Allergy and asthma proceedings最新文献

{"title":"Rethinking the management of hereditary angioedema.","authors":"Paula Busse, Kim Wilson, Henriette Farkas, Shanna Fishel, Amod Athavale, Abigail Silber, Ellie Goldman, Catherine Miller, Shruti Nambiar","doi":"10.2500/aap.2026.47.260004","DOIUrl":"10.2500/aap.2026.47.260004","url":null,"abstract":"<p><p><b>Background:</b> Hereditary angioedema with C1INH deficiency (HAE-C1INH) is a rare, debilitating genetic disorder characterized by recurrent, unpredictable attacks. Although treatments exist, patients with HAE still alter their lives to avoid triggers and experience substantial physical, psychosocial, and financial burdens. <b>Objective:</b> To estimate the burden that HAE-C1INH patients experience despite currently approved therapies, aiming to identify unmet needs related to HAE, its therapies and the ability to achieve normalization of life. <b>Methods:</b> A web-based survey was conducted from March to April 2025 among 100 US adults with HAE-C1INH currently receiving long-term prophylaxis and/or on-demand therapies. Responses captured attack frequency, the impact of living with HAE, avoidance of attack triggers, and the patients' unmet needs. Descriptive statistical analysis was conducted. <b>Results:</b> Even with treatment, 80% of respondents reported ≥1 HAE attack in the past year and 61% thought about HAE at least weekly. Mental health was the aspect that respondents felt was most impacted by HAE (54% of respondents), and 73% reported taking ≥2 measures to avoid attack triggers. Several concerns impacted the ability to reach normalization; lifetime use of medication was the most commonly reported concern (68% of respondents). The greatest unmet needs associated with long-term prophylaxis were cost- and access-related. <b>Conclusion:</b> Substantial unmet needs related to disease control and achieving normalization remain for patients with HAE-C1INH, despite existing treatments. This study re-enforces the need to not only assess the frequency and severity of attacks, but also the psychosocial, mental, logistical, and financial burden of lifelong management of HAE-C1INH in clinical practice.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":" ","pages":"92-101"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206419","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":"What to do when your adult patient with severe asthma does not respond to a biologic.","authors":"Dennis K Ledford","doi":"10.2500/aap.2026.47.260003","DOIUrl":"10.2500/aap.2026.47.260003","url":null,"abstract":"<p><p><b>Background:</b> Asthma management has been revolutionized by the introduction and expansion of biologic therapies. Since the approval of omalizumab for allergic asthma in 2003, six additional biologics with an asthma indication have been FDA-approved, and several more are in late-phase development. The clinical challenge is that all of these therapies reduce exacerbations, but asthma exacerbations are difficult to predict. A subgroup of 20-40% of biologic-treated patients will achieve asthma remission, or near remission depending on the criteria used, during biologic therapy, an ideal outcome. For the remaining 60-80% of treated patients, the benefits are evident but usually less defined or quantifiable. Symptoms often improve, but patient-reported outcomes lack precision to verify efficacy. All biologic therapies reduce exacerbations by an average of 50%; they do not eliminate exacerbations for most patients. In long-term, unblinded, safety trials, the majority of treated subjects have zero to one exacerbation per year. Thus, for an individual patient, assessing response and predicting response can be problematic, and strategies for addressing suboptimal responses are not standardized. <b>Methods:</b> This article summarizes a potential approach to use when biologic therapy in adults with asthma is, or appears to be, insufficiently effective. <b>Results:</b> The major points are: 1) set expectations prior to therapy to facilitate decision making and do not expect remission or near remission depending on criteria used; 2) reassess the source of symptoms and findings with the possibility that the asthma diagnosis is not accurate or co-morbidities are the major contributors to the clinical presentation; 3) evaluate adherence with both small molecule therapy (i.e. inhaled controller therapy) and with the biologic regimen if administered in-home; 4) change the biologic to an alternative biologic, generally affecting a different pathway. <b>Conclusions:</b> This strategy is not a guarantee of success but may assist in clinical decision-making.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 2","pages":"78-84"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147466610","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":"Real-world quality of life in patients with hereditary angioedema receiving lanadelumab or other long-term prophylaxis.","authors":"Mark Davis-Lorton, Daniel Soteres, William R Lumry, Jennifer Hall, Hannah Connolly, Daniel Fox, Krystal Sing, Bob G Schultz, Salomé Juethner","doi":"10.2500/aap.2026.47.250104","DOIUrl":"10.2500/aap.2026.47.250104","url":null,"abstract":"<p><p><b>Background:</b> Hereditary angioedema (HAE) is a rare, potentially fatal genetic disorder characterized by unpredictable attacks of bodily swelling that substantially impair patients' quality of life (QoL). Lanadelumab is approved for long-term prophylaxis (LTP) in patients with HAE; however, there are limited real-world data that compare lanadelumab with other treatments to guide patient care. <b>Objective:</b> The objective was to describe real-world QoL and related outcomes of patients with HAE who received lanadelumab versus other LTP. <b>Methods:</b> Data were drawn from a real-world, cross-sectional survey of physicians and their consulting patients with HAE in the United States from January 2023 to January 2024. Physician-reported attack and disease severity, pain, fatigue, QoL, and patient-reported outcomes were compared among patients receiving lanadelumab or other LTP. <b>Results:</b> Physicians reported data on 86 patients treated with lanadelumab and 84 treated with other LTP. A statistically significantly higher proportion of patients receiving lanadelumab had no chronic pain (58.1%) and no chronic fatigue (51.2%) at the time of the survey than those receiving other LTP (38.1% [p = 0.0023] and 34.9% [p = 0.0037], respectively). More patients receiving lanadelumab had \"very good\" physician-reported QoL and less patient-reported QoL impairment at the time of the survey compared with those receiving other LTP (p = 0.0102). A higher proportion of patients receiving lanadelumab compared with other LTP reported complete satisfaction overall with their treatment (30.2% versus 17.9%, respectively; p = 0.0144) and complete satisfaction with the efficacy of their treatment (44.2% versus 11.9%, respectively; p < 0.0001). <b>Conclusion:</b> In this real-world study, physicians reported a higher proportion of patients receiving lanadelumab had no chronic pain or fatigue compared with those receiving other LTP. Both physicians and patients reported higher QoL in those receiving lanadelumab. Continued real-world research in patients with HAE to further assess the effect of lanadelumab on QoL will help guide patient care.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 2","pages":"102-111"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147466668","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":"Comprehensive assessment of allergic manifestations including drug hypersensitivity in adult patients with inborn errors of immunity.","authors":"Pelin Korkmaz, Ilkim Deniz Toprak, Semra Demir, Osman Ozan Yegit, Nevzat Kahveci, Merve Hormet Igde, Sule Celik Kamaci, Ayse Feyza Aslan, Merve Dilsad Atasever, Deniz Eyice Karabacak, Mehmet Emin Sezgin, Selin Ece Guzel, Esra Kaya, Bircan Erden, Zeynep Kilinc, Isil Gogem Imren Aksit, Leyla Bolek, Derya Unal, Asli Gelincik","doi":"10.2500/aap.2026.47.260007","DOIUrl":"10.2500/aap.2026.47.260007","url":null,"abstract":"<p><p><b>Background:</b> The determination of the prevalence and clinical relevance of allergic manifestations in individuals with human inborn errors of immunity (IEI) remains inadequately established. Here, our objective was to assess the allergic manifestations observed in patients diagnosed with IEI. <b>Method:</b> We evaluated allergic manifestations, including rhinitis, asthma, dermatitis, and venom, drug, and food allergies, in 220 adult patients with IEI. T and B cell subsets, the timing of allergy onset, skin test results, and drug hypersensitivity tests were assessed by using medical records and follow-up data. <b>Results:</b> Antibody deficiencies accounted for 85.9% of the cohort. Allergic rhinitis was the most frequent manifestation (21.8%), followed by asthma (15.9%), atopic dermatitis (12.3%), and drug hypersensitivity (10.9%). Food allergy was rare (0.9%), and no venom allergy was identified. Severe asthma was observed in two patients. Bronchiectasis was more frequent in the patients with asthma versus patients without asthma (28.6% versus 14.4%; p = 0.03). Asthma was more prevalent among patients receiving prophylactic antibiotics (34.1% in those receiving prophylactic antibiotics versus 11.7% in those not receiving prophylactic antibiotics; p = 0.001), and prophylaxis was more common in patients with asthma receiving treatment steps 3-5 than steps 1-2 (57.8% in patients at steps 3-5 versus 18.7% in patients at steps 1-2; p = 0.02). Among 28 drug hypersensitivity reactions in 24 patients (from 47 initially reported cases of patients after exclusion of predictable adverse reactions), immediate-type reactions predominated (78.6%), most commonly urticaria and anaphylaxis (each 21.4%). Among patients with allergic disease, 62% were diagnosed with allergy before IEI. The median (interquartile range) age at the IEI diagnosis was 28 years (18-38 years), and IEI diagnostic delay did not differ by allergy status. The interval between allergy and IEI diagnosis was longer when allergy preceded IEI (median 10 years; p = 0.01). Adult-onset asthma was associated with a higher age at IEI diagnosis (p = 0.004). Aeroallergen sensitization was associated with higher total, memory, and switched memory B cell counts (all p ≤ 0.01) and a higher switched memory B cell proportion (p = 0.04). <b>Conclusion:</b> Allergic manifestations are common in adults with IEI and often occur years before the diagnosis of immunodeficiency. Adult-onset asthma was associated with a higher age at IEI diagnosis, which suggests delayed recognition of underlying immune dysfunction in this subgroup. In addition, aeroallergen sensitization was associated with higher B cell subset counts, which highlights immunologic heterogeneity among adults with allergy and with IEI.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 2","pages":"140-148"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147466510","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":"Mosquito bite hypersensitivity in children: Clinical features outweigh specific IgE in diagnosis.","authors":"Kazim Okan Dolu, Idan Firat Unay, Yasemin Tepe, Zeynep Efsan Baser Sinoplu, Cagla Karavaizoglu, Elanur Yolal Karimov, Hande Ucler Cinar, Himmet Haluk Akar","doi":"10.2500/aap.2026.47.250103","DOIUrl":"10.2500/aap.2026.47.250103","url":null,"abstract":"<p><p><b>Background:</b> Mosquito bite hypersensitivity results from abnormal immune responses to salivary proteins with potent immunomodulatory properties. In children, both type I (immunoglobulin E [IgE] mediated) and type IV (cell mediated) mechanisms contribute to the reaction spectrum, ranging from localized erythema to extensive inflammatory lesions. Although mosquito-specific IgE assays are commercially available, their diagnostic utility and correlation with clinical severity remain unclear. <b>Objective:</b> The objective was to describe the clinical and immunologic characteristics of children with mosquito hypersensitivity, evaluate the diagnostic relevance of mosquito-specific IgE, and explore associations with atopic background. <b>Methods:</b> A retrospective study was conducted on 206 children who underwent mosquito-specific IgE testing between June 2023 and June 2025. The mosquito allergy group included children with large local reactions, prolonged lesions, or systemic symptoms; the controls had typical reactions only. Clinical features, atopic comorbidities, total IgE levels, eosinophil percentages, and inhalant sensitizations were compared between the groups. <b>Results:</b> Atopic diseases were significantly more common in the mosquito allergy group versus the controls (87.0% versus 52.7%; p < 0.001). Mosquito-specific IgE positivity was low and similar across the groups (mosquito allergy group 6/77 [7.8%] vs controls 13/129 [10.1%]; p = 0.63), which showed no correlation with reaction type, duration, or severity. The total IgE levels were significantly higher in the mosquito allergy group (p = 0.045). The most frequent lesions were erythematous papules (88.3%) and immediate wheals (89.6%), whereas bullous lesions were rare (7.8%) and self-limited. Quality of life was mainly affected by avoidance of outdoor activities (16.9%) and psychological distress (15.6%). <b>Conclusion:</b> In pediatric mosquito hypersensitivity, clinical assessment outweighs mosquito-specific IgE testing for diagnosis. Despite the strong association with atopy, specific IgE positivity remains low, which supports the primacy of clinical history and lesion morphology in diagnostic decision-making.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 2","pages":"112-119"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147466635","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":"Exhaled breath condensate thymic stromal lymphopoietin, OX40 ligand, eotaxin, and interleukin-23 in children with atopic dermatitis and persistent wheeze.","authors":"Cem Geyik, Murat Cansever, Fulya Bektas, Koray Dorterler, Berkay Saraymen, Fulya Tahan","doi":"10.2500/aap.2026.47.260002","DOIUrl":"10.2500/aap.2026.47.260002","url":null,"abstract":"<p><p><b>Background:</b> Atopic dermatitis is a chronic inflammatory condition. It is estimated that 60% of children with severe atopic dermatitis will go on to develop asthma. This study aimed to assess the presence and extent of early airway inflammation in infants with atopic dermatitis. <b>Methods:</b> A total of 73 infants aged <36 months were included in the study, which comprised a group with atopic dermatitis (n = 30), a group with persistent wheezing (n = 22), and a control group of healthy infants (n = 21). The subjects who exhibited persistent wheezing were selected according to the criteria set forth in the Asthma Predictive Index. Exhaled breath condensates (EBC) were collected via the R-tube method. The levels of thymic stromal lymphopoietin (TSLP), OX40 ligand (OX40L), eotaxin, and interleukin-23 (IL-23) in EBCs were determined by using enzyme-linked immunosorbent assay (ELISA). <b>Results:</b> No statistically significant difference was observed in the levels of TSLP and OX40L in EBC among the groups. Eotaxin showed a directionally higher level in the persistent wheezing group; the difference was attenuated after age adjustment and Bonferroni correction but persisted in the 12-30-month sensitivity analysis (persistent wheezing group versus controls, p = 0.011, Bonferroni adjusted). The atopic dermatitis and persistent wheezing groups had lower EBC IL-23 levels than did the controls (age-adjusted analyses, p < 0.001). <b>Conclusion:</b> This study is among the first to quantify TSLP, OX40L, eotaxin, and IL-23 in EBCs from infants with atopic dermatitis, those with persistent wheezing, and healthy controls. Eotaxin levels were directionally higher in the persistent wheezing group than in the controls; however, this difference did not remain statistically significant after age adjustment and Bonferroni correction, and should be interpreted as suggestive rather than confirmatory of eosinophil-associated airway inflammation. In a 12-30-month sensitivity analysis, the persistent wheezing group had a higher natural log-transformed eotaxin concentration than did the controls (p = 0.011, Bonferroni adjusted), which supports this signal within a narrower age window. A lower EBC IL-23 level is biologically intriguing but should be interpreted cautiously given residual confounding and EBC variability.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 2","pages":"124-132"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147466583","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":"Cow's milk protein allergy: A risk factor for infections in infants?","authors":"Gaye Kocatepe, Dilara Fatma Kocacik Uygun, Senay Ture, Sevtap Velipasaoglu, Humeyra Yilmaz, Mine Erkan, Aysen Bingol","doi":"10.2500/aap.2026.47.250098","DOIUrl":"10.2500/aap.2026.47.250098","url":null,"abstract":"<p><p><b>Background:</b> Cow's milk protein allergy (CMPA) imposes a significant burden on the lives of infants and families and can cause various complications, but there are limited data on the clinical burden associated with infection. <b>Objective:</b> This study aimed to compare infection frequency, antibiotic use, and hospitalization rates between children with CMPA and healthy controls. <b>Methods:</b> Patients diagnosed with CMPA (IgE-mediated or non-IgE-mediated) in the pediatric allergy-immunology outpatient clinic and healthy infants admitted to the social pediatrics outpatient clinic were evaluated prospectively at initial visit, 6 months, and 12 months. Clinical characteristics, history of respiratory, skin, gastrointestinal, and urinary tract infections, antibiotic use, and hospitalization rates were analyzed. <b>Results:</b> Compared to controls, the CMPA group had significantly lower prevalence and duration of exclusive breastfeeding (p < 0.001 for both) and significantly higher income (p = 0.035), presence of siblings (p < 0.001), household size (p < 0.001), rate of suburban dwelling (p = 0.008), and rate of atopic dermatitis (p = 0.003). Rates of infection (all systems), antibiotic use, and hospitalization were higher in the CMPA group compared to controls (p < 0.001 for all) and among patients with IgE-mediated CMPA compared to those with non-IgE-mediated CMPA (p < 0.05 for all). Respiratory and skin infections were more common and gastrointestinal infections were less common in IgE-mediated CMPA compared to non-IgE-mediated CMPA (p < 0.001 for all). <b>Conclusion:</b> CMPA (especially the IgE phenotype) was associated with increased infection frequency and severity in infants. These findings suggest the need for a more careful approach to infection risk in patients with CMPA and the importance of disease control.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 2","pages":"e17-e23"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147466579","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":"Hypogammaglobulinemia during infancy and atopic dermatitis.","authors":"Stephanie Griffin, Joanna Fishbein, Trey Wetzel, Samuel Puglisi, Punita Ponda","doi":"10.2500/aap.2026.47.250094","DOIUrl":"10.2500/aap.2026.47.250094","url":null,"abstract":"<p><p><b>Background:</b> Hypogammaglobulinemia during infancy (HI) is often transient, resolves with time, and typically does not associate with a specific immunologic deficiency. If hypogammaglobulinemia persists, then it may be secondary to an immunologic disorder and be associated with significant clinically diagnosed infections. When phenotyping HI, any implications of associated atopic dermatitis (AD) can be clinically helpful. <b>Objective:</b> The purpose of this study was to explore the clinical and immunologic differences between patients who have HI and AD versus those with AD alone or with HI alone. <b>Methods:</b> We conducted a retrospective record review of patients with AD, HI with AD (HIcAD), and HI only seen in a large academic practice. Patient characteristics, comorbidities, clinical, and laboratory parameters as well as immunoglobulin G (IgG) at the last follow-up were noted. If HI resolved, then the age of resolution was noted. Data were analyzed by using the χ² test, Fisher exact test, Wilcoxon rank sum test, Monte Carlo estimates, and Kaplan-Meier product-limit curves, as appropriate. <b>Results:</b> There was no significant difference in age of presentation, gender at birth, or number or type of clinically diagnosed infections among the groups, but there was a significant difference in the levels of IgG, IgA, IgM, and IgE. More children in the HIcAD group had high IgE levels, significantly higher leukocyte counts, eosinophil counts, T and B cell numbers, and severe AD, and resolved HI in the study period than in the HI-only group. <b>Conclusion:</b> Analysis of our findings suggests that infants with HIcAD are more likely to have severe AD, to resolve hypogammaglobulinemia, and to have immunologic dysregulation without increased clinically diagnosed infections.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 2","pages":"133-139"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147466589","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":"Comparison of clinical characteristics in primary immunodeficiency patients based on the presence of autoimmunity or autoinflammation.","authors":"Seçim Kolak, Fatih Çölkesen, Mehmet Emin Gerek, Ferhat Sağun, Emrah Harman, Şükran Aslan Savaş, Şevket Arslan","doi":"10.2500/aap.2026.47.250102","DOIUrl":"10.2500/aap.2026.47.250102","url":null,"abstract":"<p><p><b>Background:</b> Autoimmunity and autoinflammation are increasingly recognized manifestations of immune dysregulation in patients with primary immunodeficiency (PID), alongside recurrent infections. <b>Objective:</b> The objectives were to determine the prevalence of autoimmune and autoinflammatory findings in patients with PID and to compare their clinical, laboratory, and immunologic characteristics. <b>Methods:</b> This retrospective study included 130 adult patients with PID who were followed up at a tertiary university immunology clinic. The patients were divided into three groups: those without immune dysregulation (group 1), those with predominant autoimmune features (group 2), and those with predominant autoinflammatory features (group 3). Demographic data, laboratory parameters, immunoglobulin levels, lymphocyte subsets, switched memory B cells, and genetic mutation data were analyzed. <b>Results:</b> Autoimmune manifestations were predominant in 32.3% and autoinflammatory findings were predominant in 9.2% of the patients. The patients in group 3 showed significantly elevated C-reactive protein, erythrocyte sedimentation rate (ESR), and fibrinogen levels (p < 0.05). Of the patients in group 2, the platelet count, serum immunoglobulin E (IgE) level, and switched memory B cells were significantly lower compared with other groups (p = 0.001, p = 0.007, p = 0.005, respectively). There were no significant differences in genetic mutation frequency or mortality among groups. <b>Conclusion:</b> Autoimmunity and autoinflammation are frequent in PID and associated with distinct immunologic profiles. Elevated acute phase reactants may indicate autoinflammation, whereas low IgE levels and decreased switched memory B cells may serve as early markers of autoimmunity. Routine evaluation for immune dysregulation in patients with PID is recommended.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 2","pages":"149-156"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147466487","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":"Across the arc of allergy: From maternal immune tolerance to food sensitization pathways and lifesaving anaphylaxis care.","authors":"Joseph A Bellanti, Russell A Settipane","doi":"10.2500/aap.2026.47.250097","DOIUrl":"10.2500/aap.2026.47.250097","url":null,"abstract":"","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"47 1","pages":"1-4"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12787060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145942125","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}