Clinical and Experimental Allergy最新文献

英文中文

Getting the Basics Right in Allergy Care 掌握过敏护理的基本知识。

IF 5.2 2区医学 Q1 ALLERGY

Clinical and Experimental Allergy

Pub Date : 2025-12-30 DOI: 10.1111/cea.70206

Robert J. Boyle, Mohamed H. Shamji

In this journal and other allergy specialty journals, we often read about important scientific breakthroughs with potential to improve the lives of people affected by allergic conditions. This month, we highlight areas where attention to ‘the basics’ is all that is needed to improve the clinical care of people with allergies.The first Editor's Choice article explores patterns of adrenaline auto-injector prescribing in England. Adrenaline auto-injectors are medical devices which aim to promptly reverse symptoms of anaphylaxis and potentially prevent fatal outcome. Their design, dosing, indications and effectiveness have all attracted debate and controversy [1, 2]. But since their licensing in 1989 they have become an allergy must-have item and a commercial success story. Although there is considerable uncertainty about dosing, it is likely that the treatment dose for larger, older children and adults should be higher than the dose for younger children. Michaelis et al. show us that in community practice, prescription of inappropriately low dose adrenaline auto-injectors is relatively common [3]. In an analysis of 2 years of prescribing data for England, the authors found over 1700 patients, mainly adults, were prescribed a low-dose (150 μg) adrenaline autoinjector. Using national resuscitation council guidance, they estimated that up to half of all 150 microgram prescriptions may have been underdosed. This adds to the known issue that in many regions there is no availability of 500 microgram adrenaline auto-injectors, meaning that ‘correct’ prescription of 300 microgram devices could also be considered to represent underdosing. Clearly further work is needed to ensure more robust prescribing guidance, but checking a patient's weight and the relevant adrenaline dose before issuing a repeat prescription seems like a relatively simple step for clinical practitioners to make (Figure 1).The second article suggesting a need to get the basics right concerns hospital-based documentation of allergy in electronic health records [4]. Qiyu et al. used freedom of information requests to ensure a high rate of response to their survey of public health system hospitals in the United Kingdom. They found widespread evidence of inadequate technological support in hospital systems for documenting known allergies in patients. A very wide variety of electronic reporting systems was used between, and even within, each hospital group. It was not uncommon to find hospitals using electronic systems which simply couldn't capture certain types of allergies—for example, over half of hospital trusts had no category for recording food allergy incidents. In their analyses, Qiyu et al. found associations between inadequate electronic reporting systems and incidents of patients being exposed to known allergens. They also carefully documented cases of harm caused by inadequate documentation at a single hospital trust, where th

在这本杂志和其他过敏专业期刊上，我们经常读到一些重要的科学突破，这些突破有可能改善过敏患者的生活。本月，我们将重点介绍一些领域，在这些领域，只要关注“基础”，就能改善对过敏患者的临床护理。第一篇编辑选择文章探讨了英格兰肾上腺素自动注射器的处方模式。肾上腺素自动注射器是一种医疗设备，旨在迅速逆转过敏反应的症状，并可能防止致命的后果。它们的设计、剂量、适应症和有效性都引起了争论和争议[1,2]。但自1989年获得许可以来，它们已成为抗过敏必备产品和商业上的成功故事。虽然剂量有相当大的不确定性，但较大、较大的儿童和成人的治疗剂量可能高于年幼儿童的剂量。Michaelis等人告诉我们，在社区实践中，处方不适当的低剂量肾上腺素自动注射器是比较常见的[0]。在对英国2年处方数据的分析中，作者发现超过1700名患者，主要是成年人，被开了低剂量（150 μg）肾上腺素自动注射器。根据国家复苏委员会的指导，他们估计，在所有150微克的处方中，可能有多达一半的处方剂量不足。这增加了一个已知的问题，即在许多地区没有500微克肾上腺素自动注射器，这意味着300微克设备的“正确”处方也可能被认为是剂量不足。显然，需要进一步的工作来确保更有力的处方指导，但在重复处方之前检查患者的体重和相关的肾上腺素剂量对临床医生来说似乎是相对简单的一步（图1）。第二篇文章建议有必要正确处理电子健康记录中基于医院的过敏记录。Qiyu等人使用信息自由要求来确保他们对英国公共卫生系统医院的调查的高回复率。他们发现，有广泛的证据表明，医院系统在记录患者已知过敏反应方面的技术支持不足。每个医院集团之间甚至内部都使用了各种各样的电子报告系统。医院使用的电子系统根本无法记录某些类型的过敏，这并不罕见——例如，超过一半的医院信托没有记录食物过敏事件的类别。在他们的分析中，Qiyu等人发现不完善的电子报告系统与暴露于已知过敏原的患者事件之间存在关联。他们还仔细记录了在一家医院信托中由于文件不足造成的伤害案例，其中每年大约有1例可预防的中度伤害案例，部分原因是由于已知过敏的文件不足。这项研究强调了建立适当的电子健康记录系统和协调各地区和国家的方法的重要性，以更好地保护过敏患者免受医疗机构无意中暴露于已知过敏原的影响（图2）。在临床实践中，我们经常被鼓励购买最新的设备，并确保我们的病人有机会获得更昂贵的诊断或治疗。在我们本月的第三篇编辑选择文章中，Noble等人评估了一种这样的诊断测试——分数呼出一氧化氮（FENO）。他们探讨了这种常用的临床测试的诊断价值，以检测两组患有哮喘的成人人群中哮喘控制的临床显著变化。该小组使用了两个表型良好的哮喘成人临床试验人群，他们接受了FENO和哮喘控制的重复测量。他们发现，FENO的变化在检测哮喘相关生活质量的临床重要变化方面具有较差的诊断性能。使用通常推荐的FENO变化截止值，敏感性和特异性分别为47%和57%。这并不意味着我们应该在临床实践中停止使用一氧化氮测量，因为有证据表明，feno指导的实践可能会减少哮喘恶化。然而，研究结果确实强调了成人哮喘患者FENO变化与生活质量之间关系的薄弱。起草手稿。M.H.S.批准了手稿。作者声明无利益冲突。

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引用次数: 0

Correction to “Pharmacological Suppression of the Kallikrein Kinin System with KVD900: An Orally Available Plasma Kallikrein Inhibitor for the On-demand Treatment of Hereditary Angioedema” 更正“KVD900对钾likrein激肽系统的药理学抑制：一种口服血浆钾likrein抑制剂用于遗传性血管性水肿的按需治疗”。

IF 5.2 2区医学 Q1 ALLERGY

Clinical and Experimental Allergy

Pub Date : 2025-12-29 DOI: 10.1111/cea.70171

Duckworth, EJ, Murugesan, N, Li, L, et al. Pharmacological Suppression of the Kallikrein Kinin System with KVD900: An Orally Available Plasma Kallikrein Inhibitor for the On-demand Treatment of Hereditary Angioedema. Clin Exp Allergy. 2022; 52: 1059–1070. https://doi.org/10.1111/cea.14122

Throughout the manuscript the units for the association constant (kon) are missing the correct unit designation 10^-X M, as indicated in the attached files.

Firstly, in the Abstract Results section, the sentence reads “The association constant (K_on) of KVD900 for PKa is >10 × 10⁶ M⁻¹ s⁻¹.” Instead, the unit of the association constant should be corrected and reported as “>10 × 10^-6 M⁻¹ s⁻¹” in that the correct value for the association constant is >10 μM^-1 sec^-1 in line with the statement that it is fast acting.

Secondly, in the Results section, the sentence reads “Analysis of the rate constants of association (K_on) for PKa revealed that the K_on for KVD900 was >10 × 10⁶ M⁻¹ s⁻¹.” which should also be corrected to “>10 × 10^-6 M⁻¹ s⁻¹” here in the body text.

Finally, in the Discussion section the association constant Kon for KVD900, lanadelumab and C1-INH are all reported without the correct 10^-X unit of measurement. The sentence reads “Interestingly, we found that the K_on of >10 × 10⁶ M⁻¹ s⁻¹ for KVD900 was among the highest in this series of inhibitors. K_on did not correlate with the IC₅₀ for isolated PKa (R² = .035; Pearson correlation = −0.188, data not shown) but did so significantly with whole plasma IC₅₀ (R² = .677; Pearson correlation = .823) (Figure 2C). The K_on of KVD900 is also faster than the reported 3.4 × 10⁶ M ⁻¹ s ⁻¹ for the PKa inhibitor DX- 2930 (lanadelumab) and orders of magnitude faster than the 1.7 × 10⁴ M⁻¹ s⁻¹ estimate for C1- INH.”.

We apologize for this error.

刘建军，刘建军，李建军，等。KVD900对钾likrein激肽系统的药理学抑制：一种口服血浆钾likrein抑制剂用于遗传性血管性水肿的按需治疗。临床经验过敏。2022；52: 1059 - 1070。https://doi.org/10.1111/cea.14122在整个手稿中，关联常数（kon）的单位缺少正确的单位名称10-X M，如所附文件所示。首先，在摘要结果部分，句子为“KVD900对PKa的关联常数（Kon）为>；10 × 106 M−1 s−1。”相反，应该将关联常数的单位更正为“>10 × 10-6 M−1 s−1”，因为关联常数的正确值是>；10 μM-1 sec-1，这与它是快速作用的说法是一致的。其次，在结果部分，“分析PKa的关联速率常数（Kon）显示KVD900的Kon为>；10 × 106 M−1 s−1”这句话应该在正文中更正为“>10 × 10-6 M−1 s−1”。最后，在讨论部分中，KVD900、lanadelumab和C1-INH的关联常数Kon都没有正确的10-X测量单位。“有趣的是，我们发现KVD900的>；10 × 106 M−1 s−1的Kon在这一系列抑制剂中是最高的。Kon与分离PKa的IC50没有相关性（R2 = 0.035； Pearson相关性= - 0.188，数据未显示），但与全血浆IC50有显著相关性（R2 = 0.677； Pearson相关性= 0.823）（图2C）。KVD900的Kon也比报道的PKa抑制剂DX- 2930 （lanadelumab）的3.4 × 106 M−1 s−1快，比C1- INH的1.7 × 104 M−1 s−1快几个数量级。我们为这个错误道歉。

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引用次数: 0

Clinical Characteristics of Cow's Milk Allergy in Hong Kong Children: Lessons From a 26-Year Single-Centre Study. 香港儿童牛奶过敏的临床特征：来自26年单中心研究的经验教训。

IF 5.2 2区医学 Q1 ALLERGY

Clinical and Experimental Allergy

Pub Date : 2025-12-23 DOI: 10.1111/cea.70202

Christy Wing Man Leung, Ting Fan Leung

引用次数: 0

Oesophageal Epithelial Cell-Intrinsic MHCII Regulates Food Antigen-Dependent Eosinophilic Esophagitis in an IFNγ-Dependent Manner 食管上皮细胞内在MHCII以ifn γ依赖的方式调节食物抗原依赖性嗜酸性食管炎。

IF 5.2 2区医学 Q1 ALLERGY

Clinical and Experimental Allergy

Pub Date : 2025-12-22 DOI: 10.1111/cea.70205

Eric M. Rodríguez-López, Rachel L. Clement, Megha Lal, Yusen Zhou, Stephen D. Carro, Charles-Antoine Assenmacher, Ravi Gautam, Jarad Beers, Amanda B. Muir, Jonathan M. Spergel, Melanie A. Ruffner, Laurence C. Eisenlohr, David A. Hill

Background

Eosinophilic oesophagitis (EoE) is a chronic food allergy that causes oesophageal inflammation and dysfunction. Recent work demonstrates IFNγ-dependent gene signatures in inflamed EoE biopsies. IFNγ has been implicated in the promotion of MHCII expression on oesophageal epithelial cells (EECs). However, the regulation of EEC-MHCII expression in vivo, and its contribution to EoE, is unknown.

Objective

The objective of this study was to determine the regulation and role of EEC-intrinsic MHCII expression in EoE.

Methods

We examined the expression of HLA II-pathway transcripts in human EECs using single cell RNA-seq datasets and primary human tissues and mouse systems to interrogate the contribution of IFNγ to EEC-MHCII expression. Finally, we used a mouse disease model to test the contribution of epithelial MHCII to food antigen-dependent EoE.

Results

HLA II transcripts were upregulated in EECs of active EoE patients, compared with controls. Similarly, EEC-MHCII expression was higher in mice with EoE-like inflammation. EEC-MHCII expression was governed by IFNγ-responsive transcriptional regulation. EEC-specific MHCII deficiency resulted in exacerbated eosinophilic inflammation in a model of food antigen-dependent EoE.

Conclusion

We find a novel immunoregulatory role for IFNγ-dependent EEC-MHCII in the context of oesophageal food allergy.

Clinical Relevance

Our results expand our understanding of oesophageal immune physiology and identify EEC-MHCII as mediating an anti-inflammatory axis that could be leveraged therapeutically.

背景：嗜酸性食管炎（EoE）是一种引起食管炎症和功能障碍的慢性食物过敏。最近的研究证实了炎症性EoE活检中ifn γ依赖性基因的特征。IFNγ参与促进食管上皮细胞（EECs）上MHCII的表达。然而，EEC-MHCII在体内表达的调控及其对EoE的贡献尚不清楚。目的：本研究的目的是确定eec内在MHCII表达在EoE中的调节作用。方法：我们使用单细胞RNA-seq数据集和原代人组织和小鼠系统检测人eec中HLA ii通路转录本的表达，以询问IFNγ对EEC-MHCII表达的贡献。最后，我们使用小鼠疾病模型来测试上皮MHCII对食物抗原依赖性EoE的贡献。结果：与对照组相比，活动性EoE患者的EECs中HLA II转录本上调。同样，EEC-MHCII在eo样炎症小鼠中表达较高。EEC-MHCII的表达受ifn - γ应答性转录调控的调控。在食物抗原依赖性EoE模型中，eec特异性MHCII缺乏导致嗜酸性粒细胞炎症加重。结论：我们发现ifn γ依赖性EEC-MHCII在食道食物过敏中具有新的免疫调节作用。临床意义：我们的研究结果扩展了我们对食管免疫生理学的理解，并确定EEC-MHCII介导了一种可用于治疗的抗炎轴。

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引用次数: 0

Early-Life Secondhand Smoke Exposure and Development of Atopic Dermatitis up to Adulthood. 早期二手烟暴露与特应性皮炎的发展直至成年。

IF 5.2 2区医学 Q1 ALLERGY

Clinical and Experimental Allergy

Pub Date : 2025-12-21 DOI: 10.1111/cea.70204

Anna Zettergren, Niklas Andersson, Anne-Sophie Merritt, Inger Kull, Petter Ljungman, Erik Melén, Göran Pershagen, Susanne Lundin, Emma K Johansson, Natalia Ballardini, Sandra Ekström, Anna Bergström

引用次数: 0

National and Regional Drug Survival of Omalizumab in Chronic Spontaneous Urticaria: A Danish Cohort Study. Omalizumab治疗慢性自发性荨麻疹的国家和地区药物生存期：丹麦队列研究

IF 5.2 2区医学 Q1 ALLERGY

Clinical and Experimental Allergy

Pub Date : 2025-12-18 DOI: 10.1111/cea.70201

Ditte Georgina Zhang, Mia-Louise Nielsen, Christian Vestergaard, Jesper Elberling, Carsten Bindslev-Jensen, Susanne Fabricius, Zarqa Ali, Jacob P Thyssen, Alexander Egeberg, Simon Francis Thomsen

引用次数: 0

Pru p 7 Sensitisation in Northern China: High Prevalence and Wide Cross-Reactivity. pru7致敏在中国北方：高流行率和广泛的交叉反应。

IF 5.2 2区医学 Q1 ALLERGY

Clinical and Experimental Allergy

Pub Date : 2025-12-12 DOI: 10.1111/cea.70194

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