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

{"title":"Vernal keratoconjunctivitis: The burden of being allergic","authors":"Maria Cristina Artesani MD ,&nbsp;Mariacristina Esposito MD ,&nbsp;Luca Buzzonetti MD ,&nbsp;Giovanni Di Nardo MD, PhD ,&nbsp;Alessandro Giovanni Fiocchi MD ,&nbsp;Maurizio Mennini MD, PhD","doi":"10.1016/j.jacig.2025.100421","DOIUrl":"10.1016/j.jacig.2025.100421","url":null,"abstract":"<div><h3>Background</h3><div>Vernal keratoconjunctivitis (VKC) is a chronic inflammatory eye condition predominantly affecting children. Despite its varied clinical manifestations, VKC poses challenges in diagnosis and management because of its multifactorial nature, potentially involving allergic sensitization and comorbidities.</div></div><div><h3>Objective</h3><div>The purpose of this study was to comprehensively assess VKC, focusing on the possible effect of allergic sensitization on the clinical form, severity, and quality of life of pediatric patients with VKC.</div></div><div><h3>Methods</h3><div>In this retrospective study, encompassing 248 children aged 5 to 12 diagnosed with VKC, clinical data, ophthalmologic assessments, and quality-of-life metrics were systematically collected. Patients were divided into sensitized and nonsensitized groups according to allergy investigations. Comprehensive evaluations included clinical history, symptom scoring, Bonini grading for severity, allergen tests, blood examinations, and ophthalmologic examinations.</div></div><div><h3>Results</h3><div>Among the enrolled patients, a prevalence of nonsensitized cases (56%) emerged. Both sensitized and nonsensitized groups displayed similar demographic profiles and clinical forms of VKC. A significantly higher occurrence of rhinitis and asthma was observed in the sensitized group. No significant differences were found in ophthalmologic and hematologic parameters between the 2 groups. Despite this, sensitized patients exhibited a significantly higher impact on quality of life, as indicated by QUICK questionnaire scores.</div></div><div><h3>Conclusion</h3><div>The study underscores the importance of comprehensive allergy assessments during VKC diagnosis, suggesting potential associations between sensitization and atopic comorbidities impacting patients’ quality of life. Future investigations into environmental factors, specific allergens, and treatment response are pivotal for a holistic understanding of VKC’s implications for pediatric patients’ well-being.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100421"},"PeriodicalIF":0.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445677","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":"Multidisciplinary care in pediatric severe asthma: A comparative outcomes analysis","authors":"Adam S. Price MD ,&nbsp;Akilah A. Jefferson-Shah MD ,&nbsp;Robert D. Pesek MD ,&nbsp;Erhan Ararat MD ,&nbsp;Safia F. Nawaz MD ,&nbsp;Matthew Pertzborn MD ,&nbsp;Kim Cobb RT ,&nbsp;Haley Long RT ,&nbsp;Monica Y. Miller LMSW ,&nbsp;Brandi N. Whitaker PhD ,&nbsp;Stacie M. Jones MD ,&nbsp;Scott Stewart MS ,&nbsp;Daniel Liu MD ,&nbsp;Tamara T. Perry MD","doi":"10.1016/j.jacig.2025.100417","DOIUrl":"10.1016/j.jacig.2025.100417","url":null,"abstract":"<div><h3>Background</h3><div>There are limited data comparing the effectiveness of multidisciplinary severe asthma clinics (SACs) with that of conventional single-discipline clinics (SDCs) for pediatric severe asthma.</div></div><div><h3>Objective</h3><div>Our aim was to compare asthma outcomes between SACs and SDCs clinics and examine longitudinal health outcomes for patients with severe asthma who were followed in SACs.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study comparing pediatric asthma outcomes among patients with severe asthma between 2018 and 2022 who were treated at the multidisciplinary Arkansas Children's SAC with those of patients with severe asthma treated at SDCs. The primary outcome was acute health care utilization, including hospitalizations and emergency department visits. Secondary outcomes included systemic corticosteroid prescriptions and controller medications. For SAC enrollees, longitudinal outcomes including health care utilization, symptom control, and spirometry were evaluated 12 months before and after enrollment. Data sources included the electronic health record and SAC patient registry.</div></div><div><h3>Results</h3><div>The study population included 280 patients with severe asthma, aged 5 to 18 years, from the SAC (n = 56) and SDCs (n = 224). The SAC patients were more likely to be Black (79% vs 52% [<em>P</em> = .0002]), be non-Hispanic (100% vs 88% [<em>P</em> = .01]), have had at least 1 hospitalization (21% vs 10% [<em>P</em> = .04]), and have received at least 2 prescriptions for a systemic corticosteroid (34% vs 17% [<em>P</em> = .01]). Longitudinal outcomes among patients for the 12 months before SAC enrollment versus 12 months after SAC enrollment demonstrated significant reductions in acute exacerbations (from 35 to 8 [<em>P</em> &lt; .001]), hospitalizations (from 21 to 1 [<em>P</em> &lt; .001]), and intensive care unit admissions (from 8 to 1 [<em>P</em> = .02]).</div></div><div><h3>Conclusions</h3><div>The study highlights significant morbidity among predominately Black pediatric patients with severe asthma, particularly those followed in a SAC versus in SDCs at a tertiary care referral center. The findings demonstrate the value of targeted multidisciplinary approaches to reduce asthma utilization and improve outcomes among high-risk patients.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100417"},"PeriodicalIF":0.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143332867","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":"Multicomponent intervention for schoolchildren with asthma: Pilot cluster randomized controlled trial","authors":"Marina Reznik MD, MS ,&nbsp;Florinda Islamovic MD ,&nbsp;Jill S. Halterman MD, MPH ,&nbsp;Cheng-Shiun Leu PhD ,&nbsp;Jiaqing Zhang PhD ,&nbsp;Philip O. Ozuah MD, PhD","doi":"10.1016/j.jacig.2025.100418","DOIUrl":"10.1016/j.jacig.2025.100418","url":null,"abstract":"<div><h3>Background</h3><div>Physical activity (PA) is an important factor in asthma management. However, studies report low PA in children with asthma living in underserved communities.</div></div><div><h3>Objective</h3><div>We assessed preliminary effectiveness of a pilot multicomponent asthma intervention that includes classroom-based PA, asthma education to increase knowledge and reduce stigma, and care coordination to facilitate guideline-based care, on PA and symptom-free days (SFD) in urban, historically marginalized children with asthma.</div></div><div><h3>Methods</h3><div>Children aged 7-10 years with asthma and their caregivers were recruited from 4 Bronx, NY, schools. We randomly assigned 2 schools as intervention and 2 as control sites. Child PA (primary outcome) was measured by accelerometers at 4 time points, and caregivers completed surveys on asthma symptoms. Analyses used generalized linear mixed models with generalized estimating equation adjusting for clustering. Clinical Trial Registration: <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> NCT01873755.</div></div><div><h3>Results</h3><div>We included 107 children (53% male participants, 82% Hispanic, mean [standard deviation] age 9.0 [1.0] years, 76% with persistent or uncontrolled asthma). Children in the intervention group had a significantly greater increase in total moderate-to-vigorous PA and step counts at 12 months after intervention in the entire sample (β = 6.05, <em>P</em> &lt; .0001; β = 579.11, <em>P</em> = .008, respectively) and in those with persistent or uncontrolled asthma compared to controls (β = 6.20, <em>P</em> &lt; .001; β = 639.08, <em>P</em> = .004, respectively). Similar beneficial intervention effects were found in improvement in SFD over 2 weeks in the entire sample (β = 1.38, <em>P</em> = .018) and in children with persistent or uncontrolled asthma (β = 1.82, <em>P</em> = .011) compared to controls.</div></div><div><h3>Conclusion</h3><div>A pilot intervention addressing multiple barriers to PA, including stigma, teacher confidence in asthma management, access to PA, and in-school medication, improved PA levels and SFD in students with asthma.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100418"},"PeriodicalIF":0.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143332868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hereditary angioedema diagnosis evaluation score (HADES): A new clinical scoring system for predicting hereditary angioedema with C1 inhibitor deficiency","authors":"Ricardo Zwiener MD ,&nbsp;Rafael Zamora MD ,&nbsp;Carlos María Galmarini MD, PhD ,&nbsp;Laura Brion PhD ,&nbsp;Laura Arias MD ,&nbsp;Andrea Pino MD ,&nbsp;Paula Rozenfeld PhD","doi":"10.1016/j.jacig.2025.100414","DOIUrl":"10.1016/j.jacig.2025.100414","url":null,"abstract":"<div><h3>Background</h3><div>Diagnosis of hereditary angioedema (HAE) poses challenges because of its rarity and its overlapping symptoms with allergic and gastrointestinal conditions, resulting in misdiagnosis.</div></div><div><h3>Objective</h3><div>We developed a predictive score using clinical variables for suspected HAE patients with C1 inhibitor deficiency (HAE-C1INH) to increase suspicion of HAE and thus improve diagnosis.</div></div><div><h3>Methods</h3><div>The HADES (HAE diagnosis evaluation score) study used a nationwide retrospective cohort of individuals with suspected HAE-C1INH in Argentina. A questionnaire was designed to collect relevant clinical information on possible predictors for HAE. Blood samples were analyzed for C1-INH/C1q levels and C1-INH function. A predictive score was developed from the odds ratios derived from multivariate logistic regression analysis.</div></div><div><h3>Results</h3><div>The study included 2423 individuals (1642 suspected index cases and 781 family cases). Only patients with confirmed HAE types I or II (n = 499) were included in the final analysis; acquired angioedema/<em>F12</em> gene variants were excluded. Eight clinical variables were identified as independent predictors of HAE: age at onset ≤20 years, recurrent limb edema, abdominal pain, vomiting, trauma as a trigger, absence of wheals, family history of angioedema, and recurrent edema lasting ≥24 hours. The predictive score demonstrated favorable performance in identifying HAE cases within the index population (range, 0-18.5), with low scores (1.5-6.5) associated with high sensitivity (100%) and negative predictive value (100%), and high scores (≥15) associated with high specificity (99.4%) and positive predictive value (75.0%).</div></div><div><h3>Conclusions</h3><div>The predictive HADES offers a simple and efficient method for improving testing for suspicion of HAE by using clinical parameters. Further validation studies are required to confirm its reliability and accuracy.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100414"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153888","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":"Coexistence of coloboma, heart defects, atresia choanae, growth retardation, genital abnormalities, and ear anomalies (CHARGE) syndrome and heterotaxy in a newborn with athymia","authors":"Rica Patil DO ,&nbsp;Jacquelyn Hunter MD ,&nbsp;Alan Knutsen MD ,&nbsp;Stephen R. Braddock MD","doi":"10.1016/j.jacig.2025.100416","DOIUrl":"10.1016/j.jacig.2025.100416","url":null,"abstract":"<div><div>The case presented highlights a unique presentation of coloboma, heart defects, atresia choanae, growth retardation, genital abnormalities, and ear anomalies (CHARGE) syndrome along with athymia and heterotaxy to establish a possible association between these 2 well-known patterns of multiple malformations.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100416"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403210","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":"Subcutaneous immunotherapy in a patient taking ofatumumab for multiple sclerosis and upadacitinib for atopic dermatitis","authors":"Twan Sia BA ,&nbsp;Leeon Bacchus BA ,&nbsp;Stanley Liu BS ,&nbsp;John Leung MD","doi":"10.1016/j.jacig.2025.100411","DOIUrl":"10.1016/j.jacig.2025.100411","url":null,"abstract":"<div><div>Allergen-specific immunotherapy has not been well-studied in the setting of increasingly common immune system-targeting medications. Subcutaneous immunotherapy may not be contraindicated in patients taking anti-CD20 mAbs antibodies and/or Janus kinase inhibitors.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100411"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135144","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":"Home exposure to moisture and mold is associated with poorer asthma control in children: CHAMPIASTHMA study","authors":"Margaux Sauvere MD ,&nbsp;Stéphanie Lejeune MD, PhD ,&nbsp;Flore Chagnon MD ,&nbsp;Elodie Drumez BSt ,&nbsp;Camille Cisterne MD ,&nbsp;Clémence Mordacq MD ,&nbsp;Caroline Thumerelle MD ,&nbsp;Manuela Scalbert MD ,&nbsp;Armelle Le Mee MD ,&nbsp;Mohamed Amani MD ,&nbsp;Sawsan El Mourad MD ,&nbsp;Sophie Enchery MD ,&nbsp;Guillaume Pouessel MD ,&nbsp;Juliette Roussel MD ,&nbsp;Maxime Dartus MD ,&nbsp;Hélène Behal BSt ,&nbsp;Antoine Deschildre MD","doi":"10.1016/j.jacig.2025.100415","DOIUrl":"10.1016/j.jacig.2025.100415","url":null,"abstract":"<div><h3>Background</h3><div>Deleterious indoor environment is a risk factor for poor asthma control in children.</div></div><div><h3>Objective</h3><div>We assessed the association between exposure to moisture and/or mold (EMM) and asthma control in children.</div></div><div><h3>Methods</h3><div>The CHAMPIASTHMA study is a multicenter cross-sectional observational study. Children with recurrent wheeze/asthma aged 1 to 17 years were stratified by EMM, as assessed by a standardized questionnaire administered to their parents. The primary outcome was asthma control according to Global Initiative on Asthma guidelines. Secondary outcomes were: control according to asthma control test or pediatric asthma control test score, exacerbations (unscheduled visits, oral corticosteroid receipt, and hospitalization), asthma treatment step, and mold sensitization. Clinical trial registration: NCT04918394.</div></div><div><h3>Results</h3><div>Four hundred twenty-four patients were included, among whom 146 (34%) noted EMM. Patients with EMM more frequently had disease that was not controlled according to Global Initiative on Asthma guidelines (64 [45%] vs 90 [33%]; <em>P</em> = .03), and had lower asthma control test scores (22 [19-25] vs 24 [21-25]; <em>P</em> = .02), more frequent unscheduled visits (65 [45%] vs 86 [32%]; <em>P</em> = .02), and a trend for higher oral corticosteroids receipt in the past year (53 [37%] vs 74 [27%]; <em>P</em> = .09). There was no difference in asthma treatment step and hospitalization for exacerbations. Forty-two (12%) of 341 children were sensitized to molds, with no difference between the EMM and non-EMM groups (<em>P</em> = .85).</div></div><div><h3>Conclusion</h3><div>The CHAMPIASTHMA study highlights that EMM is associated with poorer disease control and asthma outcomes in children. The search for EMM during scheduled visits should be systematic, especially in cases of uncontrolled asthma.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100415"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562609","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":"Elevated mepolizumab levels in patients with severe asthma responsive to 1 year’s mepolizumab treatment","authors":"Takayasu Nishimaki MD ,&nbsp;Hitoshi Sasano MD, PhD ,&nbsp;Sonoko Harada PhD ,&nbsp;Tomohito Takeshige MD, PhD ,&nbsp;Yuuki Sandhu MD, PhD ,&nbsp;Yuki Tanabe MD ,&nbsp;Kei Matsuno MD, PhD ,&nbsp;Tetsutaro Nagaoka MD, PhD ,&nbsp;Jun Ito MD, PhD ,&nbsp;Ryo Atsuta MD, PhD ,&nbsp;Mayu Ohuchi PhD ,&nbsp;Shigehiro Yagishita MD, PhD ,&nbsp;Akinobu Hamada PhD ,&nbsp;Kazuhisa Takahashi MD, PhD ,&nbsp;Norihiro Harada MD, PhD","doi":"10.1016/j.jacig.2025.100410","DOIUrl":"10.1016/j.jacig.2025.100410","url":null,"abstract":"<div><h3>Background</h3><div>Asthma involves variable airflow limitation and persistent airway inflammation. Eosinophilic asthma, characterized by cytokine-mediated type 2 inflammation, is generally treated with inhaled corticosteroids. However, patients with severe asthma may require biologics, such as mepolizumab, which targets IL-5 and can manage uncontrolled eosinophilic asthma.</div></div><div><h3>Objective</h3><div>We investigated the relationship between serum mepolizumab concentrations and treatment response in patients with severe asthma.</div></div><div><h3>Methods</h3><div>Patients with mepolizumab-treated severe asthma were enrolled onto this prospective cohort study. Baseline assessments were conducted and repeated at 3, 6, and 12 months. Those with response were categorized on the basis of improvements in asthma control test score, lung function, and asthma exacerbations. We quantified the serum concentration of mepolizumab at 3, 6, and 12 months after treatment by liquid chromatography coupled with tandem mass spectrometry.</div></div><div><h3>Results</h3><div>Twenty-five adult patients aged 20 years and older with severe asthma were included in the analysis. Serum mepolizumab concentrations significantly increased at 6 and 12 months compared with those at 3 months, particularly in those with disease that responded to therapy. Furthermore, the relative change in mepolizumab concentration was significantly higher in those with response than in those with no response. Body size parameters were negatively correlated with mepolizumab concentration. In those with response, there were inverse correlations between mepolizumab concentration and baseline body size parameters.</div></div><div><h3>Conclusions</h3><div>The study observed a yearlong increase in mepolizumab concentrations, particularly in those with response, indicating a potential mepolizumab surplus. Correlations between mepolizumab concentrations and baseline characteristics suggested differing mepolizumab requirements between those with response and those with no response. Further research is needed to validate these findings and optimize treatment strategies for patients with severe asthma.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100410"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153853","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":"Effectiveness of dupilumab treatment against refractory eosinophilic chronic rhinosinusitis","authors":"Daiki Nakashima MD ,&nbsp;Tsuguhisa Nakayama MD, PhD ,&nbsp;Shunsuke Minagawa MD, PhD ,&nbsp;Tetsuya Adachi MD, PhD ,&nbsp;Chieko Mitsuyama MD ,&nbsp;Yoko Shida MD ,&nbsp;Tsuneya Nakajima MD, PhD ,&nbsp;Shin-ichi Haruna MD, PhD ,&nbsp;Yoshinori Matsuwaki MD, PhD","doi":"10.1016/j.jacig.2025.100412","DOIUrl":"10.1016/j.jacig.2025.100412","url":null,"abstract":"<div><h3>Background</h3><div>Eosinophilic chronic rhinosinusitis (ECRS) is a subgroup of chronic rhinosinusitis with nasal polyps (CRSwNP), which is a disease characterized by eosinophilic infiltration of the sinonasal mucosa. Few studies that reported the effect of dupilumab on CRSwNP focused on a single phenotype of CRSwNP, such as ECRS.</div></div><div><h3>Objectives</h3><div>This study aimed to determine the effectiveness of dupilumab in ECRS with postoperative recurrence.</div></div><div><h3>Methods</h3><div>We retrospectively enrolled 107 patients and assessed the effectiveness of dupilumab by various clinical outcomes. We performed multivariable analysis on nasal polyp score (NPS) and computed tomography score and a meta-analysis of the effect of dupilumab on chronic rhinosinusitis regarding improvement in the NPS.</div></div><div><h3>Results</h3><div>At 12 months of dupilumab treatment, there were 65 patients (60.7%) in the excellent response group and 42 (39.3%) in the moderate response group. Nasal polyps had disappeared in 91 patients (85.9%) at 12 months, and there was improvement in all end points; 104 patients (97.2%) were able to eliminate systemic corticosteroid therapy. In the multivariate analysis, male sex was significantly associated with patients who did not show an improvement to 0 in the NPS and computed tomography score (odds ratios: 7.58 and 2.45; <em>P</em> = .01 and <em>P</em> = .04, respectively). The meta-analysis showed that dupilumab treatment resulted in a trend toward better improvement in the NPS (mean difference = −5.41) than previously reported results.</div></div><div><h3>Conclusions</h3><div>Dupilumab shows effectiveness in treating ECRS and could serve as an alternative therapeutic option to systemic corticosteroids. This effectiveness may be further enhanced by limiting the target population to recurrent ECRS.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100412"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348005","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":"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}