Allergy and asthma proceedings最新文献

{"title":"The burden of systemic corticosteroids in patients with chronic rhinosinusitis with nasal polyps.","authors":"Anju T Peters, Jayant M Pinto, Kathleen M Buchheit, Sietze Reitsma, Andrew Thamboo, Shigeharu Fujieda, Mark Corbett, Eric Zaccone, Amr Radwan, Paul J Rowe, Yamo Deniz","doi":"10.2500/aap.2025.46.250050","DOIUrl":"10.2500/aap.2025.46.250050","url":null,"abstract":"<p><p><b>Background:</b> Systemic corticosteroids (SCS) are widely used to treat patients with chronic rhinosinusitis with nasal polyps (CRSwNP) that is insufficiently controlled with first-line treatments. However, such treatment must be balanced against the risk of adverse effects with protracted or repeated use. Increasing awareness of these adverse effects and the introduction of biologics are changing established management approaches. <b>Objective:</b> The objective was to review the role of SCS in the management of CRSwNP in the evolving treatment landscape. <b>Methods:</b> A literature search was conducted for salient articles on SCS in CRSwNP, including guidelines. <b>Results:</b> SCS reduce inflammation through broad actions on various immune mediators. Short courses of SCS improve symptoms (especially olfactory function) and reduce polyp size, benefits that do not persist long-term after treatment ends. SCS are widely used before endoscopic sinus surgery to improve the visibility of the surgical field and after surgery to improve outcomes, although evidence for benefit of postsurgical SCS is lacking. Adverse effects associated with SCS can manifest in a wide range of organs and systems. Use of SCS in patients with CRSwNP is associated with an increased risk of avascular necrosis, pneumonia, obesity, anxiety and/or depression, fracture, sleep apnea, hypothalamic-pituitary-adrenal axis suppression, diabetes, and hypertension. The SCS dosage regimen for CRSwNP is not well defined, and there is wide variation in clinical practice. Clinical guidelines refer to \"short courses\" of SCS but provide minimal guidance and lack consensus. Biologic treatments for CRSwNP have well-documented steroid-sparing effects, but the extent to which biologics might be able to reduce the use of or replace SCS may depend on economics as well as relative benefit-to-risk ratios. <b>Conclusion:</b> Short courses of SCS are widely used in patients with CRSwNP, but their use must be balanced against the risk of adverse effects. Use of biologics may reduce the use of SCS in CRSwNP, minimizing these adverse effects.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 5","pages":"406-413"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food allergy concurrent with atopic dermatitis: Correlation with age of onset and severity.","authors":"Ismail Ozanli, Nezihe Nefise Uluc, Nagehan Iskender, Taha Yasin Akin, Yusuf Ziya Varli, Sibel Balci, Isil Eser Simsek, Metin Aydogan","doi":"10.2500/aap.2025.46.250054","DOIUrl":"10.2500/aap.2025.46.250054","url":null,"abstract":"<p><p><b>Background:</b> Data on the frequency of food sensitivity (FS) and food allergy (FA) in patients with atopic dermatitis (AD) differ among studies. <b>Objectives:</b> The aim of this study was to determine the frequency of FS and FA in different AD phenotypes according to the age of onset and severity of AD. In addition, we aimed to investigate the risk of FA in these patients. <b>Methods:</b> Patients diagnosed with AD between 2022 and 2024 were included in the study. All patients with AD admitted during this period were analyzed for the coexistence of FA and FS. <b>Results:</b> The study included 257 children with AD. Of these patients, 147 of 257 were girls (57.2%). The median (interquartile range [IQR]) age of onset of AD was 6 months (2.5-30 months). By the age of AD onset, FS and FA were present in 60.3% and 32.5%, respectively, in patients with moderate-to-severe AD, with disease onset between ages 0 and 3 months. Among the patients with disease onset between ages 4 and 11 months, the corresponding rates in moderate-to-severe cases were 59.6% for FS and 17.4% for FA. FS was present in 39.3% of moderate-to-severe cases with AD onset age after 12 months, but none had FA. Being in the moderate-to-severe category for AD increased the risk of FA 14-16 times compared with the mild AD group. <b>Conclusion:</b> FS is significantly more prevalent than FA in patients with AD. In children in whom FS test results are positive, the diagnosis of AD-FA coexistence should not be made without performing an elimination diet and oral food challenge test. This approach will help prevent unnecessary food elimination.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 5","pages":"e137-e143"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence and allergy: Shaping the future of diagnosis and therapy.","authors":"Joseph A Bellanti, Russell A Settipane","doi":"10.2500/aap.2025.46.250064","DOIUrl":"10.2500/aap.2025.46.250064","url":null,"abstract":"","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 5","pages":"351-353"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric allergen immunotherapy in the United States: Current practice, safety, and unmet needs for long-term and preventive outcomes.","authors":"Dana V Wallace","doi":"10.2500/aap.2025.46.250058","DOIUrl":"10.2500/aap.2025.46.250058","url":null,"abstract":"<p><p><b>Background:</b> Allergen immunotherapy (AIT) is the only disease-modifying treatment for allergic rhinitis (AR), allergic asthma, and, potentially, atopic dermatitis (AD) in children. Despite demonstrated efficacy, AIT remains underutilized in the United States. Subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) both reduce symptoms and medication use, although much supporting evidence comes from non-U.S. studies by using extracts not approved domestically. Moreover, most U.S. trials of multiallergen SCIT lack rigorous placebo controlled data. <b>Objective:</b> The objectives were to examine current evidence on pediatric AIT, evaluate clinical efficacy and safety, and highlight key research gaps, particularly within the U.S. context. <b>Methods:</b> A literature search was conducted by using terms that included pediatric AIT, SCIT, SLIT tablets; SLIT drops; and off-label SLIT. The review focused on AIT for AR, asthma, and AD in children, with comparative analysis of SCIT and SLIT in terms of efficacy, safety, and preventative potential. <b>Results:</b> Both SCIT and SLIT are effective for AR and, to a lesser extent, asthma and AD. SLIT tablets offer the advantages of at-home use and a favorable safety profile but in the U.S. are limited to single allergens, which poses challenges for patients who were polysensitized. AIT shows potential for tertiary prevention, such as delaying asthma onset or reducing new sensitizations, although more U.S.-based pediatric data are needed. SCIT carries a risk of systemic reactions; SLIT maintains excellent safety. Knowledge gaps remain with regard to optimal treatment duration, extract formulation, and multiallergen use in children who are polyallergic. <b>Conclusion:</b> AIT is a valuable disease-modifying option for pediatric allergic diseases, but broader U.S. adoption is hindered by regulatory, reimbursement, and evidence limitations. Shared decision-making is critical to align treatment with patient needs. High-quality U.S.-based studies are essential to optimize care and long-term outcomes for children who are allergic.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 5","pages":"362-381"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Got milk? Enzyme-linked immunosorbent assay analysis of casein proteins in methylprednisolone.","authors":"Vishaka R Hatcher, Manuel Y Caballero, Meredith M Schuldt, Karla E Adams","doi":"10.2500/aap.2025.46.250047","DOIUrl":"10.2500/aap.2025.46.250047","url":null,"abstract":"<p><p><b>Background:</b> Sporadic reports have been published with regard to allergic reactions in patients with bovine milk allergy after receiving parenteral lactose-containing methylprednisolone. Persistent milk allergy is a risk factor for other atopic diseases, in which corticosteroids, <i>e.g.,</i> methylprednisolone, are commonly an adjunctive treatment. Laboratory investigations to validate the presence of residual milk protein as the cause for reactions are scarce. Thus, individualized recommendations for the use of methylprednisolone in patients with milk allergy remain undefined. <b>Objective:</b> We hypothesized that excipient contaminants, e.g., residual caseins, may be responsible for these reactions. We sought to evaluate for the presence of casein proteins in lactose-containing methylprednisolone and provide recommendations with regard to its use in patients with milk allergy. <b>Methods:</b> To assess for incomplete purification of lactose from its bovine milk source, standardized enzyme-linked immunosorbent assay (ELISA) was performed from five vials across four lots of commercially available lactose-containing methylprednisolone to detect casein subtypes Bos d 9 and Bos d 11, the two most abundant milk proteins. <b>Results:</b> High-fidelity ELISA revealed no detectable Bos d 9 in any vials of lactose-containing methylprednisolone. Trace amounts of Bos d 11 were detected in all vials compared with Bos d 9 (p = 0.008). Molecular modeling revealed minimal similarity between Bos d 9 and Bos d 11. <b>Conclusion:</b> Undetectable Bos d 9 and trace Bos d 11 in lactose-containing methylprednisolone raises optimism but warrants further investigation of immunoglobulin E binding epitopes and the clinical relevance of casein subtypes. It is reassuring that milk protein eliciting doses are usually 10⁶-fold higher than the nanogram quantities of Bos d 11 detected in our study, although this is limited by exposure route. Vaccines and medications with possible trace milk proteins remain largely well tolerated in patients with milk allergy. Lactose-containing methylprednisolone can likely be used with low risk of adverse reaction in most patients with milk allergy.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 5","pages":"431-437"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline disease characteristics among patients with chronic rhinosinusitis with nasal polyps in AROMA: A global registry study.","authors":"Anju T Peters, Rachna Shah, Enrico Heffler, Martin Wagenmann, Shigeharu Fujieda, Changming Xia, Scott Nash, Michael Clotz, Mark Corbett, Amr Radwan","doi":"10.2500/aap.2025.46.250055","DOIUrl":"10.2500/aap.2025.46.250055","url":null,"abstract":"<p><p><b>Background:</b> Chronic rhinosinusitis with nasal polyps (CRSwNP) is a predominantly type 2 inflammatory disease of the nasal and paranasal sinuses. In phase III clinical trials, dupilumab significantly improved objective and patient-reported measures of CRSwNP versus placebo. However, a real-world evidence gap exists between efficacy and effectiveness data for dupilumab in CRSwNP, particularly in the United States. <b>Objective:</b> Assessing Long-teRm Outcomes of dupiluMAb Treatment in Adult Patients With CRSwNP (AROMA) aims to characterize patients who receive dupilumab for CRSwNP in a real-world setting and evaluate long-term effectiveness. <b>Methods:</b> AROMA is a prospective global registry study that is recruiting adult patients with uncontrolled CRSwNP who were initiating dupilumab and following them for up to 36 months. Baseline demographics and disease characteristics were assessed for all patients entering the registry. <b>Results:</b> As of February 2023, the study had recruited 303 patients of a target enrollment of 700, with a mean age of 50.8 years, and 57.1% were recruited in the United States. A history of asthma was reported in 70.6% of the patients and a history of allergic rhinitis in 70.6% of the patients. In the 24 months before enrollment, 61.7% of the patients had at least one sinonasal surgery and 68.6% used systemic corticosteroids. At baseline, 35.0% of the patients were receiving intranasal corticosteroids and 33.3% were receiving leukotriene receptor antagonists. In the Global Patient Assessment, 31.7% and 29.7% of the patients reported moderate and severe CRSwNP symptoms, respectively, during the past week. <b>Conclusion:</b> Patients in AROMA had a high disease burden in terms of symptoms, comorbidities, and treatment burden. Nearly two-thirds of patients with CRSwNP had at least one sinonasal surgery before initiating dupilumab.Clinical trial NCT04959448 (AROMA), <ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"http://www.clinicaltrials.gov\">www.clinicaltrials.gov</ext-link>.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 5","pages":"414-421"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Egg allergy in children: Patterns of consumption of homemade fermented milk products by mothers during pregnancy.","authors":"Pelin Karatas, Zeynep Gulec Koksal, Pinar Uysal","doi":"10.2500/aap.2025.46.250045","DOIUrl":"10.2500/aap.2025.46.250045","url":null,"abstract":"<p><p><b>Background:</b> During pregnancy, the mother's gut microbiota is passed onto the baby and the baby's gut microbiota resembles the mother's. The bioactive peptides and microbial metabolites contained in fermented foods help the formation of healthy gut microbiota. <b>Objective:</b> The aim of this study was to investigate habits of consumption of homemade fermented milk and dairy products (FMP) during pregnancy by mothers of children with egg allergy. <b>Methods:</b> Mothers of children with egg allergy ages < 3 years (EA group [n = 93]) and age- and sex-matched healthy children (HC group [n = 77]) admitted to the pediatric allergy and immunology outpatient clinic between January 2023 and June 2023 were included in this case-control study. Data were collected by using the random sampling method. A sociodemographic form was used for the mother and child, and the frequency, amount, and variety of weekly consumption of FMPs (yogurt, cheese, tarhana, and kefir) during pregnancy were investigated. <b>Results:</b> The homemade FMPs during pregnancy of the mothers of the EA group were yogurt, tarhana, and cheese. The number of mothers in the EA group who consumed homemade yogurt (p = 0.049) and tarhana (p < 0.001) was lower than those in the HC group. Mothers in the EA group were also less likely to consume yogurt regularly (p = 0.036). Mothers in the EA group also consumed less homemade yogurt (p = 0.020), cheese (p = 0.001), and tarhana (p < 0.001) than those in the HC group. The diversity of homemade yogurt and cheese (p = 0.048); yogurt, cheese, and tarhana (p < 0.001) consumed during pregnancy was lower in the EA group compared with the HC group. <b>Conclusion:</b> Mothers of children with egg allergy exhibited lower frequencies, quantities, and varieties of homemade FMPs consumption during pregnancy. Consumption of homemade FMPs by mothers during pregnancy may protect against egg allergy in their children.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 5","pages":"e144-e150"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicenter questionnaire study investigating characteristics of adults with unexplained chronic cough versus explained chronic cough.","authors":"Alisa Gnaensky, Mahboobeh Mahdavinia, Shahzad Mustafa, Jill A Poole, Mandel Sher, Raffi Tachdjian, Andrew White, Joshua S Bernstein, Umesh Singh, Jonathan A Bernstein","doi":"10.2500/aap.2025.46.250065","DOIUrl":"10.2500/aap.2025.46.250065","url":null,"abstract":"<p><p><b>Objective:</b> Previously, we reported that older women taking increased numbers of cough medications with increased number and frequency of medical encounters and normal or near-normal lung function more likely had unexplained chronic cough (UCC) versus asthma and/or chronic obstructive pulmonary disease. This study sought to identify clinical risk factors that could differentiate UCC from explained chronic cough (ECC). <b>Methods:</b> A validated electronic questionnaire was distributed to patients with chronic cough (CC) at seven cough centers throughout the United States. The mean ± standard error, frequencies of continuous variables (one-way analysis), and cross-tabulation frequencies for categorical variables (two-way analysis) were calculated. Univariate comparisons between UCC and ECC were performed by using the t-test and nonparametric one-way analysis. Significant determinants of UCC and cough severity were assessed by using multiple logistic regression. <b>Results:</b> A total of 150 patients were enrolled, of whom 29 of 150 were classified as having UCC, and 121 of 150 were classified as having ECC. No significant differences for family history, age, gender, and race, or seasonality differentiated UCC from ECC. Multiple logistic regression revealed the absence of postnasal drip significantly differentiated UCC from ECC (odds ratio 4.8 [95% Confidence Level, 1.6-15.3]). The severity of CC was worse for patients with UCC, patients with chronic bronchitis and/or emphysema, hypertension, ex-smoking history, high body mass index, female gender, education level, and reactivity to more environmental irritants (perfume, p = 0.006; household cleaners, p = 0.01; air fresheners, p = 0.03; cold air, p = 0.007; cigarette smoke, p = 0.05). <b>Conclusion:</b> Patients with UCC more frequently presented with specific demographic features, comorbid characteristics, and more severe cough induced by environmental irritants compared with ECC. These clinical characteristics may be useful for identifying risk factors that can accelerate the diagnosis of UCC.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 5","pages":"422-430"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update in stinging insect hypersensitivity.","authors":"David B K Golden","doi":"10.2500/aap.2025.46.250060","DOIUrl":"10.2500/aap.2025.46.250060","url":null,"abstract":"<p><p><b>Background:</b> The ACAAI//AAAAI Joint Task Force on Practice Parameters periodically develops updated guidance based on all available evidence. <b>Methods:</b> This review summarizes advances in diagnosis and management of insect sting allergy from published practice parameters, and developments under review for the 2026 update. <b>Results:</b> Changes in the species and distribution of stinging insects in the US may be due to migration and invasion. Overall prevalence has not changed, but fatalities from insect sting allergy increased 50% in 30 years. Diagnostic evaluation includes both skin and serum immunoglobulinE testing although positive predictive value is dependent on the history. Evaluation may include venom component testing. Mastocytosis and hereditary alpha tryptasemia must be considered in many cases; testing for baseline serum tryptase is now routine. Testing for c-KIT gene mutation in peripheral blood and tryptase genotype are important supplemental tests. The risk of beta blockers and angiotensin converting enzyme inhibitors is relatively low in most cases, and they are not contraindicated during venom immunotherapy (VIT). VIT is indicated in high-risk patients (30-70% risk of anaphylaxis), but is not required in those with cutaneous reactions (3-10% risk of anaphylaxis). VIT can be safely initiated with rush regimens. Recurrent systemic reactions are rare, and may require omalizumab treatment (off-label). VIT can be discontinued after 5 years in most patients, but extended or indefinite VIT (often at 12-week intervals) is recommended in patients with known high-risk factors or where stopping would cause markedly impaired quality of life. <b>Conclusion:</b> Continued research has refined our clinical approach to patients with concerns about stinging insect hypersensitivity.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 5","pages":"382-387"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The lymphocyte-eosinophil to neutrophil-monocyte ratio as a potential composite biomarker associated with asthma exacerbations in adults.","authors":"Ning Zhang, Congyi Xie, Jinzhan Chen, Haiyan Chen","doi":"10.2500/aap.2025.46.250056","DOIUrl":"10.2500/aap.2025.46.250056","url":null,"abstract":"<p><p><b>Background:</b> This study evaluates the lymphocyte-eosinophil to neutrophil-monocyte ratio (LENMR) as a novel inflammatory indicator of the exacerbation risk in adults with asthma. <b>Methods:</b> This cross-sectional study included 1344 adults with asthma from the 2007-2012 cycles of the National Health and Nutrition Examination Survey. The association between LENMR and asthma exacerbations was evaluated by using multivariable logistic regression with progressive adjustment for confounders. Subgroup analyses were conducted to assess the consistency of associations. Restricted cubic spline and threshold effect models were used to explore potential nonlinear relationships. <b>Results:</b> A higher LENMR was significantly associated with an increased risk of asthma exacerbations. In the fully adjusted model, the participants in the highest quartile had a 77% higher odds of exacerbation compared with the lowest quartile (odds ratio 1.77 [95% confidence interval, 1.19-2.65]; p = 0.007). Associations were consistent across subgroups. Restricted cubic spline analysis revealed a significant nonlinear relationship, with a threshold effect identified at LENMR = 0.31. <b>Conclusion:</b> An elevated LENMR is positively associated with asthma exacerbations under specific thresholds.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 5","pages":"e157-e165"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}