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Specific immunoglobulin E for aeroallergens: 0.35 kUA/L cutoff value is too low. 空气过敏原特异性免疫球蛋白E: 0.35 kUA/L临界值过低。
IF 2.2 3区 医学
Allergy and asthma proceedings Pub Date : 2025-09-01 DOI: 10.2500/aap.2025.46.250063
Anette Flugt, Helene M Rasmussen, Lone Agertoft, Soren Moller, Josefine Gradman
{"title":"Specific immunoglobulin E for aeroallergens: 0.35 kUA/L cutoff value is too low.","authors":"Anette Flugt, Helene M Rasmussen, Lone Agertoft, Soren Moller, Josefine Gradman","doi":"10.2500/aap.2025.46.250063","DOIUrl":"10.2500/aap.2025.46.250063","url":null,"abstract":"<p><p><b>Background:</b> Measurement of specific immunoglobulin E (sIgE) is often used interchangeably with a skin-prick test (SPT) to detect allergic sensitization. Evidence of concordance between the two methods for aeroallergens in children is limited. Potentially, discordance can lead to misclassification in atopy diagnosis and subsequent clinical management. The arbitrary sIgE cutoff value of 0.35 kUA/L is used uniformly for all allergens. <b>Objective:</b> The aim of the study was to evaluate the agreement between sIgE with a cutoff of 0.35 kUA/L and a positive SPT result (cutoff of 3 mm) for 10 aeroallergens and to investigate the sIgE level that corresponds best with a positive SPT result in school-age children. <b>Methods:</b> Measurement of sIgE and SPT for birch, Timothy grass, mugwort, horse, dog, cat, Dermatophagoides pteronyssinus, Dermatophagoides farinae, Alternaria, and Cladosporium were performed in 300 children ages 6 to 14 years: 132 children with asthma and 168 controls. The agreement between sIgE and SPT results for the individual aeroallergens was assessed by using the Cohen κ coefficient with different sIgE cutoff values. <b>Results:</b> In total, the 300 children had 297 positive SPT results and 445 positive IgE analyses. The incidence of sensitization to Alternaria and Cladosporium was too low for further analysis. The agreement between the sIgE cutoff of 0.35 kUA/L and the SPT result cutoff of 3 mm was moderate to substantial for the remaining eight aeroallergens. The estimated optimal sIgE cutoff level that predicted an SPT result of ≥3 mm was 0.75 kUA/L for grass, horse, dog, and cat; 1.0 kUA/L for mugwort; 3.0 kUA/L for D. pteronyssinus; 5.0 kUA/L for birch; and 10.0 kUA/L for D. farinae. Using an sIgE cutoff of 0.75 kUA/L slightly increased the agreement for all eight allergens. <b>Conclusion:</b> Compared with an SPT result, a cutoff of 3 mm, analysis of our data suggests that an sIgE cutoff of 0.35 kUA/L is too low and that the optimal cutoff differs for the different aeroallergens.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 6","pages":"506-511"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385842","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}
引用次数: 0
In-vivo allergen extract potency is maintained in a sublingual immunotherapy maintenance vial of pollens and mites. 体内过敏原提取物的效力是维持在舌下免疫治疗维持瓶花粉和螨虫。
IF 2.2 3区 医学
Allergy and asthma proceedings Pub Date : 2025-09-01 DOI: 10.2500/aap.2025.46.250075
Désirée Larenas-Linnemann, Ralph Mosges
{"title":"<i>In-vivo</i> allergen extract potency is maintained in a sublingual immunotherapy maintenance vial of pollens and mites.","authors":"Désirée Larenas-Linnemann, Ralph Mosges","doi":"10.2500/aap.2025.46.250075","DOIUrl":"10.2500/aap.2025.46.250075","url":null,"abstract":"<p><p><b>Background:</b> Allergen immunotherapy (IT) in Europe is generally administered as monoallergen IT. However, in some patients and in other parts of the world, multiallergen IT is common practice. A key question is whether allergens in a mixture retain their allergenicity over time. <b>Objective:</b> To demonstrate if allergenicity, as measured by skin-prick testing (SPT), is maintained after 6 months in a sublingual immunotherapy (SLIT) maintenance vial with three allergen extracts in a single individual vaccine, including two pollens and Dermatophagoides. <b>Methods:</b> We prepared two maintenance SLIT vials that contained mixed Dermatophagoides species (2000 AU/mL), ash tree and Bermuda grass pollens (1:50 w/v), one 6 months before SPT and the second 0-2 weeks before SPT, and three fresh vials (0-2 weeks before SPT) for each individual allergen. Duplicate SPTs were conducted with all five vials, diluent and positive (histamine 1 mg/mL) controls. Wheals were measured at 10 minutes (controls) and 20 minutes (allergen vaccines). The mean wheal diameter was calculated as the average of the longest and orthogonal diameters, i.e., (D<sub>1</sub> + D₂)/2. For each allergen extract, two replicate wheals were obtained per participant; their mean diameters were averaged to yield a patient-level mean wheal diameter. These patient-level means were then averaged across all the participants. The paired t-test was used to calculate statistically significant differences between the mean wheal diameters of the extracts, with significance at p < 0.05. <b>Results:</b> The mean ± standard deviation wheal diameter produced by the 6-month-old and the fresh extracts were 8.7 ± 3.3 mm and 8.4 ± 2.87 mm, respectively. This difference was not significant. Moreover, the potency of both pollen extracts was conserved when mixed with house-dust mite extracts. <b>Conclusion:</b> In our pilot study, allergenicity of tree and grass pollen allergens in an allergen mix with Dermatophagoides in a SLIT maintenance vial was maintained over 6 months. Replication in a larger population would consolidate our findings.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 6","pages":"e176-e182"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385273","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}
引用次数: 0
Pediatric ondansetron hypersensitivity: Clinical features and a preliminary diagnostic approach. 儿童昂丹司琼过敏:临床特征和初步诊断方法。
IF 2.2 3区 医学
Allergy and asthma proceedings Pub Date : 2025-09-01 DOI: 10.2500/aap.2025.46.250057
Cankat Genis, Cagrı Torun Ozel, Ahmet Selmanoglu, Zeynep Sengul Emeksiz, Emine Dibek Misirlioglu
{"title":"Pediatric ondansetron hypersensitivity: Clinical features and a preliminary diagnostic approach.","authors":"Cankat Genis, Cagrı Torun Ozel, Ahmet Selmanoglu, Zeynep Sengul Emeksiz, Emine Dibek Misirlioglu","doi":"10.2500/aap.2025.46.250057","DOIUrl":"10.2500/aap.2025.46.250057","url":null,"abstract":"<p><p><b>Background:</b> Ondansetron is a common antiemetic that rarely causes hypersensitivity. Skin-prick testing (SPT) and intradermal testing (IDT) may assist in diagnosing ondansetron hypersensitivity; however, their sensitivity, specificity, and optimal concentrations remain unclear. To our knowledge, drug provocation testing (DPT), the criterion standard for diagnosis, has not been previously applied in pediatric cases. <b>Objective:</b> In this study, we aimed to evaluate ondansetron hypersensitivity in children by using a preliminary diagnostic approach that incorporated SPT, IDT, and DPT. <b>Methods:</b> We retrospectively reviewed pediatric patients who were evaluated for suspected ondansetron hypersensitivity between 2019 and 2025. We performed an SPT by using an ondansetron concentration of 2 mg/mL, followed by an IDT with concentrations of 0.02 and 0.2 mg/mL in patients with negative SPT results. In cases of patients with negative skin test results, we conducted DPTs. <b>Results:</b> We included seven pediatric patients ages 3-16 years. All had negative SPT results, which underscores its limited sensitivity. IDT results were positive in three patients with a history of anaphylaxis (one at 0.02 mg/mL, two at 0.2 mg/mL); DPT was not performed in these patients. Among the four with negative skin test results, DPT was performed in three and yielded negative results. We confirmed hypersensitivity in three patients. In another three, no clinical reactivity was observed at the time of DPT, and the diagnosis remained inconclusive in one patient. <b>Conclusion:</b> To our knowledge, this is the first pediatric case series to propose a preliminary diagnostic approach that incorporated DPT in the evaluation of suspected ondansetron hypersensitivity. The findings highlight the limited sensitivity of SPT, emphasize the diagnostic value of IDT, particularly in patients with anaphylaxis, and support the safe applicability of DPT in patients with negative skin test results, with all three DPTs yielding negative results.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 6","pages":"e183-e190"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385780","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}
引用次数: 0
Baseline disease characteristics among patients with chronic rhinosinusitis with nasal polyps in AROMA: A global registry study. 慢性鼻窦炎合并鼻息肉患者的基线疾病特征:一项全球登记研究。
IF 2.2 3区 医学
Allergy and asthma proceedings Pub Date : 2025-09-01 DOI: 10.2500/aap.2025.46.250055
Anju T Peters, Rachna Shah, Enrico Heffler, Martin Wagenmann, Shigeharu Fujieda, Changming Xia, Scott Nash, Michael Clotz, Mark Corbett, Amr Radwan
{"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":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of chronic urticaria: Treatment options when omalizumab fails. 慢性荨麻疹的管理:当omalizumab失败时的治疗选择。
IF 2.2 3区 医学
Allergy and asthma proceedings Pub Date : 2025-09-01 DOI: 10.2500/aap.2025.46.250072
David M Lang
{"title":"Management of chronic urticaria: Treatment options when omalizumab fails.","authors":"David M Lang","doi":"10.2500/aap.2025.46.250072","DOIUrl":"10.2500/aap.2025.46.250072","url":null,"abstract":"<p><p>Substantial progress in our understanding of chronic urticaria has been accomplished in recent years. We now recognize the heterogeneity of this condition, which is comprised of a number of endotypes and phenotypes. Laboratory testing to identify a cause for chronic urticaria has been discouraged, as this does not lead to improved outcomes and is not cost-effective; however, evidence has shown selected laboratory tests are important for their prognostic value. Therapeutic options for chronic urticaria, particularly for patients who are antihistamine-resistant, have also improved. Despite this, chronic urticaria has continued to be a vexatious condition for both patients and health care providers, and many patients continue to experience unmet needs. Guidelines recommend a step-care approach for management of chronic urticaria that can encourage substantial improvement in clinical course and quality of life. Use of anti-IgE therapy for more than the past decade has enabled many patients with antihistamine-resistant chronic urticaria to achieve improved outcomes; however, a substantial proportion continue to experience ongoing symptoms and impaired quality of life. The armamentarium for management of patients with refractory chronic urticaria has recently expanded, and will soon expand further. This article focuses on the approach to management of antihistamine-resistant patients who continue to experience poorly controlled chronic urticaria despite anti-IgE therapy prescribed at FDA-approved doses.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 6","pages":"455-461"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385778","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}
引用次数: 0
Comparative analysis of demographic and clinical features in common variable immunodeficiency and selective immunoglobulin G deficiency. 常见变异性免疫缺陷与选择性免疫球蛋白G缺乏症的人口学及临床特征比较分析。
IF 2.2 3区 医学
Allergy and asthma proceedings Pub Date : 2025-09-01 DOI: 10.2500/aap.2025.46.250077
Mehmet Emin Gerek, Fatih Colkesen, Tugba Onalan, Fatma Arzu Akkus, Mehmet Kilinc, Recep Evcen, Selim Kahraman, Sevket Arslan
{"title":"Comparative analysis of demographic and clinical features in common variable immunodeficiency and selective immunoglobulin G deficiency.","authors":"Mehmet Emin Gerek, Fatih Colkesen, Tugba Onalan, Fatma Arzu Akkus, Mehmet Kilinc, Recep Evcen, Selim Kahraman, Sevket Arslan","doi":"10.2500/aap.2025.46.250077","DOIUrl":"10.2500/aap.2025.46.250077","url":null,"abstract":"<p><p><b>Background:</b> Common variable immunodeficiency (CVID) and selective immunoglobulin G (IgG) deficiency (sIgGD) are primary antibody deficiencies with divergent clinical trajectories. CVID is characterized by recurrent infections and systemic noninfectious complications, whereas sIgGD typically follows a milder course. Despite sharing clinical features such as recurrent infections, comparative data on complications and mortality remain limited, which hinders risk-stratified management. <b>Objective:</b> This study compared the prevalence, clinical impact, and mortality associated with noninfectious complications in CVID and sIgGD, and identified predictors of adverse outcomes to support risk-stratified management and examined clinical differences within the CVID group based on baseline serum IgM levels. <b>Methods:</b> A single-center retrospective cohort study (2018-2024) included 111 patients with CVID and 19 patients with sIgGD. Diagnostic criteria for CVID included hypogammaglobulinemia (IgG level < 400 mg/dL with low IgA/IgM), impaired vaccine responses, and exclusion of secondary causes. The sIgGD required isolated IgG deficiency with normal IgA/IgM and intact vaccine responses. Noninfectious complications, including organ-specific and systemic manifestations as well as bronchiectasis were evaluated. In patients with CVID, a predefined subgroup analysis was performed based on baseline serum IgM levels (normal versus <40 mg/dL). Multivariate logistic regression identified mortality predictors. <b>Results:</b> The patients with CVID exhibited significantly higher rates of recurrent sinopulmonary infections (70.3% versus 42.1%), bronchiectasis (46.8% versus 21.1%), and noninfectious complications (57.7% versus 31.6%), including autoimmune disorders such as hematologic manifestations (33.3% versus 10.5%). In the CVID group, the patients with low IgM levels exhibited a significantly higher prevalence of gastrointestinal involvement (24.0% versus 5.6%; p = 0.035). Bronchiectasis (odds ratio [OR] 5.22) and noninfectious complications (OR 7.95) independently predicted mortality in CVID. Male sex showed borderline risk. In contrast, no mortality was observed in the sIgGD cohort over the study period. <b>Conclusion:</b> CVID is associated with substantial noninfectious morbidity and mortality, which necessitates early identification and long-term monitoring. In contrast, sIgGD exhibits a milder clinical phenotype, although preventive care remains important. These findings support distinct management strategies and highlight the utility of clinical markers for risk stratification.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 6","pages":"498-505"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385667","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}
引用次数: 0
The value of skin testing with tumor necrosis factor-inhibitors in patients with local and systemic hypersensitivity reactions. 肿瘤坏死因子抑制剂皮肤试验在局部和全身过敏反应患者中的价值。
IF 2.2 3区 医学
Allergy and asthma proceedings Pub Date : 2025-09-01 DOI: 10.2500/aap.2025.46.250079
Nilay Orak Akbay, Betul Ozdel Ozturk, Alper Doganci, Zeynep Celebi Sozener, Sebnem Ataman, Sevim Bavbek
{"title":"The value of skin testing with tumor necrosis factor-inhibitors in patients with local and systemic hypersensitivity reactions.","authors":"Nilay Orak Akbay, Betul Ozdel Ozturk, Alper Doganci, Zeynep Celebi Sozener, Sebnem Ataman, Sevim Bavbek","doi":"10.2500/aap.2025.46.250079","DOIUrl":"10.2500/aap.2025.46.250079","url":null,"abstract":"<p><p><b>Background:</b> Hypersensitivity reactions (HSR) to tumor necrosis factor α inhibitors (TNFi) can occur but data about skin testing in such reactions are limited. <b>Objective:</b> To evaluate skin testing in patients with HSRs to TNFi. <b>Methods:</b> A detailed review of demographics and clinical characteristics, features of index reactions, results of skin tests, and outcomes of desensitization protocols were obtained. <b>Results:</b> The cohort comprised 64 patients (women/men: 41/23). Treatment distribution included etanercept (n = 50 [78.1%]), adalimumab (n = 11 [17.2%]), and infliximab (n = 3 [4.7%]). HSRs were seen as an injection-site reaction (ISR) in 47 patients (73.4%), generalized urticaria in 8 patients (12.5%), and anaphylaxis in 3 patients (4.7%). Forty-four patients (44/64 [72%]) had positivity on skin tests as either skin-prick test (SPT) or intradermal test (IDT). Among other reaction types, the patients with ISRs exhibited the highest skin test positivity (p = 0.043). Among the 17 patients who underwent rapid subcutaneous or intravenous desensitization, 15 patients (88.2%) had positive skin test results, and all desensitization procedures were successfully completed, despite some experiencing local breakthrough reactions (BTR). <b>Conclusion:</b> This study, which includes the largest number of patients reported in the literature, highlights the important role of skin testing in diagnosing HSRs to TNFi. Notably, etanercept demonstrated the highest positivity rate. Successful completion of desensitization protocols despite some BTRs highlights the importance of desensitization in patients experiencing HSRs to these treatments.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 6","pages":"489-497"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385782","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}
引用次数: 0
Adaptation of the urticaria patient daily diary for caregiver completion in pediatric chronic spontaneous urticaria. 儿童慢性自发性荨麻疹患者每日日记对护理人员完成的适应性。
IF 2.2 3区 医学
Allergy and asthma proceedings Pub Date : 2025-09-01 DOI: 10.2500/aap.2025.46.250062
Diane Whalley, Maria-Magdalena Balp, Christel Naujoks, Donna D Gardner, Elaine Dery, Karsten Weller, Lauri-Ann Van Der Poel, Michel Erlewyn-Lajeunesse, Weily Soong
{"title":"Adaptation of the urticaria patient daily diary for caregiver completion in pediatric chronic spontaneous urticaria.","authors":"Diane Whalley, Maria-Magdalena Balp, Christel Naujoks, Donna D Gardner, Elaine Dery, Karsten Weller, Lauri-Ann Van Der Poel, Michel Erlewyn-Lajeunesse, Weily Soong","doi":"10.2500/aap.2025.46.250062","DOIUrl":"10.2500/aap.2025.46.250062","url":null,"abstract":"<p><p><b>Background:</b> The Urticaria Patient Daily Diary (UPDD) assesses patient-reported symptoms (itch, hives, angioedema) and impacts in adults and adolescents with chronic spontaneous urticaria (CSU). <b>Objective:</b> The objective was to adapt the UPDD for caregiver completion for patients ages 2-11 years. <b>Methods:</b> To inform modification of the UPDD, two iterative rounds of hybrid concept-elicitation/cognitive-debriefing interviews were conducted with clinical experts and caregivers of children with CSU recruited <i>via</i> patient organizations in the United States and Canada. After concept elicitation, the participants reviewed a draft UPDD-Caregiver Version with initial modifications for caregiver completion. Data were analyzed by using thematic analysis. <b>Results:</b> Four clinicians and 12 caregivers were interviewed (round 1:4 clinicians, 5 caregivers; round 2:7 caregivers). Key symptoms reported by the caregivers were itch (n = 12), hives (n = 12), and swelling and/or angioedema (n = 7). All four clinicians confirmed itch and hives to be key symptoms in children ages 2-11 years with CSU, with associated angioedema for some. Scratching was confirmed as the key observable sign of itch. Caregiver-reported impacts included waking in the night (n = 10); difficulty getting to sleep (n = 8); and daily life impacts, including activities at school (n = 10), play (n = 8), with family and/or friends (n = 4), and sports (n = 3). After round 1, minor revisions were made to enhance comprehension of the UPDD-Caregiver Version, and an overall symptom severity item was added. Relevance, acceptability, and comprehension of the final measure were confirmed by round 2 participants; no further changes were required. <b>Conclusion:</b> The UPDD-Caregiver Version is a relevant and acceptable measure for caregiver completion to assess symptoms and impacts of CSU in children ages 2-11 years.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 6","pages":"462-470"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385321","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}
引用次数: 0
Multicenter questionnaire study investigating characteristics of adults with unexplained chronic cough versus explained chronic cough. 多中心问卷研究调查成人不明原因慢性咳嗽与不明原因慢性咳嗽的特点。
IF 2.2 3区 医学
Allergy and asthma proceedings Pub Date : 2025-09-01 DOI: 10.2500/aap.2025.46.250065
Alisa Gnaensky, Mahboobeh Mahdavinia, Shahzad Mustafa, Jill A Poole, Mandel Sher, Raffi Tachdjian, Andrew White, Joshua S Bernstein, Umesh Singh, Jonathan A Bernstein
{"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":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Egg allergy in children: Patterns of consumption of homemade fermented milk products by mothers during pregnancy. 儿童鸡蛋过敏:母亲在怀孕期间食用自制发酵乳制品的模式。
IF 2.2 3区 医学
Allergy and asthma proceedings Pub Date : 2025-09-01 DOI: 10.2500/aap.2025.46.250045
Pelin Karatas, Zeynep Gulec Koksal, Pinar Uysal
{"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":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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