World Allergy Organization Journal最新文献

{"title":"Profile of mild/moderate asthma patients: Baseline data from the MANI cohort","authors":"Giovanna Elisiana Carpagnano PhD ,&nbsp;Matteo Bonini PhD ,&nbsp;Manuela Latorre PhD ,&nbsp;Eleonora Nucera MD ,&nbsp;Irene Prediletto PhD ,&nbsp;Francesca Puggioni MD ,&nbsp;Giulia Scioscia PhD ,&nbsp;Pierachille Santus PhD ,&nbsp;Giovanni Sotgiu PhD ,&nbsp;Francesco Blasi PhD ,&nbsp;Giorgio Walter Canonica MD ,&nbsp;Pierluigi Paggiaro MD ,&nbsp;Arianna Aruanno PhD ,&nbsp;Ilaria Baiardini PhD ,&nbsp;Diego Bagnasco PhD ,&nbsp;Benedetta Bondi MD ,&nbsp;Giulia Candeliere MD ,&nbsp;Francesca Cefaloni MD ,&nbsp;Gabriele Fontanili MD ,&nbsp;Laura Melissari MD ,&nbsp;Fulvio Braido MD","doi":"10.1016/j.waojou.2025.101082","DOIUrl":"10.1016/j.waojou.2025.101082","url":null,"abstract":"<div><div>Although 90% of asthmatic patients suffer from mild and moderate disease, little is known about the burden on health status and quality of life, the long-term trajectory of disease severity, and the socio-economic impact. The Mild Moderated Asthma Network of Italy (MANI) is a real-world, cross-sectional, prospective, observational cohort study designed to explore these issues. Here we aimed to provide an identikit of asthmatic patients receiving treatment according to GINA steps 1–4, and enrolled in the centers of excellence participating in the MANI. Among 679 analyzed patients, 63% were female, and the mean age was 50 ± 16 years. Asthma was mild in 15.8% of patients (GINA steps 1–2) and moderate in 84.2% (GINA steps 3–4). The mean age of asthma diagnosis was 34.3 ± 17.7 years, 50% of patients were suffering from allergic rhinitis, and 13% from nasal polyposis. Mean FEV1% was 91.4 ± 19.4%, predicted with a FEV1/FVC ratio of 74.7 ± 11.9. The mean asthma control test value was 21.2 ± 3.73, and AQLQ score was 5.74 ± 1.07. Among the included patients, 17.2% had at least one asthma exacerbation in the previous year, with 14.2% requiring systemic steroids; 6.2% were referred to an emergency room in the year prior to enrollment; 2.2% required an asthma-related hospitalization; and 0.6% had been admitted to an Intensive Care Unit (ICU). Unscheduled visits were necessary for 3.8% of patients, 6.5% reported ≥5 lost work days due to asthma, and 11.5% declared ≥10 lost days of spare time. About 70% of patients were receiving treatment according to GINA Track 1. Uncontrolled cases constituted 16.7% of patients treated according to GINA steps 1–2, and 26.3% of patients treated according to GINA steps 3-4 were uncontrolled. Compared to patients with mild asthma, those with moderate asthma had more impaired lung function (FEV1% 88.5 ± 18.4 vs 94.4 ± 17.9, p = 0.05; FEV1/FVC 73.0 ± 9.76 vs 79.6 ± 9.56, p &gt; 0.001), exhibited greater need for systemic corticosteroids for treating exacerbations (13.8% vs 2.3%, p = 0.032), and showed greater adherence to therapy (TAI score 50.0 ± 5.66 vs 45.7 ± 8.42, p &lt; 0.001). Overall, mild/moderate asthma exhibited a substantial clinical and care impact. Patients treated with GINA steps 3–4 constituted the vast majority of patients attending specialist centers. A quarter of these patients were uncontrolled, and therefore need re-evaluation or treatment upgrade. Expanding recruitment of the MANI study will allow further phenotyping of these patients.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 8","pages":"Article 101082"},"PeriodicalIF":3.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type 2 Inflammatory Syndrome: Atopic and non-atopic endotypes","authors":"Pedro Giavina-Bianchi MD, PhD ,&nbsp;Rosana Camara Agondi MD, PhD ,&nbsp;Marcelo Vivolo Aun MD, PhD ,&nbsp;Jorge Kalil MD, PhD","doi":"10.1016/j.waojou.2025.101080","DOIUrl":"10.1016/j.waojou.2025.101080","url":null,"abstract":"","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 8","pages":"Article 101080"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How accurate are ChatGPT-4 responses in chronic urticaria? A critical analysis with information quality metrics","authors":"Ivan Cherrez-Ojeda Ph.D.(c) ,&nbsp;Marco Faytong-Haro Ph.D.(c) ,&nbsp;Patricio Alvarez-Muñoz Ph.D. ,&nbsp;José Ignacio Larco MD ,&nbsp;Erika de Arruda Chaves MD ,&nbsp;Isabel Rojo MD ,&nbsp;Carol Vivian Moncayo MD ,&nbsp;German D. Ramon MD ,&nbsp;Gabriela Rodas-Valero MD ,&nbsp;Emek Kocatürk MD ,&nbsp;Giselle S. Mosnaim MD ,&nbsp;Karla Robles-Velasco MD","doi":"10.1016/j.waojou.2025.101071","DOIUrl":"10.1016/j.waojou.2025.101071","url":null,"abstract":"<div><h3>Background</h3><div>The increasing use of artificial intelligence (AI) in healthcare, especially in delivering medical information, prompts concerns over the reliability and accuracy of AI-generated responses. This study evaluates the quality, reliability, and readability of ChatGPT-4 responses for chronic urticaria (CU) care, considering the potential implications of inaccurate medical information.</div></div><div><h3>Objective</h3><div>The goal of the study was to assess the quality, reliability, and readability of ChatGPT-4 responses to inquiries on CU management in accordance with international guidelines, utilizing validated metrics to evaluate the effectiveness of ChatGPT-4 as a resource for medical information acquisition.</div></div><div><h3>Methods</h3><div>Twenty-four questions were derived from the EAACI/GA²LEN/EuroGuiDerm/APAAACI recommendations and utilized as prompts for ChatGPT-4 to obtain responses in individual chats for each question. The inquiries were categorized into 3 groups: A.) Classification and Diagnosis, B.) Assessment and Monitoring, and C.) Treatment and Management Recommendations. The responses were separately evaluated by allergy specialists utilizing the DISCERN instrument for quality assessment, Journal of the American Medical Association (JAMA) benchmark criteria for reliability evaluation, and Flesch scores for readability analysis. The scores were further examined by median calculations and Intraclass Correlation Coefficient assessments.</div></div><div><h3>Results</h3><div>Categories A and C exhibited insufficient reliability according to JAMA, with median scores of 1 and 0, respectively. Category B exhibited a low reliability score (median 2, interquartile range 2). The information quality from category C questions was satisfactory (median 51.5, IQR 12.5). All 3 groups exhibited confusing readability levels according to the Flesch assessment.</div></div><div><h3>Limitations</h3><div>The study's limitations encompass the emphasis on CU, possible bias in question selection, the use of particular instruments such as DISCERN, JAMA, and Flesch, as well as reliance on expert opinion for assessment.</div></div><div><h3>Conclusion</h3><div>ChatGPT-4 demonstrates potential for producing medical content; nonetheless, its reliability is shaky underscoring the necessity for caution and confirmation when employing AI-generated medical information, especially in the management of CU.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 7","pages":"Article 101071"},"PeriodicalIF":3.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning-based model for acute asthma exacerbation detection using routine blood parameters","authors":"Youpeng Chen ,&nbsp;Junquan Sun ,&nbsp;Yabang Chen ,&nbsp;Enzhong Li ,&nbsp;Jiancai Lu ,&nbsp;Huanhua Tang ,&nbsp;Yifei Xie ,&nbsp;Jiana Zhang ,&nbsp;Lesi Peng ,&nbsp;Haojie Wu ,&nbsp;Zhangkai J. Cheng ,&nbsp;Baoqing Sun","doi":"10.1016/j.waojou.2025.101074","DOIUrl":"10.1016/j.waojou.2025.101074","url":null,"abstract":"<div><h3>Background</h3><div>Acute asthma exacerbations (AAEs) are a leading cause of asthma-related morbidity and mortality, especially in resource-limited settings where pulmonary function tests are unavailable or when patients are unable to cooperate with testing. This study aimed to develop and validate a diagnostic model for AAE using routine blood parameters through machine learning techniques.</div></div><div><h3>Methods</h3><div>We developed a machine learning-based diagnostic model using routine blood test parameters. Data from 23,013 asthma patients treated at the First Affiliated Hospital of Guangzhou Medical University were analyzed. Significant variables were identified through logistic regression, and 12 machine learning algorithms were used to construct diagnostic models, which were evaluated using Receiver Operating Characteristic (ROC) analysis, calibration, and Decision Curve Analysis (DCA).</div></div><div><h3>Results</h3><div>The Generalized Linear Model Boosting combined with Random Forest (glmBoost + RF) algorithm using 14 variables achieved comparable performance (Area Under the Curve [AUC] = 0.981) to the more complex Least Absolute Shrinkage and Selection Operator combined with Random Forest (Lasso + RF) algorithm using 25 variables (AUC = 0.985). Both models demonstrated excellent calibration and consistent performance across different demographic subgroups. DCA confirmed superior clinical utility compared to conventional strategies.</div></div><div><h3>Conclusions</h3><div>This machine learning model provides an efficient and practical tool for detecting AAE using routine blood parameters, offering potential value in clinical practice, especially in resource-limited settings.</div></div><div><h3>Clinical trial number</h3><div>Not applicable.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 7","pages":"Article 101074"},"PeriodicalIF":3.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Lactococcus lactis carrying active For t 2 protein in immunotherapy for Forcipomyia taiwana allergy in mice","authors":"Mey-Fann Lee PhD ,&nbsp;Yi-Hsing Chen MD, PhD ,&nbsp;Chu-Hui Chiang PhD ,&nbsp;Chi-Sheng Wu MS ,&nbsp;Nancy M. Wang PhD","doi":"10.1016/j.waojou.2025.101073","DOIUrl":"10.1016/j.waojou.2025.101073","url":null,"abstract":"<div><h3>Background</h3><div><em>Forcipomyia taiwana</em> (Diptera: Ceratopogonidae) allergy is Taiwan's most prevalent biting insect allergy. Our previous studies identified and cloned major <em>F. taiwana</em> allergens For t 2 and determined its strong immunogenicity to human fibroblasts. This study investigated whether oral administration of food-grade <em>Lactococcus lactis</em> containing For t 2 ameliorated midge-allergic symptoms in a mouse model.</div></div><div><h3>Methods</h3><div>BALB/c mice, divided into viable, sonicated, and autoclaved groups, were fed with <em>L. lactis</em>-For t 2 5 times weekly for 4 weeks. Immune molecules related to allergies in serum were analyzed and 16S rRNA profiles of fecal samples were compared.</div></div><div><h3>Results</h3><div>The results revealed administration of <em>L. lactis</em>-For t 2 significantly decreased the level of total IgE and ameliorated midge allergen-challenge-induced scratch bouts found in the viable and sonicated groups, but not the autoclaved group. The sonicated group showed a significant reduction in IL-4, IL-13, IL-17, MCP-1, and TNF-α levels. Its effect was comparable to that of the viable group and was even more pronounced in reducing IL-9 expression. Further, we performed a comprehensive analysis of 16S rRNA profiles corresponding to fecal samples. Clostridiaceae and Clostridium were the dominant family and genus in the autoclaved group, whereas Duncaniella and Kineothrix were the dominant genus in the sonicated and viable groups, respectively.</div></div><div><h3>Conclusions</h3><div>The results imply that mucosal allergen-specific immunotherapy of <em>L. lactis</em> For t 2 is a better cost-effective alternative to conventional subcutaneous allergen-specific immunotherapy. This study shows that non-viable <em>L. lactis</em>-derived For t 2 active protein may be a promising therapeutic for treating midge allergy.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 7","pages":"Article 101073"},"PeriodicalIF":3.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic testing for chronic spontaneous urticaria with or without angioedema: The do's, don't and maybe's","authors":"Jonathan A. Bernstein MD ,&nbsp;Ignacio Ansotegui MD, PhD ,&nbsp;Riccardo Asero MD ,&nbsp;Aleena Banerji MD ,&nbsp;Stephen Betschel HBSc, MD ,&nbsp;Timothy Craig DO ,&nbsp;José Luis García-Abujeta MD ,&nbsp;René Maximiliano Gómez MD, PhD ,&nbsp;Anete S. Grumach MD, PhD ,&nbsp;Michihiro Hide MD, PhD ,&nbsp;David M. Lang MD ,&nbsp;Michael Levin MD, PhD ,&nbsp;Hilary J. Longhurst PhD ,&nbsp;Marcus Maurer MD ,&nbsp;Mario Morais-Almeida MD ,&nbsp;Dinh Nguyen Van MD, PhD ,&nbsp;Helena Pité MD, PhD ,&nbsp;Marc A. Riedl MD ,&nbsp;María Isabel Rojo Gutiérrez MD ,&nbsp;Sarbjit S. Saini MD ,&nbsp;Torsten Zuberbier MD, PhD","doi":"10.1016/j.waojou.2025.101068","DOIUrl":"10.1016/j.waojou.2025.101068","url":null,"abstract":"<div><div>Chronic spontaneous urticaria (CSU), with or without angioedema, is heterogeneous and comprised of different endotypes and phenotypes. Because acute urticaria will mostly resolve spontaneously, routine testing and laboratory evaluation is not required unless supported by the clinical history or physical examination. With the advent of omalizumab, there has been a surge of interest in identifying biomarkers that could predict response to this treatment. In the process of investigating biomarkers as prognosticators, several CSU phenotypes and endotypes have emerged, which have made it evident that novel therapies targeting non-IgE mechanistic pathways are needed to control symptoms in patients unresponsive to the currently recommended therapies by the most recent international guidelines. The current data support peripheral eosinophils, autoantibodies against IgE or FcεRI α subunit measured by basophil histamine release assays, total IgE levels and IgG autoantibodies against thyroid peroxidase (TPO) as specific markers to differentiate type 1 autoimmune (autoallergic) CSU from type 2b autoimmune CSU before starting treatment especially with omalizumab. These markers have been included as exploratory endpoints in many clinical trials investigating novel therapies or for repurposing existing biologics to determine responders and non-responders, but these data are not completely clear at this time. Therefore, further randomized controlled studies and real-world studies are needed to demonstrate more conclusively the utility of ordering these tests in CSU patients when they initially present or when it is determined they are not responsive to high dose second generation H1-antihistamines (SGAH) before they can be included in evidence-based CSU guidelines. This review examines the value of obtaining diagnostic tests in the initial evaluation of CSU patients to predict treatment response.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 7","pages":"Article 101068"},"PeriodicalIF":3.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mendelian randomization analysis reveals causal relationship between allergic diseases and influenza","authors":"Hui Li BSc ,&nbsp;Yanping Zong BSc ,&nbsp;Lei He BSc ,&nbsp;Yujie Sun BSc ,&nbsp;Weibing Shi MD ,&nbsp;Jinchen Guo MD","doi":"10.1016/j.waojou.2025.101077","DOIUrl":"10.1016/j.waojou.2025.101077","url":null,"abstract":"<div><h3>Background</h3><div>Allergic diseases and influenza share similar genetic backgrounds and pathophysiological mechanisms. Observational studies have established a correlation between these 2 conditions; however, the precise direction of the causal relationship remains unclear. This Mendelian randomization (MR) study aims to evaluate the causal relationship between allergic diseases and influenza.</div></div><div><h3>Materials and methods</h3><div>This study utilized summary statistical data from genome-wide association studies (GWAS) and employed the two-sample MR method to comprehensively analyze the causal relationships between allergic diseases (asthma, hay fever, eczema), atopic dermatitis (AD), hay fever or allergic rhinitis (AR), and different types of influenza (including all influenza, regular influenza excluding pneumonia, and severe influenza that encompasses both influenza and pneumonia) using genetic factors as instrumental variables. The analysis primarily relied on the inverse variance weighted random effects model (IVW-RE).</div></div><div><h3>Results</h3><div>The IVW-RE analysis revealed significant correlations between allergic diseases (asthma, hay fever, or eczema) and both all influenza and severe influenza (influenza and pneumonia). Additionally, AR (hay fever or allergic rhinitis) was associated with both all influenza and regular influenza (excluding pneumonia). Furthermore, a significant correlation was found between asthma and severe influenza (influenza and pneumonia). However, there is no evidence to support a causal relationship between AD and influenza.</div></div><div><h3>Conclusion</h3><div>The results of this MR study support a causal relationship between allergic diseases, asthma, and influenza, including severe influenza. This finding suggests that allergic diseases and asthma are significant risk factors for influenza. Additionally, this study provides high-quality causal evidence that can inform clinical practices aimed at preventing the onset of influenza, particularly in populations with respiratory allergies and asthma.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 7","pages":"Article 101077"},"PeriodicalIF":3.9,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144229916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of prenatal vitamin D supplementation on respiratory and allergy-related outcomes in children: A systematic review and meta-analysis of randomized controlled trials","authors":"Qin Li BSc ,&nbsp;Xiaoshuang Xu BSc ,&nbsp;Ying Liu MD ,&nbsp;Shao Yin MD ,&nbsp;Qian Hu MSc ,&nbsp;Qiang Ji MSc ,&nbsp;Yue Zhong MSc ,&nbsp;Fengya Zhu MD","doi":"10.1016/j.waojou.2025.101075","DOIUrl":"10.1016/j.waojou.2025.101075","url":null,"abstract":"<div><h3>Background</h3><div>Vitamin D is critical for immune regulation and respiratory health, yet its supplementation during pregnancy shows inconsistent results in preventing respiratory and allergy-related outcomes in children. This systematic review and meta-analysis aim to evaluate the impact of maternal vitamin D supplementation on respiratory tract infections (RTI), asthma, wheezing, eczema, and allergy in offspring.</div></div><div><h3>Methods</h3><div>A comprehensive search was performed in PubMed, Embase, Web of Science, Cochrane Library up to December 2024. We included randomized controlled trials (RCTs) examining the effects of prenatal vitamin D supplementation on respiratory and allergy-related outcomes in children. The GRADE approach was applied to assess the quality of evidence, and the Cochrane risk-of-bias tool was used to evaluate study quality.</div></div><div><h3>Results</h3><div>Seven RCTs were included (3958 mother-infant pairs). Prenatal vitamin D supplementation did not significantly reduce RTI in children compared to controls (RR = 1.018, 95% CI: 0.965 to 1.074, p = 0.514). Similarly, no significant effects were observed for asthma (RR = 0.395, 95% CI: 0.670 to 1.308, p = 0.699), wheezing (RR = 0.824, 95% CI: 0.826 to 1.089, p = 0.174), eczema (RR = 0.954, 95% CI: 0.826 to 1.102, p = 0.522), allergic conditions (RR = 0.938, 95% CI: 0.841 to 1.047, p = 0.255), or IgE positivity (RR = 0.942, 95% CI: 0.736 to 1.207, p = 0.639). Subgroup analyses showed no significant effect modification based on control group supplementation or follow-up duration.</div></div><div><h3>Conclusion</h3><div>There is moderate-quality evidence suggesting that prenatal vitamin D supplementation has minimal or no significant effect on reducing respiratory tract infections and allergy-related outcomes in children.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 7","pages":"Article 101075"},"PeriodicalIF":3.9,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the awareness of pediatric residents of anaphylaxis diagnosis through clinical scenarios","authors":"Tülay Tuğçe Kutsal Gültekin M.D. ,&nbsp;Ayşe Gökçe Kutsal M.D. ,&nbsp;Gökhan Yörüsün M.D. ,&nbsp;Ahmet Selmanoğlu M.D. ,&nbsp;Kaan Çelebier M.D. ,&nbsp;Zeynep Şengül Emeksiz ,&nbsp;Emine Dibek Mısırlıoğlu","doi":"10.1016/j.waojou.2025.101076","DOIUrl":"10.1016/j.waojou.2025.101076","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Anaphylaxis is an acute onset, life-threatening systemic hypersensitivity reaction requiring urgent medical intervention. Early recognition and appropriate treatment of anaphylaxis are crucial for patient survival. This study aims to assess the awareness of pediatric residents regarding the diagnostic criteria, differential diagnosis, and appropriate treatment approaches for anaphylaxis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;Active pediatric residents volunteering in participating in the study were included. Participants were given a questionnaire consisting of 10 clinical scenarios assessing diagnostic criteria and 15 questions evaluating professional experience and knowledge.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 198 pediatric residents were included in the study. The average clinical working experience of the participants was 18 months. On average, participants answered 7.3 out of 10 clinical scenario questions correctly (min-max: 3–10). In the clinical scenario describing a 2-year-old patient with a history of anaphylaxis to milk-based formula, the patient developed coughing and wheezing after entering the kitchen while the mother was boiling milk. The patient had a respiratory rate of 52/min, SpO&lt;sub&gt;2&lt;/sub&gt; of 90%, and bilateral wheezing. This case, which involved no ingestion and presented only with signs of bronchospasm, was the scenario that participants found most challenging. While 64.1% of the participants classified it as anaphylaxis, 35.9% identified that the clinical presentation did not meet the diagnostic criteria for anaphylaxis. Similarly, the scenario involving a 17-year-old patient with acute rheumatic fever who developed syncope 5 min after receiving a benzathine penicillin injection and presented with confusion, heart rate of 58 bpm, blood pressure of 80/50 mmHg, respiratory rate of 38 breaths/min, SpO2 of 95%, and sinus bradycardia on ECG, was the least correctly identified as vasovagal syncope in terms of a differential diagnosis of anaphylaxis (33.8%). The results indicated that pediatric residents were less successful in diagnosing anaphylaxis in cases without skin/mucosal involvement and in drug/venom-related anaphylaxis cases. When both scenario-based and knowledge-based questions were considered, residents in their final 2 years and those who had received specialist training demonstrated significantly higher overall correct response rates (p &lt; 0.001, p = 0.002). Epinephrine was selected as the first-line treatment in 99.5% of cases; 81.3% of participants correctly identified the dosage, 97.5% the route of administration, and 89.4% the site of administration.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;In our country, the emergency treatment and follow-up of pediatric patients experiencing anaphylaxis are mostly carried out by pediatric specialists. Therefore, the education and training on the diagnosis and emergency management of anaphylaxis, a pediatric emergency,","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 7","pages":"Article 101076"},"PeriodicalIF":3.9,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144229917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarker profile and disease burden associated with intermittent and long-term oral corticosteroid use in patients with severe asthma prior to biologic initiation in real-life (STAR)","authors":"Florence Schleich MD, PhD ,&nbsp;Désirée Larenas-Linnemann MD, FAAAAI, Dist.Intl.FACAAI ,&nbsp;Alan Altraja MD, PhD ,&nbsp;Luis Pérez de Llano MD, PhD ,&nbsp;Konstantinos Kostikas MD, PhD, FERS ,&nbsp;Mohsen Sadatsafavi MD, PhD ,&nbsp;Arnaud Bourdin MD, PhD ,&nbsp;Roy Alton Pleasants PharmD ,&nbsp;Mark Hew MBBS, PhD, FRACP ,&nbsp;Wenjia Chen PhD ,&nbsp;Libardo Jiménez-Maldonado MD ,&nbsp;Simon Couillard MD, MSc ,&nbsp;Charlotte Suppli Ulrik MD, DMSc ,&nbsp;Adeeb A. Bulkhi MD, MS ,&nbsp;Ming-Ju Tsai MD, PhD ,&nbsp;George C. Christoff MD, MPH, PhD ,&nbsp;Nikolaos G. Papadopoulos MD, PhD, FRCP ,&nbsp;Paul E. Pfeffer MRCP(UK), PhD ,&nbsp;Dermot Ryan MD, FRCGP ,&nbsp;Celine Bergeron MD, FRCPC, MSc ,&nbsp;David B. Price FRCGP","doi":"10.1016/j.waojou.2025.101066","DOIUrl":"10.1016/j.waojou.2025.101066","url":null,"abstract":"<div><h3>Background</h3><div>Asthma characterization using blood eosinophil count (BEC) (among other biomarkers and clinical indices) is recommended in severe asthma (SA), but the masking effect of oral corticosteroids (OCS), makes this challenging.</div></div><div><h3>Aim</h3><div>Our aim was to explore the effect of OCS use (both intermittent [iOCS] and long-term [LTOCS]) prior to biologic initiation on SA phenotype and biomarker profile in real-life and to characterize the burden of SA among patients prescribed LTOCS by biomarker profile.</div></div><div><h3>Methods</h3><div>This was a registry-based cohort study, including data from 23 countries collected between 2003 and 2023 and shared with the Internatonal Severe Asthma Registry (ISAR). Patients with SA were categorized into 3 cohorts, those with: (i) no prescription for OCS, (ii) prescription(s) for iOCS (ie, ≤90 days in previous 12-months, usually short courses for exacerbations), and (iii) prescriptions for LTOCS (ie, &gt;90 days in previous 12-months). Biomarker distribution (ie, BEC, fractional exhaled nitric oxide [FeNO], and total Immunoglobulin E [IgE]) were quantified in the year prior to biologic initiation in patients with SA according to OCS prescription pattern. Phenotypes were characterized for those prescribed LTOCS according to BEC cut-off (&lt;150 and ≥ 150 cells/μL).</div></div><div><h3>Results</h3><div>Of 4305 patients included, 5.0% (n = 215), 54.1% (n = 2330) and 40.9% (n = 1760) were prescribed no OCS, iOCS, and LTOCS, respectively. The BEC distribution varied by prescription pattern and LTOCS dose (&lt;5 mg to ≥20 mg/day); BEC was &lt;150 cells/μL in 28.6% (n = 369/1288) of LTOCS patients, compared to 19.5% (n = 284/1460) of iOCS patients and 14.0% (n = 21/150) of those in the no OCS group. Median BEC was also significantly lower in the LTOCS versus the iOCS group (310 vs 400 cells/μL; p &lt; 0.001). A similar pattern was noted for IgE, but not FeNO. Among LTOCS patients with BEC &lt;150 cells/μL, 39.9% experienced ≥4 exacerbations, 75.1% had uncontrolled asthma symptoms and 55.9% had evidence of persistent airflow obstruction (compared with 40.9%, 76.2% and 59.5% of those with BEC ≥150 cells/μL, respectively).</div></div><div><h3>Conclusions</h3><div>OCS, whether prescribed intermittently or long term, affect BEC distribution potentially leading to heightened risk of phenotype misclassification and influencing subsequent treatment decisions. FeNO appears to be less susceptible to OCS-induced suppression. Disease burden was high for those in the LTOCS group and was high independent of dose and BEC. Our findings highlight the importance of considering OCS use, even intermittent use, when characterizing SA, and suggests the need for earlier phenotyping and alternative treatment strategies for LTOCS patients with low BEC.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 7","pages":"Article 101066"},"PeriodicalIF":3.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}