><div><h3>Conclusion</h3><div>After a consultation in an angioedema expert center, the diagnosis of AE-ACEI has been excluded in almost half the patients. We identified a five-point score that could help in the diagnosis of AE-ACEI and in the decision to contraindicate the use of ACE inhibitors for life.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 3","pages":"Article 101037"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A real-life evaluation of SNOT-22 domains in a cohort of CRSwNP patients treated with biologic therapies for 12 months","authors":"Giulia Anna Maria Luigia Costanzo MD ,&nbsp;Andrea Giovanni Ledda MD ,&nbsp;Giada Sambugaro MD ,&nbsp;Giuseppe Murdaca MD, PhD ,&nbsp;Cristiano Caruso MD, PhDs ,&nbsp;Silvia Canalis MD ,&nbsp;Paolo Serra MD ,&nbsp;Maria Pina Barca MD ,&nbsp;Stefano Del Giacco MD ,&nbsp;Davide Firinu","doi":"10.1016/j.waojou.2025.101041","DOIUrl":"10.1016/j.waojou.2025.101041","url":null,"abstract":"<div><h3>Background</h3><div>Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory disorder associated with rhinorrhea, nasal obstruction, nasal congestion, hyposmia, anosmia, and facial pain or pressure for over 12 weeks. This study examines the Sino-Nasal Outcome Test 22 (SNOT-22) score and its relationship to nasal, otologyc, sleep and emotional domains in CRSwNP patients during the first year of biologics treatment, comparing the pre-biologics score to that at 1, 6, and 12 months in a cohort of 59 patients with CRSwNP.</div></div><div><h3>Methods</h3><div>We included 59 patients with CRSwNP (with or without asthma) who received add on therapy with targeted monoclonal antibodies (mAbs). At each visit we administered the SNOT-22 questionnaire and both total score and single domains scores were recorded.</div></div><div><h3>Results</h3><div>In this real-life, observational study, we found a significant SNOT-22 total score reduction for patients treated with anti-IgE after 1 month, but this significant difference was not maintained at 6 or 12 months compared with the baseline. The use of anti-interleukin 5/5R (IL5/5R) leads to a significant reduction of the SNOT-22 total score after 1 month, which is maintained after 6 months but not at 12 months compared with the baseline. The use of an anti-interleukin 13/4R (IL13/4R) leads to a statistically significant reduction of the SNOT-22 score after 1 month of therapy, which is maintained after 6 and 12 months compared with the baseline. When examining the single domains, we observed that patients who received anti-IL13/4R treatment demonstrated a significant reduction in each domain at each time point (T) compared to the baseline. Patients who received anti-IL5/5R treatment demonstrated an improvement in the nasal domain at each T compared to the baseline. However, the improvement in the otologyc domain was not sustained after 12 months. Similarly, the sleep domain remained unchanged, and the emotional domain only improved significantly after 12 months. Similarly, there was a reduction of the emotional domain in patients treated with anti-IgE.</div></div><div><h3>Conclusion</h3><div>Our real-life study describes the kinetics over the first year of treatment with mAbs in CRSwNP, showing different patterns in reducing symptoms and improving Health Related Quality of Life (HRQoL). SNOT-22 with the factorial division in 4 domains can help distinguish fast responders from low or non-responders to a mAb based on clinical response after 1 month and more accurately assign the right mAb to the right patient.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 3","pages":"Article 101041"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden of asthma attributable to high body mass index in older adults 1990–2021 and prediction to 2050: An analysis of Global Burden of Disease Study 2021","authors":"Zhikang Wang MPH ,&nbsp;Yifang Liu PhD ,&nbsp;Yilin Li MPH ,&nbsp;Qi Wang PhD ,&nbsp;Junan Liu PhD","doi":"10.1016/j.waojou.2025.101040","DOIUrl":"10.1016/j.waojou.2025.101040","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have shown that high body mass index was a primary risk factor for asthma, particularly impacting older adults. This study aimed to assess the spatial and temporal trends for asthma burden attributable to high body mass index in older adults from 1990 to 2021 and to project trends up to 2050.</div></div><div><h3>Method</h3><div>We extracted data from the Global Burden of Disease Study 2021 for population aged over 60 years with asthma attributable to high BMI. Relevant indicators included number of deaths, disability-adjusted life years, mortality, and disability-adjusted life years rates and the rates were directly standardized. Spearman rank correlation test tested the burden against the Socio-demographic Index (SDI). Decomposition analysis was used to decompose changes in burden according to population structure, population growth, and epidemiologic changes. The Bayesian age-period-cohort model was used to predict the burden.</div></div><div><h3>Results</h3><div>From 1990 to 2021, despite downward trends in global mortality and disability-adjusted life-year rates, global asthma deaths, and disability-adjusted life years attributable to high body mass index increase by 69% and 46%, rising to 43,628 cases (95% CI: 18,366–71 088) and 1,223,969 years (95% CI: 526,972–1 945,426). Age-standardized mortality rates and disability-adjusted life years rates were more severe in regions with lower SDI, such as Oceania. Mortality rates and disability-adjusted life-year rates increased with age, with a higher burden observed in females compared to males. Population growth had a significant impact on the increase in deaths and disability-adjusted life years from 1990 to 2021, contributing approximately 158% and 222%, respectively. Asthma deaths and disability-adjusted life years attributable to high body mass index will continue to rise to 101,252 cases and 2,941,172 years up to 2050.</div></div><div><h3>Conclusion</h3><div>The global asthma burden due to high body mass index in older adults has risen significantly and is expected to continue this trend, highlighting the importance of developing public health strategies to address this issue.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 3","pages":"Article 101040"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}