World Allergy Organization Journal最新文献

{"title":"Perceptions of the impact of individual allergic rhinitis symptoms: A survey of ARIA clinical experts","authors":"Sara Gil-Mata MD ,&nbsp;Tatiana Teixeira MD ,&nbsp;Anna Bedbrook BSc ,&nbsp;Jean Bousquet PhD ,&nbsp;Bernardo Sousa-Pinto PhD ,&nbsp;Rafael José Vieira MD","doi":"10.1016/j.waojou.2024.100999","DOIUrl":"10.1016/j.waojou.2024.100999","url":null,"abstract":"<div><h3>Background</h3><div>Allergic rhinitis (AR) is a highly prevalent disease. We aimed to assess the symptoms that physicians who see patients with AR perceive as the most bothersome in their patients.</div></div><div><h3>Methods</h3><div>We performed a cross-sectional study based on an online questionnaire sent to all members of the Allergic Rhinitis and its Impact on Asthma (ARIA) initiative. The survey included questions on the physicians' perceptions of patients’ AR symptoms as well as of their own AR symptoms.</div></div><div><h3>Results</h3><div>Among 401 respondents, 155 (38.7%) reported having AR. ARIA members reported nasal symptoms to be the most frequent (89.7%) and bothersome (80.0%) symptoms experienced by themselves. Likewise, nasal symptoms were reported by ARIA members as the most frequent (94.8% in members with AR vs 96.0% in members without AR) and bothersome (57.0% in members with AR vs 67.9% in members without AR) in their patients. We found a significant association (p = 0.001) between physicians’ own symptoms and those perceived as the most bothersome in their patients.</div></div><div><h3>Conclusion</h3><div>Physicians perceive nasal symptoms to be the most frequent and the most bothersome symptoms in AR patients. The physicians' personal experiences with AR may influence their perception of patients’ symptoms.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 12","pages":"Article 100999"},"PeriodicalIF":3.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882984","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":"Allergic disease and keratoconus: A two-sample univariable and multivariable Mendelian randomization study","authors":"Hanlu Xu ,&nbsp;Yajing Wen ,&nbsp;Huikang Zheng ,&nbsp;Dan Jiang ,&nbsp;Wei Chen","doi":"10.1016/j.waojou.2024.100993","DOIUrl":"10.1016/j.waojou.2024.100993","url":null,"abstract":"<div><h3>Background</h3><div>There is accumulating evidence that allergy is a risk factor for keratoconus. Nonetheless the association between allergic disease and keratoconus remains controversial. We performed a two-sample Mendelian randomization (MR) study to determine the putative causal association of 4 allergic diseases (allergic conjunctivitis, allergic asthma, allergic rhinitis and atopic dermatitis) with keratoconus.</div></div><div><h3>Methods</h3><div>Summary statistics were obtained from genome-wide association studies (GWAS) of allergic conjunctivitis (AC) (20,958 cases and 356,319 controls), allergic asthma (AA) (9631 cases and 210,122 controls), allergic rhinitis (AR) (11,009 cases and 359,149 controls), atopic dermatitis (AD) (13,473 cases and 336,589 controls), keratoconus (KC) (2116 cases and 24,626 controls) and 91 circulating inflammatory cytokines (n = 14,824). Two-sample univariable and multivariable MR analyses were performed. A two-step MR was then applied to determine whether systemic inflammatory cytokines mediated the effect of allergic disease on keratoconus.</div></div><div><h3>Results</h3><div>The causal odds ratio (OR) estimate of genetically determined KC was 1.66 (95% CI: 1.32–2.08; P &lt; 0.001) for AC, 1.29 (95% CI: 1.10–1.51, P = 0.0014) for AA, 1.39 (95% CI: 1.15–1.68; P &lt; 0.001) for AR and 1.30 (95% CI: 1.17–1.45, P &lt; 0.001) for AD. Multivariable MR indicated a suggestive association between AC and KC after conditioning on other allergic diseases (OR 1.61; 95% CI: 1.10–2.34; P adjusted = 0.054). Two-step MR revealed that the effect was not mediated by systemic inflammatory cytokines.</div></div><div><h3>Conclusions</h3><div>Our findings provide evidence of a potential causal relationship between AC and KC. The effect of AC on KC may be mediated via other systemic inflammatory cytokines not included in the present study, or by alternative mechanisms. These findings may offer insight for prevention and intervention strategies to lower the risk of KC in patients with AC.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 12","pages":"Article 100993"},"PeriodicalIF":3.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699927","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":"Comparing pharmacists versus allergists in low-risk penicillin allergy delabelling: The Hong Kong Penicillin Allergy Pharmacist Initiative (HK-PAPI)","authors":"James K.Y. Hooi MBChB ,&nbsp;Marshall C.H. Low BPharm ,&nbsp;Jonathan C.L. To BPharm ,&nbsp;Hugo W.F. Mak MBBS ,&nbsp;Mandy M. Choi BPharm ,&nbsp;Chris C.P. Tam BPharm ,&nbsp;Raymond W.M. Mak MSc ,&nbsp;Vincent K.C. Wong MPharm ,&nbsp;Timo C.C. Chan MClinPharm ,&nbsp;Andrew W.T. Li MClinPharm ,&nbsp;Charlie C.Y. Mak MClinPharm ,&nbsp;Valerie Chiang MBBS ,&nbsp;Gordon K.H. Chu MBBS ,&nbsp;Jane C.Y. Wong MBBS ,&nbsp;Philip H. Li MD","doi":"10.1016/j.waojou.2024.101003","DOIUrl":"10.1016/j.waojou.2024.101003","url":null,"abstract":"<div><h3>Background</h3><div>Mislabelled penicillin allergies are associated with a myriad of adverse outcomes and development of anti-microbial resistance. With the overwhelming need for specialist allergy services, pharmacist initiatives such as the Hong Kong Penicillin Allergy Pharmacist Initiative (HK-PAPI) have been advocated. However, evidence of their effectiveness, safety and impact on health-related quality-of-life (HR-QoL) are lacking.</div><div>To assess and compare the effectiveness, safety and improvements on HR-QoL of pharmacists vs allergists in a pilot low-risk penicillin allergy delabelling initiative.</div></div><div><h3>Methods</h3><div>All adult patients referred for low-risk penicillin allergy were randomized and evaluated by either pharmacists or allergists in a 1:3 ratio. Outcomes and changes in Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q) scores were compared.</div></div><div><h3>Results</h3><div>Of 323 patients referred, 96.3% (311/323) completed penicillin allergy evaluation (pharmacists: 83 [24.3%] vs allergists: 228 [66.7%]). Overall, 93.6% (291/311) were delabelled with no difference between evaluations by pharmacists and allergists (92.8% vs 93.9%, p = 0.729). There were no severe or systemic reactions in either cohort. Patients evaluated by either pharmacists (43.4 [SD:29.1] to 10.5 [SD:5.93], p &lt; 0.001) or allergists (37.2 [SD:22.2] to 29.1 [SD:22.4], p &lt; 0.001) reported improved HR-QoL as reflected by DrHy-Q scores. However, absolute changes in DrHy-Q scores were significantly greater among patients evaluated by pharmacists compared to those by allergists (−24.6 [SD:25.1] vs −9.19 [SD:13.7], p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Evaluations and delabelling by pharmacists (vs allergists) were comparably effective and safe among patients with low-risk penicillin allergy. Moreover, patients evaluated by pharmacists even reported significantly greater improvements in HR-QoL, highlighting the potential of multidisciplinary allergy initiatives.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 12","pages":"Article 101003"},"PeriodicalIF":3.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699934","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":"Levels of total IgE versus specific IgE during childhood for defining and predicting T2-high asthma","authors":"Tamo Sultan MD ,&nbsp;Frederikke Skov MD ,&nbsp;Nicklas Brustad MD, PhD ,&nbsp;Nilo Vahman MD, PhD ,&nbsp;Jakob Stokholm MD, PhD ,&nbsp;Klaus Bønnelykke MD, PhD ,&nbsp;Ann-Marie Malby Schoos MD, PhD, DMSc ,&nbsp;Bo Chawes MD, PhD, DMSc","doi":"10.1016/j.waojou.2024.100994","DOIUrl":"10.1016/j.waojou.2024.100994","url":null,"abstract":"<div><h3>Background</h3><div>T2-high asthma is characterized by elevated blood eosinophils (b-eos), and/or fractional exhaled nitric oxide (FeNO), and/or being “allergy-driven”, which is not well-defined.</div></div><div><h3>Objective</h3><div>To investigate the role of total and specific immunoglobulin E (tIgE/sIgE) for defining and predicting T2-high asthma in childhood as biomarkers of “allergy-driven”.</div></div><div><h3>Methods</h3><div>We utilized data from the COPSAC2000 (n = 411) and COPSAC2010 (n = 700) mother-child cohorts with repeated measurements of tIgE, sIgE, b-eos and FeNO through childhood. We defined T2-high asthma by elevated b-eos (≥0.3 × 10⁹/L) and/or FeNO (≥20 ppb) and analyzed association with elevated tIgE (age-specific cut-offs) and sIgE (≥0.35 kU/L) using logistic regression at ages 7/10/13/18 years. Further, we analyzed the association between elevated tIgE and sIgE at age 0–4 years and later risk of T2-high asthma using logistic regression and ROC models.</div></div><div><h3>Results</h3><div>Elevated tIgE was associated with risk of T2-high asthma at all time points, whereas elevated sIgE showed similar results at ages 10/13/18 years. There was no overall model fit preference for a combination of tIgE and sIgE instead of tIgE or sIgE alone using Vuong's Likelihood-Ratio-Test, Akaike or Bayesian Information Criterion. Further, elevated tIgE at age 0–4 years was associated with later risk of T2-high asthma at all time points (AUC = 0.63–0.70, sensitivity = 0.62–0.81, specificity = 0.57–0.78), whereas elevated sIgE at 0–4 years was only associated with T2-high asthma at 18 years (AUC = 0.66, sensitivity = 0.45, specificity = 0.88). There were no significant differences in AUC values between tIgE and sIgE (DeLong's test).</div></div><div><h3>Conclusion</h3><div>Elevated tIgE and sIgE are equally useful stand-alone biomarkers for defining and predicting risk of T2-high asthma in childhood.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 12","pages":"Article 100994"},"PeriodicalIF":3.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699930","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":"Dissecting the pathogenic effects of smoking in blood DNA methylation on allergic diseases","authors":"Junhao Tu PhD, MD ,&nbsp;Wei Wan PhD, MD ,&nbsp;Binxiang Tang MSc ,&nbsp;Fan Jiang MSc ,&nbsp;Jinyang Wen PhD, MD ,&nbsp;Qing Luo PhD, MD ,&nbsp;Jing Ye PhD, MD","doi":"10.1016/j.waojou.2024.100995","DOIUrl":"10.1016/j.waojou.2024.100995","url":null,"abstract":"<div><h3>Background</h3><div>Allergic diseases, such as asthma and allergic rhinitis, present significant health challenges globally. Elucidating the genetic and epigenetic foundations is crucial for developing effective interventions.</div></div><div><h3>Methods</h3><div>We performed two-sample Mendelian Randomization (MR) analyses to investigate the associations between smoking behaviors and various allergic diseases, leveraging data from the FinnGen database. Additionally, we examined the relationships of DNA methylation (CpG sites) with allergic diseases, employing mQTLs as epigenetic proxies. Furthermore, we conducted reverse MR analyses on CpG sites that exhibited cross-allergic disease effects.</div></div><div><h3>Results</h3><div>In our genomic MR analysis, smoking behaviors such as smoking initiation and the number of cigarettes smoked per day were identified to be causally associated with an increased risk of asthma. Additionally, there was suggestive evidence linking smoking initiation to atopic contact dermatitis. Our epigenetic MR analysis found that methylation changes at 46 CpG sites, assessed via mQTLs, were significantly associated with asthma risk. Notably, cg17272563 (PRRT1), cg03689048 (BAT3), cg20069688 (STK19), and cg20513976 (LIME1) were identified with cross-allergic effects. Crucially, reverse MR analysis substantiated these associations.</div></div><div><h3>Conclusions</h3><div>Our study has highlighted the associations between smoking behaviors and allergic diseases in the genetic and epigenetic landscape, notably asthma. We identified several DNA methylation-related CpG sites, such as cg03689048 (BAT3), cg17272563 (PRRT1), and cg20069688 (STK19), which demonstrate cross-allergic potential and reverse causal relationships.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 12","pages":"Article 100995"},"PeriodicalIF":3.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699928","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":"Longitudinal multi-trajectory phenotypes of severe eosinophilic asthma on type 2 biologics treatment","authors":"Duong Duc Pham, MD, PhD ,&nbsp;Ji-Hyang Lee, MD, PhD ,&nbsp;Hyouk-Soo Kwon, MD, PhD ,&nbsp;Woo-Jung Song, MD, PhD ,&nbsp;You Sook Cho, MD, PhD ,&nbsp;Hyunkyoung Kim, MSc ,&nbsp;Jae-Woo Kwon, MD, PhD ,&nbsp;So-Young Park, MD, PhD ,&nbsp;Sujeong Kim, MD, PhD ,&nbsp;Gyu Young Hur, MD, PhD ,&nbsp;Byung Keun Kim, MD, PhD ,&nbsp;Young-Hee Nam, MD, PhD ,&nbsp;Min-Suk Yang, MD, PhD ,&nbsp;Mi-Yeong Kim, MD, PhD ,&nbsp;Sae-Hoon Kim, MD, PhD ,&nbsp;Byung-Jae Lee, MD, PhD ,&nbsp;Taehoon Lee, MD, PhD ,&nbsp;So Young Park, MD, PhD ,&nbsp;Min-Hye Kim, MD, PhD ,&nbsp;Young-Joo Cho, MD, PhD ,&nbsp;Tae-Bum Kim, MD, PhD","doi":"10.1016/j.waojou.2024.101000","DOIUrl":"10.1016/j.waojou.2024.101000","url":null,"abstract":"<div><h3>Background</h3><div>Limited understanding exists regarding the progression trajectory of severe eosinophilic asthma (SEA) patients on type 2 biologics therapies.</div></div><div><h3>Objective</h3><div>We aim to explore distinct longitudinal phenotypes of these patients based on crucial asthma biomarkers.</div></div><div><h3>Methods</h3><div>We enrolled 101 adult patients with SEA. Of these, 51 were treated with anti-IL5/IL5Rα or anti-IL5/IL5RαR antibody, and 50 with anti-IL-4Rα antibody. Multi-trajectory analysis, an extension of univariate group-based trajectory modeling, was used to categorize patients based on their trajectories of forced expiratory volume in 1 s (FEV₁), blood eosinophil counts (BEC), and fractional exhaled nitric oxide (FeNO) levels at baseline, and after 1, 6, and 12 months of treatment. Associations between trajectory-based clusters and clinical parameters were examined.</div></div><div><h3>Results</h3><div>Among anti-IL5/IL5Rα antibody-treated patients, 2 clusters were identified. The cluster characterized by higher baseline BEC and lower FEV₁ showed a better response, with improvements in FEV₁ and reductions in BEC over time. Among anti-IL-4Rα antibody-treated, 3 clusters were identified. Clusters with moderate BEC and FeNO at baseline demonstrated better improvements in FEV₁ and reductions in FeNO, despite increased BEC during follow-up. Conversely, individuals with extremely low FeNO and high BEC at baseline were more likely to experience poorer progression, demonstrating an increase in FeNO and a reduction in FEV₁.</div></div><div><h3>Conclusion</h3><div>To optimally monitor treatment response in SEA patients on type 2 biologics, integrating longitudinal biomarker features is essential.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 12","pages":"Article 101000"},"PeriodicalIF":3.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699929","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":"Evaluating clinical importance of sensitization to Ara h 6 quantitively in Japanese children","authors":"Sakura Sato MD ,&nbsp;Noriyuki Yanagida MD, PhD ,&nbsp;Ken-ichi Nagakura MD, PhD ,&nbsp;Kyohei Takahashi MD, PhD, MPH ,&nbsp;Magnus P. Borres MD, PhD ,&nbsp;Motohiro Ebisawa MD, PhD","doi":"10.1016/j.waojou.2024.101001","DOIUrl":"10.1016/j.waojou.2024.101001","url":null,"abstract":"<div><h3>Background</h3><div>The clinical importance of sensitization to <em>Arachis hypogaea</em> 6 (Ara h 6) in Japanese children remains unelucidated. We aimed to quantitatively evaluate the clinical importance of sensitization to Ara h 6 in managing peanut allergy in Japanese children.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the data of children with or without symptoms induced by an oral food challenge or home dosing of up to 3 g of peanuts. The specific immunoglobulin E (sIgE) levels against peanuts, Ara h 2, and Ara h 6 were quantified using an ImmunoCAP assay.</div></div><div><h3>Results</h3><div>We examined 273 patients aged 4.6–9.8 years (median 6.3); 189 (69%) were male, 187 (68%) had allergies to peanuts, and 43 (16%) had anaphylactic reactions to peanuts. Ara h 6 and Ara h 2 co-sensitization was observed in 224 patients (82%). Ara h 6-sIgE levels were significantly associated with the probability of allergic reactions and anaphylaxis. The 95% probability of allergic reactions to peanuts was obtained at 44.5 kU_A/L of Ara h 6-sIgE, but the 95% probability of anaphylaxis could not be calculated. A combination of Ara h 6 and Ara h 2 could not improve diagnostic accuracy for allergic reactions and anaphylaxis to peanuts.</div></div><div><h3>Conclusion</h3><div>Sensitization to Ara h 6 played an important role in managing peanut allergy in Japanese children, and sIgE levels provided valuable predictive information for allergic reactions to peanuts. However, the measurement of Ara h 6 did not improve the diagnostic accuracy of anaphylaxis, and Ara h 2 alone might be sufficient for clinical evaluation in peanut allergy.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 12","pages":"Article 101001"},"PeriodicalIF":3.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A global survey addressing sustainability of pollen monitoring","authors":"Divya Dwarakanath BSc, MPhil ,&nbsp;Andelija Milic BSc, PhD ,&nbsp;Paul J. Beggs BSc, PhD ,&nbsp;Darren Wraith BCom, GradDipHE, BMath, PhD ,&nbsp;Janet M. Davies BSc, PhD","doi":"10.1016/j.waojou.2024.100997","DOIUrl":"10.1016/j.waojou.2024.100997","url":null,"abstract":"<div><h3>Background</h3><div>Contemporary airborne pollen records underpin environmental health warnings, yet how pollen monitoring networks are sustained is poorly understood. This study investigated by whom and how pollen monitoring sites across the globe are managed and funded.</div></div><div><h3>Methods</h3><div>Coordinators listed in the Worldwide Map of Pollen Monitoring Stations were invited to complete a digital questionnaire designed to survey the people and organisations involved, types, and duration of funding sources, as well as uses, purpose, and sharing of pollen information. Quantitative data were analysed by descriptive statistics and open text responses were examined by qualitative thematic analysis.</div></div><div><h3>Results</h3><div>Eighty-four of 241 (35%) coordinators from 37 countries responded. Universities (42%) and hospitals/health services (29%) were most commonly responsible for monitoring. Most sites involved employees (87%) in pollen monitoring, of whom many were part-time (41%) or casual (11%), as well as students (29%) and volunteers (6%). Pollen monitoring was additional to core duties for over one-third of sites (35%), and 25% reported pollen monitoring was an in-kind contribution. Whilst funding for pollen monitoring was often sourced from government agencies (33%), government research grants (24%), or non-government grants (8%), 92% reported more than 1 funding source, and 99% reported dependence on “partnerships or grants requiring co-contributions”, indicating a complex resourcing structure, of short duration (median 3 years). Common reasons why airborne pollen was monitored included clinical allergy, population environmental health, aerobiology and forecasting. Climate change, research, and social duty were also referenced.</div></div><div><h3>Conclusions</h3><div>Aerobiological monitoring is currently sustained by complex, insecure, and insufficient resourcing, as well as reliance on volunteerism. There are multiple direct, health-related, and other important uses of aerobiology data, that are aligned to multiple dimensions of sustainability. Evidence from this study can be used to inform the design of strategies to sustain the generation of aerobiology data.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 12","pages":"Article 100997"},"PeriodicalIF":3.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of guidelines for the management of atopic dermatitis in children","authors":"Maya Deva MBBS ,&nbsp;Merryn J. Netting PhD ,&nbsp;Jemma Weidinger MN, NP ,&nbsp;Roland Brand FACD ,&nbsp;Richard KS. Loh FRACP ,&nbsp;Sandra L. Vale PhD","doi":"10.1016/j.waojou.2024.100989","DOIUrl":"10.1016/j.waojou.2024.100989","url":null,"abstract":"<div><div>Atopic dermatitis (AD) is a chronic disease that is increasing in prevalence, particularly in children and people with skin of colour. Current management involves topical treatments, phototherapy and immunosuppressants, as well as newer therapies like dupilumab. Health professionals should also be aware of the specific management considerations for AD in people with skin of colour. This systematic review was conducted to examine global guidelines for the management of AD in children, compare management recommendations, examine specific recommendations for children with skin of colour, and assess the quality of the guidelines.</div><div>The databases Medline, Embase, CINAHL, Scopus, Guidelines International Network, and Emcare Nursing and Allied Health were searched to identify guidelines or articles relating to the management of AD in children from 1990 to 2023. A grey literature search was also undertaken. The recommendations from the guidelines were extracted and compared, and the quality of the guidelines was assessed using the Appraisal Guidelines for Research and Evaluation (AGREE) II tool.</div><div>A total of 1644 articles were identified from the initial search. Title and abstract screening, full text screening, and reference checking yielded 28 guidelines for the final appraisal and data extraction. The main variations in management recommendations were the timing of emollients, bleach baths, bath additives, oral antihistamines, and the age cut-offs for topical calcineurin inhibitors. Many guidelines were not updated to reflect newer therapies like dupilumab and topical phosphodiesterase-4 (PDE4) inhibitors. There were minimal recommendations regarding management of skin of colour. Only 12/28 guidelines met the satisfactory cut-off score for the AGREE II appraisal, largely due to a lack of well-documented methodology.</div><div>This review showed that the recommendations for AD management in skin of colour were consistently lacking. Despite generally consistent management strategies over the last 5 years, less than half of the guidelines met high-quality criteria, emphasising the importance of using tools like AGREE II in future guideline development.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 12","pages":"Article 100989"},"PeriodicalIF":3.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662832","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 allergen immunotherapy efficacy based on early maintenance phase response in routine clinical practice","authors":"Rundong Qin MD ,&nbsp;Wanyi Fu Ph.D ,&nbsp;Renbin Huang MD ,&nbsp;Mo Xian MD,&nbsp;Yubiao Guo MD,&nbsp;Li He MD,&nbsp;Xu Shi MD,&nbsp;Jing Li MD","doi":"10.1016/j.waojou.2024.100986","DOIUrl":"10.1016/j.waojou.2024.100986","url":null,"abstract":"<div><h3>Background</h3><div>While allergen-specific immunotherapy (AIT) is acknowledged as an effective treatment, its efficacy varies, and consensus on predictive indicators for AIT responders remains elusive.</div></div><div><h3>Objective</h3><div>This study aimed to identify alternative parameters for predicting AIT responders based on clinical data collected in daily practice.</div></div><div><h3>Method</h3><div>We conducted a retrospective analysis of patients with house-dust-mite-driven asthma and/or rhinitis who completed 3 years of subcutaneous AIT (3y-AIT). We assessed the efficacy of AIT using the estimated daily symptom and medication score (edSMS) during different treatment periods, including up-dosing, maintenance I, II, and III phases. These scores were derived from detailed records of symptoms and medication use for AIT injections. A responder was defined as an individual with a reduction in edSMS of at least 30% from up-dosing to maintenance III phase (ΔedSMS_U-M3).</div></div><div><h3>Results</h3><div>A cohort of 133 patients was analyzed, revealing a significant overall improvement in the disease condition after 3y-AIT. Responders demonstrated lower rates of polysensitization, daily tobacco smoke exposure, and milder pretreatment disease severity compared to non-responders (p = 0.003, p = 0.001, and p = 0.019, respectively). We observed 8 clinical response patterns among included subjects, but only a small group of patients (16/133, 12.03%) demonstrated consistent improvement throughout the 3y-AIT. Serum total immunoglobulin E (tIgE), specific immunoglobulin E (sIgE), sIgE/tIgE ratios, and edSMS during the up-dosing phase failed to differentiate the clinical response patterns or correlate with 3y-AIT efficacy. Notably, the reduction in edSMS from up-dosing phase to maintenance I phase (ΔedSMS_U-M1) significantly associated with the 3y-AIT outcome (r = 0.443, p &lt; 0.001). Receiver-operating characteristic curves indicated that ΔedSMS_U-M1, with a cut-off of 18.40%, effectively predicted responders (AUC: 0.75, sensitivity: 76.20%, specificity: 76.70%).</div></div><div><h3>Conclusion</h3><div>The individualized clinical responses to AIT may pose challenges in identifying predictors for treatment efficacy. Nonetheless, despite this complexity, our study highlights that the effectiveness observed in the early maintenance phase serves as a suitable predictor of 3y-AIT outcomes.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"17 12","pages":"Article 100986"},"PeriodicalIF":3.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662831","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}