Asian Pacific journal of allergy and immunology最新文献

{"title":"Patterns of food allergen sensitization and co-sensitization in Jordan: A laboratory-based analysis.","authors":"Ahmad Al Athamneh, Anas Khaleel, Leena Ahmad, Saba Alshatali, Abdel Fawaz Bagoudou, Raneen Alkhriesat, Rama Badah","doi":"10.12932/AP-190326-2260","DOIUrl":"https://doi.org/10.12932/AP-190326-2260","url":null,"abstract":"<p><strong>Background: </strong>Food allergy is an increasing global health concern, yet laboratory-based data on food allergen sensitization in Jordan remain limited.</p><p><strong>Objective: </strong>To estimate the prevalence and burden of sensitization to common food allergens among patients undergoing serum specific IgE (sIgE) testing in Jordan, and to characterize co-sensitization patterns in routine clinical practice.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent a standardized 34-food allergen sIgE panel between 2021 and 2024. Sensitization more frequently associated with clinical symptoms was defined a priori as Class ≥ 2; analyses were repeated at Class ≥ 1 as a sensitivity analysis. Patients were categorized as non-sensitized, monosensitized, oligosensitized (2-4 allergens), or polysensitized (≥ 5). Allergen-specific prevalence was estimated with Wilson 95% confidence intervals, and co-sensitization was explored using correlation matrices and hierarchical clustering.</p><p><strong>Results: </strong>Among 405 patients (13,770 tests), 28.4% were sensitized to at least one food allergen (n = 115); most had no or a single positive result, whereas 6.7% (n = 27) were polysensitized. Shellfish (8.2%; 95%CI 5.8-11.4), cow's milk (7.4%; 5.2-10.5), and egg white (6.9%; 4.8-9.9) were most prevalent. No significant differences were observed by age or sex after adjustment for multiple comparisons. Co-sensitization analysis identified interpretable clusters, particularly among nuts/seeds, cereals, and selected animal-derived allergens. Similar patterns were observed at Class ≥ 1.</p><p><strong>Conclusions: </strong>These laboratory-based findings may support diagnostic testing, counseling, and allergy service planning in Jordan.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787727","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":"Small airway dysfunction and associated clinical characteristics in severe asthma under omalizumab and mepolizumab treatment.","authors":"Muhammet Yıldırım, Bülent Akkurt, Zeynep Peker Koç, İlker Özdemir, Seçil Kepil Özdemir, Serir Özkan","doi":"10.12932/AP-050426-2269","DOIUrl":"https://doi.org/10.12932/AP-050426-2269","url":null,"abstract":"<p><strong>Background: </strong>Small airway dysfunction (SAD) plays a critical role in the pathophysiology of asthma.</p><p><strong>Objective: </strong>This study aimed to evaluate the frequency of SAD in patients with severe asthma, and to assess its association with asthma control.</p><p><strong>Methods: </strong>A total of 84 severe asthma patients were included in the study. Patients were classified into phenotypes according to the presence of allergy, fungal sensitization, obesity, blood eosinophil counts and frequency of asthma exacerbations. Impulse oscillometry (IOS) and spirometry were performed for all patients.</p><p><strong>Results: </strong>Sixty-nine patients (83.1%) had allergic, 75 (91.5%) eosinophilic, 43 (51.2%) obese asthma, 25 (31.6%) asthma with fungal sensitization, and 24 (28.6%) were frequent-exacerbators. The detection rates of SAD by IOS and spirometry in the overall group, allergic asthma, eosinophilic asthma, obese asthma, asthma with frequent-exacerbations and asthma with fungal sensitization groups were as follows, respectively: 85.7% and 84.0%; 87.0% and 86.4%; 89.3% and 86.1%; 86.0% and 82.5%; 87.5% and 85.7%; 92.0% and 87.0%. The rate of SAD detected by IOS was significantly higher in the eosinophilic group compared with the non-eosinophilic group (89.3% vs. 57.1%, p = 0.047). SAD was detected in 92.5% of patients with controlled and 100% of those with uncontrolled asthma (p = 0.292). Area of reactance (AX) and resonant frequency (Fres ) were lower in the controlled group (p = 0.044, 0.005, respectively).</p><p><strong>Conclusions: </strong>The frequency of SAD is significantly higher in eosinophilic asthma compared with non-eosinophilic asthma, while similar across allergic, obese, fungal sensitization and frequent-exacerbator phenotypes. Higher AX and Fres values may be potentially indicative of uncontrolled asthma.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787696","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":"Drug persistence of omalizumab, cyclosporine, and hydroxychloroquine in antihistamine-refractory chronic spontaneous urticaria: A biomarker-stratified real-world study.","authors":"Heh-Shiang Sheu, Yi-Ming Chen, Jun-Peng Chen, Chao-Kuei Juan, Wen-Nan Huang, Yi-Hsing Chen, Kuo-Tung Tang","doi":"10.12932/AP-260126-2221","DOIUrl":"10.12932/AP-260126-2221","url":null,"abstract":"<p><strong>Background: </strong>Real-world comparative data on alternatives to omalizumab for antihistamine-refractory chronic spontaneous urticaria (CSU) are limited, particularly in resource-constrained Asia-Pacific settings.</p><p><strong>Objective: </strong>To compare drug survival among patients treated with omalizumab, cyclosporine, or hydroxychloroquine and evaluate associations between biomarkers and treatment persistenceใ.</p><p><strong>Methods: </strong>This retrospective single-center cohort of 409 patients (omalizumab n = 97, cyclosporine n = 85, hydroxychloroquine n = 227) analyzed drug survival using Kaplan-Meier analysis and Cox regression. Patients were stratified by total IgE and autoimmune biomarkers (antinuclear antibodies [ANA], thyroid autoantibodies).</p><p><strong>Results: </strong>Omalizumab showed significantly longer drug survival than hydroxychloroquine (hazard ratio [HR] 0.65, 95% confidence interval [CI] 0.50-0.85), while cyclosporine did not retain significance after multivariable adjustment. After stratification by potential biomarkers, omalizumab demonstrated significantly longer drug survival than hydroxychloroquine in patients with elevated total IgE (HR 0.48, 95% CI 0.32-0.72), negative ANA (HR 0.63, 95%CI 0.45-0.88), or negative IgG thyroid autoantibodies (HR 0.58, 95% CI 0.37-0.93). In patients with normal total IgE levels, no significant differences in drug survival were observed among the three treatments (p = 0.795). Hydroxychloroquine showed drug survival comparable to cyclosporine irrespective of ANA status and among patients with IgG thyroid autoantibodies.</p><p><strong>Conclusions: </strong>While omalizumab demonstrated longer overall drug survival, our findings suggest that in patients with normal total IgE or positive autoimmune biomarkers, hydroxychloroquine and cyclosporine may offer comparable drug persistence. These observations warrant prospective validation and suggest the potential value of biomarker-informed treatment approaches in resource-limited Asia-Pacific settings.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598224","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":"Reducing penicillin allergy mislabelling: A one-day structured training program improves nurses' knowledge and self-reported confidence in allergy assessment and skin testing.","authors":"Xinyu Duan, Weihong Shi, Jinxian Huang, Ligang Yang, Elaine Lee, Gabriel K C Leung, Xinyu Duan, Mudiao Chen, Xueyu He, Han Liu, Philip H Li","doi":"10.12932/AP-270226-2243","DOIUrl":"https://doi.org/10.12932/AP-270226-2243","url":null,"abstract":"<p><strong>Background: </strong>Penicillins are the most commonly prescribed antibiotics; however, penicillin allergy (PA) labels are highly prevalent and often inaccurate, leading to suboptimal antibiotic selection use. In Mainland China, PA mislabeling is exacerbated by inappropriate penicillin skin testing (PST) practices. Nurses play a crucial role in assessing and labeling suspected PA, but the lack of systematic, evidence-based training limits their ability to address mislabeling effectively.</p><p><strong>Objective: </strong>To evaluate the impact of a structured one-day PA training course targeting nurses on their knowledge and self-reported confidence in PA assessment and skin testing practices.</p><p><strong>Methods: </strong>A quasi-experimental pre- and post-test design was employed with 60 nurses in Mainland China who completed training course. Knowledge and self-reported confidence were assessed using a standardized 0-100 questionnaire (≥70=satisfactory) before training and at 1-month follow-up. Baseline results were also compared with those of nurses in Hong Kong.</p><p><strong>Results: </strong>At baseline, overall knowledge did not differ significantly between Chinese Mainland and Hong Kong nurses, but Mainland nurses scored lower on PST-related practical knowledge questions (63.5 ± 32.9% vs. 56.6 ± 23.6%; p = 0.031). Following the training, there were significant improvements in both knowledge (64.3 ± 18.8 to 86.9 ± 9.9; p < 0.001) and self-reported confidence (72.0 ± 12.6 to 81.9 ± 8.7; p < 0.001). The proportion achieving a \"satisfactory\" score increased from 45.0% to 93.3% (p < 0.001).</p><p><strong>Conclusions: </strong>A structured one-day training program significantly enhanced nurses' knowledge and confidence in PA assessment and PST. These findings support the integration of standardized, evidence-based PA training into nursing curricula, which may contribute to reducing mislabeling and promoting optimal antibiotic stewardship.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598236","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":"A multicenter study of crisaborole use in pediatric patients with atopic dermatitis in real-world setting in Thailand.","authors":"Susheera Chatproedprai, Nootchanard Rujimethapass, Patawee Na Bangxang, Siriwan Wananukul, Wanida Limpongsanurak, Wanee Wisuthsarewong, Srisupalak Singalavanija, Karaked Chantawarangul, Kantima Kanchanapoomi, Therdpong Tempark, Chonnakarn Sukneewat, Rattanavalai Nitiyarom","doi":"10.12932/AP-250326-2261","DOIUrl":"https://doi.org/10.12932/AP-250326-2261","url":null,"abstract":"<p><strong>Background: </strong>Increasing evidence supports the efficacy of crisaborole in atopic dermatitis (AD). Ethnic differences in AD endotypes may influence treatment outcomes, while data in Southeast Asian children remain limited.</p><p><strong>Objective: </strong>To evaluate the efficacy and safety of crisaborole in Thai children aged >3 months with mild-to-moderate AD in a real-world multicenter setting.</p><p><strong>Methods: </strong>This prospective observational study enrolled pediatric patients with mild-to-moderate AD were recruited from dermatology clinics at three tertiary hospitals in Bangkok between July 2023 and July 2024. Eligible patients applied crisaborole twice daily to all AD lesions. Outcomes included Investigator's Static Global Assessment (ISGA) success and improvements in pruritus and clinical signs at days 14 and 28. Disease severity was assessed using the Atopic Dermatitis Severity Index (ADSI) and Total Signs Score (TSS).</p><p><strong>Results: </strong>Ninety Thai participants (median age 5.4 years; 54.4% girls) were enrolled. The intent-to-treat population included 89 and 84 participants at days 14 and 28, respectively. ISGA success rates were 10.1% and 38.1%, while pruritus severity improved in 50.6% and 71.4% of patients at days 14 and 28, respectively. Clinical signs improvement varied by feature and significant reductions in ADSI and TSS from baseline. Treatment-related adverse events occurred in 47.2% of patients, most commonly application-site redness (32.6%), burning/stinging (19.1%), and exudation (5.6%); all were mild and transient.</p><p><strong>Conclusions: </strong>Crisaborole treatment was associated with improved clinical outcomes and was generally well tolerated. However, the observational design and lack of a control group preclude causal conclusions regarding efficacy. Controlled studies are needed to confirm these findings.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598269","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 diagnostic approach and clinical outcomes in children with suspected beta-lactam allergy.","authors":"Wang Chin Eileen Ng, Marcus Wing Choy Loe, John Zhong Heng Low, Si Hui Goh, Kok Wee Chong","doi":"10.12932/AP-250226-2241","DOIUrl":"https://doi.org/10.12932/AP-250226-2241","url":null,"abstract":"<p><strong>Background: </strong>Beta-lactams (BLs) are commonly implicated in hypersensitivity reactions among children. However, majority of self-reported BL allergies may be viral exanthems and antibiotics side effects. International guidelines have recommended de-labelling BL allergies in children with delayed mild hypersensitivity reactions via direct drug provocation tests (DPTs) without prior skin testing. However, studies on the safety of direct DPTs in Asia remain limited.</p><p><strong>Objective: </strong>Our study aims to describe the diagnostic approach and clinical outcomes in children with suspected BL allergies and evaluate the safety of direct DPTs for children with immediate and delayed mild BL hypersensitivity reactions.</p><p><strong>Methods: </strong>This is a retrospective cohort study involving 395 children who underwent 425 BL DPTs for suspected BL hypersensitivity reactions, with or without skin testing.</p><p><strong>Results: </strong>Median age of children at the time of DPT was 8.0 years, with 47.3% being males. The onset of hypersensitivity symptoms was immediate (within one hour from last BL dose) in 21.3% of children, delayed in 30.1% while the remaining had unknown onset. Of the diagnostic direct oral DPTs to index BLs, 89.3% passed and were successfully de-labelled. Majority (88.9%) of challenge reactions in diagnostic direct oral DPTs were mild cutaneous symptoms, except for three cases (8.3%) of cytokine release syndrome and one case of anaphylaxis (2.8%). A younger age at index reaction was the only statistically significant factor associated with passing diagnostic direct oral DPTs.</p><p><strong>Conclusions: </strong>Direct oral DPT is a safe method for de-labelling BL allergies in children for both immediate and delayed mild hypersensitivity reactions.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598261","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":"External validation of the PEN-FAST clinical decision rule in children with reported penicillin allergy: A pediatric cohort study.","authors":"Araya Yuenyongviwat, Kanyanee Wedchakama, Pasuree Sangsupawanich, Vanlaya Koosakulchai","doi":"10.12932/AP-210226-2237","DOIUrl":"https://doi.org/10.12932/AP-210226-2237","url":null,"abstract":"<p><strong>Background: </strong>Although penicillin allergy is frequently reported, the majority of labeled patients do not have confirmed hypersensitivity upon formal evaluation. The PEN-FAST clinical decision rule was developed to identify adults at low risk of true penicillin allergy; however, evidence supporting its performance in children remains limited.</p><p><strong>Objective: </strong>To evaluate the diagnostic performance of the PEN-FAST score in a pediatric population with reported penicillin allergy.</p><p><strong>Methods: </strong>We performed a retrospective cohort study including children younger than 18 years with a documented penicillin allergy label who underwent allergy evaluation at a tertiary referral center between January 2012 and February 2023. Children with suspected severe cutaneous adverse reactions (SCARs) or insufficient information to calculate the PEN-FAST score were excluded. Diagnostic evaluation included skin testing and/or drug provocation testing (DPT). Diagnostic performance of the PEN-FAST score was assessed by calculating sensitivity, specificity, predictive values, and the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>Among 267 children included in the analysis, 19 (7.1%) had confirmed penicillin allergy. Using the original PEN-FAST cutoff of ≥ 3, the AUC was 0.62 (95%CI, 0.51-0.73), with sensitivity of 68.4%, specificity of 55.7%, positive predictive value of 10.6%, and negative predictive value of 95.8%. Exploratory analyses using alternative PEN-FAST score representations showed only minimal differences in discrimination.</p><p><strong>Conclusions: </strong>In this pediatric cohort, the PEN-FAST score demonstrated limited accuracy in distinguishing true penicillin allergy. These findings suggest that the adult-derived decision rule may require further refinement before routine application in children.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142628","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":"Molecular insights and emerging therapies in shrimp & fish allergy: Contrasting perspectives from Asia and the West.","authors":"Agnes Sze-Yin Leung, Supaluk Tangvalelerd, Surapon Piboonpocanun, Orathai Jirapongsananuruk, Punchama Pacharn","doi":"10.12932/AP-060126-2204","DOIUrl":"https://doi.org/10.12932/AP-060126-2204","url":null,"abstract":"<p><p>Seafood allergy is a global health concern with substantial geographic variation in prevalence. This review examines molecular diagnostics and emerging therapies for shrimp and fish allergies, highlighting contrasting perspectives between Asian and Western populations in allergen sensitization profiles, clinical phenotypes, diagnostic performance, and therapeutic development. In shrimp allergy, tropomyosin (TM) is a major allergen recognized by 50-80% of patients. TM's high structural conservation underlies IgE-mediated cross-reactivity among crustaceans, insects, and mites, complicating diagnostic testing. Non-TM allergens including Arginine Kinase (AK), Myosin Light Chain (MLC), Sarcoplasmic Calcium-Binding Protein (SCBP), and Hemocyanin (Hc) contribute substantially to sensitization, particularly in Asian pediatric cohorts. In contrast, Western populations demonstrate predominant TM sensitization. In fish allergy, beta-parvalbumin is the predominant allergen, conferring extensive cross-reactivity across bony fish species. However, minor allergens such as beta-enolase, aldolase A, and collagen are clinically relevant, especially in parvalbumin-negative cases. Component-resolved diagnosis (CRD) is essential for diagnostic precision, particularly in selective fish allergies. IgE cross-reactivity with TM leads to false-positive results on skin prick tests (SPT) and specific IgE (sIgE) testing. Immunotherapy is an emerging therapeutic option. Oral Immunotherapy (OIT) for shrimp and fish has demonstrated promising results. Sublingual Immunotherapy (SLIT) offers a potentially safer alternative approach. Omalizumab may facilitate OIT in high-risk patients. Knowledge gaps remain regarding extract standardization, population-specific diagnostic algorithms and cutoffs, and the clinical relevance of emerging allergens, highlighting priorities for advancing personalized diagnosis and treatment across diverse global populations.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":"44 2","pages":"265-282"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429666","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":"Superior magnitude and durability of hybrid immunity following SARS-CoV-2 infection.","authors":"Paskorn Sritipsukho, Sira Nanthapisal, Boonchu Sirichongkolthong, Pakatip Sinlapamongkolkul, Peera Jaru-Ampornpan, Orawan Himananto, Kirana Yoohat, Jaraspim Narkpuk, Thorntun Deangphare","doi":"10.12932/AP-080126-2208","DOIUrl":"10.12932/AP-080126-2208","url":null,"abstract":"<p><strong>Background: </strong>The emergence of the SARS-CoV-2 Delta variant necessitated examining hybrid immunity (vaccination- plus-infection) to optimize boosting strategies. We analyzed the kinetics, magnitude, and durability of anti-spike receptor binding domain immunoglobulin G (Anti-sRBD IgG) following Delta infection.</p><p><strong>Objective: </strong>This study analyzed the kinetics, magnitude, and long-term durability of anti-spike receptor binding domain immunoglobulin G (Anti-sRBD IgG) levels following Delta variant infection across individuals with diverse vaccination histories.</p><p><strong>Methods: </strong>This observational cohort study monitored 161 patients with varying vaccination histories for up to 16 weeks post-infection. Responses were compared against SARS-CoV-2 naïve controls receiving a two-dose inactivated series plus a heterologous booster. Sub-analyses assessed post-infection booster immunogenicity.</p><p><strong>Results: </strong>Prior vaccination significantly enhanced humoral responses. Patients with two prior doses achieved the highest median Anti-sRBD IgG peaks, surpassing vaccine-boosted naïve controls. While unvaccinated individuals exhibited delayed primary responses, hybrid immunity demonstrated superior durability with slower antibody decay than vaccine-only immunity. Crucially, while a post-infection booster effectively primed unvaccinated patients, early boosting in previously vaccinated individuals yielded minimal immunological gain.</p><p><strong>Conclusions: </strong>Prior vaccination significantly enhanced humoral responses. Patients with two prior doses achieved the highest median Anti-sRBD IgG peaks, surpassing vaccine-boosted naïve controls. While unvaccinated individuals exhibited delayed primary responses, hybrid immunity demonstrated superior durability with slower antibody decay than vaccine-only immunity. Crucially, while a post-infection booster effectively primed unvaccinated patients, early boosting in previously vaccinated individuals yielded minimal immunological gain.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142631","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":"Hypersensitivity reactions associated with nutraceuticals and dietary supplements: A narrative review.","authors":"Witchaya Srisuwatchari, Phawit Norchai","doi":"10.12932/AP-270226-2242","DOIUrl":"https://doi.org/10.12932/AP-270226-2242","url":null,"abstract":"<p><p>The global use of nutraceuticals and dietary supplements-including vitamins, minerals, probiotics, and botanical extracts-has increased substantially, driven largely by consumer perceptions of safety and health benefits. However, their potential to cause hypersensitivity reactions (HSRs) is underrecognized. This review synthesizes published case reports, case series, systematic reviews, and pharmacovigilance data to characterize HSRs linked to these products, identify risk factors, and examine diagnostic and regulatory challenges. We classified reactions as immediate (< 1-6 h after administration), non-immediate (> 1-6 h after administration to several weeks). Immediate HSRs, including anaphylaxis, have been reported after vitamins B complex, short-chain galacto-oligosaccharides (GOS), whole-food supplements such as spirulina, natto (poly[γ-glutamic acid]) and royal jelly, and botanical/plant derived products; diagnosis commonly used skin-prick and intradermal testing and basophil activation tests. Non-immediate HSRs-ranging from maculopapular eruptions to severe cutaneous adverse reactions-have been associated with cobalamin, chromium picolinate, alpha-lipoic acid, diindolylmethane (DIM), glucosamine/chondroitin, and euglena; diagnosis often relies on patch testing, lymphocyte transformation assays, and cautious drug provocation when indicated. These products can also cause allergic contact dermatitis, and occupational sensitization (e.g., rhinitis/asthma) has been reported in workers exposed to psyllium and Aspergillus oryzae-derived lactase. Diagnostic accuracy is limited by nonstandardized reagents, variable test concentrations, complex product formulations, and cross-reactivity (notably within botanical families such as Asteraceae and among plant proteins/legumes), complicating interpretation and increasing risk for atopic individuals. Evidence remains dominated by case-based reports and passive surveillance. To reduce risk, we recommend heightened clinician awareness, development of standardized diagnostic reagents and protocols, mandatory adverse-event reporting, clearer ingredient labeling, and premarket allergenicity assessment.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":"44 2","pages":"283-296"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429676","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}