Clinical and Translational Allergy最新文献

{"title":"Higher prevalence of dupilumab-induced ocular adverse events in atopic dermatitis compared to asthma: A daily practice analysis","authors":"Anne R. Schlösser,&nbsp;Lotte Bult,&nbsp;John C. Thelen,&nbsp;Alberta A. H. J. Thiadens,&nbsp;Renske Schappin,&nbsp;Tamar E. C. Nijsten,&nbsp;Johannes C. C. M. in 't Veen,&nbsp;Gerrit J. Braunstahl,&nbsp;DirkJan Hijnen","doi":"10.1002/clt2.12386","DOIUrl":"https://doi.org/10.1002/clt2.12386","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dupilumab has been shown to be an effective treatment in moderate-to-severe atopic dermatitis (AD) and severe asthma (SA). However, comparative real-world analyses of adverse events (AE), particularly dupilumab-associated ocular surface disease (DAOSD), are lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This is the first real-world study to provide insight into the prevalence of AEs associated with dupilumab in AD compared with SA. Secondary objectives were to assess the prevalence, onset and therapeutic strategies of DAOSD and evaluate dupilumab discontinuation rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from two daily practice registries including AD and SA patients receiving dupilumab treatment were analyzed. Adverse events, including DAOSD, were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 322 AD and 148 SA patients were included. Headaches (23.6%), injection site reactions (10.1%), and influenza-like symptoms (13.5%) were more prevalent in SA patients. Interestingly, ocular AEs were significantly more prevalent in AD patients (62.1%, <i>p</i> &lt; 0.001), including conjunctivitis (17.1%, <i>p</i> = 0.004). 88% AD and 47% SA patients with ocular AEs received one or more ophthalmic treatment(s). Additionally, 20% of AD and 17.6% of SA patients discontinued dupilumab treatment due to ocular AEs, while only 65% of these AD and none of these SA patients were referred to an ophthalmologist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The higher incidence of DAOSD in AD patients compared with SA patients in this real-world study highlights the importance of physician awareness, especially when prescribing dupilumab to AD patients. Conversely, the findings of this study help alleviate potential concerns about ocular AEs in patients with SA who do not have comorbid AD. Furthermore, the effective management of most ocular AEs with ophthalmic treatments suggests favorable tolerability of dupilumab in daily practice, and multidisciplinary collaboration is essential to proactively manage ocular AEs before discontinuing dupilumab.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 8","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12386","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141994174","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}

{"title":"Level of education, but not occupation, is differentially associated with asthma phenotypes in adults","authors":"Muwada Bashir Awad Bashir,&nbsp;Rani Basna,&nbsp;Göran Wennergren,&nbsp;Madeleine Rådinger,&nbsp;Helena Backman,&nbsp;Emma Goksör,&nbsp;Jan Lötvall,&nbsp;Linda Ekerljung,&nbsp;Hannu Kankaanranta,&nbsp;Bright I. Nwaru","doi":"10.1002/clt2.12389","DOIUrl":"10.1002/clt2.12389","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Education, but not occupation, was differentially associated with adult asthma phenotypes in the general population. Further research into socioeconomic status variation in various asthma phenotypes is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 8","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12389","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975237","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}

{"title":"Can cashew nut allergy resolve spontaneously?","authors":"Tamazoust Guiddir,&nbsp;Audrey Siberil,&nbsp;Françoise Lepape,&nbsp;Marion Hacker,&nbsp;Ariane Nemni","doi":"10.1002/clt2.12385","DOIUrl":"10.1002/clt2.12385","url":null,"abstract":"&lt;p&gt;To the Editor&lt;/p&gt;&lt;p&gt;Cashew nut allergy (CNA) is increasing worldwide and is responsible for severe anaphylaxis, particularly in young children.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Symptoms range from mild reactions to severe anaphylaxis. The three main allergens are storage proteins: Ana o 1, Ana o 2 (cupin superfamily) and Ana o 3 (prolamin superfamily).&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Lifetime avoidance of cashew nut is currently recommended for those with CNA. However, little is known about the natural history of CNA.&lt;/p&gt;&lt;p&gt;We report a cohort of five children with severe anaphylaxis to cashew nut who recovered and were able to eat cashew nut after a successful oral food challenge (Table 1). They all presented severe anaphylaxis according to the ordinal food allergy severity score (oFAAS-5)&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; (grade 3 to grade 5) at diagnosis at a mean age of 3 years [1.5–4]. Two patients had no atopy, one had a personal and familial atopic history and two others had only personal atopy. They all had no allergies or sensitizations to peanuts or tree nuts. Three patients consumed native cashew (between one and three cashew units) during the first reaction and two patients consumed cashew in cooked meals (unknown quantity). Allergology explorations were performed a mean 1.1 years [0.15–5] after the first reaction. All patients were sensitized to pistachio, but only two had a confirmed food allergy to pistachio. Skin prick tests (SPTs) were performed with commercial extract (ALK-Abello) and were deemed positive when wheal size was ≥ 3 mm. Cashew SPTs were positive for four children (mean 6 mm, range [3–20]). Cashew-specific IgEs (ImmunoCap® by Phadia 1000 System, Thermo Fisher Scientific) were positive for all patients, with a mean of 1 KU/L [0.36–2.49]. The recombinant Ana o 3 was not tested for at diagnosis for three patients and was positive for two of them (0.63 and 1.97 KU/L). After the reaction, they all observed strict avoidance of cashew and pistachio in their diet, without any recurrence. During a mean follow-up of 2.4 years (range [1–4]), the SPT and the cashew-specific IgEs became negative (Figure 1) and all patients tested negative for recombinant Ana o 3. An oral food challenge in four patients was successful at a cashew nut cumulated dose of 7800 mg. One patient refused the challenge, but after a successful pistachio challenge, he ate one cashew unit at home without any reaction.&lt;/p&gt;&lt;p&gt;We reported the cases of five children who presented severe anaphylaxis to cashew nut and who spontaneously recovered after a mean follow-up of 2.4 years [1–4]. As for peanut, ingestion of cashew is associated with a high rate of severe anaphylactic reactions,&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; but in our cohort it seemed not to be correlated with persistence of the allergy. Oral immunotherapy (OIT) may help develop tolerance to cashew, as reported by Elizur et al.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; in a cohort of 50 children aged &gt;4 years, who presented severe clinical reactio","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 8","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12385","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975174","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}

{"title":"Milk ladder versus early oral immunotherapy in infants with cow's milk protein allergy","authors":"Yurika Matsumoto,&nbsp;Mayumi Fujita,&nbsp;Tsukahara Ayumi,&nbsp;Tetsuya Takamasu,&nbsp;Chisato Inuo","doi":"10.1002/clt2.12388","DOIUrl":"10.1002/clt2.12388","url":null,"abstract":"&lt;p&gt;Cow's milk protein allergy (CMPA) significantly decreases the quality of life of infants and their families, necessitating effective management. Avoidance of cow's milk protein (CMP) has been the primary approach, awaiting the development of a natural tolerance.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Oral immunotherapy (OIT) for CMPA gradually increases the use of pure CMP, such as milk, to enhance tolerance. A previous study demonstrated the efficacy and safety of early OIT (E-OIT) for infants with CMPA.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The Milk Ladder (ML) method modifies the OIT strategy and enhances CMP tolerance through stepwise exposure to milk-containing foods.&lt;span&gt;&lt;sup&gt;1, 3-5&lt;/sup&gt;&lt;/span&gt; Despite growing adoption, ML lacks extensive validation and requires further research.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; To the best of our knowledge, there have been no comparative studies of E-OIT and ML in infants with CMPA. This study aimed to compare the efficacy and safety of ML and E-OIT in infants with CMPA.&lt;/p&gt;&lt;p&gt;We retrospectively analyzed infants younger than 2 years who started intervention for CMPA at the Department of Allergy at Kanagawa Children's Medical Center from April 2016 to March 2022, with a treatment protocol shift in April 2018 from E-OIT to ML. Inclusion criteria included a CMPA diagnosis based on parent-reported immediate allergic reaction to CMP ingestion or a serum milk-specific IgE level greater than 5 kU&lt;sub&gt;A&lt;/sub&gt;/L.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Patients with only gastrointestinal symptoms were excluded due to different CMPA types. The ML protocol started with baked milk (BM), advancing toward less processed forms, while E-OIT began with controlled doses of milk or yogurt. For detailed protocols, see the Supplementary materials in Supporting Information S1.&lt;/p&gt;&lt;p&gt;CMP tolerance was defined as the ability to consume 100 mL of milk or an equivalent amount of approximately 3300 mg of CMP daily without experiencing symptoms. Low dairy tolerance for processed foods was defined as the ability to consume processed foods. Products high in dairy ingredients, such as cheese, yogurt, and pizza were excluded. These were confirmed through repeated intake at home. All patients underwent treatment review and assessment through interviews approximately every 3 months to assess progress and adjust care, as necessary.&lt;/p&gt;&lt;p&gt;This study conformed to the guidelines established by the Declaration of Helsinki and was approved by the Kanagawa Children's Medical Center Research Ethics Committee (approval no. 2105-4). Informed consent was obtained from the parents of all patients.&lt;/p&gt;&lt;p&gt;The analyses were performed according to the intention-to-treat principle (ITT) 2 years post intervention. The Mann–Whitney &lt;i&gt;U&lt;/i&gt; test was used to compare continuous variables, while the Chi-squared test or Fisher's exact test was used for categorical variables. To evaluate the progression of CMP tolerance over time, Kaplan–Meier analysis with a log-rank test was performed. Statistical s","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 8","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11309850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906086","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}

{"title":"Clinical and biological characteristics associated with bronchial or pulmonary abnormalities on chest CT imaging in patients with systemic mastocytosis","authors":"Raphael Vallière,&nbsp;Cristina Bulai Livideanu,&nbsp;Thomas Villeneuve,&nbsp;Grégoire Prévot,&nbsp;Laurent L. Reber,&nbsp;Laurent Guilleminault","doi":"10.1002/clt2.12387","DOIUrl":"10.1002/clt2.12387","url":null,"abstract":"&lt;p&gt;To the Editor,&lt;/p&gt;&lt;p&gt;Mastocytosis is a heterogeneous group of diseases characterized by a numerical increase and accumulation of clonal mast cells in various organ systems. In systemic mastocytosis, the severity varies from indolent to aggressive mastocytosis, the latter being associated with a worse prognosis.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Although the lungs are known to be rich in mast cells, comorbid respiratory diseases have only been sporadically suggested as associated with SM in case reports.&lt;span&gt;&lt;sup&gt;2-4&lt;/sup&gt;&lt;/span&gt; To our knowledge, no data are available on chest CT scans in patients with SM.&lt;/p&gt;&lt;p&gt;The aim of our study is to determine clinical and biological characteristics associated with bronchial or pulmonary abnormalities on chest CT scans in patients with SM.&lt;/p&gt;&lt;p&gt;A retrospective observational study was carried out at Toulouse University Hospital Center from 2003 to 2022 using our mastocytosis registry. All patients with (1) a diagnosis of SM based on bone marrow biopsy according to criteria published elsewhere&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; and (2) a CT scan image available in their medical record were included. This study was conducted in accordance with French ethics requirements (RC31/17/0095) and the guidelines of the National Commission for Data Protection and Liberties (CNIL number: 2206723 v 0).&lt;/p&gt;&lt;p&gt;Chest CT scans were evaluated by two physicians blinded to the patients' clinical and functional details. The two observers easily established a consensus about the predominant chest CT scan pattern according to the definitions of the Fleischner Society.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Continuous data were expressed as median and interquartile range and categorical data as number of patients and percentages. An increased risk of a predominant pattern on chest CT scan was assessed for aggressive versus indolent SM and serum tryptase ≥20 μg/L versus &lt;20 μg/L. For this analysis, we used a multivariable logistic regression with a calculation of adjusted odds ratios (aORs) with a 95% confidence interval. aORs were adjusted on the following covariates: age, sex and smoking status. We were not able to determine aOR if the CT scan abnormality was absent in the control group.&lt;/p&gt;&lt;p&gt;A total of 103 patients with SM were included in the study (Table 1). Of them, 60.2% were females and the median age was 54 [40–60]. Mastocytosis was indolent in 70 (73%) patients, cKit mutation was found in 91 (85%) patients and median serum tryptase was 15 [30–51] µg/l. A predominant chest CT scan pattern was observed in 36 (35.0%) patients. The lung lesions were as follows: nodules (&lt;i&gt;n&lt;/i&gt; = 11), emphysema (&lt;i&gt;n&lt;/i&gt; = 9), bronchiectasis (&lt;i&gt;n&lt;/i&gt; = 6), bronchial wall thickening (&lt;i&gt;n&lt;/i&gt; = 6) and interstitial lung diseases (&lt;i&gt;n&lt;/i&gt; = 4).&lt;/p&gt;&lt;p&gt;According to the multivariable analysis, an increased risk of emphysema was observed for aggressive mastocytosis compared to indolent mastocytosis (aOR 5.0 [95% CI: 1.1–27.6]) (Figure 1). An increased risk of bronchi","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 8","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11303256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896927","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}

{"title":"Being born in autumn or winter is associated with asthma and allergic rhinitis in Finland","authors":"Riikka Hänninen,&nbsp;Aada Murtomäki,&nbsp;Fanni Svärd,&nbsp;Aarno Dietz,&nbsp;Paulus Torkki,&nbsp;Jari Haukka,&nbsp;Mikko Nuutinen,&nbsp;Sanna Toppila-Salmi","doi":"10.1002/clt2.12383","DOIUrl":"10.1002/clt2.12383","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Our population-based study has previously shown that being born in winter or spring was associated with adult-onset asthma. The aim was to study if season of birth (SOB) is associated with airway allergy and related diseases: NSAID exacerbated respiratory disease (N-ERD), asthma, allergic rhinitis (AR), nonallergic rhinitis (NAR), chronic rhinosinusitis with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP) in Finland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A randomly sampled retrospective registry-based follow-up data (<i>n</i> = 74,868) of patients visiting Hospital District of Helsinki and Uusimaa (HUS) in Finland was used. The birth date, sex, visit date and comorbidities were collected from electronic health record data during visits from 2005 to 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean (SD, range) age of the sample was 34.53 (25.47, 0–102) years, with 48.7 % being men. We divided the whole population in four groups based on the season they were born (SOB-groups). When observing these four SOB-groups, the proportion of those having asthma was 43.1%, 42.1%, 41.1%, 42.7%, in winter, spring, summer, and autumn SOB-groups, respectively. The proportion of those having AR was 12.6%, 12.0%, 10.7%, 12.1%, respectively. When having summer as a reference, being born in any other time of year was significantly associated with AR and, being born in autumn or winter was associated with asthma. No significant association was observed in CRS or N-ERD or NAR groups in adjusted models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study suggests that early life immunological events may have a role a role in pathogenesis of asthma and AR. As no association was observed between SOB and CRSsNP, CRSwNP, N-ERD or NAR, further studies on this are warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 7","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12383","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731049","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}

{"title":"Dupilumab induces a significant decrease of food specific immunoglobulin E levels in pediatric atopic dermatitis patients","authors":"Lisa P. van der Rijst,&nbsp;Michelle S. Hilbrands,&nbsp;Nicolaas P. A. Zuithoff,&nbsp;Marjolein S. de Bruin-Weller,&nbsp;André C. Knulst,&nbsp;Thuy-My Le,&nbsp;Marlies de Graaf","doi":"10.1002/clt2.12381","DOIUrl":"10.1002/clt2.12381","url":null,"abstract":"&lt;p&gt;To the Editor,&lt;/p&gt;&lt;p&gt;Atopic dermatitis (AD) and food allergy (FA) are common chronic diseases that have a major impact on quality of life and socio-economic burden.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; AD is strongly associated with the development of immunoglobulin E (IgE)-mediated FA.&lt;span&gt;&lt;sup&gt;3-5&lt;/sup&gt;&lt;/span&gt; The associated immune response involves allergen specific T helper type 2 cells inducing a pro-inflammatory cytokine release, including interleukin (IL)-4 and IL-13, thereby causing initiation of B cell immunoglobulin class switching to specific IgE (sIgE).&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Dupilumab, a human monoclonal antibody that is approved for treatment of (moderate to) severe AD in children from the age of 6 months, blocks the IL-4 and IL-13 signaling pathway.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; Spekhorst et al. showed that dupilumab induces a profound decrease in sIgE levels of several food allergens in adult AD patients with comorbid FA, highlighting the positive effect of blocking IL-4 and IL-13 signaling on sIgE levels.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; As FA often develops at a young age, and the effect of dupilumab on food sIgE levels in pediatric patients remains unclear, it is of particular interest to evaluate the effect of dupilumab in this young patient population. Therefore, the aim of this study was to investigate the effect of dupilumab on food sIgE levels of 10 common allergens in food allergic pediatric patients with moderate to severe AD.&lt;/p&gt;&lt;p&gt;Pediatric AD patients (aged 4–17 years) treated with dupilumab with a suggestive clinical history of FA for peanut, hazelnut, cashew nut, pistachio, almond, walnut, hen's egg, cow's milk, kiwi, and/or apple with a corresponding positive sIgE (≥0.35 kU/L) at the start of treatment (baseline), were included. Patients who were never exposed to specific food allergens, due to severe IgE-mediated reactions to other food allergens (e.g., hazelnut, leading to avoidance of other nuts) or to parental anxiety (e.g., due to severe parental FA), with a corresponding positive sIgE, were also included. sIgE levels were measured at baseline and at least once during 1 year of follow-up. Data were extracted from the prospective BioDay registry between August 2019 and July 2023. A covariance pattern model was used to analyze the development of (s)IgE values over time. All analyses were performed for each food separately using a covariance pattern model (detailed explanation of methods is described in Supporting Information S1).&lt;/p&gt;&lt;p&gt;A total of 36 pediatric patients with a mean age of 12.5 (standard deviation ±3.6) years were included (Table 1). A total of 120 FAs, with 1008 corresponding sIgE samples, were identified (Table S1). Peanut (18.3%) and hazelnut (16.7%) were the most common foods to which patients were sensitized. Results of baseline food sIgE levels stratified by severity of FA are shown in Table S2. Two (5.6%) patients discontinued dupilumab treatment at a mean treatment duration of 16.5 weeks.&lt;/p&gt;&lt;p&gt;A significa","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 7","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12381","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632840","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}

{"title":"House dust mite immunotherapy: A real-world, prescription data-based analysis","authors":"R. Mösges,&nbsp;H. Richter,&nbsp;A. Sager,&nbsp;J. Weber,&nbsp;T. Müller","doi":"10.1002/clt2.12382","DOIUrl":"10.1002/clt2.12382","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>House dust mite (HDM) sensitisation can contribute to the development of allergic rhinoconjunctivitis (AR) or allergic asthma (AA). As treatment, allergen immunotherapy (AIT) is a promising approach, since it aims building immunotolerance against allergens, therewith establishing long-term efficacy. The evaluation of AIT has been investigated in many randomised controlled trials, whereas few real-world evidence studies are available.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used data from the longitudinal prescription data base IQVIA™ LRx. Data on initial AIT prescriptions against HDM from January 2009 to December 2013 was analysed regarding treatment (subcutaneous AIT with either depigmented polymerised allergen extract [dSCIT] or other allergens [oSCIT], or sublingual immunotherapy [SLIT]) and treatment duration. Treatment groups were compared with a control group of AR patients not receiving AIT. Data on symptomatic medication was collected until February 2017 and progression of AR and AA was compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data of 7260 patients with AIT prescriptions and of 21,780 control patients was analysed. AIT was associated with a significant decrease of AR medication intake compared with control (dSCIT: −34.0%, <i>p</i> &lt; 0.0001; oSCIT: −25.7%, <i>p</i> &lt; 0.0001; SLIT: −37.7%, <i>p</i> = 0.0026). In asthmatics, SCIT was associated with a significant decrease of asthma medication compared with control (dSCIT: −45.2%, <i>p</i> &lt; 0.0001; oSCIT: −32.9%, <i>p</i> &lt; 0.0001). Further, a significantly reduced likelihood for onset of asthma medication was demonstrated in patients treated with SCIT compared with controls (dSCIT OR: 0.759, <i>p</i> = 0.0476; oSCIT OR: 0.815, <i>p</i> = 0.0339).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Real-world data analyses indicate that AIT, particularly given via a subcutaneous route, reduces the need of medication against AR and AA and might delay the onset of asthma medication in patients with AR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 7","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12382","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579144","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}

{"title":"Comparison of skin prick test and prick-to-prick test with fruits and vegetables in the diagnosis of food allergy","authors":"Severina Terlouw,&nbsp;Frank E. van Boven,&nbsp;Monika Borsboom-van Zonneveld,&nbsp;Tineke de Graaf-in ’t Veld,&nbsp;Roy Gerth van Wijk,&nbsp;Paul L. A. van Daele,&nbsp;Maurits S. van Maaren,&nbsp;Jac H. S. A. M. Kuijpers,&nbsp;Sharon Veenbergen,&nbsp;Nicolette W. de Jong","doi":"10.1002/clt2.12375","DOIUrl":"10.1002/clt2.12375","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Prick-to-prick (PTP) test with fresh food is accepted as a reliable tool for measuring sensitization to fruits and vegetables. Not all fruits and vegetables are available throughout the year. The objective of this study was to investigate whether skin prick test (SPT) performed with frozen juice of fruits and vegetables (FJFV) is a good alternative to PTP tests performed with fresh fruits and vegetables (FFV).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adult patients suspected of having a food allergy to fruits and/or vegetables were included. A questionnaire was used to score symptoms after consumption of apple, kiwi, peach, tomato, and carrot. SPTs with FJFV, and PTP tests with FFV were performed. Intra-class correlation coefficients (ICC) between the SPT and PTP test results were calculated. The sensitivity and specificity of both diagnostic tests towards food allergen specific symptoms (FASS) were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-six patients were included. FASS was positive in 75% for apple, 53% for kiwi, 44% for peach, 25% for tomato, and 22% for carrot. ICC between SPT and PTP test results were moderate for apple (0.72) and kiwi (0.71), strong for peach (0.75) and tomato (0.89), and very strong for carrot (0.94). Sensitivity was equal for the SPT and PTP tests for apple (0.93), peach (0.81), and carrot (1.00), and comparable for kiwi (0.50 resp. 0.70), and tomato (0.44 resp. 0.56). Specificity was equal for apple (0.33), peach (0.15), and carrot (0.41), and comparable for kiwi (0.29 resp. 0.21) and tomato (0.80 resp. 0.72).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Results of SPT with FJFV and PTP test with FFV are comparable. SPT with FJFV is a good alternative in the daily practice of the allergists.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 7","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11226404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544599","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}

{"title":"Lack of detection of aluminium-reactive T-lymphocytes in patients with SCIT-induced granulomas","authors":"Stine Skovbo Hoffmann,&nbsp;Jesper Elberling,&nbsp;Jeanne Duus Johansen,&nbsp;Lars Heede Blom","doi":"10.1002/clt2.12378","DOIUrl":"10.1002/clt2.12378","url":null,"abstract":"&lt;p&gt;Aluminium contact allergy is mainly seen in children with itching vaccination granulomas following immunization with aluminium-adsorbed vaccines, but may also occur in adults following allergen-specific subcutaneous immunotherapy, SCIT, as these vaccines too are aluminium-adsorbed.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Traditional method of determining sensitization to aluminium is patch testing, an in vivo skin test considered the gold standard for detecting contact allergy.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Still, it has the disadvantage of only detecting the allergic response in the skin, and not systemic reactions. In adults there is a great risk of false-negative patch test results even though new recommendations on a higher aluminium concentration, rising from 2% to 10% aluminium chloride hexahydrate (AlCl&lt;sub&gt;3&lt;/sub&gt;H&lt;sub&gt;2&lt;/sub&gt;O&lt;sub&gt;6&lt;/sub&gt;), has been implemented.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;An alternative to patch testing is the blood in vitro lymphocyte proliferation test (LPT), also known as the lymphocyte transformation test (LTT), which we investigated using a well-established LPT protocol. This has previously been shown to detect and characterize metal-specific cells and was used to detect circulating aluminium-specific proliferation. The LPT test is based on a single blood sample and has mostly been used to detect drug hypersensitivity. Still, its role in detecting metal allergy is expanding,&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; with recent studies suggesting using the test as a supplement to the patch test when only a few allergens are to be investigated.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Our study aimed to determine the diagnostic performance of LPT in adults with SCIT-induced vaccination granulomas, and to evaluate the association between LPT and patch test reactions.&lt;/p&gt;&lt;p&gt;We included six participants with SCIT-induced granulomas and 10 healthy controls. Inclusion of patients was limited by the small number of SCIT-recipients referred to our department.&lt;/p&gt;&lt;p&gt;Characteristics of the participants with SCIT-induced granulomas are shown in Table 1. All granulomas were long-lasting, and except for one participant with 2 granulomas, all had 3 or more palpable and itching granulomas, mainly on the upper arms but also on the flanks. The control group were matched for age and sex, and did not undergo patch testing, but had no history of post-vaccination granulomas, contact dermatitis, contact allergy, or other skin diseases, had never received SCIT and not been vaccinated with an aluminium-adsorbed vaccine within the last year.&lt;/p&gt;&lt;p&gt;Participants with granulomas were all patch tested with AlCl&lt;sub&gt;3&lt;/sub&gt;H&lt;sub&gt;2&lt;/sub&gt;O&lt;sub&gt;6&lt;/sub&gt; 2% (before 2021) or 10% mixed in petrolatum and applied under Finn chambers, an aluminium Finn chamber and an empty plastic chamber as control (8 mm; Smartpractice, Phoenix, AZ, USA), all applied on the upper back and secured with Scanpor&lt;sup&gt;®&lt;/sup&gt; tape (Norgesplaster, Vennesla, Norway). Application time was 2 days, and patch test reactions we","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 7","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11217595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476063","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}