The journal of allergy and clinical immunology. Global最新文献

{"title":"A case of hereditary alpha tryptasemia and presumptive eosinophilic granulomatosis with polyangiitis","authors":"Sonia Iqbal DO ,&nbsp;Joseph A. Baxter DO ,&nbsp;Karla E. Adams MD","doi":"10.1016/j.jacig.2025.100481","DOIUrl":"10.1016/j.jacig.2025.100481","url":null,"abstract":"<div><div>This case is notable for the potential overlap of hereditary alpha tryptasemia and eosinophilic granulomatosis with polyangiitis. The successful use of mepolizumab, initially for eosinophilic granulomatosis with polyangiitis but potentially benefiting the patient's hereditary alpha tryptasemia, offers a novel approach to managing complex cases involving both rare disorders.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 3","pages":"Article 100481"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quail egg allergy with tolerance to chicken eggs: A case report","authors":"Ana Delgado-Prada MD ,&nbsp;Maria Jose Martinez-Martinez MSc ,&nbsp;Enrique Burches MD, PhD ,&nbsp;Angel Sastre-Sastre MD ,&nbsp;Fernando Pineda De La Losa PhD ,&nbsp;Celia Morales-Rubio MD, PhD","doi":"10.1016/j.jacig.2025.100486","DOIUrl":"10.1016/j.jacig.2025.100486","url":null,"abstract":"<div><div>This case study details a rare quail egg allergy with tolerance to chicken eggs in a 50-year-old woman.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 3","pages":"Article 100486"},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung functions and IgE component sensitizations: Five wheezing phenotypes in adolescents from the T-Child study in Tokyo","authors":"Kiwako Yamamoto-Hanada MD, PhD ,&nbsp;Limin Yang MD, PhD ,&nbsp;Mayako Saito-Abe MD, PhD ,&nbsp;Fumi Ishikawa MD ,&nbsp;Miori Sato MD ,&nbsp;Yumiko Miyaji MD, PhD ,&nbsp;Motoko Mitsui-Iwama MD, PhD ,&nbsp;Yusuke Inazuka MD, PhD ,&nbsp;Koji Nishimura MD ,&nbsp;Kenji Toyokuni MD, PhD ,&nbsp;Hiroya Ogita MD ,&nbsp;Tomoyuki Kiguchi MD ,&nbsp;Yoshitsune Miyagi MD ,&nbsp;Shinichiro Inagaki MD, PhD ,&nbsp;Shigenori Kabashima MD, PhD ,&nbsp;Tatsuki Fukuie MD, PhD ,&nbsp;Masami Narita MD, PhD ,&nbsp;Elizabeth Huiwen Tham MBBS, MRCPCH, Mmed (Paed) ,&nbsp;Yukihiro Ohya MD, PhD","doi":"10.1016/j.jacig.2025.100480","DOIUrl":"10.1016/j.jacig.2025.100480","url":null,"abstract":"<div><h3>Background</h3><div>The endophenotypes of allergic disorders are known to vary across racial groups, underscoring the importance of studying allergic disease phenotypes in the population of Tokyo.</div></div><div><h3>Objective</h3><div>We sought to elucidate the developmental trajectories of wheezing among adolescents and their associations with pulmonary function and IgE sensitization in the Japanese pediatric population.</div></div><div><h3>Methods</h3><div>The research used data from the Tokyo Children’s Health, Illness, and Development study, a comprehensive Tokyo birth cohort study, which recruited 1701 mother-infant dyads prenatally and followed the children up from birth till age 13 years. The analytical approach was conducted in 4 distinct phases: (1) delineation of trajectory groups using latent class growth analysis; (2) detailed characterization of each identified trajectory; (3) assessment of the relationships between predictors and wheezing groups through multinomial logistic regression; and (4) examination of the interrelations among trajectory groups, lung function, and IgE sensitization at age 13 years.</div></div><div><h3>Results</h3><div>A total of 5 unique wheezing phenotypes were discerned: early-onset transient wheezing (10.2%), late-onset transient wheezing (7.3%), low frequent wheezing (15.0%), persistent wheezing (11.9%), and never/infrequent wheezing (55.5%). No statistically significant deterioration in impulse oscillometry parameters and spirometry parameters except %V25 was detected across any of the phenotypes. Nonetheless, the persistent wheezing phenotype demonstrated an association with lowered %V25, elevated fractional exhaled nitric oxide levels, and an increased prevalence of sensitization to multiple allergens at age 13 years.</div></div><div><h3>Conclusions</h3><div>The wheezing phenotypes identified in this study displayed distinct characteristics. Importantly, despite the diverse wheezing trajectories observed from birth, adolescents in Tokyo did not exhibit any discernible decline in lung function.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 3","pages":"Article 100480"},"PeriodicalIF":0.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generational shifts in atopic disease among immigrant families to North America from Southern India","authors":"Sangeetha M. Kodoth MD ,&nbsp;Priyanka Dadha PhD ,&nbsp;Shruti Sehgal MD(Hom), MS ,&nbsp;Christopher Warren PhD ,&nbsp;Sai R. Nimmagadda MD ,&nbsp;Lucy A. Bilaver PhD ,&nbsp;Ruchi S. Gupta MD, MPH","doi":"10.1016/j.jacig.2025.100472","DOIUrl":"10.1016/j.jacig.2025.100472","url":null,"abstract":"<div><h3>Background</h3><div>The Indian diaspora is a fast-growing population in North America, but there are limited data on the prevalence of atopic diseases after migration.</div></div><div><h3>Objective</h3><div>We investigated the impact of migration on atopic disease prevalence among physician families who migrated from Kerala, Southern India, to North America.</div></div><div><h3>Methods</h3><div>A cross-sectional questionnaire was administered to collect demographic information, migration, and atopic history—including allergic rhinitis (AR), food allergy (FA), asthma, and atopic dermatitis (AD)—of physician migrants from Kerala, Southern India, and their families.</div></div><div><h3>Results</h3><div>Of the 164 completed surveys, 148 were included in the final analyses. Postmigration prevalence of AR and FA were significantly higher than premigration prevalence (AR-pre 12.8% [95% confidence interval (CI), 8.1-19.6] vs AR-post 21.6% [95% CI, 15.5-29.3] [<em>P</em> = .048], and FA-pre 2.7% [95% CI, 0.9-7.2] vs FA-post 9.5% [95% CI, 5.5-15.7] [<em>P</em> = .022]). Cow’s milk (4.1%) was the common food trigger reported, followed by fruits (2.0%) and shellfish (2.0%). In 137 respondent families with children, North America–born compared to migrant children had a higher prevalence of asthma (18.6% [95% CI, 13.4-25.1] vs 8.6% [95% CI, 4.1-16.7] [<em>P</em> = .033]), AR (36.1% [95% CI, 29.2-43.5] vs 19.4% [95% CI, 12.2-29.1] [<em>P</em> = .005]), and FA (17.5% [95% CI, 12.4-23.9] vs 5.4% [95% CI 2.0-12.7] [<em>P</em> = .008]).</div></div><div><h3>Conclusion</h3><div>Respondents exhibited increased prevalence of AR and FA after migration. North America–born children showed elevated risk for asthma, AR, and FA compared to respondents and children who migrated after birth. Research into lost protective factors and new risk factors, including environmental and dietary changes, is needed to decrease the impact on future generations.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 3","pages":"Article 100472"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dupilumab efficacy in patients with type 2 asthma and early Feno level reductions","authors":"Ian D. Pavord MD ,&nbsp;Michael E. Wechsler MD ,&nbsp;William W. Busse MD ,&nbsp;Christian Domingo MD ,&nbsp;Changming Xia PhD ,&nbsp;Rebecca Gall MD ,&nbsp;Nami Pandit-Abid PharmD ,&nbsp;Juby A. Jacob-Nara MD, DHSc ,&nbsp;Amr Radwan MBBChir ,&nbsp;Paul J. Rowe MD ,&nbsp;Yamo Deniz MD","doi":"10.1016/j.jacig.2025.100474","DOIUrl":"10.1016/j.jacig.2025.100474","url":null,"abstract":"<div><h3>Background</h3><div>The QUEST (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> identifier NCT02414854) and TRAVERSE (NCT02134028) studies demonstrated the efficacy of dupilumab, 200 or 300 mg, versus placebo every 2 weeks for 52 weeks (QUEST) and dupilumab, 300 mg, for an additional 96 weeks (TRAVERSE) in patients with uncontrolled, moderate-to-severe asthma.</div></div><div><h3>Objective</h3><div>This analysis assessed dupilumab efficacy in patients from QUEST who enrolled in TRAVERSE and were stratified by a reduction in fractional exhaled nitric oxide (F<span>eno</span>) level by week 2 of QUEST.</div></div><div><h3>Methods</h3><div>Patients with an F<span>eno</span> level of at least 25 ppb at parent study baseline (PSBL) were defined as those with or without a minimally important F<span>eno</span> level reduction/response (a ≥20% reduction in patients with an F<span>eno</span> level of ≥50 ppb and a reduction of &gt;10 ppb in those with an F<span>eno</span> level of &lt;50 ppb at PSBL) by week 2 of QUEST. We assessed annualized severe exacerbation rates (AERs) and changes from PSBL in prebronchodilator FEV₁ value, 5-item Asthma Control Questionnaire score, and Asthma Quality of Life Questionnaire score.</div></div><div><h3>Results</h3><div>During QUEST, dupilumab (compared with placebo) reduced AER by 58% to 59% across F<span>eno</span> response subgroups (unadjusted AER = 0.392-0.523 for dupilumab vs 1.052-1.280 for placebo) and improved prebronchodilator FEV₁ value regardless of F<span>eno</span> response. These improvements were sustained during TRAVERSE, with a slightly greater magnitude in F<span>eno</span> responders. Dupilumab also improved 5-item Asthma Control Questionnaire and Asthma Quality of Life Questionnaire scores independently of F<span>eno</span> responses.</div></div><div><h3>Conclusion</h3><div>Dupilumab sustained efficacy for up to 3 years in patients with and without a minimally important early reduction in F<span>eno</span> level. Greater improvements were seen in patients with an early reduction in F<span>eno</span> level, but patients without such a reduction also showed favorable outcomes during their treatment with dupilumab.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 3","pages":"Article 100474"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing diagnostic tests for shrimp allergy in children: A multicenter trial","authors":"Yuri Takaoka MD, PhD ,&nbsp;Yuki Tsurinaga MD ,&nbsp;Yukiko Hiraguchi MD, PhD ,&nbsp;Masaaki Hamada MD, PhD ,&nbsp;Atsuko Nakano MD ,&nbsp;Tomoko Kawakami MD ,&nbsp;Ikuo Okafuji MD, PhD ,&nbsp;Nayu Iwakoshi MD ,&nbsp;Masaaki Doi MD, PhD ,&nbsp;Keita Otsuka MD ,&nbsp;Yukiko Sugimoto MD ,&nbsp;Norihito Iba MD ,&nbsp;Junko Kumon MD ,&nbsp;Rumi Ueno MD ,&nbsp;Tamana Nakano MD ,&nbsp;Tomohiro Yamaguchi MD ,&nbsp;Yohei Fuksawa MD ,&nbsp;Amane Shigekawa MD ,&nbsp;Yukinori Yoshida MD, PhD ,&nbsp;Makoto Kameda MD","doi":"10.1016/j.jacig.2025.100471","DOIUrl":"10.1016/j.jacig.2025.100471","url":null,"abstract":"<div><h3>Background</h3><div>Clinical research on pediatric shrimp allergy is limited.</div></div><div><h3>Objective</h3><div>We sought to evaluate the diagnostic accuracy and safety of testing methods for shrimp allergy.</div></div><div><h3>Methods</h3><div>An oral food challenge (OFC) for shrimp was conducted on Japanese children with suspected shrimp allergy. Before the OFC, shrimp-, tropomyosin-, house dust mite–, and cockroach-specific IgE levels were measured, along with skin prick tests (SPTs). OFC results using epinephrine as a safety indicator determined persistent, mild, or tolerant shrimp allergy.</div></div><div><h3>Results</h3><div>Sixty-six children (median age, 6 years) underwent the OFC. All patients demonstrated house dust mite–specific IgE level exceeding 0.35 IUA/mL. Sixteen were diagnosed with persistent shrimp allergy, defined by Anaphylaxis Scoring Aichi scores greater than or equal to 10 or scores of 5 with urticaria. A 15-year-old required epinephrine for anaphylaxis. Eight children with negative results (scores ≤ 9) reported mild symptoms after repeated home ingestion following the OFC. Median SPT wheal diameters in persistent, mild allergic, and tolerant groups were similarly elevated (8.5 vs 9.5 vs 8.0 mm; <em>P</em> = .99). Patients with persistent shrimp allergy had higher median shrimp- and tropomyosin-specific IgE level than those classified as mild or tolerant (shrimp: 73.5 vs 30.0 vs 9.4 IUA/mL; <em>P</em> = .01; tropomyosin: 68.0 vs 41.9 vs 11.5 IUA/mL; <em>P</em> = .16). Receiver-operating characteristic analysis determined optimal IgE cutoff values as 58.2 IUA/mL for shrimp-specific IgE and 33.5 IUA/mL for tropomyosin-specific IgE.</div></div><div><h3>Conclusions</h3><div>SPT showed limited symptom correlation, whereas shrimp-specific IgE demonstrated greater diagnostic value than tropomyosin-specific IgE. No IgE cutoff accurately predicts a successfully passed OFC.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 3","pages":"Article 100471"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying patient preferences for treatments for refractory chronic spontaneous urticaria","authors":"Olufemi Babalola MHS, MSc, PhD ,&nbsp;Richard Hass PhD ,&nbsp;John McAna PhD ,&nbsp;Manav Segal MD ,&nbsp;Juan Marcos Gonzalez PhD ,&nbsp;Olajumoke Fadugba MD","doi":"10.1016/j.jacig.2025.100468","DOIUrl":"10.1016/j.jacig.2025.100468","url":null,"abstract":"<div><h3>Background</h3><div>In recent years, it has become increasingly common to incorporate the patient perspective into drug development and regulatory decision making.</div></div><div><h3>Objective</h3><div>This study aimed to measure and quantify patient preferences (priorities and trade-offs) for attributes that characterize current and emerging refractory chronic spontaneous urticaria (rCSU) treatments.</div></div><div><h3>Methods</h3><div>Adult patients with self-reported rCSU symptoms completed an online discrete choice experiment survey. The survey included 10 questions that asked respondents to choose between 2 hypothetical rCSU treatment profiles having similar attributes with varying levels. The attributes included the following: chance of control of symptoms, time to symptom control, return of symptoms after discontinuation of therapy (complete remission), allergic reaction, risk of kidney dysfunction (usually reversible), and mode and frequency of administration. Relative attribute importance and maximum acceptable risks were calculated.</div></div><div><h3>Results</h3><div>A total of 213 subjects with a mean age of 51 years completed the survey. Efficacy (symptom control) and mode of administration were the 2 most important attributes to treatment choice, followed by risk of kidney dysfunction and time to achieve symptom control. Complete remission of symptoms and risk of allergic reaction were identified as least important. With regard to mode of administration, topical treatment was the most preferred option and infusion therapy was least preferred. Respondents who were presented with a scenario of refractory and severe chronic spontaneous urticaria were willing to accept increased risk of reversible kidney dysfunction in exchange for improvement in symptom control or complete remission. Respondents were willing to accept infusion over topical treatment if there was significant increase in treatment efficacy.</div></div><div><h3>Conclusion</h3><div>These study results can be used to inform development and evaluation of future rCSU therapies by product developers and regulatory authorities, respectively.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 3","pages":"Article 100468"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mutations of MRGPRX2, drug sensitivity, and genetic markers related to disease","authors":"Subashini Hemamala Ratnayake MSc, BSc ,&nbsp;Kanishka Senarath PhD ,&nbsp;Dakshika Gangani PhD ,&nbsp;Dhanushka Dasanayake MBBS ,&nbsp;Rajiva de Silva MBBS ,&nbsp;Shiroma Handunnetti PhD","doi":"10.1016/j.jacig.2025.100467","DOIUrl":"10.1016/j.jacig.2025.100467","url":null,"abstract":"<div><div>Mast cells (MCs) express the novel class A Mas-related G protein–coupled receptor X2 (MRGPRX2). Additionally, neurons and other leukocytes including basophils express MRGPRX2. MC activation dependent on IgE is a well-established and extensively researched mechanism of type I hypersensitivity and allergic reactions. It was not until MRGPRX2 was identified as the receptor in charge of pseudo-allergy or IgE-independent MC activation that non–IgE-mediated MC degranulation was defined and acknowledged, despite the known clinical phenotype of “pseudo-allergy.” The identification and characterization of MRGPRX2 subsequently solved the enigma of non–IgE-mediated (pseudo-allergic) response. Studies indicate that MRGPRX2 is involved in the manifestation of symptoms in atopic dermatitis, neurogenic inflammation, and chronic urticaria. In 2021, it was reported that naturally occurring missense mutations in the <em>MRGPRX2</em> gene could lead to a loss-of-function phenotype affecting MC activation by a wide range of ligands. Mutations resulting in gain of function have also been reported. The likelihood and features of anaphylactic reactions brought on by the MRGPRX2 receptor are affected by mutations in the <em>MRGPRX2</em> gene. Changes in receptor function brought on by these mutations may be a factor in diseases like chronic urticaria and other disorders involving MCs. It is therefore necessary to ascertain not just the distribution of these mutations but also their potential implications in allergies and other illnesses. Creating a potent high-affinity antagonist is one of the best strategies to block the MRGPRX2 receptor. This review presents a current in-depth analysis of how these changes in the <em>MRGPRX2</em> gene affect treatment responsiveness and illness susceptibility; it also highlights the significance of further research into the potential roles of gain-of-function and loss-of-function mutations of <em>MRGPRX2</em> in drug-induced anaphylaxis.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 3","pages":"Article 100467"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical correlations with unmet social needs in critically ill children with asthma","authors":"Scott E. Call MD ,&nbsp;Lisa Goto MD ,&nbsp;Gwynne Latimer MD ,&nbsp;Eduardo A. Trujillo Rivera PhD ,&nbsp;Amanda Jepson MSW ,&nbsp;Mercedes Tate MSW ,&nbsp;Shayla E. Stringfield BS ,&nbsp;Gayle Gilmore MSSA, LICSW ,&nbsp;Kitman Wai MD, MS ,&nbsp;Shamily Jadhav ,&nbsp;Paola Jaminet ,&nbsp;Rachel H.F. Margolis PhD, LICSW ,&nbsp;Shilpa J. Patel MD, MPH ,&nbsp;Terry Dean MD, PhD","doi":"10.1016/j.jacig.2025.100466","DOIUrl":"10.1016/j.jacig.2025.100466","url":null,"abstract":"<div><h3>Background</h3><div>Social drivers of health have been implicated as playing a major role in determining pediatric asthma outcomes. However, the impact of self-reported, family-level unmet social needs on asthma outcomes in critically ill pediatric patients is unknown.</div></div><div><h3>Objective</h3><div>Our aim was to determine whether the presence of unmet social needs at the time of intensive care unit (ICU) admission are associated with ICU-related and postadmission outcomes.</div></div><div><h3>Methods</h3><div>This was a 12-month (February 2022-January 2023) prospective cohort study at a single, urban pediatric health care system. Families of patients admitted to the pediatric ICU for asthma were screened for unmet social needs in multiple domains. Regression analyses were performed to correlate unmet needs with the following clinical outcomes: duration of bilevel positive airway pressure use; lengths of ICU and hospital stay; and rates of 6-month outpatient follow-up, ED visitation, and hospital readmission.</div></div><div><h3>Results</h3><div>Of 164 screened families, 57% reported at least 1 unmet social need. Unmet needs were significantly associated with longer hospitalizations (ie, a 3% increase per year of age (odds ratio =1.03 [95% CI = 1.00-1.07]) and a higher likelihood of returning for emergency care (adds ratio =2.6 [95% CI = 1.1-6.2]), even after accounting for race, insurance payer, and medical comorbidities. Additionally, patients provided with resources reported fewer needs when rescreened at outpatient follow-up (median = –1 need [<em>P</em> = .001]).</div></div><div><h3>Conclusion</h3><div>Families of critically ill pediatric patients with asthma reported a high rate of unmet social needs. Furthermore, those with needs were vulnerable to longer stays and repeat asthma exacerbations requiring emergency care. Identification of these families presents an opportunity to target a high-risk population with durable medical and social interventions.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 3","pages":"Article 100466"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A newly identified pathology of episodic angioedema with hypereosinophilia (Gleich syndrome) revealed by nultiomics analysis","authors":"Tatsuya Koreeda MS ,&nbsp;Hirokazu Muraoka MD, PhD, MPH ,&nbsp;Yasunori Sato PhD","doi":"10.1016/j.jacig.2025.100465","DOIUrl":"10.1016/j.jacig.2025.100465","url":null,"abstract":"<div><h3>Background</h3><div>Episodic angioedema with eosinophilia (Gleich syndrome) is a rare disease marked by periodic angioedema, fever, and severe eosinophilia, with limited understanding of its pathogenesis.</div></div><div><h3>Objective</h3><div>We sought to identify pathogenic factors contributing to severe Gleich syndrome through a comprehensive multiomics approach, using whole-genome sequencing (WGS) and RNA sequencing (RNA-seq).</div></div><div><h3>Methods</h3><div>A multiomics analysis was conducted on a 16- to 20-year-old female patient with severe Gleich syndrome, presenting with periodic high fever, extensive urticaria/eczema, and marked eosinophilia. The analysis included WGS and RNA-seq of blood samples.</div></div><div><h3>Results</h3><div>WGS revealed high-impact pathogenic mutations that have the potential to significantly alter gene function in 16 genes, including PR domain containing 16 (gene involved in transcriptional regulation). RNA-seq identified differentially expressed genes linked to immune response regulation and viral defense. Combined <em>z</em>-score analysis of WGS and RNA-seq highlighted angiotensin-converting enzyme as a key gene, with significant downregulation during disease progression that normalized with treatment. IFNG was also implicated.</div></div><div><h3>Conclusions</h3><div>The findings suggest that decreased angiotensin-converting enzyme expression, driven by PR domain containing 16 (gene involved in transcriptional regulation) mutations and altered IFNG expression, may contribute to increased bradykinin levels and activation of the arachidonic acid cascade, leading to the severe inflammation and angioedema characteristic of Gleich syndrome. This study underscores the utility of integrating WGS and RNA-seq data in elucidating the molecular basis of rare diseases and offers a foundation for developing therapeutic strategies for hypereosinophilic syndromes.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 3","pages":"Article 100465"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}