Frontiers in allergy最新文献

{"title":"Study protocol for a randomized double-blinded placebo-controlled trial on ASA therapy for patients with chronic rhinosinusitis with nasal polyps, NSAID-exacerbated respiratory disease, and asthma.","authors":"Sanna Toppila-Salmi, Annina Lyly, Viljami Salmi, Mikko Nuutinen, Michael Kilpiö, Tanzeela Hanif, Mikko Niemi, Anu Laulajainen-Hongisto, Lena Hafrén, Mika Mäkelä, Paula Kauppi, Paula Virkkula, Alma Helevä","doi":"10.3389/falgy.2025.1542481","DOIUrl":"10.3389/falgy.2025.1542481","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory condition affecting the nasal passages and paranasal sinuses. It is characterized by persistent inflammation and often leads to a considerable decline in health-related quality of life (HRQoL). A subset of these patients-approximately 17.7%-have NSAID-exacerbated respiratory disease (N-ERD), a more severe form that frequently necessitates repeated sinus surgeries and rescue therapies. Compared with individuals without N-ERD, affected patients are more prone to asthma flare-ups, severe hypersensitivity reactions, and loss of smell. Treatment with acetylsalicylic acid (ASA) following desensitization (ATAD) has been suggested as a therapeutic option in cases of severe CRSwNP with N-ERD. While this approach may offer symptom improvement, decreased polyp burden, and enhanced QoL, it is not without risks, such as gastrointestinal irritation and bleeding complications. This randomized, double-blind, placebo-controlled clinical trial (RDBCT) assesses the effectiveness and safety of ATAD in comparison with placebo in patients suffering from severe CRSwNP, N-ERD, and asthma. The study explores various outcomes, including reduction in polyp burden, improvement in QoL, treatment-related side effects, and biomarker analyses derived from nasal swabs, blood, and urine samples.</p><p><strong>Methods: </strong>AirGOs Medical is an investigator-initiated RDBCT conducted at Helsinki University Hospital. Participants are randomized to receive either ATAD or placebo. The primary endpoint is the change in the SNOT-22 score observed at the 11-month follow-up. Secondary measures include variations in nasal polyp scores, CRS symptom control, general HRQoL, work productivity loss, peak nasal inspiratory flow (PNIF) with or without acoustic rhinometry (ARM), olfactory function assessed by the Sniffin' Sticks identification test, spirometry, peak expiratory flow (PEF), and histopathological findings at the 12-month follow-up.</p><p><strong>Discussion: </strong>The AirGOs Medical trial is expected to generate data on the therapeutic value and safety profile of ATAD in patients with coexisting severe CRSwNP, N-ERD, and asthma, potentially informing future clinical practice.</p><p><strong>Trial registration: </strong>[ClinicalTrials.gov], identifier [NCT03825757]. Registered on 28.2.2019.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1542481"},"PeriodicalIF":3.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217719","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":"Hereditary alpha tryptasemia and food allergy.","authors":"Abigail Lang","doi":"10.3389/falgy.2025.1583462","DOIUrl":"10.3389/falgy.2025.1583462","url":null,"abstract":"<p><p>Food allergy (FA) and hereditary alpha-tryptasemia (HαT) are both relatively common conditions, but potential associations between these diagnoses have not been well-studied. Prior studies have suggested that acute rises in tryptase following food allergy reactions may not be as significant as reactions triggered by venom or drug allergy, but preliminary evidence suggests that the presence of α-tryptase and HαT is a risk factor for more severe reactions to foods. This mini review summarizes the epidemiology and diagnostic considerations of FA for patients with co-morbid HαT, potential effect of α-tryptase on food allergy reaction severity, and implications of tryptase genotyping in the management of FA. Additional research is needed to further investigate the relationship between FA and HαT.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1583462"},"PeriodicalIF":3.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217718","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 safety and efficacy of oral immunotherapy compared to epicutaneous immunotherapy in peanut allergen desensitisation amongst the paediatric cohort-a narrative review.","authors":"Ehtesam A Chowdhury, Olivia C Jadeja","doi":"10.3389/falgy.2025.1613237","DOIUrl":"10.3389/falgy.2025.1613237","url":null,"abstract":"<p><p>Peanut allergies result from a type 1 hypersensitivity reaction, with a prevalence of approximately 1% in children under 5 years of age. The allergens that instigate this reaction are the peanut proteins (Ara h 1-Ara h 8) for which IgE antibodies are specifically produced. Allergen immunotherapy (AIT), despite the uncertainty regarding its mode of action, has been increasingly utilised with the aim of desensitisation against these allergens. AIT encompasses various modes of administration, including epicutaneous immunotherapy (EPIT) and oral immunotherapy (OIT). The review adheres to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, with a comprehensive literature search conducted using databases including MEDLINE®, Embase™, PubMed®, and Google Scholar™. Search terms targeted OIT and EPIT in the desensitisation and management of peanut allergy in children, with studies spanning the past 20 years included based on predefined eligibility criteria. The extent of the immunotherapies' efficacy and safety in children is yet to be thoroughly established; however, OIT demonstrated increased desensitisation rates amongst children when compared to EPIT. The long-term efficacy has not been fully established, with sustained unresponsiveness not reported within most studies. Both modes of administration had a high proportion of participants experiencing adverse effects (AEs), with gastrointestinal symptoms more common with OIT and cutaneous reactions with EPIT. Serious AEs were observed less frequently, however, systemic reactions such as anaphylaxis were more apparent with OIT. Future research should focus on peanut EPIT, as the literature was relatively scarce. Furthermore, research studies should assess sustained unresponsiveness to fully gauge the long-term effects of AIT in children.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1613237"},"PeriodicalIF":3.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217720","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":"Clinical characteristics and treatment of unilateral allergic fungal rhinosinusitis: a retrospective case series and literature review.","authors":"Xiaodong Chen, Jiawei Chen, Jian Wang, Min Xu, Tao Xue, Dingjun Zha, Fuquan Chen","doi":"10.3389/falgy.2025.1521574","DOIUrl":"10.3389/falgy.2025.1521574","url":null,"abstract":"<p><p>To retrospectively summarize the clinical manifestations, pathological characteristics, and efficacy of unilateral allergic fungal rhinosinusitis (AFRS), we analyzed the clinical data of 23 patients diagnosed with unilateral AFRS in a teaching hospital setting. All the patients showed positive reaction for fungal allergens via the skin prick test or serum-specific IgE test. CT scan showed lesions of the sinuses were unilateral. The average postoperative follow-up time was 72 months. Among the cases, 20 cases were cured, and 3 cases were improved. The VAS score decreased from 8.5 preoperatively to 1.1 postoperatively. The eosinophilic mucin, typical CT findings, and fungal-specific type I hypersensitivity are the three clinical features of AFRS. Endoscopic sinus surgery and oral glucocorticoids are effective treatments for AFRS.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1521574"},"PeriodicalIF":3.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210400","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":"Real world evidence of dupilumab effectiveness in a Colombian cohort of patients diagnosed with severe asthma.","authors":"Abraham Alí-Munive, Josefina Zakzuk, Nelson J Alvis-Zakzuk, Elizabeth García, Claudia Diaz Bossa, Diana Jimena Cano Rosales, Fabio Bolívar, Alejandro Carreño, Paula Rodríguez-Ordoñez, Natalia Gómez-Ardila, Gabriel Patiño, Sergio Londoño, Carlos A Torres-Duque","doi":"10.3389/falgy.2025.1564033","DOIUrl":"10.3389/falgy.2025.1564033","url":null,"abstract":"<p><strong>Background: </strong>Real-world effectiveness and safety of dupilumab for asthma treatment have been evaluated in USA and Europe, but research from Latin America is lacking. We aimed to describe the effectiveness of dupilumab in terms of changes in the annual rate of asthma exacerbations (AER) and their impact on lung function in Colombian patients.</p><p><strong>Methods: </strong>Real-world, descriptive, and multi-centric (five clinical centers located in four different cities in Colombia) retrospective study that included patients aged ≥18 years with severe asthma, as defined by the GINA criteria. Data were collected from medical records of medical centers specialized in pulmonology or allergy care) spanning from 12 months before the prescription of dupilumab (baseline) to 25 months later. Follow-up data were categorized at various time points (2-4, 5-7, 8-10, 11-13, 14-18, and 19-25 months). Main outcomes were annual rates of asthma exacerbations (emergency visits or hospitalizations due to asthma), lung function measured through FEV₁ and percent predicted FEV₁ (FEV₁pp), and Asthma Control Test (ACT) scores. Outcome rates were compared between baseline and follow-up data points. FeNO and absolute eosinophil counts throughout the observed period was also explored.</p><p><strong>Results: </strong>A total of 98 patients were included. At baseline, the mean AER was 0.61 ± 1.45 per adult. Lower AER were observed after one (0.11 ± 0.54) or two-years (0.08 ± 0.20) of dupilumab treatment (<i>p</i> = 0.03). FEV1 measurements after one or two years of dupilumab treatment were significantly lower than baseline (<i>p</i> = 0.03). Mean change from baseline in FEV₁ was 302.1 ± 481.97 ml (<i>n</i> = 19), 282.00 ± 231.99 ml (<i>n</i> = 10), and 248.18 ± 281.21 ml (<i>n</i> = 11) in the 2-4-, 11-13-, and 19-25-month follow-up periods, respectively. FEV₁pp showed higher but not significant values from the 2-4-month period, with a median change of 12.5% (IQR: 0.3, 21.5). The proportion of patients with uncontrolled asthma (ACT ≤15) decreased from 68% at baseline to 19% and 20% at year-one and second year of treatment, respectively (<i>p</i> = 0.003). The proportion of patients reaching FeNO values below 25 ppb was lower after dupilumab treatment than in baseline (<i>p</i> < 0.0001). Of the total cohort (<i>n</i> = 99), 15 (15.2%) experienced an adverse event (AE). Three patients discontinued dupilumab permanently, and two discontinued dupilumab due to AEs.</p><p><strong>Conclusions: </strong>Dupilumab is an effective and well-tolerated treatment for severe asthma in Colombia, resulting in reduced exacerbations and improved asthma control, lung function, and FeNO levels.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1564033"},"PeriodicalIF":3.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164217","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":"Defining \"Normal\" basal serum tryptase levels: a context-dependent approach to improve diagnostics in systemic mastocytosis.","authors":"Francesca Crupi, Jessica Caroprese, Francesco Mannelli","doi":"10.3389/falgy.2025.1592001","DOIUrl":"10.3389/falgy.2025.1592001","url":null,"abstract":"<p><p>Serum tryptase level has long been used as a biomarker in clinical practice to suspect mast-cell associated disorders. Basal serum tryptase (BST) above 20 ng/ml represents a minor criterion according to WHO and ICC for the diagnosis of systemic mastocytosis (SM) although normal BST value does not exclude the diagnosis. Nevertheless, BST can be elevated also due to non-SM related diseases as well as hereditary alpha-tryptasemia (H<i>α</i>T), an autosomal dominant germline condition that consists in the increase of the number of copies of the <i>TPSAB1</i> gene encoding the alpha isoform of tryptase. The prevalence of H<i>α</i>T is estimated at around 5% of the general population. Individuals with H<i>α</i>T genotype can be asymptomatic; however, some of them can experience a range of symptoms with a large variability in type and severity, posing a problem of differential diagnosis with SM. The increasing awareness on a potentially SM underlying diverse clinical manifestations has led to excessive BST testing by several specialists, a trend that risks over interpreting some borderline results. The interpretation of elevated BST should thus be carefully appraised in specific clinical contexts on individual basis. This review is intended to examine the existing literature on this topic and offers a guide for interpreting the BST to rationalize the application of invasive diagnostic procedures.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1592001"},"PeriodicalIF":3.3,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153031","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":"Multi-omics technology reveals the changes in gut microbiota to stimulate aromatic amino acid metabolism in children with allergic rhinitis and constipation.","authors":"Chunyan Wang, Haiying Liu, Xiaoli Li, Wei Kong, Hui Wu, Congfu Huang","doi":"10.3389/falgy.2025.1562832","DOIUrl":"10.3389/falgy.2025.1562832","url":null,"abstract":"<p><strong>Background: </strong>Comorbid allergic rhinitis and constipation (ARFC) in children are associated with gut microbiota (GM) dysbiosis and metabolic perturbations; however, the underlying mechanistic interplay remains unclear.</p><p><strong>Objective: </strong>This multi-omics study aimed to characterize GM and fecal metabolomic signatures in preschool ARFC children and elucidate microbial-metabolite interactions driving dual symptomatology.</p><p><strong>Methods: </strong>Fecal samples from 16 ARFC and 15 healthy control (HC) children underwent high-throughput absolute quantification 16S rRNA sequencing and untargeted metabolomics. Differential taxa and metabolites were identified via LEfSe and OPLS-DA (VIP > 1, false discovery rate (FDR) <i>q</i> < 0.05). Microbial-metabolite networks were reconstructed using genome-scale metabolic modeling and KEGG pathway analysis.</p><p><strong>Results: </strong>The ARFC group exhibited distinct β-diversity (<i>P</i> = 0.031), marked by elevated <i>Hungatella</i>, <i>Tyzzerella</i>, and <i>Bifidobacterium longum</i> (<i>P</i> < 0.05). Metabolomics revealed upregulated aromatic amino acids (AAAs), neurotransmitters, and bile acids (FDR <i>q</i> < 0.05), with enrichment in tryptophan/tyrosine pathways (<i>P</i> < 0.01). Bioinformatic modeling linked <i>Hungatella</i> to tryptophan hydroxylase (EC:1.14.16.4), driving serotonin synthesis, and <i>Tyzzerella</i> to indoleamine 2,3-dioxygenase (EC:1.13.11.52), promoting kynurenine production. <i>Bifidobacterium longum</i> correlated with phenylalanine hydroxylase (EC:1.14.16.1), enhancing phenylalanine derivatives. A combined GM-metabolite diagnostic model demonstrated robust accuracy (AUC = 0.8).</p><p><strong>Conclusion: </strong>GM dysbiosis in ARFC children activates AAA metabolism, generating neuroactive and pro-inflammatory metabolites that may exacerbate allergic and gastrointestinal symptoms. These findings highlight microbial-metabolite axes as therapeutic targets. Study limitations include cohort size and lack of disease-specific controls, necessitating validation in expanded cohorts.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1562832"},"PeriodicalIF":3.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144833","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":"Effect of seasonal exposure in aeroallergen-sensitised patients with irritable bowel syndrome-diarrhoea.","authors":"Carlo Maria Rossi, Marco Vincenzo Lenti, Stefania Merli, Martina Fiorita, Antonio Lo Bello, Mario Andrea Latorre, Paola Ilaria Bianchi, Nicola Aronico, Annalisa De Silvestri, Antonio Di Sabatino","doi":"10.3389/falgy.2025.1568595","DOIUrl":"10.3389/falgy.2025.1568595","url":null,"abstract":"<p><strong>Background: </strong>Pollen allergy may influence irritable bowel syndrome (IBS) symptoms; however, available data are scant.</p><p><strong>Aims: </strong>This study aims to assess symptom variability in atopic IBS patients.</p><p><strong>Methods: </strong>We retrospectively analysed consecutive adult IBS patients evaluated between 2021 and 2024. Patients from the overall IBS cohort and the IBS-diarrhoea (IBS-D) subgroup were classified according to their sensitisation into grass-positive, house dust mite (HDM)-positive, or unsensitised. Symptom burden was assessed using the gastrointestinal symptom rating scale (GSRS) and a visual analogue scale for abdominal pain/distension, both outside the season period (T0) and during the pollination season (T1).</p><p><strong>Results: </strong>A total of 61 IBS patients were recruited (median age 34 years, IQR 25-50, F:M ratio 3.6:1), including 38 patients (62.8%) with IBS-D (median age 30 years, IQR 28-47, F:M ratio 2.8:1). Atopy was common in the IBS-D subgroup, particularly with respiratory manifestations. The mean GSRS significantly (<i>p</i> < 0.01) increased at T1 (variance of 3.4 points) only in grass-sensitised patients as opposed to those sensitised to HDM or unsensitised ones; this effect was present only in the IBS-D subgroup, while no significant variation was observed in the overall cohort.</p><p><strong>Conclusions: </strong>Pollination season influences symptoms in IBS-D patients sensitised to seasonal allergens.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1568595"},"PeriodicalIF":3.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129675","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":"Analysis of the multicomponent ALEX array data to examine patterns of sensitization in Cape Town, South Africa.","authors":"Sarah Pedretti, Alexander Sittmann, Arné Von Hagen, Jonny Peter","doi":"10.3389/falgy.2025.1572509","DOIUrl":"10.3389/falgy.2025.1572509","url":null,"abstract":"<p><strong>Introduction: </strong>This study analysed allergen sensitization patterns in Cape Town, a biodiversity-rich region with a Mediterranean climate, using ALEX® and ALEX²® multiplex component-resolved diagnostics tools. It aimed to address gaps in allergen sensitisation pattern data and complement aerobiological monitoring.</p><p><strong>Methods and results: </strong>A retrospective review of 708 adults and children attending two tertiary allergy clinics (2019-2024) found that house dust mites were the most common allergens, affecting 50%-60% of participants, with Der p 23 particularly prevalent (53%). Grass pollen sensitization was also high (46%), with 85% sensitised to the C4 grass Bermuda. Tree pollen sensitisation occurred in 29% with 14% sensitised to a diverse range of trees but neither London plane nor Cypress currently recommended in limited testing panels. Common food allergens included fruits (30%), seafood (27%), and nuts (25%), often linked to pollen cross-reactivity.</p><p><strong>Conclusion: </strong>Our study confirms a known pattern of aeroallergen sensitisation for a coastal temperate region, with increasing pollen sensitisation, particular C4 grasses. Clinicians should be aware of the diversity of tree pollen sensitisation, cross-reactivity patterns between food and pollen sensitisations and rates of minor allergen sensitisations for Blomia and animal danders when considering allergen-immunotherapies.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1572509"},"PeriodicalIF":3.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121602","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":"A deep dive into shrimp allergy: clinical spectrum of shrimp allergy in a Tunisian pilot study.","authors":"Dhouha Krir, Imen Zamali, Yousr Galai, Ahlem Ben Hmid, Ines Ben Sghaier, Yosra Nasri, Hayet Kebaier, Hechmi Louzir, Nissaf Ben Alaya Bouafif, Mélika Ben Ahmed, Samar Samoud","doi":"10.3389/falgy.2025.1568475","DOIUrl":"https://doi.org/10.3389/falgy.2025.1568475","url":null,"abstract":"<p><p>Shrimp allergy has emerged as a growing health concern in Tunisia, likely due to changing dietary habits. This study aimed to characterize the clinical features of shrimp-allergic patients and investigate potential cross-reactivity with house dust mites (HDMs) and snails using <i>in vitro</i> diagnostic methods. Thirty-one patients with a self-reported history of shrimp allergy were referred to the Clinical Immunology Department of the Pasteur Institute of Tunis. Total IgE and Serum-specific IgE (sIgE) levels to shrimp, snail, and HDMs, as well as recombinant allergens rPen a1 and rDer p10, were measured using the ImmunoCAP® immunoassay. The study population consisted mainly of young adults [mean age: 15.5 years (10-27.2)], with a male-to-female ratio of 1.4. The most common symptoms were oropharyngeal pruritus and urticaria. Shrimp allergy was confirmed in 54.8% of patients, with a median sIgE titer of 0.18 [0.03-28.8] kUA/L. Among these patients, 58.8% exhibited cross-reactivity, predominantly with snails [median sIgE: 3.07 (0.04-16.85) kUA/L]. Among shrimp-allergic patients, 70.5% tested positive for rPen a1 [median sIgE: 28.42 (5.78-51.05) kUA/L], while 58.8% were positive for rDer p10 (median sIgE: 0.56 [5 × 10^-5-87.95] kUA/L). The median total IgE level was 297 [158.6-475] IU/ml, significantly higher in shrimp-allergic patients (<i>p</i> = 0.005). The median shrimp sIgE/total IgE ratio was 0.001 [0-0.069], also significantly elevated in shrimp-sensitized individuals (<i>p</i> = 0.005). Multivariable analysis showed significant correlations between total IgE and shrimp sIgE, rPen a1, and rDer p10 levels (<i>p</i> = 0.043, <i>p</i> = 0.045, <i>p</i> = 0.043, respectively), while no correlation was found with d1 or snail sIgE after adjusting for age. rDer p10 and f24 were the strongest predictors of sIgE to snail, with standardized coefficients of 8.785 and -5.028, respectively. However, these associations did not reach statistical significance. This study underscores the critical role of tropomyosin as a primary allergen in shrimp allergy in Tunisia, highlighting its importance in immunodiagnosis and its strong association with HDMs and snail sensitization. Further research is needed to explore HDMs sensitization in patients who are negative for rPen a1 and rDer p10.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1568475"},"PeriodicalIF":3.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082520","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}