Frontiers in allergy最新文献

{"title":"Hereditary angioedema care across selected health systems in the Balkan Peninsula area: policy gaps, practice variation, and actionable recommendations.","authors":"George N Konstantinou, Sladjana Andrejevic, Natasha Angjeleska, Elif Karakoc-Aydiner, Noémi Anna Bara, Marko Barešić, Krasimira Baynova, Cathrine Chliva, Ljerka Čulav, Nihal Mete Gökmen, Mensuda Hasanhodžić, Mehmet Hoxha, Gül Karakaya, Eris Mesonjesi, Radovan Mijanovic, Maria Staevska, Efthalia Stefanaki, Fotis Psarros, Matija Rijavec, Paraskevi Xepapadaki, Mihaela Zidarn, Anastasios E Germenis, Anna Valerieva","doi":"10.3389/falgy.2026.1871835","DOIUrl":"10.3389/falgy.2026.1871835","url":null,"abstract":"<p><p>Hereditary angioedema is a rare but potentially life-threatening disorder in which outcomes depend not only on correct diagnosis and effective medicines, but also on how health systems organize referral, laboratory confirmation, emergency pathways, reimbursement, home treatment, and long-term follow-up. Selected health systems in the Balkan Peninsula area provide a particularly informative setting for health-system comparison because neighboring countries with active hereditary angioedema expertise differ substantially in rare-disease governance, registry maturity, diagnostic infrastructure, treatment coverage, and patient-organization capacity. This Policy and Practice Review synthesizes international guidance, published regional literature, comparative country information from the Balkan Experts in Angioedema: Consensus and Ongoing Navigation (BEACON) initiative, and advocacy-informed implementation insights to assess current care delivery in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Greece, Romania, Serbia, Slovenia, and Türkiye. Across the region, the most consistent problems are prolonged diagnostic delay, unequal access to complement and genetic testing, approved-but-not-reimbursed modern therapies, hospital-only access to rescue medication, uneven use of home treatment and self-administration, incomplete emergency preparedness, and variable registry and advocacy infrastructure. Countries with stronger alignment between policy frameworks, specialist centers, registries, reimbursement pathways, and patient organizations appear better positioned to deliver guideline-concordant care, whereas fragmentation at any point in the care pathway reduces the practical value of therapeutic advances. The review argues that the main barriers to equitable hereditary angioedema care across the included health systems are now predominantly regulatory, financing, organizational, and educational rather than scientific. We therefore propose actionable recommendations for ministries and payers, specialist centers and professional societies, emergency-care systems, registry stakeholders, and patient organizations, with the goal of converting regional heterogeneity into a structured quality-improvement agenda.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1871835"},"PeriodicalIF":3.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671462","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: Advancing equity in allergic disease management through innovative clinical strategies.","authors":"Ayobami Akenroye, Akilah A Jefferson, Sharmilee M Nyenhuis","doi":"10.3389/falgy.2026.1918802","DOIUrl":"https://doi.org/10.3389/falgy.2026.1918802","url":null,"abstract":"","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1918802"},"PeriodicalIF":3.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671515","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":"Homeopathic medication for seasonal allergic rhinitis-a randomised placebo-controlled trial.","authors":"J Siewert, H Cramer, M Ortiz, T Tissen-Diabaté, S Roll, K Wegscheider, K Linde, T Reinhold, S N Willich, M Teut, B Brinkhaus","doi":"10.3389/falgy.2026.1815934","DOIUrl":"10.3389/falgy.2026.1815934","url":null,"abstract":"<p><strong>Background: </strong>The study aim was to evaluate the efficacy of homeopathic medication in SAR patients.</p><p><strong>Methods: </strong>In a double-blind, three-arm randomised trial, patients at eleven outpatient clinics and two medical centres were randomised to receive (1) individualised homeopathic case taking (IHCT) and standardised homeopathic medication with Galphimia Glauca (GG), (2) IHCT and individualised homeopathic treatment (IHG), or (3) IHCT and placebo (PG). Primary outcome was disease-specific quality of life, assessed using the Rhinitis Quality of Life Questionnaire (RQLQ) after three and four weeks. Secondary outcomes included response rate (≥0.5-point change in RQLQ), rescue medication use, and total nasal and non-nasal symptom scores (TNSS, TNNSS).</p><p><strong>Results: </strong>Sixty-two SAR patients (mean age ± SD: 46.9 ± 14.9; 43.5% female) were recruited, approximately 25% of the planned sample size. After weeks three and four, there were no significant differences in RQLQ (<i>p</i> = 0.244) between GG (adjusted mean, 1.2, 95% CI 0.7-1.7), IHG (1.7, 1.2-2.3), and PG (1.4, 0.8-2.0). High response rates were observed (GG: 86.4%, IHG: 66.7%, PG: 81.3%), while RM use was 21.7%, 55.6%, and 29.4%, respectively. There were no relevant differences in RM score, TNSS and TNNSS between the three groups. Eight adverse events but no serious adverse events were reported.</p><p><strong>Conclusion: </strong>Standardised and individualised homeopathic drugs were not superior compared to placebo suggesting that treatment response was not based on study medication. The validity of the study and its conclusions are limited by the fact that the recruitment target was not achieved.</p><p><strong>Trial registration: </strong>This study has been registered in the German Clinical Trial Registry with trial ID DRKS00018081.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1815934"},"PeriodicalIF":3.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654836","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 role of <i>Pistacia lentiscus</i> oil in the prevention of chronic rhinosinusitis recurrence during long-term therapy: a retrospective observational case-control study.","authors":"Alexander Bertuccioli, Davide Sisti, Chiara Maria Palazzi, Annalisa Belli, Maurizio Bignami, Marco B L Rocchi, Giulia Monti, Giulia Di Vincenzo, Alberto Macchi","doi":"10.3389/falgy.2026.1911930","DOIUrl":"10.3389/falgy.2026.1911930","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic rhinosinusitis (CRS) is a prevalent inflammatory disease of the upper airways, frequently characterized by recurrence and impaired quality of life. Persistent inflammation and bacterial biofilms contribute to disease chronicity. Topical plant-derived therapies may offer a preventive strategy in long-term CRS management. This study evaluated the effectiveness of a Pistacia lentiscus-based nasal medical device in reducing the impact of CRS recurrence on patients' daily life.</p><p><strong>Methods: </strong>In this retrospective, observational, single- center case-control study, 100 adult patients with chronic rhinosinusitis (CRS) and recurrent disease were identified and included from clinical records. Patients were stratified according to prior exposure to nasal drops containing ultra-fractionated Pistacia lentiscus oil in addition to isotonic saline nasal irrigation, or to isotonic saline nasal irrigation alone, according to routine clinical practice. All patients had undergone a 12-month follow-up regimen with assessments available at baseline, 30 days, and 12 months. The primary outcome was symptom severity measured using the Sino-Nasal Outcome Test (SNOT-22). Secondary outcomes included nasal cytology parameters, biofilm presence, nasal discharge, bacterial elements, supranuclear stria, and ciliary motility.</p><p><strong>Results: </strong>Of the 100 identified subjects, 92 were included in the final analysis due to loss to follow-up. In the exposed group, SNOT-22 scores showed a 40.6% reduction after the first month, compared with a 7.8% reduction observed in the control group (<i>p</i> < 0.001). Only patients exposed to Pistacia lentiscus oil demonstrated statistically significant reductions over time in nasal discharge (<i>p</i> < 0.005), biofilm presence (<i>p</i> < 0.005), and bacterial elements (<i>p</i> < 0.05), while no significant changes were observed in the control group for these parameters. Ciliary motility remained unchanged in both groups across the study period.</p><p><strong>Discussion: </strong>Overall, within the limits of this retrospective case-control design, patients exposed to Pistacia lentiscus oil in addition to standard saline irrigation showed greater improvement in patient-reported symptoms and selected cytological markers compared with patients treated with saline irrigation alone.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1911930"},"PeriodicalIF":3.4,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632913","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":"Interleukin-33 at the intersection of inflammation and repair.","authors":"Fernanda Martinez-Moreno, Elina Jerschow, Victor E Ortega, Hirohito Kita, Sergio E Chiarella","doi":"10.3389/falgy.2026.1894127","DOIUrl":"10.3389/falgy.2026.1894127","url":null,"abstract":"<p><p>Interleukin 33 (IL-33) is a cytokine of the IL-1 family that acts as an alarmin in both innate and adaptive immunity. IL-33 is constitutively nuclear in epithelial and endothelial cells, where its activity is limited by nuclear retention. Release of IL-33 in response to cellular stress or injury can mediate type 2 immune responses or tissue repair, depending on the local tissue environment. IL-33 activity is regulated at multiple levels, including nuclear retention, oxidation, proteolytic processing, and metabolic regulation. Following its release, oxidation rapidly suppresses IL-33 activity, while mast cell and neutrophil proteases can generate smaller active fragments that target cells expressing the IL-33 ST2 receptor. Simultaneously, tissue metabolic status influences cellular responsiveness through the mTORC1 and AMPK pathways, which link metabolic capacity to effector function. These conditions may explain why IL-33 can mediate an inflammatory response, but in other circumstances, it contributes to tissue repair. Such pleiotropic properties may also underline the variability in clinical responses to IL-33/ST2-targeted therapies across various diseases. The appreciation of IL-33 as a cytokine whose activity is conditioned by its structural, redox, and metabolic environment is critical to optimizing its therapeutic potential as a target.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1894127"},"PeriodicalIF":3.4,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632979","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":"From inflammaging to steroid resistance: reframing the pathogenesis of neutrophilic asthma.","authors":"Lei Li, Moping Sun, Yibo He, Xinning Liu","doi":"10.3389/falgy.2026.1859908","DOIUrl":"10.3389/falgy.2026.1859908","url":null,"abstract":"<p><p>Asthma is a chronic respiratory disease characterized by airway obstruction, persistent inflammation, and tissue remodeling. Among its subtypes, neutrophilic asthma (NA) is particularly challenging due to its high severity and glucocorticoid resistance. NA is primarily characterized by T2-low (non-T-helper cell type 2-driven) airway inflammation, driven by a network of mediators-including IL-6, IL-8, IL-17, IL-1β, TNF-α, and IFN-<i>γ</i>-which act in concert to orchestrate neutrophil recruitment and perpetuate chronic neutrophilic inflammation. Currently, NA lacks defined therapeutic targets, largely due to an incomplete understanding of its pathogenesis. In our previous study, transcriptomic analysis revealed that the pathogenesis of NA is closely associated with aging. Specifically, the accumulation of aging-related cells releases the senescence-associated secretory phenotype (SASP), which appears to play a pivotal role in establishing and amplifying neutrophilic inflammation. Disrupting the pathological loop orchestrated by cellular aging (\"aging-inflammation amplification-steroid resistance\") thus emerges as a compelling therapeutic rationale. In this article, we systematically explore the complex signaling networks mediating the interplay between aging and NA, aiming to provide new theoretical insights and research directions for the treatment of this refractory asthma subtype.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1859908"},"PeriodicalIF":3.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13416615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622890","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: Impact of viral infections on childhood asthma: susceptibility and pathomechanisms.","authors":"Nicole Maison, Ulrich von Both, Jimmy Omony","doi":"10.3389/falgy.2026.1916993","DOIUrl":"10.3389/falgy.2026.1916993","url":null,"abstract":"","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1916993"},"PeriodicalIF":3.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13414176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622926","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: Innovations in allergy diagnostics and management: a global perspective.","authors":"Andrijana Nesic, Ivana Prodić, Maja Krstić Ristivojević, Davor Plavec","doi":"10.3389/falgy.2026.1909853","DOIUrl":"10.3389/falgy.2026.1909853","url":null,"abstract":"","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1909853"},"PeriodicalIF":3.4,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610743","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":"Allergic diseases in early childhood and their association with migraine: a large-scale retrospective study.","authors":"Shay Nemet, Meirav Har-Even, Avner Herman Cohen, Teddy Lazebnik, Esther Ganelin-Cohen, Yoel Levinsky, Vered Shkalim Zemer","doi":"10.3389/falgy.2026.1879233","DOIUrl":"10.3389/falgy.2026.1879233","url":null,"abstract":"<p><strong>Introduction: </strong>Migraine is a common pediatric neurological disorder, and its relationship with allergic disease in early childhood remains incompletely defined.</p><p><strong>Objective: </strong>To explore the prevalence and distribution of allergic disorders among children with migraine.</p><p><strong>Methods: </strong>The electronic medical records from a large Health Maintenance Organization were searched, spanning from 2000 to 2023, for children from birth to 5 years of age diagnosed with allergic diseases who were diagnosed with migraine at age 5-18 years. Demographic characteristics and allergic comorbidities were analyzed and compared between children with migraine with and without allergic disease.</p><p><strong>Results: </strong>Among 6,839 children with migraine, 2,216 (32.4%) had at least one allergic comorbidity. Children with allergic disease presented at a younger age than those without allergies (median age 3 vs. 4 years, <i>p</i> < 0.001). Asthma was the only allergic disease that demonstrated a significant sex difference, being more common in males (<i>p</i> = 0.011). High socioeconomic status was the most common category in most allergic diseases, except for asthma. Atopic dermatitis was the most common allergic condition (41.7%), and multimorbidity was uncommon.</p><p><strong>Conclusions: </strong>This study demonstrates that allergic diseases in early childhood are associated with younger age at migraine diagnosis and with distinct demographic patterns. The distribution of allergic phenotypes in early-life observed in the cohort may play a role in migraine susceptibility. Future research should explore the mechanistic pathways linking early-childhood atopy and migraine and evaluate whether targeted management of allergic diseases can modify migraine outcomes in children.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1879233"},"PeriodicalIF":3.4,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586163","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 potential of targeted IL-4 therapy for the comorbidity of atopic dermatitis and attention-deficit/hyperactivity disorder in children via the skin-brain axis.","authors":"Yingjie Zhou, Yuan Sun, Weisheng Hu, Qing Wang, Zijia Chen, Ning Huang, Lingling Li","doi":"10.3389/falgy.2026.1887240","DOIUrl":"10.3389/falgy.2026.1887240","url":null,"abstract":"<p><p>Although Atopic Dermatitis (AD) and Attention-Deficit/Hyperactivity Disorder (ADHD) frequently coexist in children, the underlying mechanisms remain unclear. The \"Skin-Brain Axis\"(SBA) hypothesis, based on the shared ectodermal origin of the skin and the central nervous system(CNS), provides a theoretical foundation for communication between AD and ADHD. However, standardized biomarkers and direct clinical validation are currently lacking. Interleukin-4 (IL-4), a key cytokine driving skin inflammation in AD, may theoretically influence CNS development via the SBA, thereby contributing to the pathophysiology of ADHD; but this hypothesis has not yet been validated in humans. Based on the SBA, the review integrates the dual role of IL-4 in the pathogenesis of AD and ADHD, explores the possibility of IL-4 acting as a bridging signal between peripheral skin inflammation and neurodevelopmental abnormalities, and summarizes existing clinical and preclinical evidence for IL-4-targeted therapies for AD-ADHD comorbidity, while also highlighting current gaps in evidence and limitations in application. Future research should include prospective clinical trials with neurocognitive assessment and brain imaging as endpoints, using direct neuroimmune effects and indirect effects (such as itch relief and improved sleep) as reference indicators, to systematically evaluate the feasibility of IL-4 inhibitors in controlling neurobehavioral symptoms and provide a practical research pathway for clinical translation.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1887240"},"PeriodicalIF":3.4,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586237","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}