World Allergy Organization Journal最新文献

{"title":"A preliminary investigation of the differences in immune responses in different strains of mice with localized allergic rhinitis tolerance models","authors":"Qidi Zhang MD ,&nbsp;Wanting Zhu MD ,&nbsp;Zhixin Zou MD ,&nbsp;Wenting Yu PhD ,&nbsp;Pei Gao PhD ,&nbsp;Ziyi Long MD ,&nbsp;Ying Wang PhD ,&nbsp;Jianjun Chen PhD","doi":"10.1016/j.waojou.2025.101115","DOIUrl":"10.1016/j.waojou.2025.101115","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to compare systematically strain-specific immune differences between BALB/c and C57BL/6 mice in a local tolerance model and explore the underlying mechanisms.</div></div><div><h3>Methods</h3><div>BALB/c and C57BL/6 mice received daily intranasal ovalbumin (OVA; 25 mg/ml, 10μl/nostril) or PBS for 15 weeks. Systemic responses (serum OVA-specific IgE, IgG1, IgG2a; splenocyte cytokine secretion: IL-4, IL-10, IFN-γ) and local nasal responses (symptoms, histopathology: polymorphonuclear/goblet cell infiltration; immunohistochemistry: TGF-β, IL-10, eotaxin; RNA-seq transcriptomics of nasal mucosa) were assessed at the 8th and 15th weeks.</div></div><div><h3>Results</h3><div>BALB/c mice initially exhibited worsening nasal symptoms, which was followed by significant alleviation. In contrast, C57BL/6 mice showed a significant worsening of symptoms. Serum levels of IgE, IgG1, and IgG2a increased significantly over time in BALB/c mice. In C57BL/6 mice, serum IgE and IgG1 levels also increased significantly, while IgG2a levels showed no significant changes. In splenocyte supernatants, BALB/c mice showed IL-4 levels that initially increased significantly but later decreased significantly, whereas IL-10 levels were significantly elevated and sustained. Conversely, C57BL/6 mice exhibited no significant changes in these splenocyte cytokines. Within nasal mucosa, BALB/c mice displayed polymorphonuclear cell infiltration and significantly elevated eotaxin levels, which subsequently stabilized, alongside significant upregulation of TGF-β and IL-10 expression. At 15th week, C57BL/6 mice demonstrated significantly higher nasal PMN infiltration and eotaxin levels compared to BALB/c mice, but showed no significant increase in TGF-β or IL-10 compared to controls. RNA-seq analysis of nasal mucosa revealed that BALB/c mice at 15th week exhibited significant upregulation of genes involved in biological processes, tolerance-related signaling pathways, and negative regulatory pathways. Conversely, C57BL/6 mice showed significant upregulation of genes associated with cell synthesis- and secretion-related pathways.</div></div><div><h3>Conclusion</h3><div>Based on the criteria defining “local tolerance” in this model—significant symptom attenuation despite allergen escalation coupled with downregulation of nasal inflammatory markers (eotaxin, polymorphonuclear cell infiltration)—local tolerance was successfully induced in BALB/c mice by long-term OVA stimulation, but not in C57BL/6 mice. The normal function of T regulatory cells is key to establishing local tolerance.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 9","pages":"Article 101115"},"PeriodicalIF":4.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026644","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":"Drug hypersensitivity reactions in children in clinical practice: A WAO Statement","authors":"Steering Committee Authors,&nbsp;M. Pilar Berges-Gimeno MD, PhD ,&nbsp;Emilio Alvarez-Cuesta MD, PhD, MQM ,&nbsp;Marina Atanaskovic-Markovic MD, PhD ,&nbsp;Marina Attanassi MD, PhD ,&nbsp;Carlo Caffareli MD, PhD ,&nbsp;Jean-Christoph Caubet MD ,&nbsp;George du Toit MBBCh, MRCPCH ,&nbsp;Antonieta Guzman-Melendez MD, PhD ,&nbsp;Semanur Kuyucu MD, PhD ,&nbsp;Ricardo Madrigal-Burgaleta PhD, FRCP ,&nbsp;Lina Mayorga MD, PhD ,&nbsp;Elizabeth Powell MBChB, PhD ,&nbsp;Michelle Ramien MD, MSc ,&nbsp;Eva Rebelo Gomes MD, PhD ,&nbsp;Francesca Mori MD, PhD ,&nbsp;Andrew A. White MD ,&nbsp;Ignacio J. Ansotegui MD, PhD ,&nbsp;Review Panel Authors,&nbsp;Marcelo Vivolo Aun MD, PhD ,&nbsp;Masao Yamaguchi MD, PhD","doi":"10.1016/j.waojou.2025.101087","DOIUrl":"10.1016/j.waojou.2025.101087","url":null,"abstract":"<div><div>Drug hypersensitivity reactions (DHRs) in children and adolescents are less common than in adults but can have serious consequences if mismanaged. Mislabeling children as drug-allergic due to incomplete diagnostic evaluations leads to unnecessary medication restrictions, increased healthcare costs, and suboptimal treatment choices. This Statement from the World Allergy Organization (WAO) provides evidence-based recommendations for evaluating and managing pediatric DHRs, emphasizing accurate diagnosis through <em>in vivo</em> and <em>in vitro</em> testing, risk stratification, and personalized approaches. Antibiotics, particularly β-lactams, and non-steroidal anti-inflammatory drugs (NSAIDs) are the most frequently implicated drugs, with non-immediate reactions, such as maculopapular exanthema, being the most common presentation. The document also addresses emerging concerns, including monoclonal antibody-induced anaphylaxis and drug-induced enterocolitis syndrome. It underscores the need for specialized care in allergy centers with expertise in pediatric populations and advocates for multidisciplinary programs to manage complex cases, such as chemotherapy hypersensitivity and perioperative drug allergy. By addressing diagnostic challenges and clinical uncertainties, this document aims to improve the management of DHRs in children, reduce mislabeling, and enhance patient outcomes worldwide.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 9","pages":"Article 101087"},"PeriodicalIF":4.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913768","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":"Allergic diseases are signalling a public health crisis — It is time for a global allergy health plan","authors":"Tari Haahtela MD, PhD","doi":"10.1016/j.waojou.2025.101106","DOIUrl":"10.1016/j.waojou.2025.101106","url":null,"abstract":"","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 9","pages":"Article 101106"},"PeriodicalIF":4.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895085","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":"Discontinuation of biologic therapy in severe asthma: Evidence and strategies for safe withdrawal: A scoping review","authors":"Johanna Ramirez-Villamizar MD ,&nbsp;Ciro D. Ibarra-Enríquez MD ,&nbsp;Juan Sebastián Galindo-Sánchez MD ,&nbsp;Carlos Serrano-Reyes MD ,&nbsp;Liliana Fernández-Trujillo MD","doi":"10.1016/j.waojou.2025.101107","DOIUrl":"10.1016/j.waojou.2025.101107","url":null,"abstract":"<div><h3>Introduction</h3><div>Severe asthma is characterized by poor disease control despite the use of high-dose inhaled corticosteroids and long-acting bronchodilators. Biologic therapies have revolutionized its management, allowing some patients to achieve remission. However, uncertainty remains regarding the optimal duration of treatment and the safest strategies for discontinuation. This study reviews the available evidence on the withdrawal of biologic therapy in patients with severe asthma in remission, evaluating their clinical outcomes.</div></div><div><h3>Methods</h3><div>A literature review was conducted in PubMed, EMBASE, Epistemonikos, and LILACS up to May 2024, using terms related to severe asthma and discontinuation of biologic therapies. Studies evaluating asthma control after dose reduction or withdrawal of biologic treatment were included, considering outcomes such as exacerbations, lung function, and inflammatory biomarkers.</div></div><div><h3>Results</h3><div>Of the 2494 studies identified, 23 articles were included after full-text review. Discontinuation of tezepelumab led to a gradual loss of clinical control in most patients, although baseline levels of inflammation were not reached. Regarding mepolizumab, 59% of patients experienced at least 1 significant exacerbation within the first year after withdrawal, suggesting the need for prolonged use. For omalizumab, results were heterogeneous: 67% of patients who continued treatment remained exacerbation-free, compared to 47.7 of those who discontinued it. Studies that implemented gradual tapering strategies showed higher success rates in discontinuation without loss of clinical control.</div></div><div><h3>Conclusion</h3><div>Evidence suggests that discontinuation of biologic therapy should be individualized, and a minimum treatment duration of 5 years may be appropriate before considering withdrawal. Optimal candidates include those with sustained clinical control, stable lung function, suppressed inflammatory biomarkers, and no need for oral corticosteroids. Gradual decreasing strategies may optimize treatment withdrawal while minimizing the risk of relapse.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 9","pages":"Article 101107"},"PeriodicalIF":4.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887026","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":"Methodology of the international cross-sectional prevalence and severity study of pediatric and adult IgE-mediated food allergies (ASSESS FA)","authors":"Ruchi Gupta MD, MPH ,&nbsp;Tarek Mnif PharmD ,&nbsp;Suzanne Reed PhD ,&nbsp;Mira Hleyhel PhD ,&nbsp;Stefani Dritsa PhD ,&nbsp;Perrine LeCalvé MSc ,&nbsp;Alissar Moussallem PharmD, MPH ,&nbsp;Paolo Tassinari MD ,&nbsp;Jessica Marvel MPH ,&nbsp;Alessandro Fiocchi MD","doi":"10.1016/j.waojou.2025.101105","DOIUrl":"10.1016/j.waojou.2025.101105","url":null,"abstract":"<div><h3>Background</h3><div>The burden and prevalence of food allergy (FA), a condition known to negatively impact the quality of life (QoL) of patients and their families, vary across countries due to cultural habits and clinical practices and have been assessed differently among previous studies. To date, no validated scale exists to measure FA severity risk.</div></div><div><h3>Objective</h3><div>The study objectives were to develop a standardized methodology to estimate FA point prevalence in children and adults in 9 countries, to assess FA impact on QoL, and to construct a framework to define FA severity risk based on QoL and FA clinical severity.</div></div><div><h3>Methods</h3><div>This was a cross-sectional, international study that collected self-reported data through an online quantitative survey. Participants were recruited from general population panels: parents/caregivers of children aged 6 months-17 years, and adults aged 18–65 years. The survey instrument was developed by a panel of clinical FA experts and epidemiologists.</div></div><div><h3>Results</h3><div>Weighted prevalence rates were calculated for the 4 generated case definitions of FA (self-reported, physician-diagnosed, symptom-convincing, and confirmed FA). Several validated scales, including the Food Allergy Quality of Life Questionnaire (FAQLQ) and the Food Allergy Independent Measure (FAIM), were used to assess FA impact on QoL in patients with symptom-convincing FA. Four FA severity risk profiles were generated: non-severe, at-risk, highly impacted QoL, and severe patients.</div></div><div><h3>Conclusion</h3><div>The ASSESS FA study developed a methodology to estimate the prevalence of FA and its impact on QoL consistently across countries, age groups, and food allergens. The severity risk framework was based on both the clinical severity and impact on QoL aspects of FA.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 9","pages":"Article 101105"},"PeriodicalIF":4.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890620","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":"LncRNA PELATON regulates Th2 cell differentiation by miR-10b-5p/GATA3 axis in allergic rhinitis","authors":"Zhen Liu MD ,&nbsp;Yumei Li PhD ,&nbsp;Xiangkun Zhao MM ,&nbsp;Qi Sun MD ,&nbsp;Yu Zhang MD ,&nbsp;Yaqi Wang MM ,&nbsp;Han Fang MD ,&nbsp;Yujuan Yang MD ,&nbsp;Yakui Mou MD ,&nbsp;Xicheng Song MD","doi":"10.1016/j.waojou.2025.101108","DOIUrl":"10.1016/j.waojou.2025.101108","url":null,"abstract":"<div><h3>Background</h3><div>Long non-coding RNAs (lncRNAs) have been increasingly recognized as critical regulators in the pathogenesis of immunoinflammatory diseases. Nevertheless, their mechanistic contributions to Th2-driven allergic rhinitis (AR) remain unclear. This study investigated the immunomodulatory function of lncRNA PELATON in AR pathogenesis by exploring its regulatory effects on Th2 cell differentiation.</div></div><div><h3>Methods</h3><div>A total of 32 participants were enrolled, comprising 16 patients diagnosed with AR and 16 control subjects. The allergy levels of the participants were assessed using the skin prick test (SPT), and the levels of PELATON expression in PBMCs were detected by qPCR. Spearman's correlation analysis was used to calculate the correlation between the 2 variables. Changes in GATA3, IL-4, IL-5, and IL-13 expression were examined, as well as changes in Th2 cell differentiation resulting from the overexpression of PELATON and miR-10b-5p. Modulation of miR-10b-5p and GATA3 expression by PELATON was studied via transcriptome sequencing, dual-luciferase reporter assays, and <em>in vitro</em> experiments.</div></div><div><h3>Results</h3><div>LncRNA PELATON expression was elevated in patients with AR and showed a significant correlation with allergy levels. PELATON was enriched in CD4⁺T cells. Overexpression of PELATON in PBMCs led to an increase in the proportion of Th2 cells and the levels of GATA3, IL-4, IL-5, and IL-13 expression, while the overexpression of miR-10b-5p reduced the expression levels of GATA3, IL-4, IL-5, and IL-13. PELATON bound directly to miR-10b-5p and inhibited the negative regulatory effect of miR-10b-5p on GATA3, thereby forming a ceRNA network that promoted Th2 cell differentiation.</div></div><div><h3>Conclusion</h3><div>LncRNA PELATON competitively binds to miR-10b-5p and promotes GATA3 expression, resulting in Th2 cell differentiation and activation in AR. Formation of the lncRNA PELATON/miR-10b-5p/GATA3 ceRNA network is a regulatory mechanism that offers new possibilities for finding therapeutic targets for AR.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 9","pages":"Article 101108"},"PeriodicalIF":4.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887025","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":"Prevalence and risk factors of <i>de novo</i> atopic diseases in pediatric liver transplant recipients: A retrospective cohort study.","authors":"Krittapaun Sombatwatthana, Watcharoot Kanchongkittiphon, Potjanee Kiewngam, Wanlapa Jotikasthira, Songpon Getsuwan, Napapat Butsriphum, Wiparat Manuyakorn, Suporn Treepongkaruna","doi":"10.1016/j.waojou.2025.101102","DOIUrl":"10.1016/j.waojou.2025.101102","url":null,"abstract":"<p><strong>Background: </strong>Atopic diseases are common in pediatric liver transplant (LT) recipients, yet their prevalence, remission, and risk factors remain unclear.</p><p><strong>Objective: </strong>To investigate the prevalence, onset, remission, and risk factors for food allergy (FA), allergic rhinitis (AR), and asthma in pediatric LT recipients.</p><p><strong>Results: </strong>Among 118 pediatric LT recipients, 71 (60.2%) developed atopic diseases post-transplant. <i>De novo</i> FA was the most common (40.7%), with a median onset of 9.5 months after LT. Most cases were IgE-mediated, with cow's milk and egg as the most common allergens. Over 3 years, 56.3% outgrew at least one allergic food. AR was diagnosed in 24.4%, with house dust mites as the primary sensitizing allergens. Asthma was less frequent (3.4%). Younger age at LT (<2 years) significantly increased FA risk (OR: 5.5, 95% CI: 2.0-15.2), as did Epstein-Barr virus (EBV) reactivation (OR: 6.5, 95% CI: 1.2-33.8). AR risk was higher in those with a first-degree family history of atopy (OR: 5.6, 95% CI: 2.1-14.7) or an atopic organ donor (OR: 4.6, 95% CI: 1.3-16.2).</p><p><strong>Conclusion: </strong><i>De novo</i> FA and AR are common in pediatric LT recipients, with significant associations with age at transplant, EBV reactivation, and genetic predisposition. Early monitoring and intervention are crucial to managing atopic diseases in this population.</p>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 8","pages":"101102"},"PeriodicalIF":4.3,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876813","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":"Impact of providing education on the recognition and differential diagnosis of angioedema among emergency department physicians.","authors":"Derya Unal, Semra Demir, Sacide Rana Işik, Müge Olgaç, Raif Coşkun, Kadriye Terzioğlu, Ramazan Ersoy, Şengül Beyaz, Nida Öztop, Can Tüzer, Osman Ozan Yeğit, Seda Karsli, Halim Işsever, Asli Gelincik, Bahattin Çolakoğlu, Suna Büyüköztürk","doi":"10.1016/j.waojou.2025.101101","DOIUrl":"10.1016/j.waojou.2025.101101","url":null,"abstract":"<p><strong>Background: </strong>We aimed to assess knowledge of emergency department (ED) physicians regarding the classification and treatment of angioedema and to evaluate the impact of a training program on this knowledge base.</p><p><strong>Methods: </strong>A total of 11 questions about angioedema and its types were posed to ED physicians from various hospitals, either in person or via e-mail, before the implementation of an educational module on the subject (pre-test). Following a brief training period, the ED physicians were presented with the same set of questions once again (post-test). The reliability between the repeated tests were estimated using intraclass correlation coefficients (ICC). Item difficulty was calculated separately for each question in both the pre-test and post-test.</p><p><strong>Results: </strong>A total of 541 ED physicians participated in the pre-test survey, and 162 of them declined to participate in the post-test survey. The remaining 379 participated in the post-test survey as well. The ICC between the repeated tests indicated a moderate level of reliability (mean ICC = 0.5; 0.42-0.57; lower and upper 95% confidence intervals). The mean item difficulty was 0.36 in the pre-test, indicating that the items had an appropriate level of difficulty. In the post-test, the mean item difficulty increased to 0.57, suggesting that the items were generally easier, likely reflecting improved knowledge or skills following the intervention. The level of knowledge regarding the clinical features of different types of angioedema was found to be inadequate. Following the training period, there was a notable increase in the number of correct answers, with a statistically significant difference (p = 0.002). Similarly, a remarkable increase was observed in the number of respondents who indicated that bradykinin-mediated-angioedema should be considered in cases of unresponsiveness to antihistamine and-corticosteroid treatment (p < 0.001). Regarding queries about hereditary angioedema (HAE), the majority of ED physicians had no prior experience in treating a patient with HAE, and only a small number were familiar with the symptoms of HAE. Following the training ED physicians demonstrated enhanced knowledge of HAE symptoms and diagnostic criteria (p < 0.001). Similarly, a notable enhancement in familiarity with HAE attack treatments was observed when the inquiries related to these treatments were compared between the pre-test and post-test phases (p < 0.001).</p><p><strong>Conclusion: </strong>In light of the potential lethality of attacks mediated by bradykinin, a training program should include the recognition of rare types of angioedema, with a particular emphasis on HAE disease.</p>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 8","pages":"101101"},"PeriodicalIF":4.3,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876737","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 clinical characteristics and inflammatory endotypes of chronic rhinosinusitis with nasal polyps in Southern China: A multi-center, cross sectional study.","authors":"Zhaofeng Xu, Ming Lai, Xin Luo, Wenxiang Gao, Wendong Liu, Ziqi Huang, Wufuer Jiang, Xuelan Zeng, Yang Liu, Qintai Yang, Jianbo Shi, Yinyan Lai","doi":"10.1016/j.waojou.2025.101096","DOIUrl":"10.1016/j.waojou.2025.101096","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a prevalent inflammatory disease characterized by prolonged symptoms and frequent recurrences. According to clinical and pathological characteristics, patients can be classified into different endotypes. Limited data exist on the endotype distribution of CRSwNP in Southern China.</p><p><strong>Objective: </strong>This study aimed to delineate the clinical characteristics and inflammatory endotypes of CRSwNP in Southern China, with a focus on the impact of asthma and allergic comorbidities on disease severity and recurrence.</p><p><strong>Methods: </strong>This multi-center, cross-sectional study analyzed 375 adult patients with CRSwNP from 3 hospitals in Southern China. Patients were classified into type 2 and non-type 2 endotypes based on clinical criteria, including blood eosinophil counts, serum immunoglobulin E levels, and tissue eosinophil percentages. Data on demographics, clinical symptoms, comorbidities, and histopathological features were collected. Statistical analyses identified factors associated with disease severity and recurrence.</p><p><strong>Results: </strong>Among the 375 patients, 75.7% had type 2 CRSwNP. Patients with type 2 CRSwNP, particularly those with asthma, had more severe symptoms and lower quality of life scores than those with non-type 2 CRSwNP. Allergic rhinitis (AR) was associated with a higher risk of recurrence but not with disease severity. Middle-aged and older patients were more likely to exhibit type 2 features and asthma as a comorbidity.</p><p><strong>Conclusions: </strong>Type 2 CRSwNP is predominant in Southern China, with significant implications for disease management. The presence of asthma as a comorbidity exacerbates symptoms and reduces quality of life. AR as a comorbidity was not relevant to the severity of CRSwNP.</p>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 8","pages":"101096"},"PeriodicalIF":4.3,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876814","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":"High sensitization to <i>Rhizopus nigricans</i> in children with allergic asthma in Southwest China: A microfluidic chip and proteomics study.","authors":"Heping Fang, Juan Li, Xiangyu Li, Xiang Wen, Dan Zeng, Yuyi Tang, Run Wang, Na Zang, Wen Zhong, Luo Ren, Enmei Liu","doi":"10.1016/j.waojou.2025.101097","DOIUrl":"10.1016/j.waojou.2025.101097","url":null,"abstract":"<p><strong>Background: </strong>Fungi play a significant role in promoting acute exacerbations and poor control of allergic asthma (AA), particularly in children. In Southwest China, characterized by a humid and warm climate, moderate year-round fungal pollution is closely associated with the onset of childhood asthma. Despite this, little is known about the characteristics of fungal allergens in asthmatic children in this region.</p><p><strong>Objective: </strong>This study aimed to investigate fungal sensitization in children with AA and its association with AA features.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at a children's hospital in Southwest China, involving 281 AA children and 20 healthy controls. Specific IgE (sIgE) levels for 13 fungal species and 3 <i>Staphylococcal enterotoxins</i> (SEs) were measured using microfluidic chips. Olink proteomics was used to analyze plasma samples from 46 AA children to explore molecular features associated with fungal sensitization.</p><p><strong>Results: </strong>The sensitization rate to fungi and SEs in AA children was 75.4% (compared to 30% in healthy controls), with <i>Rhizopus nigricans</i> (RN) showing the highest sensitization rate at 67.3% (0% in healthy children). RN-sIgE was significantly correlated with total IgE (<i>Rho</i> = 0.76), <i>D. pteronyssinus</i>-sIgE (<i>Rho</i> = 0.67), <i>D. farinae</i>-sIgE (<i>Rho</i> = 0.67), blood eosinophil count (BEC, <i>Rho</i> = 0.26), fractional exhaled nitric oxide (FeNO, <i>Rho</i> = 0.20), and Childhood Asthma Control Test (C-ACT, <i>Rho</i> = -0.17). Proteomic analysis identified 61 upregulated plasma proteins in AA children with RN sensitization, including IL5RA, PRG2, PRSS2 and PRG3, forming a protein-protein interaction (PPI) network linked to innate immunity (53.1%) and proteolysis (21.9%). These proteins showed greater overlap with mycosis-associated proteins in the UK Biobank than with AA-associated proteins. A total IgE threshold of 395.0 kU/L statistically predicted RN sensitization with high accuracy (AUC 0.91) in this population. This was demonstrated in a case of refractory \"nonallergic\" asthma (negative for 19 common allergens) with an elevated total IgE level (461.4 IU/mL) and RN sensitization (0.72 IU/mL).</p><p><strong>Conclusion: </strong>RN sensitization is relatively common in children with AA from Southwest China and may be associated with innate immune responses and proteolysis pathways. These findings suggest a possible underappreciation of RN's role in AA, warranting further investigation.</p>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 8","pages":"101097"},"PeriodicalIF":4.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876736","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}