World Allergy Organization Journal最新文献

{"title":"Does angioedema in patients with chronic spontaneous urticaria impact response to omalizumab?","authors":"Thomas B. Casale MD ,&nbsp;Benjamin Trzaskoma MS ,&nbsp;Michael Holden MD ,&nbsp;Jonathan A. Bernstein MD ,&nbsp;Marcus Maurer MD","doi":"10.1016/j.waojou.2024.100943","DOIUrl":"10.1016/j.waojou.2024.100943","url":null,"abstract":"<div><p>The presence of angioedema, or deep skin swelling, in addition to hives (wheals) in patients with chronic spontaneous urticaria (CSU) can complicate disease management. There is evidence that omalizumab is effective for patients with CSU with angioedema, but the time to a clinically meaningful response has not been assessed. This <em>post hoc</em> analysis examined data from the phase 3, randomized, double-blind ASTERIA I and ASTERIA II studies: patients with CSU with hives were grouped by presence (n = 216) or absence of angioedema (n = 265) at baseline. The time to minimally important difference (MID, change from baseline of ≥11 points) in weekly Urticaria Activity Score (UAS7) was analyzed using Kaplan-Meier analyses. Median time to MID for omalizumab 300 mg was similar in patients with and without angioedema. Median time to MID for omalizumab 150 mg was similar to 300 mg for patients without angioedema, and was longer for patients with angioedema. Therefore, the response to omalizumab for patients with CSU with angioedema was dose dependent. We recommend that the best approach for clinicians, in line with guidelines, would be initial administration of omalizumab 300 mg every 4 weeks for all patients.</p></div><div><h3>Clinical trials registration</h3><p>Clinicaltrials.gov <span><span>NCT01287117</span><svg><path></path></svg></span> (registered 27 January 2011) and <span><span>NCT01292473</span><svg><path></path></svg></span> (registered 7 February 2011).</p></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 8","pages":"Article 100943"},"PeriodicalIF":3.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1939455124000747/pdfft?md5=ee64bd00420dc27599643e88b5916440&pid=1-s2.0-S1939455124000747-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141950412","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":"Serum exosomal miR-141-3p and miR-3679-5p levels associated with endotype and postoperative recurrence in chronic rhinosinusitis with nasal polyps","authors":"Gang Wang MD,&nbsp;Zizhen Liu MD,&nbsp;Jiabin Zhan MD,&nbsp;Rui Li MD,&nbsp;Yi Ye MD,&nbsp;Yanyan Qi MD,&nbsp;Xin Wei PhD,&nbsp;Jing Zheng PhD","doi":"10.1016/j.waojou.2024.100938","DOIUrl":"10.1016/j.waojou.2024.100938","url":null,"abstract":"<div><h3>Background</h3><p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease. Exosomes were involved in different inflammatory diseases, but their roles in CRSwNP were poorly explored.</p></div><div><h3>Method</h3><p>We collected serum samples from 8 CRSwNP patients and 8 healthy controls (HC) and isolated their exosomes. MiRNA sequencing was performed for the exosome samples and differentially expressed miRNAs were identified. The top 3 differentially expressed exosomal miRNAs were confirmed in 2 validation cohorts, and their diagnostic values, predictive values for eosinophilic endotype, and recurrence were evaluated.</p></div><div><h3>Results</h3><p>Distinctive serum exosomal miRNA profiles were observed between CRSwNP and HC groups. Reverse transcription-polymerase chain reaction results in the first validation cohort revealed that serum exosomal miR-141-3p levels were increased, and miR-18a-5p and miR-3679-5p levels were decreased in the CRSwNP group compared to the HC group. These 3 miRNAs were further validated in the second validation cohort, and the results showed that miR-141-3p levels were elevated and miR-3679-5p levels were reduced in the serum exosomes in the eosinophilic CRSwNP group in comparison with the non-eosinophilic CRSwNP group. Receiver operating characteristic (ROC) curves highlighted that exosomal miR-141-3p and miR-3679-5p exhibited promising values for predicting the eosinophilic endotype. The patients in the second cohort were followed up for 2 years, and categorized into recurrence and non-recurrence groups. The serum exosomal miR-141-3p levels were increased and miR-3679-5p levels were reduced in the recurrence group in comparison with the non-recurrence group. ROC curves and Kaplan-Meier survival analysis revealed significant associations between the levels of exosomal miR-141-3p and miR-3679-5p and the risk of postoperative recurrence.</p></div><div><h3>Conclusions</h3><p>This study identified unique miRNA expression patterns in serum exosomes of CRSwNP patients. Circulating exosomal miR-141-3p and miR-3679-5p emerged as novel biomarkers for diagnosing CRSwNP, predicting the eosinophilic endotype, and forecasting postoperative recurrence.</p></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 8","pages":"Article 100938"},"PeriodicalIF":3.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1939455124000693/pdfft?md5=fdcb88433f972d72b5931b52ae839c60&pid=1-s2.0-S1939455124000693-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951697","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":"Platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio as predictors of refractory anaphylaxis","authors":"Le Vinh Nghi MD ,&nbsp;Nguyen Hoang Phuc MD ,&nbsp;Pham Dang Hai MD, PhD","doi":"10.1016/j.waojou.2024.100944","DOIUrl":"10.1016/j.waojou.2024.100944","url":null,"abstract":"<div><h3>Background</h3><p>Refractory anaphylaxis poses an ongoing, lethal hypersensitivity response that unpredictably involves multiple organs despite appropriate intramuscular (IM) adrenaline injections. Studies on the association of the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) concerning anaphylactic severity have yet to be carried out. The study aimed to evaluate the association between blood PLR and NLR levels and refractory anaphylaxis.</p></div><div><h3>Methods</h3><p>We carried out a retrospective cross-sectional study in which medical records of patients with anaphylaxis who sought urgent care at the Emergency Department (ED) of Tertiary Hospital in Hanoi, Vietnam, were evaluated. Based on the United Kingdom Resuscitation Council guidelines in 2021, patients were classified as refractory anaphylaxis if they needed more than two appropriate doses of intramuscular adrenaline for anaphylactic symptoms resolution. Clinical data and laboratory results were obtained in the medical records. Logistic regression analysis determined the association between contributing factors and refractory anaphylaxis.</p></div><div><h3>Results</h3><p>One-hundred eighteen adults (age 51.80 ± 18.25 years) were analyzed, including 38 refractory anaphylaxis patients (32.2%). Refractory anaphylaxis patients exhibited notably elevated platelet-to-lymphocyte ratio (PLR) (<em>P</em> = 0.006) and increased neutrophil-to-lymphocyte ratio (NLR) (<em>P</em> &lt; 0.001) in comparison to non-refractory anaphylaxis patients. Receiver operating characteristic curve (ROC) analysis demonstrated an optimal PLR cutoff value of 129.5 (area under the ROC curve [AUC] 0.658, sensitivity 73.68%, specificity 61.25%, <em>P</em> = 0.004) and an optimal NLR cutoff value of 4 (AUC 0.736, sensitivity 65.79%, specificity 73.75%, <em>P</em> &lt; 0.001) for refractory anaphylaxis. Multivariate logistic regression analysis revealed a PLR≥129.5 (OR = 4.83, 95% CI: 1.87–12.48) and an NLR≥4 (OR = 4.60, 95% CI: 1.86–11.41) were independently associated with refractory anaphylaxis.</p></div><div><h3>Conclusion</h3><p>Elevated PLR and NLR serve as independent indicators significantly associated with refractory anaphylaxis.</p></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 8","pages":"Article 100944"},"PeriodicalIF":3.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1939455124000759/pdfft?md5=6b0ac9485144fae069fa1e6aa6fee96f&pid=1-s2.0-S1939455124000759-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141953154","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":"Habitual snoring coexisting with respiratory allergies in children: Prevalence and impact on quality of life extending beyond primary snoring","authors":"Suttipong Ittiporn MD ,&nbsp;Arachaporn Angsubhakorn MD ,&nbsp;Chalisa Tangkanangnukul MD ,&nbsp;Kanlaya Prajongdee MSN","doi":"10.1016/j.waojou.2024.100913","DOIUrl":"10.1016/j.waojou.2024.100913","url":null,"abstract":"<div><h3>Background</h3><p>Children who have respiratory allergies are more likely to experience sleep disturbances. Persistent sleep-disordered breathing directly contributes to poor symptom control for asthma and allergic rhinitis, including deterioration in quality of life. This study aimed to investigate the prevalence, risk factors of habitual snoring, and the correlation between 18-item obstructive sleep apnea (OSA-18) scores and the level of asthma and allergic rhinitis (AR) symptoms control for habitual snorers with respiratory allergies.</p></div><div><h3>Material and methods</h3><p>A cross-sectional design was conducted on Thai children aged 2 to 15 who were diagnosed with asthma and AR in a respiratory allergy clinic at the Medical Education Center. The Pediatric Sleep Questionnaire was used to determine the prevalence of habitual snoring. Patients with habitual snoring completed the OSA-18 quality of life questionnaire, which was divided into 5 subscales: sleep disturbance, physical symptoms, emotional distress, daytime function, and caregiver concerns. Symptom control for asthma and AR was evaluated according to the Global Initiative for Asthma (GINA) guidelines and the Visual Analog Scales (VAS), respectively. Multivariable logistic regression models and adjusted odds ratios were used to assess associations.</p></div><div><h3>Results</h3><p>A total of 565 participants were enrolled, and 363 (64.2%) were male. Habitual snoring had the highest prevalence of sleep-disordered breathing in 29.6% of patients with respiratory allergies. Patients with poorly controlled symptoms had a significantly higher risk of habitual snoring than well controlled symptoms for AR (52.0% vs 19.1%, adjusted Odds Ratio: aOR 4.39, 95%CI 2.25–8.58, p &lt; 0.001) and for asthma concomitant with AR (54.9% vs. 18.8%, aOR 5.18, 95%CI 2.52–10.68, p &lt; 0.001). Habitual snorers with poorly controlled asthma negatively affected their quality of life more than those with well controlled asthma (37.7% vs 13.3%, p = 0.005), as did patients with underlying AR (46.2% vs 22.9%, p = 0.002). In comparison to habitual snorers with well controlled symptoms, those with poorly controlled symptoms for respiratory allergies had higher mean the OSA-18 scores across all subscales.</p></div><div><h3>Conclusion</h3><p>Nearly one-third of children with respiratory allergies develop habitual snoring. Poorly controlled symptoms of asthma and allergic rhinitis raise the possibility of developing habitual snoring. Their quality of life and caregivers were shown to be affected just as negatively as those with obstructive sleep apnea (OSA) syndrome.</p></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 8","pages":"Article 100913"},"PeriodicalIF":3.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1939455124000449/pdfft?md5=6c7195b56db5bc0389ef4bf87a215b46&pid=1-s2.0-S1939455124000449-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141950996","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":"Type 2 asthma paediatric patients eligible for dupilumab: An Italian biomarker-based analysis","authors":"Giorgio Piacentini MD ,&nbsp;Alessandro Fiocchi MD ,&nbsp;Gianluigi Marseglia MD ,&nbsp;Michele Miraglia Del Giudice MD ,&nbsp;Renato Cutrera MD ,&nbsp;Rossella Bitonti MSc ,&nbsp;Francesca Fanelli MSc ,&nbsp;Annalisa Stassaldi MSc ,&nbsp;Giuliana Nicolosi MD ,&nbsp;Gianluca Furneri MSc","doi":"10.1016/j.waojou.2024.100933","DOIUrl":"10.1016/j.waojou.2024.100933","url":null,"abstract":"<div><h3>Background</h3><p>Type 2 inflammation is the principal determinant of asthma in children, and it leads to the downstream activation of eosinophils (EOS), the production of immunoglobulin-E (IgE), and increased levels of fraction of exhaled nitric oxide (FeNO). Dupilumab received the approval for the treatment of uncontrolled severe Type 2 asthma in children.</p></div><div><h3>Objective</h3><p>The aim of this analysis was to calculate the Type 2 severe asthma paediatric population who would be eligible for treatment with dupilumab in Italy and characterize them by expected biomarker status.</p></div><div><h3>Methods</h3><p>The calculation of the dupilumab-eligible population employed a two-phase approach: 1) estimating the total number of children aged 6–11 years with uncontrolled severe asthma; and 2) stratifying the severe uncontrolled asthma population, based on appropriate biomarker levels, thus identifying patients eligible for treatment with dupilumab. The VOYAGE study provided the data for this analysis.</p></div><div><h3>Results</h3><p>The two-phase approach utilizing VOYAGE data revealed that the average number of paediatric patients with uncontrolled severe asthma was N = 1007. Stratification of these patients, as per VOYAGE data, indicated that the majority (N = 740; 73.5%) would have ≥2 elevated biomarkers, and over one-third patients (N = 434, 43.1%) would exhibit simultaneously elevated levels of EOS, FeNO and IgE. Of the paediatric patients, N = 864 were identified as eligible to dupilumab treatment, constituting 85.8% of the target population. Notably, nearly half eligible patients (N = 454) displayed elevated levels of both EOS and FeNO biomarkers, while the substantial majority (81.1%) exhibited at least an increase of EOS levels (N = 817). Patients with increased FeNO levels without a concurrent increase in EOS were less frequent (N = 47; 5.4% of the eligible population).</p></div><div><h3>Conclusion</h3><p>The simultaneous testing of multiple biomarkers during baseline patient assessment and disease follow-up is highly recommended. Utilizing cost-effective tests, physicians can estimate the prevalence of severe Type 2 asthma, categorize patients into distinct phenotypes (eosinophilic, allergic, or mixed), and consequently identify and prescribe the most suitable therapeutic interventions. This approach also facilitates the ongoing evaluation and adjustment of the treatment strategies based on individual patient responses.</p></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 8","pages":"Article 100933"},"PeriodicalIF":3.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1939455124000644/pdfft?md5=dc291fef14ab1f2546be46a32599a53f&pid=1-s2.0-S1939455124000644-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951699","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":"Idiopathic hypereosinophilic syndromes and rare dysimmune conditions associated with hyper-eosinophilia in practice: An innovative multidisciplinary approach","authors":"Marco Caminati MD ,&nbsp;Lucia Federica Carpagnano MD ,&nbsp;Chiara Alberti MSc ,&nbsp;Francesco Amaddeo PhD ,&nbsp;Riccardo Bixio MD ,&nbsp;Federico Caldart MD ,&nbsp;Lucia De Franceschi PhD ,&nbsp;Micol Del Giglio PhD ,&nbsp;Giuliana Festi MD ,&nbsp;Simonetta Friso PhD ,&nbsp;Luca Frulloni MD ,&nbsp;Paolo Gisondi MD ,&nbsp;Mauro Krampera PhD ,&nbsp;Giuseppe Lippi PhD ,&nbsp;Claudio Micheletto MD ,&nbsp;Giorgio Piacentini PhD ,&nbsp;Patrick Pinter MD ,&nbsp;Maurizio Rossini PhD ,&nbsp;Michele Schiappoli MD ,&nbsp;Cristina Tecchio PhD ,&nbsp;Matilde Carlucci MD","doi":"10.1016/j.waojou.2024.100928","DOIUrl":"10.1016/j.waojou.2024.100928","url":null,"abstract":"<div><p>Hypereosinophilic syndromes (HES) represent a group of rare dis-immune conditions characterized by blood hyper-eosinophilia and eosinophilic related burden. Especially the idiopathic subtype (I-HES) is particularly difficult to diagnose because of its heterogeneous clinical presentation, the lack of specific findings on physical exam, lab tools, and imaging informative enough to unequivocally confirm the diagnosis and the overlap with other entities, including eosinophilic organ-diseases or systemic dis-immune conditions other than I-HES (from atopy to eosinophilic granulomatosis with polyangiitis [EGPA], the last often extremely difficult to distinguish from HES). Taken together, all the features mentioned above account for an extremely difficult early recognition HES and on-time referral to a specialized centre. The referral itself is challenging due to a not univocal specialist identification, because of the variability of physicians managing HES in different settings (including allergist/clinical immunologist, haematologist, internal medicine doctors, pulmonologist, rheumatologist). Furthermore, the approach in terms of personalized treatment identification and follow-up plan (timing, organ assessment), is poorly standardized. Further translational and clinical research is needed to address the mentioned unmet needs, but on practical grounds increasing the overall clinicians’ awareness on HES and implementing healthcare pathways for HES patients represent a roadmap that every clinician might try to realize in his specific setting.</p><p>The present review aims at providing an overview about the current challenges and unmet needs in the practical approach to HES and rare hypereosinophilic allergo-immunological diseases, including a proposal for an innovative multidisciplinary organizational model.</p></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 8","pages":"Article 100928"},"PeriodicalIF":3.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1939455124000590/pdfft?md5=e72b657f434e42a1d2e7e6fcbd168195&pid=1-s2.0-S1939455124000590-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951714","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":"Peanut-specific IgG subclasses as biomarkers of peanut allergy in LEAP study participants","authors":"Carolyn H. Baloh MD ,&nbsp;Noha Lim ,&nbsp;Michelle Huffaker ,&nbsp;Pooja Patel ,&nbsp;Jody Tversky ,&nbsp;George Du Toit MB, BCh ,&nbsp;Gideon Lack MB, BCh ,&nbsp;Tanya M. Laidlaw ,&nbsp;Donald W. MacGlashan","doi":"10.1016/j.waojou.2024.100940","DOIUrl":"10.1016/j.waojou.2024.100940","url":null,"abstract":"<div><p>Antigen-specific IgG2 and IgG3 are rarely measured in food allergy clinical trials despite known function in preventing mast cell and basophil activation. Our objective was to determine whether measuring peanut-specific IgG2 and IgG3 levels would correlate with peanut allergy status. Peanut-specific IgG subclasses were measured via ELISA assays in Learning Early About Peanut allergy (LEAP) trial participants at 5 years of age and were correlated with peanut allergy vs peanut sensitization vs non-peanut allergic and peanut consumption vs peanut avoidance. Peanut-specific IgG1, IgG2, IgG3, and IgG4 levels were significantly different between participants with peanut allergy vs peanut sensitization vs non-peanut allergic, and a multivariate logistic regression model and stepwise selection found that IgG1 most closely associated with peanut allergy status. Similarly, all subclasses differentiated those consuming vs those avoiding peanut, but subsequent modeling found that IgG4 most closely associated with consumption status. Amongst the peanut-specific IgG subclasses, IgG1 was the best biomarker for peanut allergy, while IgG4 was the best biomarker for peanut antigen exposure in this highly atopic cohort. Our study did not find added value from evaluating peanut-specific IgG 2 and 3 as biomarkers of peanut allergy, although they did correlate with peanut allergy. Subsequent studies should assess the value of adding IgG subclasses to multivariate models predicting peanut allergy status.</p></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 8","pages":"Article 100940"},"PeriodicalIF":3.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1939455124000711/pdfft?md5=6ea47316031c761514926d18ee09e304&pid=1-s2.0-S1939455124000711-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006510","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":"Vascular endothelial growth factor (VEGF) emerging as a mediator of hereditary angioedema (HAE)","authors":"Pedro Giavina-Bianchi MD, PhD ,&nbsp;Marcelo Vivolo Aun MD, PhD ,&nbsp;Jorge Kalil MD, PhD","doi":"10.1016/j.waojou.2024.100942","DOIUrl":"10.1016/j.waojou.2024.100942","url":null,"abstract":"","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 8","pages":"Article 100942"},"PeriodicalIF":3.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1939455124000735/pdfft?md5=6c363a80c9d81d5da8632fec240e1592&pid=1-s2.0-S1939455124000735-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141947893","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":"Thank You to Our 2023 Reviewers","authors":"Alessandro Fiocchi MD,&nbsp;Mona Al-Ahmad MD","doi":"10.1016/j.waojou.2024.100945","DOIUrl":"10.1016/j.waojou.2024.100945","url":null,"abstract":"","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 8","pages":"Article 100945"},"PeriodicalIF":3.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1939455124000760/pdfft?md5=350079a58ff80005a621a177c16ba2ca&pid=1-s2.0-S1939455124000760-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952568","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":"Penicillin allergy de-labeling: Adaptation of risk stratification tool for patients and families","authors":"Simonne L. Horwitz MD, JD, MBA ,&nbsp;Ye Shen MPH ,&nbsp;Stephanie C. Erdle MD, FRCPC ,&nbsp;Chelsea Elwood BMScH, MSc, MD, FRCSC ,&nbsp;Raymond Mak MD, FRCPC ,&nbsp;John Jacob PhD, MSc, MBA ,&nbsp;Tiffany Wong MD, FRCPC","doi":"10.1016/j.waojou.2024.100939","DOIUrl":"10.1016/j.waojou.2024.100939","url":null,"abstract":"<div><p>Penicillin allergy is reported in 10% of the population; however, over 90% of patients are deemed non-allergic upon allergist assessment. The goal of this quality improvement project is to validate a patient-driven assessment tool to safely identify patients at low risk of penicillin allergy and de-label them. Pediatric patients and pregnant women referred to the institution's allergy clinics for penicillin allergy assessment were invited to use the patient tool to complete a self-assessment, resulting in the assignment of a risk category. The risk stratification determined using the patient tool was compared against the allergist's assessment.</p><p>The patient tool demonstrated agreement with the allergist assessment in 57/84 (67.9%, 95% CI [56.7%,77.4%]) assessments, intra-class correlation (ICC) = 0.618, p &lt; 0.001. In 22/84 (26.2%) assessments, the patient tool determined a higher risk category, primarily due to differences in patients’ perceived timing and description of symptoms. Only 5/84 (6.0%) patients were placed in a lower risk category by the patient tool compared to the allergist assessment. The patient tool demonstrates good validity in determining penicillin allergy risk, offering potential as a method of empowering patients to advocate in their care. Iterative changes to the patient tool will be applied to increase agreement.</p></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 8","pages":"Article 100939"},"PeriodicalIF":3.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S193945512400070X/pdfft?md5=5df5d877f62ea8f9a001e26c95785778&pid=1-s2.0-S193945512400070X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141949855","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}