Allergy, Asthma & Immunology Research最新文献

{"title":"Precision Medicine for Asthma: Tailored to its Severity and Endotype/Phenotype.","authors":"Rory Chan, Neve E Horn, Salman Siddiqui","doi":"10.4168/aair.2026.18.1.19","DOIUrl":"10.4168/aair.2026.18.1.19","url":null,"abstract":"<p><p>Asthma is a chronic respiratory disease affecting more than 300 million people globally and remains a major cause of morbidity, mortality, and healthcare burden. Traditionally, asthma has been managed using a stepwise treatment algorithm focused on inhaled corticosteroids, bronchodilators, and add-on therapies. While this approach provides a broad framework for care, it does not adequately account for the heterogeneity of the disease, which encompasses diverse clinical phenotypes, underlying endotypes, and variable treatment responses. Many patients with moderate-to-severe asthma continue to experience poor control, frequent exacerbations, and impaired quality of life despite standard therapies. Precision medicine offers an alternative strategy by identifying and targeting specific \"treatable traits\" across pulmonary, extrapulmonary, and behavioral domains. Advances in biomarker profiling-including blood eosinophils, fractional exhaled nitric oxide, volatile organic compounds, and transcriptomics-have enabled more accurate risk prediction and patient stratification. Imaging techniques, such as high-resolution computed tomography and hyperpolarized magnetic resonance imaging, are improving the ability to detect small airways dysfunction, mucus plugging, and other key disease mechanisms. Biologic therapies directed at type 2 inflammation pathways, including anti-immunoglobulin E, anti-interleukin (IL)5, anti-IL4Rα, and anti-thymic stromal lymphopoietin agents, have significantly reduced exacerbation rates and improved lung function, although biomarker variability, high treatment costs, and limited accessibility remain barriers to widespread use. Emerging oral, inhaled, and long-acting biologics further expand the therapeutic landscape. Looking forward, the integration of multi-omics, deep phenotyping, and artificial intelligence promises to transform asthma management by enabling personalized therapy tailored to individual patient profiles. This narrative review examines the limitations of the conventional stepwise approach, highlights recent advances in phenotyping and targeted treatment, and explores the role of novel technologies in shaping the future of asthma care. By moving beyond the one-size-fits-all model, precision medicine has the potential to improve long-term outcomes, safety, and quality of life for patients with asthma.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 1","pages":"19-38"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146058601","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":"RFC1 Repeat Expansion in Chronic Cough: Findings From the Korean Chronic Cough Registry.","authors":"Kyung Eun Park, Jiwon Lee, Jun-Pyo Choi, Ji-Yoon Oh, Ha-Kyeong Won, Hwa Young Lee, Surinder S Birring, Heung-Woo Park, Sang Heon Cho, Woo-Jung Song","doi":"10.4168/aair.2026.18.1.55","DOIUrl":"10.4168/aair.2026.18.1.55","url":null,"abstract":"<p><strong>Purpose: </strong>Biallelic repeat expansions in the Replication Factor C Subunit 1 (<i>RFC1</i>) gene are associated with cerebellar ataxia, neuropathy, and vestibular areflexia syndrome (CANVAS). Recent studies have shown that chronic cough often precedes neurological symptoms in CANVAS by 10-20 years, suggesting a potential link between <i>RFC1</i> repeat expansion and chronic cough. However, the prevalence and clinical relevance of <i>RFC1</i> expansions in chronic cough, particularly in non-Caucasian populations, remain unknown.</p><p><strong>Methods: </strong>We analyzed 128 consecutive patients with chronic cough who were enrolled in the Korean Chronic Cough Registry at 2 tertiary clinics. All patients underwent a comprehensive clinical evaluation and were followed up for at least 6 months to assess treatment response and to identify the diagnosis of refractory chronic cough (RCC). <i>RFC1</i> repeat expansions, including both biallelic and monoallelic variants, were assessed using flanking and repeat-primed polymerase chain reactions. Whole genome sequencing (WGS) was performed in selected cases to explore additional genetic variants.</p><p><strong>Results: </strong><i>RFC1</i> repeat expansions were identified in 12 patients with chronic cough, comprising 3 biallelic (2.3%), and 9 monoallelic (7.0%) carriers. RCC was diagnosed in 55 of the 109 subjects who completed follow-up. The percentage of <i>RFC1</i> expansions was significantly higher in RCC than in non-RCC (18.2% vs. 1.9%, <i>P</i> = 0.005), comprising 5.5% biallelic and 12.7% monoallelic expansions in the RCC group. Carriers had longer cough duration (11.0 vs. 4.0 years, <i>P</i> = 0.048) and poorer cough-specific quality of life (Leicester Cough Questionnaire score: 8.5 ± 2.2 vs. 10.5 ± 3.4; <i>P</i> = 0.027). All of the biallelic carriers were diagnosed with RCC and showed poor response to antitussive therapies. WGS identified no additional pathogenic variants in most cases.</p><p><strong>Conclusions: </strong>This is the first study to evaluate <i>RFC1</i> repeat expansions in non-Caucasian patients with chronic cough. The findings suggest that <i>RFC1</i> expansions may define a distinct, treatment-refractory phenotype of chronic cough.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 1","pages":"55-66"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146058609","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":"Immune Profile After Oral Immunotherapy in Children With Persistent Cow's Milk Protein Allergy.","authors":"Miguel Ângelo-Dias, Catarina Martins, Susana Piedade, Ângela Gaspar, Inês Mota, Luís-Miguel Borrego","doi":"10.4168/aair.2026.18.1.87","DOIUrl":"10.4168/aair.2026.18.1.87","url":null,"abstract":"<p><strong>Purpose: </strong>Cow's milk protein allergy (CMPA) is the most common food allergy in childhood. Oral immunotherapy (OIT) has proven effective in achieving tolerance in children with persistent CMPA (pCMPA), although the underlying immunological mechanisms that allow for tolerance remain incompletely understood. We aimed to characterize the immune profile of pCMPA children following successful OIT and compare it to healthy controls (HC).</p><p><strong>Methods: </strong>Thirty pCMPA children and 33 HC were recruited. T and B cell populations were assessed by flow cytometry, and specific immunoglobulins (sIgs) to milk allergens were measured by fluorometric enzyme-immunoassay.</p><p><strong>Results: </strong>Compared to HC, pCMPA children showed reduced B cells and activated T cells. Activated CD4⁺ T cells negatively correlated with OIT duration. Although sIgEs to casein remained ≥ class 3 in some patients, overall post-OIT sIgEs were lower compared to pre-OIT levels. Additionally, sIgG4 increased after OIT, particularly in patients with detectable sIgA. After OIT, pCMPA patients with sIgEs ≥ class 3 presented shorter relapse periods and fewer B cells and T cells compared to those with sIgEs < class 3. Interestingly, sIgEs correlated positively with regulatory T cells, though different sIgEs specificities showed distinct relationships with immune parameters. Age-related differences were observed: only children > 10 years showed significant reductions in T and B cells compared to their respective age-matched controls.</p><p><strong>Conclusions: </strong>OIT modulates immune activation in pCMPA, reducing sIgE and increasing sIgG4 levels. Different relations between distinct sIgs and immune parameters may denote different stimulating and tolerance-inducing capacities for distinct cow's milk components. Age and time since OIT completion influence immune recovery, highlighting the complexity of tolerance mechanisms.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 1","pages":"87-103"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146058573","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":"Ocular Allergy Within the Framework of the EAACI Nomenclature of Allergic Diseases and Hypersensitivity Reactions.","authors":"Ewa Bogacka, Magdalena Zemelka-Wiącek, Ioana Agache, Monika Jędrzejczak-Czechowicz, Anna Groblewska, Marta Chełmińska, Maciej Chałubiński, Marek Jutel","doi":"10.4168/aair.2026.18.1.6","DOIUrl":"10.4168/aair.2026.18.1.6","url":null,"abstract":"<p><p>Ocular allergy encompasses a heterogeneous group of diseases with overlapping clinical features and complex immunopathological mechanisms. This often creates challenges in classification and, consequently, in optimizing patient management. The nomenclature published in 2023 by the European Academy of Allergy and Clinical Immunology (EAACI) addresses these issues by redefining these conditions and linking clinical phenotypes and environmental modifiers to underlying types of hypersensitivity. This framework enhances diagnostic precision and supports mechanism-guided management. This article applies the EAACI approach based on hypersensitivity types to ocular allergy. The examples addressed include seasonal and perennial allergic conjunctivitis, driven mainly by type I and IV hypersensitivity reactions; vernal and atopic keratoconjunctivitis, involving mixed type I, IVb and IVa pathways; giant papillary conjunctivitis, a tissue-driven type V reaction; and contact blepharoconjunctivitis, a type IVa delayed hypersensitivity reaction with additional components. Distinct endotypes-such as local or acute allergic conjunctivitis, dupilumab-induced ocular disease, and vernal keratoconjunctivitis/atopic keratoconjunctivitis overlap-further illustrate heterogeneity, with the ocular surface microbiome emerging as a modifier. Diagnostics are increasingly aligning with mechanisms, and the EAACI framework translates this complexity into a mechanism-indexed map; this supports the selection of responders for targeted interventions while minimizing overtreatment.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 1","pages":"6-18"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146058589","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":"Bronchodilator Response of TEV/FEV3 and Its Implications in Pediatric Asthma.","authors":"Hamin Kim, Yoon Hee Kim, Jae Hwa Jung, Mireu Park, Yun Young Roh, Jong Deok Kim, Min Jung Kim, Yong Ju Lee, Kyung Won Kim, Myung Hyun Sohn, Soo Yeon Kim","doi":"10.4168/aair.2025.17.6.787","DOIUrl":"10.4168/aair.2025.17.6.787","url":null,"abstract":"<p><p>The diagnosis of asthma in children is challenging due to limitations of conventional spirometry, which primarily assesses large airway function and requires considerable patient effort. Terminal expiration volume (TEV)/forced expiratory volume in 3 seconds (FEV3) has been proposed as a new metric that may help assess small airway dysfunction, where TEV represents the volume difference between FEV3 and forced expiratory volume in 1 seconds (FEV1) and reflects terminal expiratory airflow. We aimed to evaluate the bronchodilator response (BDR) of TEV/FEV3 (BDR-TEV/FEV3) as an index reflecting variable small airway obstruction in children. This retrospective study included 1,199 children who underwent both spirometry and bronchial provocation testing for asthma at a tertiary hospital between January 2017 and December 2019. BDR-TEV/FEV3 was compared according to asthma status and severity. The findings were verified using an external validation group (n = 105). We also explored the association between BDR-TEV/FEV3 and established indices of airway inflammation. BDR-TEV/FEV3 was significantly higher in children with asthma than in those without asthma (3.74% vs. 1.81%, <i>P</i> < 0.001) and showed a stepwise increment with asthma severity (<i>P</i> for trend < 0.001). Moreover, BDR-TEV/FEV3 showed a positive correlation with changes in airflow limitation markers, impulse oscillometry parameters, and inflammatory markers such as eosinophil count and fractional exhaled nitric oxide. The change in TEV/FEV3 after bronchodilator inhalation significantly differed between asthmatic and non-asthmatic children and across asthma severity groups. BDR-TEV/FEV3 may be used as a parameter to assess the reversibility of small airway obstruction in children with asthma.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"17 6","pages":"787-796"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660043","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":"Efficacy of Biologics on Nasal Symptoms in Severe Asthmatics: We Need Additional Biomarkers or Strategies to Assess Phenotypes or Endotypes.","authors":"Ho Jin Yong, Young-Koo Jee","doi":"10.4168/aair.2025.17.6.669","DOIUrl":"10.4168/aair.2025.17.6.669","url":null,"abstract":"","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"17 6","pages":"669-671"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660028","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 Antibiotic Exposure on Pediatric Drug Eruption: A Nationwide Cohort Study in Korea.","authors":"Soo Min Jeon, Junwoo Jo, Juhee Ryu, Jin-Won Kwon, Jiung Jeong","doi":"10.4168/aair.2025.17.6.775","DOIUrl":"10.4168/aair.2025.17.6.775","url":null,"abstract":"<p><strong>Purpose: </strong>Antibiotic-related drug eruption is a common cutaneous adverse reaction in pediatric populations. However, its incidence and risk factor remain unclear. This study investigated the incidence of drug eruptions in pediatrics and its association with antibiotic exposure to identify potential risk factors.</p><p><strong>Methods: </strong>Using the Health Insurance Review and Assessment Service-Pediatric Patient Sample database (2009-2019), we conducted a retrospective nationwide cohort study involving 6,699,010 pediatric patients. Drug eruptions were identified based on administrative claims data using the International Classification of Diseases, 10th Revision codes L27.0 and L27.1. The incidence was compared between antibiotic-exposed and unexposed groups.</p><p><strong>Results: </strong>We analyzed 4,107,522 patients in the antibiotic-exposed group and 2,591,488 patients in the antibiotic-unexposed group. The overall incidence of drug eruptions was 10.84 per 10,000 person-years, with higher rates in the antibiotic-exposed group than in the antibiotic-unexposed group (14.59 vs. 4.89 per 10,000 person-years, Log rank <i>P</i> < 0.001). Any exposure to antibiotics significantly increased drug eruption risk (adjusted hazard ratio, 2.86; 95% confidence interval, 2.27-3.60). The risk of drug eruption was higher among pediatric patients who used multiple antibiotics than in those with single antibiotic use. The association remained consistent across age groups and was robust in sensitivity analyses, including extended follow-ups and inpatient-only outcomes.</p><p><strong>Conclusions: </strong>Antibiotic exposure increases the risk of drug eruption in pediatric populations, particularly with multiple antibiotic use. Careful consideration is needed when prescribing antibiotics to children, especially in combination therapy.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"17 6","pages":"775-786"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660066","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":"Association Between Obstructive Sleep Apnea and Atopic Dermatitis in the Korean Adult Population: Results From the 2019-2022 Korea National Health and Nutrition Examination Survey.","authors":"Jung Min Lee, Wanhyung Lee","doi":"10.4168/aair.2025.17.6.765","DOIUrl":"10.4168/aair.2025.17.6.765","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the association between the risk of obstructive sleep apnea (OSA) and atopic dermatitis (AD), in addition to the dose-response relationship between the risk of OSA and the prevalence of AD.</p><p><strong>Methods: </strong>This study analyzed data from 15,095 participants aged ≥ 40 years who were part of the 2019-2022 Korea National Health and Nutrition Examination Survey (KNHANES). AD was assessed using self-reported questionnaires, and the risk of OSA was determined using the STOP-BANG score. Demographic distributions were analyzed by using χ² tests, whereas adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression analysis. The weighted prevalence of AD and 95% CIs were calculated to account for the complex sampling design of KNHANES.</p><p><strong>Results: </strong>Multivariable logistic regression revealed a significant association between OSA risk and AD, with an OR of 2.159 (95% CI, 1.456-3.202). The weighted prevalence of AD increased with higher OSA risk, from 1.43% in the low-risk group to 1.74% in the intermediate-risk group, and 2.17% in the high-risk group (<i>P</i> value for trend = 0.013).</p><p><strong>Conclusions: </strong>OSA risk was significantly associated with AD prevalence, having a dose-response relationship. Given the observed associations, incorporating OSA management into clinical strategies may warrant further investigation as a potential avenue for mitigating AD-related risk.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"17 6","pages":"765-774"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660075","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":"Siglec-8 as a Biomarker for Predicting Anti-IL-5 Response in Severe Asthma.","authors":"Youngsoo Lee, Hyunkyung Kim, Chae Eun Lee, Byung-Jae Lee, Min-Hye Kim, So-Young Park, Byung Keun Kim, Sae-Hoon Kim, Sang Hoon Kim, Hye-Kyung Park, Taehoon Lee, Ji-Su Shim, Chan Sun Park, Han Ki Park, Jae-Woo Kwon, Sujeong Kim, Young-Hee Nam, Min-Suk Yang, Jae-Woo Jung, Tae-Bum Kim","doi":"10.4168/aair.2025.17.6.742","DOIUrl":"10.4168/aair.2025.17.6.742","url":null,"abstract":"<p><strong>Purpose: </strong>Biologic therapies have revolutionized the management of severe asthma (SA), yet the variability in patient responses necessitates identification/verification of predictive biomarkers. Siglec-8, a sialic acid-binding immunoglobulin-like lectin 8 selectively that is expressed on eosinophils, could serve as a biomarker for predicting responsiveness to biologics in patients with SA. It is necessary to evaluate the predictive value of baseline serum Siglec-8 levels compared to other parameters, including blood eosinophil counts, in determining clinical responses to anti-interleukin 5 (IL-5) therapies in patients with SA.</p><p><strong>Methods: </strong>This study included 68 patients with SA from the Precision Medicine Intervention in Severe Asthma study, who had initiated anti-IL-5 therapies and whose baseline serum Siglec-8 levels were measured. Clinical outcomes were assessed at 6 and 12 months following treatment. Excellent responders were defined as patients with zero exacerbations during follow-up. Multivariable logistic regression and receiver operating characteristic curve analyses were performed to compare the predictive performance of serum Siglec-8 levels versus that of other parameters.</p><p><strong>Results: </strong>Data from 29 patients treated with mepolizumab and 39 patients treated with reslizumab were analyzed. Baseline serum Siglec-8 levels showed a trend toward better diagnostic performance compared to blood eosinophil counts for predicting 6- and 12-month clinical responses (area under the curve, 0.931 vs. 0.836; <i>P</i> = 0.08 for 6-month responders; and 0.811 vs. 0.628, <i>P</i> = 0.05 for 12-month excellent responders). Additionally, the ratio of serum Siglec-8 levels to blood eosinophil counts significantly increased after 6 months of anti-IL-5 therapy (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Baseline serum Siglec-8 levels showed a trend toward better predictive performance than other parameters for predicting 6- and 12-month responses to anti-IL-5 therapies in patients with SA. These findings suggest that Siglec-8 may have the potential as a biomarker for guiding treatment decisions, although further validation in larger, prospective studies is warranted.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05164939.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"17 6","pages":"742-753"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660006","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":"Update on Tree Nut and Seed Allergies: Prevalence, Clinical Characteristics, Diagnosis, and Management.","authors":"Kyunguk Jeong, Sooyoung Lee","doi":"10.4168/aair.2025.17.6.672","DOIUrl":"10.4168/aair.2025.17.6.672","url":null,"abstract":"<p><p>Tree nut (TN) and seed allergies have become increasingly recognized as important global health concerns, paralleling rising consumption driven by dietary trends. These allergies are often severe, typically develop in childhood, and may persist throughout life. Recent population-based studies show rising prevalence, particularly for TNs and sesame, with substantial regional variability. Clinical outcomes are strongly influenced by the underlying sensitization profile: storage proteins and lipid transfer proteins are associated with systemic reactions and anaphylaxis, whereas sensitization to pathogenesis-related group 10 and profilins usually results in milder manifestations including pollen-food syndrome. Co-sensitization among TNs and seeds occurs frequently; however, clinical co-allergy is observed to a lesser degree, with the highest overlap reported between cashew-pistachio and walnut-pecan. Advances in diagnosis, including component-resolved diagnostics and the basophil activation test, improve discrimination between clinical allergy and asymptomatic sensitization or mild localized reactions, and help minimize the need for oral food challenges. Acute management aligns with standard principles for immunoglobulin E-mediated food allergy, with prompt intramuscular epinephrine being the first-line treatment for anaphylaxis. Long-term management emphasizes accurate allergen identification, pragmatic dietary recommendation that supports inclusion of tolerated nuts, and preparedness with epinephrine for accidental exposure. Emerging data support the use of oral immunotherapy for selected TNs and sesame, with promising desensitization rates. Regulatory progress in allergen labeling and targeted education in high-risk settings, such as schools, restaurants, and air travel, are essential for prevention. Further studies are required to clarify natural history, to optimize immunotherapy, and to refine management for better supporting affected individuals across the lifespan.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"17 6","pages":"672-691"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660051","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}