Allergologia et immunopathologia最新文献

{"title":"Creation of an international Inter-Society Pediatric Allergology Network (ISPAN): preliminary data from a survey of pediatric allergist in Italy, Spain, and Portugal.","authors":"Maria Angela Tosca, Chiara Trincianti, Ana Martinez-Canavate Burgos, Liberio Ribeiro, Maria Mesa Del Castillo, Ana Neves, Salvatore Barberi, Franco Frati, Michele Miraglia Del Giudice","doi":"10.15586/aei.v54i2.1609","DOIUrl":"https://doi.org/10.15586/aei.v54i2.1609","url":null,"abstract":"<p><p>Allergic rhinitis and asthma are among the most important chronic diseases in children and young adults, with increasing prevalence and significant impact on the healthcare system and quality of life. Allergen Immunotherapy (AIT) remains the only causal treatment capable of modifying the natural course of allergy. However, despite its proven efficacy, real-world data on its application in the pediatric population remain limited. This study aimed to evaluate and compare the management and clinical practice of allergic diseases in the pediatric population, particularly the current use of AIT for respiratory allergy, by pediatricians and allergists in Italy, Spain, and Portugal. A comprehensive online survey developed by the pediatric allergy societies of the three countries was distributed to pediatric allergists to collect demographic data, diagnostic and treatment approaches, and AIT prescription attitudes. A total of 171 responses were analyzed in this study. The results show that most allergists treat high numbers of pediatric allergic patients on weekly basis, primarily using skin and laboratory tests for diagnosis of allergy, and pulmonary function tests to diagnose asthma. AIT was prescribed by the majority of allergists (91.2%), primarily for children aged ≥5 years, and mainly for allergic rhinoconjunctivitis and asthma. Of the respondents, 64.1% chose sublingual AIT over subcutaneous AIT (35.9%) because of compliance (77.6%) or practical reasons (67.9%). Patients were mainly treated for 3 years (39.7%) to 5 years (21.2%) and were regularly monitored every 6 months (51.3%). This initiative marks the first multinational collaboration between pediatric national allergology societies in Mediterranean countries, establishing a fundamental network for future collaborations. This study provides valuable insights and encourages further efforts to harmonize pediatric allergy care across similar sociocultural and environmental regions.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 2","pages":"57-61"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of topical intranasal curcumin in the experimentally induced allergic rhinitis model in rats (revised).","authors":"Erbay Demir, Muhsin Koten, Fatma Elif Usturalı Keskin, Canan Eryıldız, Selis Gülseven Güven","doi":"10.15586/aei.v54i2.1719","DOIUrl":"https://doi.org/10.15586/aei.v54i2.1719","url":null,"abstract":"<p><p>Curcumin, a flavonoid derived from turmeric, has demonstrated antioxidant, anti-inflammatory, and antiallergic effects. This study evaluated the therapeutic efficacy of intranasal curcumin in an allergic rhinitis (AR) rat model. Forty rats were randomized into four groups: a sham control, an AR model with no treatment (negative control), an AR model treated with intranasal mometasone furoate (positive control), and an AR model treated with intranasal curcumin. Allergic symptoms (sneezing, itching, nasal discharge) were evaluated by both unblinded and blinded observers. Serum Ovalbumin (OVA)-specific IgE levels were measured using ELISA. Nasal mucosal histopathology (edema, cilia loss, goblet cell hyperplasia, inflammation, eosinophilia) was assessed by light microscopy. Intranasal curcumin significantly improved histopathological findings and reduced allergic symptoms, with efficacy comparable to steroid treatment. It alleviates AR symptoms and inflammation, suggesting a promising, low-cost alternative for AR management.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 2","pages":"135-142"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of oral food challenge in children with IgE-mediated food allergy.","authors":"Aymen Hişmioğulları, Özlem Sancaklı, Melike Ocak, Soner Günder, Figen Çelebi Çelik, Kadir Buğra Sarı, Ayça Demir, Canan Şule Karkıner, Özge Atay, Demet Can","doi":"10.15586/aei.v54i3.1625","DOIUrl":"10.15586/aei.v54i3.1625","url":null,"abstract":"<p><strong>Background: </strong>Oral food challenges (OFCs) are the gold standard for diagnosing IgE-mediated food allergies in children, although they carry an inherent risk of inducing allergic reactions, including anaphylaxis. This study examined clinical outcomes and predictors of positive OFC results in a pediatric cohort from a region with high exposure to sesame and tree nuts.</p><p><strong>Methods: </strong>We retrospectively analyzed 310 OFCs in 211 children (median age: 21 months [IQR: 14-37.3]) at a tertiary pediatric allergy center from January 1 to December 31, 2023. Reaction patterns and predictors of OFC positivity, including age, sex, initial reaction type, skin prick test (SPT) wheal size, and serum-specific IgE (sIgE) levels, were evaluated.</p><p><strong>Results: </strong>OFC positivity occurred in 12.3% (38/310) of the challenges, and was most commonly triggered by milk or dairy products (44.7%), tree nuts (23.6%), and eggs (18.4%). Cutaneous symptoms predominated (94.7%), followed by gastrointestinal (10.6%) and respiratory (7.9%) manifestations. Anaphylaxis occurred in 13.2% (5/38) of the positive OFCs. Positive OFC patients were older (P = 0.009), had longer follow-up (P = 0.046), and were more likely to have presented with urticaria (P < 0.001) or anaphylaxis (P < 0.001). Multivariate logistic regression identified milk or dairy products (OR: 3.326, 95% CI: 1.437-7.702, P = 0.005), sesame (OR: 7.022, 95% CI: 1.194-41.311, P = 0.031), and hazelnut (OR: 11.286, 95% CI: 3.858-33.017, P < 0.001) as independent predictors of OFC positivity.</p><p><strong>Conclusion: </strong>OFC positivity was 12.3%, and was predominantly triggered by milk, tree nuts, and eggs. Severe reactions, including anaphylaxis, occurred despite low sIgE and SPT values, confirming the limited utility of sensitization markers in predicting clinical reactivity. Older age, longer follow-up, history of urticaria or anaphylaxis, and challenges with milk, sesame, or hazelnut were independently associated with positive OFCs. These results underscore the critical role of risk-stratified, closely monitored OFCs in ensuring diagnostic accuracy and guiding safe, personalized management in pediatric IgE-mediated food allergy.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 S Pt 1","pages":"10-17"},"PeriodicalIF":2.1,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of <i>IL-13</i> gene polymorphisms in pediatric patients with food allergy.","authors":"Maria-Teodora Coșoreanu, Camelia-Elena Berghea, Felicia Galoș, Luis-Ovidiu Popa, Mara-Ioana Ionescu, Andreea Ioan, Ioana Țieranu, Eliza-Elena Cinteză, Olivia-Mihaela Popa","doi":"10.15586/aei.v54iSP1.1637","DOIUrl":"https://doi.org/10.15586/aei.v54iSP1.1637","url":null,"abstract":"<p><p>Food allergies represent immune-mediated adverse reactions to dietary proteins, with incompletely elucidated causes and etiopathogenic mechanisms, and have a significant negative impact on the quality of life of children and their families. The aim of the study was to assess the associations between <i>IL-13</i> gene single-nucleotide polymorphisms (SNPs) rs20541 and rs1800925 and the risk of developing IgE-mediated or non-IgE-mediated food allergies, as well as other patient characteristics. The study included 115 healthy controls and 165 children with food allergy, divided into two groups based on the presence of either IgE-mediated (N=85) or non-IgE-mediated (N=80) food allergy, all of Romanian origin. Genotyping of the two SNPs was performed using Real-Time PCR with TaqMan Allelic Discrimination Assays. OpenEpi and PLINK v1.07 were used for the statistical analysis. The frequency of carriers of the minor allele T of rs1800925 was significantly higher in patients with non-IgE-mediated food allergy (50% vs. 35.6%, p=0.04, OR=1.8). CT heterozygotes of rs1800925 were at high risk for non-IgE-mediated food allergy compared to CC and TT homozygotes (p=0.01, OR=2.13). No associations were found with IgE-mediated food allergy. The present study investigates for the first time <i>IL-13</i> gene SNPs in non-IgE-mediated food allergy. The results provide evidence that variation in the <i>IL-13</i> gene is involved in the pathogenesis of this disease. Further investigation is required to confirm these findings.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 S Pt 1","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146155448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of obstructive sleep apnea syndrome in bronchial asthma patients: investigating the obesity-inflammation interplay through LEP, IL-6, and NLR.","authors":"Lili Miao","doi":"10.15586/aei.v54i1.1473","DOIUrl":"https://doi.org/10.15586/aei.v54i1.1473","url":null,"abstract":"<p><strong>Background: </strong>Bronchial asthma (BA) frequently coexists with obstructive sleep apnea syndrome (OSAS). The obesity-inflammation axis may underlie this overlap, but pragmatic predictors and biomarker utility remain incompletely defined.</p><p><strong>Objective: </strong>To identify clinical predictors of OSAS in BA and evaluate the diagnostic performance of leptin (LEP), interleukin-6 (IL-6), and neutrophil-to-lymphocyte ratio (NLR), individually and in combination.</p><p><strong>Materials and methods: </strong>In a prospective study, 263 adults with BA were enrolled and classified into OSAS (n=124) and non-OSAS (n=139) groups by polysomnography. The OSAS group was stratified by apnea-hypopnea index (AHI) into mild (n=59), moderate (n=42), and severe (n=23). Clinical variables were compared with univariate tests. Independent predictors were identified using binary logistic regression. Serum LEP and IL-6 (immunoassays) and NLR (hematology) were measured. Biomarker-AHI relationships were assessed by Spearman's correlation. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curves and DeLong's test.</p><p><strong>Results: </strong>On univariate analysis, OSAS cases were older and more often male, with higher rates of obesity, severe BA, neck circumference >40 cm, rhinitis, and gastroesophageal reflux disease (GERD). Logistic regression confirmed obesity, severe BA, neck circumference >40 cm, rhinitis, and GERD as independent predictors. LEP, IL-6, and NLR were significantly higher in OSAS than non-OSAS and increased progressively across AHI strata. LEP correlated strongly with IL-6, IL-6 with NLR, and LEP with NLR to a lesser extent (all P<0.001). For diagnosing BA-OSAS, AUCs were 0.746 (LEP), 0.771 (IL-6), 0.742 (NLR), and 0.826 for their combination, which outperformed individual markers (DeLong, P<0.05).</p><p><strong>Conclusion: </strong>Obesity, neck circumference >40 cm, severe BA, rhinitis, and GERD independently predict OSAS in BA. LEP, IL-6, and NLR correlate with OSAS severity, and their combined use provides superior diagnostic value for identifying BA-OSAS comorbidity and may aid targeted screening and referral. (≈240 words).</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 1","pages":"96-104"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of immunotherapy with a mixture of polymerized allergen extracts of <i>Alternaria alternata</i> and <i>olea europaea</i> in children.","authors":"Javier Torres-Borrego, Laura Pilar Marín López, Raquel Castañeda-Mendieta, Ana Martínez-Cañavate Burgos","doi":"10.15586/aei.v54i1.1499","DOIUrl":"10.15586/aei.v54i1.1499","url":null,"abstract":"<p><strong>Background: </strong>In southern Europe, allergy to <i>Alternaria alternata</i> (<i>A. alternata</i>) and <i>Olea europaea</i> (<i>O. europaea</i>) pollen are prevalent, significantly contributing to allergic conditions like asthma and rhinitis. This study investigates the effectiveness and safety of immunotherapy in pediatric patients utilizing a glutaraldehyde-polymerized allergen extract mixture of <i>A. alternata</i> and <i>O. europaea</i>.</p><p><strong>Methods: </strong>This real-world, retrospective, observational study included pediatric patients diagnosed with rhinitis with or without asthma, co-sensitized to <i>A. alternata</i> and <i>O. europaea</i>. Patients received immunotherapy with a mixture of individually polymerized allergen extracts of <i>A. alternata</i> and <i>O. europaea</i>, each at a concentration of 10,000 TU/mL. Effectiveness was assessed by comparing rhinitis and asthma severity and medication requirements before and after at least 6 months of treatment. Safety was evaluated by documenting local and systemic adverse reactions.</p><p><strong>Results: </strong>A total of 49 patients were included, with a median treatment duration of 9 months. Prior to treatment, 84% (41/49) of patients had moderate-severe rhinitis, which significantly decreased to 49% (24/49) posttreatment (p=0.001). Asthma severity also improved considerably, with the proportion of patients experiencing intermittent-mild asthma rising from 8% pretreatment to 61% posttreatment. The use of medication for both rhinitis and asthma also declined. Out of 424 injections, only two local reactions were reported (0.47%), with no systemic reactions.</p><p><strong>Conclusion: </strong>Immunotherapy using a mixture of glutaraldehyde-polymerized <i>A. alternata</i> and <i>O. europaea</i> extract is both safe and effective in reducing the severity of rhinitis and asthma in children. This treatment exhibits a high safety profile, with a very low incidence of adverse reactions, making it a promising therapeutic option for pediatric patients with coexisting sensitivities to these common allergens.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 1","pages":"139-144"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of atrial fibrillation in primary immunodeficiencies: evaluation of atrial electromechanical delay and P-wave dispersion.","authors":"Inan Mustafa Ilker, Balaban Yasemin Akgul, Yagcı Ahmet Faruk, Kaya Cihad, Sonmez Ezgi, Fikriye Kalkan, Demirel Fevzi, Yeşillik Sait, Bugan Barış, Kartal Ozgur","doi":"10.15586/aei.v54i1.1465","DOIUrl":"https://doi.org/10.15586/aei.v54i1.1465","url":null,"abstract":"<p><strong>Background: </strong>Primary immunodeficiency diseases (PIDs) are an expanding group of rarely observed immune system disorders. Various clinical conditions, such as autoimmunity, immune dysregulation, and inflammation, could affect multiple organ systems in PID patients. The heart may be one of these organs; however, studies on this topic are rare. Atrial fibrillation (AF) is a significant cause of mortality and morbidity in the community and an increased P-wave dispersion (PWD) and atrial electromechanical delay (AED) are well-known markers indicating a predisposition to AF. We aimed to determine whether AED and/or increased PWD predict the early risk of AF in PID patients.</p><p><strong>Methods: </strong>This single-center, prospective controlled study included 61 PID and 60 control group patients. All participants underwent resting electrocardiography, echocardiography, and atrial electromechanical conduction time (AECT) monitoring using tissue Doppler imaging evaluated by an experienced cardiologist.</p><p><strong>Results: </strong>The PID group had a statistically significantly higher Pmax, Pmin, and PWD values, compared to the control group (102 [92-108] vs. 88 [82-99] ms, P < 0.001; 74 [70-80] vs. 68 [62-72] ms, P < 0.001; 26 [22-30] vs. 21 [18-26] ms, P = 0.001, respectively). Right atrial delay and interatrial delay were discovered to be statistically significantly higher in PID group (4 [2-6] vs. 2 [2-4] ms, P < 0.001; 6 [4-8] vs. 4 [4-6] ms, P = 0.039, respectively). Left atrial delay was also discovered to be high in the PID group, although this difference was not statistically significant (6 [4-6] vs. 4 [3-6] ms; P = 0.05).</p><p><strong>Conclusion: </strong>We demonstrated that the well-known predictors of AF, AECT, and PWD were increased in PID patients. This result aids in the follow up and survival of PID patients, who experience multiple complications, by enabling the early identification of AF-related mortality and morbidity risk.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 1","pages":"87-95"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of topical intranasal curcumin in the experimentally induced allergic rhinitis model in rats.","authors":"Erbay Demir, Muhsin Koten, Fatma Elif Usturalı Keskin, Canan Eryıldız, Selis Gülseven Güven","doi":"10.15586/aei.v54i1.1468","DOIUrl":"https://doi.org/10.15586/aei.v54i1.1468","url":null,"abstract":"<p><p>Curcumin, a flavonoid derived from turmeric, has demonstrated antioxidant, anti-inflammatory, and anti-allergic effects. This study evaluated the therapeutic efficacy of intranasal curcumin in an allergic rhinitis (AR) rat model. Forty rats were randomized into five groups: a Sham control, an AR model with no treatment (negative control), an AR model treated with intranasal mometasone furoate (positive control), and an AR model treated with intranasal curcumin. Allergic symptoms (sneezing, itching, nasal discharge) were evaluated by both unblinded and blinded observers. Serum ovalbumin (OVA)-specific IgE levels were measured using ELISA. Nasal mucosal histopathology (edema, cilia loss, goblet cell hyperplasia, inflammation, eosinophilia) was assessed by light microscopy. Intranasal curcumin significantly improved histopathological findings and reduced allergic symptoms, with efficacy comparable to steroid treatment. Intranasal curcumin alleviated allergic rhinitis symptoms and inflammation, suggesting a promising, low-cost alternative for AR management.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 1","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reclassification of NSAID hypersensitivity according to the WAO 2025 guidelines: insights from a cohort of 527 patients.","authors":"Ismet Bulut, Zeynep Yegin Katran","doi":"10.15586/aei.v54i1.1579","DOIUrl":"https://doi.org/10.15586/aei.v54i1.1579","url":null,"abstract":"<p><strong>Background: </strong>Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most common culprits of drug hypersensitivity. Previous classifications, including the European Academy of Allergy and Clinical Immunology (EAACI) and the European Network for Drug Allergy framework, left a subset of patients unclassified under the \"blended\" category, particularly those with anaphylaxis not fitting into standard groups. The World Allergy Organization (WAO) 2025 guidelines introduced new subcategories, such as mixed NSAID-exacerbated cutaneous disease (NECD) and mixed NSAID-exacerbated respiratory disease (NERD) to address this gap.</p><p><strong>Objective: </strong>To evaluate how patients with reliable histories of NSAID hypersensitivity were reclassified under the WAO 2025 system, and to determine whether the new categories address the limitations of the previous framework.</p><p><strong>Methods: </strong>We retrospectively analyzed 527 patients with cross-reactive NSAID hypersensitivity confirmed by clinical history and/or aspirin provocation testing at a tertiary allergy center. Patients were classified according to both EAACI 2019 and WAO 2025 guidelines. Demographics, comorbidities (asthma, rhinitis, urticaria, and nasal polyps), laboratory findings (immunoglobulin E, eosinophils, and tryptase), and provocation test outcomes with alternative NSAIDs were evaluated. Statistical analyses included Chi-square/Fisher's Exact tests and logistic regression.</p><p><strong>Results: </strong>According to EAACI 2019, patients were classified as NECD (n = 228, 43.3%), NERD (n = 27, 5.1%), NSAID-induced urticaria/angioedema (NIUA) (n = 165, 31.3%), single NSAID-induced urticaria/angioedema/anaphylaxis (SNIUAA) (n = 55, 10.4%), and blended (n = 53, 10.1%). Using WAO 2025 guidelines, the blended category was eliminated and redistributed: NIUA increased to 197 (37.4%), mixed NECD (n = 7, 1.3%), and mixed NERD (n = 13, 2.5%) were newly defined. Other groups (NECD, NERD, SNIUAA) remained unchanged. Provocation testing confirmed high tolerability to paracetamol (97.8%), nimesulid (96.1%), meloxicam (94.1%), and celecoxib (92.2%), while aspirin challenge had the highest positivity (22.2%). Atopy was significantly associated with salicylate reactions (p = 0.048), and male gender with salicylate hypersensitivity (p = 0.0087).</p><p><strong>Conclusion: </strong>The WAO 2025 classification successfully reallocated previously blended cases, particularly into NIUA, mixed NECD, and mixed NERD, thereby improving diagnostic clarity. This updated framework reduces ambiguity and may enhance patient management by better reflecting clinical heterogeneity.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 1","pages":"166-171"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution, molecular characterization, and treatment options for dermatophyte and non-dermatophyte fungi isolated from human and animal samples: An integrated computational and experimental approach.","authors":"Saba Sana, Ahsaan Ahmed, Layyaba Nazir, Usman Shehzad, R Rukhma, Muhammad Nauman Aftab, Najeeb Ullah, Nawal Al-Hoshani, Maher S Alwethaynani, Hanan Abdulrahman Sagini, Shaza N Alkhatib, Fakhria A Al-Joufi","doi":"10.15586/aei.v54i1.1508","DOIUrl":"https://doi.org/10.15586/aei.v54i1.1508","url":null,"abstract":"<p><strong>Background: </strong>Cutaneous infections caused by dermatophytes and non-dermatophytes fungi have become significant public health and veterinary concern.</p><p><strong>Objective: </strong>The current study deals with the distribution, characterization, and antifungal susceptibility profile of these fungi.</p><p><strong>Materials and methods: </strong>A total of 40 sample were screened by KOH mount; positive samples were cultured on SDA. Purified isolates were identified by macroscopic and microscopic characters. Molecular characterization by PCR and sanger sequencing of ITS region confirmed the fungi. Evolutionary trees were constructed using MEGA 11. Different treatment options were evaluated, including amphotericin B, nystatin, fluconazole, itraconazole, and essential oil of <i>Nigella sativa</i>. Initially molecular docking was performed against selected fungal targets (5eqb and 5v5z) using molecular-operating environment (MOE v.2018.01) and Maestro modeling interface 12.3. <i>In vitro</i> antimycotic activity was performed by agar disc diffusion, followed by micro-broth dilution method.</p><p><strong>Results: </strong>KOH mount revealed that 65% (13/20) samples positive for fungal components. Culture positivity for samples was 23.07% for dermatophytes and 76.92% for non-dermatophytes. Dermatophytes were detected in skin samples. However, non-dermatophytes were isolated from all types of samples. Sequence analysis confirmed the distribution of <i>Arthroderma multifidum, Aspergillus sydowii</i>, and <i>Aspergillus sublatus. In-silico</i> analysis revealed itraconazole as the most effective antimycotic agent with -7.93 kcal/mol (5eqb) and -10.89 (5v5z) kcal/mol. <i>In vitro</i> analysis strengthens docking analysis, itraconazole was the most effective agent with the highest mean ZOI against <i>A. multifidum</i> (72.00±3.46 mm), <i>A. sydowii</i> (62.00±3.00 mm), and <i>A. sublatus</i> (64.00±1.73 mm). Moreover, essential oil of <i>N. sativa</i> was the most effective antifungal against <i>A. sydowii</i> (ZOI; 31.00±3.46 mm, MIC; 3.125±0.00 mg/mL).</p><p><strong>Conclusion: </strong>The current study is the first report of <i>A. sydowii</i> and <i>A. sublatus</i> in onychomycosis and hair infections in Pakistan. This study provides awareness about the existence of new fungal pathogens and highlights the availability of effective treatment options for emerging fungal infections.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 1","pages":"196-211"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}