World Allergy Organization Journal最新文献

{"title":"Efficacy and safety of sublingual immunotherapy using a combination of Dermatophagoides pteronyssinus and Blomia tropicalis extracts in patients with allergic rhinitis: A randomized, double-blind, placebo-controlled trial","authors":"Priscilla Rios Cordeiro Macedo MD, MSc ,&nbsp;Priscila Moraes MD ,&nbsp;Luísa Karla Arruda MD, PhD ,&nbsp;Fábio Fernandes Morato Castro MD, PhD ,&nbsp;Jorge Kalil MD, PhD ,&nbsp;Clóvis Eduardo Santos Galvão MD, PhD","doi":"10.1016/j.waojou.2024.101020","DOIUrl":"10.1016/j.waojou.2024.101020","url":null,"abstract":"<div><h3>Background</h3><div>Allergen immunotherapy is the only treatment that may modify the natural course of allergic diseases. Sublingual immunotherapy (SLIT) is a promising treatment, especially for children. Few studies currently exist related to optimal dosing for <em>Blomia tropicalis</em>.</div></div><div><h3>Methods</h3><div>This was a double-blind, randomized, placebo-controlled trial of SLIT to treat house dust mite-induced Allergic Rhinitis (AR). A total of 65 patients, ages 12–16 years, were treated for 12 months and randomized into SLIT versus placebo. The SLIT group received a combination of <em>Dermatophagoides pteronyssinus</em> and <em>Blomia tropicalis</em> allergens. Sensitization was confirmed by skin prick test or serum specific IgE. Total Nasal Symptom Score (TNSS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), current treatment, and need for medication to control symptoms were ascertained during the study. Total serum IgE, serum specific IgE, and IgG4 levels for <em>Der p</em> 1 and <em>Blo t</em> were assessed at baseline and, 6 and 12 months after treatment.</div></div><div><h3>Results</h3><div>There was no significant difference in the number of adverse events between groups. The SLIT group showed a significant reduction in antihistamine use to control symptoms (p &lt; 0.0001) compared to placebo. There was no significant change in serum total IgE, serum specific IgE, and IgG4 for either allergen when comparing the SLIT and placebo groups.</div></div><div><h3>Conclusion</h3><div>After 1 year, SLIT using a dose of 1 mcg of Der p 1/day and 753 UBE of Blo t/day lowered the need for medications for break-through symptoms, with a good safety profile.\"</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 2","pages":"Article 101020"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179478","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":"Diphenhydramine: It is time to say a final goodbye","authors":"James H. Clark, MD ,&nbsp;Eli O. Meltzer, MD ,&nbsp;Robert M. Naclerio, MD","doi":"10.1016/j.waojou.2025.101027","DOIUrl":"10.1016/j.waojou.2025.101027","url":null,"abstract":"<div><div>Diphenhydramine, once a pioneering antihistamine, is now overshadowed by second-generation antihistamines with similar efficacy and fewer adverse effects. Current data suggest that the adverse side-effect profile of diphenhydramine is higher among children and older adults. This has led to countries such as Germany and Sweden restricting access to first-generation antihistamines and societal guidelines advocating for the use of second-generation antihistamines. Despite its well-documented problematic therapeutic ratio, diphenhydramine remains available in over 300 formulations, most of which are over-the-counter.</div><div>Based on a comprehensive evaluation of practice patterns and the prevalence and incidence of adverse clinical events, we believe that diphenhydramine has reached the end of its life cycle, and in its class of therapies it is a relatively greater public health hazard. We recommend it should no longer be widely prescribed or continue to be readily available over the counter.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 2","pages":"Article 101027"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179818","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":"Research team diversity impacts scientific output in allergy and immunology programs","authors":"Takeya Adachi, MD, PhD ,&nbsp;Norika Narimatsu ,&nbsp;Yasushi Ogawa, MD, PhD ,&nbsp;Masako Toriya, PhD ,&nbsp;Tamami Fukushi, PhD ,&nbsp;Masashi Shirabe, PhD ,&nbsp;Masaki Futamura, MD, PhD ,&nbsp;Takenori Inomata, MD, PhD, MBA ,&nbsp;Keigo Kainuma, MD, PhD ,&nbsp;Keiko Kan-o, MD, PhD ,&nbsp;Yosuke Kurashima, PhD ,&nbsp;Katsunori Masaki, MD, PhD ,&nbsp;Saeko Nakajima, MD, PhD ,&nbsp;Masafumi Sakashita, MD, PhD ,&nbsp;Sakura Sato, MD ,&nbsp;Mayumi Tamari, MD, PhD ,&nbsp;Hideaki Morita, MD, PhD ,&nbsp;Amane Koizumi, MD, PhD","doi":"10.1016/j.waojou.2024.101004","DOIUrl":"10.1016/j.waojou.2024.101004","url":null,"abstract":"<div><h3>Background</h3><div>This study examined the relationship between the disciplinary diversity of research teams and research output (RO) in allergy and immunology programs funded by the National Institutes of Health (NIH) in the United States, Medical Research Council (MRC) in the United Kingdom, and Japan Society for the Promotion of Science (JSPS).</div></div><div><h3>Methods</h3><div>Using a dataset containing 1243, 3645, and 1468 articles funded by the NIH, MRC, and JSPS, respectively, we analyzed the correlation between disciplinary diversity and RO in allergy and immunology programs that received grants from 2017 to 2021. Diversity was measured using All Science Journal Classification codes counts, Shannon-Wiener index, and newly developed Omnidisciplinary index (o-index). The impact of diversity on RO was evaluated Normalized Paper Count (reflecting research quantity), Normalized Top 1% Paper Count (reflecting research excellence), and Normalized Top 10% Paper Count (reflecting research substantiality).</div></div><div><h3>Results</h3><div>There were no significant differences in diversity between the funding agencies, indicating a marginal relationship between team composition and RO (p = 0.641 for Shannon-Winner index). RO was positively correlated with team diversity in NIH- and MRC-funded programs and positively correlated with the degree of specialization in JSPS-funded programs.</div></div><div><h3>Conclusions</h3><div>These results underscore the complexity of the relationship between research team diversity and RO and the influence of contextual factors such as country-specific characteristics and grant program objectives. Specifically, the analysis of JSPS-funded groups suggests that the degree of specialization has a greater impact on RO than disciplinary diversity. This study contributes to ongoing efforts to optimize team composition to improve RO in allergy and immunology programs.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101004"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933477","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":"Predicting the effectiveness of omalizumab in patients with refractory chronic rhinosinusitis with nasal polyps comorbid with asthma based on inflammatory biomarkers","authors":"Yutong Sima MD ,&nbsp;Ming Zheng MD ,&nbsp;Yan Zhao PhD ,&nbsp;Siqi Ge PhD ,&nbsp;Chengyao Liu MD ,&nbsp;Ping Wang BS ,&nbsp;Xiangdong Wang MD, PhD ,&nbsp;Luo Zhang MD, PhD","doi":"10.1016/j.waojou.2024.101009","DOIUrl":"10.1016/j.waojou.2024.101009","url":null,"abstract":"<div><h3>Background</h3><div>The treatment of refractory chronic rhinosinusitis with nasal polyps (CRSwNP) with omalizumab has been well studied based on clinical evaluation. Nevertheless, ideal quantitative or qualitative biomarkers for predicting a different response to biologics urgently need to be explored. We aim to identify potential biomarkers for predicting a good or poor response in patients with refractory CRSwNP.</div></div><div><h3>Methodology</h3><div>Patients received an endoscopic and radiological evaluation, a visual analogue scale (VAS) assessment, and a 22-item sinonasal outcome test (SNOT-22). Forty-eight biomarkers involving type 1 (T1), type 2 (T2), and type 3 (T3) inflammatory factors, chemokines, and remodeling factors were detected in nasal secretion and serum samples at baseline and after 24 weeks of omalizumab treatment.</div></div><div><h3>Results</h3><div>Eighteen patients with CRSwNP and 16 patients as control were enrolled. Patients with CRSwNP who received oamlizumab treatment with the SNOT-22 and VAS scores improved by 8.9 and 2 points in 72.22% and 50%, respectively. The nasal polyp score (NPS) and Lund-Mackay score were significantly improved in 55.56% of patients. The concentrations of T2 inflammatory biomarker, granulocyte-macrophage colony-stimulating factor (GM-CSF), T3 inflammatory biomarkers, granulocyte colony-stimulating factor (G-CSF), chemokine (C-X-C motif) ligand (CXCL)-1, and chemokine (C–C motif) ligand-20 (CCL-20), T1 inflammatory biomarker, IP-10 (CXCL-10), and granzyme B in nasal secretion and serum periostin were significantly decreased. Serum CCL-3 (AUC = 0.836) and CCL-4 (AUC = 0.909) levels predicted the improvement of SNOT-22 score, respectively. Serum IL-8 (AUC = 0.883) predicted poor improvement in nasal congestion score. Nasal secretion CXCL-1 (AUC = 0.812), GM-CSF (AUC = 0.813), IgE (AUC = 0.900) and IP-10 (AUC = 0.800) effectively predicted none or less improvement in nasal polyp score.</div></div><div><h3>Conclusions</h3><div>Omalizumab remarkably affects inflammatory mediators in different pathways. CCL-3 and CCL-4 in serum and IgE, CXCL-1, GM-CSF, and IP-10 in nasal secretion may be considered as preferable biomarkers for predicting favorable or ineffective response to omalizumab therapy in patients with refractory CRSwNP comorbid with asthma, based on various clinical indicators.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101009"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933555","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":"COVID-19 related epigenetic changes and atopic dermatitis: An exploratory analysis","authors":"Zhenwei Tang MD ,&nbsp;Yu Chen MBBS ,&nbsp;Yuzhen Ouyang MBBS ,&nbsp;Yu Peng MD, PhD ,&nbsp;Xiaoyong Man MD, PhD","doi":"10.1016/j.waojou.2024.101022","DOIUrl":"10.1016/j.waojou.2024.101022","url":null,"abstract":"<div><h3>Background</h3><div>While epidemiological data suggest a connection between atopic dermatitis (AD) and COVID-19, the molecular mechanisms underlying this relationship remain unclear.</div></div><div><h3>Objective</h3><div>To investigate whether COVID-19-related CpGs may contribute to AD development and whether this association is mediated through the regulation of specific genes’ expression.</div></div><div><h3>Methods</h3><div>We combined Mendelian randomization and transcriptome analysis for data-driven explorations.</div></div><div><h3>Results</h3><div>Among the 172 CpGs -associated with COVID-19 infection, merely 3 of them exhibited significant impacts on the risk of AD, including cg04543273, cg11916609, and cg10636246. In the following analysis of the causal effects of CpGs and their related gene expression, cg04543273 inhibited LMAN2 expression. However, there was not a significant impact of cg11916609 and cg10636246 on the expression of their corresponding genes. Besides, transcriptome analysis suggested that LMAN2 expression was significantly upregulated among the COVID-19-infected population, and LMAN2 expression was obviously correlated with Type 2 helper cells across different post-infection time points.</div></div><div><h3>Conclusion</h3><div>Overall, this study provides new insights of the COVID-19-related onset and exacerbation of AD-COVID-19-related epigenetic changes and their regulatory impact on transcription. A novel role of LMAN2 was proposed in the relationship between viral infection and AD. More studies are warranted to further explore the mechanism of LMAN2-related immunopathology.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101022"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048570","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":"Multi-biofluid metabolomics analysis of allergic respiratory rhinitis and asthma in early childhood","authors":"Chih-Yung Chiu MD, PhD ,&nbsp;Meng-Han Chiang MS ,&nbsp;Chieh-Ni Kuo BS ,&nbsp;Mei-Ling Cheng PhD ,&nbsp;Gigin Lin MD, PhD","doi":"10.1016/j.waojou.2024.101013","DOIUrl":"10.1016/j.waojou.2024.101013","url":null,"abstract":"<div><h3>Background</h3><div>Childhood rhinitis and asthma are allergic respiratory diseases triggered by common allergens, but they affect different parts of the respiratory system, leading to distinct symptoms. However, a comprehensive multi-biofluid metabolomics-based approach to uncover valuable insights into childhood allergies and allergen sensitization remains unaddressed.</div></div><div><h3>Methods</h3><div>Seventy-six children, comprising 26 with rhinitis, 26 with asthma, and 24 healthy controls, were enrolled. Fecal, blood, and urine metabolomic analyses using ¹H nuclear magnetic resonance (NMR) spectroscopy were conducted. An integrative analysis of their associations with allergen-specific IgE levels in the context of allergic rhinitis and asthma were also assessed.</div></div><div><h3>Results</h3><div>The analysis of 228 various biofluid samples revealed strong positive correlations between stool and blood metabolites, while blood metabolites exhibited negative correlations with most urine metabolites. Five and 19 metabolites were significantly different in children with rhinitis and asthma, respectively (<em>P</em> &lt; 0.05). Among them, blood isovaleric acid correlated positively with stool IgE levels in rhinitis, while stool butyric acid and acetic acid in asthma exhibited strong negative correlations with total serum and mite allergen-specific IgE levels (<em>P</em> &lt; 0.01). Blood metabolic profiles appeared to have the highest area under the curve (AUC) of 0.732 for rhinitis, whereas stool metabolic profiles had the highest AUC of 0.799 for asthma.</div></div><div><h3>Conclusions</h3><div>Multiple biofluid metabolomics provides comprehensive insights into childhood allergies, with blood profiles associated with allergic rhinitis and fecal profiles linked to asthma. Their short-chain fatty acid metabolites related to IgE levels emphasize the significant role of the gut microbiota in childhood rhinitis and asthma.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101013"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985334","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":"Gut microbiota and plasma metabolites in pregnant mothers and infant atopic dermatitis: A multi-omics study","authors":"Bingqian Du MA.Sc ,&nbsp;Aga Shama BA.Sc ,&nbsp;Yi Zhang BA.Sc ,&nbsp;Baolan Chen MA.Sc ,&nbsp;Yongqi Bu BA.Sc ,&nbsp;Pei-an Chen MA.Sc ,&nbsp;Chuzhi Lin BA.Sc ,&nbsp;Jie Liu MA.Sc ,&nbsp;Juan Zheng MA.Sc ,&nbsp;Zhenjun Li MD, PhD ,&nbsp;Qingsong Chen PhD ,&nbsp;Yu Sun PhD ,&nbsp;Xi Fu PhD","doi":"10.1016/j.waojou.2024.101017","DOIUrl":"10.1016/j.waojou.2024.101017","url":null,"abstract":"<div><h3>Background</h3><div>Many studies reported the influence of infants' gut microbiota on atopic dermatitis (AD) postnatally, yet the role of maternal gut microbiota and plasma metabolites in infants’ AD remains largely unexplored.</div></div><div><h3>Methods</h3><div>Sixty-three pregnant mother-infants were enrolled and followed after childbirth in Guangzhou, China. Demographic information, maternal stool and plasma samples, and records for infants’ AD were collected. Maternal gut microbiota/metabolome and plasma metabolome were profiled using shotgun metagenomics and non-targeted metabolomics. Logistic regression and multi-omics analysis were used to explore characteristic maternal gut microbiota in the AD and health groups.</div></div><div><h3>Results</h3><div>The α-diversity of maternal gut microbiota in health group was significantly higher than AD group (Shannon diversity <em>P</em> = 0.02, Simpson diversity <em>P</em> = 0.04). Short-chain fatty acids (SCFAs) producing microorganisms, including <em>Faecalibacterium</em>, <em>Roseburia</em>, <em>Butyricicoccus</em>, and <em>Ruminococcus</em>, as well as the abundance of phenylalanine, tyrosine, and tryptophan biosynthesis pathway, were enriched in health group (LDA&gt;2 and <em>P</em> &lt; 0.05). Virulent factors (VFs) involved in immune modulation were enriched in the health group, while VFs involving in adhesin were enriched in the AD group (<em>P</em> &lt; 0.05). Metabolomic analysis showed that a polyunsaturated fatty acid/linoleic acid, 13S-hydroxyoctadecadienoic, were negatively associated with AD in both the gut and plasma samples (FDR&lt;0.05). Several other linoleic acids and flavonoids were negatively associated with AD (FDR&lt;0.05). Neural network analysis revealed that microorganisms enriched in health group may produce these protective fatty acids.</div></div><div><h3>Conclusions</h3><div>Our findings show that maternal gut microorganisms/metabolites and plasma metabolites during pregnancy impact subsequent pathogenesis of infants AD. This illuminates new strategies against early AD in offspring.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101017"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030328","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 and urine eosinophil-derived neurotoxin (EDN) levels predict biologic response in severe asthma","authors":"Yu Ri Kang MD ,&nbsp;Hyunkyoung Kim MS, MPH ,&nbsp;Chae Eun Lee BS ,&nbsp;Jae-Woo Jung MD, PhD ,&nbsp;Ji-Yong Moon MD, PhD ,&nbsp;So Young Park MD, MS ,&nbsp;Sae-Hoon Kim MD, PhD ,&nbsp;Min-Suk Yang MD, PhD ,&nbsp;Byung Keun Kim MD, PhD ,&nbsp;Jae-Woo Kwon MD, PhD ,&nbsp;Hye-Kyung Park MD, PhD ,&nbsp;Young-Hee Nam MD, PhD ,&nbsp;Young-Joo Cho MD, PhD ,&nbsp;Taehoon Lee MD, PhD ,&nbsp;Ian M. Adcock MD, PhD ,&nbsp;Pank Bhavsar MD, PhD ,&nbsp;Kian Fan Chung MD, PhD ,&nbsp;Tae-Bum Kim MD, PhD","doi":"10.1016/j.waojou.2024.100990","DOIUrl":"10.1016/j.waojou.2024.100990","url":null,"abstract":"<div><h3>Background</h3><div>Eosinophils are crucial in allergic inflammation, and their correlation with asthma severity has made them a focal point in predicting treatment outcomes. Blood eosinophil count is a commonly utilized marker. However, its limitations have prompted alternative biomarker exploration, such as eosinophil-derived neurotoxin (EDN).</div></div><div><h3>Objective</h3><div>This research was conducted over 24 weeks on 56 patients with severe asthma treated with mepolizumab, reslizumab, and dupilumab. We aimed to evaluate the clinical significance of blood eosinophil count and their potential, including those of blood EDN levels and urine EDN values as biomarkers for predicting treatment response.</div></div><div><h3>Methods</h3><div>The analysis encompassed examining correlations between biomarkers and clinical features, including exacerbation rates and lung function, through ELISA assays and subsequent statistical analyses. The study protocol is registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (<span><span>NCT05164939</span><svg><path></path></svg></span>).</div></div><div><h3>Results</h3><div>The findings underscore strong correlations between serum EDN levels, blood eosinophil counts, and treatment responses, with EDN demonstrating comparable predictive capabilities to blood eosinophil counts to determine treatment responses. Different biologics exhibited varying efficacy regarding baseline eosinophil counts and EDN levels.</div></div><div><h3>Conclusions</h3><div>Blood eosinophil counts and EDN levels show potential as predictive markers for treatment responses in patients with severe asthma undergoing biologic therapies. However, further comprehensive studies are warranted to enhance the reliability and applicability of EDN as an effective asthma treatment biomarker.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 100990"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081236","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 in Italy: How, when, and why—A real-world study conducted through a patient association","authors":"Giovanni Paoletti MD ,&nbsp;Emanuele Nappi MD ,&nbsp;Maria Chiara Bragato MD ,&nbsp;Paola Valli MD ,&nbsp;Mattia Giovannini MD ,&nbsp;Domenico Gargano MD ,&nbsp;Luca Pecoraro MD ,&nbsp;Deborah Diso MSc ,&nbsp;Simona Barbaglia MSc ,&nbsp;Giorgio Walter Canonica MD ,&nbsp;Enrico Heffler MD, PhD","doi":"10.1016/j.waojou.2024.101015","DOIUrl":"10.1016/j.waojou.2024.101015","url":null,"abstract":"<div><h3>Background</h3><div>Allergen immunotherapy (AIT) is the only treatment that modifies the natural course of allergies. However, AIT is only used in some eligible patients, is frequently underused, and only a few studies investigated this aspects. Understanding AIT utilization patterns might disclose information about why it is underused, thus providing valuable insights on how to broaden the positive impact it can have on the population.</div></div><div><h3>Methods</h3><div>A questionnaire aiming to assess the trends of the use of AIT in Italy, patient health literacy on AIT, and the impact of respiratory allergies and AIT on patients' lives was submitted to patients affiliated with Respiriamo Insieme APS patient's association during the period between May and October 2023.</div></div><div><h3>Results</h3><div>Nine hundred forty-four patients completed the questionnaire. Most patients reported to be affected by allergic rhinitis (81.1%), allergic asthma (45.4%), and/or allergic conjunctivitis (41.2%), and many of them presenting a combination of these diseases. Only 53.8% knew about AIT's existence, and AIT was proposed to only 33.1% of the 858 patients affected by allergic rhinitis and/or allergic asthma, of which 29.2% decided not to initiate the therapy. Common reasons for AIT refusal were related to indecisiveness (26.5%), costs (22.9%), and skepticism (19.3%). Among the remaining 70.8% who accepted to start AIT, 21.4% discontinued the treatment beforehand, on average 18.26 months from initiation. There was a high heterogeneity in the suggested duration of AIT, with 20.4% of patients receiving indications to continue AIT for less than 3 years. AIT positively impacted patients' lives as most patients who completed AIT found it effective and safe, and experienced a significant reduction in the workdays/schooldays lost due to disease exacerbations.</div></div><div><h3>Conclusions</h3><div>The outcomes of this research pointed out a lot of misinformation surrounding AIT, calling for improvements in awareness and information on its efficacy and safety. Also, we noted a significant reduction in work/school days lost in patients who completed AIT and a good patient-reported safety and efficacy profile. We advocate for better economic accessibility through national-level standardization in treatment refundability. Notably, the collaboration with the patient association was crucial, and it would have been challenging to conduct this research otherwise.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101015"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985326","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":"Changes in anaphylaxis trends and characteristics in emergency department admissions in Türkiye: From 2015 to 2021 based on the Ministry of Health database","authors":"Elif Soyak Aytekin MD ,&nbsp;Seda Şirin MD ,&nbsp;Esra Kıratlı Nalbant MD ,&nbsp;Naim Ata MD ,&nbsp;Ahmet Sertçelik MD ,&nbsp;Mustafa Mahir Ülgü MD ,&nbsp;Şuayip Birinci MD ,&nbsp;Koray Harmancı MD ,&nbsp;Zülfikar Akelma MD","doi":"10.1016/j.waojou.2024.101019","DOIUrl":"10.1016/j.waojou.2024.101019","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of anaphylaxis is increasing worldwide. However, there is a lack of data on anaphylaxis trends in Türkiye. This study aims to analyse trends in anaphylaxis-related emergency department (ED) visits and examines factors associated with fatal anaphylaxis in Türkiye.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from Türkiye's Ministry of Health database from 2015 to 2022. Codes from the International Classification of Diseases, 10th revision (ICD-10), were used to identify anaphylaxis.</div></div><div><h3>Results</h3><div>During the study period, a total 21,370 ED admissions for anaphylaxis were identified, and anaphylaxis admissions increased 1.23-fold from 3.90 to 4.79 per 10⁵ population per year. The anaphylaxis trigger was unknown in 79.9% of cases, followed by drugs (11.7%), food (5.7%) and venom (2.7%). Epinephrine was administered in 49.6% of cases, and a total of 424 patients (2.1% of total cases) died. The frequency of intensive care unit (ICU) hospitalization increased 6.0-fold from 2015 to 2021, and age-adjusted average-weighted mortality rate for anaphylaxis was 0.66 per million. Older age, presence of asthma, and ICU hospitalization were found to be significantly associated with fatal anaphylaxis (p &lt; 0.001 for all). Frequencies of death were 9.1% for venom anaphylaxis, 1.2% in drug anaphylaxis, and 0.2% for food anaphylaxis. Epinephrine autoinjector (EAI) was prescribed for 6.9% of all patients.</div></div><div><h3>Conclusions</h3><div>This is the first study of ED admissions for anaphylaxis using a large, nationwide data from Türkiye. Increasing numbers of ED admissions, ICU hospitalizations and mortality show that anaphylaxis is an important public health issue in Türkiye.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101019"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985331","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}