Asian Pacific journal of allergy and immunology最新文献

{"title":"Improving cytokine-induced killer cell expansion using a gas-permeable culture method for clinical-scale production.","authors":"Supannikar Tawinwung, Suparat Tudsamran, Rattapoom Thaiwong, Thiti Asawapanumas, Kitsada Wudhikarn, Chantiya Chanswangphuwana, Nattiya Hirankarn, Udomsak Bunworasate, Koramit Suppipat","doi":"10.12932/AP-190822-1437","DOIUrl":"10.12932/AP-190822-1437","url":null,"abstract":"<p><strong>Background: </strong>Cytokine-induced killer (CIK) cells are a heterogeneous group of immune cells that exert potent MHC-unrestricted cytotoxicity toward various cancer cells in both solid and hematological malignancies.</p><p><strong>Objective: </strong>The purposes of this study were to compare the expansion and characteristics of cytokine-induced killer cells between a standard culture method and a gas-permeable culture method and to develop a clinical-scale expansion protocol for cytokine-induced killer cells using a gas-permeable culture method.</p><p><strong>Methods: </strong>We compared the absolute cell number, fold change, cell subsets, activation markers, cytokine concentrations, and cytotoxicity toward myeloid leukemia cell lines between cytokine-induced killer cells expanded using two different culture methods. Then, we determined the ability to achieve clinical-scale expansion of cytokine-induced killer cells using the gas-permeable culture method.</p><p><strong>Results: </strong>Cytokine-induced killer cells in the gas-permeable culture method group exhibited significantly better expansion but maintained similar cell subsets, activation markers, and cytotoxicity to those in the standard culture method group. In addition, we successfully manufactured cytokine-induced killer cells for clinical use using the gas-permeable culture method. We also showed the clinical efficacy of allogeneic cytokine-induced killer cells produced by the gas-permeable culture method in a patient with acute myeloid leukemia that relapsed after allogeneic hematopoietic stem cell transplantation. This patient maintained ongoing disease remission for 2 years with minimal side effects after cytokine-induced killer cell infusion.</p><p><strong>Conclusions: </strong>We successfully developed a simple and effective protocol for the ex vivo expansion of cytokine-induced killer cells using the gas-permeable culture method for clinical application.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"673-684"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10452116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Humoral and cellular immune responses against SARS-CoV-2 variants of concern induced by heterologous CoronaVac/ChAdOx-1 versus homologous ChAdOx-1 vaccination in the elderly.","authors":"Chalerm Liwsrisakun, Supansa Pata, Witida Laopajon, Nuchjira Takheaw, Warawut Chaiwong, Pilaiporn Duangjit, Juthamas Inchai, Kantinan Chuensirikulchai, Passaworn Cheyasawan, Chaicharn Pothirat, Chaiwat Bumroongkit, Athavudh Deesomchok, Theerakorn Theerakittikul, Atikun Limsukon, Pattraporn Tajarernmuang, Nutchanok Niyatiwatchanchai, Konlawij Trongtrakul, Watchara Kasinrerk","doi":"10.12932/AP-120822-1434","DOIUrl":"10.12932/AP-120822-1434","url":null,"abstract":"<p><strong>Background: </strong>The concept of heterologous vaccination against SARS-CoV-2 infection has been adopted in Thailand with limited data on the induction of humoral and cellular immunity, particularly the CoronaVac/ChAdOx-1 (CoVac/ChAd) regimen in the elderly.</p><p><strong>Objective: </strong>In this study, the immune responses of the elderly induced by heterologous CoVac/ChAd and homologous ChAdOx-1 (ChAd/ChAd) vaccinations were demonstrated.</p><p><strong>Methods: </strong>A prospective observational study involving healthy participants aged ≥ 60 years who received heterologous CoVac/ChAd or homologous ChAd/ChAd vaccination was conducted. Surrogate neutralizing antibody (NAb) and T-cell responses against the SARS-CoV-2 wild type (WT) and variants of concern were determined at pre and post vaccinations.</p><p><strong>Results: </strong>At 4 and 12 weeks after heterologous or homologous vaccination, the NAb levels against WT, Alpha, Beta, and Delta variants between each group were not significantly different, except for significant lower NAb against the Beta variant in heterologous group at 12 weeks after vaccination. The NAb against the Omicron at 4 weeks post-vaccination were below the cutoff level for antibody detection in both groups. However, higher spike-specific CD4 T cell producing IFN-γ and TNF-α in the heterologous than the homologous vaccination were observed. Insignificant difference of cellular immune responses to spike-peptides of Alpha, Beta, and Delta variants and their WT homologues was demonstrated.</p><p><strong>Conclusions: </strong>In the elderly, heterologous CoVac/ChAd vaccination could induce NAb response against the WT and non-Omicron variants not different from the homologous ChAd/ChAd vaccination. Both regimens could not give adequate NAb of the Omicron strain. The heterologous vaccination, however, induced higher spike-specific Th1 cell response.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"654-664"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10694833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyroptosis induced by TLR9 ligand, ODN1826, requires ROS production and caspase-11 activation in Raw264.7 cells.","authors":"Matsayapan Pudla, Rattatammanoon Saengfak, Chularat Luangjindarat, Pongsak Utaisincharoen","doi":"10.12932/AP-041222-1511","DOIUrl":"10.12932/AP-041222-1511","url":null,"abstract":"<p><strong>Background: </strong>Toll-like receptor 9 (TLR9), located in the endosomal compartment, is known to play a role in inflammation by recognizing oligonucleotides that contain CpG motive (CpG-ODN). Signaling by TLR9 leads to the production of proinflammatory cytokines and can trigger cell death.</p><p><strong>Objective: </strong>This study aims to investigate the molecular mechanism of pyroptosis induced by ODN1826 in the mouse macrophage cell line (Raw264.7).</p><p><strong>Methods: </strong>The protein expression and the amount of lactate dehydrogenase (LDH) of ODN1826-treated cells were determined by immunoblotting and LDH assay, respectively. In addition, the level of cytokine production was observed by ELISA assay and the ROS production was determined by flow cytometry.</p><p><strong>Results: </strong>Our results showed that ODN1826 induced pyroptosis as judged by LDH releases. Furthermore, caspase-11 and gasdermin D activation, which are the key molecules in pyroptosis, were also observed in ODN1826-activated cells. Moreover, we also demonstrated that Reactive Oxygen Species (ROS) production by ODN1826 is essential for caspase-11 activation and gasdermin D release, which leads to pyroptosis.</p><p><strong>Conclusions: </strong>ODN1826 induces pyroptosis in Raw264.7 cells via caspase-11 and GSDMD activation. Moreover, the production of ROS by this ligand plays an essential role in the regulation of caspase-11 and GSDMD activation, which then controls pyroptosis in TLR9 activation.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"745-752"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9986739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of House Dust Mite Subcutaneous Immunotherapy with a rush and cluster combination protocol in the build-up phase.","authors":"Araya Yuenyongviwat, Nutchaya Jintanapanya, Pasuree Sangsupawanich, Vanlaya Koosakulchai","doi":"10.12932/AP-260922-1465","DOIUrl":"10.12932/AP-260922-1465","url":null,"abstract":"<p><strong>Background: </strong>Conventional and cluster subcutaneous immunotherapy (SCIT) are effective but may be time-consuming. Rush SCIT may offer a more convenient treatment option to patients and be of shorter duration; however, it is also associated with a higher incidence of systemic adverse reactions. Therefore, a combination of protocols between rush and cluster SCIT could have a superior risk-benefit ratio.</p><p><strong>Objective: </strong>To determine the safety of the combination of rush and cluster HDM-SCIT and to identify the risk factors for local and systemic adverse reactions.</p><p><strong>Methods: </strong>We retrospectively reviewed the charts of patients who received HDM-SCIT, with rush and cluster combination protocols, at a tertiary care hospital between January 2009 and December 2020. Data were collected at the initial visit (demographic data; underlying allergic disease; current medication; and laboratory investigation results including skin prick test, serum specific IgE (sIgE) levels to aeroallergen, total IgE, and eosinophil count) and follow-up visits (rate and severity of local and systemic adverse reactions).</p><p><strong>Results: </strong>In total, 698 injections (28 patients) were reviewed. Overall, 13 patients developed systemic adverse reactions, at 3% (21/698) per injection visit. All reactions occurred within 60 minutes. In total, 6 patients experienced large local reactions, at 1.1% (8/698) per injection visit. A high level of sIgE to D. pteronyssinus was significantly associated with systemic adverse reactions (HR = 1.02; P = 0.009).</p><p><strong>Conclusions: </strong>HDM-SCIT with a combination of rush and cluster schedules in the build-up phase could be used as an alternative protocol, given its acceptable systemic adverse reaction rate and shortened duration.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"613-619"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9661267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative immediate hypersensitivity incidence, clinical characteristics, and outcomes after allergological evaluation: A multi-disciplinary protocol from tertiary hospital, Thailand.","authors":"Thanachit Krikeerati, Chamard Wongsa, Torpong Thongngarm, Patcharapong Rujirawan, Nutsakol Borrisut, Pattrapun Wongsripuemtet, Papapit Tuchinda, Yuttana Srinoulprasert, Chanika Subchookul, Chalisa Veerapong, Pattarapa Khunsakdeeyodom, Mongkhon Sompornrattanaphan","doi":"10.12932/AP-150922-1456","DOIUrl":"10.12932/AP-150922-1456","url":null,"abstract":"<p><strong>Background: </strong>Perioperative immediate hypersensitivity reaction (POH) is an immediate hypersensitivity reaction during an anesthesiologist monitored procedure. We report data of clinically-suspected POH (csPOH) patients undergoing an allergist-performed unified diagnostic workup algorithm for POH.</p><p><strong>Objective: </strong>To describe the characteristics of patients with csPOH, POH events, and the POH outcomes of procedures after the unified diagnostic workup algorithm for POH.</p><p><strong>Methods: </strong>A prospective cohort was conducted in adult patients with csPOH at Siriraj Hospital, a tertiary hospital, in Thailand from January 2018 to August 2022. Diagnostic workup for POH by the allergist included an initial assessment, followed by comprehensive allergological evaluation. Patients were then follow-up for POH outcomes during subsequent anesthesia procedures.</p><p><strong>Results: </strong>Of 68 patients were csPOH, only 52 patients were diagnosed with POH by allergists. The incidence was 1:4,304 anesthetic procedures for POH, and 1:11,900 anesthetic procedures for at least grade III POH. Most patients had a grade III (51.2%) or II (46.4%) reaction. The leading identified causative agents were antibiotics (36.8%), antiseptics (21%), latex (13.1%), and morphine (13.1%). Cefazolin and chlorhexidine were the most common antibiotic and antiseptic, respectively. During a median follow-up time of 2.1 years, all 14 patients completing comprehensive allergological evaluation underwent subsequent anesthesia without recurrence of POH.</p><p><strong>Conclusions: </strong>The incidence of POH at our hospital was comparable to the global incidence. Antibiotics were the most common causative agent. Complete records, collaboration among the multidisciplinary team, and comprehensive evaluation of POH allow for safe subsequent procedures.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"539-549"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10694830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent chronic spontaneous urticaria in a tropical country: Clinical characteristics and associated factors.","authors":"Pichaya Limphoka, Sukhum Jiamton, Leena Chularojanamontri, Kanokvalai Kulthanan, Papapit Tuchinda","doi":"10.12932/AP-261124-1984","DOIUrl":"10.12932/AP-261124-1984","url":null,"abstract":"<p><strong>Background: </strong>Limited data exist regarding recurrent chronic spontaneous urticaria (RCSU) following complete disease remission.</p><p><strong>Objective: </strong>This study investigated the clinical characteristics and factors associated with RCSU.</p><p><strong>Methods: </strong>We retrospectively reviewed data from chronic spontaneous urticaria (CSU) patients who actively visited the Urticaria Center of Reference and Excellence, Siriraj Hospital, between January 2021 and December 2023. Medical records were analyzed through May 2024. The RCSU was defined as a new CSU episode occurring after a 6-month symptom-free period without treatment.</p><p><strong>Results: </strong>Among 179 CSU patients, 19 (10.6%) developed RCSU. These patients had a mean age of 40 (SD 14.9) years, with a female predominance. The mean time to RCSU recurrence was 1.96 (SD 2.05) years. The UAS7 and medication scores were not significantly different between the recurrence and nonrecurrence groups (P = 0.675, P = 0.77). Multivariate analysis revealed that a shorter disease remission time from the first episode onset (< 3 years) was significantly associated with RCSU (odds ratio 5.13, 95%CI 1.83-14.29; P = 0.002).</p><p><strong>Conclusions: </strong>The RCSU rate was 10.6%. The time to disease remission from the first episode onset significantly associated with RCSU. Several clinical characteristics may corelate with the recurrence: younger age at onset, the presence of angioedema, chronic inducible urticaria comorbidity, systemic corticosteroid use, and positive antinuclear antibody status.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"513-520"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and immunological characteristics of bee venom hypersensitivity among beekeepers in Thailand.","authors":"Premmika Intapun, Dararat Dankai, Mongkol Lao-Araya","doi":"10.12932/AP-130621-1159","DOIUrl":"10.12932/AP-130621-1159","url":null,"abstract":"<p><strong>Background: </strong>Bee venom (BV) hypersensitivity can be severe and potentially life-threatening. Beekeepers heavily exposed to bee stings and are thus at a high-risk group. The data on bee sting reactions among beekeepers in Thailand is limited.</p><p><strong>Objective: </strong>To determine the prevalence, clinical and immunological characteristics, and the knowledge of BV hypersensitivity in Thai beekeepers.</p><p><strong>Methods: </strong>A self-reported questionnaire survey about BV reactions in beekeepers were conducted. Further blood test for immunological parameters: serum BV-specific IgE (BV sIgE), phospholipase A2-specific IgE (Api m1 sIgE), and BV-specific IgG4 (BV sIgG4) were compared between non-allergic beekeepers, patients with a history of bee sting anaphylaxis and the non-allergic control group.</p><p><strong>Results: </strong>A total of 202 out of 447 questionnaires (response rate 45%) were returned. The median age was 46.7 years. Systemic reactions were documented in 6.4%. Younger than 45 years was found to be a factor associated with systemic reactions (OR, 4.35; 95% CI, 1.16-16.31). The BV sIgE and Api m1 sIgE were significantly higher in the anaphylaxis group (p = 0.001). The median of BV sIgG4 was significantly higher in non-allergic beekeepers (p = 0.001). For the knowledge of BV hypersensitivity, 56.4% recognized that BV hypersensitivity could be fatal but only 6% knew about epinephrine auto-injector device.</p><p><strong>Conclusions: </strong>The prevalence of systemic reactions after stings among Thai beekeepers was not high, which might be due to the tolerance induced by natural exposure via sIgG4. The level of knowledge of BV hypersensitivity among beekeepers was insufficient, more education must be provided.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"629-635"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39575978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of patients with suspected vaccine allergies in Singapore.","authors":"Zi Teng Chai, Jia Yi Goh, Karen Jui Lin Choo, Kheng Yong Ong, Vivian Tan, Chiara Jiamin Chong, Chaw Su Naing, Haur Yueh Lee","doi":"10.12932/AP-140724-1891","DOIUrl":"10.12932/AP-140724-1891","url":null,"abstract":"<p><strong>Background: </strong>Hypersensitivity reaction to vaccines has been reported to occur in 5 per 100,000 doses. Although hypersensitivity reactions can occur to either the active vaccine component or other components such as excipients, outcome data from skin testing and provocation remains limited.</p><p><strong>Objective: </strong>To evaluate the role of skin testing and vaccine provocation in patients with an allergy label to vaccine.</p><p><strong>Methods: </strong>This is a single centre, prospective study between March 2021 and November 2021 of adults with known allergy to non-COVID vaccine. All participants underwent skin prick testing (SPT) and intradermal testing (IDT) to vaccine and excipients. A subset of patients with negative skin testing underwent graded vaccine provocation.</p><p><strong>Results: </strong>A total of 264 adults were evaluated. The most common index vaccine reactions were nonspecific rash (47.7%), angioedema (32.2%) and itch (25.0%). All patients had negative SPT to vaccines and excipients. Thirty patients (11.4%) had positive IDT to Hepatitis A, Hepatitis B, Human Papilloma Virus (HPV), Influenza, Measles-Mumps-Rubella (MMR), Pneumococcal, Rabies, Diphteria, Tetanus and Pertussis (DTaP). Out of 234 patients with negative IDT, 32 patients (12.1%) underwent vaccine provocation. Three patients (9.4%) developed reaction to influenza and MMR vaccine. One patient required systemic corticosteroids, one required antihistamine, and another patient did not require any treatment. None required admission or attendance at emergency department.</p><p><strong>Conclusions: </strong>The majority of allergy labels to vaccine are inaccurate based on low skin test positivity and low reaction rates on vaccine provocation. Vaccine provocation is safe. Excipients are unlikely to be the main cause of hypersensitivity reactions in vaccines.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"569-574"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular manifestation and generalization after ocular onset in ocular myasthenia gravis: A 5-year analysis.","authors":"Parinee Kemchoknatee, Apisama Arepagorn, Thansit Srisombut","doi":"10.12932/AP-260521-1141","DOIUrl":"10.12932/AP-260521-1141","url":null,"abstract":"<p><strong>Background: </strong>Ocular Myasthenia Gravis (OMG) is an autoimmune disease which causes ptosis, diplopia, or both. There is very limited information on the presenting symptoms, treatment trends, factors influencing generalization, and treatment outcome in Thai populations.</p><p><strong>Objective: </strong>To investigate characteristics of the presenting symptoms, associated factors for conversion to Generalized-MG (GMG), and treatment outcome in OMG patients.</p><p><strong>Methods: </strong>We analyzed data from patients diagnosed with OMG between January 2015 and December 2020 at Rajavithi Hospital, Thailand. We investigated disease generalization in time-to-event analysis and compared factors associated with disease generalization using a Cox-proportional-hazards model.</p><p><strong>Results: </strong>Of the 155 consecutive patients, 106 (68.4%) were female and their mean (SD) age was 49.3 years (15.51). There were 123 (79.35%) and 32 (20.6%) patients in the remained OMG and GMG groups respectively. Ptosis was the presenting symptom in 147 (94.8%) patients, diplopia alone was found in 8 (5.2%), and both symptoms were present in 53 (34.2%) patients. GMG patients had a higher proportion of combined ptosis and diplopia (p = 0.01), and positive AChR-Antibody test (p = 0.013). Overall, 32 (20.65%) patients converted to GMG, mostly in the first 48 months. Multivariate Cox-proportional-hazard model identified positive AChR-Ab test as a risk factor for generalization (HR, 5.32, 95% CI; 1.02-27.84).</p><p><strong>Conclusions: </strong>The conversion rate to GMG in our study was 20.65%. The presence of AChR-Ab was identified as a risk factor for generalization of the disease; therefore, patients with OMG should be advised to test for AChR-Ab for both diagnosis and prognosis purpose.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"689-695"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39575982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical practice guideline for H1 antihistamine-resistant Chronic Spontaneous Urticaria.","authors":"Qiquan Chen, Tao Cai, Lan Ge, Songmei Geng, Fei Hao, Jiang Ji, Zhehu Jin, Xiaojing Kang, Dan Ke, Jingyi Li, Dongqin Li, Jie Li, Wei Li, Hai Long, Huichun Su, Hui Tang, Huiping Wang, Ting Xiao, Zhiqiang Xie, Xu Yao, Fan Zhang, Litao Zhang, Litao Zhang, Chung Wen-Hung, Peimei Zhou, Huilan Zhu, Gang Wang, Xinghua Gao, Zhiqiang Song","doi":"10.12932/AP-110725-2118","DOIUrl":"10.12932/AP-110725-2118","url":null,"abstract":"<p><p>Chronic spontaneous urticaria (CSU), characterized by recurrent wheals and/or angioedema persisting for more than 6 weeks, represents a substantial clinical challenge. Although international guidelines endorse second-generation H1-antihistamines (sgAHs) as first-line therapy, up to 50% of patients remain refractory even at quadruple doses, significantly compromising quality of life and mental well-being. Notably, standardized guidelines for managing H1 antihistamine-resistant CSU are currently lacking. To address this gap, we aimed to develop an evidence-based clinical practice guideline for the diagnosis, assessment, and step-wise treatment of H1 antihistamine-resistant CSU. A multidisciplinary panel conducted a systematic literature review and through multiple rounds of group discussions, both offline and online, to draft recommendations. Evidence was graded using the Oxford CEBM 2011 system and recommendations assigned GRADE strengths. This guideline provides a standardized, personalized treatment algorithm for H1 antihistamine-resistant CSU, aiming to improve clinical efficacy, reduce socioeconomic burden, and direct future research toward validating novel agents such as JAK inhibitors and optimizing long-term outcomes.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":"43 3","pages":"369-381"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145436818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}