Juliette Charpy, Mathilde Seydoux, Antoine Giraudon, Julien Bonnac, Maxime Dubois, Maryline Bordes‐Demolis, Christelle Pellerin, Julien Goret
{"title":"Correspondence to ‘Hypersensitivity Reactions to Human Albumin—A Case Series and Diagnostic Algorithm’","authors":"Juliette Charpy, Mathilde Seydoux, Antoine Giraudon, Julien Bonnac, Maxime Dubois, Maryline Bordes‐Demolis, Christelle Pellerin, Julien Goret","doi":"10.1111/all.70168","DOIUrl":"https://doi.org/10.1111/all.70168","url":null,"abstract":"","PeriodicalId":122,"journal":{"name":"Allergy","volume":"118 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145609801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ching‐Wen Du, Jen‐Hung Wang, Jorge Pereda, Ivone Jakasa, Maria Oberländer Christensen, Sanja Kezic, Arthur Dervillez, Jacob P. Thyssen, Edwin En‐Te Hwu, Chia‐Yu Chu
{"title":"Assessment of the Severity of Atopic Dermatitis Using Atomic Force Microscopy Analysis of Skin Tape Strips","authors":"Ching‐Wen Du, Jen‐Hung Wang, Jorge Pereda, Ivone Jakasa, Maria Oberländer Christensen, Sanja Kezic, Arthur Dervillez, Jacob P. Thyssen, Edwin En‐Te Hwu, Chia‐Yu Chu","doi":"10.1111/all.70170","DOIUrl":"https://doi.org/10.1111/all.70170","url":null,"abstract":"","PeriodicalId":122,"journal":{"name":"Allergy","volume":"98 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145599728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nikolina Todorović, Daria Trifonova, Zicheng Liu, Mirela Curin, Laszlo Schooltink, Theo Sagmeister, Christoph Grininger, Renata Kiss, Nina Gottstein, Bernd Gesslbauer, Andreas Winkler, Tea Pavkov‐Keller, Alexander Karaulov, Rudolf Valenta, Walter Keller
Background Allergic sensitization to cats and other furry animals is a major cause of asthma and allergic rhinitis in more than 200 million people worldwide. According to the frequency of IgE recognition, allergen‐specific IgE levels, and allergenic activity, Fel d 4 is a major allergen in the cat ( Felis domesticus ). The lipocalin allergen Fel d 4 is highly homologous to dog (Can f 6) and major horse (Equ c 1) allergens. Accordingly, IgE cross‐reactivity to these allergens contributes to polysensitization and allergic responses upon exposure to different animals. Methods Fel d 4 was recombinantly produced in two systems, E. coli and Expi293F mammalian cells. Recombinant forms were characterized by circular dichroism and mass spectrometry. The Fel d 4 3D structure was determined using X‐ray crystallography. Immunoreactivity, epitope analyses, and cross‐reactive properties were assessed by ELISA and basophil release assays using allergic patients’ sera. Results We reveal the rFel d 4 crystal structures and demonstrate that mammalian cells produce an N‐glycosylated recombinant Fel d 4 allergen. The C‐terminal regions of Fel d 4, Can f 6, and Equ c 1 constitute conformational IgE ‐epitope‐containing areas responsible for cross‐reactivity. Conclusion Uncovering the IgE ‐binding sites of Fel d 4 and cross‐reactive allergens contributes to future rational design of active and passive allergen‐specific treatment forms.
对猫和其他毛茸茸的动物过敏是全球2亿多人哮喘和过敏性鼻炎的主要原因。根据IgE识别频率、过敏原特异性IgE水平和致敏活性，Fel d 4是猫（家猫）的主要过敏原。脂钙素过敏原Fel d1与狗（Can f 6）和马（eq c 1）的主要过敏原高度同源。因此，IgE对这些过敏原的交叉反应性有助于暴露于不同动物时的多致敏和过敏反应。方法在大肠杆菌和Expi293F两种哺乳动物细胞中重组制备Fel d - 4。重组形式通过圆二色性和质谱分析进行了表征。利用X射线晶体学测定了Fel 4d的三维结构。免疫反应性、表位分析和交叉反应特性通过ELISA和使用过敏患者血清的嗜碱性粒细胞释放试验进行评估。结果揭示了Fel - 4的晶体结构，并证明哺乳动物细胞可产生N -糖基化的重组Fel - 4过敏原。Fel d1、canf6和Equ c1的C末端区域构成了构象的IgE表位包含区域，负责交叉反应。结论揭示Fel - 4和交叉反应性过敏原的IgE结合位点有助于未来合理设计主动和被动过敏原特异性治疗方案。
{"title":"Major Cat Allergen Fel d 4: Structure and Identification of a Cross‐Reactive IgE ‐Epitope‐Containing Area","authors":"Nikolina Todorović, Daria Trifonova, Zicheng Liu, Mirela Curin, Laszlo Schooltink, Theo Sagmeister, Christoph Grininger, Renata Kiss, Nina Gottstein, Bernd Gesslbauer, Andreas Winkler, Tea Pavkov‐Keller, Alexander Karaulov, Rudolf Valenta, Walter Keller","doi":"10.1111/all.70146","DOIUrl":"https://doi.org/10.1111/all.70146","url":null,"abstract":"Background Allergic sensitization to cats and other furry animals is a major cause of asthma and allergic rhinitis in more than 200 million people worldwide. According to the frequency of <jats:styled-content style=\"fixed-case\">IgE</jats:styled-content> recognition, allergen‐specific <jats:styled-content style=\"fixed-case\">IgE</jats:styled-content> levels, and allergenic activity, Fel d 4 is a major allergen in the cat ( <jats:italic>Felis domesticus</jats:italic> ). The lipocalin allergen Fel d 4 is highly homologous to dog (Can f 6) and major horse (Equ c 1) allergens. Accordingly, <jats:styled-content style=\"fixed-case\">IgE</jats:styled-content> cross‐reactivity to these allergens contributes to polysensitization and allergic responses upon exposure to different animals. Methods Fel d 4 was recombinantly produced in two systems, <jats:styled-content style=\"fixed-case\"> <jats:italic>E. coli</jats:italic> </jats:styled-content> and <jats:styled-content style=\"fixed-case\">Expi293F</jats:styled-content> mammalian cells. Recombinant forms were characterized by circular dichroism and mass spectrometry. The Fel d 4 <jats:styled-content style=\"fixed-case\">3D</jats:styled-content> structure was determined using X‐ray crystallography. Immunoreactivity, epitope analyses, and cross‐reactive properties were assessed by <jats:styled-content style=\"fixed-case\">ELISA</jats:styled-content> and basophil release assays using allergic patients’ sera. Results We reveal the <jats:styled-content style=\"fixed-case\">rFel</jats:styled-content> d 4 crystal structures and demonstrate that mammalian cells produce an N‐glycosylated recombinant Fel d 4 allergen. The C‐terminal regions of Fel d 4, Can f 6, and Equ c 1 constitute conformational <jats:styled-content style=\"fixed-case\">IgE</jats:styled-content> ‐epitope‐containing areas responsible for cross‐reactivity. Conclusion Uncovering the <jats:styled-content style=\"fixed-case\">IgE</jats:styled-content> ‐binding sites of Fel d 4 and cross‐reactive allergens contributes to future rational design of active and passive allergen‐specific treatment forms.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"264 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145593400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVESImmunoglobulin G4-related disease (IgG4-RD) is frequently accompanied by allergic/atopic manifestations, yet its allergen-specific antibody landscape remains poorly defined. Therefore, we detected allergen-specific IgE and IgG4 levels in patients with IgG4-RD to clarify their contribution to IgG4-RD pathogenesis.METHODSIn total, 826 plasma samples from 370 patients with IgG4-RD and 354 healthy controls were used to perform Phage Immunoprecipitation Sequencing. Follow-up samples from 102 patients (median 3 years) captured temporal dynamics. Machine learning (XGBoost) was used to identify key allergen peptides. ELISA was used for validation in 51 IgG4-RD patients and 24 healthy controls, including an independent cohort of 20 treatment-naïve patients.RESULTSAbnormal IgE and IgG4 allergen reactivity was observed in IgG4-RD patients. Enhanced responses to Apis mellifera and Arachis hypogaea were particularly prominent and correlated with lacrimal gland, parotid gland, paranasal, pulmonary, renal (A. mellifera) and pancreatic (A. hypogaea) involvement. XGBoost achieved an AUC of 0.91-0.96 and consistently ranked 10 peptides, mainly from bee, peanut, vespid-venom and fish allergens. ELISA confirmed significantly elevated Ara h 1-specific IgG4 in IgG4-RD. Follow-up sampling showed a global decline in reactivity to most top allergens and an IgE-to-IgG4 shift to Staphylococcus aureus peptides, suggesting therapy-associated modulation and emerging tolerance.CONCLUSIONSComprehensive pan-allergen profiling suggests distinct IgE and IgG4 signatures in IgG4-RD and links specific environmental antigens to organ-selective disease patterns. These findings support a contributory role for aberrant allergen responses in IgG4-RD pathogenesis and provide a foundation for biomarker development and targeted allergen-based interventions, especially for future mechanistic investigations.
{"title":"Allergen-Specific IgE and IgG4 Signatures in IgG4-Related Disease Revealed by a Large-Scale PhIP-Seq Study.","authors":"Zhan Li,Songxin Yan,Jialei Zhang,Haolong Li,Ziyan Wu,Linlin Cheng,Yongmei Liu,Haoting Zhan,Honglin Xu,Futai Feng,Jingdi Zhang,Siyu Wang,Xinxin Feng,Changcheng Yin,Linyi Peng,Jiaxin Zhou,Yunyun Fei,Wen Zhang,Yongzhe Li","doi":"10.1111/all.70162","DOIUrl":"https://doi.org/10.1111/all.70162","url":null,"abstract":"OBJECTIVESImmunoglobulin G4-related disease (IgG4-RD) is frequently accompanied by allergic/atopic manifestations, yet its allergen-specific antibody landscape remains poorly defined. Therefore, we detected allergen-specific IgE and IgG4 levels in patients with IgG4-RD to clarify their contribution to IgG4-RD pathogenesis.METHODSIn total, 826 plasma samples from 370 patients with IgG4-RD and 354 healthy controls were used to perform Phage Immunoprecipitation Sequencing. Follow-up samples from 102 patients (median 3 years) captured temporal dynamics. Machine learning (XGBoost) was used to identify key allergen peptides. ELISA was used for validation in 51 IgG4-RD patients and 24 healthy controls, including an independent cohort of 20 treatment-naïve patients.RESULTSAbnormal IgE and IgG4 allergen reactivity was observed in IgG4-RD patients. Enhanced responses to Apis mellifera and Arachis hypogaea were particularly prominent and correlated with lacrimal gland, parotid gland, paranasal, pulmonary, renal (A. mellifera) and pancreatic (A. hypogaea) involvement. XGBoost achieved an AUC of 0.91-0.96 and consistently ranked 10 peptides, mainly from bee, peanut, vespid-venom and fish allergens. ELISA confirmed significantly elevated Ara h 1-specific IgG4 in IgG4-RD. Follow-up sampling showed a global decline in reactivity to most top allergens and an IgE-to-IgG4 shift to Staphylococcus aureus peptides, suggesting therapy-associated modulation and emerging tolerance.CONCLUSIONSComprehensive pan-allergen profiling suggests distinct IgE and IgG4 signatures in IgG4-RD and links specific environmental antigens to organ-selective disease patterns. These findings support a contributory role for aberrant allergen responses in IgG4-RD pathogenesis and provide a foundation for biomarker development and targeted allergen-based interventions, especially for future mechanistic investigations.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"11 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145559206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
André Moreira,Isabella Annesi Maesano,Jolanta Walusiak-Skorupa,Jooeun Han,Janice A Layhadi,Cezmi Akdis,María M Escribese,Mohamed H Shamji,Maria J Torres
{"title":"Healthy Planet, Healthier People: EAACI's Integrated Planetary Health Strategy for Asthma, Allergies and Immune Diseases.","authors":"André Moreira,Isabella Annesi Maesano,Jolanta Walusiak-Skorupa,Jooeun Han,Janice A Layhadi,Cezmi Akdis,María M Escribese,Mohamed H Shamji,Maria J Torres","doi":"10.1111/all.70164","DOIUrl":"https://doi.org/10.1111/all.70164","url":null,"abstract":"","PeriodicalId":122,"journal":{"name":"Allergy","volume":"131 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145559205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jean Bousquet,Bernardo Sousa-Pinto,Rafael José Vieira,Holger J Schünemann,Torsten Zuberbier,Antonio Bognanni,Alkis Togias,Boleslaw Samolinski,Arunas Valiulis,Sian Williams,Anna Bedbrook,Wienczyslawa Czarlewski,Maria Jose Torres,Mohamed H Shamji,Mário Morais-Almeida,G Walter Canonica,Leticia de Las Vecillas,Mark S Dykewicz,Cristina Jacomelli,Ludger Klimek,Lucas Leemann,Olga Lourenço,Yuliia Palamarchuk,Nikolaos G Papadopoulos,Ana Margarida Pereira,Marine Savouré,Sanna K Toppila-Salmi,Maria Teresa Ventura,Juan Jose Yepes-Nuñez,Alvaro A Cruz,Giorgio Ciprandi,Bilun Gemicioglu,Mattia Giovannini,Brigita Gradauskiene,Tuomas Jartti,Miloš Jeseňák,Piotr Kuna,Violeta Kvedariene,Désirée E Larenas-Linnemann,Amir H A Latiff,Yousser Mohammad,Ken Ohta,Padukudru A Mahesh,Isabella Pali-Schöll,Oliver Pfaar,Frederico S Regateiro,Nicolas Roche,Mikhail Sofiev,Luís Taborda-Barata,Charlotte Suppli Ulrik,Marylin Valentin Rostan,Giovanni Viegi,Luo Zhang,Josep M Antó,Tari Haahtela,Ivan Cherrez-Ojeda,Juan Carlos Ivancevich,Nikolai Khaltaev,Arzu Yorgancioglu,Baharudin Abdullah,Mona Al-Ahmad,Maryam Ali Al-Nesf,Rita Amaral,Julijana Asllani,Karl-C Bergmann,Jonathan A Bernstein,Michael S Blaiss,Fulvio Braido,Paulo Camargos,Pedro Carreiro-Martins,Thomas Casale,Lorenzo Cecchi,Alessandro G Fiocchi,Antonio F M Giuliano,George Christoff,Ieva Cirule,Jaime Correia-de-Sousa,Elisio M Costa,Stefano Del Giacco,Philippe Devillier,Dejan Dokic,Elham Hossny,Tomohisa Iinuma,Carla Irani,Zhanat Ispayeva,Kaja Julge,Igor Kaidashev,Kazi S Bennoor,Helga Kraxner,Inger Kull,Marek Kulus,Maciej Kupczyk,Andriy Kurchenko,Stefania La Grutta,Neven Miculinic,Lan Le Thi Tuyet,Michael Makris,Branislava Milenkovic,Sang Min Lee,Stephen Montefort,André Moreira,Joaquim Mullol,Rachel Nadif,Alla Nakonechna,Hugo E Neffen,Marek Niedoszytko,Dieudonné Nyembue,Robyn O'Hehir,Ismail Ogulur,Yoshitaka Okamoto,Heidi Olze,Oscar Palomares,Petr Panzner,Vincenzo Patella,Ruby Pawankar,Constantinos Pitsios,Todor A Popov,Francesca Puggioni,Santiago Quirce,Agné Ramonaité,Marysia Recto,Maria Susana Repka-Ramirez,Graham Roberts,Karla Robles-Velasco,Menachem Rottem,Marianella Salapatas,Joaquin Sastre,Nicola Scichilone,Juan Carlos Sisul,Dirceu Solé,Manuel E Soto-Martinez,Milan Sova,Pongsakorn Tantilipikorn,Ana Todo-Bom,Vladyslav Tsaryk,Ioanna Tsiligianni,Marilyn Urrutia-Pereira,Erkka Valovirta,Eric Van Ganse,Tuula Vasankari,Dana Wallace,De Yun Wang,Margitta Worm,Osman M Yusuf,Mihaela Zidarn,Sara Gil-Mata,Manuel Marques-Cruz,Bassam Mahboub,Ignacio J Ansotegui,Antonino Romano,Maria Cristina Artesani,Bruno Barreto,Sven Becker,Bianca Beghe,Jacques Bouchard,Melisande Bourgoin-Heck,Luisa Brussino,Roland Buhl,Mario Calvo-Gil,Victoria Cardona Dahl,José Antonio Castillo Vizuete,Denis Charpin,Niels H Chavannes,Marta Chełmińska,Lei Cheng,Ekaterine Chkhartishvili,Herberto Jose Chong-Neto,Deepa Choudhury,Derek Chu,Cemal Cingi,Enrico Compalati,Biljana Cvetkovski,Jane Da Silva,Gennaro D'Amato,Janet Davies,Danilo Di Bona,Maria V Dimou,Maria Do Ceu Teixeira,Maria Doulaptsi,José Miguel Fuentes Pérez,Radoslaw Gawlik,Ozlem Goksel,Maximiliano R Gómez,Sandra N Gonzalez Diaz,Maia Gotua,Christos Grigoreas,Ineta Grisle,Maria Antonieta Guzman,Rachel House Tan,Michael Hyland,Despo Ierodiakonou,Aspasia Karavelia,Marta Kisiel,Mitja Kosnik,Vicky Kritikos,Carlo Lombardi,Matteo Martini,Cem Meço,Eris Mesonjesi,Florin Mihaltan,Marcin Moniuszko,Robert Naclerio,Sophia Neisinger,Michal Ordak,Giovanni Paoletti,Edgar Arturo Perdomo-Flores,Nhan Pham-Thi,Emmanuel Prokopakis,Daniela Rivero Yeverino,Giovanni Rolla,Jan Romantowski,Philip W Rouadi,Maia Rukhadze,Daiju Sakurai,Laila Salameh,Faradiba Serpa Sarquis,Tanja Soklic Kosak,Michael Soyka,Olga Sozinova,Krzysztof Specjalski,Vesna Tomic-Spiric,Martina Vachova,Marianne van Hage,Ilgim Vardaloglu Koyuncu,Pakit Vichyanond,Martin Wagenmann,Fanny Wai San Ko,Pascal Werminghaus,Vicky Paraskevi Xepapadaki,Yi-Kui Xiang,João A Fonseca
The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines produced their first edition in 1999, with subsequent revisions in 2008, 2010, 2016 and 2019. A new iteration of ARIA-ARIA 2024-2025-in collaboration with EAACI is currently being developed, focusing on the management of allergic rhinitis. ARIA 2024-2025 follows the GRADE framework and is endorsed by the European Academy of Allergy and Clinical Immunology (EAACI). A set of approaches has been used to develop guideline questions, including surveying key opinion leaders and using artificial intelligence (AI)-based tools to analyse web searches on allergic rhinitis and to generate questions. Each prioritised guideline question is assessed through an Evidence-to-Decision (EtD) framework. EtDs support the systematic and transparent formulation of recommendations, comprising 12 criteria for which the best available evidence should be sought. In the context of ARIA-EAACI 2024-2025, such evidence is derived not only from randomised controlled trials but also-among others-from patient-generated data sources that better reflect the affected individuals' perspectives. Moreover, ARIA-EAACI 2024-2025 incorporates evidence on planetary health. Developed guideline recommendations will support the creation of digitalised decision algorithms and care pathways. This paper describes the methodology used to develop the person-centred, digitally enabled and AI-assisted ARIA-EAACI 2024-2025. Among others, it describes (i) the development and prioritisation of guideline questions, (ii) sources of evidence for EtDs and (iii) the development of digitalised decision algorithms and care pathways.
{"title":"Methodology for the Development of the Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI 2024-2025 Guidelines: From Evidence-to-Decision Frameworks to Digitalised Shared Decision-Making Algorithms.","authors":"Jean Bousquet,Bernardo Sousa-Pinto,Rafael José Vieira,Holger J Schünemann,Torsten Zuberbier,Antonio Bognanni,Alkis Togias,Boleslaw Samolinski,Arunas Valiulis,Sian Williams,Anna Bedbrook,Wienczyslawa Czarlewski,Maria Jose Torres,Mohamed H Shamji,Mário Morais-Almeida,G Walter Canonica,Leticia de Las Vecillas,Mark S Dykewicz,Cristina Jacomelli,Ludger Klimek,Lucas Leemann,Olga Lourenço,Yuliia Palamarchuk,Nikolaos G Papadopoulos,Ana Margarida Pereira,Marine Savouré,Sanna K Toppila-Salmi,Maria Teresa Ventura,Juan Jose Yepes-Nuñez,Alvaro A Cruz,Giorgio Ciprandi,Bilun Gemicioglu,Mattia Giovannini,Brigita Gradauskiene,Tuomas Jartti,Miloš Jeseňák,Piotr Kuna,Violeta Kvedariene,Désirée E Larenas-Linnemann,Amir H A Latiff,Yousser Mohammad,Ken Ohta,Padukudru A Mahesh,Isabella Pali-Schöll,Oliver Pfaar,Frederico S Regateiro,Nicolas Roche,Mikhail Sofiev,Luís Taborda-Barata,Charlotte Suppli Ulrik,Marylin Valentin Rostan,Giovanni Viegi,Luo Zhang,Josep M Antó,Tari Haahtela,Ivan Cherrez-Ojeda,Juan Carlos Ivancevich,Nikolai Khaltaev,Arzu Yorgancioglu,Baharudin Abdullah,Mona Al-Ahmad,Maryam Ali Al-Nesf,Rita Amaral,Julijana Asllani,Karl-C Bergmann,Jonathan A Bernstein,Michael S Blaiss,Fulvio Braido,Paulo Camargos,Pedro Carreiro-Martins,Thomas Casale,Lorenzo Cecchi,Alessandro G Fiocchi,Antonio F M Giuliano,George Christoff,Ieva Cirule,Jaime Correia-de-Sousa,Elisio M Costa,Stefano Del Giacco,Philippe Devillier,Dejan Dokic,Elham Hossny,Tomohisa Iinuma,Carla Irani,Zhanat Ispayeva,Kaja Julge,Igor Kaidashev,Kazi S Bennoor,Helga Kraxner,Inger Kull,Marek Kulus,Maciej Kupczyk,Andriy Kurchenko,Stefania La Grutta,Neven Miculinic,Lan Le Thi Tuyet,Michael Makris,Branislava Milenkovic,Sang Min Lee,Stephen Montefort,André Moreira,Joaquim Mullol,Rachel Nadif,Alla Nakonechna,Hugo E Neffen,Marek Niedoszytko,Dieudonné Nyembue,Robyn O'Hehir,Ismail Ogulur,Yoshitaka Okamoto,Heidi Olze,Oscar Palomares,Petr Panzner,Vincenzo Patella,Ruby Pawankar,Constantinos Pitsios,Todor A Popov,Francesca Puggioni,Santiago Quirce,Agné Ramonaité,Marysia Recto,Maria Susana Repka-Ramirez,Graham Roberts,Karla Robles-Velasco,Menachem Rottem,Marianella Salapatas,Joaquin Sastre,Nicola Scichilone,Juan Carlos Sisul,Dirceu Solé,Manuel E Soto-Martinez,Milan Sova,Pongsakorn Tantilipikorn,Ana Todo-Bom,Vladyslav Tsaryk,Ioanna Tsiligianni,Marilyn Urrutia-Pereira,Erkka Valovirta,Eric Van Ganse,Tuula Vasankari,Dana Wallace,De Yun Wang,Margitta Worm,Osman M Yusuf,Mihaela Zidarn,Sara Gil-Mata,Manuel Marques-Cruz,Bassam Mahboub,Ignacio J Ansotegui,Antonino Romano,Maria Cristina Artesani,Bruno Barreto,Sven Becker,Bianca Beghe,Jacques Bouchard,Melisande Bourgoin-Heck,Luisa Brussino,Roland Buhl,Mario Calvo-Gil,Victoria Cardona Dahl,José Antonio Castillo Vizuete,Denis Charpin,Niels H Chavannes,Marta Chełmińska,Lei Cheng,Ekaterine Chkhartishvili,Herberto Jose Chong-Neto,Deepa Choudhury,Derek Chu,Cemal Cingi,Enrico Compalati,Biljana Cvetkovski,Jane Da Silva,Gennaro D'Amato,Janet Davies,Danilo Di Bona,Maria V Dimou,Maria Do Ceu Teixeira,Maria Doulaptsi,José Miguel Fuentes Pérez,Radoslaw Gawlik,Ozlem Goksel,Maximiliano R Gómez,Sandra N Gonzalez Diaz,Maia Gotua,Christos Grigoreas,Ineta Grisle,Maria Antonieta Guzman,Rachel House Tan,Michael Hyland,Despo Ierodiakonou,Aspasia Karavelia,Marta Kisiel,Mitja Kosnik,Vicky Kritikos,Carlo Lombardi,Matteo Martini,Cem Meço,Eris Mesonjesi,Florin Mihaltan,Marcin Moniuszko,Robert Naclerio,Sophia Neisinger,Michal Ordak,Giovanni Paoletti,Edgar Arturo Perdomo-Flores,Nhan Pham-Thi,Emmanuel Prokopakis,Daniela Rivero Yeverino,Giovanni Rolla,Jan Romantowski,Philip W Rouadi,Maia Rukhadze,Daiju Sakurai,Laila Salameh,Faradiba Serpa Sarquis,Tanja Soklic Kosak,Michael Soyka,Olga Sozinova,Krzysztof Specjalski,Vesna Tomic-Spiric,Martina Vachova,Marianne van Hage,Ilgim Vardaloglu Koyuncu,Pakit Vichyanond,Martin Wagenmann,Fanny Wai San Ko,Pascal Werminghaus,Vicky Paraskevi Xepapadaki,Yi-Kui Xiang,João A Fonseca","doi":"10.1111/all.70100","DOIUrl":"https://doi.org/10.1111/all.70100","url":null,"abstract":"The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines produced their first edition in 1999, with subsequent revisions in 2008, 2010, 2016 and 2019. A new iteration of ARIA-ARIA 2024-2025-in collaboration with EAACI is currently being developed, focusing on the management of allergic rhinitis. ARIA 2024-2025 follows the GRADE framework and is endorsed by the European Academy of Allergy and Clinical Immunology (EAACI). A set of approaches has been used to develop guideline questions, including surveying key opinion leaders and using artificial intelligence (AI)-based tools to analyse web searches on allergic rhinitis and to generate questions. Each prioritised guideline question is assessed through an Evidence-to-Decision (EtD) framework. EtDs support the systematic and transparent formulation of recommendations, comprising 12 criteria for which the best available evidence should be sought. In the context of ARIA-EAACI 2024-2025, such evidence is derived not only from randomised controlled trials but also-among others-from patient-generated data sources that better reflect the affected individuals' perspectives. Moreover, ARIA-EAACI 2024-2025 incorporates evidence on planetary health. Developed guideline recommendations will support the creation of digitalised decision algorithms and care pathways. This paper describes the methodology used to develop the person-centred, digitally enabled and AI-assisted ARIA-EAACI 2024-2025. Among others, it describes (i) the development and prioritisation of guideline questions, (ii) sources of evidence for EtDs and (iii) the development of digitalised decision algorithms and care pathways.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"5 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145559210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Na'ama Epstein‐Rigbi, Matan Elkan, Yair Tzarfati, Michael B. Levy, Liat Nachshon, Yael Koren, Yitzhak Katz, Arnon Elizur, Michael R. Goldberg
Background OIT‐induced gastrointestinal eosinophilic reactions (OITIGER) is comprised of abdominal pain/vomiting unrelated to the timing of dose administration, typically associated with increased absolute eosinophil counts (AEC). Previously described risk factors during milk OIT included higher baseline AEC, higher OIT starting dose (SD) and faster dose increase. The effect of a revised milk OIT protocol (lower SD and slower dose escalations), on the rate and severity of OITIGER, was examined. Methods Milk OIT patients treated with a revised protocol between 2017 and 2021 ( n = 269) were compared to a milk cohort from 2010 to 2015 ( n = 604) who were treated with the previous protocol. OITIGER rate, severity, and treatment outcomes were compared. Results Patients in the revised protocol were slightly older ( p < 0.001), but other demographics and baseline AEC were similar. The rates for OITIGER were comparable (8.2% vs. 9.1%). However, there was a significant reduction in the rate of severe presentation, defined by vomiting ≥ 3 times/month (45.5% vs. 72.7%, p = 0.023) among OITIGER patients undergoing the revised protocol. Upon multivariate logistic regression, baseline AEC > 600/μL was a risk factor [OR 2.16 (CI 1.30–3.60), p = 0.003] for OITIGER, while the revised protocol was protective for severe OITIGER [OR 0.30 (CI 0.10–0.89), p = 0.031]. Older age was associated with less OITIGER [OR 0.92 (CI 0.85–0.99), p = 0.018] and borderline less severe OITIGER [OR 0.85 (CI 0.72–1.00), p = 0.050]. A lower fold increase in AEC was observed in OITIGER patients in the revised protocol (2.25 [1.63–3.45] vs. 1.79 [1.34–2.11], p = 0.009). Conclusions A revised protocol was associated with reduced AEC increase, and ameliorated the severity of OITIGER during OIT.
背景：OIT诱导的胃肠道嗜酸性粒细胞反应（OITIGER）由腹痛/呕吐组成，与给药时间无关，通常与嗜酸性粒细胞绝对计数（AEC）增加有关。先前描述的牛奶OIT期间的危险因素包括较高的基线AEC，较高的OIT起始剂量（SD）和更快的剂量增加。研究了修订后的牛奶OIT方案（较低的SD和较慢的剂量递增）对OITIGER的发生率和严重程度的影响。方法将2017年至2021年期间接受修订方案治疗的牛奶OIT患者（n = 269）与2010年至2015年接受先前方案治疗的牛奶队列（n = 604）进行比较。比较oittiger率、严重程度和治疗结果。结果修订方案中的患者年龄稍大（p < 0.001），但其他人口统计学和基线AEC相似。OITIGER的发生率具有可比性（8.2%对9.1%）。然而，在接受修订方案的OITIGER患者中，严重症状（定义为呕吐≥3次/月）发生率显著降低（45.5% vs. 72.7%, p = 0.023）。经多因素logistic回归，基线AEC >； 600/μL是OITIGER的危险因素[OR 2.16 (CI 1.30-3.60), p = 0.003]，而修订后的方案对严重OITIGER具有保护作用[OR 0.30 (CI 0.10-0.89), p = 0.031]。年龄越大，OITIGER越轻[OR 0.92 (CI 0.85 - 0.99), p = 0.018]， OITIGER越轻[OR 0.85 (CI 0.72-1.00), p = 0.050]。在修订后的方案中，OITIGER患者的AEC增加了较低的1倍（2.25[1.63-3.45]对1.79 [1.34-2.11],p = 0.009）。结论：经修订的方案可减少OIT期间AEC的增加，并改善oittiger的严重程度。
{"title":"Decreased Severity of Oral Immunotherapy Induced Gastrointestinal Eosinophilic Reactions Following Revisions in Milk‐Treatment Protocol","authors":"Na'ama Epstein‐Rigbi, Matan Elkan, Yair Tzarfati, Michael B. Levy, Liat Nachshon, Yael Koren, Yitzhak Katz, Arnon Elizur, Michael R. Goldberg","doi":"10.1111/all.70165","DOIUrl":"https://doi.org/10.1111/all.70165","url":null,"abstract":"Background OIT‐induced gastrointestinal eosinophilic reactions (OITIGER) is comprised of abdominal pain/vomiting unrelated to the timing of dose administration, typically associated with increased absolute eosinophil counts (AEC). Previously described risk factors during milk OIT included higher baseline AEC, higher OIT starting dose (SD) and faster dose increase. The effect of a revised milk OIT protocol (lower SD and slower dose escalations), on the rate and severity of OITIGER, was examined. Methods Milk OIT patients treated with a revised protocol between 2017 and 2021 ( <jats:italic>n</jats:italic> = 269) were compared to a milk cohort from 2010 to 2015 ( <jats:italic>n</jats:italic> = 604) who were treated with the previous protocol. OITIGER rate, severity, and treatment outcomes were compared. Results Patients in the revised protocol were slightly older ( <jats:italic>p</jats:italic> < 0.001), but other demographics and baseline AEC were similar. The rates for OITIGER were comparable (8.2% vs. 9.1%). However, there was a significant reduction in the rate of severe presentation, defined by vomiting ≥ 3 times/month (45.5% vs. 72.7%, <jats:italic>p</jats:italic> = 0.023) among OITIGER patients undergoing the revised protocol. Upon multivariate logistic regression, baseline AEC > 600/μL was a risk factor [OR 2.16 (CI 1.30–3.60), <jats:italic>p</jats:italic> = 0.003] for OITIGER, while the revised protocol was protective for severe OITIGER [OR 0.30 (CI 0.10–0.89), <jats:italic>p</jats:italic> = 0.031]. Older age was associated with less OITIGER [OR 0.92 (CI 0.85–0.99), <jats:italic>p</jats:italic> = 0.018] and borderline less severe OITIGER [OR 0.85 (CI 0.72–1.00), <jats:italic>p</jats:italic> = 0.050]. A lower fold increase in AEC was observed in OITIGER patients in the revised protocol (2.25 [1.63–3.45] vs. 1.79 [1.34–2.11], <jats:italic>p</jats:italic> = 0.009). Conclusions A revised protocol was associated with reduced AEC increase, and ameliorated the severity of OITIGER during OIT.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"4 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145553604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Duan Ni, Gabriela Pinget, Brigitte Santner‐Nanan, Jian Tan, Julen Gabriel Araneta Reyes, Catherine L. Lai, Yanan Wang, Cuong Tran, Julie M. Clarke, Laurence Macia, Dianne E. Campbell, Peter Hsu, Ralph Nanan
{"title":"Effects of Butyrylated High Amylose Maize Starch ( HAMSB ) as an Adjuvant for Oral Immunotherapy","authors":"Duan Ni, Gabriela Pinget, Brigitte Santner‐Nanan, Jian Tan, Julen Gabriel Araneta Reyes, Catherine L. Lai, Yanan Wang, Cuong Tran, Julie M. Clarke, Laurence Macia, Dianne E. Campbell, Peter Hsu, Ralph Nanan","doi":"10.1111/all.70161","DOIUrl":"https://doi.org/10.1111/all.70161","url":null,"abstract":"","PeriodicalId":122,"journal":{"name":"Allergy","volume":"101 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145545417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUNDClinical trials (CTs) have shown that allergen immunotherapy (AIT) is effective for local allergic rhinitis (LAR) while treatment is ongoing. However, its long-term effects remain unknown. This study investigates the long-term clinical and preventive effect of AIT in responder LAR patients.METHODSLAR patients obtaining a clinical benefit from 1-year CT of subcutaneous AIT were enrolled in this 10-year follow-up study (AIT cohort). All completed a full 3-year AIT course and were followed for additional 7 years. A matched group of LAR patients who did not receive AIT (non-AIT cohort) was followed over the same period. Primary outcomes included nasal-ocular symptom scores (visual analogue scale, VAS), reliever medication use and medication-free days (MFD). Secondary outcomes were asthma incidence, asthma control (asthma control test, ACT), lung function (FEV1), quality of life (QoL), emergency visits, new sensitizations detected by nasal allergen challenge (NAC), and the analysis of the minimal clinically important difference (MCID). Assessments were conducted at baseline and at years 1, 3, 5, 7, and 10.RESULTSSixty-six patients were included (AIT n = 32; non-AIT n = 34). The AIT cohort showed a sustained reduction in nasal-ocular symptoms from year 1 (p < 0.001) and significantly more MFD from year 3 (p < 0.001). Asthma developed in 40.7% of non-AIT vs. 8.0% of AIT patients (p = 0.021). New sensitizations occurred in 38.2% of non-AIT and 6.3% of AIT patients (p = 0.002). FEV1 improved in the AIT cohort and declined in non-AIT (p < 0.001). QoL and emergency visits also favored AIT.CONCLUSIONAIT induces a sustained clinical improvement and prevents the onset of asthma and local sensitizations in responder LAR patients.
{"title":"Long-Term Effect of Allergen Immunotherapy in Responder Local Allergic Rhinitis Patients: Symptom Control, and Prevention of Asthma and Allergic Sensitizations.","authors":"Almudena Testera-Montes,Laura Zubiaga-Fernandez,Carlos J Aranda,Irene Garcia-Esteban,Trinidad Ilda Gaitan-Nievas,Dulce Sanchez-Torralvo,Cristobalina Mayorga,Maria J Torres,Ibon Eguiluz-Gracia,Carmen Rondon","doi":"10.1111/all.70153","DOIUrl":"https://doi.org/10.1111/all.70153","url":null,"abstract":"BACKGROUNDClinical trials (CTs) have shown that allergen immunotherapy (AIT) is effective for local allergic rhinitis (LAR) while treatment is ongoing. However, its long-term effects remain unknown. This study investigates the long-term clinical and preventive effect of AIT in responder LAR patients.METHODSLAR patients obtaining a clinical benefit from 1-year CT of subcutaneous AIT were enrolled in this 10-year follow-up study (AIT cohort). All completed a full 3-year AIT course and were followed for additional 7 years. A matched group of LAR patients who did not receive AIT (non-AIT cohort) was followed over the same period. Primary outcomes included nasal-ocular symptom scores (visual analogue scale, VAS), reliever medication use and medication-free days (MFD). Secondary outcomes were asthma incidence, asthma control (asthma control test, ACT), lung function (FEV1), quality of life (QoL), emergency visits, new sensitizations detected by nasal allergen challenge (NAC), and the analysis of the minimal clinically important difference (MCID). Assessments were conducted at baseline and at years 1, 3, 5, 7, and 10.RESULTSSixty-six patients were included (AIT n = 32; non-AIT n = 34). The AIT cohort showed a sustained reduction in nasal-ocular symptoms from year 1 (p < 0.001) and significantly more MFD from year 3 (p < 0.001). Asthma developed in 40.7% of non-AIT vs. 8.0% of AIT patients (p = 0.021). New sensitizations occurred in 38.2% of non-AIT and 6.3% of AIT patients (p = 0.002). FEV1 improved in the AIT cohort and declined in non-AIT (p < 0.001). QoL and emergency visits also favored AIT.CONCLUSIONAIT induces a sustained clinical improvement and prevents the onset of asthma and local sensitizations in responder LAR patients.","PeriodicalId":122,"journal":{"name":"Allergy","volume":"117 1","pages":""},"PeriodicalIF":12.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145545077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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