Frontiers in allergy最新文献

{"title":"Innovative diagnostic techniques and their clinical implications in food allergy: current clinical practice and future perspectives.","authors":"Carlo Maria Rossi, Stefania Merli, Linda Borgonovo, Michelle Giardina, Monarita Yacoub, Baoran Yang, Francesca Losa, Fabio Lodi Rizzini, Serena Nannipieri, Marta Piantanida, Patrizia Pignatti, Donatella Preziosi, Federica Rivolta, Andrea Toniato, Serena Traversi, Alessandro Vrenna, Martina Votto, Antonio Di Sabatino, Vincenzo Patella","doi":"10.3389/falgy.2026.1835353","DOIUrl":"10.3389/falgy.2026.1835353","url":null,"abstract":"<p><p>Food allergy (FA) is an immune-mediated adverse reaction to food components (mainly proteins) and represents an increasing global health problem, affecting millions of individuals and imposing substantial clinical, psychosocial, and economic burdens. Accurate diagnosis is essential to prevent life-threatening reactions while avoiding unnecessary dietary restrictions and impaired quality of life. Current diagnostic approaches rely on clinical history, skin prick tests (SPT), measurement of serum allergen-specific IgE (sIgE), and oral food challenges (OFC). However, SPT and sIgE are highly sensitive but lack specificity, frequently identifying clinically irrelevant sensitization, whereas OFC remains the diagnostic gold standard despite being resource-demanding and carrying a substantial risk of systemic reactions. In recent years, several innovative diagnostic approaches have emerged with the aim of improving diagnostic accuracy and reducing reliance on OFC. Component-resolved diagnostics (CRD) enable detailed characterization of molecular sensitization profiles, supporting improved risk stratification and identification of clinically relevant cross-reactivity patterns. Functional cellular assays, including the basophil activation test (BAT) and the mast cell activation test (MAT), offer direct assessment of IgE-mediated effector cell responses and have demonstrated higher diagnostic specificity compared with conventional testing. Epitope-specific IgE profiling and the allergen-specific IgG4/IgE ratio may additionally contribute to a better understanding of disease phenotype and evolution. Furthermore, advances in multi-omics technologies combined with artificial intelligence and machine learning are creating new opportunities for biomarker discovery and predictive modelling in FA. This narrative review summarizes current innovative diagnostic techniques in food allergy, discussing their clinical applications, limitations, and future directions toward more precise and personalized diagnostic approaches.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1835353"},"PeriodicalIF":3.4,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The forgotten billion: bridging the global allergy care chasm through scalable, equity-driven strategies.","authors":"Sheng-Guang Li, Lina Zhang, Jing Zhang, Ji Li, Yadan Zou, Ting Long, Ruohan Yu, Yanfeng Zhang","doi":"10.3389/falgy.2026.1823900","DOIUrl":"10.3389/falgy.2026.1823900","url":null,"abstract":"<p><strong>Background: </strong>Allergic diseases affect more than one billion people globally, yet care access is profoundly unequal. The \"forgotten billion\" refers to underserved populations-especially in LMICs and marginalized groups within high-income countries-who face disproportionate morbidity and preventable deaths due to gaps in diagnosis, essential medicines, immunotherapy and biologics, trained workforce, and policy prioritization.</p><p><strong>Objective: </strong>To synthesize recent (2014-2026) evidence on global burden and inequities in allergic disease care, analyze system-level gaps, review scalable innovations, present diverse case studies, and propose prioritized recommendations, monitoring frameworks, and a research and financing agenda.</p><p><strong>Methods: </strong>We conducted a structured narrative review of peer-reviewed literature and global guidance documents, focusing on burden metrics (prevalence, DALYs, mortality), access indicators, interventions (task-sharing, telemedicine, point-of-care tools, immunotherapy access, digital health, procurement/policy levers), and implementation science frameworks. Sources prioritized include WHO materials and guideline bodies (GINA, ARIA, EAACI), plus global reports and primary studies.</p><p><strong>Results: </strong>Asthma illustrates the equity chasm: in 2019 it caused approximately 21.6 million DALYs and approximately 461,000 deaths globally, with approximately 90% of burden borne in LMICs and most deaths occurring in LMICs. Systematic reviews show essential inhaled asthma medicines-especially inhaled corticosteroids (ICS) and ICS-containing combinations-are often unavailable or unaffordable in LMICs. Scalable strategies with documented impact include task-shifted care packages (Malawi), standardized primary care training (South Africa), community health worker home visiting (Boston), and public-sector access programs (Brazil), alongside national allergy strategies (Finland).</p><p><strong>Conclusions: </strong>Closing the allergy care chasm requires shifting from specialist-centric innovation to systems-first equity: universal access to essential medicines and equitable pathways to targeted therapies for severe disease, standardized primary care delivery with task-sharing, market-shaping and pricing policy reform, digitally enabled self-management designed to reduce (not widen) inequities, and integrated environmental action. Implementation must be measured with equity-sensitive frameworks and supported by durable financing aligned with UHC and NCD agendas.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1823900"},"PeriodicalIF":3.4,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cat exposure and asthma outcomes in a cohort of children with asthma and allergy.","authors":"Resthie R Putri, Cecilia Lundholm, Anna Hedman, Mwenya Mubanga, Hanna Karim, Jon R Konradsen, Catarina Almqvist","doi":"10.3389/falgy.2026.1840756","DOIUrl":"10.3389/falgy.2026.1840756","url":null,"abstract":"<p><strong>Introduction: </strong>The impact of current pet exposure on children with allergic asthma is not yet fully understood. This study aimed to investigate the association between cat exposure and asthma outcomes in children with established asthma and allergy.</p><p><strong>Methods: </strong>A population-based cohort study using Swedish national health, sociodemographic, and quality registers was conducted. We included 30 277 children aged 4-17 years (born 2006-2020), with validated diagnoses of asthma and allergy, who had asthma care during the two years preceding exposure assessment. Cat exposure was defined as parental cat ownership recorded in the National Cat Register in 2023. Asthma outcomes, assessed during 2023-2024, included: asthma exacerbation and moderate-to-severe asthma. In a subset with available data (<i>n</i> = 1428), Forced Expiratory Volume in 1 Second (FEV₁) and asthma control test (ACT) were evaluated. Odds ratios (ORs) were adjusted for sex, age, initial asthma severity, baseline airway allergy severity, parental asthma and allergy, population density, parental birth country, and socioeconomic status.</p><p><strong>Results: </strong>Of the study population (median age: 9.5 years, 39% females), 9.4% (<i>n</i> = 2,862) had cat exposure. Initial asthma severity was comparable between the cat-exposed and non-exposed groups (19.5% vs. 20.6% with moderate-to-severe asthma). Asthma exacerbation occurred in 3.3% of the cat-exposed group vs. 3.5% of the non-exposed group (adjusted OR: 1.12, 95% CI: 0.90-1.39). Moderate-to-severe asthma was observed in 9.6% vs. 10.1% (adjusted OR: 0.96, 0.84-1.10). No significant differences were found in ACT or FEV₁ z-scores. Within the cat-exposed group, no association between the number of cats, cat sex, or age and asthma outcomes was observed.</p><p><strong>Conclusion: </strong>In this cohort of children with asthma and allergy, no association between cat exposure and asthma exacerbations, severity, lung function, or asthma control was observed. These findings suggest that cat exposure may not adversely affect asthma outcomes in this population.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1840756"},"PeriodicalIF":3.4,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective effects of sodium hyaluronate nasal spray on murine nasal mucosa via preservation of airway surface liquid and mucociliary clearance.","authors":"Weizheng Zhao, Jinqi Lang, Yongtai Wang, Liwei Sun, Jiani Li, Cuida Meng, Dongdong Zhu","doi":"10.3389/falgy.2026.1866527","DOIUrl":"10.3389/falgy.2026.1866527","url":null,"abstract":"<p><strong>Background: </strong>Saline nasal irrigation is widely used in the management of nasal diseases; however, its inability to replicate the physicochemical properties of airway surface liquid (ASL) may limit its long-term efficacy. We aimed to investigate the protective mechanisms of sodium hyaluronate (hyaluronic acid, HA) nasal spray on the nasal mucosa and to compare its effects with conventional saline.</p><p><strong>Methods: </strong>BALB/c mice were subjected to intranasal mugwort allergen exposure and treated with either saline or sodium hyaluronate nasal spray for 1-7 days. Behavioral assessments and nasal crusting scores were recorded. Cytokine levels (IL-4, IL-25, IL-33, TSLP) were quantified using ELISA. Histological analyses (H&E, PAS, Alcian Blue) and immunohistochemistry (ZO-1, Occludin) were performed. <i>Ex vivo</i> mucociliary clearance (MCC) was assessed under different liquid environments.</p><p><strong>Results: </strong>HA treatment significantly reduced nasal scratching and attenuated crust formation following prolonged allergen exposure. This was accompanied by suppression of Th2 cytokines and epithelial-derived alarmins in both nasal mucosa and serum. HA preserved mucus layer thickness and goblet cell density and significantly delayed the decline in MCC. Tight junction protein expression remained unchanged.</p><p><strong>Conclusion: </strong>Sodium hyaluronate nasal spray confers mucosal protection primarily through preservation of ASL homeostasis and MCC function rather than modulation of epithelial tight junctions. These findings highlight HA as a promising alternative to saline for long-term management of nasal mucosal disorders.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1866527"},"PeriodicalIF":3.4,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrative skin-blood transcriptomic analysis identifies circulating biomarkers reflecting disease activity in atopic dermatitis.","authors":"Alberto Fernández-Bernaldez, Ana Jiménez-Sánchez, Pablo Chicharro, Celia González-Agudo, Fátima Sánchez-Cabo, Alicia Vara, Mar Llamas-Velasco, Manuel José Gómez, Hortensia de la Fuente","doi":"10.3389/falgy.2026.1837776","DOIUrl":"10.3389/falgy.2026.1837776","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD) is characterized by complex immune dysregulation primarily studied in lesional skin. Identifying circulating molecular signatures that mirror cutaneous inflammation could enable non-invasive disease monitoring.</p><p><strong>Methods: </strong>Transcriptomic data from lesional skin and peripheral blood T lymphocytes of patients with AD were analyzed using differential expression, pathway enrichment, upstream regulator prediction, and protein-protein interaction network modeling. Genes dysregulated in both compartments were prioritized and validated in serum samples from patients with moderate-to-severe AD.</p><p><strong>Results: </strong>Despite limited concordance at the individual gene level, skin and blood shared a common inflammatory regulatory landscape, including activation of Th2- and Th17-related cytokine signaling, together with a consistently prediction of ESR1 inhibition across both compartments. Network analysis identified key hub genes and a neuro-immune signaling module. Among shared molecules, serum S100A8 levels positively correlated with disease severity, while SOCS3 showed a negative association. LCN2 and CTLA4 displayed trends toward correlation.</p><p><strong>Conclusions: </strong>Systemic molecular alterations in AD partially reflect cutaneous inflammation and support circulating S100A8 and SOCS3 as potential biomarkers of disease activity.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1837776"},"PeriodicalIF":3.4,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An immunodominance perspective on a paradoxical phenomenon: discovery and modeling of ragweed and tree sensitization as negative predictors for high mugwort IgE reactivity.","authors":"Yuqiao Zhang, Xiyuan Yan, Fengxia Yang, Shurong Li, Xueliang Shen, Ruixia Ma","doi":"10.3389/falgy.2026.1758315","DOIUrl":"10.3389/falgy.2026.1758315","url":null,"abstract":"<p><strong>Background: </strong>Mugwort allergy poses a significant disease burden in Northwestern China. While sensitization to mugwort can be confirmed through specific IgE testing, the immunological factors that influence the intensity of the IgE response among sensitized individuals remain poorly understood. This study aimed to explore whether sensitization profiles to other common inhalant allergens are associated with the magnitude of mugwort-specific IgE responses in already-sensitized patients, and to characterize the patterns of co-sensitization that may reflect underlying immune mechanisms.</p><p><strong>Methods: </strong>In this retrospective retrospective study, we enrolled 635 mugwort-sIgE-positive patients from a tertiary hospital. Levels of sIgE to multiple inhalant allergens, including ragweed, trees, and dust mites, were measured. The least absolute shrinkage and selection operator (LASSO) regression identified the most predictive features for high mugwort IgE reactivity (grade ≥4). An XGBoost model was developed and validated on a temporal validation set (<i>n</i> = 159). Model interpretability was achieved using SHapley Additive exPlanations (SHAP), and a clinical nomogram was constructed.</p><p><strong>Results: </strong>Three features-ragweed, tree, and dust mite sIgE concentrations-were selected, all exhibiting negative coefficients. The XGBoost model demonstrated excellent discrimination, with an AUC of 0.851 (95% CI: 0.781-0.919) on the test set and 0.827 on the temporal validation set. SHAP analysis revealed the counterintuitive, negative predictive effects of these allergens on high mugwort reactivity, supporting an immunodominance-based \"molecular masking\" hypothesis. The derived nomogram and risk stratification system effectively stratified patients, with the high-risk group having an actual positive rate of 85%. Decision curve analysis confirmed the clinical utility of the model.</p><p><strong>Conclusion: </strong>From an immunodominance perspective, we discovered and modeled sensitization to ragweed, trees, and dust mites as negative predictors for high mugwort reactivity. The interpretable machine learning model provides a precise tool for early identification and stratified management of high-risk mugwort-allergic patients.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1758315"},"PeriodicalIF":3.4,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13287044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemoglobin-to-Red cell distribution width ratio and asthma risk: cross-population validation and vitamin D mediation analysis.","authors":"Yanbiao Xiao, Jun Lai, Yanglin Zhang","doi":"10.3389/falgy.2026.1819644","DOIUrl":"10.3389/falgy.2026.1819644","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to explore the association between hemoglobin-to-red blood cell distribution width ratio (HRR) and asthma risk using a large U.S. population-based cohort (NHANES), and to validate the core association in an independent Chinese clinical cohort (Ganzhou People's Hospital) to improve cross-population generalizability. The mediating role of vitamin D in the HRR-asthma association was further explored only in the NHANES discovery cohort.</p><p><strong>Patients and methods: </strong>Data from NHANES 2011-2018 and 2021-2023 (<i>n</i> = 19,140) were used as the discovery cohort. An independent clinical cohort from Ganzhou People's Hospital (<i>n</i> = 519) was used for external validation. Logistic regression models were constructed to assess the HRR-asthma association with stepwise adjustment for confounders. Variance inflation factor (VIF) was used to examine multicollinearity. Discrimination (AUC), calibration (Hosmer-Lemeshow test), and clinical utility (DCA) were evaluated. Mediation analysis was only performed in the NHANES cohort due to unavailability of vitamin D data in the clinical cohort.</p><p><strong>Results: </strong>In the NHANES cohort, fully adjusted logistic regression showed a significant inverse association between HRR and asthma (OR = 0.60, 95%CI: 0.45-0.80, <i>P</i> < 0.001), and vitamin D completely mediated this association (indirect effect <i>β</i>=0.011, <i>P</i> = 0.001). In the Ganzhou cohort, the inverse association was consistently validated (fully adjusted OR = 0.21, 95%CI: 0.06-0.75, <i>P</i> = 0.017). The HRR-integrated multivariable model showed moderate discrimination in the NHANES cohort (AUC=0.539, 95%CI: 0.528-0.551) with good calibration (<i>P</i> = 0.32). In the Ganzhou cohort, the multivariable prediction model exhibited moderate discriminatory ability (AUC=0.718, 95%CI: 0.667-0.770), whereas HRR alone showed low-to-moderate discrimination (AUC=0.375, equivalent to 0.625 for the inverse association).</p><p><strong>Conclusion: </strong>HRR is inversely associated with asthma risk across U.S. general and Chinese clinical populations. Vitamin D fully mediates the association in NHANES but could not be validated in the clinical cohort. HRR is a simple, low-cost, cross-population risk-associated component within a comprehensive clinical prediction model, rather than a standalone diagnostic marker.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1819644"},"PeriodicalIF":3.4,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13279617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serological and biochemical characterization of Aspergillus fumigatus Asp f 10 as a potential diagnostic marker in ABPA and related respiratory diseases.","authors":"Shramana Ghosh, Angira Dasgupta, Rajat Kanti Sarkar, Chandrabati Chatterjee, Mahesh Padukudru Anand, Kashinath Bhattacharya, Utpal Bakshi, Gaurab Sircar","doi":"10.3389/falgy.2026.1733299","DOIUrl":"10.3389/falgy.2026.1733299","url":null,"abstract":"<p><strong>Background: </strong><i>Aspergillus fumigatus</i> is a major cause of allergic bronchopulmonary aspergillosis (ABPA), yet diagnosis remains challenging due to overlap with other atopic conditions. Asp f 10, a secreted aspartic protease, is listed as an allergen but remains poorly characterized in terms of biochemical properties and diagnostic relevance.</p><p><strong>Methods: </strong>We profiled the <i>A. fumigatus</i> secretome under host-mimicking conditions to identify IgG-reactive proteins, followed by cloning and recombinant expression of full-length and mature Asp f 10. Biochemical stability, enzymatic activity, and serological reactivity (IgE and IgG) were evaluated using sera from patients with ABPA, steroid-unresponsive severe asthma with <i>Aspergillus</i> sensitization (SAAS), and other allergic and non-allergic controls. Diagnostic performance was assessed by ROC and linear discriminant analyses.</p><p><strong>Results: </strong>Asp f 10 was identified as an extracellular IgG-reactive protease. Recombinant mature Asp f 10 exhibited folded conformation, structural stability, and gelatinolytic activity, whereas the full-length protein lacked defined structure. Both isoforms bound patient IgE and IgG; however, only Asp f 10-specific IgG responses were significantly elevated in ABPA and SAAS. ROC analysis demonstrated excellent diagnostic capacity for IgG (AUC = 0.90), far surpassing IgE (AUC = 0.54). Despite IgE recognition, mature Asp f 10 failed to induce histamine release, suggesting limited effector activity.</p><p><strong>Conclusion: </strong>Asp f 10 is a biologically active protease, and Asp f 10-specific IgG responses provide a robust biomarker for ABPA, outperforming IgE in diagnostic accuracy. Incorporating Asp f 10 into serological panels may improve differential diagnosis of <i>Aspergillus</i>-associated respiratory diseases.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1733299"},"PeriodicalIF":3.4,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13279211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances in biomarkers for efficacy assessment in allergen-specific immunotherapy.","authors":"Hong Huang, Dan Zeng","doi":"10.3389/falgy.2026.1793591","DOIUrl":"10.3389/falgy.2026.1793591","url":null,"abstract":"<p><p>Allergen-specific immunotherapy (AIT) is a disease-modifying therapeutic approach that addresses the fundamental etiology of allergic diseases by inducing immune tolerance through modulation of the immune system. Nevertheless, assessing AIT efficacy necessitates long-term treatment, underscoring the need for reliable predictive biomarkers. This review summarizes the recent advances in biomarker research for predicting the effectiveness of AIT, including immunoglobulins, cellular parameters, functional cytokine assays, and provocation tests. This study aims to predict the efficacy of AIT treatment early by classifying and evaluating biomarkers. Combining immunoglobulins, such as sIgE and tIgE, and their ratios, along with cytokine levels (e.g., IL-10, IL-35), could be used to predict clinical efficacy and to construct a composite prediction scoring system for improved accuracy. Monitoring of changes in sIgE, sIgG4, sIgG2, cellular markers, and cellular functions (e.g., BAT, ECP, cytokines) should be implemented to assess patient adherence and guide therapy, as they are closely associated with clinical outcomes. Although multiple biomarkers show promising potential, a standardized, unified panel of biological parameters has not yet been established. Future research should integrate multi-omics technologies, combine provocation tests with clinical evaluations, and develop accurate predictive models and more reliable, stable biomarkers for the evaluation of AIT efficacy.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1793591"},"PeriodicalIF":3.4,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Millettia speciosa reprograms the lung proteome and suppresses CCL24-driven eosinophilic inflammation in allergic asthma.","authors":"Hangrui Yang, Geyuan Wu, Shuo Liang, Raona Zan, Yitao Chen, Weiwei Yuan, Hong Chen, Guiqiong Huang","doi":"10.3389/falgy.2026.1726706","DOIUrl":"10.3389/falgy.2026.1726706","url":null,"abstract":"<p><strong>Background: </strong>Asthma is a Th2-skewed inflammatory disorder characterized by eosinophilic infiltration, cytokine dysregulation, and airway remodeling. Emerging evidence highlights the role of immunometabolic pathways and the gut-lung axis in asthma pathogenesis.</p><p><strong>Methods: </strong>We investigate the therapeutic effects of Niudali (Millettia speciosa)<b>,</b> a traditional Chinese medicinal herb, in an ovalbumin-induced mouse model of allergic asthma using high-resolution data-independent acquisition (DIA) lung proteomics integrated with cytokine profiling.</p><p><strong>Results: </strong>Niudali treatment significantly alleviated airway inflammation and eosinophilic infiltration. Proteomic analysis revealed 179 differentially expressed proteins (DEPs), with a notable finding that CCL24, a key eosinophil-recruiting chemokine, was completely suppressed in Niudali-treated mice but highly expressed in the asthma model. This highlights the central role of CCL24 inhibition in the mechanism through which Niudali mitigates eosinophil-mediated inflammation.Functional enrichment analyses revealed that Niudali modulates pathways involved in complement and coagulation cascades, lipid transport, antioxidant defense, and PPAR signaling, reflecting a shift toward immune resolution and metabolic homeostasis. Network analysis identified key hub proteins, including Alb, Apoe, Apoa1, Proc, and Serpina7, which orchestrate lipid metabolism, antioxidant functions, and immune regulation. The modulation of serpins, apolipoproteins, and extracellular space-related proteins suggests a broad immunometabolic reprogramming effect. Notably, this molecular signature aligns with the gut-lung axis paradigm, potentially reflecting microbiota-mediated modulation via short-chain fatty acids (SCFAs). Consistent with proteomic findings, bronchoalveolar lavage fluid (BALF) analyses showed significant reductions in IgE, IL-4, IL-5, and IL-6<b>,</b> further confirming suppression of Th2-mediated inflammation.</p><p><strong>Conclusion: </strong>study provides proteomic evidence that Niudali treats asthma by disrupting the CCL24-eosinophil axis and rebalancing immunometabolic networks. These findings support Niudali as a promising candidate for gut-lung axis-targeted interventions in asthma and provide a systems-level framework for future microbiome metabolome integrated studies. While our findings suggest a potential link between these molecular changes and the gut-lung axis, this mechanism was not directly investigated in the present study and should therefore be considered hypothetical. Future studies incorporating microbiome and metabolomic analyses will be essential to clarify the role of gut-derived metabolites, including SCFAs, in mediating these effects.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1726706"},"PeriodicalIF":3.4,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}