Allergy and asthma proceedings最新文献

{"title":"The alpha-gal syndrome: Understanding the role of tick bites, and the delays in severe anaphylaxis.","authors":"Thomas A E Platts-Mills, Charlene Altamirano Dunaway, Roopesh Singh Gangwar, Lisa J Workman, Jeffrey M Wilson","doi":"10.2500/aap.2026.47.260040","DOIUrl":"10.2500/aap.2026.47.260040","url":null,"abstract":"<p><p>The presence of serum immunoglobulin E (IgE) antibodies to the oligosaccharide galactose-alpha-1,3-galactose (α-gal) was first recognized during the investigation of allergic reactions to the monoclonal antibody cetuximab. The availability of an assay for IgE to α-gal made it possible to show that the patients who reported delayed allergic reactions to meat also had IgE to α-gal. This syndrome of delayed reactions to meat in patients with IgE to an oligosaccharide that was present in nonprimate mammals represented a complete contrast to the other forms of food allergy. However, the realization that the sensitization resulted from bites of the lone star tick, Ambloymma americanum, provided an explanation for the increase in cases in an area of the United States where there had been a major increase in the deer population, which is the primary breeding host of this tick. In contrast to almost all other IgE-mediated reactions, there is no relationship between the delay after eating red meat and the severity of allergic reactions. There is also increasing evidence that serum tryptase in the range of 20-90 ng/mL can occur after severe reactions related to α-gal. In addition, a recently reported fatal anaphylaxis, which started 4 hours after the individual ate a hamburger, included a postmortem tryptase of >2000 ng/mL. A working hypothesis to explain the delay in reactions relates to the time taken to process glycolipids in food derived from mammals, first into chylomicrons and, finally, to low-density lipoproteins. However, the quantitative presence of α-gal that remains on these particles may have major individual differences. In contrast to the patients who have symptoms related to eating meat, there are many individuals who are sensitized and who are not aware of any symptoms. In addition, individuals who are sensitized to alpha-gal can react rapidly to intravenous injections to the monoclonal antibody cetuximab, or polyclonal antibodies to venom, or the newer antivenom digested to Fab or Fab'2.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 4","pages":"237-246"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148314887","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":"Immunoglobulin E-mediated pumpkin seed allergy in children: Case series and narrative review with a structured literature search.","authors":"Bilge Acikalin, Melike Ocak, Bulent Enis Sekerel","doi":"10.2500/aap.2026.47.260028","DOIUrl":"10.2500/aap.2026.47.260028","url":null,"abstract":"<p><p><b>Background:</b> Pumpkin seed allergy is a rare but potentially severe immunoglobulin E (IgE) mediated food allergy, with limited pediatric data and few documented cases worldwide. <b>Objective:</b> To describe the clinical and diagnostic characteristics of pediatric pumpkin seed allergy and to synthesize all previously reported cases through a systematically searched narrative review. <b>Methods:</b> We retrospectively reviewed the records of children diagnosed with IgE-mediated pumpkin seed allergy at a tertiary pediatric allergy clinic in Turkey (2016-2024). The diagnosis relied on the clinical history, specific IgE (sIgE), and skin-prick tests (SPT); patients in select cases had oral food challenges. Data on clinical presentation, comorbidities, co-allergies, and laboratory findings were extracted. A structured literature search of medical literature data bases identified all published cases of patients with pumpkin seed allergy, which were qualitatively reviewed. <b>Results:</b> Twenty-five children (76% boys) were identified, with a median diagnosis age of 2.98 years. Immediate reactions were universal, and anaphylaxis occurred in 64%. The median SPT wheal was 13 mm, and the median sIgE level was 10.3 kUA/L. Atopic comorbidities were frequent (atopic dermatitis, 92%; asthma, 48%). Co-allergy was common (tree nuts, 76%; other seeds, 72%); watermelon seed sensitization occurred in 83%, with six patients experiencing clinical reactions after watermelon seed ingestion. Pumpkin pulp was tolerated in all the patients. A literature review revealed 14 previously published cases, mostly adults, with 57% experiencing anaphylaxis. <b>Conclusion:</b> Pumpkin seed allergy, although uncommon, frequently causes systemic reactions in children. Our case series underscores the need for clinician awareness, diagnostic inclusion of pumpkin seed in high-consumption regions, and further research into its molecular allergens and cross-reactivity.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 4","pages":"e50-e56"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhaler recognition as a marker for adherence in pediatric patients with asthma.","authors":"Jenny Huang, Mansi Kothari, Rahul Revan, Pavadee Poowuttikul","doi":"10.2500/aap.2026.47.260005","DOIUrl":"10.2500/aap.2026.47.260005","url":null,"abstract":"<p><p><b>Background:</b> Poor adherence to daily asthma controller medications contributes to increased emergency department (ED) visits and hospitalizations in children. A simple bedside tool to assess adherence is needed in clinical settings. <b>Objective:</b> The objective was to determine whether a child's or a caregiver's ability to recognize the prescribed daily controller inhaler is associated with poor adherence and increased asthma morbidity. <b>Methods:</b> A retrospective chart review was conducted on 163 pediatric patients (ages 3-18 years) admitted for asthma exacerbation on patient's and/or caregiver's ability to identify the patient's prescribed daily controller inhaler. Patients were classified as recognizing or not recognizing their inhaler. Clinical outcomes, including ED visits, hospital admissions, systemic corticosteroid use, and adherence markers (prescription refills and follow-up visits), were compared between the groups. <b>Results:</b> The patients unable to recognize their inhaler had significantly poorer adherence, with fewer prescription refills (p = 0.001) and lower rates of specialty follow-up (p ≤ 0.001). These patients also had higher rates of asthma-related ED visits (p = 0.003) and systemic corticosteroid use (p = 0.010). No significant association was found with inpatient admissions, impairment of daily symptoms, or frequency of albuterol use. Patients with three or more intensive care unit admissions in the past year were more likely to recognize their inhalers (p = 0.013), possibly due to increased exposure to asthma education. <b>Conclusion:</b> The inability to recognize a prescribed daily controller inhaler is associated with poor adherence and increased asthma-related ED visits and systemic corticosteroid use. This simple bedside assessment may help identify patients at high risk and guide targeted interventions to improve adherence and asthma outcome.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 3","pages":"184-189"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breathing through the night: A meta-analysis of childhood asthma and obstructive sleep apnea in sleep-disordered contexts.","authors":"Kaiwen Zheng, Yuling Zhao, Jiayi Li, Xing Chen","doi":"10.2500/aap.2026.47.260014","DOIUrl":"10.2500/aap.2026.47.260014","url":null,"abstract":"<p><p><b>Background:</b> The study was to systematically evaluate the correlation between childhood asthma and obstructive sleep apnea (OSA). <b>Methods:</b> Several medical literature data bases were searched for studies published up to March 2025, by using the keywords \"asthma\" and \"obstructive sleep apnea\" and \"child*.\" We included observational studies, children with OSA diagnosed <i>via</i> polysomnography, clinical criteria, or validated tools; and asthma confirmed by physician diagnosis, medication use, or validated questionnaires and international code. <b>Results:</b> Eleven studies were included that covered populations in the United States, Europe, and Asia. The pooled odds ratio (OR) for the association between childhood asthma and OSA was 1.66 (95% confidence interval [CI], 1.21-2.26; p < 0.001). Subgroup analysis by study design showed significant associations in cohort (OR 2.00 [95% CI, 1.35-2.96]) and cross-sectional (OR 1.55 [95% CI, 0.69-3.44]) but not in case-control studies (OR 0.85 [95% CI, 0.32-2.28]). Geographically, the association was strongest in America (OR 1.99 [95% CI, 1.35-2.96]) and Asia (OR 1.64 [95% CI, 1.19-2.25]), with a nonsignificant trend in Europe (OR 0.91 [95% CI, 0.34-2.42]). Sensitivity analyses directionally consistent with the results, and Egger's test (p = .587) indicated no significant publication bias. <b>Conclusion:</b> Childhood asthma is significantly associated with an increased risk of OSA, with sleep disorders likely exacerbating this relationship. Integrated screening and management strategies are warranted, particularly in high-risk regions such as America and Asia.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 3","pages":"e36-e47"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of eosinophilic esophagitis with immune modulating agents.","authors":"Neha Pancholy, Gisoo Ghaffari","doi":"10.2500/aap.2026.47.260020","DOIUrl":"10.2500/aap.2026.47.260020","url":null,"abstract":"<p><p><b>Background:</b> Eosinophilic esophagitis (EoE) is a chronic inflammatory and an immune-mediated condition diagnosed based on both clinical and pathologic findings. EoE has been identified as one of the leading causes of esophageal dysfunction worldwide. If untreated, EoE often follows a progressive course that leads to fibrosis and esophageal stricture and perforation. The use of biologic therapies that target specific pathways will help us understand the essential pathophysiologic steps in EoE, in addition to providing symptomatic treatment. In this narrative review, we review the potential targeted therapies of these cells and related pathways, the evidence of therapeutic benefit, and suggestions for future therapeutic approaches. An updated review of treatment options is necessary given deeper understanding of the pathogenesis and more recent advances in treatment since the consensus recommendations published in 2016. <b>Objective:</b> We sought to review the contemporary data with regard to treatment approaches in EoE, particularly through immune-modulating therapeutic approaches. <b>Methods:</b> The MEDLINE (PubMed) data base was queried by using specified search terms. Articles were selected based on their contribution to the understanding of how therapeutics for EoE, particularly those that modulate immunity play a role in the management of this disease. <b>Results:</b> Among immune-modulating therapies for EoE, anti-interleukin (IL) 5/IL-5 Receptor (R) α and anti-IL-13/IL-4 Receptor (R) α therapies have the most accumulated clinical trial and safety data at this time. Other emerging immunologic targets that warrant discussion include thymic stromal lymphopoietin and Sialic acid-binding IG-like lectin 8 (Siglec-8). Furthermore, the contribution of fibroblasts and myofibroblasts to the pathogenesis of EoE also provides many potential therapeutic targets. Allergen-specific immunotherapies have shown variable benefit in the treatment of EoE. <b>Conclusion:</b> Immune-modulating therapies seem to be a promising avenue of the treatment of EoE; both established and emerging targets of therapy exist to manage this condition.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 3","pages":"170-176"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply.","authors":"Emily Gansert, Ricardo J Estrada-Mendizabal, Matthew M Farley, Dayne H Voelker, Alexei Gonzalez-Estrada","doi":"10.2500/aap.2026.47.260022a","DOIUrl":"10.2500/aap.2026.47.260022a","url":null,"abstract":"","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 3","pages":"e49"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759986","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 evolving spectrum of type 2 inflammation and beyond.","authors":"","doi":"10.2500/aap.2026.47.260029","DOIUrl":"10.2500/aap.2026.47.260029","url":null,"abstract":"","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 3","pages":"159-161"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13170564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759955","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":"Comorbidity burden in patients with anaphylaxis: A 25-year nationwide population-based matched case-control study.","authors":"Eli Magen, Israel Magen, Eugene Merzon, Eldad Rahamim, Ilan Green, Avivit Golan-Cohen, Shlomo Vinker, Ariel Israel","doi":"10.2500/aap.2026.47.260021","DOIUrl":"10.2500/aap.2026.47.260021","url":null,"abstract":"<p><p><b>Background:</b> Anaphylaxis is a severe systemic hypersensitivity reaction that occurs in diverse clinical contexts. Its broader comorbidity profile in population-based settings has not been well characterized. <b>Objective:</b> The objective was to evaluate the prevalence and spectrum of comorbid diseases in patients with anaphylaxis compared with matched controls in a nationwide population. <b>Methods:</b> We conducted a retrospective population-based matched case-control study by using electronic health record data from a nationwide health maintenance organization in Israel between 2001 and 2024. Anaphylaxis cases were confirmed by manual chart review according to World Allergy Organization criteria with documented epinephrine treatment. The controls were matched on age, sex, and calendar time, and had no history of anaphylaxis. Baseline comorbidities documented at least 3 months before the index date were analyzed by using conditional logistic regression. Multiple comparisons were addressed by using false discovery rate adjustment. <b>Results:</b> The study included 778 patients with anaphylaxis and 3112 matched controls. The patients with anaphylaxis had a significantly higher prevalence of atopic and allergic diseases, including asthma, allergic rhinitis, allergic conjunctivitis, atopic dermatitis, contact dermatitis, and chronic idiopathic urticaria. The composite atopic disease burden was markedly higher in the anaphylaxis group. Selected immune-mediated and cardiovascular conditions were also more prevalent, although the effect sizes were generally modest and several associations did not remain statistically significant after a multiple-comparison correction. An eliciting allergen was identified in 82.4% of the patients, with drugs as the most frequent triggers, followed by food and insect venom. Idiopathic anaphylaxis accounted for 17.6% of the patients. Baseline medication utilization was higher among the patients with anaphylaxis, particularly for allergic, respiratory, and gastrointestinal therapies. <b>Conclusion:</b> In this nationwide adult cohort, individuals with anaphylaxis demonstrated a higher prevalence of atopic disease and modest differences in selected systemic comorbidities compared with matched controls. These findings describe epidemiologic associations and do not imply causality. Further prospective studies are warranted.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 3","pages":"196-206"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts presented at the Western Society of Allergy, Asthma & Immunology, February 1-5, 2026, Wailea, Hawaii.","authors":"","doi":"10.2500/aap.2026.47.260023","DOIUrl":"10.2500/aap.2026.47.260023","url":null,"abstract":"","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 3","pages":"230"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759829","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":"Time for action: How to combat myths and misinformation on social media.","authors":"Shane Stone, Maria P Henao, Taha Al-Shaikhly","doi":"10.2500/aap.2026.47.260022","DOIUrl":"10.2500/aap.2026.47.260022","url":null,"abstract":"","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 3","pages":"e48"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759994","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}