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

{"title":"Alleviating effect of intranasal zinc on symptoms of allergic rhinitis","authors":"Huadong Xu PhD ,&nbsp;Keming Tong BS ,&nbsp;Naruhito Iwasaki MD, PhD ,&nbsp;Nobutaka Ohgami PhD ,&nbsp;Akira Tazaki PhD ,&nbsp;Takumi Kagawa MMSc ,&nbsp;Yanjun Gao MMSc ,&nbsp;Delgama A.S.M. Nishadhi MMSc ,&nbsp;Akihito Harusato MD, PhD ,&nbsp;Masafumi Sakashita MD, PhD ,&nbsp;Kazuhiro Ogi MD, PhD ,&nbsp;Shigeharu Fujieda MD, PhD ,&nbsp;Shogo Sumiya MD ,&nbsp;Shinichi Iwasaki MD, PhD ,&nbsp;Masashi Kato MD, PhD","doi":"10.1016/j.jacig.2025.100408","DOIUrl":"10.1016/j.jacig.2025.100408","url":null,"abstract":"<div><h3>Background</h3><div>There is no information about the clinical implications and kinetics of zinc (Zn) in the nasal cavity, a center of allergic inflammation, and serum in subjects with allergic rhinitis (AR).</div></div><div><h3>Objective</h3><div>Effects of intranasal Zn on symptoms before and after allergen provocation were investigated in humans and mice with or without AR.</div></div><div><h3>Methods</h3><div>The first clinical follow-up study for Zn levels in nasal epithelial lining fluid (ELF) and serum was conducted in 57 control subjects and 44 patients with Japanese cedar pollinosis (JCP), a representative seasonal AR, from preseason to season. The clinical implications and kinetics of Zn levels in ELF and serum were further investigated in model mice with JCP.</div></div><div><h3>Results</h3><div>This clinical study showed that the Zn level in nasal ELF from patients with JCP was increased after pollen exposure and became significantly higher than that in nasal ELF from controls in the JCP season. Conversely, the serum Zn level in patients was decreased after pollen exposure and became significantly lower than that in the controls in the JCP season. To further investigate the clinical implication of Zn level, model mice that mimicked the kinetics of intranasal and serum Zn levels as well as the symptoms in patients with JCP were established. The mouse interventional study showed that the symptoms of mice with provocative JCP were significantly improved by treatment with the putative human-equivalent dose of Zn. The relative number of mucin-secreting goblet cells, a sign of provocative allergic rhinitis, in the mice was decreased by intranasal treatment with Zn.</div></div><div><h3>Conclusion</h3><div>The study’s behavioral and pathologic results indicate that an increased level of intranasal Zn can alleviate symptoms of AR.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100408"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153863","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 of delayed asthma diagnosis with asthma exacerbations in children","authors":"Chung-Il Wi MD ,&nbsp;Euijung Ryu PhD ,&nbsp;Katherine S. King MS ,&nbsp;Jung Hyun Kwon MD, PhD ,&nbsp;Joshua T. Bublitz BS ,&nbsp;Miguel Park MD ,&nbsp;Sergio E. Chiarella MD ,&nbsp;Jason D. Greenwood MD, MS ,&nbsp;Thanai Pongdee MD ,&nbsp;Lynnea Myers PhD ,&nbsp;Björn Nordlund PhD ,&nbsp;Sunghwan Sohn PhD ,&nbsp;Elham Sagheb MS ,&nbsp;Bhavani Singh Agnikula Kshatriya MS ,&nbsp;Dave Watson PhD ,&nbsp;Hongfang Liu PhD ,&nbsp;Beverley J. Sheares MD, MS ,&nbsp;Carla M. Davis MD ,&nbsp;Wade Schulz MD, PhD ,&nbsp;Young J. Juhn MD, MPH","doi":"10.1016/j.jacig.2025.100409","DOIUrl":"10.1016/j.jacig.2025.100409","url":null,"abstract":"<div><h3>Background</h3><div>There is a significant delay between symptom onset and diagnosis of childhood asthma, but the impact of this delay on asthma outcomes has not been well understood.</div></div><div><h3>Objectives</h3><div>We sought to study the association of delayed diagnosis of asthma with asthma exacerbations (AEs) in children.</div></div><div><h3>Methods</h3><div>Using the Mayo Clinic birth cohort, we identified children with a diagnosis of asthma from electronic health records. We defined onset date as the date when subjects first met predetermined asthma criteria ascertained by an electronic health records–based natural language processing algorithm. Delay in diagnosis (DD) was defined as first diagnosis &gt;30 days from onset date (vs timely diagnosis [TD] within 30 days). The primary outcome was AE after the index date (for DD: first diagnosis date vs for TD: clinic visit at similar delay from diagnosis as matched DD counterpart). A Cox proportional hazard model was used to test the association between delayed diagnosis status and risk of AE, adjusting for sociodemographics, care quality, and asthma severity.</div></div><div><h3>Results</h3><div>Among 537 matched pairs of DD and TD (median age at index date: 4.1 years), a total of 344 and 253 children in DD and TD, respectively, had ≥1 AE during median follow-up period of 9.3 years. Children in the DD group had a significantly increased risk of AE compared to TD (adjusted hazard ratio: 1.53; 95% CI: 1.28, 1.80; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>DD of asthma in children is associated with an increased risk of AE compared to TD. TD of asthma should be an important priority in childhood asthma management.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100409"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143332862","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":"Diagnostic disparities in inborn errors of immunity: From clinical suspicion to diagnosis","authors":"Karen M. Gilbert PhD ,&nbsp;Robert F. LeCates MA ,&nbsp;Alison A. Galbraith MD, MPH ,&nbsp;Paul J. Maglione MD, PhD ,&nbsp;Stephanie Argetsinger MPH ,&nbsp;Nicholas L. Rider DO ,&nbsp;Jocelyn R. Farmer MD, PhD ,&nbsp;Mei-Sing Ong PhD","doi":"10.1016/j.jacig.2025.100407","DOIUrl":"10.1016/j.jacig.2025.100407","url":null,"abstract":"<div><h3>Background</h3><div>Emerging evidence suggests that inborn errors of immunity (IEI) are underdiagnosed among underserved populations. However, there remains a lack of national studies evaluating diagnostic disparities in IEI.</div></div><div><h3>Objective</h3><div>We examined disparities in the timely IEI diagnosis and related health outcomes.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed of a US national claims database (years 2007 to 2021). Participants included patients diagnosed with an “unspecified immune deficiency” (uID) and presented with IEI-related symptoms, who later received an IEI diagnosis (n = 1429). We quantified the diagnostic interval from clinical suspicion (uID) to IEI diagnosis and examined its association with sociodemographic factors and related health outcomes.</div></div><div><h3>Results</h3><div>The median (interquartile range) diagnostic interval was 369 (126-808) days. Diagnostic interval was 14% longer among patients residing in predominantly non-White neighborhoods, compared with those in predominantly White neighborhoods (<em>P</em> = .04), despite having more severe IEI-related symptoms at uID diagnosis and significantly more health care encounters for pneumonia (incidence rate ratio, 2.24; 95% confidence interval, 1.40-3.70) and sepsis (incidence rate ratio, 2.15; 95% confidence interval, 1.21-3.99) in the year after uID diagnosis. Residence in neighborhoods with greater deprivation was also associated with more severe IEI-related symptoms and greater health care utilization in the year after uID diagnosis. Older age was associated with longer diagnostic interval (<em>P</em> &lt; .001). Longer diagnostic interval was associated with a longer interval to receiving IgR therapy (hazard ratio, 0.64; 95% confidence interval, 0.49-0.83).</div></div><div><h3>Conclusion</h3><div>We observed significant racial and socioeconomic disparities in the timeliness of IEI diagnosis and IEI-related outcomes. Further studies are needed to address the underlying factors contributing to diagnostic inequity.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100407"},"PeriodicalIF":0.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153885","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":"Urticaria unveiled in hereditary angioedema with carboxypeptidase N mutation","authors":"Pedro Giavina-Bianchi MD, PhD,&nbsp;Mara Giavina-Bianchi MD, PhD,&nbsp;Jorge Kalil MD, PhD","doi":"10.1016/j.jacig.2025.100405","DOIUrl":"10.1016/j.jacig.2025.100405","url":null,"abstract":"","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100405"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153418","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 significance of very high IgE levels (≥1000 IU/mL): Population-based study of 118,211 adults","authors":"Shay Nemet MD ,&nbsp;Daniel Elbirt MD ,&nbsp;Ramon Cohen MD ,&nbsp;Keren Mahlab-Guri MD ,&nbsp;Shira Bezalel-Rosenberg MD ,&nbsp;Ilan Asher MD ,&nbsp;Aviv Talmon MD ,&nbsp;Limor Rubin MD ,&nbsp;Yaarit Ribak MD ,&nbsp;Ruslan Sergienko MHA ,&nbsp;Udi Nussinovitch MD, PhD ,&nbsp;Yuval Tal MD, PhD ,&nbsp;Oded Shamriz MD","doi":"10.1016/j.jacig.2025.100403","DOIUrl":"10.1016/j.jacig.2025.100403","url":null,"abstract":"<div><h3>Background</h3><div>Very high serum IgE (≥1000 IU/mL) is reported in atopic disorders. However, data on its significance in nonallergic disorders are limited.</div></div><div><h3>Objective</h3><div>We aimed to analyze the diagnostic value of very high IgE in adults.</div></div><div><h3>Methods</h3><div>A retrospective nationwide study was conducted using the electronic database of Clalit Health Services, covering adults (≥18 years) treated between 2002 and 2022. Subjects with IgE ≥ 1000 IU/mL were compared to the controls with IgE &lt; 100 IU/mL across 3 age groups (18-30, 31-64, and ≥65 years). Outcomes included eosinophilic, autoimmune, autoinflammatory, and cardiovascular disorders (CVD), cancer, and inborn errors of immunity (IEI). A multivariable Cox regression model determined statistical significance (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>The study included 118,211 subjects: 110,116 controls and 8635 with very high IgE levels. Excluding insect sting and drug allergies, very high IgE was more common across all tested allergic disorders, with asthma showing the highest rate (64.49%). Univariable analysis showed higher prevalence of CVD (3.88% vs 2.72%, <em>P</em> &lt; .001), eosinophilic disorders (0.42% vs 0.06%, <em>P</em> &lt; .001), and IEI (0.35% vs 0.20%, <em>P</em> = .004) in the very high IgE group. Multivariable analysis revealed age-dependent significant results: higher CVD risk in ages 31-64 (hazard ratio = 1.249; 95% confidence interval, 1.054-1.481; <em>P</em> = .010) and borderline IEI association in ages 18-30 (hazard ratio = 1.802; 95% confidence interval, 0.978-3.321; <em>P</em> = .059). Risk of eosinophilic disorders was increased across all age groups (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Very high IgE level of ≥1000 IU/mL is associated with increased risks of CVD, IEI, and eosinophilic disorders. Physicians should consider further assessment for these conditions in nonallergic patients with very high IgE levels.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100403"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153887","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":"Moving to lower-poverty neighborhoods offers broad benefits for children with asthma, regardless of sex or other baseline characteristics","authors":"Torie L. Grant MD, MHS ,&nbsp;Laken C. Roberts Lavigne PhD, MPH ,&nbsp;Craig Evan Pollack MD, MHS ,&nbsp;Pete Cimbolic BA ,&nbsp;Susan Balcer-Whaley MPH ,&nbsp;Roger D. Peng PhD ,&nbsp;Elizabeth C. Matsui MD, MHS ,&nbsp;Corinne A. Keet MD, PhD","doi":"10.1016/j.jacig.2025.100402","DOIUrl":"10.1016/j.jacig.2025.100402","url":null,"abstract":"<div><h3>Background</h3><div>It was previously found that moving to lower-poverty/higher-opportunity neighborhoods as part of a housing mobility program was associated with improvements in asthma exacerbations and symptoms among children with asthma. Whether some subsets of children with asthma experience a greater improvement in asthma morbidity after moving is unknown.</div></div><div><h3>Objective</h3><div>Our aim was to determine whether the benefits of moving to lower-poverty/higher-opportunity neighborhoods were concentrated in subsets of participants with asthma.</div></div><div><h3>Methods</h3><div>We conducted a secondary analysis of the participants in the Mobility Asthma Project. Generalized estimating equations were used to assess the association between moving and asthma exacerbations and maximum symptom days. Separately, these models were then stratified by sex, age, body mass index, allergic sensitization, asthma severity, and stress before the move to estimate stratum-specific odds ratios for moving.</div></div><div><h3>Results</h3><div>Participants broadly experienced a postmove reduction in odds of an exacerbation and maximum symptom days. Male children and children at a higher asthma controller medication treatment step experienced a greater reduction in maximum symptom days with moving.</div></div><div><h3>Conclusion</h3><div>Children with asthma experience a reduction in odds of an exacerbation and symptoms after moving to lower-poverty/higher-opportunity neighborhoods. These improvements in asthma outcomes are seen regardless of baseline sex, age, body mass index, allergic sensitization, asthma severity, and premove stress.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100402"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143332869","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":"Phase 1 study of safety, tolerability, and efficacy of intradermal DNA vaccine ASP2390 in adults allergic to house dust mites","authors":"Thomas Kayser MD, BS ,&nbsp;Ronald Smulders MD, PhD ,&nbsp;Tomohiro Kusawake PhD ,&nbsp;Erik Wambre PhD ,&nbsp;Gurunadh R. Chichili PhD ,&nbsp;Mary B. Blauwet DrPH ,&nbsp;Anna Spence MS ,&nbsp;Melanie Patton BS ,&nbsp;Rima Tabash PhD ,&nbsp;Hannah A. DeBerg PhD ,&nbsp;Sugandhika Khosa MS ,&nbsp;Philipp Badorrek MD ,&nbsp;Jens M. Hohlfeld MD ,&nbsp;Brian C. Ferslew PharmD, PhD","doi":"10.1016/j.jacig.2025.100404","DOIUrl":"10.1016/j.jacig.2025.100404","url":null,"abstract":"<div><h3>Background</h3><div>House dust mite (HDM) allergies are prevalent, yet current treatments like allergen avoidance, pharmacotherapy, and conventional allergen immunotherapy present limitations. The novel LAMP (lysosomal-associated membrane protein)-based DNA vaccine ASP2390 targets major HDM allergens, potentially shifting immune responses toward nonallergic pathways and minimizing the risk of atopy, with positive safety and efficacy signals in preclinical models.</div></div><div><h3>Objective</h3><div>We evaluated the safety, tolerability, and efficacy of first-in-human intradermal ASP2390 in adults with HDM allergy.</div></div><div><h3>Methods</h3><div>A randomized, double-blind, placebo-controlled phase 1 trial was conducted in adults with HDM-induced allergic rhinitis. Participants received either 1 mg or 4 mg of ASP2390 or placebo intradermally once weekly for 12 weeks, with safety, tolerability, and pharmacodynamic responses assessed over a 63-week period, including early-phase clinical effects assessed via HDM exposure in an allergen challenge chamber.</div></div><div><h3>Results</h3><div>Twenty-eight adults (mean age, 26.9 years; 23 male participants), with 7 receiving 1 mg and 13 receiving 4 mg ASP2390, 8 receiving placebo, showed no serious adverse events or withdrawals due to treatment-emergent adverse events. The most common events were nasopharyngitis, coronavirus disease 2019, headache, fatigue, and diarrhea; fatigue and headache were the most frequent systemic reactions, and injection-site tenderness the most frequent local reaction. There were no substantial changes in allergen-specific immunoglobulin levels, basophil activation, or T helper cell subpopulations, and no difference in allergic clinical responses compared to placebo.</div></div><div><h3>Conclusion</h3><div>Intradermal DNA vaccine ASP2390 is safe and well tolerated but does not show an immunologic or clinical response in a small sample of adults allergic to HDM.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100404"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143332861","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 validity of dried blood spot assay for the measurement of functional C1 inhibitor in angioedema due to C1 inhibitor deficiency","authors":"Jonathan A. Bernstein MD ,&nbsp;Jie Cheng PhD ,&nbsp;Thomas Pisani MSc ,&nbsp;Dan Sexton PhD ,&nbsp;Rachel E. Whitaker PhD ,&nbsp;Daniel Nova Estepan PharmD, RPh ,&nbsp;Neil Inhaber MD","doi":"10.1016/j.jacig.2025.100401","DOIUrl":"10.1016/j.jacig.2025.100401","url":null,"abstract":"<div><h3>Background</h3><div>Functional C1 inhibitor (fC1INH) is a key biomarker for the diagnosis of hereditary angioedema due to C1 inhibitor (C1INH) deficiency. A novel fC1INH assay from dried blood spot (DBS) reduces practical fC1INH testing limitations versus conventional fC1INH assays, but its sensitivity and specificity have not yet been characterized.</div></div><div><h3>Objective</h3><div>We sought to assess the sensitivity and specificity of fC1INH DBS assay and conventional fC1INH ELISA and chromogenic assay.</div></div><div><h3>Methods</h3><div>fC1INH DBS assay was performed in samples from 30 patients with previously diagnosed recurrent angioedema due to C1INH deficiency and from 100 healthy controls. Whole blood samples were spotted onto blotting paper and dried for 3 hours or longer, and then fC1INH from DBS was measured through its C1s protease inhibitory activity using liquid chromatography tandem mass spectrometry. fC1INH ELISA and chromogenic assays were performed by reanalyzing a subset of 29 patients and 50 healthy controls. Sensitivity and specificity were evaluated using a negative sample mean − 1.96 SD cutoff.</div></div><div><h3>Results</h3><div>fC1INH DBS assay had a sensitivity of 0.93, a specificity of 0.97, and area under the curve of the receiver-operating characteristic curve of 0.996 (95% CI, 0.989-1.000). In the subset, DBS and chromogenic assay had similar sensitivity (DBS, 1.00; chromogenic assay, 0.97) and specificity (DBS, 0.94; chromogenic assay, 1.00); ELISA sensitivity was lower (0.62) and specificity similar (1.00).</div></div><div><h3>Conclusions</h3><div>fC1INH DBS assay had similar sensitivity and specificity when contrasted with fC1INH chromogenic assay. Because of its easier sample collection and logistic benefits, fC1INH DBS assay may allow more accessible hereditary angioedema diagnostic testing, especially in underserved regions.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100401"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153886","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 33-year diagnostic odyssey in an Ashkenazi Jewish patient with Aicardi-Goutières syndrome","authors":"Oskar Schnappauf PhD ,&nbsp;Hongying Wang PhD ,&nbsp;Ivona Aksentijevich MD ,&nbsp;Daniel L. Kastner MD, PhD ,&nbsp;Ronald M. Laxer MD","doi":"10.1016/j.jacig.2025.100400","DOIUrl":"10.1016/j.jacig.2025.100400","url":null,"abstract":"<div><div>The critical need for awareness and genetic testing of the <em>SAMHD1</em> deletion in Ashkenazi Jewish patients is highlighted owing to its relatively high carrier frequency. Early detection can prevent severe disease complications through targeted therapy.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100400"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152583","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":"Acute/baseline ratios of all 3 MC mediator metabolites can enhance diagnosis and management of mast cell activation syndrome","authors":"Joseph H. Butterfield MD ,&nbsp;Adela Taylor MD","doi":"10.1016/j.jacig.2024.100399","DOIUrl":"10.1016/j.jacig.2024.100399","url":null,"abstract":"<div><h3>Background</h3><div>Mast cell (MC) activation syndrome (MCAS) can be a challenge to diagnose and treat despite the near continuous appearance of publications outlining specific criteria. Follow-up of the clinical responses to treatment is often lacking, and confirmation that leukotriene C₄ (LTC₄) is an active participant in MCAS has been overlooked.</div></div><div><h3>Objective</h3><div>Three patients with MCAS characterized by anaphylaxis are presented to illustrate (1) the value of contemporaneous urinary mediator sampling during MCAS in addition to serum tryptase measurements and (2) substantiation of the fact that not only can LTC₄ (measured metabolite LTE₄) be the highest metabolite measured, but (3) blockade of the LTE₄ receptor can contribute to symptom prevention.</div></div><div><h3>Method</h3><div>The study methods comprised clinical review and quantitation of acute and baseline levels of tryptase and urinary MC mediators.</div></div><div><h3>Results</h3><div>The cases of 3 patients with MCAS are reviewed. In the first case, vespid sting–induced anaphylaxis was associated with a marked increase in the LTE₄ excretion. The addition of montelukast was instituted, and subsequent stings did not evoke symptoms. In the second case, acute measurements showed substantial increased levels of (2,3-dinor)-11β-prostaglandin F_2α, and LTE₄. The addition of aspirin plus montelukast prevented subsequent attacks. The third case documents a perioperative anaphylactic event with an acute/baseline LTE₄ ratio far higher than those of tryptase or other metabolites.</div></div><div><h3>Conclusions</h3><div>The value of measuring all 3 MC mediator metabolites during MCAS should not be overlooked. These measurements can facilitate the successful prevention of attacks. Furthermore, results from these tests show that histamine is often a minor player, whereas acute/baseline levels of the metabolites of LTC₄ and prostaglandin D₂ are frequently much higher, warranting nonantihistamine treatment.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100399"},"PeriodicalIF":0.0,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153417","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}