Yutong Sima, Jianfeng Liu, Jinfeng Liu, Gang Zheng, Yi Yang, Xiaolin Peng, Yan Qi, Xiaowei Wang, Yu Zhao, Yanjun Wang, Penglong Zhao, Jinming Zhao, Yuan Zhang, Ming Zheng, Chengyao Liu, Xiaohong Song, Yi Dong, Xia Gong, Wei Lv, Zhenlin Wang, Xiangdong Wang, Luo Zhang
Background
Eucalyptol, limonene, and pinene enteric capsules (ELP) are typical mucoactive drugs used in chronic rhinosinusitis with nasal polyps (CRSwNP). However, reliable evidence regarding its efficacy in this population remains limited. This study aimed to evaluate the clinical efficacy and safety of ELP, particularly on nasal ciliary function and inflammatory biomarkers.
Methods
This prospective, randomized, controlled, multicenter clinical study enrolled CRSwNP patients who underwent endoscopic sinus surgery (ESS). Participants were randomly assigned at a 1:2 ratio to the intranasal corticosteroid (INCS) group or the ELP + INCS group. Clinical outcomes were assessed over 12 weeks using sinus computed tomography, nasal endoscopy, saccharin tests (STs) and the 22-item sinonasal outcome tests (SNOT-22). Local inflammation in nasal secretions were quantified via a Luminex assay, and adverse effects (AEs) was monitored throughout the study period.
Results
A total of 174 CRSwNP patients were included in the final analysis. Compared to the INCS group, the ELP + INCS group demonstrated significantly greater improvements in Lund-Mackay score (LMS) and Lund-Kennedy score (LKS) (p = 0.029 and 0.025, respectively). A higher proportion of patients in the ELP + INCS group also showed improvement in the runny nose score (weeks 8 and 12), cough score (week 4), and frustration score (week 8). Furthermore, STT was significantly shorter in the ELP + INCS group at week 4 (p = 0.015). Subgroup analysis revealed that the ELP + INCS group had significantly lower concentrations of granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-4, granulocyte colony-stimulating factor (G-CSF) and thrombopoietin (Tpo) compared to the INCS group. No significant difference was observed in the incidence of AEs between the two groups.
Conclusion
The combination of ELP and INCS represents an effective and well-tolerated treatment strategy for patients with CRSwNP following endoscopic sinus surgery.
Trial Registration
The trial was registered with the Chinese Clinical Trial Registry (www.chictr.org.cn; registration number ChiCTR2200055224)
{"title":"A Multicenter, Randomized, Controlled Clinical Trial on the Efficacy and Safety of Eucalyptol, Limonene, and Pinene Enteric Capsules in the Treatment of Chronic Rhinosinusitis With Nasal Polyps Postoperatively","authors":"Yutong Sima, Jianfeng Liu, Jinfeng Liu, Gang Zheng, Yi Yang, Xiaolin Peng, Yan Qi, Xiaowei Wang, Yu Zhao, Yanjun Wang, Penglong Zhao, Jinming Zhao, Yuan Zhang, Ming Zheng, Chengyao Liu, Xiaohong Song, Yi Dong, Xia Gong, Wei Lv, Zhenlin Wang, Xiangdong Wang, Luo Zhang","doi":"10.1002/clt2.70123","DOIUrl":"10.1002/clt2.70123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Eucalyptol, limonene, and pinene enteric capsules (ELP) are typical mucoactive drugs used in chronic rhinosinusitis with nasal polyps (CRSwNP). However, reliable evidence regarding its efficacy in this population remains limited. This study aimed to evaluate the clinical efficacy and safety of ELP, particularly on nasal ciliary function and inflammatory biomarkers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective, randomized, controlled, multicenter clinical study enrolled CRSwNP patients who underwent endoscopic sinus surgery (ESS). Participants were randomly assigned at a 1:2 ratio to the intranasal corticosteroid (INCS) group or the ELP + INCS group. Clinical outcomes were assessed over 12 weeks using sinus computed tomography, nasal endoscopy, saccharin tests (STs) and the 22-item sinonasal outcome tests (SNOT-22). Local inflammation in nasal secretions were quantified via a Luminex assay, and adverse effects (AEs) was monitored throughout the study period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 174 CRSwNP patients were included in the final analysis. Compared to the INCS group, the ELP + INCS group demonstrated significantly greater improvements in Lund-Mackay score (LMS) and Lund-Kennedy score (LKS) (<i>p</i> = 0.029 and 0.025, respectively). A higher proportion of patients in the ELP + INCS group also showed improvement in the runny nose score (weeks 8 and 12), cough score (week 4), and frustration score (week 8). Furthermore, STT was significantly shorter in the ELP + INCS group at week 4 (<i>p</i> = 0.015). Subgroup analysis revealed that the ELP + INCS group had significantly lower concentrations of granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-4, granulocyte colony-stimulating factor (G-CSF) and thrombopoietin (Tpo) compared to the INCS group. No significant difference was observed in the incidence of AEs between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The combination of ELP and INCS represents an effective and well-tolerated treatment strategy for patients with CRSwNP following endoscopic sinus surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>The trial was registered with the Chinese Clinical Trial Registry (www.chictr.org.cn; registration number ChiCTR2200055224)</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 12","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12669804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ivan Cherrez-Ojeda, Torsten Zuberbier, Gabriela Rodas-Valero, Jorge Sanchez, Michael Rudenko, Stephanie Dramburg, Pascal Demoly, Davide Caimmi, René Maximiliano Gómez, German D. Ramon, Ghada E. Fouda, Kim R. Quimby, Herberto Chong-Neto, Oscar Calderon Llosa, Jose Ignacio Larco, Olga Patricia Monge Ortega, Marco Faytong-Haro, Oliver Pfaar, Jean Bousquet, Karla Robles-Velasco
Background
Chat Generative Pre-Trained Transformer 4 (ChatGPT-4) represents an advancing large language model (LLM) with potential applications in medical education and patient care. While Allergen Immunotherapy (AIT) can change the course of allergic diseases, it can also bring uncertainty to patients, who turn to readily available resources such as ChatGPT-4 to address these doubts. This study aimed to use validated tools to evaluate the information provided by ChatGPT-4 regarding AIT in terms of quality, reliability, and readability.
Methods
In accordance with EAACI clinical guidelines about AIT, 24 questions were selected and introduced in ChatGPT-4. Independent reviewers evaluated ChatGPT-4 responses using three validated tools: the DISCERN instrument (quality), JAMA Benchmark criteria (reliability), and Flesch-Kincaid Readability Tests (readability). Descriptive statistics summarized findings across categories.
Results
ChatGPT-4 responses were generally rated as “fair quality” on DISCERN, with strengths in classification/formulations and special populations. Notably, the tool provided good-quality responses on the preventive effects of AIT in children and premedication to reduce adverse reactions. However, JAMA Benchmark scores consistently indicated “insufficient information” (median = 0–1), primarily due to absent authorship, attribution, disclosure, and currency. Readability analyses revealed a college graduate–level requirement, with most responses classified as “very difficult” to understand. Overall, ChatGPT-4 demonstrated fair quality, insufficient reliability, and difficult readability for patients.
Conclusions
ChatGPT-4 provides generally well-structured responses on AIT but lacks reliability and readability for clinical or patient-directed use. Until specialized, reference-based models are developed, healthcare professionals should supervise its use, particularly in sensitive areas such as dosing and safety.
{"title":"Evaluation of the Quality and Reliability of ChatGPT-4's Responses on Allergen Immunotherapy Using Validated Instruments for Health Information Quality Assessment","authors":"Ivan Cherrez-Ojeda, Torsten Zuberbier, Gabriela Rodas-Valero, Jorge Sanchez, Michael Rudenko, Stephanie Dramburg, Pascal Demoly, Davide Caimmi, René Maximiliano Gómez, German D. Ramon, Ghada E. Fouda, Kim R. Quimby, Herberto Chong-Neto, Oscar Calderon Llosa, Jose Ignacio Larco, Olga Patricia Monge Ortega, Marco Faytong-Haro, Oliver Pfaar, Jean Bousquet, Karla Robles-Velasco","doi":"10.1002/clt2.70130","DOIUrl":"10.1002/clt2.70130","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chat Generative Pre-Trained Transformer 4 (ChatGPT-4) represents an advancing large language model (LLM) with potential applications in medical education and patient care. While Allergen Immunotherapy (AIT) can change the course of allergic diseases, it can also bring uncertainty to patients, who turn to readily available resources such as ChatGPT-4 to address these doubts. This study aimed to use validated tools to evaluate the information provided by ChatGPT-4 regarding AIT in terms of quality, reliability, and readability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In accordance with EAACI clinical guidelines about AIT, 24 questions were selected and introduced in ChatGPT-4. Independent reviewers evaluated ChatGPT-4 responses using three validated tools: the DISCERN instrument (quality), JAMA Benchmark criteria (reliability), and Flesch-Kincaid Readability Tests (readability). Descriptive statistics summarized findings across categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ChatGPT-4 responses were generally rated as “fair quality” on DISCERN, with strengths in classification/formulations and special populations. Notably, the tool provided good-quality responses on the preventive effects of AIT in children and premedication to reduce adverse reactions. However, JAMA Benchmark scores consistently indicated “insufficient information” (median = 0–1), primarily due to absent authorship, attribution, disclosure, and currency. Readability analyses revealed a college graduate–level requirement, with most responses classified as “very difficult” to understand. Overall, ChatGPT-4 demonstrated fair quality, insufficient reliability, and difficult readability for patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ChatGPT-4 provides generally well-structured responses on AIT but lacks reliability and readability for clinical or patient-directed use. Until specialized, reference-based models are developed, healthcare professionals should supervise its use, particularly in sensitive areas such as dosing and safety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 12","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145630888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Barbara Cuomo, Maria Carmen Verga, Enza D'Auria, Michele Miraglia Del Giudice, Caterina Anania, Fabio Decimo, Giuliana Giannì, Giovanni Cosimo Indirli, Enrica Manca, Filippo Mondì, Valentina Nosratian, Erica Pendezza, Marco Ugo Andrea Sartorio, Mauro Calvani
Background
Milk ladder (ML) is considered a potential therapeutic option for managing cow’s milk allergy (CMA). Although the ML was initially developed to reintroduce cow's milk into the diet for individuals with non-IgE mediated CMA, it has also recently been used in IgE-mediated CMA.
Objective
To perform a systematic review and meta-analysis of the safety and efficacy of ML in children with IgE-mediated milk allergy.
Methods
We conducted a systematic literature review and meta-analysis of controlled studies in accordance with PRISMA guidelines. ML safety and ML efficacy compared to a strict avoidance diet and oral immunotherapy in children with IgE mediated CMA was evaluated. Meta-analysis was performed where ≥ 3 studies reported data. Methodological quality and risk of bias were systematically assessed.
Results
Six controlled studies (two randomized controlled trials and four observational controlled studies) met the inclusion criteria. ML resulted in the development of tolerance in 69% of participants (OR = 4.48; 95% CI = 2.51–8.00), with a significant improvement compared to the elimination diet. The meta-analysis of four studies showed that ML was 4.5 times more effective than a strict avoidance diet in inducing partial or total tolerance in ITT analysis and 8.4 times in PP analysis. Certainty of evidence was moderate, with low heterogeneity among studies. No significant difference in adverse events, severe systemic allergic reactions, and adrenaline use between the ML and avoidance diet groups were found. Only one study reported comparable efficacy between ML and oral immunotherapy with raw milk (OIT). No difference was found in the total number of mild to moderate adverse reactions between the groups (68.2% and 77.8, respectively; p = 0.44). The rates of epinephrine use at home were 14.3% and 11.8%, respectively, without significant difference between ML and OIT groups (p = 1).
Conclusions
ML represents a promising therapeutic approach for accelerating tolerance in children with IgE-mediated CMPA. Further research is needed to clarify milk ladder safety, as well as to identify predictive biomarkers for patient selection.
{"title":"Milk Ladder Efficacy and Safety in IgE-Mediated Cow's Milk Allergy: A Systematic Review and Meta-Analysis of Controlled Studies","authors":"Barbara Cuomo, Maria Carmen Verga, Enza D'Auria, Michele Miraglia Del Giudice, Caterina Anania, Fabio Decimo, Giuliana Giannì, Giovanni Cosimo Indirli, Enrica Manca, Filippo Mondì, Valentina Nosratian, Erica Pendezza, Marco Ugo Andrea Sartorio, Mauro Calvani","doi":"10.1002/clt2.70122","DOIUrl":"https://doi.org/10.1002/clt2.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Milk ladder (ML) is considered a potential therapeutic option for managing cow’s milk allergy (CMA). Although the ML was initially developed to reintroduce cow's milk into the diet for individuals with non-IgE mediated CMA, it has also recently been used in IgE-mediated CMA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To perform a systematic review and meta-analysis of the safety and efficacy of ML in children with IgE-mediated milk allergy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic literature review and meta-analysis of controlled studies in accordance with PRISMA guidelines. ML safety and ML efficacy compared to a strict avoidance diet and oral immunotherapy in children with IgE mediated CMA was evaluated. Meta-analysis was performed where ≥ 3 studies reported data. Methodological quality and risk of bias were systematically assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six controlled studies (two randomized controlled trials and four observational controlled studies) met the inclusion criteria. ML resulted in the development of tolerance in 69% of participants (OR = 4.48; 95% CI = 2.51–8.00), with a significant improvement compared to the elimination diet. The meta-analysis of four studies showed that ML was 4.5 times more effective than a strict avoidance diet in inducing partial or total tolerance in ITT analysis and 8.4 times in PP analysis. Certainty of evidence was moderate, with low heterogeneity among studies. No significant difference in adverse events, severe systemic allergic reactions, and adrenaline use between the ML and avoidance diet groups were found. Only one study reported comparable efficacy between ML and oral immunotherapy with raw milk (OIT). No difference was found in the total number of mild to moderate adverse reactions between the groups (68.2% and 77.8, respectively; <i>p</i> = 0.44). The rates of epinephrine use at home were 14.3% and 11.8%, respectively, without significant difference between ML and OIT groups (<i>p</i> = 1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ML represents a promising therapeutic approach for accelerating tolerance in children with IgE-mediated CMPA. Further research is needed to clarify milk ladder safety, as well as to identify predictive biomarkers for patient selection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 12","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ariane Bialas, Marie Rabe, Niklas Artz, Andreas Boldt, Jan C. Simon, Regina Treudler, Benjamin Klein
Background
Atopic diseases—including atopic dermatitis (AD), asthma (AA), and allergic rhinitis (AR)—are driven by Th2 inflammation and often occur together (atopic multimorbidity), along with non-atopic comorbidities. Chronic spontaneous urticaria (CSU) is an autoimmune mast cell-driven disease, but its relationship to classic atopic diseases remains unclear. This study investigated the association of CSU with classical atopic diseases as well as sensitization patterns and T cell activation in atopic multimorbidity.
Methods
We conducted a prospective, single-center study involving 123 participants who completed structured questionnaires regarding physician-diagnosed AD, AA, AR, and/or CSU, as well as non-atopic comorbidities and a history of type I sensitizations. AD patients (n = 22, with or without AR/AA, but not CSU) and healthy controls (n = 20) underwent additional immunophenotyping. Peripheral blood T cell subsets and T cell activation status were measured by flow cytometry and compared across groups.
Results
Individuals with atopic multimorbidity exhibited more frequent type I sensitizations, sleep disorders, and elevated serum IgE levels. CSU differed from classical atopic diseases regarding age of onset and duration and was therefore excluded from immunophenotyping. T cell subsets and activation in AD did not differ by presence of atopic multimorbidity but correlated with disease activity scores.
Conclusion
Our findings highlight the burden associated with atopic multimorbidity, demonstrated by increased serum IgE and sensitization rates in individuals with multiple atopic diseases. Importantly, T cell activation appeared to be more closely related to AD disease activity rather than the presence of classic atopic comorbidities.
{"title":"Atopic Multimorbidity in Adults With a Focus on Sensitization Patterns and T Cell Activation","authors":"Ariane Bialas, Marie Rabe, Niklas Artz, Andreas Boldt, Jan C. Simon, Regina Treudler, Benjamin Klein","doi":"10.1002/clt2.70129","DOIUrl":"https://doi.org/10.1002/clt2.70129","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atopic diseases—including atopic dermatitis (AD), asthma (AA), and allergic rhinitis (AR)—are driven by Th2 inflammation and often occur together (atopic multimorbidity), along with non-atopic comorbidities. Chronic spontaneous urticaria (CSU) is an autoimmune mast cell-driven disease, but its relationship to classic atopic diseases remains unclear. This study investigated the association of CSU with classical atopic diseases as well as sensitization patterns and T cell activation in atopic multimorbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a prospective, single-center study involving 123 participants who completed structured questionnaires regarding physician-diagnosed AD, AA, AR, and/or CSU, as well as non-atopic comorbidities and a history of type I sensitizations. AD patients (<i>n</i> = 22, with or without AR/AA, but not CSU) and healthy controls (<i>n</i> = 20) underwent additional immunophenotyping. Peripheral blood T cell subsets and T cell activation status were measured by flow cytometry and compared across groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Individuals with atopic multimorbidity exhibited more frequent type I sensitizations, sleep disorders, and elevated serum IgE levels. CSU differed from classical atopic diseases regarding age of onset and duration and was therefore excluded from immunophenotyping. T cell subsets and activation in AD did not differ by presence of atopic multimorbidity but correlated with disease activity scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings highlight the burden associated with atopic multimorbidity, demonstrated by increased serum IgE and sensitization rates in individuals with multiple atopic diseases. Importantly, T cell activation appeared to be more closely related to AD disease activity rather than the presence of classic atopic comorbidities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 12","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bronchial asthma (hereafter referred to as asthma) is a heterogeneous disease characterized by chronic airway inflammation, airway hyperresponsiveness (AHR), and reversible airflow limitation. Recent advancements in the “gut-lung” axis concept have elucidated the intricate immunometabolic crosstalk between the gastrointestinal tract and pulmonary system, offering novel insights into the pathogenesis and therapeutic strategies for asthma.
Objective
Exploring the research progress of the “gut-lung” axis in bronchial asthma, providing new insights into the pathogenesis and treatment of asthma.
Methods
This article reviewed a large number of relevant studies, elucidating the role of the “gut-lung” axis in bronchial asthma, and further discussing the potential of the microbiota in the treatment of bronchial asthma.
Conclusion
Gut microbiota and their metabolites exert profound effects on pulmonary immune homeostasis through immune modulation, metabolic signaling, and neuroendocrine pathways, which are critically implicated in asthma pathogenesis. Conversely, systemic immune dysregulation in asthma may reciprocally induce intestinal barrier dysfunction. Asthma is a variable disease here. It may be that some of this variability relates to different diets or environmental/gut exposures although this needs to be confirmed in human studies. This review comprehensively delineates the mechanistic role of the gut-lung axis in asthma, encompassing microbiota-immune system interactions, regulatory effects of microbial-derived metabolites such as short-chain fatty acids (SCFAs) and bile acids, and microbiota-targeted therapeutic approaches including probiotics, dietary interventions, and metabolite-based therapies. Furthermore, we also discuss the limitations and future development directions of current research to provide new ideas for precision treatment of asthma.
{"title":"Advances in the Gut-Lung Axis and Bronchial Asthma: From Mechanisms to Therapeutic Potential","authors":"Ting Zheng, Yi Huang, Hongmei Yao","doi":"10.1002/clt2.70128","DOIUrl":"https://doi.org/10.1002/clt2.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bronchial asthma (hereafter referred to as asthma) is a heterogeneous disease characterized by chronic airway inflammation, airway hyperresponsiveness (AHR), and reversible airflow limitation. Recent advancements in the “gut-lung” axis concept have elucidated the intricate immunometabolic crosstalk between the gastrointestinal tract and pulmonary system, offering novel insights into the pathogenesis and therapeutic strategies for asthma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Exploring the research progress of the “gut-lung” axis in bronchial asthma, providing new insights into the pathogenesis and treatment of asthma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This article reviewed a large number of relevant studies, elucidating the role of the “gut-lung” axis in bronchial asthma, and further discussing the potential of the microbiota in the treatment of bronchial asthma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Gut microbiota and their metabolites exert profound effects on pulmonary immune homeostasis through immune modulation, metabolic signaling, and neuroendocrine pathways, which are critically implicated in asthma pathogenesis. Conversely, systemic immune dysregulation in asthma may reciprocally induce intestinal barrier dysfunction. Asthma is a variable disease here. It may be that some of this variability relates to different diets or environmental/gut exposures although this needs to be confirmed in human studies. This review comprehensively delineates the mechanistic role of the gut-lung axis in asthma, encompassing microbiota-immune system interactions, regulatory effects of microbial-derived metabolites such as short-chain fatty acids (SCFAs) and bile acids, and microbiota-targeted therapeutic approaches including probiotics, dietary interventions, and metabolite-based therapies. Furthermore, we also discuss the limitations and future development directions of current research to provide new ideas for precision treatment of asthma.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 12","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Urticaria is a prevalent condition affecting a significant portion of the global population. Both dermatologists and patients require access to up-to-date and accurate information. Traditional search engines often fall short in meeting these needs. Despite the growing reliance on AI for medical inquiries, the accuracy and quality of AI-generated remain understudied. This study aims to evaluate and compare the performance of two widely used AI models, ChatGPT-4o and DeepSeek-R1, in addressing urticaria-related queries.
Methods
An e-Delphi procedure was employed to generate and refine a set of urticaria-related questions, as well as to develop an evaluation framework for AI-generated responses. ChatGPT-4o and DeepSeek-R1 were then prompted with the finalized questions, and their responses were recorded. A single-blind comparative assessment was conducted among 67 participants (29 dermatologists and 38 non-dermatologists). The responses from both AI models were assessed across simplicity, accuracy, professionalism, clinical feasibility, comprehensibility, and completeness.
Results
DeepSeek-R1 outperformed ChatGPT-4o in most metrics. Dermatologists rated DeepSeek significantly higher in simplicity (p < 0.001), accuracy (p < 0.001), completeness (p = 0.001), professionalism (p < 0.001), and clinical feasibility (p < 0.001). Non-dermatologists found DeepSeek's responses more concise (p < 0.001) and comprehensible (p < 0.001). Both models showed comparable integration of cutting-edge knowledge (p = 0.06), though DeepSeek exhibited greater output stability, as evidenced by lower standard deviations. When compared with the guidelines, the answers provided by DeepSeek-R1 contained no errors, while ChatGPT-4o made errors in three clinical questions.
Conclusion
AI-generated answers require rigorous evaluation to ensure their reliability and suitability for medical applications. Based on the current study, DeepSeek-R1 outperforms ChatGPT-4o in addressing urticaria-related queries, demonstrating higher potential for both clinical and patient use.
{"title":"Evaluating Generative AI Large Language Models for Urticaria Management: A Comparative Analysis of DeepSeek-R1 and ChatGPT-4o","authors":"Mengyao Yang, Jingchen Liang, Luyue Zhang, Hongshan Liu, Ying Chen, Yawen Wang, Chunzhi Qi, Yuxin Ma, Ziyun Gao, Xinyue Zhang, Xinwu Niu, Xiaopeng Wang, Jianwen Ren, Jingyi Yuan, Weihui Zeng, Zhao Wang","doi":"10.1002/clt2.70113","DOIUrl":"https://doi.org/10.1002/clt2.70113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Urticaria is a prevalent condition affecting a significant portion of the global population. Both dermatologists and patients require access to up-to-date and accurate information. Traditional search engines often fall short in meeting these needs. Despite the growing reliance on AI for medical inquiries, the accuracy and quality of AI-generated remain understudied. This study aims to evaluate and compare the performance of two widely used AI models, ChatGPT-4o and DeepSeek-R1, in addressing urticaria-related queries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An e-Delphi procedure was employed to generate and refine a set of urticaria-related questions, as well as to develop an evaluation framework for AI-generated responses. ChatGPT-4o and DeepSeek-R1 were then prompted with the finalized questions, and their responses were recorded. A single-blind comparative assessment was conducted among 67 participants (29 dermatologists and 38 non-dermatologists). The responses from both AI models were assessed across simplicity, accuracy, professionalism, clinical feasibility, comprehensibility, and completeness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>DeepSeek-R1 outperformed ChatGPT-4o in most metrics. Dermatologists rated DeepSeek significantly higher in simplicity (<i>p</i> < 0.001), accuracy (<i>p</i> < 0.001), completeness (<i>p</i> = 0.001), professionalism (<i>p</i> < 0.001), and clinical feasibility (<i>p</i> < 0.001). Non-dermatologists found DeepSeek's responses more concise (<i>p</i> < 0.001) and comprehensible (<i>p</i> < 0.001). Both models showed comparable integration of cutting-edge knowledge (<i>p</i> = 0.06), though DeepSeek exhibited greater output stability, as evidenced by lower standard deviations. When compared with the guidelines, the answers provided by DeepSeek-R1 contained no errors, while ChatGPT-4o made errors in three clinical questions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AI-generated answers require rigorous evaluation to ensure their reliability and suitability for medical applications. Based on the current study, DeepSeek-R1 outperforms ChatGPT-4o in addressing urticaria-related queries, demonstrating higher potential for both clinical and patient use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 11","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145619268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sharon Van Nevel, Nan Zhang, Zhaofeng Xu, Manon Blauwblomme, Elke Vandewalle, Gabriele Holtappels, Natalie De Ruyck, Filip Van Nieuwerburgh, Stijn Vanhee, Philippe Gevaert, Claus Bachert
Background
Chronic rhinosinusitis with nasal polyps (CRSwNP) is generally characterized by tissue-infiltrating eosinophils. Various biologic treatments, targeting the inflammation, have demonstrated efficacy in reducing nasal polyp size and symptoms. However, their specific impact on granulocyte populations within polyps remains largely unclear. This study explores how different biological treatments modulate local nasal polyp inflammation by assessing changes in granulocyte presence and recruitment before and after treatment.
Methods
Type 2-high CRSwNP patients received treatment with mepolizumab, benralizumab, omalizumab, or dupilumab. Immunohistochemistry and protein measurements were performed on their nasal polyp tissue. Bulk RNA-sequencing was conducted on pre- and post-treatment nasal samples, identifying differentially expressed genes. These results were integrated with single-cell data from CRSwNP patients.
Results
Nasal polyp tissue from type 2-high patients exhibited substantial eosinophil infiltration and limited neutrophils present. All tested biologics reduced eosinophil-related proteins and genes in nasal tissue. However, our data suggest that benralizumab, mepolizumab and omalizumab could induce a concurrent upregulation of neutrophilic markers. In these patients, chemoattractant genes for neutrophils primarily originated from the epithelial cell cluster, whereas receptors for these biologics were expressed by plasma cells, dendritic cells, and mast cells.
Conclusion
Biological treatments effectively reduced eosinophilic inflammation in nasal polyps. However, most biologics could induce an eosinophil-to-neutrophil shift, indicating that solely targeting eosinophils may be insufficient as a treatment approach. Understanding these secondary effects on local immune pathways is critical for optimizing CRSwNP treatment strategies.
{"title":"Distinct Effects of Biological Treatments on Eosinophils and Neutrophils in Chronic Rhinosinusitis With Nasal Polyp Patients","authors":"Sharon Van Nevel, Nan Zhang, Zhaofeng Xu, Manon Blauwblomme, Elke Vandewalle, Gabriele Holtappels, Natalie De Ruyck, Filip Van Nieuwerburgh, Stijn Vanhee, Philippe Gevaert, Claus Bachert","doi":"10.1002/clt2.70117","DOIUrl":"https://doi.org/10.1002/clt2.70117","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is generally characterized by tissue-infiltrating eosinophils. Various biologic treatments, targeting the inflammation, have demonstrated efficacy in reducing nasal polyp size and symptoms. However, their specific impact on granulocyte populations within polyps remains largely unclear. This study explores how different biological treatments modulate local nasal polyp inflammation by assessing changes in granulocyte presence and recruitment before and after treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Type 2-high CRSwNP patients received treatment with mepolizumab, benralizumab, omalizumab, or dupilumab. Immunohistochemistry and protein measurements were performed on their nasal polyp tissue. Bulk RNA-sequencing was conducted on pre- and post-treatment nasal samples, identifying differentially expressed genes. These results were integrated with single-cell data from CRSwNP patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nasal polyp tissue from type 2-high patients exhibited substantial eosinophil infiltration and limited neutrophils present. All tested biologics reduced eosinophil-related proteins and genes in nasal tissue. However, our data suggest that benralizumab, mepolizumab and omalizumab could induce a concurrent upregulation of neutrophilic markers. In these patients, chemoattractant genes for neutrophils primarily originated from the epithelial cell cluster, whereas receptors for these biologics were expressed by plasma cells, dendritic cells, and mast cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Biological treatments effectively reduced eosinophilic inflammation in nasal polyps. However, most biologics could induce an eosinophil-to-neutrophil shift, indicating that solely targeting eosinophils may be insufficient as a treatment approach. Understanding these secondary effects on local immune pathways is critical for optimizing CRSwNP treatment strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 12","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yu Zhang, Yu Song, Xu Zhang, Jingyun Li, Zengxiao Zhang, Lin Xi, Luo Zhang, Yuan Zhang
Background
Nasal allergen challenge (NAC) is currently the only available test to confirm nasal responsiveness to allergens and is a core diagnostic tool for allergic rhinitis. NAC is currently diagnosed by combining existing subjective measures and objective assessment methods in pairs to assess outcomes, based on a strong positive result for a single item or a moderately positive result for a combination of two items. However, there are few data on the diagnostic outcomes and characteristics of its various diagnostic combinations.
Objective
To evaluate the differences and characteristics of various existing diagnostic methods (combinations of subjective and objective indicators) for NAC.
Method
During January 2023–December 2024, patients with history of chronic rhinitis (CR) who experienced nasal symptoms upon exposure to dust, as well as healthy controls, were enrolled. Demographic and clinical data were collected, followed by a NAC with Dermatophagoides farinae (Df). Total nasal symptom score (TNSS), visual analog scales (VAS), acoustic rhinometry (AcRh), Active anterior rhinomanometry (AAR) and 4-phase-rhinomanometry (4PR) were used for assessment before and after NAC. The diagnostic results, minimum NAC concentration at positive trigger, and type of positive response (subjective or objective) were recorded.
Result
A total of 180 patients and 133 healthy controls were enrolled in the study. Significant differences in positive rates were observed across the six diagnostic evaluation combinations (p = 0.001). The combination of subjective TNSS evaluation with objective AAR assessment demonstrated the highest positive rate among patients (55.6%), whereas the combination of subjective VAS evaluation with objective AcRh assessment yielded the lowest positive rate (31.7%). Furthermore, when diagnostic combinations triggered positive results, they favored strong objective positivity.
Conclusion
The diagnostic results derived from pairwise combinations of various subjective measurements and objective assessments exhibit variability, with objective assessments demonstrating a higher propensity to yield positive results compared to subjective measurements.
{"title":"Variability of Diagnostic Outcomes in Nasal Allergen Challenge: The Role of Combined Subjective and Objective Indicators","authors":"Yu Zhang, Yu Song, Xu Zhang, Jingyun Li, Zengxiao Zhang, Lin Xi, Luo Zhang, Yuan Zhang","doi":"10.1002/clt2.70124","DOIUrl":"10.1002/clt2.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nasal allergen challenge (NAC) is currently the only available test to confirm nasal responsiveness to allergens and is a core diagnostic tool for allergic rhinitis. NAC is currently diagnosed by combining existing subjective measures and objective assessment methods in pairs to assess outcomes, based on a strong positive result for a single item or a moderately positive result for a combination of two items. However, there are few data on the diagnostic outcomes and characteristics of its various diagnostic combinations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the differences and characteristics of various existing diagnostic methods (combinations of subjective and objective indicators) for NAC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>During January 2023–December 2024, patients with history of chronic rhinitis (CR) who experienced nasal symptoms upon exposure to dust, as well as healthy controls, were enrolled. Demographic and clinical data were collected, followed by a NAC with <i>Dermatophagoides farinae</i> (Df). Total nasal symptom score (TNSS), visual analog scales (VAS), acoustic rhinometry (AcRh), Active anterior rhinomanometry (AAR) and 4-phase-rhinomanometry (4PR) were used for assessment before and after NAC. The diagnostic results, minimum NAC concentration at positive trigger, and type of positive response (subjective or objective) were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>A total of 180 patients and 133 healthy controls were enrolled in the study. Significant differences in positive rates were observed across the six diagnostic evaluation combinations (<i>p</i> = 0.001). The combination of subjective TNSS evaluation with objective AAR assessment demonstrated the highest positive rate among patients (55.6%), whereas the combination of subjective VAS evaluation with objective AcRh assessment yielded the lowest positive rate (31.7%). Furthermore, when diagnostic combinations triggered positive results, they favored strong objective positivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The diagnostic results derived from pairwise combinations of various subjective measurements and objective assessments exhibit variability, with objective assessments demonstrating a higher propensity to yield positive results compared to subjective measurements.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 11","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12628074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yan Zhao, Litao Zhang, Liming Wu, Bin Yang, Jinyan Wang, Yumei Li, Qingchun Diao, Jingyi Li, Qing Sun, Xiaohong Zhu, Xiaoyong Man, Lihua Wang, Yanyan Feng, Tao Cai, Huiming Zeng, Linfeng Li, Jianyun Lu, Hong Ren, Fuqiu Li, Qianjin Lu, Xiaohua Tao, Rong Xiao, Chao Ji, Wenjie Zhao, Wei Chu, Bo Chen, Jianzhong Zhang
<div> <section> <h3> Background</h3> <p>Atopic dermatitis (AD) often coexists with other type 2 inflammatory diseases. Stapokibart, a humanized IgG4 monoclonal antibody targeting interleukin-4 receptor alpha subunit, showed high efficacy and favorable safety in a phase 3 trial. This post-hoc analysis aimed to compare the efficacy and safety of stapokibart in AD patients with and without type 2 comorbidities.</p> </section> <section> <h3> Methods</h3> <p>During 16-week double-blind period, participants were randomly assigned to stapokibart 600 (loading dose)-300 mg (<i>n</i> = 251) or placebo (<i>n</i> = 249) treatment every other week (Q2W). All patients received stapokibart 300 mg Q2W during subsequent 36-week maintenance period. Patients with ≥ 1 of the following conditions were classified into comorbid subgroup: allergic rhinitis, asthma, food allergies, chronic urticaria, or chronic obstructive pulmonary disease. Post-hoc outcomes included response rates of ≥ 75%/90% improvement in Eczema Area and Severity Index score (EASI-75/90), Investigator's Global Assessment score of 0 or 1 (IGA 0/1) with ≥ 2-point reduction, and ≥ 4-point reduction in weekly average of daily peak pruritus numerical rating scale score (PP-NRS4), and the percentage change from baseline in weekly average of daily PP-NRS score. Treatment-emergent adverse events (TEAEs) were also analyzed by subgroups.</p> </section> <section> <h3> Results</h3> <p>Ninety-two patients (36.7%) in stapokibart group and 102 (41.0%) in placebo group had type 2 comorbidities. The demographic characteristics and baseline disease scores were generally comparable across four groups. At week 16, stapokibart demonstrated superior efficacy over placebo in patients with and without type 2 comorbidities. In patients with comorbidities, the response rates of EASI-75, IGA 0/1, and PP-NRS4 in stapokibart and placebo groups were 77.2% versus 26.5%, 55.4% versus 17.6%, and 43.5% versus 12.7%, respectively. In patients without comorbidities, these response rates were 61.0% versus 25.3%, 37.7% versus 15.1%, and 31.4% versus 11.0%, respectively (all <i>p</i> values < 0.0001). All patients showed further improvements in efficacy outcomes during weeks 20–52. TEAEs occurred in 88.8% and 87.7% of comorbid and non-comorbid patients over weeks 0–52. The incidence of conjunctivitis was 5.9% and 5.0%, respectively.</p> </section> <section> <h3> Conclusion</h3> <p>Stapokibart was effective and safe in adults with moderate-to-severe AD both with and without type 2 comorbidities in both short-term and long-term treatment.
{"title":"Efficacy and Safety of Stapokibart in Adults With Moderate-to-Severe Atopic Dermatitis With and Without Type 2 Comorbidities: A Post Hoc Analysis of a Phase 3 Trial","authors":"Yan Zhao, Litao Zhang, Liming Wu, Bin Yang, Jinyan Wang, Yumei Li, Qingchun Diao, Jingyi Li, Qing Sun, Xiaohong Zhu, Xiaoyong Man, Lihua Wang, Yanyan Feng, Tao Cai, Huiming Zeng, Linfeng Li, Jianyun Lu, Hong Ren, Fuqiu Li, Qianjin Lu, Xiaohua Tao, Rong Xiao, Chao Ji, Wenjie Zhao, Wei Chu, Bo Chen, Jianzhong Zhang","doi":"10.1002/clt2.70121","DOIUrl":"10.1002/clt2.70121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atopic dermatitis (AD) often coexists with other type 2 inflammatory diseases. Stapokibart, a humanized IgG4 monoclonal antibody targeting interleukin-4 receptor alpha subunit, showed high efficacy and favorable safety in a phase 3 trial. This post-hoc analysis aimed to compare the efficacy and safety of stapokibart in AD patients with and without type 2 comorbidities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>During 16-week double-blind period, participants were randomly assigned to stapokibart 600 (loading dose)-300 mg (<i>n</i> = 251) or placebo (<i>n</i> = 249) treatment every other week (Q2W). All patients received stapokibart 300 mg Q2W during subsequent 36-week maintenance period. Patients with ≥ 1 of the following conditions were classified into comorbid subgroup: allergic rhinitis, asthma, food allergies, chronic urticaria, or chronic obstructive pulmonary disease. Post-hoc outcomes included response rates of ≥ 75%/90% improvement in Eczema Area and Severity Index score (EASI-75/90), Investigator's Global Assessment score of 0 or 1 (IGA 0/1) with ≥ 2-point reduction, and ≥ 4-point reduction in weekly average of daily peak pruritus numerical rating scale score (PP-NRS4), and the percentage change from baseline in weekly average of daily PP-NRS score. Treatment-emergent adverse events (TEAEs) were also analyzed by subgroups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-two patients (36.7%) in stapokibart group and 102 (41.0%) in placebo group had type 2 comorbidities. The demographic characteristics and baseline disease scores were generally comparable across four groups. At week 16, stapokibart demonstrated superior efficacy over placebo in patients with and without type 2 comorbidities. In patients with comorbidities, the response rates of EASI-75, IGA 0/1, and PP-NRS4 in stapokibart and placebo groups were 77.2% versus 26.5%, 55.4% versus 17.6%, and 43.5% versus 12.7%, respectively. In patients without comorbidities, these response rates were 61.0% versus 25.3%, 37.7% versus 15.1%, and 31.4% versus 11.0%, respectively (all <i>p</i> values < 0.0001). All patients showed further improvements in efficacy outcomes during weeks 20–52. TEAEs occurred in 88.8% and 87.7% of comorbid and non-comorbid patients over weeks 0–52. The incidence of conjunctivitis was 5.9% and 5.0%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Stapokibart was effective and safe in adults with moderate-to-severe AD both with and without type 2 comorbidities in both short-term and long-term treatment.","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 11","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12628279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145548547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Skin is the largest organ of the human body, and acts as a fundamental barrier. Beyond its protective role, it serves as a key immune organ, mediating immune surveillance and regulation. Exposure to environmental factors such as mechanical trauma, detergents, air pollution, and microbial dysbiosis can compromise the skin barrier triggering the release of pro-inflammatory cytokines that contribute to the pathogenesis of allergic diseases including atopic dermatitis (AD). Nutrition profoundly impacts skin health, influencing cell proliferation, tissue repair, and immune functions.
Methods
This review aims to explore the relationship between diet and skin barrier function, with a specific focus on AD.
Results
The evidence on micro- and macronutrients, probiotics, and various dietary patterns, highlighting their potential to enhance or impair skin barrier integrity, provides a comprehensive exploration of how diet may serve as a modifiable factor in supporting skin health and preventing allergic diseases. This review also outlines directions for improving future research.
Conclusion
Diet is an important modifiable factor in preserving skin barrier integrity and may contribute to the prevention and management of AD. However, inconsistent evidence precludes definitive dietary recommendations, highlighting the need for further research.
{"title":"Feeding the Skin Barrier: The Impact of Macro- and Micronutrients on Skin Barrier Function","authors":"Klaudia Ryczaj, Burcin Beken, Cezmi Akdis","doi":"10.1002/clt2.70105","DOIUrl":"10.1002/clt2.70105","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Skin is the largest organ of the human body, and acts as a fundamental barrier. Beyond its protective role, it serves as a key immune organ, mediating immune surveillance and regulation. Exposure to environmental factors such as mechanical trauma, detergents, air pollution, and microbial dysbiosis can compromise the skin barrier triggering the release of pro-inflammatory cytokines that contribute to the pathogenesis of allergic diseases including atopic dermatitis (AD). Nutrition profoundly impacts skin health, influencing cell proliferation, tissue repair, and immune functions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review aims to explore the relationship between diet and skin barrier function, with a specific focus on AD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The evidence on micro- and macronutrients, probiotics, and various dietary patterns, highlighting their potential to enhance or impair skin barrier integrity, provides a comprehensive exploration of how diet may serve as a modifiable factor in supporting skin health and preventing allergic diseases. This review also outlines directions for improving future research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Diet is an important modifiable factor in preserving skin barrier integrity and may contribute to the prevention and management of AD. However, inconsistent evidence precludes definitive dietary recommendations, highlighting the need for further research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 11","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12626168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145548539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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