Allergy, Asthma & Immunology Research最新文献

{"title":"Wheat Allergy: Clinical Phenotypes, Diagnostic Approaches, and Management Strategies.","authors":"Jung-Won Park, Kyung Hee Park, Jae-Hyun Lee","doi":"10.4168/aair.2026.18.2.158","DOIUrl":"10.4168/aair.2026.18.2.158","url":null,"abstract":"<p><p>Wheat triggers a broad spectrum of allergic diseases, with prevalence varying across regions. In adults, it is the leading cause of food-induced anaphylaxis, most often as wheat-dependent exercise-induced anaphylaxis (WDEIA), while occupational exposure causes baker's asthma. In children, wheat allergy manifests as immediate-type reactions, including anaphylaxis, and contributes to atopic dermatitis. Recently, wheat is known as one of key triggers of eosinophilic esophagitis across all age groups. Wheat proteins are classified into water/salt-soluble and -insoluble fractions, with distinct physiochemical profiles. Among insoluble proteins, ω-5 gliadin and high- and low-molecular weight glutenins are well recognized as major allergens in WDEIA. Conversely, both gluten proteins and water-salt soluble allergens, such as α-amylase inhibitors and lipid-transfer proteins, are key allergens in pediatric wheat allergy and baker's asthma. Accurate diagnosis requires component-resolved diagnostics (CRD), given the complex physicochemical properties of wheat proteins. However, conventional skin prick testing and some multiplex specific immunoglobulin E assays lack full CRD integration, likely underestimating true prevalence. Management primarily relies on avoidance, but strict elimination is difficult due to wheat's ubiquity. In WDEIA, cofactors such as exercise, alcohol, or nonsteroidal anti-inflammatory drugs commonly precipitate reactions, with provoking doses varying widely, necessitating individualized strategies. Oral immunotherapy has been attempted for pediatric wheat allergy but demonstrated lower efficacy than for other foods, underscoring the need for patient-tailored strategies. Baker's asthma management focuses on work-place control, personal respiratory protective equipment, and pharmacotherapy. Overall, improved CRD-based diagnostics and novel therapeutic approaches are needed to enhance care for this diverse spectrum of wheat-related allergic diseases.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 2","pages":"158-172"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Health Insurance Type on Access to Biologics and Systemic Corticosteroid Exposure in Patients With Severe Asthma: A Real-World Study From the Korean Severe Asthma Registry (KoSAR).","authors":"Kyoung-Hee Sohn, Sun-Kyung Lee, Hwa Young Lee, So Ri Kim, Seung Eun Lee, Joo-Hee Kim, Woo-Jung Song, Sang-Heon Kim","doi":"10.4168/aair.2026.18.2.192","DOIUrl":"10.4168/aair.2026.18.2.192","url":null,"abstract":"<p><strong>Purpose: </strong>The impact of socioeconomic status on asthma control has been widely investigated. However, evidence regarding the impact of health insurance type on biologic utilization and systemic corticosteroid (SCS) exposure among patients with severe asthma remains limited. This study aimed to evaluate the associations between health insurance type, biologic utilization, and SCS dose in South Korea.</p><p><strong>Methods: </strong>Data from the Korean Severe Asthma Registry (KoSAR) between March 2022 and October 2023 were analyzed. Patients were categorized into 4 different groups based on their health insurance type: National Health Insurance (NHI) with private health insurance (PHI), NHI-only, and Medical Aid (MA) with PHI, and MA-only.</p><p><strong>Results: </strong>Among the 578 patients with severe asthma, 327 (56.6%) were classified as NHI+PHI, 192 (33.2%) as NHI-only, 22 (3.8%) as MA+PHI, and 37 (6.4%) as MA-only. Decline in lung function, asthma exacerbations, and impaired quality of life were significantly more prevalent in the MA+PHI and MA-only groups. Overall, 159 patients (27.5%) were identified as biologic users. The most frequently prescribed biologics were dupilumab (8.8%), reslizumab (8.5%), omalizumab (7.1%), followed by mepolizumab (2.3%). Biologic utilization varied significantly by insurance type, with rates of 30.9% in the NHI+PHI group, 27.1% in the NHI-only group, and only 8.1% in the MA-only group (<i>P</i> = 0.011). Conversely, dependence on SCS (defined as SCS use for more than one month) showed an inverse pattern, being most prevalent in the MA-only group (52.6%), followed by the NHI-only group (36.8%) and the NHI+PHI group (26.7%) (<i>P</i> = 0.017).</p><p><strong>Conclusions: </strong>Our study showed that differences in biologic and SCS use were associated with insurance type. These findings suggest that insurance coverage and out-of-pocket expenses are important factors influencing access to optimal care for severe asthma, emphasizing the need for policy interventions to promote health equity.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 2","pages":"192-203"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin Barrier Dysfunction in Contact and Atopic Dermatitis: A Comparative Review.","authors":"Jihye Maeng, Sekyoo Jeong, Hyunjung Kim","doi":"10.4168/aair.2026.18.2.173","DOIUrl":"10.4168/aair.2026.18.2.173","url":null,"abstract":"<p><p>The epidermis, the outermost layer of the skin, consists of 5 distinct layers, with the stratum corneum (SC) serving as the primary barrier. Disruption of skin barrier leads to inflammatory skin conditions, including irritant contact dermatitis (ICD), allergic contact dermatitis (ACD), and atopic dermatitis (AD). ICD arises from direct damage to the SC by irritants, while ACD is mediated by a type IV hypersensitivity. AD is characterized by chronic inflammation and genetic defects that compromise barrier integrity. Accordingly, strategies aimed at barrier restoration, such as the use of ceramide-based moisturizers, are key therapeutic approaches. Recent guidelines emphasize the importance of barrier-enhancing interventions, yet compliance remains a challenge in occupational settings. This review explores the implications of skin barrier dysfunction in contact dermatitis and AD, highlighting emerging therapeutic strategies aimed at restoring barrier function and reducing disease burden.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 2","pages":"173-181"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Risk Factor Atlas for Allergy-Related Airway Diseases: Evidence From Multi-Biobank Genetic Study.","authors":"Tao Guo, Peiyu Luo, Guobing Jia, Dehong Liu, Hui Xie","doi":"10.4168/aair.2026.18.2.224","DOIUrl":"10.4168/aair.2026.18.2.224","url":null,"abstract":"<p><strong>Purpose: </strong>Understanding factors contributing to allergy-related airway diseases (AADs).</p><p><strong>Methods: </strong>We conducted a meta-analysis of Mendelian randomization (MR) estimates from multi-biobank to investigate the effects of 83 common factors on asthma, allergic rhinitis (AR), chronic rhinosinusitis (CRS), and nasal polyps (NPs). Data for AADs were obtained from multiple independent populations including FinnGen, UK Biobank and large consortia (asthma, 137,498 cases and 1,009,466 controls; AR, 51,712 cases and 592,784 controls; CRS, 24,688 cases and 760,073 controls; and NP, 11,796 cases and 760,075 controls). The meta-analyses combining the above multi-biobank MR results were employed as our main results.</p><p><strong>Results: </strong>Genetically proxied social isolation, smoking time and frequency, sedentary time, global and central obesity, C-reactive protein (CRP), insomnia, major depressive disorder (MDD), anxiety, attention deficit hyperactivity disorder, neuroticism, posttraumatic stress disorder (PTSD), rheumatoid arthritis (RA), atopic dermatitis (AD), type 1 diabetes (T1D), gastroesophageal reflux disease (GERD), childhood obesity, early menarche, smoking around birth, and childhood maltreatment could increase the risk of asthma. Education, higher income, cheese intake, sleep duration, high density lipoprotein cholesterol, forced expiratory volume in 1 second/forced vital capacity, well-being and ulcerative colitis were associated with a decreased risk of asthma. Social isolation, CRP, Crohn's disease, GERD, insomnia, MDD, neuroticism and AD could increase the risk of AR, whereas well-being could decrease the risk of AR. Sedentary time, MDD, anxiety, PTSD, opioid use disorder, RA, AD, T1D, hypothyroidism, and GERD could increase the risk of CRS, whereas coffee intake, apolipoprotein A1, and well-being were associated with a decreased risk of CRS. Smoking duration, RA, AD and T1D could increase the risk of NP, whereas fresh fruit intake could decrease the risk of NP.</p><p><strong>Conclusions: </strong>This study offers potential causal evidence for AAD risk factors and provides actionable targets for primary prevention.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 2","pages":"224-241"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Korean Versions of the Scale of Food Allergy Anxiety and the Food Allergy Anxiety Scales for Children and Parents.","authors":"Eun Yeong Chang, Sehun Jang, Jeongmin Song, Minyoung Jung, Jiwon Kim, Minji Kim, Yechan Kyung, Hye Won Yoo, Ji Young Lee, Mina Park, Hyemi Park, Yunhye Oh, Sukyung Kim, Jihyun Kim, Kangmo Ahn","doi":"10.4168/aair.2026.18.2.300","DOIUrl":"10.4168/aair.2026.18.2.300","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the reliability and validity of the Korean versions of the Child- and Parent-Rated Scale of Food Allergy Anxiety (K-SOFAA-C and K-SOFAA-P) and the Food Allergy Anxiety Scale for Children (K-FAAS-C). Additionally, we sought to identify factors associated with high levels of food allergy (FA)-related anxiety in Korean children and their parents.</p><p><strong>Methods: </strong>We enrolled patients aged 6-18 years with FA and their parents. The original English versions of the SOFAA-C, SOFAA-P, and FAAS-C were translated into Korean. Internal consistency was assessed using Cronbach's α coefficients. Convergent validity was evaluated by examining the correlations between each questionnaire and the Korean version of the Food Allergy Quality of Life Questionnaire (K-FAQLQ) as well as generic anxiety scales. Logistic regression analyses were performed to identify factors associated with high anxiety.</p><p><strong>Results: </strong>The K-SOFAA-C, K-FAAS-C, and K-SOFAA-P demonstrated excellent internal consistency, with Cronbach's α values exceeding 0.80. Total scores of the K-SOFAA-C, K-FAAS-C, and K-SOFAA-P showed significant positive correlations with age-appropriate K-FAQLQ scores (<i>r</i> = 0.469, 0.886, 0.549, 0.929, and 0.665; all <i>P</i> < 0.05) and with generic anxiety scales (<i>r</i> = 0.621, 0.393, 0.269, and 0.348; all <i>P</i> < 0.05). Respiratory symptoms were significantly associated with higher K-SOFAA-C (adjusted odds ratio [aOR], 4.38; 95% confidence interval [CI], 1.12-17.17) and K-SOFAA-P scores (aOR, 10.57; 95% CI, 1.94-57.52). Residing in non-metropolitan areas was associated with higher K-FAAS-C scores (aOR, 3.72; 95% CI, 1.06-13.11).</p><p><strong>Conclusions: </strong>The K-SOFAA-C, K-FAAS-C, and K-SOFAA-P are reliable and valid instruments for assessing FA-related anxiety in Korean children and their parents. These tools may facilitate clinical assessment and management by identifying individuals at high risk of FA-related anxiety, particularly those with respiratory symptoms or living in non-metropolitan areas.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 2","pages":"300-312"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life Impairment in Patients With Chronic Cough: How Does It Compare to Other Chronic Conditions?","authors":"Sang Min Lee, Young-Koo Jee","doi":"10.4168/aair.2026.18.2.155","DOIUrl":"10.4168/aair.2026.18.2.155","url":null,"abstract":"","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 2","pages":"155-157"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Study of Drug-Associated Severe Allergic Reactions: An Analysis of High-Risk Medications and Epidemiological Trends Based on the FAERS Database.","authors":"Wei Mo, Mingyuan Ouyang, Hui Yang, Weili Kong","doi":"10.4168/aair.2026.18.2.242","DOIUrl":"10.4168/aair.2026.18.2.242","url":null,"abstract":"<p><strong>Purpose: </strong>Drug-induced anaphylactic shock (DIAS) is a severe adverse drug reaction. This study aimed to identify drugs significantly associated with DIAS through the real-time updated analysis of large-sample data.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 20,748,017 adverse event reports from the Food and Drug Administration Adverse Event Reporting System database spanning from the first quarter of 2004 to the fourth quarter of 2023 to identify the main drugs causing anaphylactic shock. Descriptive statistical analysis was used to report the basic characteristics, while disproportionality analysis was employed to assess the correlation between specific drugs and DIAS events using metrics such as the reporting odds ratio (ROR), proportional reporting ratio (PRR), and χ² test values. Additionally, detailed descriptive analyses were performed to examine yearly trends, sex and age distributions, and the sources and countries of reported DIAS events.</p><p><strong>Results: </strong>There were a total of 21,073 DIAS events, accounting for 0.10% of all reports. The median weight of the DIAS patients was 70 kg, the median age was 55 years, and the incidence of DIAS was significantly higher among females (56.57%) than among males (35.24%). DIAS was primarily associated with indications such as anesthesia, sclerosis, and arthritis. The top 10 drugs most strongly associated with anaphylactic shock were amoxicillin, propofol, moxifloxacin, infliximab, omalizumab, carboplatin, paclitaxel, cefuroxime, ceftriaxone, natalizumab, and rocuronium bromide. Asymmetric analysis revealed that the top 10 drugs with the strongest signals were remifentanil, carboplatin, propofol, ceftriaxone, iopromide, atracurium, meloxicam, cefuroxime, desflurane, and ringer lactate. (all ROR > 3, PRR > 2, χ² > 4, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Antibiotics, anesthetics, monoclonal antibodies (mAbs), and antitumor drugs are the main categories of drugs associated with anaphylactic shock. Specifically, high clinical vigilance should be given to β-lactam antibiotics, intravenous anesthetics, antitumor drugs, and mAbs. Future research on DIAS should further explore its mechanisms, evaluate risk factors, and develop effective prevention strategies to enhance the safety and efficacy of drug therapy.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 2","pages":"242-253"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Butyrate Silences <i>MUC5AC</i> in Airway Epithelial Cells Through Histone Deacetylation at Its Promoter Region.","authors":"Sang Hee Jo, Ikhyeon Bae, Myeong Seong Sim, Hye Jeong Kim, Chun Kim, Il Yup Chung, Hun Soo Chang","doi":"10.4168/aair.2026.18.2.204","DOIUrl":"10.4168/aair.2026.18.2.204","url":null,"abstract":"<p><strong>Purpose: </strong>Mucin 5AC (MUC5AC) is a mucin that forms a gel on the surface of the airway epithelium, and its hyperproduction plays a pathological role in chronic inflammatory airway diseases. Short-chain fatty acids (SCFAs), microbial fermentation products of dietary fiber in the gut, have been shown to significantly impact the development of allergic airway disease. Nonetheless, little is known about whether and how SCFAs influence the function of airway epithelial cells. In this study, we investigated the direct effects of SCFAs, especially butyrate, on MUC5AC production and the underlying mechanisms.</p><p><strong>Methods: </strong>NCI-H292 cells and normal human bronchial epithelial cells were treated with inflammatory mediators and butyrate. MUC5AC expression, signal transduction pathways, and promoter histone acetylation were assessed using quantitative real-time polymerase chain reaction, immunoblotting, immunocytochemistry, and chromatin immunoprecipitation (ChIP) assays.</p><p><strong>Results: </strong>Among SCFAs, butyrate has a strong inhibitory effect on MUC5AC expression at low micromolar concentrations in airway epithelial cells. Butyrate abolished MUC5AC expression induced by various inflammatory mediators, including epidermal growth factor (EGF). In line, butyrate upregulated forkhead box protein A (FOXA) 2, which inhibits goblet cell differentiation, while it downregulated SAM-pointed domain-containing ETS transcription factor (SPDEF) and FOXA3, which promote goblet cell metaplasia. Interestingly, butyrate exerts its inhibitory effect independent of its receptors and does not interfere with the early phase of EGF receptor signaling pathway. ChIP analysis revealed that butyrate increased H3K27 acetylation in both the proximal and distal regions of the <i>MUC5AC</i> promoter at the late phase following EGF stimulation, but this acetylation returned to baseline in the presence of butyrate.</p><p><strong>Conclusions: </strong>Our findings indicate that butyrate plays a critical role in reprogramming the transcriptional and epigenetic regulation of MUC5AC production. This may represent a general mechanism for controlling MUC5AC production in both healthy and diseased states.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 2","pages":"204-223"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Clinical Improvement of Severe Atopic Dermatitis Refractory to Dupilumab After Intramuscular Injections of Autologous Total Immunoglobulin G: A Case Report.","authors":"Dong-Ho Nahm, Myoung-Eun Kim","doi":"10.4168/aair.2026.18.2.313","DOIUrl":"10.4168/aair.2026.18.2.313","url":null,"abstract":"","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 2","pages":"313-317"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential MicroRNA Expression in Chronic Spontaneous Urticaria in Relation to Treatment Response.","authors":"Youngsoo Lee, Jin Young Noh, Jiwon Yoon, Boyoun Choi, JungMo Kim, Hyun Goo Woo, Young-Min Ye","doi":"10.4168/aair.2026.18.2.271","DOIUrl":"10.4168/aair.2026.18.2.271","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic spontaneous urticaria (CSU) is a mast cell-driven skin disorder characterized by a complex pathogenesis involving immune dysregulation and inflammation. MicroRNAs (miRNAs) have emerged as critical post-transcriptional regulators in various diseases. This study aimed to investigate differentially expressed serum miRNAs in CSU and its association with treatment response.</p><p><strong>Methods: </strong>Thirty CSU patients (37.9 ± 9.8 years, 15 females) and 10 normal controls were enrolled. Patients were stratified by clinical response to H₁-antihistamines (H1AHs) and omalizumab. Serum miRNAs were profiled using the Affymetrix GeneChip^® miRNA 4.0 Array. Differentially expressed miRNAs were identified, and bioinformatic analyses were performed to predict target genes and assess pathway enrichment.</p><p><strong>Results: </strong>Eighteen miRNAs were differentially expressed between CSU patients and normal controls, with 10 upregulated and 8 downregulated in CSU. Compared to H1AH responders, 23 miRNAs were downregulated in H1AH nonresponders. In omalizumab-treated patients, 4 miRNAs, hsa-miR-503-5p, hsa-miR-1282, hsa-miR-93-5p, and hsa-miR-638, were reduced in complete responders. Bioinformatic analysis identified 3 hub genes (MYC proto-oncogene [<i>MYC</i>], cyclin D1 [<i>CCND1</i>], ribonucleotide reductase regulatory subunit M2) in H1AH nonresponse, and 14 key target genes, including heat shock protein family A (Hsp70) member 8 (<i>HSPA8</i>), <i>CCND1</i>, and E2F transcription factor 3, in omalizumab complete responders. Notably, hsa-miR-93-5p and its predicted target <i>CCND1</i> were associated with both H1AH nonresponsiveness and omalizumab complete response.</p><p><strong>Conclusions: </strong>Distinct serum miRNA signatures are associated with treatment responses in CSU. In particular, miR-93-5p with network targets, including <i>MYC</i>, <i>CCND1</i>, and <i>HSPA8</i>, indicates shared regulatory pathways underlying H1AH refractoriness and omalizumab responsiveness. These findings offer mechanistic insights into CSU pathogenesis and support a personalized approach to treatment.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 2","pages":"271-285"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}