Frontiers in allergy最新文献

{"title":"Identification of an elusive <i>SERPING1</i> deletion in a family with hereditary angioedema type I utilizing soft clipping.","authors":"Keith Wetherby, Joseph Chiao, Emily Faulkner, Yongjian Guo, Shaobin Hou, J Joanna Yu, Jinguo Chen, Lili Wan, H Henry Li","doi":"10.3389/falgy.2025.1565283","DOIUrl":"https://doi.org/10.3389/falgy.2025.1565283","url":null,"abstract":"<p><strong>Background: </strong>Hereditary angioedema (HAE) is an autosomal dominant genetic disorder caused by mutations in the C1 esterase inhibitor gene, SERPING1, leading to overproduction of bradykinin and debilitating swelling attacks. Variants in the <i>SERPING1</i> gene are typically detected in a clinical setting by DNA sequencing or multiplex ligation-dependent probe amplification (MLPA), with over 893 total variants identified. Approximately 5% of patients with C1-esterase inhibitor deficiencies do not have detectable <i>SERPING1</i> pathogenic variants. We further investigated a family with laboratory-confirmed HAE type I despite previous negative genetic test results for <i>SERPING1</i> mutations.</p><p><strong>Methods: </strong>We consented and collected whole blood samples from three family members with clinical diagnoses of HAE. The samples underwent genomic DNA extraction and evaluation for purity prior to sequencing. The DNA samples were processed through a semi-automated whole exome library prep pipeline and sequenced. <i>SERPING1</i> MLPA was performed to assess exon-level copy number variation (CNV) for exons 1 through 8. Additionally, we incorporated a well-established bioinformatics technique called soft clipping into our variant analysis pipeline to detect structural variants.</p><p><strong>Results: </strong>Clinical variant analysis revealed two common benign variants of <i>SERPING1</i> in the proband. NGS and MLPA did not detect any <i>SERPING1</i> pathogenic variants or genomic rearrangements, but additional structural variant analysis identified a high rate of soft clipping in exon 6 of the <i>SERPING1</i> gene. Sanger sequencing of exon 6 revealed a heterozygous 56-base-pair deletion [NC_000011.10: g.57606508-57606563del, NM_000062(<i>SERPING1</i>): c.990_1029 + 16del] spanning the 3' exon-intron boundary in all three subjects.</p><p><strong>Summary: </strong>Without additional techniques following NGS and MLPA, such as a soft clipping analysis method, many difficult-to-detect large insertions and deletions may go undetected. We propose that a systematic approach to undetected HAE-causing mutation analysis, incorporating soft clipping as part of an overall strategy, would be more effective in identifying a small percentage of causal variants in approximately 5% of C1-esterase inhibitor HAE cases where no mutation is found by standard laboratory procedures, especially when there are high clinical suspicions of a familiar disorder.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1565283"},"PeriodicalIF":3.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028375","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":"Exposure to outdoor aerospora and associated respiratory health risks among adults in Potchefstroom, North-West province, South Africa.","authors":"Dorra Gharbi, Frank Harald Neumann, Keneilwe Podile, Marinda McDonald, Jo-Hanné Linde, Megan Frampton, Jennifer Leigh Liebenberg, Sarel Cilliers, Tshiamo Mmatladi, Phumelele Nkosi, Keamogestswe Paledi, Stuart Piketh, Jurgens Staats, Roelof P Burger, Henno Havenga, Rebecca M Garland, Petra Bester, Pedro Humberto Lebre, Cristian Ricci","doi":"10.3389/falgy.2025.1568669","DOIUrl":"https://doi.org/10.3389/falgy.2025.1568669","url":null,"abstract":"<p><strong>Background: </strong>Data on allergic rhinitis and respiratory health metrics are limited for South Africa, with grass pollen as a key outdoor aeroallergen. Exotic trees such as plane trees and ragweed produce highly allergenic pollen, dominating indigenous trees and weeds. Pollen allergy prevalence data is lacking in cities of North-West province such as Potchefstroom.</p><p><strong>Objectives: </strong>This study aimed to (i) assess the prevalence of allergies to major aeroallergens, including Poaceae (grasses), <i>Cupressus/Hesperocyparis</i> (cypresses), <i>Platanus</i> (plane tree), <i>Ulmus</i> (elm), <i>Quercus</i> (oak), <i>Betula</i> (birch), <i>Olea</i> (olive), <i>Artemisia</i> (sagebrush), <i>Amaranthus</i> (amaranth), <i>Plantago</i> (plantain), <i>Morus</i> (mulberry), and <i>Ambrosia</i> (ragweed), along with fungal spores such as <i>Alternaria</i>, <i>Cladosporium</i>, and <i>Penicillium/Aspergillus</i>, and (ii) investigate the monthly incidence of major aeroallergens and reactivity levels in sensitized adults in Potchefstroom.</p><p><strong>Methods: </strong>Skin prick tests (SPTs) were performed on 202 adults aged 18-64 years with confirmed allergic symptoms during a field campaign at North-West University (NWU)'s Potchefstroom campus. A test panel of grass, weed, tree, and fungal spore extracts previously identified via aerobiological monitoring was used. Symptom scores were recorded using ISAAC questionnaires; <i>Spearman</i>'s statistical correlation between symptom frequency and monthly aeroallergen concentrations were analyzed.</p><p><strong>Results: </strong>Among the participants, 184 (91%) exhibited positive SPT reactions: 104 (57%) are monosensitized to pollen, 45 (24%) to fungal spores, and 35 (19%) are polysensitized. Aeroallergen prevalence was higher in females (73%) than in males (27%). The most common pollen allergens were <i>Cynodon dactylon</i> (Bermuda grass) (85%), <i>Zea mays</i> (maize) (46%), <i>Platanus</i> spp. (plane tree) (35%), and <i>Ulmus campestris</i> (field elm) (33%). Among fungal spores, <i>Alternaria</i> was the most common (93%), followed by <i>Cladosporium</i> (27%). A significant and positive statistical correlation was found between allergic rhinitis symptoms and monthly pollen concentrations of <i>Betula</i>, <i>Morus</i>, <i>Platanus</i>, and <i>Quercus</i>.</p><p><strong>Discussion & conclusion: </strong>This pilot study linked aeroallergens detected in Potchefstroom with allergy profiles of local residents. The findings highlight the need for more comprehensive regional studies that integrate allergen testing with aerobiological data. Raising awareness and implementing health strategies are essential for managing allergic rhinitis in South Africa. More affordable and available SPTs kits, adapted to allergy prevalence in South Africa, are strongly suggested.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1568669"},"PeriodicalIF":3.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063354","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 randomized controlled trial evaluating prophylactic treatment of <i>Artemisia</i> pollinosis using azelastine hydrochloride and fluticasone propionate nasal spray.","authors":"Le Cui, Na Gao, Cairong Bai, Yali Zuo, Wendong Hao, Kai Guan","doi":"10.3389/falgy.2025.1559201","DOIUrl":"https://doi.org/10.3389/falgy.2025.1559201","url":null,"abstract":"<p><strong>Background: </strong>Prophylactic treatment for pollinosis is advantageous for managing nasal symptoms in patients with seasonal allergic rhinitis. Inadequate control of rhinitis symptoms increases the risk of acute asthma attacks. Nevertheless, there is limited research on the use of nasal glucocorticoids and antihistamines for the preventive treatment of pollinosis.</p><p><strong>Objective: </strong>This study aimed to assess the efficacy of prophylactic treatment for nasal symptoms and acute asthma attacks by enrolling patients with <i>Artemisia</i> pollinosis to use a combined device of azelastine hydrochloride and fluticasone nasal spray prior to the pollen season.</p><p><strong>Methods: </strong>The study was registered at Chictr.org.cn (ChiCTR2300073758). A total of 120 patients with <i>Artemisia</i> pollinosis were randomly assigned to either a prophylactic treatment group or a control group at a 1:1 ratio. In the prophylactic treatment group, the nasal spray was initiated approximately two weeks before the onset of the pollen season.</p><p><strong>Results: </strong>During both the pollen season and the concurrent medication period, the prophylactic treatment group presented significantly lower total nasal symptom scores (TNSS) (means of 5.97 and 5.94) than the control group (means of 7.86 and 7.80) (<i>P</i> = 0.015 and 0.016). Although the prophylactic treatment group had a lower asthma attack rate than the control group, the difference was not statistically significant (<i>P</i> = 0.284).</p><p><strong>Conclusions: </strong>Prophylactic treatment with azelastine hydrochloride and fluticasone propionate nasal sprays can alleviate nasal symptoms and may reduce acute asthma attacks during the pollen season.</p><p><strong>Clinical trial registration: </strong>[Chictr.org.cn], identifier (ChiCTR2300073758).</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1559201"},"PeriodicalIF":3.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064623","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":"Regulation of eosinophil recruitment and heterogeneity during allergic airway inflammation.","authors":"Lisa-Marie Graf, Daniel Radtke, David Voehringer","doi":"10.3389/falgy.2025.1585142","DOIUrl":"https://doi.org/10.3389/falgy.2025.1585142","url":null,"abstract":"<p><p>Eosinophils represent a granulocyte cell type that is strongly associated with type 2 inflammatory conditions. During steady state conditions few eosinophils are found in lung tissue, though they may contribute to homeostasis. In allergic airway inflammation, eosinophils are strongly increased and associated to disease severity. The underlying type 2 immune response tightly regulates eosinophil development, recruitment, survival, and heterogeneity. Inflammatory eosinophils in the lung are unfavourable, as they can cause tissue damage, amplify type 2 immunity and induce bronchial obstruction by expelling granular proteins and cytokines. In this review we provide an overview about mechanisms regulating development of eosinophils in the bone marrow and their extravasation into the lung including recent findings on induction and diversity of eosinophilia in allergic airway inflammation.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1585142"},"PeriodicalIF":3.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059994","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":"Association between the CALLY index, vitamin D, and asthma: insights from NHANES.","authors":"Yachun Liu, Yufeng Wei","doi":"10.3389/falgy.2025.1557677","DOIUrl":"https://doi.org/10.3389/falgy.2025.1557677","url":null,"abstract":"<p><strong>Purpose: </strong>The CALLY index integrates C-reactive protein (CRP), albumin and lymphocyte counts to accurately reflect the inflammatory, nutritional and immune status of the body. Multiple studies have indicated that the CALLY index plays a key role in a variety of diseases, especially asthma, and is closely associated with inflammatory response, airway remodeling and immune imbalance in asthma. Research has shown that vitamin D is associated with asthma susceptibility, severity, and control, and its levels may influence inflammatory and immune markers associated with the CALLY index, which may play a role in the association between the CALLY index and asthma.</p><p><strong>Patients: </strong>Using data from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2010, the association between CALLY index and asthma and the role of vitamin D in American adults were analyzed in depth. Through multiple logistic regression, subgroup analysis, and other statistical means, the potential pathophysiological links between the three are revealed, providing theoretical support for the prevention and treatment of related diseases.</p><p><strong>Results: </strong>A total of 17,946 individuals were included in this study, of which 2,317 were diagnosed with asthma. Fully adjusted multivariate logistic regression analysis revealed that the CALLY index was significantly negatively associated with asthma, with an odds ratio (OR) of 0.996 [95% confidence interval (CI) 0.993-0.999]. Specifically, each unit increase in the CALLY index was associated with a 0.996-fold reduction in asthma risk. In addition, mediation effect analysis showed that vitamin D partially mediated the association between the CALLY index and asthma, with a mediation ratio of 3.36%.</p><p><strong>Conclusion: </strong>This study reveals an association between the CALLY index and reduced risk of asthma in the US population and suggests that vitamin D plays an incomplete mediating role. This finding provides a new theoretical basis for the diagnosis, treatment, and prevention of asthma and is expected to be a potential biomarker.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1557677"},"PeriodicalIF":3.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043879","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":"Evaluation of a translational swine model of respiratory hypersensitivity induced by exposure to <i>Phleum pratense</i> pollen allergens.","authors":"Jessica Ledesma-Aparicio, Gustavo Salazar-Guerrero, Axel Soto-Muñoz, Carmen Ramírez-Estudillo, Mónica Luz Gómez-Esquivel, Juan Pablo Reyes-Grajeda, César A Reyes-López, Marco A Vega-López","doi":"10.3389/falgy.2025.1557656","DOIUrl":"https://doi.org/10.3389/falgy.2025.1557656","url":null,"abstract":"<p><strong>Introduction: </strong>Asthma is a disease characterized by chronic inflammation of the airway mucosa that causes tissue remodeling and a reversible decrease in airflow. The causative agent of asthma is still unknown; however, several studies have shown that environmental factors such as allergens present in pollens are involved. This project's objective was to develop and evaluate a model of respiratory hypersensitivity in Vietnamese minipigs, which is closer in many aspects to humans than rodents, using <i>Phleum pratense</i> allergenic pollen extract.</p><p><strong>Methods: </strong>In this hypersensitivity model, human-like signs were observed during a challenge with the allergens. Intradermal and passive anaphylaxis tests confirmed that specific IgE mediated the response.</p><p><strong>Results: </strong>Significant changes in lung tissue remodeling, high levels of serum allergen-specific IgA, IgG, and to a lesser extent IgE were found in the sensitized pigs, which could favor tolerance and pathogenesis. However, since chronic pathology did not develop, elevated levels of cytokines were not proven.</p><p><strong>Discussion: </strong>This work demonstrated that the immunization protocol in this experimental model can induce a type I respiratory hypersensitivity-like response mediated by antigen-specific IgE, with pathophysiological similarities to those of humans and prospective for translational basic and applied research.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1557656"},"PeriodicalIF":3.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044005","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":"Editorial: Allergies and anti-allergy drug discovery in Africa.","authors":"Sabelo Hadebe, Andrew Glory Mtewa, Mushagalusa Kasali Félicien, Jonathan Peter, Precious Takondwa Makondi","doi":"10.3389/falgy.2025.1593023","DOIUrl":"https://doi.org/10.3389/falgy.2025.1593023","url":null,"abstract":"","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1593023"},"PeriodicalIF":3.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060736","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":"Cure for the itch: current clinical standards and therapies in allergic eczema.","authors":"Jennifer E Lazor, Bree A Bozsoki, Pranay Bharadwaj","doi":"10.3389/falgy.2025.1569292","DOIUrl":"https://doi.org/10.3389/falgy.2025.1569292","url":null,"abstract":"<p><p>Allergic Eczema (AE) is a chronic, relapsing skin condition that significantly affects the quality of life of the AE patients and their caretakers. Decades of scientific and clinical research has helped understand the highly complex underpinnings of AE presentation wherein a multitude of variables, including the conspicuous variables such as environmental allergens, immunological triggers, genetic predisposition of individuals, to more nuanced socio-economic status, play an important part. Given the complexity of the disease, it is imperative to develop biomarkers enabling early and reliable clinical identifications and help in the active management of the disease, thereby minimizing the impact and burden of the disease on the patients. In this mini review, we provide a brief overview of AE, affected demographics, variables that trigger its onset, and summarize the discovery of various clinical biomarkers such as total and specific serum IgE levels, Th2 cytokine levels, filaggrin (FLG) mutations, periostin levels in skin, etc. that have been developed over the years to further improve the state of clinical monitoring of AE presentation and progression. Lastly, we also provide an overview of the clinical interventions and therapies, such as topical agents, phototherapy, and biologics, that are available to the patients to manage AE-related complications. While we have vastly improved the standard of care and diagnosis for the AE patients, there are still many unmet needs such as developing non-invasive, effective, and reliable clinical predictors and biomarkers which can usher better personalized treatments and provide a better quality of life to affected demographics.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1569292"},"PeriodicalIF":3.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059899","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":"Development and validation of a Delphi consensus-based questionnaire for the multidisciplinary management of type 2 inflammation-related diseases.","authors":"Francisco Javier Ortiz de Frutos, Carolina Cisneros, José Miguel Villacampa, Óscar Palomares, Ignacio Dávila","doi":"10.3389/falgy.2025.1543504","DOIUrl":"https://doi.org/10.3389/falgy.2025.1543504","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to validate a 15-item screening questionnaire for the early detection of coexisting type 2 (T2) inflammatory diseases, such as asthma, atopic dermatitis, and chronic rhinosinusitis with nasal polyps (CRSwNP), among others.</p><p><strong>Methods: </strong>The questionnaire, designed through expert consensus by a scientific committee, underwent Delphi methodology for validation. A multidisciplinary panel of 19 clinicians from different specialties reviewed the questionnaire for clinical relevance, while 39 patients from different regions of Spain evaluated its comprehensibility.</p><p><strong>Results: </strong>The clinician panel reached a consensus on the relevance of 13 out of 15 items in the first round and agreed that a single positive response was sufficient to justify referral to the appropriate specialist. Two items were modified and validated in the second round. The patient panel unanimously agreed on the comprehensibility of the questionnaire in the first round. Linguistic variations were also ranked to ensure clarity across regions, further enhancing the validation of the tool.</p><p><strong>Conclusion: </strong>This validated questionnaire offers a practical tool for early detection of T2 inflammatory diseases. Its simplicity and comprehensibility, confirmed by clinicians and patients, make it suitable for use in various healthcare settings, supporting timely specialist referrals and improved patient care. Future studies will evaluate its effectiveness in real-world clinical practice.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1543504"},"PeriodicalIF":3.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999519","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":"Fire ant-venom anaphylaxis prevalence in the general population and patients with systemic mastocytosis.","authors":"Jeremy C McMurray, Brandon J Schornack, Karla E Adams, Robert L McCoy, Amanda K Marshall, Janet A Brunader, Irina Maric, Dean D Metcalfe, Nathan A Boggs","doi":"10.3389/falgy.2025.1570123","DOIUrl":"https://doi.org/10.3389/falgy.2025.1570123","url":null,"abstract":"<p><strong>Background: </strong>Stinging Hymenoptera can induce fatal anaphylaxis, especially in patients with systemic mastocytosis. Fire ants, <i>Solenopsis invicta</i> and <i>S. richteri,</i> from South America have recently colonized three continents. Prevalence of fire ant-venom anaphylaxis in the general population and in systemic mastocytosis is unknown. The aim was to determine fire ant-venom anaphylaxis prevalence among Tricare beneficiaries and those with systemic mastocytosis.</p><p><strong>Methods: </strong>We queried the beneficiary immunotherapy prescription database for patients who received immunotherapy with Hymenoptera venom or fire ant whole-body extract and the Tricare beneficiary population health registry database for patients with an ICD-10 code for Hymenoptera venom allergy (HVA). Greater than 95% of the beneficiary population were patients living in the United States. Chart review of a random sample of 150 patients linked to a HVA ICD-10 code was performed to determine the percent of patients with Hymenoptera-venom anaphylaxis. Retrospective review of a systemic mastocytosis cohort was performed to assess fire ant-venom anaphylaxis rate and treatment patterns.</p><p><strong>Results: </strong>Fire ant immunotherapy was the most frequently ordered individual immunotherapy prescription 45.9% (<i>n</i> = 878). Fire ant prescriptions surpassed all flying Hymenoptera immunotherapy prescriptions combined in six states. Fire ant and flying Hymenoptera-venom anaphylaxis prevalence in the general population was 0.048% and 0.083%, respectively. Fire ant-venom anaphylaxis prevalence in the 14 colonized states was 0.085%. More patients with systemic mastocytosis had anaphylaxis triggered by fire ant than all flying Hymenoptera combined.</p><p><strong>Conclusion: </strong>Fire ant-venom anaphylaxis prevalence in the general population and patients with systemic mastocytosis is higher than all flying Hymenoptera-venom anaphylaxis combined in colonized states. Fire ant-venom anaphylaxis in systemic mastocytosis is frequently misdiagnosed and not treated with epinephrine.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"6 ","pages":"1570123"},"PeriodicalIF":3.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064868","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}