{"title":"Biologics in IgE-mediated food allergy: A systematic review and meta-analysis of interventional studies","authors":"Ulugbek B. Nurmatov MSc, MPH, MD, PhD , Lucia Lo Scalzo MD , Francesca Galletta MD , Marianna Krasnenkova MD, PhD , Stefania Arasi MSc, MD, PhD , Ignacio J. Ansotegui MD, PhD , Nara Tagiyeva-Milne MD, MPH, PhD , Alessandro Fiocchi MD","doi":"10.1016/j.waojou.2025.101069","DOIUrl":"10.1016/j.waojou.2025.101069","url":null,"abstract":"<div><h3>Background and aims</h3><div>IgE-mediated food allergy (FA) is a major healthcare problem, affecting millions of children and adults worldwide. FA management usually involves elimination diets; however, there is increasing interest in alternative strategies that enable individualized optimal approaches. Yet, there is little consensus on the optimal strategies for managing FA. This review aimed to evaluate the effectiveness and safety of biologics, including omalizumab (OMA), as monotherapy or in combination with oral immunotherapy (OIT), for FA management.</div></div><div><h3>Methods</h3><div>A systematic review (SR) and meta-analysis (MA) was conducted, searching 10 international electronic databases (from their start to May 2024) for randomized controlled trials (RCTs) assessing biologics in FA patients. The outcomes were desensitization, increased tolerated dose of food allergens, sustained unresponsiveness, adverse events/reactions (ARs/AEs), quality of life (QoL) measures, immunological biomarkers, and cost-effectiveness. Data were pooled using random-effects model. The study quality was assessed by the Cochrane Risk of Bias.</div></div><div><h3>Results</h3><div>We included 11 RCTs, 2 secondary reports from earlier RCTs and 2 US National Clinical Trials with 1010 participants in total. Nine RCTs were at low, 3 at moderate, and 1 at high risk of bias. Meta-analyses demonstrated that OMA significantly improved desensitization rates and increased food tolerance thresholds compared to placebo (risk ratio (RR) 2.035, 95% CI: 1.29 to 3.22 and RR 4.90, 95% CI 2.14 to 11.20, respectively.) OMA reduced the risk of food allergic reactions (RR 0.55, 95% CI 0.36 to 0.85) without significantly increasing skin (RR = 1.09, 95% CI 0.45 to 2.65) or other adverse or severe reactions. Immunologic outcomes showed decreased hypersensitivity, a lowered allergic and inflammatory response. QoL measures improved for patients and parents with multifood oral immunotherapy. However, no studies investigated the cost-effectiveness of biologics in FA management.</div></div><div><h3>Conclusions</h3><div>Based on the existing literature and our SR and MA, OMA can be recommended for use in carefully selected patients with IgE-mediated food allergies as monotherapy. However, patient-specific factors need to be addressed to reduce the risk of food-induced allergic reactions. OMA in combination with oral immunotherapy is recommended for cow's milk allergy. For the other foods, it will be recommended based on the results of ongoing, large RCTs in the field of biologics for food allergy. In order to recommend a wider indication for use, more research is needed to evaluate optimal treatment durations, long-term outcomes, and cost-effectiveness.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 7","pages":"Article 101069"},"PeriodicalIF":3.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138607","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}
Daniel G. Lapirow MD , Sara Vogrin MBiostat , Joseph F. De Luca MBBS , Jack D. Godsell MBBS , Jason A. Trubiano MBBS, PhD
{"title":"The role of penicillin major and minor determinants in skin testing for suspected penicillin hypersensitivity","authors":"Daniel G. Lapirow MD , Sara Vogrin MBiostat , Joseph F. De Luca MBBS , Jack D. Godsell MBBS , Jason A. Trubiano MBBS, PhD","doi":"10.1016/j.waojou.2025.101063","DOIUrl":"10.1016/j.waojou.2025.101063","url":null,"abstract":"<div><h3>Background</h3><div>In the evaluation of patient-reported penicillin allergy labels (PALs), the utility of skin testing to the penicillin major determinant, known as penicilloyl polylysine (PPL), and to the minor determinant mixture (MDM), has been questioned.</div></div><div><h3>Methods</h3><div>A review of a clinical antibiotic allergy database from April 2015 to December 2023 at Austin Health (Melbourne, Australia) was performed. Patients with PALs who underwent skin prick testing (SPT) and intradermal testing (IDT) to a previously-published standardised beta-lactam panel were selected. Those with positive SPT or IDT to PPL and/or MDM were identified.</div></div><div><h3>Results</h3><div>A total of 1316 individuals were included in our analysis. Positive skin testing to any reagent was recorded for 168/1316 (12.77%). Positive results to PPL and/or MDM were recorded for 26/1316 (1.98%), including 6 with isolated positive results to PPL and/or MDM, and 20 with additional positive skin testing to at least 1 native penicillin. The number needed to test to confirm 1 additional penicillin allergy with the use of PPL and MDM was calculated at 217.39. Immediate hypersensitivities were reported by all 6 individuals testing positive to the penicillin determinants alone, including 4 with anaphylaxis.</div></div><div><h3>Conclusion</h3><div>These results suggest limited yield in the routine inclusion of PPL and MDM in skin testing panels, particularly in evaluating delayed hypersensitivities. Restricting their use to select cohorts, such as those with anaphylaxis, may prove more efficient and cost-effective.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 6","pages":"Article 101063"},"PeriodicalIF":3.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068922","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}
Anete S. Grumach MD, PhD , Marc A. Riedl MD, MS , Lei Cheng MD, PhD , Siddharth Jain MD , Daniel Nova Estepan PharmD, RPh , Andrea Zanichelli MD, PhD
{"title":"Hereditary angioedema diagnosis: Reflecting on the past, envisioning the future","authors":"Anete S. Grumach MD, PhD , Marc A. Riedl MD, MS , Lei Cheng MD, PhD , Siddharth Jain MD , Daniel Nova Estepan PharmD, RPh , Andrea Zanichelli MD, PhD","doi":"10.1016/j.waojou.2025.101060","DOIUrl":"10.1016/j.waojou.2025.101060","url":null,"abstract":"<div><div>Individuals with hereditary angioedema (HAE), a rare disease most frequently associated with deficiency (HAE-C1INH-Type1) or dysfunction (HAE-C1INH-Type2) of C1 inhibitor (C1INH), continue to experience frequent misdiagnoses and long delays in diagnosis, preventing appropriate management strategies and placing the patients at continued risk of inappropriate management of painful, debilitating, and potentially fatal swelling attacks. Physician education to increase HAE awareness is important to initiate diagnostic testing for patients who may be at risk of HAE. Standard tests for diagnosing HAE-C1INH-Type1 and HAE-C1INH-Type2 include measurements of antigenic C4 level, antigenic C1INH level, and C1INH function; in contrast, known subtypes of HAE due to normal C1INH can only be confirmed through genetic testing. Current diagnostic tests have certain limitations related to sample handling, storage, and transportation; concerns about the sensitivity and specificity of current assays have also been reported. Furthermore, the accessibility of diagnostic testing for HAE is not universal. Therefore, there is a persistent need for robust and accessible diagnostic tools for HAE. In this review, we provide an overview of currently available assays for HAE diagnosis and summarize some of the novel diagnostic tools that may aid in overcoming diagnostic challenges in HAE and supporting the care of patients with HAE.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 6","pages":"Article 101060"},"PeriodicalIF":3.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941902","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}
Matheus Fonseca Aarestrup MD , Akinori Cardozo Nagato PhD , Paula Fonseca Aarestrup MD , Edir Paula Cheloni MD , Beatriz Julião V. Aarestrup PhD , José Otávio Amaral Correa PhD , Fernando Monteiro Aarestrup MD PhD
{"title":"Using mobile technology to increase adherence to sublingual immunotherapy: Real-world study with a new app/web platform AllergyVax®","authors":"Matheus Fonseca Aarestrup MD , Akinori Cardozo Nagato PhD , Paula Fonseca Aarestrup MD , Edir Paula Cheloni MD , Beatriz Julião V. Aarestrup PhD , José Otávio Amaral Correa PhD , Fernando Monteiro Aarestrup MD PhD","doi":"10.1016/j.waojou.2025.101064","DOIUrl":"10.1016/j.waojou.2025.101064","url":null,"abstract":"<div><div>Allergen immunotherapy (AIT) is a key therapeutic approach for allergic rhinitis and asthma, demonstrating the ability to modify disease progression by targeting type 2 inflammation. This study evaluates the efficacy of a mobile application (app/web platform) AllergyVax®, designed to implement a patient-centered care (PCC) strategy to increase patient engagement in the treatment. A retrospective cross-sectional analysis was conducted with 482 patients diagnosed with respiratory allergic diseases who initiated sublingual immunotherapy (SLIT). Participants were divided into 2 groups: Group A received standard information, while Group B utilized the AllergyVax® app for managing treatment. This app provided daily reminders, evaluated symptom control through standardized questionnaires, and facilitated communication between patients and healthcare providers. Results indicated a significant increase in adherence rates among app users, with 92.11% adhering to SLIT compared to 46.32% in the non-app group. The app users exhibited a 2.42 times greater likelihood of maintaining adherence and reduced dropout rates by 82%. The AllergyVax® app improved adherence across all demographics, emphasizing the importance of innovative digital tools in enhancing patient engagement and treatment outcomes. In conclusion, this study highlights the critical role of mobile technology in promoting adherence to SLIT, suggesting that integrating digital solutions into AIT can lead to better management of allergic diseases and improved patient outcomes.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 6","pages":"Article 101064"},"PeriodicalIF":3.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937260","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}
Xuan Yu , Hejie Li , Wei Tang , Xi Lian , Wenting Yu , Ting Li , Shimin Zong , Hongjun Xiao
{"title":"Enhanced allergic Eustachian tube response in surfactant protein D knockout mice induced by ovalbumin","authors":"Xuan Yu , Hejie Li , Wei Tang , Xi Lian , Wenting Yu , Ting Li , Shimin Zong , Hongjun Xiao","doi":"10.1016/j.waojou.2025.101061","DOIUrl":"10.1016/j.waojou.2025.101061","url":null,"abstract":"<div><h3>Background</h3><div>Allergic reactions have been widely recognized as closely associated with the development of Eustachian tube dysfunction (ETD). However, the precise pathophysiological mechanisms remain unclear, and effective models to elucidate the role of allergic responses in ETD are lacking. Surfactant protein D (SPD), an important immune defense factor in the Eustachian tube (ET), not only reduces surface tension but also exhibits anti-adhesion and inflammation-regulating properties. Nevertheless, the role of SPD in allergic inflammation of the ET has not been fully explored.</div></div><div><h3>Objective</h3><div>This study aimed to investigate the morphological and functional changes in the ET induced by ovalbumin under SPD gene deficiency and to explore the underlying mechanisms.</div></div><div><h3>Methods</h3><div>Experimental models were established using C57 mice with different SPD genotypes, divided into control groups (WT-PBS and SPD-KO-PBS) and allergic groups (WT-OVA and SPD-KO-OVA). Allergic symptoms were recorded following intraperitoneal OVA injection and nasal challenges, and serum total IgE levels were measured. Histological methods were used to evaluate the number and morphological changes of eosinophils in the ET. Immunostaining was performed to analyze the secretion of Muc5b and Muc5ac. ET function was assessed by measuring passive opening pressure (POP) and comparing active clearance of negative pressure (ACNP). Mucociliary clearance (MCC) was evaluated using small-animal imaging techniques. Exogenous SPD was administered intranasally to SPD-KO-OVA mice to evaluate therapeutic effects.</div></div><div><h3>Results</h3><div>Allergic mice exhibited significant inflammatory features, including increased sneezing frequency, elevated serum IgE levels, eosinophil infiltration in the ET mucosa, goblet cell hyperplasia, and abnormal mucin secretion. Meanwhile, ACNP and MCC functions were significantly impaired. Compared with the WT-OVA group, SPD-KO-OVA mice demonstrated more severe eosinophil infiltration, thickened ET mucosa, enhanced mucus gland secretion, elevated POP, and further impaired ACNP and MCC functions, with excessive mucus accumulation in the middle ear cavity. Abnormal overexpression of Muc5ac and Muc5b may further exacerbate OVA-induced ET dysfunction. Intranasal SPD treatment significantly attenuated mucosal inflammation, reduced eosinophil infiltration and mucin production, and restored ACNP function in SPD-KO-OVA mice.</div></div><div><h3>Conclusions</h3><div>SPD plays a critical role in regulating allergic inflammation and protecting ET function. Its deficiency exacerbates OVA-induced inflammation and functional impairment of the ET, while exogenous SPD administration ameliorates tissue inflammation and restores ACNP efficacy. These findings highlight SPD as a therapeutic target for allergic ETD.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 6","pages":"Article 101061"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924084","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":"Risk factors/cofactors for heightened anaphylaxis severity in Japanese adults: A 10-year single-center retrospective cohort study","authors":"Makoto Nojo , Shintaro Suzuki , Tomoki Uno , Yoshito Miyata , Tanaka Akihiko , Hironori Sagara","doi":"10.1016/j.waojou.2025.101062","DOIUrl":"10.1016/j.waojou.2025.101062","url":null,"abstract":"<div><h3>Background</h3><div>Anaphylaxis is a severe and life-threatening allergic reaction. Although the risk factors/cofactors for anaphylaxis vary between countries and regions, limited information is available on these factors within the Japanese context. Therefore, we aimed to discern risk factors/cofactors associated with heightened anaphylaxis severity in Japanese adults.</div></div><div><h3>Methods</h3><div>In total, 507 adult patients with anaphylaxis who visited our clinic (Tokyo, Japan) between January 2010 and June 2020 were included in the analysis. Data on patient backgrounds, clinical characteristics, and causative allergens were extracted from patients’ medical records. We retrospectively analyzed information on patient background and clinical characteristics associated with an increased severity of anaphylaxis. Logistic regression modeling was used to identify background features and clinical characteristics that contribute to anaphylaxis severity.</div></div><div><h3>Results</h3><div>Multivariate analysis revealed that age, smoking history, asthma, and alcohol consumption at the onset of anaphylaxis were significant risk factors contributing to the increased severity of anaphylaxis. Moreover, drug-induced anaphylaxis was associated with heightened severity than food, anisakis and other allergens.</div></div><div><h3>Conclusion</h3><div>We successfully identified risk factors/cofactors contributing to the heightened severity of anaphylaxis among adults in Japan. Additionally, our findings suggest that alcohol consumption and smoking are related to anaphylaxis severity in adults. The insights derived from this study will assist in identifying more effective preventive measures and treatment strategies in clinical practice.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 6","pages":"Article 101062"},"PeriodicalIF":3.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924085","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}
Carlo Lombardi MD , Rikki F. Canevari MD , Diego Bagnasco MD , Maria Beatrice Bilò MD , Giorgio Walter Canonica MD , Cristiano Caruso MD , Paolo Castelnuovo MD , Lorenzo Cecchi MD , Orietta Calcinoni MD , Mauro Carone MD , Marco Cassatella MD , Renato Cutrera MD , Gianni Danesi MD , Eugenio De Corso MD , Mario Di Gioacchino MD , Fabiano Di Marco MD , Stefania Gallo MD , Matteo Gelardi MD , Enrico Heffler MD , Clara Imperatore MD , M.T. Zedda
{"title":"ARIA-Italy multidisciplinary consensus on nasal polyposis and biological treatments: Update 2025","authors":"Carlo Lombardi MD , Rikki F. Canevari MD , Diego Bagnasco MD , Maria Beatrice Bilò MD , Giorgio Walter Canonica MD , Cristiano Caruso MD , Paolo Castelnuovo MD , Lorenzo Cecchi MD , Orietta Calcinoni MD , Mauro Carone MD , Marco Cassatella MD , Renato Cutrera MD , Gianni Danesi MD , Eugenio De Corso MD , Mario Di Gioacchino MD , Fabiano Di Marco MD , Stefania Gallo MD , Matteo Gelardi MD , Enrico Heffler MD , Clara Imperatore MD , M.T. Zedda","doi":"10.1016/j.waojou.2025.101058","DOIUrl":"10.1016/j.waojou.2025.101058","url":null,"abstract":"<div><div>In recent years, it was recognized that type-2 inflammation connects nasal polyposis and severe asthma (SA) in addition to other type-2 diseases. Thus, some biological drugs developed for SA appeared to exert a favourable effect also in nasal polyposis. So far, there are several trials supporting this concept; therefore, some monoclonal antibodies already used for SA were assessed also in chronic rhinosinusistis with nasal polyposis (CRSwNP), with promising results.</div><div>Since different specialists are involved in the management of nasal polyposis (eg, pulmonologists, ENT specialists, allergists, immunologists, pediatricians), it was felt that an updated educational and informative document was needed to better identify the indications of biological therapies in nasal polyposis. We collected the main Italian scientific societies, and prepared (under the umbrella of Allergic Rhinitis and its Impact on Asthma, ARIA) a document endorsed by all societies, to provide a provisional statement for the future use of monoclonal antibodies (MAbs) as a medical treatment for polyposis, possibly associated with SA. The above mentioned document was the first endorsed document on this aspect, and the additional evidence required an update. The current pathogenic knowledge and the experimental evidence are herein reviewed, and some suggestions for a correct prescription and follow-up are provided.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 5","pages":"Article 101058"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922263","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}
Jiale Zhang Doctor of Medicine (M.D.) , Aoli Li Master of Medicine , Li Liu Master of Medicine , Bo Chang Master of Medicine , Wenting Luo Doctor of Medicine (M.D.) , Baoqing Sun Master of Medicine
{"title":"Cross-reactivity and sensitization profiles of cockroach and moth allergens provide new insights in cockroach-allergic patients","authors":"Jiale Zhang Doctor of Medicine (M.D.) , Aoli Li Master of Medicine , Li Liu Master of Medicine , Bo Chang Master of Medicine , Wenting Luo Doctor of Medicine (M.D.) , Baoqing Sun Master of Medicine","doi":"10.1016/j.waojou.2025.101057","DOIUrl":"10.1016/j.waojou.2025.101057","url":null,"abstract":"<div><h3>Background</h3><div>Inhalant insect allergens are widely implicated as common triggers of respiratory allergies, but little is known about cross-reactivity between cockroaches and other insect allergens. This study mainly investigates sensitization profiles and cross-reactivity between cockroach allergens and moth allergens to provide insights into the clinical management of cockroach-allergic patients.</div></div><div><h3>Methods</h3><div>A total of 386 suspected cockroach-sensitized patients were enrolled. Sensitization rates were determined using IgE testing for common airborne allergens. Cross-reactivity was evaluated using IgE inhibition assays, immunoblotting, and basophil activation tests. Age-related sensitization patterns were analyzed to assess variability in immune response across different demographics.</div></div><div><h3>Results</h3><div>A high frequency of silk moth was observed in cockroach-sensitized patients, with sensitization rates to German cockroach and silk moth allergens at 81.09% and 81.61%, respectively, and a high co-sensitization rate (54.66%). Age analysis revealed similar peak sensitization of German cockroach and silk moth in school-age children and young adults, with a lower prevalence in the elderly. Additionally, cockroach crude extract can inhibit the IgE-binding of cockroach-sensitized patients' sera and silk moth crude extract, while various moths can activate basophils as well.</div></div><div><h3>Conclusions</h3><div>This study highlights the similar age-related sensitization patterns between German cockroach and silk moth, differing from those observed with house dust mites. Besides, cross-reactivity between different cockroach and moth allergens was confirmed through significant IgE inhibition, multiple sequences alignment of shared epitopes and basophil activation tests. These findings highlight the need to consider cross-reactivity between cockroach and moth allergens in clinical evaluations.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 5","pages":"Article 101057"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913252","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}
Erminia Ridolo PhD , Martina Ottoni MD , Francesca Nicoletta MD , Francesca Locatelli MD , Luigi Martinelli MD , Matteo Maule MD , Naila Arif Cheema MD , Francesco Blasi PhD , Pierluigi Paggiaro MD , Enrico Heffler PhD , Luisa Brussino PhD , Giorgio Walter Canonica MD , Gianenrico Senna MD , Marco Caminati MD
{"title":"Role of body anthropometry in severe asthmatic patients: Evidences from the Severe Asthma Network in Italy (SANI) registry","authors":"Erminia Ridolo PhD , Martina Ottoni MD , Francesca Nicoletta MD , Francesca Locatelli MD , Luigi Martinelli MD , Matteo Maule MD , Naila Arif Cheema MD , Francesco Blasi PhD , Pierluigi Paggiaro MD , Enrico Heffler PhD , Luisa Brussino PhD , Giorgio Walter Canonica MD , Gianenrico Senna MD , Marco Caminati MD","doi":"10.1016/j.waojou.2025.101056","DOIUrl":"10.1016/j.waojou.2025.101056","url":null,"abstract":"<div><div>Asthma and obesity are both chronic diseases. Obesity is a common comorbidity and a risk factor of severe asthma, associated with increased asthma exacerbation risk, poorer asthma control and reduced quality of life. However, the responsible mechanisms are poorly understood. The aim of this study was to detect parameters associated with obesity in patients with severe asthma in order to check different pattern of inflammation in obese asthmatics. Baseline data from the Severe Asthma Network in Italy (SANI) registry were analysed in 1922 patients with severe asthma. Demographic, clinical and functional features were compared, according to body mass index (BMI). The prevalence of overweight and obesity among severe asthma patients was 34,8 and 20,3, respectively. Females were more prevalent in the obese cluster (p < 0.001). Asthma onset age in overweight and obese patients was higher than in normal population (p < 0.001). Obese subjects reported less frequently chronic rhinosinusitis with nasal polyposis (CRSwNP) and more frequently impaired sleep quality, cardiovascular disease, and type-2 diabetes (p < 0.001). Severe asthma patients with obesity had lower predicted FVC values (89.0 ± 19.2 vs 93.5 ± 20.2; p 0.002) and higher FEV1/FVC ratio (69.9 ± 11.5 vs 66.9 ± 12.4; p < 0.001) than patients without obesity. Obese asthmatics had lower blood eosinophilic count, and fractional exhaled nitric oxide (FeNO) levels than non-obese asthmatics. Asthma control test (ACT) was significantly poorer in obese patients (17, IQR 12–21) than other subgroups. Regarding treatment, overweight and obese patients were more likely to receive a GINA-Step 5 therapy (p 0.023), with more than 20 of obese asthmatics having frequent exacerbations requiring oral corticosteroid (OCS). Patients with severe asthma and obesity presented different characteristics that support the existence of distinct asthma phenotype in obese patients.</div></div><div><h3>Trial registration</h3><div>Trial registry: <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>. ID: NCT06625216. Retrospectively registered October 3, 2024.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 5","pages":"Article 101056"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908037","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}