Allergy, Asthma & Immunology Research最新文献

{"title":"Real-World Performance of Non-Allergist-Led Penicillin Allergy Delabeling: Prospective Head-to-Head Comparison of APAAACI vs. PENFAST.","authors":"Freya Kl Chung, Weihong Shi, Man Yui Chong, Elaine Lee, Jackie Sh Yim, Valerie Chiang, Philip H Li","doi":"10.4168/aair.2026.18.4.599","DOIUrl":"10.4168/aair.2026.18.4.599","url":null,"abstract":"<p><strong>Purpose: </strong>Although around 90% of penicillin allergies are mislabelled, delabeling initiatives have been hindered by limited access to drug allergy services. Asia Pacific Association of Allergy, Asthma, and Clinical Immunology (APAAACI) and PENFAST risk-stratification tools can facilitate non-allergist delabeling, but their comparative real-world performance remains unknown. The purpose of this study was to prospectively evaluate APAAACI and PENFAST against allergist assessment and drug provocation testing (DPT) outcomes.</p><p><strong>Methods: </strong>In a blinded, head-to-head study, 103 adults with penicillin allergy labels underwent independent risk stratification using both APAAACI and PENFAST tools, followed by allergist evaluation and allergy testing (skin tests, <i>in vitro</i> tests, and DPT). We assessed diagnostic performance (area under the curve [AUC]-receiver operating characteristic, accuracy, sensitivity, specificity, positive and negative predictive values [NPVs]) and agreement (Cohen's κ) of these tools.</p><p><strong>Results: </strong>Overall, allergist assessment demonstrated the highest AUC of 0.82 (95% confidence interval [CI], 0.69-0.95), outperforming APAAACI (AUC, 0.79; 95% CI, 0.66-0.92; <i>P</i> = 0.012) and PENFAST (AUC, 0.75; 95% CI, 0.62-0.89; <i>P</i> = 0.010). Both APAAACI and PENFAST demonstrated high sensitivity (0.88) and NPV (APAAACI, 0.99; PENFAST, 0.98), missing only one non-severe DPT-positive case. APAAACI showed excellent agreement with allergist assessment (κ = 0.96, <i>P</i> < 0.001) versus moderate agreement for PENFAST (κ = 0.43). Allergist evaluation had superior specificity (0.77 vs. 0.71 [APAAACI] and 0.63 [PENFAST]) and overall accuracy (0.78 vs. 0.72 and 0.65).</p><p><strong>Conclusions: </strong>APAAACI and PENFAST can both effectively identify low-risk patients labelled with penicillin allergy when used by non-allergists, with comparable sensitivity to allergist assessment. APAAACI's stronger agreement with allergist assessment may suggest particular utility in Asian populations. These tools can significantly improve access to delabeling in settings lacking specialist allergy services.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 4","pages":"599-610"},"PeriodicalIF":4.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668358","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":"Associations Between Serum Resolvin D1 Levels and Food Allergy Persistence in Children.","authors":"Mireu Park, Haerin Jang, Sumin Lee, Eun Gyul Kim, Mi Na Kim, Hamin Kim, Soo Yeon Kim, Lark Kyun Kim, Jong Deok Kim, Yong Ju Lee, Min Jung Kim, Yoon Hee Kim, Myung Hyun Sohn, Kyung Won Kim","doi":"10.4168/aair.2026.18.4.525","DOIUrl":"10.4168/aair.2026.18.4.525","url":null,"abstract":"<p><strong>Purpose: </strong>The pathophysiology and natural course of childhood food allergies (FAs) remains largely elusive. Recent findings have implicated resolvins, omega-3 metabolites, in the pathogenesis and resolution of FAs, highlighting their potential clinical significance. This investigation aimed to elucidate the clinical implications of resolvins in the manifestation and resolution of childhood FAs.</p><p><strong>Methods: </strong>Serum samples were collected from a cohort of children diagnosed with FA and healthy controls upon their first visit to the Severance Children's Hospital (Seoul, Korea). FA persistence was assessed for each patient based on follow-up records. Resolvin D1 (RvD1) levels were measured and their correlation with total immunoglobulin E (IgE) and allergen-specific IgE levels were evaluated.</p><p><strong>Results: </strong>This study included 278 children (mean age 3.28 ± 3.17 years; 62% male), consisting of 92 children with resolved FA (resolved FA group), 113 children with persistent FA (persistent FA group), and 73 children (control group). RvD1 levels were significantly higher in children with FA than in controls (<i>P</i> < 0.001), and were significantly higher in the persistent FA group than in the resolved FA group (<i>P</i> = 0.045). A positive correlation was found between total IgE and RvD1 levels (<i>r</i> = 0.32, <i>P</i> < 0.001), particularly in the persistent FA subgroup. Furthermore, the correlation between RvD1 and total IgE was stronger in children with multiple FAs (<i>r</i> = 0.367, <i>P</i> < 0.001). RvD1 levels were also positively correlated with egg- and milk-specific IgE levels, especially in the persistent FA group.</p><p><strong>Conclusions: </strong>Our findings suggest that RvD1 is a candidate metabolite associated with the persistence of childhood FA, across various food allergens and may provide complementary information to existing clinical features.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 4","pages":"525-534"},"PeriodicalIF":4.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668261","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":"Predictive Biomarker for Persistent Food Allergy in Children.","authors":"Kangmo Ahn","doi":"10.4168/aair.2026.18.4.470","DOIUrl":"10.4168/aair.2026.18.4.470","url":null,"abstract":"","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 4","pages":"470-473"},"PeriodicalIF":4.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668372","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 Allergen-Specific Subcutaneous Immunotherapy on 12-Month Health-Related Quality of Life in Children and Their Parental Caregivers.","authors":"Wenjing Zhou, Xingyu Guo, Bo Ding, Yaqin Li, Yin Lai, Yanming Lu","doi":"10.4168/aair.2026.18.4.584","DOIUrl":"10.4168/aair.2026.18.4.584","url":null,"abstract":"<p><strong>Purpose: </strong>Respiratory allergies impair children's health-related quality of life (HRQoL) and increase caregiver burden. While allergen-specific subcutaneous immunotherapy (SCIT) is known to improve clinical outcomes, its short-term impact on HRQoL in children and their parental caregivers remains underexplored. We aimed to evaluate the 12-month impact of SCIT on HRQoL, identify the determinants of HRQoL, and assess the correlation between symptom improvements and HRQoL gains.</p><p><strong>Methods: </strong>This prospective study enrolled children with allergic rhinitis and/or asthma receiving either SCIT or standard pharmacotherapy, alongside their parental caregivers. Validated generic and disease-specific HRQoL instruments were administered at baseline and the 12-month follow-up. HRQoL changes were analyzed using paired <i>t</i>-tests and Cohen's <i>d</i> effect sizes (ESs). Factors influencing HRQoL were identified using multivariable regression, and correlations between symptom changes and HRQoL gains were examined.</p><p><strong>Results: </strong>After 12 months, children in the SCIT group (n = 132) showed significantly greater improvements in HRQoL than those receiving standard pharmacotherapy (n = 120) (ESs: 0.52-1.34 vs. 0.21-1.05), particularly in the domains of \"usual activities\" and \"pain/discomfort.\" Caregivers in the SCIT group also experienced greater improvements in HRQoL (ESs: 0.54-0.60 vs. 0.23-0.26), particularly in the domains of \"exhaustion,\" \"anxiety,\" and \"day-to-day activities.\" Multivariable regression analysis identified significant factors influencing HRQoL for both children and caregivers, including coexisting allergic conditions, disease control status, SCIT, and caregiver burdens. Symptom improvements with SCIT showed moderate-to-strong correlations with HRQoL gains.</p><p><strong>Conclusions: </strong>Over a 12-month period, SCIT was associated with significantly greater improvements in HRQoL for children with respiratory allergies and their parental caregivers compared with standard pharmacotherapy. Generic HRQoL instruments demonstrated good sensitivity to short-term treatment-related changes, supporting their utility as complementary outcome measures in SCIT evaluation.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06535087.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 4","pages":"584-598"},"PeriodicalIF":4.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668361","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 Lipid Dysregulation in Atopic Dermatitis and Related Inflammatory Skin Diseases.","authors":"Han Bi Kim, Jinseo Park, Chan Sol Lim, Ji Young Um, Bo Young Chung, Chun Wook Park, Dong-Kyu Lee, Hye One Kim","doi":"10.4168/aair.2026.18.4.485","DOIUrl":"10.4168/aair.2026.18.4.485","url":null,"abstract":"<p><p>Epidermal lipids are essential for skin barrier function and actively influence cutaneous immune homeostasis. Recent advances have transformed our understanding of skin lipid dysregulation in allergic diseases, revealing complex bidirectional relationships between barrier dysfunction and immune activation. This review provides a comprehensive analysis of the 2020-2025 literature on skin lipid metabolism in allergic and inflammatory diseases, with a particular focus on molecular mechanisms, diagnostic biomarkers, therapeutic advances, and implications for precision medicine. Key discoveries include the finding that sphingomyelin deacylase, long linked to ceramide (CER) deficiency, is actually the β-subunit of acid ceramidase. In atopic dermatitis, this enzyme shifts its substrate specificity to sphingomyelin, depleting the barrier lipid pool. Type 2 cytokines, particularly interleukin (IL)-4 and IL-13, suppress lipid biosynthesis through Janus kinase (JAK)/Signal Transducer and Activator of Transcription 6-mediated downregulation of fatty acid (FA) elongases. This suppression, particularly affecting elongation of very long-chain fatty acid (ELOVL) enzymes, such as ELOVL1, ELOVL3, and ELOVL6, disrupts the synthesis of ultra-long-chain CERs essential for barrier function. JAK inhibitors effectively reverse T helper 2 (Th2)-mediated lipid suppression, while optimized topical lipid ratios (3:1:1 CER: cholesterol: FA) enhance barrier repair. Innovations, such as lipid nanoparticles and microbiome-modulating therapies, further support personalized treatment strategies. The integration of barrier repair with targeted immunomodulation-guided by lipidomic and genomic profiling-marks a paradigm shift toward predictive and preventive approaches in allergic skin diseases. Early intervention strategies that simultaneously address immune dysregulation and lipid metabolism hold promise for preventing the atopic march and sustaining long-term remission.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 4","pages":"485-506"},"PeriodicalIF":4.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148667964","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":"Subtype-Specific Efficacy of Topical <i>Streptococcus</i> Postbiotic Emollient in Adolescents and Adults With Atopic Dermatitis and Comorbid Allergies: A <i>Post-hoc</i> Analysis of a Randomized, Double-Blind, Vehicle-Controlled Trial.","authors":"Jiseung Kang, Yesol Yim, Haeun Lee, So Min Kang, Dong-Geol Lee, Young Mok Heo, Hyungwoo Jo, Seunghyun Kang, Hyeon Jin Kim, Dong Keon Yon, Christa J Nehs","doi":"10.4168/aair.2026.18.4.611","DOIUrl":"10.4168/aair.2026.18.4.611","url":null,"abstract":"<p><p>Topical <i>Streptococcus</i> postbiotic emollient (Strain CX) has shown efficacy for mild-to-moderate atopic dermatitis (AD) in a previous study; however, treatment responses according to allergic comorbidity status have not yet been explored. We conducted a <i>post hoc</i> analysis to evaluate the differential therapeutic effects of Strain CX in patients with AD stratified by the presence or absence of allergic comorbidities. This <i>post hoc</i> analysis was derived from a randomized, double-blind, vehicle-controlled trial (Clinical Research Information Service of South Korea, KCT0007876). A total of 98 patients with mild-to-moderate AD were stratified into placebo (n = 33), AD without allergic comorbidities (n = 29), and AD with allergic comorbidities (n = 36) groups. The primary outcomes were the Investigator's Global Assessment (IGA) score and the proportions of participants achieving 25% or 50% improvement in the Eczema Area and Severity Index (EASI), assessed at weeks 4 and 8. The secondary outcomes included a range of skin-related clinical and molecular measures, along with additional evaluations of serum inflammatory and allergic biomarkers as laboratory measures in the per-protocol analysis set. At week 8, 55.2% (16/29) of participants in the AD without allergic comorbidities group achieved an IGA score of 0 or 1 with ≥ 1 point reduction, compared to 30.6% (11/36) in the AD with allergic comorbidities group (<i>P</i> = 0.0272). Both Strain CX intervention groups showed significant improvements in skin parameters, including EASI, skin moisture, and transepidermal water loss. Notably, the AD with allergic comorbidities group solely exhibited significant reductions in systemic inflammatory markers, including sIL-2R (mean, -231.19; 95% confidence interval [CI], -378.82 to -83.57 pg/mL), CCL17 (-127.05; 95% CI, -251.80 to -2.31 pg/mL), and CCL22 (-578.40; 95% CI, -939.31 to -217.49 pg/mL). Clinical skin responses improved more in patients with AD without allergic comorbidities, while immunomodulatory benefits were observed in those with allergic comorbidities. These findings support patient stratification based on allergic comorbidity status for personalized Strain CX treatment strategies. Trial Registration: Clinical Research Information Service Identifier: KCT0007876.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 4","pages":"611-619"},"PeriodicalIF":4.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148667931","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":"Serum Neuropeptides in Chronic Spontaneous Urticaria: Associations With Disease Activity and Clinical Phenotypes.","authors":"Zhenrui Shi, Xinyi Deng, Jieru Ren, Siyao Lu, Guozhen Tan","doi":"10.4168/aair.2026.18.3.453","DOIUrl":"10.4168/aair.2026.18.3.453","url":null,"abstract":"<p><p>Neuropeptides have been implicated in chronic spontaneous urticaria (CSU), but clinical data remain limited. We measured serum calcitonin gene-related peptide (CGRP), neuropeptide Y (NPY), vasoactive intestinal polypeptide (VIP), and stem cell factor by enzyme-linked immunosorbent assay in 80 patients with CSU and 40 age- and sex-matched healthy controls. CSU patients were categorized as flare or non-flare at sampling according to the presence or absence of wheals on the day of blood collection, and disease activity was assessed using the Urticaria Activity Score and its 7-day version (UAS7). Median serum CGRP levels were significantly higher in CSU patients than in healthy controls (263.86 pg/mL <i>vs.</i> 235.13 pg/mL, <i>P</i> < 0.001). In the CSU group, there was a non-significant trend toward higher CGRP levels in the non-flare group compared to the flare group (283.74 pg/mL <i>vs.</i> 251.01 pg/mL, <i>P</i> = 0.062). Serum VIP levels correlated positively with UAS7 (<i>r</i> = 0.238, <i>P</i> = 0.035), whereas NPY showed no clear group differences. Stem cell factor was below the detection limit in most samples. These findings support a possible role of CGRP and VIP in CSU and VIP as a candidate biomarker of disease burden that warrants validation in larger, longitudinal, multi-center studies.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 3","pages":"453-460"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136547","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":"Prevalence of Immediate-Type Food Allergy and Food-Induced Anaphylaxis in Korean Schoolchildren.","authors":"You Hoon Jeon, Gitae Seo, Chae Hyun Im, Hyeon-Jong Yang, Kee-Jae Lee, Jihyun Kim, Eun Lee, Dong In Suh, Hye Mi Jee, Yong Ju Lee, Hyo-Bin Kim, Woo Kyung Kim, So-Yeon Lee, Kangmo Ahn","doi":"10.4168/aair.2026.18.3.428","DOIUrl":"10.4168/aair.2026.18.3.428","url":null,"abstract":"<p><strong>Purpose: </strong>This study assessed the prevalence, major triggers, and risk factors of food allergy (FA) and food-induced anaphylaxis among Korean school-aged children.</p><p><strong>Methods: </strong>In 2022, a nationwide school-based survey was conducted using a structured questionnaire. Cluster sampling yielded a representative sample of 12,558 students aged 6-7, 9-10, and 12-13 years from 213 elementary and 103 middle schools in Korea.</p><p><strong>Results: </strong>The prevalence of self-reported perceived FA was 15.3%; recurrent immediate-type (< 4 hours) FA, 7.8%; and physician-diagnosed FA, 5.5%, with food-induced anaphylaxis in 0.7% of cases. The leading allergens for recurrent immediate-type FA were peach (1.13%), milk (0.82%), egg (0.79%), kiwi (0.65%), walnut (0.62%), peanut (0.62%), apple (0.61%), crab (0.59%), shrimp (0.54%), and pineapple (0.33%). By food group, fruits (3.67%) were most frequent, followed by crustaceans (1.20%), and tree nuts (1.18%). Major anaphylaxis triggers included egg (0.19%), milk (0.11%), walnut (0.10%), peanut (0.09%), and peach (0.06%). Fruit allergy was more common in older age groups, accompanied by increased oral allergy symptoms, suggesting a rising burden of pollen FA syndrome. In these groups, crustaceans were also major allergens. Among tree nuts, walnut was the most common. Perilla seed, a uniquely observed allergen in Korea, had prevalences of 0.11% for allergy and 0.02% for perilla seed-induced anaphylaxis. Multiple food allergies were reported by 29.9% of children with FA. Significant risk factors included paternal allergic disease, parental history of FA, delayed complementary food introduction (≥ 7 months), prolonged breastfeeding (≥ 7 months), and current allergic diseases, particularly atopic dermatitis.</p><p><strong>Conclusions: </strong>In Korean school-aged children, recurrent immediate-type FA and food-induced anaphylaxis affect 7.8% and 0.7%, respectively. Fruits, milk, egg, tree nuts, and peanuts are the most common triggers, with notable age-related differences. These findings underscore the need for continued surveillance, early identification of high-risk groups, and targeted prevention and management strategies.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 3","pages":"428-439"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136595","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":"How Pregnancy Affects Asthma in Korea: Risk Factors and Adherence Decline.","authors":"Myoung-Nam Lim, Jin-Sung Park, Jae-Woo Kwon","doi":"10.4168/aair.2026.18.3.351","DOIUrl":"10.4168/aair.2026.18.3.351","url":null,"abstract":"<p><strong>Purpose: </strong>Pregnancy is a well-known trigger for asthma exacerbations, but risk prediction remains limited. This study aimed to evaluate the impact of pregnancy on asthma control, identify risk factors for exacerbations, and assess adherence to asthma management during and after pregnancy in Korea.</p><p><strong>Methods: </strong>Women with asthma who gave birth between 2012 and 2015 in Korea were identified using the Korean National Health Insurance claims database. Asthma was defined as having at least three asthma diagnoses and at least one prescription of medication for asthma within 4 years before pregnancy. Asthma exacerbations during pregnancy were defined as the requirement for oral corticosteroid treatment or hospitalization, or an emergency department visit. A case-control study was conducted to evaluate risk factors for these exacerbations within the overall cohort and, specifically, among women who discontinued asthma medication during pregnancy. Postpartum adherence to asthma medication was also assessed.</p><p><strong>Results: </strong>Among 123,355 women with asthma, 14.8% experienced asthma exacerbation during pregnancy, while 82.9% discontinued asthma medication during pregnancy. Long-term asthma control, spanning the 4 years before conception was more strongly associated with pregnancy outcomes than the 1-year assessment. During pregnancy, poor adherence to asthma treatment was strongly associated with exacerbations, and women who discontinued medication were particularly vulnerable if they had a history of pre-pregnancy exacerbations, moderate to severe rhinitis, multiple gestation, neuropsychiatric disorders, or prior inhaled corticosteroid use. Even after delivery, only 27.4% of asthmatics continued taking asthma medication.</p><p><strong>Conclusions: </strong>This study emphasizes that long-term asthma control and medication maintenance throughout pregnancy are crucial for preventing exacerbations. High-risk women were characterized by comorbidities such as rhinitis, neuropsychiatric disorders, and multiple gestation. These findings underscore the importance of sustained asthma management and patient education not only before and during pregnancy but also throughout the postpartum period.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 3","pages":"351-361"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136607","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":"Work-Related Asthma: An Occupational Medicine Perspective.","authors":"Yangwoo Kim, Inah Kim, Jaechul Song","doi":"10.4168/aair.2026.18.3.323","DOIUrl":"10.4168/aair.2026.18.3.323","url":null,"abstract":"<p><p>Work-related asthma (WRA), encompassing occupational asthma and work-exacerbated asthma, is among the most prevalent yet preventable occupational respiratory diseases, with population-based studies estimating that 10% to 25% of adult asthma cases are attributable to workplace exposure. This review examines epidemiology, causative agents, pathogenesis, clinical evaluation, management, and WRA prevention from an occupational medicine perspective, with emphasis on Korean surveillance data. The Korea Work-related Asthma Surveillance program (2004-2009) identified 236 cases with a crude incidence of 3.31 per million workers, revealing a 40- to 90-fold detection gap when compared to European population-based estimates of 250 to 300 per million workers annually. Korean cases showed a distinctive agent profile, with isocyanates accounting for 46.6%-a figure that far exceeds the 13% to 23% in Western surveillance systems-which reflects the prominence of the furniture manufacturing industry. Temporal trends demonstrated successful prevention, with isocyanate-related cases decreasing from 65.0% to 26.9% during the period 2004-2009. Despite treatment advances, the prognosis remains poor: only 32% of patients achieve symptomatic recovery following the complete avoidance of exposure, and continued exposure increases the symptom burden 10-fold. Workers' compensation data confirm persistent underdiagnosis, with only 0 to 5 cases annually approved during the period 2013-2023 despite expanding recognition of occupational diseases overall. The Korea Occupational Disease Surveillance Center, established in 2022, offers an opportunity to bridge the prolonged surveillance gap. Clinicians treating working adults should maintain a high index of suspicion for the occupational causes of asthma, pursue early diagnosis and exposure cessation, and integrate workplace assessments into their routine clinical evaluations.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 3","pages":"323-338"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136677","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}