Xiaosong Zheng, Jian Wang, Shuling Tang, Xia Lei, Ya Ju Duan
{"title":"Global, regional, and national burdens of atopic dermatitis from 1990 to 2021: a trend analysis.","authors":"Xiaosong Zheng, Jian Wang, Shuling Tang, Xia Lei, Ya Ju Duan","doi":"10.15586/aei.v54i3.1613","DOIUrl":"10.15586/aei.v54i3.1613","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD) is a widespread dermatological condition, particularly affecting children globally. In spite of its high prevalence, comprehensive data on its burden and trends are limited.</p><p><strong>Methods: </strong>Using the Global Burden of Disease Study 2021 (GBD 2021) data from 204 countries and 21 regions (1990-2021), we analyzed AD prevalence, incidence, and disability-adjusted life years (DALYs), calculating age-standardized rates (ASRs) and estimated annual percentage changes (EAPCs).</p><p><strong>Objective: </strong>This study is designed to examine the temporal trends in the burden of AD across global, regional, and national levels.</p><p><strong>Results: </strong>Globally, AD cases rose from 107.5 million (1990) to 129.0 million (2021). The high-income Asia Pacific region had instances of age-standardized prevalence (ASPR), age-standardized incidence rate (ASIR), and age-standardized DALYs, with Japan leading among 204 countries. High sociodemographic index (SDI) regions showed the highest ASPR, ASIR, and age-standardized DALYs, while medium and high SDI regions experienced the largest increases. Females exhibited higher ASRs than males. Age-specific prevalence and DALYs peaked in children aged 5-9 years, whereas incidence was the highest in those aged under 5 years. Projections based on 1990-2021 data suggest declining global trends in ASPR, ASIR, and age-standardized DALYs by 2050.</p><p><strong>Conclusions: </strong>Global AD prevalence and DALYs continue to rise, whereas ASPR and age-standardized DALYs are declining. High SDI regions exhibit the highest prevalence, yet low-income countries show increasing age-standardized DALYs, underscoring profound regional heterogeneity. Thus, the absolute burden of AD is escalating worldwide, while individual-level risk appears to be improving.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 3","pages":"102-140"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147872807","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}
Seçim Kolak, Fatih Çölkesen, Mehmet Emin Gerek, Ferhat Sağun, Emrah Harman, Şükran Aslan Savaş, Şevket Arslan
{"title":"Effect of age on omalizumab response in chronic urticaria: a retrospective comparison between adult and geriatric populations.","authors":"Seçim Kolak, Fatih Çölkesen, Mehmet Emin Gerek, Ferhat Sağun, Emrah Harman, Şükran Aslan Savaş, Şevket Arslan","doi":"10.15586/aei.v54i3.1591","DOIUrl":"10.15586/aei.v54i3.1591","url":null,"abstract":"<p><strong>Background: </strong>Chronic urticaria (CU) can occur at any age, but comorbidities, age-related immune changes, and polypharmacy may influence treatment outcomes in older adults. Limited data exist on the effect of age on omalizumab efficacy. This study aimed to evaluate the impact of age on treatment response, safety, and clinical-laboratory features in adult (aged <65 years) and geriatric (aged ≥65 years) CU patients receiving omalizumab.</p><p><strong>Methods: </strong>This retrospective study included 153 CU patients who initiated omalizumab between 2019 and 2024 because of resistance to antihistamines. Patients were categorized by age (<65 or ≥65 years) and by Urticaria Control Test (UCT) scores at the 4th month (responders: UCT ≥12; non-responders: UCT <12). Demographic, clinical, and laboratory parameters were compared between groups.</p><p><strong>Results: </strong>The median age was 44 years (interquartile range: 35-54), and 63.4% were females. Of all the patients, 130 (85.0%) were aged <65 years and 23 (15.0%) were aged ≥65 years. The overall response rate was 83.7%, with no significant difference between age groups (P = 0.965). Geriatric patients had more comorbidities (P < 0.001), polypharmacy (P = 0.004), and malignancy (P = 0.045). Basophil (P = 0.013) and eosinophil (P = 0.024) counts were lower in the elderly. Among non-responders, autoimmune disease (P = 0.004), elevated anti-thyroglobulin (P = 0.016), and lower baseline UCT scores (P = 0.009) were more frequent. No serious adverse events occurred.</p><p><strong>Conclusions: </strong>Omalizumab is effective and safe for CU even in older adults. Age, comorbidities, and polypharmacy do not affect treatment response, while autoimmunity and baseline disease activity may predict outcomes.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 3","pages":"1-8"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147872524","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":"Peach sublingual immunotherapy for lipid transfer protein syndrome.","authors":"Öner Özdemir","doi":"10.15586/aei.v54i3.1746","DOIUrl":"https://doi.org/10.15586/aei.v54i3.1746","url":null,"abstract":"","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 3","pages":"231-232"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147872954","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":"Aeroallergen sensitization in chronic spontaneous urticaria.","authors":"Selma Yeşilkaya","doi":"10.15586/aei.v54i3.1631","DOIUrl":"10.15586/aei.v54i3.1631","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the prevalence and distribution of aeroallergen sensitization in adult patients with chronic spontaneous urticaria (CSU), compared to a control group with allergic rhinitis (AR).</p><p><strong>Method: </strong>This retrospective cross-sectional study included 158 CSU and 166 AR patients examined between October 15, 2023, and July 1, 2025. Demographics, clinical features, skin prick test (SPT) results for common aeroallergens (house dust mites, pollens, molds, animal danders), and hematological markers (e.g., basophil/eosinophil counts, total IgE) were examined.</p><p><strong>Results: </strong>The CSU group was significantly older than controls (p<0.001), and female sex was similarly dominant in both groups (p=0.296). Aeroallergen sensitization was less frequent in CSU (39.24%) than AR (100%; p<0.001), with house dust mite (20.89% vs. 43.98%; p<0.001) and pollen (11.39% vs. 34.94%; p<0.001) detected as the primary allergens. Multiple sensitizations were also less common in the CSU group (5.06% vs. 21.08%; p<0.001). In terms of comorbidities, asthma was rarer among individuals with CSU (0.63% vs. 14.46%; p<0.001). Basophil (p<0.001) and eosinophil counts (p<0.001) were significantly lower in CSU, while total IgE levels were similar but trended lower in CSU (p=0.159).</p><p><strong>Conclusion: </strong>Aeroallergen sensitization is less prevalent in CSU than AR, suggesting limited atopic involvement in this population, in contrast to several studies in the literature. Optimizing CSU management in this context will necessitate accurate assessment of sensitization profiles, since atopic characteristics appear to be heterogeneous.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 3","pages":"96-101"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147872960","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}
Begum Gorgulu Akin, Fikriye Kalkan, Sarpcan Maden, Makbule Seda Bayrak Durmaz, Betul Ozdel Ozturk, Mehmet Burak Kursun, Sadan Soyyiğit
{"title":"Forgotten Skin: What do our geriatric patch test findings reveal?","authors":"Begum Gorgulu Akin, Fikriye Kalkan, Sarpcan Maden, Makbule Seda Bayrak Durmaz, Betul Ozdel Ozturk, Mehmet Burak Kursun, Sadan Soyyiğit","doi":"10.15586/aei.v54i3.1621","DOIUrl":"10.15586/aei.v54i3.1621","url":null,"abstract":"<p><p>Allergic contact dermatitis (ACD) in the elderly is influenced by age-related immunological changes, cumulative exposure, and skin barrier alterations. However, data comparing sensitization profiles among different geriatric populations remains limited. We aimed to evaluate and compare the patterns and severity of patch test reactions in patients aged 65-74 (young-old group) and those aged 75 years or older (old-old group), using the European Standard Series (ESS). A total of 128 patients aged 65 years or older were retrospectively analyzed. Patch testing was performed with the ESS, and reactions were assessed at 48 and 96 hours according to the International Contact Dermatitis Research Group (ICDRG) criteria. Of the patients, 106 were classified as young-old and 22 as old-old. The most frequent allergens in the young-old group were propolis (20%), fragrance mix I (17%), methyldibromo glutaronitrile (16%), peru balsam (15.1%), and nickel sulfate (14.2%), while methylchloroisothiazolinone/methylisothiazolinone (22.7%), methylisothiazolinone (13.6%), propolis (13.6%), and textile dye mix (13.6%) were the most common that in the old-old group. Across both groups, preservative and fragrance-related allergens predominated. According to ICDRG grading, most reactions were weak positive (+), whereas moderate positive (++) and strong positive (+++) reactions were less frequent, particularly in the old-old group. In conclusion, preservatives, propolis and fragrance-related allergens remain the leading causes of contact sensitization in the elderly, while metal sensitization decreases with advancing age. The reduced frequency and intensity of positive reactions in the old-old group may reflect immunosenescence and diminished T-cell responsiveness in advanced age.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 3","pages":"87-95"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147872471","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":"Peach sublingual immunotherapy for lipid transfer protein syndrome.","authors":"Victoria Villalobos Violán","doi":"10.15586/aei.v54i3.1772","DOIUrl":"https://doi.org/10.15586/aei.v54i3.1772","url":null,"abstract":"","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 3","pages":"239-240"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873015","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}
Selim Kahraman, Fatih Çölkesen, Mehmet Emin Gerek, Seçim Kolak, Tuğba Önalan, Filiz Sadi Aykan, Mehmet Kılınç, Recep Evcen, Fatma Arzu Akkuş, Şevket Arslan
{"title":"Comparison of prognostic models for predicting severe noninfectious complications in common variable immunodeficiency.","authors":"Selim Kahraman, Fatih Çölkesen, Mehmet Emin Gerek, Seçim Kolak, Tuğba Önalan, Filiz Sadi Aykan, Mehmet Kılınç, Recep Evcen, Fatma Arzu Akkuş, Şevket Arslan","doi":"10.15586/aei.v54i3.1596","DOIUrl":"10.15586/aei.v54i3.1596","url":null,"abstract":"<p><p>A significant clinical heterogeneity of common variable immunodeficiency (CVID) complicates the prediction of severe noninfectious complications (NICs), thereby hindering personalized treatment strategies. This study aimed to compare retrospectively the performance of three distinct prognostic models-low switched memory B-cell (SMB) count, the composite Variable Immunodeficiency Score by Upfront Analytic Link (VISUAL), and the monogenic common variable immunodeficiency (Mo-CVID) score-for predicting NIC development in a single-center Turkish patient cohort. Clinical and immunologic data from 71 CVID patients were analyzed. Univariate analyses were used to compare patient groups, while multivariate logistic regression was employed to identify independent risk factors. During follow-up, 62.0% of patients developed at least one NIC. At diagnosis, patients with NICs exhibited significant immunologic differences, including lower platelet counts, a reduced CD4-CD8 ratio, and significantly lower SMB proportions. The multivariate analysis revealed that only the VISUAL score was a significant and independent predictor of NICs (odds ratio: 1.481; P = 0.005). Furthermore, receiver operating characteristic analysis confirmed its good discriminatory ability (area under the curve: 0.764), with an optimal cut-off value of >8.5. In contrast, neither a low SMB count as a categoric variable nor the Mo-CVID score remained as independent predictors in the final model. The VISUAL score, which integrates multiple B- and T-cell abnormalities, is a superior and more reliable tool for risk stratification in CVID. Its successful validation supports its use as a universal clinical instrument to identify high-risk individuals who may benefit from closer surveillance and earlier therapeutic interventions.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 3","pages":"9-16"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873017","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}
Peter Kunč, Jaroslav Fábry, Peter Ferenc, Martina Neuschlová, Renata Péčová
{"title":"Application of FeNO in the diagnostic and therapeutic algorithm of pediatric asthma: From chronic cough and wheeze to personalized management.","authors":"Peter Kunč, Jaroslav Fábry, Peter Ferenc, Martina Neuschlová, Renata Péčová","doi":"10.15586/aei.v54i3.1576","DOIUrl":"10.15586/aei.v54i3.1576","url":null,"abstract":"<p><p>Bronchial asthma is the most common chronic respiratory disease in children. Treatment approaches should aim to achieve disease control, reduce limiting symptoms, and improve quality of life. The routine management of patients with asthma relies on the assessment of symptoms (including persistent cough and wheezing) and spirometry results However, these strategies do not consider the level of airway inflammation, which is a fundamental pathognomonic feature of the disease. The use of biomarkers is increasing in an effort to better understand individual asthma pathways (endotyping), offering the potential for personalized treatment with innovative biologics. Elevated levels of fractional exhaled nitric oxide (FeNO) are an indirect marker of T2 airway inflammation. FeNO is one of the few biomarkers that has been implemented in routine clinical practice because of its undeniable advantages, such as accessibility, noninvasiveness, simple implementation, and cost-effectiveness. However, the current scientific evidence in children is insufficient to recommend its universal use in the diagnosis and treatment of all patients. Considering its known limitations, FeNO can enhance therapeutic processes, particularly in children with severe asthma. High FeNO levels predict a good therapeutic response to corticosteroids and selected biologics (e.g., omalizumab and dupilumab) and indicate an increased risk of exacerbation. Similarly, measuring FeNO levels in children with recurrent wheezing can help determine the risk of future asthma development. Various factors contributing to FeNO value variability must be considered when interpreting the results. The lack of robust clinical studies is reflected in inconsistent guidelines from professional societies regarding the use of FeNO in managing childhood asthma. This review aims to evaluate the advantages, disadvantages, and potential applications of FeNO measurements in light of new findings in the field.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 3","pages":"206-221"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873019","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}
Catalina Gómez Galán, Vanessa Fernández Díaz, María Cols I Roig, Laura Saura García, Carlos José Ruíz Hernández, Estibaliz Iglesias Jiménez, Martha Jiménez Freites, Belgica Minaya Polanco, Julian Andrés Manrique Niño, Adrianna Machinena Spera
{"title":"Asthma or not asthma? That is the question.","authors":"Catalina Gómez Galán, Vanessa Fernández Díaz, María Cols I Roig, Laura Saura García, Carlos José Ruíz Hernández, Estibaliz Iglesias Jiménez, Martha Jiménez Freites, Belgica Minaya Polanco, Julian Andrés Manrique Niño, Adrianna Machinena Spera","doi":"10.15586/aei.v54i3.1583","DOIUrl":"10.15586/aei.v54i3.1583","url":null,"abstract":"<p><p>A 12-year-old boy with a family history of atopy and no relevant personal medical history was referred to the Pediatric Allergy Out-Clinic due to a persistent cough lasting 1 year, refractory to multiple therapeutic interventions. He presented with a daily productive cough, occasionally leading to vomiting, associated with exertional dyspnea during moderate physical activity. He denied any clear seasonality or identifiable triggers. He reported episodes of low-grade fever 2-3 days per month, dysphagia, and occasionally experienced a subjective sensation of food impaction. Blood tests performed at another center showed sensitization to house dust mites (<i>Dermatophagoides)</i>, olive pollen, pellitory (<i>Parietaria</i>), and animal dander. Physical examination was unremarkable. Spirometry performed in the Pediatric Allergy outpatient clinic revealed an obstructive ventilatory pattern with a negative bronchodilator response. High-resolution chest CT scan revealed multiple bilateral cylindrical bronchiectasis, predominantly in the upper lobes, as well as diffuse dilation of the thoracic esophagus up to 6 cm in diameter, extending to the esophagogastric junction, suggestive of stenosis at this level. The patient was urgently referred to the Pediatric Pulmonology and Pediatric Gastroenterology department. Further gastrointestinal studies-including an esophagogastroduodenal transit study, upper digestive endoscopy, and esophageal high-resolution manometry-confirmed a diagnosis of type II achalasia. Surgical intervention (Heller myotomy technique and Dor anterior fundoplication) was performed, and 30 months post-surgery, the patient remains asymptomatic, pulmonary function has normalized, and chest CT scan revealed no pleuroparenchymal abnormalities. Achalasia should be considered in the differential diagnosis of chronic productive cough unresponsive to treatment in children.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 3","pages":"193-197"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147872956","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}
Lívia Maria Nunes Campelo, Georgia Veras de Araújo Gueiros Lira, Emanuel Savio Cavalcanti Sarinho
{"title":"Environmental exposure to allergens in the home and analysis instruments: a scoping review.","authors":"Lívia Maria Nunes Campelo, Georgia Veras de Araújo Gueiros Lira, Emanuel Savio Cavalcanti Sarinho","doi":"10.15586/aei.v54i3.1600","DOIUrl":"10.15586/aei.v54i3.1600","url":null,"abstract":"<p><p>The objective was to identify possible validated instruments used to assess environmental exposure to allergens in the home. A scoping review was conducted including full articles published in Portuguese, English, and Spanish, up to July 2025, without a time limit, in the databases MEDLINE/PubMed, EMBASE, Scopus, CINAHL, and Web of Science databases. Three studies, published between 1999 and 2022, comprised the review. Three validated instruments were identified: one restricted to criterion validation and two with more comprehensive validation (construct, content, criterion, and reliability assessment). The main respiratory allergens assessed by the instruments were house dust mites, animal epithelia (particularly cats and dogs), cockroaches, and fungi. The review identified a small number of instruments in the literature, including a single instrument capable of assessing exposure to allergens in the home without the need for targeted observation, using direct interviews with patients as the assessment method. The results presented indicate a shortage of validated, widely used instruments worldwide to investigate the home environment of patients with respiratory allergies, thereby compromising the development of necessary guidelines to mitigate allergen exposure, a fundamental principle of all allergy treatment.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"54 3","pages":"198-205"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147872500","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}